title: Pretreatment dietary patterns, weight status, and head and neck squamous cell carcinoma prognosis.
abstract: BACKGROUND
  Few studies have evaluated the association of diet and weight status with head and neck cancer outcomes.
  
  
  OBJECTIVE
  The purpose of this study was to determine whether pretreatment dietary patterns and weight status are associated with head and neck cancer prognosis.
  
  
  METHODS
  This was a longitudinal study of 542 patients with newly diagnosed head and neck cancer who completed food-frequency questionnaires and health surveys before treatment. Clinical data were abstracted from medical records and the Social Security Death Index. Dietary patterns were identified by using principal component analysis. Cox proportional hazard models were used to examine the association of derived dietary patterns (fit by quintiles of exposure) and weight status with time to recurrence and survival, with control for covariates.
  
  
  RESULTS
  During the study period, there were 229 deaths and 184 recurrences. Two dietary patterns were identified: a whole-foods pattern (characterized by high intakes of vegetables, fruit, fish, poultry, and whole grains) and a Western pattern (characterized by high intakes of red and processed meats, refined grains, potatoes, and French fries). In multivariable analyses, significantly fewer deaths were observed in subjects most adherent to the whole-foods pattern (HR: 0.56; 95% CI: 0.34, 0.92; P-trend = 0.01). Subjects classified as overweight or obese had significantly fewer deaths (HR: 0.65; 95% CI: 0.49, 0.85; P = 0.001) and recurrences (HR: 0.70; 95% CI: 0.52, 0.95; P = 0.02) than did normal-weight or underweight subjects.
  
  
  CONCLUSIONS
  Consumption of a diet rich in vegetables, fruit, fish, poultry, and whole grains and being overweight before diagnosis with head and neck cancer are associated with a better prognosis.
authors.affiliation: Department of Environmental Health Sciences, University of Michigan Medical School, Ann Arbor, MI 48109-0482, USA.
authors.forename: Anna E
authors.initials: AE
authors.lastname: Arthur
authors.forename: Karen E
authors.initials: KE
authors.lastname: Peterson
authors.forename: Laura S
authors.initials: LS
authors.lastname: Rozek
authors.forename: Jeremy M G
authors.initials: JM
authors.lastname: Taylor
authors.forename: Emily
authors.initials: E
authors.lastname: Light
authors.forename: Douglas B
authors.initials: DB
authors.lastname: Chepeha
authors.forename: James R
authors.initials: JR
authors.lastname: Hébert
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Terrell
authors.forename: Gregory T
authors.initials: GT
authors.lastname: Wolf
authors.forename: Sonia A
authors.initials: SA
authors.lastname: Duffy
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000175:diagnosis* / Q000517:prevention & control; D004032:Diet / Q000009:adverse effects; D005260:Female; D055951:Functional Food; D006258:Head and Neck Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000517:prevention & control; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008824:Michigan; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D009765:Obesity / Q000150:complications*; D050177:Overweight / Q000150:complications*; D011379:Prognosis; D011446:Prospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D016019:Survival Analysis; D055815:Young Adult