Case-Control Study of Dietary Patterns and Endometrial Cancer Risk

Dietary patterns, rather than intakes of specific foods or nutrients, may influence risk of endometrial cancer (EC). This population-based case-control study in Canada (2002–2006) included incident EC cases (n = 506) from the Alberta Cancer Registry and controls frequency age-matched to cases (n = 981). Past-year dietary patterns were defined using factor analysis of food frequency questionnaire data. Logistic regression was used to estimate EC risk within quartiles of dietary patterns. Three patterns (sweets, meat, plants) explained 23% of the variance in the dietary data. In multivariable models, EC risk was significantly reduced by 30% for women in the highest quartile of the healthier plants pattern (OR = 0.70, 95% CI 0.50–0.98, P trend = 0.02). When stratified by body mass index (BMI; kg/m²), risk was further reduced among overweight or obese women with a BMI ≥25 (OR = 0.57, 95% CI 0.39–0.83; P trend = 0.004). EC was not associated with the less healthy sweets and meat patterns. However, risk was modestly, but not significantly, elevated for higher intakes of the meat pattern among overweight or obese women. A mostly plant-based dietary pattern may reduce EC risk. Recommendations for risk reduction should focus on maintaining a healthy weight and the role of diet should be studied further.     

Dietary Polyamines Intake and Risk of Colorectal Cancer: A Case-Control Study

Polyamines (including putrescine, spermidine, and spermine) are small, cationic molecules that are necessary for cell proliferation and differentiation. Few studies have examined the association of dietary polyamines intake with colorectal cancer risk. The aim of this study was to evaluate total polyamines, putrescine, spermidine, and spermine intake in relation to colorectal cancer risk in China. In total, 2502 colorectal cancer cases and 2538 age-(5-year interval) and sex-matched controls were recruited from July 2010 to April 2019. Odds ratios (ORs) and 95% confidence intervals (CI) were calculated by multivariable unconditional logistic regression after adjustment for various potential confounding factors. Higher intake of total polyamine, putrescine and spermidine was significantly associated with reduced risk of colorectal cancer. The adjusted ORs for the highest compared with the lowest quartile of intake were 0.60 (95% CI 0.50, 0.72; P_trend < 0.001) for total polyamines, 0.35 (95% CI 0.29, 0.43; P_trend < 0.001) for putrescine and 0.79 (95% CI 0.66, 0.95; P_trend = 0.001) for spermidine, respectively. However, higher intake of spermine was associated with increased risk of colorectal cancer, with an adjusted OR of 1.58 (95% CI 1.29, 1.93; P_trend < 0.001). This data indicate that higher intake of total polyamines, putrescine and spermidine, as well as lower intake of spermine, is associated with a decreased risk of colorectal cancer.     

Dairy Products,Calcium Intake,and Breast Cancer Risk: A Case-Control Study in China

The results of dairy food consumption and breast cancer risk are conflicting, and their relationship has not previously been studied in China. The objective of this study is to examine the association between dairy products, calcium intake, and breast cancer risk among Chinese women. A hospital-based case-control study was conducted among Chinese women in the Guangdong province from June 2007 to August 2008. Four hundred and thirty-eight consecutively recruited cases with primary breast cancer were frequency-matched to 438 controls on age and residence. Dietary intake information was collected by interviewers using a validated food frequency questionnaire. Odds ratios (ORs) and 95% confidence interval (CI) were estimated using unconditional multiple logistic regression adjusted for various potential confounders. We observed a statistically significant inverse association of dietary calcium intake with breast cancer risk, with the adjusted OR (95% CI) of 0.35 (0.22–0.56) comparing the highest with the lowest quartile. No significant association was found between dairy products measured either by dry weight of dairy product or dairy product protein intake and breast cancer risk. Our study supports a protective effect of high intake of dietary calcium on breast cancer risk, and no association with dairy product intake.     

Folate Intake and Prostate Cancer Risk: A Case-Control Study

Folate deficiency has been implicated in the carcinogenesis of several tumor types. The role of folate in prostate cancer remains indeterminate. We investigated folate as a risk factor for prostate cancer among 140 biopsy-confirmed prostate cancer patients, 230 age-matched clinic controls, and 250 negative prostate biopsy controls. Dietary folate intake was inversely associated with overall risk of prostate cancer as compared to clinic controls (P for a linear trend = 0.003). When stratified by disease severity, dietary folate and folate from natural sources were associated with reduced risk of high-grade cancer as compared to both clinic controls (P for a linear trend = 0.0009 and 0.02, respectively) and biopsy negative controls (P for a linear trend = 0.03 and 0.05, respectively). There was no interaction between alcohol consumption and folate intake. These analyses support an inverse association between dietary folate intake and prostate cancer risk and primarily risk of high-grade prostate cancer.     

