Skip to main content
Log in

Dietary fiber and grain consumption in relation to head and neck cancer in the NIH-AARP Diet and Health Study

  • Original paper
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Abstract

Background

Dietary fiber and grain consumption may reduce the risk of head and neck cancer; however, the epidemiological evidence is limited. We investigated this relationship in the National Institutes of Health (NIH)-AARP Diet and Health Study.

Methods

Cox proportional hazards models were used to calculate multivariable hazard ratios (HR) and 95% confidence intervals (CI) to investigate dietary fiber and grain intake in relation to head and neck cancer.

Results

During approximately 11 years of follow-up, 1,867 (401 women/1,466 men) cases of head and neck cancer were diagnosed. Our data indicated that the relationship between fiber and grain intake and head and neck cancer is modified by sex (p-interactions < 0.001 and 0.001, respectively). Women with higher intake of total fiber and total grains had a lower risk of head and neck cancer (HR10g/day = 0.77, 95% CI = 0.64–0.93; HRserving/1,000kcal = 0.89, 95% CI = 0.80–0.99, respectively); this inverse relation was consistent across subtypes of fiber and grains. Conversely in men, the inverse associations were weaker and nonsignificant.

Conclusions

In the largest prospective cohort study to investigate this relation to date, intake of total fiber and grain foods was inversely associated with head and neck cancer incidence among women, but not among men.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Rhys Evans P, Montgomery P, Gullane P (2003) Principles and practice of head and neck oncology. Martin Dunitz, London

    Google Scholar 

  2. Parkin DM, Bray F, Ferlay J, Pisani P (2005) Global cancer statistics, 2002. CA Cancer J Clin 55:74–108

    Article  PubMed  Google Scholar 

  3. Jemal A, Siegel R, Ward E (2009) Cancer statistics, 2009. CA Cancer J Clin 59:225–249

    Article  PubMed  Google Scholar 

  4. Sturgis EM, Wei Q, Spitz MR (2004) Descriptive epidemiology and risk factors for head and neck cancer. Semin Oncol 31:726–733

    Article  PubMed  Google Scholar 

  5. Chyou PH, Nomura AM, Stemmermann GN (1995) Diet, alcohol, smoking and cancer of the upper aerodigestive tract: a prospective study among Hawaii Japanese men. Int J Cancer 60:616–621

    Article  PubMed  CAS  Google Scholar 

  6. Kjaerheim K, Gaard M, Andersen A (1998) The role of alcohol, tobacco, and dietary factors in upper aerogastric tract cancers: a prospective study of 10,900 Norwegian men. Cancer Causes Control 9:99–108

    Article  PubMed  CAS  Google Scholar 

  7. Kasum CM, Jacobs DR Jr, Nicodemus K, Folsom AR (2002) Dietary risk factors for upper aerodigestive tract cancers. Int J Cancer 99:267–272

    Article  PubMed  CAS  Google Scholar 

  8. Boeing H, Dietrich T, Hoffmann K (2006) Intake of fruits and vegetables and risk of cancer of the upper aero-digestive tract: the prospective EPIC-study. Cancer Causes Control 17:957–969

    Article  PubMed  Google Scholar 

  9. Freedman ND, Park Y, Subar AF (2007) Fruit and vegetable intake and head and neck cancer risk in a large United States prospective cohort study. Int J Cancer 121:2753–2760

    Google Scholar 

  10. World Cancer Research Fund/American Institute for Cancer Research (2007) Food, nutrition, physical activity, and the prevention of cancer: a global perspective. AICR, Washington

    Google Scholar 

  11. La Vecchia C, Tavani A (1998) Fruit and vegetables, and human cancer. Eur J Cancer Prev 7:3–8

    Article  PubMed  CAS  Google Scholar 

  12. Riboli E, Kaaks R, Esteve J (1996) Nutrition and laryngeal cancer. Cancer Causes Control 7:147–156

    Article  PubMed  CAS  Google Scholar 

  13. Garavello W, Lucenteforte E, Bosetti C, La Vecchia C (2009) The role of foods and nutrients on oral and pharyngeal cancer risk. Minerva Stomatol 58:25–34

    PubMed  CAS  Google Scholar 

  14. Levi F, Pasche C, Lucchini F (2000) Refined and whole grain cereals and the risk of oral, oesophageal and laryngeal cancer. Eur J Clin Nutr 54:487–489

    Article  PubMed  CAS  Google Scholar 

  15. Chatenoud L, Tavani A, La Vecchia C (1998) Whole grain food intake and cancer risk. Int J Cancer 77:24–28

    Article  PubMed  CAS  Google Scholar 

  16. McLaughlin JK, Gridley G, Block G (1988) Dietary factors in oral and pharyngeal cancer. J Natl Cancer Inst 80:1237–1243

    Article  PubMed  CAS  Google Scholar 

  17. De Stefani E, Ronco A, Mendilaharsu M, Deneo-Pellegrini H (1999) Diet and risk of cancer of the upper aerodigestive tract–II. Nutrients. Oral Oncol 35:22–26

