title: A population-based prospective study of energy-providing nutrients in relation to all-cause cancer mortality and cancers of digestive organs mortality.
abstract: The effect of dietary composition on mortality in low-income countries is largely unknown. We evaluated whether percentages of dietary energy derived from protein, fat and carbohydrates were associated with all-cause and cancer mortalities in a Bangladeshi population. Data from a prospective population-based cohort study of 17,244 men and women were used. Percentages of dietary energy derived from protein, fat and carbohydrates, assessed using a validated food-frequency questionnaire at baseline, were analyzed in relation to mortality over an average of 9 years (155,126 person-years) of follow-up. Cox proportional hazards regression models were used to estimate hazard ratios for all cause, all cancer and cancers of the digestive organs mortalities. Percentage of dietary energy from protein appeared to be significantly associated with cancer mortality. Fully adjusted hazard ratios for cancer mortality in increasing tertiles of percentage of dietary energy from protein were 1.0 (reference), 1.21 (0.73, 2.00) and 1.84 (1.08, 3.15) (p for trend = 0.023). These associations were much stronger for deaths from cancers of the digestive organs with fully adjusted hazard ratios in increasing tertiles of percentage of dietary energy from protein being 1.0 (reference), 2.25 (0.91, 5.59) and 4.85 (1.88, 12.51) (p for trend = 0.001). No significant associations in relation to cancer-related mortality were observed for percentage of dietary energy from fat. Novel findings from this prospective study show protein is an important risk factor or proxy to an important risk factor for cancer mortality especially from digestive organ cancers in Bangladesh.
authors: Department of Health Studies, The University of Chicago, Chicago, IL.
authors: Maria
authors: M
authors: Argos
authors: Stephanie
authors: S
authors: Melkonian
authors: Faruque
authors: F
authors: Parvez
authors: Muhammad
authors: M
authors: Rakibuz-Zaman
authors: Alauddin
authors: A
authors: Ahmed
authors: Yu
authors: Y
authors: Chen
authors: Habibul
authors: H
authors: Ahsan
mesh_terms: D000328:Adult; D001459:Bangladesh; D015331:Cohort Studies; D004032:Diet / Q000009:adverse effects / Q000706:statistics & numerical data*; D004067:Digestive System Neoplasms / Q000378:metabolism / Q000401:mortality* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D005502:Food / Q000009:adverse effects / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000378:metabolism / Q000401:mortality* / Q000473:pathology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires
keywords: Bangladesh, diet, cancer mortality, prospective study
references: J Natl Cancer Inst. 1999 Apr 7;91(7):620-5
references: 10203281
references: Int J Cancer. 1975 Apr 15;15(4):617-31
references: 1140864
references: Anal Bioanal Chem. 2004 Jun;379(3):512-8
references: 15098084
references: Basic Life Sci. 1990;52:105-18
references: 2183763
references: Food Nutr Bull. 2010 Jun;31(2):206-13
references: 20707226
references: Cancer Epidemiol Biomarkers Prev. 2001 Oct;10(10):1055-62
references: 11588131
references: Cancer Causes Control. 1993 Mar;4(2):123-32
references: 8481491
references: Cancer Lett. 1995 Jun 29;93(1):17-48
references: 7600541
references: Int J Epidemiol. 2010 Aug;39(4):1037-45
references: 20032266
references: Nutr Cancer. 1997;27(3):298-309
references: 9101561
references: BMJ. 2011 May 05;342:d2431
references: 21546419
references: Int J Cancer. 1996 Nov 4;68(3):300-4
references: 8903470
references: Mutat Res. 1991 Mar-Apr;259(3-4):277-89
references: 2017213
references: Endocr Rev. 2000 Jun;21(3):215-44
references: 10857553
references: Ann Oncol. 2006 Jun;17 Suppl 8:viii15-viii23
references: 16801335
references: Br J Cancer. 1992 Feb;65(2):263-6
references: 1739627
references: Int J Cardiol. 2013 Aug 20;167(4):1495-501
references: 22560940
references: Int J Cancer. 1999 Sep 24;83(1):15-7
references: 10449601
references: Am J Clin Nutr. 2006 Dec;84(6):1456-62
references: 17158430
references: Lancet. 2010 Jul 24;376(9737):252-8
references: 20646756
references: Am J Clin Nutr. 2011 May;93(5):1053-61
references: 21430112
references: CA Cancer J Clin. 2011 Mar-Apr;61(2):69-90
references: 21296855
references: Am J Clin Nutr. 2011 Apr;93(4):836-43
references: 21310830
references: Am J Epidemiol. 1999 Mar 15;149(6):531-40
references: 10084242
references: Br J Nutr. 2004 Nov;92(5):851-9
references: 15533275
references: Int J Epidemiol. 1998 Aug;27(4):660-6
references: 9758122
references: J Expo Sci Environ Epidemiol. 2006 Mar;16(2):191-205
references: 16160703
references: Nutr Cancer. 2002;42(1):33-40
references: 12235648
references: Eur J Cancer Prev. 1997 Jun;6(3):226-68
references: 9306073