a1 Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
a2 Department of Health Studies, University of Chicago, 5841 South Maryland Avenue, MC 2007, Chicago, IL 60637, USA
a3 Division of Hematology/Oncology, Department of Medicine, University of Chicago, Chicago, IL, USA
a4 Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA
a5 University of Chicago Comprehensive Cancer Center, Chicago, IL, USA
Objective Previous studies examining the role of single foods or nutrients in the aetiology of non-Hodgkin lymphoma (NHL) have produced inconsistent findings. Few studies have examined associations for dietary patterns, which may more accurately reflect patterns of consumption and the complexity of dietary intake. The objective of the present study was to examine whether dietary patterns identified by factor analysis were associated with NHL risk.
Setting Population-based sample residing in Nebraska from 1999 to 2002.
Subjects A total of 336 cases and 460 controls.
Results Factor analysis identified two major dietary patterns: (i) a ‘Meat, Fat and Sweets’ dietary pattern characterized by high intakes of French fries, red meat, processed meat, pizza, salty snacks, sweets and desserts, and sweetened beverages; and (ii) a ‘Fruit, Vegetables and Starch’ dietary pattern characterized by high intakes of vegetables, fruit, fish, and cereals and starches. In multivariable logistic regression models, the ‘Meat, Fat and Sweets’ dietary pattern was associated with an increased risk of overall NHL (ORQ4 v. Q1 = 3·6, 95 % CI 1·9, 6·8; P trend = 0·0004), follicular lymphoma (ORQ4 v. Q1 = 3·1, 95 % CI 1·2, 8·0; P trend = 0·01), diffuse large B-cell lymphoma (ORQ4 v. Q1 = 3·2, 95 % CI 1·1, 9·0; P trend = 0·09) and marginal zone lymphoma (ORQ4 v. Q1 = 8·2, 95 % CI 1·3, 51·2; P trend = 0·05). No association with overall or subtype-specific risk was detected for the ‘Fruit, Vegetables and Starch’ dietary pattern. No evidence of heterogeneity was detected across strata of age, sex, BMI, smoking status or alcohol consumption.
Conclusions Our results suggest that a dietary pattern high in meats, fats and sweets may be associated with an increased risk of NHL.
(Received October 17 2012)
(Revised February 19 2013)
(Accepted April 04 2013)
(Online publication May 09 2013)