Dietary inflammatory index, Mediterranean diet score, and lung cancer: a prospective study.
To investigate prospectively the associations of Dietary Inflammatory Index (DII) and Mediterranean Diet Score (MDS) with lung cancer.



We used data from men and women aged 40-69 years at recruitment in 1990-1994, who were participants in the Melbourne Collaborative Cohort Study (n = 35,303). A total of 403 incident lung cancer cases were identified over an average 18-year follow-up. Hazard ratios (HR) were estimated using Cox regression, adjusting for smoking status and other risk factors, with age as the time metric.



An inverse correlation was observed between the DII and MDS (ρ = -0.45), consistent with a higher DII being pro-inflammatory and less 'healthy,' while a high MDS reflects a 'healthier' diet. The DII was positively associated with risk of lung cancer in current smokers [HRQ4 vs Q1 = 1.70 (1.02, 2.82); Ptrend = 0.008] (p interaction between DII quartiles and smoking status = 0.03). The MDS was inversely associated with lung cancer risk overall [HR7-9 vs 0-3 = 0.64 (0.45, 0.90); Ptrend = 0.005] and for current smokers (HR7-9 vs 0-3 = 0.38 (0.19, 0.75); Ptrend = 0.005) (p interaction between MDS categories and smoking status = 0.31).



The MDS showed an inverse association with lung cancer risk, especially for current smokers. A high DII, indicating a more pro-inflammatory diet, was associated with risk of lung cancer only for current smokers. A healthy diet may reduce the risk of lung cancer, especially in smokers.
Cancer Epidemiology Centre, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, VIC, 3004, Australia. allison.hodge@cancervic.org.au.
A M
0000-0001-5464-2197
AM
Hodge
Cancer Epidemiology Centre, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, VIC, 3004, Australia.
J K
JK
Bassett
Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, 29208, USA.|Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.
N
N
Shivappa
Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, 29208, USA.|Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.
J R
JR
Hébert
Cancer Epidemiology Centre, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, VIC, 3004, Australia.|Centre for Epidemiology and Biostatistics, The University of Melbourne, Level 3, 207 Bouverie St, University of Melbourne, VIC, 3010, Australia.
D R
DR
English
Cancer Epidemiology Centre, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, VIC, 3004, Australia.|Centre for Epidemiology and Biostatistics, The University of Melbourne, Level 3, 207 Bouverie St, University of Melbourne, VIC, 3010, Australia.
G G
GG
Giles
Cancer Epidemiology Centre, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, VIC, 3004, Australia.|Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France.|Gustave Roussy, 94805, Villejuif, France.|Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.|HuGeF, Human Genetics Foundation, 10126, Torino, Italy.
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Severi
D000328:Adult; D000368:Aged; D004032:Diet / Q000009:adverse effects*; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007249:Inflammation / Q000150:complications* / Q000453:epidemiology; D008175:Lung Neoplasms / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology
Diet; Epidemiology; Inflammation; Lung cancer; Prospective; Smoking