Dietary Factors Reduce Risk of Acute Pancreatitis in a Large Multiethnic Cohort.
Pancreatitis is a source of substantial morbidity and health cost in the United States. Little is known about how diet might contribute to its pathogenesis. To characterize dietary factors that are associated with risk of pancreatitis by disease subtype, we conducted a prospective analysis of 145,886 African Americans, Native Hawaiians, Japanese Americans, Latinos, and whites in the Multiethnic Cohort.



In the Multiethnic Cohort (age at baseline, 45-75 y), we identified cases of pancreatitis using hospitalization claim files from 1993 through 2012. Patients were categorized as having gallstone-related acute pancreatitis (AP) (n = 1210), AP not related to gallstones (n = 1222), or recurrent AP or suspected chronic pancreatitis (n = 378). Diet information was obtained from a questionnaire administered when the study began. Associations were estimated by hazard ratios and 95% confidence intervals using Cox proportional hazard models adjusted for confounders.



Dietary intakes of saturated fat (P trend = .0011) and cholesterol (P trend = .0008) and their food sources, including red meat (P trend < .0001) and eggs (P trend = .0052), were associated positively with gallstone-related AP. Fiber intake, however, was associated inversely with gallstone-related AP (P trend = .0005) and AP not related to gallstones (P trend = .0035). Vitamin D, mainly from milk, was associated inversely with gallstone-related AP (P trend = .0015), whereas coffee consumption protected against AP not related to gallstones (P trend < .0001). With the exception of red meat, no other dietary factors were associated with recurrent acute or suspected chronic pancreatitis.



Associations between dietary factors and pancreatitis were observed mainly for gallstone-related AP. Interestingly, dietary fiber protected against AP related and unrelated to gallstones. Coffee drinking protected against AP not associated with gallstones. Further studies are warranted to confirm our findings.
Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California. Electronic address: vsetiawa@usc.edu.
Veronica Wendy
VW
Setiawan
Division of Gastroenterology, Department of Medicine, Cedars-Sinai Medical Center, and Department of Veterans Affairs, Los Angeles, California.
Stephen J
SJ
Pandol
Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California.
Jacqueline
J
Porcel
Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California.
Pengxiao C
PC
Wei
Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii.
Lynne R
LR
Wilkens
Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii.
Loïc
L
Le Marchand
Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; Memorial Sloan Kettering Cancer Center, New York, New York.
Malcolm C
MC
Pike
Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California.
Kristine R
KR
Monroe
D000368:Aged; D004032:Diet / Q000379:methods*; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019283:Pancreatitis, Acute Necrotizing / Q000517:prevention & control*; D011446:Prospective Studies; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
Epidemiology; Pancreas; Population