Dietary Acrylamide and the Risk of Endometrial Cancer: An Italian Case-Control

The role of dietary acrylamide on the risk of hormone-related, and specifically endometrial, cancers is debated. Epidemiological data are scanty. Thus, we examined the relation between acrylamide intake and endometrial cancer risk in a case-control study conducted between 1992 and 2006 in 3 Italian areas. Cases were 454 women with incident, histologically confirmed endometrial cancer. Controls were 908 age-matched women admitted to the same network of hospitals of cases for acute, non-neoplastic conditions. We calculated multivariate odds ratios (OR) and 95% confidence intervals (CI) using logistic regression models. The OR of endometrial cancer for increasing quintiles of dietary acrylamide, as compared to the lowest one, were 1.02 (95% CI: 0.67–1.54), 1.20 (95% CI: 0.80–1.80), 1.00 (95% CI: 0.65–1.54) and 1.17 (95% CI: 0.73–1.85). The OR for an increase of 10 μg/day of dietary acrylamide was 1.00 (95% CI: 0.91–1.10). In subgroup analyses, the ORs for high vs. low acrylamide intake were 1.28 (95% CI: 0.73–2.25) in never smokers and 1.14 (95% CI: 0.45–2.90) in ever smokers. Our data do not support an association between dietary acrylamide intake and endometrial cancer.     

Urinary Isothiocyanates Level and Liver Cancer Risk: A Nested Case-Control Study in Shanghai,China

Experimental studies have provided evidence that isothiocyanates (ITCs) from cruciferous vegetables may modulate carcinogen metabolism and facilitate carcinogen detoxification and reduce cancer risk. However, no epidemiological studies on liver cancer were reported. This study investigates the association between urinary ITCs levels and liver cancer risk among men and women in Shanghai, China. A nested case-control study of 217 incident cases of liver cancer and 427 matched controls identified from the Shanghai Women's Health Study and Shanghai Men's Health Study was conducted. Conditional logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) summarizing the association between urinary ITCs levels and liver cancer risk. Compared to those with undetectable ITCs, nonsignificantly inverse association was observed among detectable (OR = 0.80; 95% CI = 0.51–1.26), below-median (OR = 0.76; 95% CI = 0.47–1.24), and above-median concentration (OR = 0.86; 95% CI = 0.52–1.41) with liver cancer risk. Similar patterns were observed when urinary ITCs levels were categorized into tertiles or quartiles. Although our study firstly focused on the association between urinary ITCs exposure and liver cancer risk, we did not find significant results. Future multicenter prospective, different population studies are warranted to validate our findings.     

Dietary Intake and Serum Level of Carotenoids in Lung Cancer Patients: A Case-Control Study

The aim of this study was to compare the dietary intake and serum levels of some selected carotenoids of lung cancer patients with healthy subjects. Thirty-five lung cancer patients and 33 healthy people were enrolled into this case-control study. Daily intake of nutrients was estimated using a semiquantitative food frequency questionnaire and a 3-day 24-h food recall questionnaire. The concentration of serum beta-carotene and lycopene were analyzed using a high performance liquid chromatography method. Case and control groups did not differ by the means of age, gender, smoking habits, weight, body mass index, mean daily energy intake, mean daily fat intake, and the percentage of daily energy provided by fat to total daily energy intake. The beta-carotene and lycopene intake of the case subjects was 96% and 195% greater than that of the control subjects. Daily intake of fruits and vegetables in the cancer group was higher than the control group. However, the serum concentration of 118% beta-carotene and 60% lycopene were higher in the control group. Despite a higher daily dietary intake of beta-carotene and lycopene by lung cancer patients, serum beta-carotene and lycopene concentrations were significantly lower than the group without cancer.     

