Korean Journal of Community Nutrition (대한지역사회영양학회지)

The Korean Society of Community Nutrition (대한지역사회영양학회)
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Association between Relative Preference for Vegetables and Meat and Cancer Incidence in Korean Adults: A Nationwide Population-based Retrospective Cohort Study

채소 및 육류 섭취의 상대적인 선호도와 암 발생의 연관성: 국민건강보험공단 국민건강정보자료 활용

  • Yie, Ga-Eun (Department of Food and Nutrition, College of Human Ecology, Seoul National University) ;
  • Kim, An Na (Department of Food and Nutrition, College of Human Ecology, Seoul National University) ;
  • Cho, Hyun Jeong (Department of Food and Nutrition, College of Human Ecology, Seoul National University) ;
  • Kang, Minji (BK21 FOUR Education and Research Team for Sustainable Food and Nutrition, Seoul National University) ;
  • Moon, Sungji (Department of Preventive Medicine, Seoul National University College of Medicine) ;
  • Kim, Inah (Department of Occupational and Environmental Medicine, Hanyang University) ;
  • Ko, Kwang-Pil (Clinical Preventive Medicine Center, Seoul National University Bundang Hospital) ;
  • Lee, Jung Eun (Department of Food and Nutrition, College of Human Ecology, Seoul National University) ;
  • Park, Sue K. (Department of Preventive Medicine, Seoul National University)
  • 이가은 (서울대학교 생활과학대학 식품영양학과) ;
  • 김안나 (서울대학교 생활과학대학 식품영양학과) ;
  • 조현정 (서울대학교 생활과학대학 식품영양학과) ;
  • 강민지 (서울대학교 4단계 BK21 지속가능 식품영양 교육연구팀) ;
  • 문성지 (서울대학교 의과대학 예방의학교실) ;
  • 김인아 (한양대학교 의과대학 직업환경의학교실) ;
  • 고광필 (분당서울대학교병원 임상예방의학센터) ;
  • 이정은 (서울대학교 생활과학대학 식품영양학과) ;
  • 박수경 (서울대학교 의과대학 예방의학교실)
  • Received : 2021.05.03
  • Accepted : 2021.06.23
  • Published : 2021.06.30
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Abstract

Objectives: We aimed to examine the association between the relative preference for vegetables and meat and cancer incidence, in a population-based retrospective cohort in Korea. Methods: We included 10,148,131 participants (5,794,124 men; 4,354,007 women) who underwent national health screening between 2004 and 2005 from the National Health Information Database of the National Health Insurance Service (NHIS-NHID). Participants were asked whether they preferred consuming 1) vegetables more often, 2) both vegetables and meat or 3) meat more often. Participants were followed up to Dec. 31, 2017. All cancer and eighteen common cancer cases were identified through the code from the International Classification of Diseases, 10th revision. We estimated sex-specific relative risks and 95% confidence intervals, adjusting for age, body mass index, alcohol consumption, smoking, physical activity, and income level. Results: During an average follow-up of 12.4 years, 714,170 cancer cases were documented. In men, consuming meat more often was associated with lower risk of esophageal, liver, and stomach cancers, but higher risk of lung and kidney cancers. Consuming both vegetables and meat was associated with higher risk of prostate cancer, but with lower risk of esophageal, liver, and stomach cancers in men. In women, consuming meat more often was associated with a higher risk of colorectal cancer and breast, endometrial, and cervical cancers diagnosed before the age of 50. Consuming both vegetables and meat was associated with lower risk of liver cancer in women. Conclusions: Our study suggests a potential link between vegetable and meat intake and cancer incidence in the Korean population. Further investigation on the association between the intake of specific types of vegetables and meat and cancer risk in Korean prospective cohort studies is needed.

Keywords

Acknowledgement

This study was funded by the Korean Foundation for Cancer Research (CB-2017-A-2). This study used NHIS- NHID data (NHIS-2019-1-495) made by National Health Insurance Service (NHIS). The authors declare no conflict of interest with NHIS.

