Difference in Gastrointestinal Cancer Risk and Mortality by Dietary Pattern Analysis: A Systematic Review and Meta-Analysis

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dc.contributor.authorAbebe, Z.
dc.contributor.authorWassie, M.M.
dc.contributor.authorMekonnen, T.C.
dc.contributor.authorReynolds, A.C.
dc.contributor.authorMelaku, Y.A.
dc.date.issued2025
dc.descriptionPublished: 17 July 2024
dc.description.abstractCONTEXT: Several studies have demonstrated that dietary patterns identified by a posteriori and hybrid methods are associated with gastrointestinal (GI) cancer risk and mortality. These studies applied different methods for analyzing dietary data and reported inconsistent findings. OBJECTIVE: This systematic review and meta-analysis were aimed to determine the association between dietary patterns, derived using principal component analysis (PCA) and reduced rank regression (RRR), and GI cancer risk and GI cancer-caused mortality. DATA SOURCE: Articles published up to June 2023 in English were eligible for inclusion. The Medline, SCOPUS, Cochrane Library, CINHAL, PsycINFO, ProQuest, and Web of Sciences databases were used to identify prospective studies. The Preferred Reporting Item for Systematic Review and Meta-analysis Protocol 2020 was used to report results. DATA EXTRACTION: A total of 28 studies were eligible for inclusion. Varied approaches to deriving dietary patterns were used, including PCA (n = 22), RRR (n = 2), combined PCA and RRR (n = 1), cluster analysis (CA; n = 2) and combined PCA and CA (n = 1). DATA ANALYSIS: Two dietary patterns, "healthy" and "unhealthy," were derived using PCA and RRR. The healthy dietary pattern was characterized by a higher intake of fruits, whole grains, legumes, vegetables, milk, and other dairy products, whereas the unhealthy dietary pattern was characterized by a higher intake of red and processed meat, alcohol, and both refined and sugar-sweetened beverages. The findings indicated that the PCA-derived healthy dietary pattern was associated with an 8% reduced risk (relative risk [RR], 0.92; 95% CI, 0.87-0.98), and the unhealthy dietary pattern was associated with a 14% increased risk (RR, 1.14; 95% CI, 1.07-1.22) of GI cancers. Similarly, the RRR-derived healthy dietary pattern (RR, 0.83; 95% CI, 0.61-1.12) may be associated with reduced risk of GI cancers. In contrast, the RRR-derived unhealthy dietary pattern (RR, 0.93; 95% CI, 0.57-1.52) had no association with a reduced risk of GI cancers. Similarly, evidence suggested that PCA-derived healthy dietary patterns may reduce the risk of death from GI cancers, whereas PCA-derived unhealthy dietary patterns may increase the risk. CONCLUSION: Findings from prospective studies on the association of PCA-derived dietary patterns and the risk of GI cancers support the evidence of healthy and unhealthy dietary patterns as either protective or risk-increasing factors for GI cancers and for survivorship, respectively. The findings also suggest that the RRR-derived healthy dietary pattern reduces the risk of GI cancers (albeit with low precision), but no association was found for the RRR-derived unhealthy dietary pattern. Prospective studies are required to further clarify disparities in the association between PCA- and RRR-derived dietary patterns and the risk of GI cancers. Systematic review registration: PROSPERO registration no. CRD42022321644.
dc.description.statementofresponsibilityZegeye Abebe, Molla Mesele Wassie, Tefera Chane Mekonnen, Amy C. Reynolds, Yohannes Adama Melaku
dc.identifier.citationNutrition Reviews, 2025; 83(3):e991-e1013
dc.identifier.doi10.1093/nutrit/nuae090
dc.identifier.issn0029-6643
dc.identifier.issn1753-4887
dc.identifier.orcidMekonnen, T.C. [0000-0003-4680-3645]
dc.identifier.orcidMelaku, Y.A. [0000-0002-3051-7313]
dc.identifier.urihttps://hdl.handle.net/2440/143191
dc.language.isoen
dc.publisherOxford University Press
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/2009776
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/2009050
dc.rights© The Author(s) 2024. Published by Oxford University Press on behalf of the International Life Sciences Institute. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/ licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
dc.source.urihttp://dx.doi.org/10.1093/nutrit/nuae090
dc.subjectcolorectal cancer
dc.subjectdietary patterns
dc.subjectgastrointestinal
dc.subjectneoplasm
dc.subjectprincipal component analysis
dc.subjectreduced rank regression
dc.titleDifference in Gastrointestinal Cancer Risk and Mortality by Dietary Pattern Analysis: A Systematic Review and Meta-Analysis
dc.typeJournal article
pubs.publication-statusPublished

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