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Adherence to ‘Healthy Eating Index’ diet may reduce liver cancer risk

Adherence to the Alternative Healthy Eating Index2010 dietary pattern may reduce the risk for hepatocellular carcinoma, according to a study published in Hepatology.

“Diets are complex combinations of nutrients and other compounds that act synergistically within individual foods and across food combinations, thus, evaluating the association of dietary pattern with health outcomes may capture dietary effects on health more completely,” Xuehong Zhang, MD, from Massachusetts General Hospital, and colleagues wrote.

To evaluate the effect of dietary patterns on the risk for HCC, Zhang and colleagues compared patient data from the Health Professionals Follow-Up Study cohort with three commonly used dietary pattern indices: The Alternative Healthy Eating Index-2010 (AHEI-2010), Alternate Mediterranean Diet (AMED), and Dietary Approaches to Stop Hypertension (DASH).

In general, patients with higher scores on the AHEI-2010, AMED and DASH consumed less red and processed meats, total fat and trans fat, and had higher intakes of vegetable, fruits, whole grains, dietary fiber, nuts and legumes, total folate, long-chain (n-3) fatty acids, and total vitamin D than those with lower scores.

During up to 32 years of follow-up, the researchers documented 160 incident cases of HCC.

“Worldwide, liver cancer is the sixth most commonly diagnosed cancer and the second leading cause of cancer-related death,” the researchers wrote. “Clearly, identification of novel risk factors, particularly those that are modifiable, is urgently needed.”

Patients in the highest tertile of AHEI-2010 scores demonstrated a significant correlation with a lower risk for HCC compared with patients in the lowest tertile (HR = 0.61;95% CI, 0.39-0.95).

While the AMED dietary pattern index had a weaker, non-significant correlation with HCC risk, the researchers observed no link between DASH scores and HCC risk.

After further examining the major components of AHEI-2010, Zhang and colleagues found that light alcohol drinking (HR = 0.9; 95% CI, 0.84-0.96), nut and legume consumption (HR = 0.92; 95% CI, 0.85-0.99), and polyunsaturated fatty acids intake (HR = 0.84; 95% CI, 075-0.95) correlated significantly with a lower risk for HCC.

“The mechanisms underlying the observed inverse associations between healthy dietary patterns and the risk of incident HCC are poorly understood. Diet may play an important etiological role in the development of insulin resistance, inflammation, and nonalcoholic fatty liver disease (NAFLD), important predisposing factors for HCC,” Zhang and colleagues concluded. “Future studies are warranted to confirm our findings in other racial/ethnical populations, to examine associations with other dietary quality scores, and to elucidate the underlying mechanisms.” – by Talitha Bennett

Disclosure: The authors report no relevant financial disclosures.