    Article  PubMed  Google Scholar 

  18. Pelucchi C, Talamini R, Levi F (2003) Fibre intake and laryngeal cancer risk. Ann Oncol 14:162–167

    Article  PubMed  CAS  Google Scholar 

  19. Soler M, Bosetti C, Franceschi S (2001) Fiber intake and the risk of oral, pharyngeal and esophageal cancer. Int J Cancer 91:283–287

    Article  PubMed  CAS  Google Scholar 

  20. Lucenteforte E, Garavello W, Bosetti C, La Vecchia C (2009) Dietary factors and oral and pharyngeal cancer risk. Oral Oncol 45:461–467

    Article  PubMed  CAS  Google Scholar 

  21. La Vecchia C, Chatenoud L, Negri E, Franceschi S (2003) Session: whole cereal grains, fibre and human cancer wholegrain cereals and cancer in Italy. Proc Nutr Soc 62:45–49

    Article  PubMed  Google Scholar 

  22. Chatenoud L, La Vecchia C, Franceschi S (1999) Refined-cereal intake and risk of selected cancers in Italy. Am J Clin Nutr 70:1107–1110

    PubMed  CAS  Google Scholar 

  23. Franceschi S, Barra S, La Vecchia C (1992) Risk factors for cancer of the tongue and the mouth. A case–control study from northern Italy. Cancer 70:2227–2233

    Article  PubMed  CAS  Google Scholar 

  24. Schatzkin A, Subar AF, Thompson FE (2001) Design and serendipity in establishing a large cohort with wide dietary intake distributions : the National Institutes of Health-American Association of Retired Persons Diet and Health Study. Am J Epidemiol 154:1119–1125

    Article  PubMed  CAS  Google Scholar 

  25. Fritz A (2000) International classification of diseases for oncology: ICD-O. World Health Organization, Geneva

    Google Scholar 

  26. Freedman ND, Schatzkin A, Leitzmann MF, Hollenbeck AR, Abnet CC (2007) Alcohol and head and neck cancer risk in a prospective study. Br J Cancer 96:1469–1474

    PubMed  CAS  Google Scholar 

  27. Subar AF, Midthune D, Kulldorff M (2000) Evaluation of alternative approaches to assign nutrient values to food groups in food frequency questionnaires. Am J Epidemiol 152:279–286

    Article  PubMed  CAS  Google Scholar 

  28. Tippett K (1997) Design and operation: the continuing survey of food intakes by individuals and diet and health knowledge survey, 1994–1996. Continuing survey of food intakes by individuals, nationwide food surveys. US Department of Agriculture, Agricultural Research Service, Washington

    Google Scholar 

  29. Prosky L, Asp NG, Furda I (1985) Determination of total dietary fiber in foods and food products: collaborative study. J Assoc Off Anal Chem 68:677–679

    PubMed  CAS  Google Scholar 

  30. Friday JE, Bowman SA (2006) MyPyramid equivalents database for USDA survey food codes, 1994–2002. USDA, ARS, Community Nutrition Research Group, Beltsville, MD

  31. Thompson FE, Kipnis V, Midthune D (2008) Performance of a food-frequency questionnaire in the US NIH-AARP (National Institutes of Health-American Association of Retired Persons) Diet and Health Study. Public Health Nutr 11:183–195

    PubMed  Google Scholar 

  32. Willett W, Stampfer MJ (1986) Total energy intake: implications for epidemiologic analyses. Am J Epidemiol 124:17–27

    PubMed  CAS  Google Scholar 

  33. Uzcudun AE, Retolaza IR, Fernandez PB (2002) Nutrition and pharyngeal cancer: results from a case-control study in Spain. Head Neck 24:830–840

    Article  PubMed  Google Scholar 

  34. Franceschi S, Bidoli E, Baron AE (1991) Nutrition and cancer of the oral cavity and pharynx in north-east Italy. Int J Cancer 47:20–25

    Article  PubMed  CAS  Google Scholar 

  35. De Stefani E, Deneo-Pellegrini H, Mendilaharsu M, Ronco A (1999) Diet and risk of cancer of the upper aerodigestive tract–I. Foods. Oral Oncol 35:17–21

    Article  PubMed  Google Scholar 

  36. Moller ME, Dahl R, Bockman OC (1988) A possible role of the dietary fibre product, wheat bran, as a nitrite scavenger. Food Chem Toxicol 26:841–845

    Article  PubMed  CAS  Google Scholar 

  37. Fardet A New hypotheses for the health-protective mechanisms of whole-grain cereals: what is beyond fibre? Nutr Res Rev 23:65–134

  38. Maras JE, Newby PK, Bakun PJ, Ferrucci L, Tucker KL (2009) Whole grain intake: the Baltimore longitudinal study of aging. J Food Compost Anal 22:53–58

