Adherence to the WCRF/AICR dietary recommendations for cancer prevention and risk of cancer in elderly from Europe and the United States: A meta-Analysis within the CHANCES Project
Jankovic N., Geelen A., Winkels RM., Mwungura B., Fedirko V., Jenab M., Illner AK., Brenner H., Ordonez-Mena JM., De Jong JCK., Franco OH., Orfanos P., Trichopoulou A., Boffetta P., Agudo A., Peeters PH., Tjønneland A., Hallmans G., BasBueno-De-Mesquita H., Park Y., Feskens EJ., De Groot LC.
© 2016 American Association for Cancer Research. Background: It is unknown whether dietary recommendations for cancer prevention are applicable to the elderly. We analyzed WCRF/AICR recommendations in cohorts of European and U.S. adults ages 60 years and above. Methods: Individual participant data meta-Analysis included 362,114 participants (43% women), from seven prospective cohort studies, free from cancer at enrollment. The WCRF/AICR diet score was based on: (i) energy-dense foods and sugary drinks, (ii) plant foods, (iii) red and processed meat, and (iv) alcoholic drinks. Cox proportional hazards regression was used to examine the association between the diet score and cancer risks. Adjusted, cohort-specific HRs were pooled using random-effects metaanalysis. Risk advancement periods (RAP) were calculated to quantify the time period by which the risk of cancer was postponed among those adhering to the recommendations. Results: After a median follow-up of 11 to 15 years across cohorts, 70,877 cancer cases were identified. Each one-point increase in the WCRF/AICR diet score [range, 0 (no) to 4 (complete adherence)] was significantly associated with a lower risk of total cancer [HR, 0.94; 95% confidence interval (CI), 0.92-0.97] , cancers of the colorectum (HR, 0.84; 95% CI, 0.80-0.89) and prostate (HR, 0.94; 95% CI, 0.92-0.97), but not breast or lung. Adherence to an additional component of the WCRF/AICR diet score significantly postponed the incidence of cancer at any site by 1.6 years (RAP, 1.6; 95% CI, 4.09 to 2.16). Conclusions: Adherence to WCRF/AICR dietary recommendations is associated with lower risk of cancer among older adults. Impact: Dietary recommendations for cancer prevention are applicable to the elderly.