Table 3.
Evidence synthesis of the association between diet and lung cancer in the EPIC study.
| Wholegrains, Vegetables, and Fruit | |||
|---|---|---|---|
| No. of Cases (Non-Cases) |
Mean Follow-Up (Years) | Results, Relative Risk (95% Confidence Interval (CI)) | Reference |
| 860 (477,161) | NR | Fruit consumption (highest vs. lowest quintile): HR 0.60 (0.46–0.78) P trend = 0.0099 No association between vegetable consumption or vegetable subtypes and lung cancer risk. |
Miller 2004 [103] |
| 1126 (477,464) | 6.4 | Fruit consumption was significantly inversely associated with lung cancer risk (highest vs. lowest quintile): HR 0.75 (0.49–0.96). Lung cancer risk significantly decreased with higher vegetable consumption (per 100 g/day increase in vegetable intake): HR 0.90 (0.81–0.99) in smokers and HR 0.92 (0.85–0.99) overall. |
Linseisen 2007 [102] |
| 1830 (476,705) | 8.7 | A 100 g/day increase in fruit and vegetables consumption was associated with a reduced lung cancer risk: HR 0.94 (0.89–0.99). A 100 g/day increase in fruit consumption was associated with a reduced lung cancer risk: HR 0.94 (0.88–1.01). A 100 g/day increase in vegetables consumption was associated with a reduced lung cancer risk: HR 0.94 (0.83–1.07). |
Büchner 2010 [101] |
| Meat, Fish, Dairy Products, and Preservation/Processing of Food | |||
|
No. of Cases
(Non-Cases) |
Mean Follow-Up (Years) | Results, Relative risk (95% Confidence Interval (CI)) | Reference |
| 1822 (476,199) | 8.7 | There were no consistent associations between meat consumption and the risk of lung cancer: Red meat (per 50 g intake/day): RR 1.06 (0.89–1.27) Processed meat (per 50 g g/day): RR 1.13 (0.95–1.34) Consumption of white meat and fish were also not associated with the risk of lung cancer. |
Linseisen 2011 [104] |
| Dietary Patterns | |||
|
No. of Cases
(Non-Cases) |
Mean Follow-Up (Years) | Results, Relative Risk (95% Confidence Interval (CI)) | Reference |
| 3654 (421,701) | 15.3 | A higher FSAm-NPS DI score (lower nutritional quality diet) was associated with a higher lung cancer risk in men and women (highest vs. lowest quintile): HR 1.26 (1.06–1.51) P trend = 0.02, and HR 2.33 (1.23–4.43) P trend = 0.008, respectively. | Deschasaux 2018 [36] |
| Alcoholic and Non-Alcoholic Drinks | |||
|
No. of Cases
(Non-Cases) |
Mean Follow-Up (Years) | Results, Relative Risk (95% Confidence Interval (CI)) | Reference |
| 1119 (477,471) | 6.4 | Neither ethanol intake at recruitment nor mean lifelong ethanol intake significantly associated with lung cancer. | Rohrmann 2006 [105] |
| Other Dietary Exposures | |||
|
No. of Cases
(Non-Cases) |
Mean Follow-Up (Years) | Results, Relative risk (95% Confidence Interval (CI)) | Reference |
| 899 (384,848) | NR | A lower risk for lung cancer was seen for elevated serum levels of B6 and for serum methionine (fourth vs. first quartile): OR 0.44 (0.33–0.60) P trend < 0.000001, and OR 0.52 (0.39–0.69) P for trend <0.000001, respectively. Above-median levels of both were associated with a lower lung cancer risk overall: OR 0.41 (0.31–0.54), as well as separately among never, former and current smokers: OR 0.36 (0.18–0.72), OR 0.51 (0.34–0.76), and OR 0.42 (0.27–0.65), respectively. |
Johansson 2010 [106] |
| 128 (22,585) | 10.2 | Dietary intake of vitamin K2 (highest vs. lowest quintile): HR 0.38 (0.20–0.71) P trend = 0.002 | Nimptsch 2010 [108] |
| 892 (1748) | 5.2 | PA/(pyridoxal þ PLP) levels: OR 1.52 (1.27–1.81) P < 0.001 | Zuo 2018 [110] |
| 3914 (15,443) | 12.0 | Plasma vitamin C concentration (highest vs. lowest quartile): HR 0.57 (0.41–0.81) | Myint 2019 [107] |
| 3731 (413,015) | 13.9 | Haem iron intake (as a continuous variable): HR 1.03 (1.00–1.07) per 0.3 mg/1000 kcal Haem iron intake (highest vs. lowest quintile): HR 1.16 (1.02–1.32) P trend = 0.035 Non-haem iron intake (as a continuous variable): HR 0.96 (0.92–1.00) per 1.2 g/1000 kcal Non-haem iron intake (highest vs. lowest quintile): HR 0.90 (0.79–1.02) P trend = 0.068 Total iron intake (as a continuous variable): HR 0.98 (0.94–1.02) per 1.3 g/1000 kcal Total iron intake (highest vs. lowest quintile): HR 0.95 (0.84–1.07) P trend = 0.20 |
Ward 2019 [109] |
HR: hazard ratio; NR: not reported; OR: odds ratio; RR: risk ratio.