    Article  PubMed  Google Scholar 

  39. Slavin JL (2000) Mechanisms for the impact of whole grain foods on cancer risk. J Am Coll Nutr 19:300S–307S

    PubMed  CAS  Google Scholar 

  40. Fernandez E, Gallus S, La Vecchia C (2006) Nutrition and cancer risk: an overview. J Br Menopause Soc 12:139–142

    Article  PubMed  Google Scholar 

  41. Edefonti V, Bravi F, La Vecchia C Nutrient-based dietary patterns and the risk of oral and pharyngeal cancer. Oral Oncol 46:343–348

  42. Slavin JL (2000) Whole grains, refined grains and fortified refined grains: what’s the difference? Asia Pacific J Clin Nutr 9:S23–S27

    Google Scholar 

  43. Freedman ND, Abnet CC, Leitzmann MF, Hollenbeck AR, Schatzkin A (2007) Prospective investigation of the cigarette smoking-head and neck cancer association by sex. Cancer 110:1593–1601

    Article  PubMed  Google Scholar 

  44. Yoo HJ, Sepkovic DW, Bradlow HL (2001) Estrogen metabolism as a risk factor for head and neck cancer. Otolaryngol Head Neck Surg 124:241–247

    Article  PubMed  CAS  Google Scholar 

  45. Lukits J, Remenar E, Raso E (2007) Molecular identification, expression and prognostic role of estrogen- and progesterone receptors in head and neck cancer. Int J Oncol 30:155–160

    PubMed  CAS  Google Scholar 

  46. Ferguson BJ, Hudson WR, McCarty KS Jr (1987) Sex steroid receptor distribution in the human larynx and laryngeal carcinoma. Arch Otolaryngol Head Neck Surg 113:1311–1315

    PubMed  CAS  Google Scholar 

  47. Freedman ND, Lacey JV Jr, Hollenbeck AR (2007) The association of menstrual and reproductive factors with upper gastrointestinal tract cancers in the NIH-AARP cohort. Cancer 116:1572–1581

    Article  Google Scholar 

  48. Kuiper GG, Lemmen JG, Carlsson B (1998) Interaction of estrogenic chemicals and phytoestrogens with estrogen receptor beta. Endocrinology 139:4252–4263

    Article  PubMed  CAS  Google Scholar 

  49. Adlercreutz H (2007) Lignans and human health. Crit Rev Clin Lab Sci 44:483–525

    Article  PubMed  CAS  Google Scholar 

  50. Hennessey PT, Westra WH, Califano JA (2009) Human papillomavirus and head and neck squamous cell carcinoma: recent evidence and clinical implications. J Dent Res 88:300–306

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

This research was supported [in part] by the Intramural Research Program of the NIH, National Cancer Institute. Cancer incidence data from the Atlanta metropolitan area were collected by the Georgia Center for Cancer Statistics, Department of Epidemiology, Rollins School of Public Health, Emory University. Cancer incidence data from California were collected by the California Department of Health Services, Cancer Surveillance Section. Cancer incidence data from the Detroit metropolitan area were collected by the Michigan Cancer Surveillance Program, Community Health Administration, State of Michigan. The Florida cancer incidence data used in this report were collected by the Florida Cancer Data System (FCDC) under contract with the Florida Department of Health (FDOH). The views expressed herein are solely those of the authors and do not necessarily reflect those of the FCDC or FDOH. Cancer incidence data from Louisiana were collected by the Louisiana Tumor Registry, Louisiana State University Medical Center in New Orleans. Cancer incidence data from New Jersey were collected by the New Jersey State Cancer Registry, Cancer Epidemiology Services, New Jersey State Department of Health and Senior Services. Cancer incidence data from North Carolina were collected by the North Carolina Central Cancer Registry. Cancer incidence data from Pennsylvania were supplied by the Division of Health Statistics and Research, Pennsylvania Department of Health, Harrisburg, Pennsylvania. The Pennsylvania Department of Health specifically disclaims responsibility for any analyses, interpretations, or conclusions. Cancer incidence data from Arizona were collected by the Arizona Cancer Registry, Division of Public Health Services, Arizona Department of Health Services. Cancer incidence data from Texas were collected by the Texas Cancer Registry, Cancer Epidemiology and Surveillance Branch, Texas Department of State Health Services. We are indebted to the participants in the NIH-AARP Diet and Health Study for their outstanding cooperation. We also thank Sigurd Hermansen and Kerry Grace Morrissey from Westat for study outcomes ascertainment and management and Leslie Carroll at Information Management Services for data support and analysis.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Tram Kim Lam.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lam, T.K., Cross, A.J., Freedman, N. et al. Dietary fiber and grain consumption in relation to head and neck cancer in the NIH-AARP Diet and Health Study. Cancer Causes Control 22, 1405–1414 (2011). https://doi.org/10.1007/s10552-011-9813-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10552-011-9813-9

Keywords

Navigation