Prediagnosis dietary pattern and survival in patients with multiple myeloma. Issue 7 (28th February 2020)

• Record Type: Journal Article
• Authors: Lee, Dong Hoon; Fung, Teresa T.; Tabung, Fred K.; Marinac, Catherine R.; Devore, Elizabeth E.; Rosner, Bernard A.; Ghobrial, Irene M.; Colditz, Graham A.; Giovannucci, Edward L.; Birmann, Brenda M.
• Is Part Of: International journal of cancer. Volume 147:Issue 7(2020)
• Page Start: 1823
• Page End: 1830
• Publication Date: 2020-02-28
• Subjects: multiple myeloma -- survival -- dietary pattern -- healthy eating index -- Western diet -- prudent diet -- Mediterranean diet -- empirical dietary index; Cancer -- Periodicals; Cancer -- Prevention -- Periodicals; 616.994
• DOI: 10.1002/ijc.32928
• Languages: English
• ISSNs: 0020-7136

Abstract

Abstract : Inflammation and endogenous growth factors are important in multiple myeloma (MM) pathogenesis. Although diets that modulate these biologic pathways may influence MM patient survival, studies have not examined the association of dietary patterns with MM survival. We conducted pooled prospective survival analyses of 423 MM patients from the Nurses' Health Study (1986–2016) and the Health Professionals Follow‐up Study (1988–2016) using Cox regression models. We used data from repeated food frequency questionnaires (FFQ) to compute dietary patterns as of the last prediagnosis FFQ, including the Alternate Healthy Eating Index (AHEI)‐2010, alternate Mediterranean Diet, Dietary Approaches to Stop Hypertension, Prudent, Western and empirical dietary inflammatory patterns and empirical dietary indices for insulin resistance and hyperinsulinemia. During follow‐up, we documented 295 MM‐related deaths among 345 total deaths. MM‐specific mortality was 15–24% lower per one standard deviation (SD) increase (e.g., toward healthier habits) in favorable dietary pattern scores. For example, the multivariable‐adjusted hazard ratio [HR] and 95% confidence interval [CI] per 1‐SD increase in AHEI‐2010 score were 0.76, 0.67–0.87 ( p < 0.001). In contrast, MM‐specific mortality was 16–24% higher per 1‐SD increase (e.g., toward less healthy habits) in "unhealthy" diet scores; for example, the multivariable‐adjusted HR, 95% CI per 1‐SD increase in Western pattern score were 1.24, 1.07–1.44 ( p = 0.005). Associations were similar for all‐cause mortality. In conclusion, our consistent findings for multiple dietary patterns provide the first evidence that MM patients with healthier prediagnosis dietary habits may have longer survival than those with less healthy diets. Abstract : What's new? Few previous studies have focused on non‐clinical factors that may influence survival of patients with multiple myeloma. This study included 423 multiple myeloma patients from two large cohort studies with diet data collected prior to diagnosis. Patients with healthier prediagnosis dietary habits, including diets previously associated with reduced inflammation and insulin resistance (which play a role in multiple myeloma), had lower multiple myeloma‐specific mortality and lower overall mortality.