TY - JOUR
T1 - Dietary flavonoid, lignan and antioxidant capacity and risk of hepatocellular carcinoma in the European prospective investigation into cancer and nutrition study
AU - Zamora-Ros, Raul
AU - Fedirko, Veronika
AU - Trichopoulou, Antonia
AU - Gonzalez, Carlos A.
AU - Bamia, Christina
AU - Trepo, Elisabeth
AU - Nöthlings, Ute
AU - Duarte-Salles, Talita
AU - Serafini, Mauro
AU - Bredsdorff, Lea
AU - Overvad, Kim
AU - Tjønneland, Anne
AU - Halkjær, Jytte
AU - Fagherazzi, Guy
AU - Perquier, Florence
AU - Boutron-Ruault, Marie-Christine
AU - Katzke, Verena
AU - Lukanova, Annekatrin
AU - Floegel, Anna
AU - Boeing, Heiner
AU - Lagiou, Pagona
AU - Trichopoulos, Dimitrios
AU - Saieva, Calogero
AU - Agnoli, Claudia
AU - Mattiello, Amalia
AU - Tumino, Rosario
AU - Sacerdote, Carlotta
AU - Bas Bueno-de-Mesquita, H.
AU - H.M. Peeters, Petra
AU - Weiderpass, Elisabete
AU - Engeset, Dagrun
AU - Skeie, Guri
AU - Vicente Argüelles, Marcial
AU - Molina-Montes, Esther
AU - Dorronsoro, Miren
AU - José Tormo, María
AU - Ardanaz, Eva
AU - Ericson, Ulrika
AU - Sonestedt, Emily
AU - Sund, Malin
AU - Landberg, Rikard
AU - Khaw, Kay-Tee
AU - J. Wareham, Nicholas
AU - L. Crowe, Francesca
AU - Riboli, Elio
AU - Jenab, Mazda
PY - 2013
Y1 - 2013
N2 - Limited epidemiological evidence suggests a protective role for plant foods rich in flavonoids and antioxidants in hepatocellular cancer (HCC) etiology. Our aim was to prospectively investigate the association between dietary intake of flavonoids, lignans and nonenzymatic antioxidant capacity (NEAC) and HCC risk. Data from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort including 477,206 subjects (29.8% male) recruited from ten Western European countries, was analyzed. Flavonoid, lignan and NEAC intakes were calculated using a compilation of existing food composition databases linked to dietary information from validated dietary questionnaires. Dietary NEAC was based on ferric reducing antioxidant capacity (FRAP) and total radical-trapping antioxidant parameter (TRAP). Hepatitis B/C status was measured in a nested case-control subset. During a mean follow-up of 11-years, 191 incident HCC cases (66.5% men) were identified. Using Cox regression, multivariable adjusted models showed a borderline nonsignificant association of HCC with total flavonoid intake (highest versus lowest tertile, HR = 0.65, 95% CI: 0.40-1.04; ptrend = 0.065), but not with lignans. Among flavonoid subclasses, flavanols were inversely associated with HCC risk (HR = 0.62, 95% CI: 0.39-0.99; ptrend = 0.06). Dietary NEAC was inversely associated with HCC (FRAP: HR 0.50, 95% CI: 0.31-0.81; ptrend = 0.001; TRAP: HR 0.49, 95% CI: 0.31-0.79; ptrend = 0.002), but statistical significance was lost after exclusion of the first 2 years of follow-up. This study suggests that higher intake of dietary flavanols and antioxidants may be associated with a reduced HCC risk.
© 2013 UICC.
AB - Limited epidemiological evidence suggests a protective role for plant foods rich in flavonoids and antioxidants in hepatocellular cancer (HCC) etiology. Our aim was to prospectively investigate the association between dietary intake of flavonoids, lignans and nonenzymatic antioxidant capacity (NEAC) and HCC risk. Data from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort including 477,206 subjects (29.8% male) recruited from ten Western European countries, was analyzed. Flavonoid, lignan and NEAC intakes were calculated using a compilation of existing food composition databases linked to dietary information from validated dietary questionnaires. Dietary NEAC was based on ferric reducing antioxidant capacity (FRAP) and total radical-trapping antioxidant parameter (TRAP). Hepatitis B/C status was measured in a nested case-control subset. During a mean follow-up of 11-years, 191 incident HCC cases (66.5% men) were identified. Using Cox regression, multivariable adjusted models showed a borderline nonsignificant association of HCC with total flavonoid intake (highest versus lowest tertile, HR = 0.65, 95% CI: 0.40-1.04; ptrend = 0.065), but not with lignans. Among flavonoid subclasses, flavanols were inversely associated with HCC risk (HR = 0.62, 95% CI: 0.39-0.99; ptrend = 0.06). Dietary NEAC was inversely associated with HCC (FRAP: HR 0.50, 95% CI: 0.31-0.81; ptrend = 0.001; TRAP: HR 0.49, 95% CI: 0.31-0.79; ptrend = 0.002), but statistical significance was lost after exclusion of the first 2 years of follow-up. This study suggests that higher intake of dietary flavanols and antioxidants may be associated with a reduced HCC risk.
© 2013 UICC.
KW - Antioxidant capacity
KW - Dietary intake
KW - EPIC
KW - Flavonoids
KW - Hepatocellular carcinoma
KW - Lignans
U2 - 10.1002/ijc.28257
DO - 10.1002/ijc.28257
M3 - Journal article
C2 - 23649669
SN - 0020-7136
VL - 133
SP - 2429
EP - 2443
JO - International Journal of Cancer
JF - International Journal of Cancer
IS - 10
ER -