Dietary Vitamin D and Calcium Intake and Premenopausal Breast Cancer Risk in a German Case-Control Study

Epidemiological studies and laboratory data suggest that vitamin D may protect against the development of cancer, including breast cancer. Vitamin D supply affects the bioavailability of dietary calcium, which might also have anticarcinogenic effects. However, few studies considered them jointly. We used a population-based case-control study in Germany to examine the independent and joint effects of dietary vitamin D and calcium on premenopausal breast cancer risk. Dietary information was assessed using a validated food frequency questionnaire from 278 premenopausal cases and 666 age-matched controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multivariate models adjusting vitamin D models for calcium intake and vice versa. Breast cancer risk was significantly inversely associated with vitamin D intake. The OR and 95% CI for the highest intake category (≥ 5 μ g/day) was 0.50 (95% CI = 0.26–0.96) compared with the lowest (< 2 μ g/day; P_trend = 0.02). Dietary calcium intake was not associated with breast cancer (OR = 0.73, 95% CI = 0.41–1.29) for the highest (≥ 1,300 mg/day) versus the lowest category (< 700 mg/day), P_trend = 0.29). No statistically significant interaction between the 2 nutrients was observed. Our data support a protective effect of dietary vitamin D on premenopausal breast cancer risk independent of dietary calcium intake.     

Red Meat-Derived Heterocyclic Amines Increase Risk of Colon Cancer: A Population-Based Case-Control Study

Formation of mutagenic heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAHs) is one pathway believed to drive the association of colon cancer with meat consumption. Limited data exist on the associations of individual HCAs and PAHs in red or white meat with colon cancer. Analyzing data from a validated meat preparation questionnaire completed by 1062 incident colon cancer cases and 1645 population controls from an ongoing case-control study, risks of colon cancer were estimated using unconditional logistic regression models, comparing the fourth to the first quartile of mutagen estimates derived from a CHARRED based food frequency questionnaire. Total dietary intake of 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline (MeIQx) [adjusted odds ratio (aOR) = 1.87, 95% confidence interval (CI) = 1.44–2.44, P _trend < 0.0001], 2-amino-3,4,8-trimethylimidazo[4,5-f]quinoxaline (DiMeIQx) (aOR = 1.68, 95% CI = 1.29–2.17, P _trend = 0.001) and meat-derived mutagenic activity (aOR = 1.77, 95% CI = 1.36–2.30, P _trend < 0.0001) were statistically significantly associated with colon cancer risk. Meat type specific analyses revealed statistically significant associations for red meat-derived MeIQx, DiMeIQx, and mutagenic activity but not for the same mutagens derived from white meat. Our study adds evidence supporting red meat-derived, but not white-meat derived HCAs and PAHs, as an important pathway for environmental colon cancer carcinogenesis.     

Macronutrients Intake and Risk of Stomach Cancer: Findings from Case-Control Study

Studies on the association between gastric cancer (GC) and the intake of nutrients in Jordan are very limited, while findings from other reports on the intake of energy and macronutrients are controversial. This study aimed to examine the associations between intake of energy and macronutrients and the risk of GC in a Jordanian population. A case-control study was carried out between March 2015 and August 2018 in four major hospitals, including an oncology center in Jordan. Study participants were 173 cases with incident and histologically confirmed GC and 314 frequency-matched controls. Interview-based questionnaires were used to obtain the study’s information. Data on nutrient intake were collected using a validated Arabic food-frequency questionnaire (FFQ). Odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) were calculated through multinomial logistic regression and adjusted for potential confounders, including age, marital status, education, body mass index (BMI), smoking, period of smoking, family history of gastric cancer, history of gastric ulcer, and physical activity. Intakes of total fat, saturated fat, monounsaturated fat, polyunsaturated fat, cholesterol, trans-fat, and omega-6 fatty acids were significantly associated with increased risk of GC. The ORs for the highest versus the lowest tertiles were 6.47 (95% Cl: 3.29–12.77), 2.97 (95% CI: 1.58–5.58), 6.84 (95% CI: 3.46–13.52), 6.19 (95% CI: 3.15–12.17), 3.05 (95% CI: 1.58–5.88), 8.11 (95% CI: 4.20–15.69), and 2.74 (95% CI: 1.47–5.09), respectively. No significant association was found for energy, protein, carbohydrate, sugar, fibers, and omega-3 fatty acids. The findings of this study suggest that high intake of selected types of fats was associated with an increased risk of GC.     