References

  1. Hong S, Won YJ, Park YR, Jung KW, Kong HJ, Lee ES. Cancer Statistics in Korea: Incidence, mortality, survival, and prevalence in 2017. Cancer Res Treat Off J Korean Cancer Assoc 2020; 52(2): 335-350.
  2. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: Cancer J Clin 2018; 68(6): 394-424. https://doi.org/10.3322/caac.21492
  3. World Cancer Research Fund, American Institute for Cancer Research. Diet, nutrition, physical activity and cancer: A global perspective. Continuous Update Project Expert Report 2018 [internet]. WCRF/AICR; 2018 [cited 2020 Oct 13]. Available from: https://www.wcrf.org/dietandcancer.
  4. Wie GA, Cho YA, Kang HH, Ryu KA, Yoo MK, Kim YA et al. Red meat consumption is associated with an increased overall cancer risk: a prospective cohort study in Korea. Br J Nutr 2014; 112(2): 238-247. https://doi.org/10.1017/S0007114514000683
  5. Kim J, Park S, Nam BH. The risk of colorectal cancer is associated with the frequency of meat consumption in a population-based cohort in Korea. Asian Pac J Cancer Prev 2011; 12(9): 2371-2376.
  6. Shin A, Joo J, Yang HR, Bak J, Park Y, Kim J et al. Risk prediction model for colorectal cancer: National Health Insurance Corporation study, Korea. PloS one 2014; 9(2): e88079. https://doi.org/10.1371/journal.pone.0088079
  7. Kim SH, Kim S, Joung JY, Kwon WA, Seo HK, Chung J et al. Lifestyle risk prediction model for prostate cancer in a Korean population. Cancer Res Treat Off J Korean Cancer Assoc 2018; 50(4): 1194-1202.
  8. Yun YH, Lim MK, Won YJ, Park SM, Chang YJ, Oh SW et al. Dietary preference, physical activity, and cancer risk in men: National health insurance corporation study. BMC Cancer 2008; 8(1): 366. https://doi.org/10.1186/1471-2407-8-366
  9. National Health Insurance Sharing Service. National health insurance data sharing service [internet]. National Health Insurance Service; 2019 [cited 2020 Oct 13]. Available from: https://nhiss.nhis.or.kr/bd/ay/bdaya001iv.do.
  10. Lee YH, Han K, Ko SH, Ko KS, Lee KU. Data analytic process of a nationwide population-based study using national health information database established by National Health Insurance Service. Diabetes Metab J 2016; 40(1): 79-82. https://doi.org/10.4093/dmj.2016.40.1.79
  11. Cox DR. Regression models and life-tables. J R Stat Soc Ser B 1972; 34(2): 187-202.
  12. Park CY, Lim JY, Park HY. Age at natural menopause in Koreans: Secular trends and influences thereon. Menopause 2018; 25(4): 423-429. https://doi.org/10.1097/GME.0000000000001019
  13. Daniel CR, Cross AJ, Graubard BI, Park Y, Ward MH, Rothman N et al. Large prospective investigation of meat intake, related mutagens, and risk of renal cell carcinoma. Am J Clin Nutr 2012; 95(1): 155-162. https://doi.org/10.3945/ajcn.111.019364
  14. Liu J, Wang J, Leng Y, Lv C. Intake of fruit and vegetables and risk of esophageal squamous cell carcinoma: A meta-analysis of observational studies. Int J Cancer 2013; 133(2): 473-485. https://doi.org/10.1002/ijc.28024
  15. Wang Q, Chen Y, Wang X, Gong G, Li G, Li C. Consumption of fruit, but not vegetables, may reduce risk of gastric cancer: Results from a meta-analysis of cohort studies. Eur J Cancer 2014; 50(8): 1498-1509. https://doi.org/10.1016/j.ejca.2014.02.009
  16. Islami F, Ren J, Taylor P, Kamangar F. Pickled vegetables and the risk of oesophageal cancer: A meta-analysis. Br J Cancer 2009; 101(9): 1641-1647. https://doi.org/10.1038/sj.bjc.6605372
  17. Song DY, Park JE, Shim JE, Lee JE. Trends in the major dish groups and food groups contributing to sodium intake in the Korea National Health and Nutrition Examination Survey 1998-2010. J Nutr Health 2013; 46(1): 72-85. https://doi.org/10.4163/kjn.2013.46.1.72
  18. Kim EK, Ha AW, Choi EO, Ju SY. Analysis of Kimchi, vegetable and fruit consumption trends among Korean adults: Data from the Korea National Health and Nutrition Examination Survey (1998-2012). Nutr Res Pract 2016; 10(2): 188-197. https://doi.org/10.4162/nrp.2016.10.2.188
  19. Ma Y, Yang W, Simon TG, Smith-Warner SA, Fung TT, Sui J et al. Dietary patterns and risk of hepatocellular carcinoma among US men and women. Hepatology 2019; 70(2): 577-586. https://doi.org/10.1002/hep.30362
  20. Sun M, Cui H, Liang M, Wang W, Wang Y, Liu X et al. Perceived dietary salt intake and the risk of primary liver cancer: A population-based prospective study. J Hum Nutr Diet 2020; 33(6): 833-840. https://doi.org/10.1111/jhn.12761
  21. van den Berg EH, Gruppen EG, Blokzijl H, Bakker SJ, Dullaart RP. Higher sodium intake assessed by 24 hour urinary sodium excretion is associated with non-alcoholic fatty liver disease: The PREVEND cohort study. J Clin Med 2019; 8(12): 2157. https://doi.org/10.3390/jcm8122157
  22. Choi Y, Lee JE, Chang Y, Kim MK, Sung E, Shin H et al. Dietary sodium and potassium intake in relation to non-alcoholic fatty liver disease. Br J Nutr 2016; 116(8): 1447-1456. https://doi.org/10.1017/S0007114516003391
  23. Kim BH, Park JW. Epidemiology of liver cancer in South Korea. Clin Mol Hepatol 2018; 24(1): 1-9. https://doi.org/10.3350/cmh.2017.0112
  24. Tasevska N, Sinha R, Kipnis V, Subar AF, Leitzmann MF, Hollenbeck AR et al. A prospective study of meat, cooking methods, meat mutagens, heme iron, and lung cancer risks. Am J Clin Nutr 2009; 89(6): 1884-1894. https://doi.org/10.3945/ajcn.2008.27272
  25. Koo S, Park K. The association between consumption of processed meat and prevalence of metabolic syndrome among Korean adults: Based on 2007-2008 Korean national health and nutrition examination survey. J Nutr Health 2011; 44(5): 406-415. https://doi.org/10.4163/kjn.2011.44.5.406
  26. Lin M, Lucas Jr HC, Shmueli G. Research commentary-too big to fail: Large samples and the p-value problem. Inf Syst Res 2013; 24(4): 906-917. https://doi.org/10.1287/isre.2013.0480