Ni Shi

Ph.D., M.P.H.

The Ohio State University

Research Associate

PLCO (Learn more about this study)

PLCO-1809

Feb 6, 2025

Hyperinsulinemia and proinflammatory dietary pattern and the risk of esophageal cancers in the Prostate, Lung, Colon, and Ovary Prospective Study

Esophageal cancer ranks as the seventh most frequent cause of cancer deaths worldwide, with a poor five-years survival rate. Esophageal cancer is a complex and multifactorial disease in which an interaction of host genes, diet, and lifestyle plays an important role in its pathogenesis. There are two major histologic subtypes of esophageal cancer, esophageal squamous cell carcinoma (SCC) and adenocarcinoma (AC), with distinct etiologies and phenotypes. Diet factors change such as increase intake of fruit, vegetables, fruit/vegetable related vitamins, reduced intake of red meat, processed meat, or adaption of a fiber rich diet, showed the potential to reduce the incidence of esophageal SCC. Excess body weight and gastroesophageal reflux disease, the two key contributors to esophageal AC are also associated with poor diet. Therefore, both esophageal SCC and AC may be associated with poor diet quality. Poor diet quality may increase hyperinsulinemia and chronic inflammation, key metabolic processes driving cancer development. The reversed empirical Dietary Index for Hyperinsulinemia (rEDIH) and inversed Empirical Dietary Inflammatory Pattern (rEDIP) are two metabolic dietary patterns developed to measure the ability of whole diets to influence these two mechanisms. Dietary patterns account for specific combinations of foods and beverages consumed as part of the whole diet and can better capture diet-related cancer risk exposure compared to single foods or nutrients. Both rEDIH and rEDIP have been associated with several cancers in multiple U.S. cohorts, and they have previously exhibited stronger associations with lower risk of cancers than dietary patterns based on general healthy eating. However, the evidence of rEDIH and rEDIP dietary patterns on esophageal cancer is limited. Investigating the role of rEDIH and rEDIP in esophageal cancer risk is valuable for informing dietary interventions to prevent esophageal cancer.
Esophageal cancer is a complex and multifactorial disease. Only a portion of individuals with poor diet, obesity, other precancer conditions, or residents in high-risk areas of esophageal cancer developed esophageal cancer. This indicate that genetic background plays an important role in esophageal carcinogenesis. On the other hand, individual genetic variation may affect responses to the anti-inflammation dietary interventions, highlighting the need to examine gene-diet interactions. Genome-wide association studies (GWAS) have identified thousands of genetic variants associated with various diseases at the population level. Building on these findings, polygenic risk scores (PRS) estimate an individual’s genetic susceptibility to specific biological functions or diseases by aggregating the combined effects of multiple risk-associated genetic variants. PRS demonstrates significant potential in disease risk prediction, particularly when integrated with non-genetic factors, making it valuable for clinical applications, that is, enabling personalized dietary recommendations based for esophageal cancer prevention. Our long-term goal is to identify the interaction between genetic variants and Redih, rEDIP dietary patterns in esophageal carcinogenesis, and develop targeted dietary interventions tailored to individuals based on genetic variability.