title: Dietary patterns and risk of oral cancer: a case-control study in São Paulo, Brazil.
abstract: OBJECTIVE
  To analyze the association between dietary patterns and oral cancer.
  
  
  METHODS
  The study, part of a Latin American multicenter hospital-based case-control study, was conducted in São Paulo, Southeastern Brazil, between November 1998 and March 2002 and included 366 incident cases of oral cancer and 469 controls, frequency-matched with cases by sex and age. Dietary data were collected using a food frequency questionnaire. The risk associated with the intake of food groups defined a posteriori, through factor analysis (called factors), was assessed. The first factor, labeled "prudent," was characterized by the intake of vegetables, fruit, cheese, and poultry. The second factor, "traditional," consisted of the intake of rice, pasta, pulses, and meat. The third factor, "snacks," was characterized as the intake of bread, butter, salami, cheese, cakes, and desserts. The fourth, "monotonous," was inversely associated with the intake of fruit, vegetables and most other food items. Factor scores for each component retained were calculated for cases and controls. After categorization of factor scores into tertiles according to the distribution of controls, odds ratios and 95% confidence intervals were calculated using unconditional multiple logistic regression.
  
  
  RESULTS
  "Traditional" factor showed an inverse association with cancer (OR=0.51; 95% CI: 0.32; 0.81, p-value for trend 0.14), whereas "monotonous" was positively associated with the outcome (OR=1.78; 95% CI: 1.78; 2.85, p-value for trend <0.001).
  
  
  CONCLUSIONS
  The study data suggest that the traditional Brazilian diet, consisting of rice and beans plus moderate amounts of meat, may confer protection against oral cancer, independently of any other risk factors such as alcohol intake and smoking.
authors.affiliation: Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brasil. marchioni@usp.br
authors.forename: Dirce Maria Lobo
authors.initials: DM
authors.lastname: Marchioni
authors.forename: Regina Mara
authors.initials: RM
authors.lastname: Fisberg
authors.forename: José
authors.initials: J
authors.lastname: Francisco de Góis Filho
authors.forename: Luiz Paulo
authors.initials: LP
authors.lastname: Kowalski
authors.forename: Marcos
authors.initials: M
authors.lastname: Brasilino de Carvalho
authors.forename: Márcio
authors.initials: M
authors.lastname: Abrahão
authors.forename: Maria do Rosário Dias de Oliveira
authors.initials: Mdo R
authors.lastname: Latorre
authors.forename: José
authors.initials: J
authors.lastname: Eluf-Neto
authors.forename: Victor
authors.initials: V
authors.lastname: Wünsch Filho
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects; D001938:Brazil; D004812:Epidemiologic Methods; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000209:etiology*; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000209:etiology*; D009959:Oropharyngeal Neoplasms / Q000209:etiology*; D025341:Principal Component Analysis; D012907:Smoking / Q000009:adverse effects