Lung Cancer Risk in Men and Compliance with the 2018 WCRF/AICR Cancer Prevention Recommendations.

Lung cancer is the most common and deadly form of cancer worldwide, especially in men. The 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) updated cancer prevention recommendations, and a standard scoring system (2018 WCRF/AICR Score) was published. The purpose of this study was to develop the adapted version of the 2018 WCRF/AICR Score with respect to lung cancer prevention recommendation (Ad-LC WCRF/AICR Score) and to examine the association between lung cancer risk in men and the Ad-LC WCRF/AICR Score as well as its single components. A case-control study was conducted among 439 men aged 45-80 years (187 controls, 252 primary lung cancer cases). Lifestyle and dietary data were collected with a questionnaire including the 62-item food frequency questionnaire (FFQ-6®). The Ad-LC WCRF/AICR Score was used as a categorized and continuous variable. Odds ratios (ORs) and 95% confidence intervals (95% CIs) for lung cancer risk were calculated with the partly and fully adjusted model. One component of the score was independently associated with a lower risk of lung cancer in men, regardless of the set of confounders used. In the fully adjusted model following the recommendation "Limit smoking" was associated with a lower risk of lung cancer-in the never smokers by 87% (OR: 0.13; 95% CI: 0.04-0.37; p = 0.0002) and in the moderate smokers by 45% (OR: 0.55; 95% CI: 0.33-0.91; p = 0.0189) compared with the heavy smokers as a reference. By adding the single components making up the Ad-LC WCRF/AICR Score, the combination of three components or more, reducing the risk of lung cancer compared to lower compliance as a reference by 45% to 78% and by 39% to 66% for intermediate compliance (except two models out of seven) and higher compliance, respectively. In the fully adjusted model, the risk of lung cancer for the total Ad-LC WCRF/AICR Score was lower by 47% (OR: 0.53; 95% CI: 0.32-0.88; p = 0.0129) in higher compliance with the score compared to those with the lower compliance. Each one-point increase in the Ad-LC WCRF/AICR Score reduced lung cancer risk by 34% (OR: 0.66; 95% CI: 0.45-0.95; p = 0.0267). The results support previous evidence that limiting smoking reduces the risk of lung cancer in men. It also provides an insight into cancer research by showing that following the combined 2018 cancer prevention recommendations related to diet, lifestyle and body fatness was associated with a lower risk of lung cancer in men.

Changes in Vegetable Consumption in Times of COVID-19-First Findings From an International Civil Science Project.

The crisis related to the COVID-19 pandemic influenced food security and nutrition through both direct and indirect pathways. This ranged from short-term to long-term impacts, not only on health but also on food systems and thus on nutrition. This study aimed to identify how the observed constraints affected the food intake of populations across the globe. Here, special attention was paid to the consumption of vegetables and legumes and the diversity within these food groups. An online survey on Food and COVID-19 was conducted using a semi-structured questionnaire translated into several languages. Binary logistic regression models and Poisson regression models were calculated to evaluate changes in consumption patterns and to test potential determinants for the changes. For more detailed information on reasons for changes open ended questions were analysed qualitatively. Time spend at home, working from home, and mental stress were important drivers for changes in dietary intake according to the 1,042 respondents included in this analysis. The participants observed a change in food quantity (38%) and vegetable intake (27%). No changes were observed for the number of vegetable groups consumed, while significant reductions in diversity were detected within all vegetable groups. Moreover, associations between the number of consumed vegetable types during the COVID-19 pandemic and income regions as well as gender were found. The regression analysis showed that the level of decrease in vegetable diversity in the different vegetable groups were often depending on educational and occupational status, gender and household environment. Changes in food prices were related to changes in vegetable intake per se, overall vegetable diversity, and diversity within the provitamin A rich vegetable group. Food systems are not static and are transitioning quickly as could be observed during the Covid-19 pandemic. There is a need for a nutrition strategy to strengthen the resilience of vulnerable households to consume a diverse diet in adequate amount even in times of a pandemic.

Adherence to Prudent and Mediterranean Dietary Patterns Is Inversely Associated with Lung Cancer in Moderate But Not Heavy Male Polish Smokers: A Case-Control Study.

