title: A prospective study of dietary patterns and cancer mortality among Blacks and Whites in the REGARDS cohort.
abstract: Marked racial differences exist in dietary patterns and obesity, as well as cancer mortality. This study aims to assess whether dietary patterns are associated with cancer mortality overall and by race. We identified 22,041 participants from the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. Dietary patterns were categorized into: Convenience (Chinese and Mexican foods, pasta, pizza), Plant-based (fruits, vegetables), Southern (added fats, fried foods, sugar-sweetened beverages), Sweets/Fats (sugary foods) and Alcohol/Salads (alcohol, green-leafy vegetables, salad dressing). Using Cox regression, we examined the association between quartiles of dietary patterns and cancer mortality, adjusted for potential confounders, overall among all participants and stratified by race. A total of 873 cancer deaths were observed over the 10-year observation period: 582 (66.7%) in Whites and 291 (33.3%) in Blacks. Greater adherence to the Southern dietary pattern was associated with an increased risk of cancer mortality (4th vs. 1st quartile HR: 1.67; 95% CI: 1.32-2.10) overall, especially among Whites (4th vs. 1st quartile HR: 1.59; 95% CI: 1.22-2.08). The convenience (HR: 0.73; 95% CI: 0.56-0.94) and Plant-based (HR: 0.72; 95% CI: 0.55-0.93) dietary patterns were associated with up to a 28% reduced risk of cancer mortality, but only among Whites. Greater adherence to the Southern dietary pattern increased the risk of cancer mortality, while greater adherence to the convenience and Plant-based diets reduced the risk of cancer mortality among Whites. Racial differences were observed in the association between dietary patterns and cancer mortality, but warrant further study.
authors.affiliation: Departments of Epidemiology, University of Alabama at Birmingham, Birmingham, AL. tomiakin@uab.edu.|Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL. tomiakin@uab.edu.
authors.forename: Tomi
authors.initials: T
authors.lastname: Akinyemiju
authors.affiliation: Departments of Epidemiology, University of Alabama at Birmingham, Birmingham, AL.|Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Justin Xavier
authors.initials: JX
authors.lastname: Moore
authors.affiliation: Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL.|Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Maria
authors.initials: M
authors.lastname: Pisu
authors.affiliation: Department of Clinical Cancer Prevention and Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Susan G
authors.initials: SG
authors.lastname: Lakoski
authors.affiliation: Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL.
authors.forename: James
authors.initials: J
authors.lastname: Shikany
authors.affiliation: Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA.
authors.forename: Michael
authors.initials: M
authors.lastname: Goodman
authors.affiliation: Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Suzanne E
authors.initials: SE
authors.lastname: Judd
mesh_terms: D000368:Aged; D044383:Black People / Q000706:statistics & numerical data*; D015331:Cohort Studies; D004032:Diet / Q000208:ethnology* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000208:ethnology* / Q000401:mortality*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*; D001741:Black or African American
keywords: cancer; diet; mortality; prospective cohort; racial disparities