title: Associations between adherence to the World Cancer Research Fund/American Institute for Cancer Research cancer prevention recommendations and biomarkers of inflammation, hormonal, and insulin response.
abstract: Adherence to the 2007 WCRF/AICR cancer prevention recommendations has been associated with lower cancer risk but the underlying biological mechanisms have not been elucidated. We utilized dietary and lifestyle data from 11,342 women in the Nurses' Health Study and 8,136 men in the Health Professionals Follow-up Study, to investigate associations between adherence scores and markers of inflammation, hormonal and insulin response. Two scores ranging from 0 to 3 were constructed to assess adherence to the energy balance-related recommendations (weight management, physical activity, energy density); and the plant, animal foods and alcohol intake recommendations; with higher scores indicating greater adherence. The following biomarkers were assessed in plasma samples donated by chronic disease-free women (1990) and men (1994): C-reactive protein (CRP), interleukin (IL)-6, tumor necrosis factor (TNF)-α receptor 2 (TNFαR2) and adiponectin for inflammation; estrone and estradiol for hormonal response in women, C-peptide for hyperinsulinemia; and triglycerides/high density lipoprotein-cholesterol (TG/HDL) ratio for insulin resistance. In multivariable-adjusted linear regression analyses, we estimated relative concentrations of biomarkers across adherence categories. There was a significant trend of lower (higher for adiponectin) biomarker concentrations with higher adherence to the energy balance recommendations (all p trend <0.0001). Comparing the highest (3) to the lowest recommendation category (0-1), the percent difference in relative concentrations of biomarkers was CRP, -69%; IL6, -41%; TNFαR2, -13%; adiponectin, +36%; C-peptide, -43%; TG/HDL, -43%; estrone, -31%; and estradiol, -43%; in women; and CRP, -59%; IL6, -42%; TNFαR2, -10%; adiponectin, +22%; C-peptide, -44%; and TG/HDL, -40%; in men. In contrast, associations between adherence to the plant, animal foods and alcohol intake recommendations and biomarker concentrations were weaker, and mostly nonsignificant. The healthier biomarker profile associated with greater adherence to the WCRF/AICR cancer prevention recommendations is driven mainly by adherence to the energy balance-related recommendations.
authors: Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.|Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.
authors: Fred K
authors: 0000-0001-8193-7150
authors: FK
authors: Tabung
authors: Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.|Department of Nutrition, Simmons College, Boston, MA.
authors: Teresa T
authors: TT
authors: Fung
authors: Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.|Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.|Channing Division of Network Medicine, Brigham and Womens' Hospital, Boston, MA.|Department of Medicine, Harvard Medical School, Boston, MA.
authors: Jorge E
authors: JE
authors: Chavarro
authors: Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.|Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.
authors: Stephanie A
authors: SA
authors: Smith-Warner
authors: Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.|Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.|Channing Division of Network Medicine, Brigham and Womens' Hospital, Boston, MA.|Department of Medicine, Harvard Medical School, Boston, MA.
authors: Walter C
authors: WC
authors: Willett
authors: Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.|Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.|Channing Division of Network Medicine, Brigham and Womens' Hospital, Boston, MA.|Department of Medicine, Harvard Medical School, Boston, MA.
authors: Edward L
authors: EL
authors: Giovannucci
mesh_terms: D000328:Adult; D000428:Alcohol Drinking; D015415:Biomarkers; D004032:Diet; D004734:Energy Metabolism; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood; D019983:Guideline Adherence; D006801:Humans; D007249:Inflammation / Q000097:blood; D007328:Insulin / Q000378:metabolism; D007333:Insulin Resistance; D000078790:Insulin Secretion; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D012739:Gonadal Steroid Hormones; D007328:Insulin
keywords: WCRF/AICR recommendations; cancer prevention; chronic inflammation; diet; hormones; hyperinsulinemia; insulin resistance; lifestyle