Lung cancer is the most commonly diagnosed cancer in men worldwide. Studies regarding dietary patterns (DPs) and lung cancer are limited, with results remaining inconclusive, and the association of DPs with lung cancer in smokers is unclear. This study analyzed the associations between DPs, including the Polish-adapted Mediterranean diet (Polish-aMED) score, and lung cancer risk in Polish adult male smokers. This case-control study involved 439 men aged 45-80 years from northeastern Poland, including 187 newly diagnosed lung cancer cases. Dietary data was collected with a 62-item food frequency questionnaire (FFQ-6). Two approaches were applied to identify dietary patterns. The Polish-aMED score was calculated (hypothesis-driven approach) and a principal component analysis (PCA) was used to identify PCA-driven DPs (data-driven approach). A logistic regression analysis was performed to estimate the odds ratio (OR) and 95% confidence interval (95% CI) of the lung cancer risk associated with the adherence to DPs overall as well as for moderate (2.5-11 pack-years) and heavy (>11 pack-years) smokers. Among moderate smokers, the risk of lung cancer was lower by 41% (OR: 0.59; 95% CI: 0.39-0.90; p < 0.05; adjusted model) in the higher adherence to the prudent DP when compared to the lower adherence, and by 66% (OR: 0.34; 95% CI: 0.15-0.76; p < 0.05; adjusted model) in the high adherence (7-9 points) to the Polish-aMED score when compared to the low adherence (0-3 points). No significant association between the westernized traditional DP or the sweet dairy DP and lung cancer was revealed. In conclusion, the current study suggests that pro-healthy dietary patterns, including the Mediterranean pattern, may favour lower risk of lung cancer in moderate smokers, although it was not confirmed in heavy smokers.

Associations of Mediterranean Diet and a Posteriori Derived Dietary Patterns with Breast and Lung Cancer Risk: A Case-Control Study.

Lung cancer in men and breast cancer in women are the most commonly diagnosed cancers in Poland and worldwide. Results of studies involving dietary patterns (DPs) and breast or lung cancer risk in European countries outside the Mediterranean Sea region are limited and inconclusive. This study aimed to develop a 'Polish-adapted Mediterranean Diet' ('Polish-aMED') score, and then study the associations between the 'Polish-aMED' score and a posteriori-derived dietary patterns with breast or lung cancer risk in adult Poles. This pooled analysis of two case-control studies involved 560 subjects (280 men, 280 women) aged 40-75 years from Northeastern Poland. Diagnoses of breast cancer in 140 women and lung cancer in 140 men were found. The food frequency consumption of 21 selected food groups was collected using a 62-item Food Frequency Questionnaire (FFQ)-6. The 'Polish-adapted Mediterranean Diet' score which included eight items-vegetables, fruit, whole grain, fish, legumes, nuts and seeds-as well as the ratio of vegetable oils to animal fat and red and processed meat was developed (range: 0-8 points). Three DPs were identified in a Principal Component Analysis: 'Prudent', 'Non-healthy', 'Dressings and sweetened-low-fat dairy'. In a multiple logistic regression analysis, two models were created: crude, and adjusted for age, sex, type of cancer, Body Mass Index (BMI), socioeconomic status (SES) index, overall physical activity, smoking status and alcohol abuse. The risk of breast or lung cancer was lower in the average (3-5 points) and high (6-8 points) levels of the 'Polish-aMED' score compared to the low (0-2 points) level by 51% (odds ratio (OR): 0.49; 95% confidence interval (Cl): 0.30-0.80; p < 0.01; adjusted) and 63% (OR: 0.37; 95% Cl: 0.21-0.64; p < 0.001; adjusted), respectively. In the middle and upper tertiles compared to the bottom tertile of the 'Prudent' DP, the risk of cancer was lower by 38-43% (crude) but was not significant after adjustment for confounders. In the upper compared to the bottom tertile of the 'Non-healthy' DP, the risk of cancer was higher by 65% (OR: 1.65; 95% Cl: 1.05-2.59; p < 0.05; adjusted). In conclusion, the Polish adaptation of the Mediterranean diet could be considered for adults living in non-Mediterranean countries for the prevention of the breast or lung cancers. Future studies should explore the role of a traditional Mediterranean diet fitted to local dietary patterns of non-Mediterranean Europeans in cancer prevention.

Dietary patterns and breast or lung cancer risk: A pooled analysis of 2 case-control studies in north-eastern Poland.

BACKGROUND: Breast cancer in women and lung cancer in men are the most prevalent cancers in Poland and worldwide. Evidence of the impact of food groups and nutrients on the risk of breast and lung cancer is limited and lacking conclusions. Studies on food consumption and breast or lung cancer are limited. OBJECTIVES: Assessment of the association between dietary patterns and the prevalence of breast and lung cancers in adult Poles. MATERIAL AND METHODS: The study involved a pooled analysis of 2 case-control studies on 320 subjects aged 50-70 years from north-eastern Poland (160 women, 160 men). Breast cancer cases in 80 women and lung cancer cases in 80 men were diagnosed. The food consumption frequency for 21 selected foods was collected using the Questionnaire of Eating Behaviors (QEB). Principal component analysis and multiple logistic regression analysis were used. The odds ratio (OR) and 95% confidence interval (95% CI) were calculated. RESULTS: Three dietary patterns (DPs) were identified: 'Prudent', 'Processed & fast food', and 'Traditional Polish'. In the pooled analysis for both cancers, the ORs were from 0.35 (95% CI: 0.20-0.61; p < 0.05 with adjustment for age) to 0.48 (95% CI: 0.26-0.88; p < 0.05 with adjustment for age, socioeconomic status index, physical activity, smoking, and abuse of alcohol) in the upper tertile of the 'Prudent' DP in comparison to the absence of cancers (OR = 1.00). The ORs of both cancers were 1.83 (95% CI: 1.06-3.16; p < 0.05 with adjustment for age) in the upper tertile of the 'Processed & fast food' DP. The ORs of both cancers for the 'Traditional Polish' DP were insignificant. CONCLUSIONS: In the pooled analysis, a strong inverse relation was found between the 'Prudent' dietary pattern, characterized by higher frequency of dairy, fruit, vegetables, wholemeal bread, fish and juices consumption, and breast or lung cancer prevalence, irrespective of age, socioeconomic status, physical activity, smoking, alcohol abuse, and type of cancer in Polish adults from north-eastern Poland.

Nutritional knowledge, diet quality and breast or lung cancer risk: a case-control study of adults from Warmia and Mazury region in Poland.

BACKGROUND: Knowledge on proper nutrition favours the creation of pro-healthy nutritional behaviours of people. Studies related to the nutritional knowledge of adults, diet quality and incidence of breast or lung cancers are limited. OBJECTIVE: Analysis of the relationship between the level of nutritional knowledge, diet quality and risk of breast cancer in women or lung cancer in men from the Warmia and Mazury region in Poland. MATERIAL AND METHODS: The study was carried out in 202 subjects aged 23-80 years, including 107 women (17 cases of breast cancer) and 95 men (54 cases of lung cancer) from the Warmia and Mazury region in Poland. Nutritional knowledge was evaluated with the Questionnaire of Eating Behaviours (QEB), including 25 statements. Based on the frequency of the consumption of 16 food items, two diet quality indices were created: the pro-Healthy-Diet-Index-8 (pHDI-8) and the non-Healthy-Diet-Index-8 (nHDI-8). The values of pHDI-8 and nHDI-8 were calculated on the basis of the sum of the daily frequency of consumption of the selected food items and expressed as times/day. The Odds Ratio (OR) of both breast cancer or lung cancer in relation to the level of nutritional knowledge was calculated based on a logistic regression analysis. RESULTS: The incidence of breast or lung cancer in the bottom, middle and upper tertile of nutritional knowledge was 57.6%, 32.6% and 15.8%, respectively. As nutritional knowledge grew in the subsequent tertiles, pHDI-8 was on the increase (2.63 vs. 3.78 vs. 4.22 times/day) and n-HDI-8 was on the decrease (1.32 vs. 1.21 vs. 0.94 times/day). In the upper tertile of nutritional knowledge, the Odds Ratio for the incidence of breast or lung cancers varied from 0.06 (95% CI: 0.02; 0.17; p<0.05, with adjustment for cancer type and age) to 0.17 (95% CI: 0.04; 0.69; p<0.05, with adjustment for age and sex) when compared to the bottom tertile (OR=1.00). In the middle tertile of nutritional knowledge, the Odds Ratio of both cancers varied from 0.27 (95% CI: 0.12; 0.62, p<0.05, with adjustment for cancer type and age) to 0.35 (95% CI: 0.18; 0.71, p<0.05, variables without adjustment) when compared to the bottom tertile. CONCLUSIONS: A higher level of nutritional knowledge was associated with the higher quality of a pro-healthy diet and lower risk of breast cancer in women or lung cancer in men. In contrast, a lower level of nutritional knowledge was associated with a lower diet quality and a higher risk of both types of cancers.