Association between Dietary Fatty Acid Patterns and Colorectal Cancer Risk: A Large-Scale Case-Control Study in China

Associations of dietary fatty acids with the risk of colorectal cancer (CRC) remain controversial. The objective of this study was to examine whether dietary-derived fatty acid patterns were related to CRC risk among Chinese people. A total of 2806 CRC patients and 2806 frequency-matched controls were interviewed in this case-control study between July 2010 and May 2021. A food frequency questionnaire was used to gather information on dietary intake. Four fatty acid patterns were identified using factor analysis. The even-long-chain fatty acid pattern had no statistically significant association with CRC risk (adjusted Odds ratio (aOR), 1.16; 95% confidence interval (CI), 0.97–1.39; p_trend = 0.129). However, significant inverse associations were found between the medium-chain and long-chain saturated fatty acid (SFA) pattern (aOR, 0.34; 95%CI, 0.27–0.42), the highly unsaturated fatty acid pattern (aOR, 0.73; 95%CI, 0.60–0.88), the odd-chain fatty acid pattern (aOR, 0.69; 95%CI, 0.57–0.83), and CRC risk. The interaction between fatty acid patterns and sex was observed, and the association between the highly unsaturated fatty acid pattern and CRC risk differed by subsite. In conclusion, increasing the intakes of foods rich in medium-chain SFAs, highly unsaturated fatty acids, and odd-chain fatty acids may be related to a lower risk of CRC.     

Nitrate Intake Relative to Antioxidant Vitamin Intake Affects Gastric Cancer Risk: A Case-Control Study in Korea

The objective of this study was to determine whether the intake of nitrate relative to antioxidant vitamin rather than absolute intake of nitrate affects the risk of gastric cancer (GC). In a case-control study in Korea using a food frequency questionnaire, trained dietitians interviewed 136 GC cases and an equal number of controls matched by sex and age. As an index of nitrate intake relative to antioxidant vitamins intake, we calculated the nitrate:antioxidant vitamin consumption ratio. The mean daily nitrate intake from foods was very high in our subjects. Higher absolute intake of nitrate was not associated with GC risk [odds ratios (OR) = 1.13; 95% confidence interval (CI) = 0.42–3.06]. However, the GC risk distinctly increased as the nitrate:antioxidant vitamin consumption ratio increased, particularly with higher nitrate:vitamin E (OR = 2.78; 95% CI = 1.01–7.67) and nitrate:folate ratios (OR = 3.37; 95% CI = 1.28–8.87). Therefore, GC risk was influenced by the intake of nitrate relative to antioxidant vitamins. Our results suggest that a decrease in the intake of nitrate relative to antioxidant vitamins is considerably more effective in reducing GC risk than either a lower absolute intake of nitrate or a higher intake of antioxidant vitamins alone.     

Dietary Patterns and Risk of Pancreatic Cancer in a Large Population-Based Case-Control Study in the San Francisco Bay Area

Pancreatic cancer is highly lethal, and identifying modifiable risk factors could have substantial public health impact. In this population-based case-control study (532 cases, 1701 controls), we used principal component analysis and multivariable unconditional logistic regression models to examine whether a particular dietary pattern was associated with risk of pancreatic cancer, adjusting for other known risk factors. A prudent dietary pattern, characterized by greater intake of vegetables, fruit, fish, poultry, whole grains, and low-fat dairy, was associated with an approximate 50% reduction in pancreatic cancer risk among men [odds ratio (OR) = 0.51, 95% confidence intervals (CI) = 0.31–0.84, P trend = 0.001] and women (OR = 0.51, 95% CI = 0.29–0.90, P trend = 0.04). A Western dietary pattern, characterized by higher intake of red and processed meats, potato chips, sugary beverages, sweets, high fat dairy, eggs, and refined grains, was associated with a 2.4-fold increased risk of pancreatic cancer among men (95% CI = 1.3–4.2, P trend = 0.008) but was not associated with risk among women. Among men, those in the upper quintiles of the Western diet and lower quintiles of the prudent diet had a threefold increased risk. Consistent with what has been recommended for several other chronic diseases, consuming a diet rich in plant-based foods, whole grains, and white meat, might reduce risk of pancreatic cancer.     

Environmental and Dietary Factors and Lung Cancer Risk Among Chinese Women: A Case-Control Study in Southeast China

After decades of increase, lung cancer has become the leading cause of cancer death among women. The mortality rate from lung cancer is ascending at a relatively steady rate, which has greatly affected the health of the female population and become a serious issue. A case-control study of 226 female lung cancer cases and 269 controls was conducted from 2006 to 2010 in Fujian Province. A structured questionnaire was used to gather information on demographic characteristics as well as dietary and environmental factors. Odds ratios and 95% confidence intervals were estimated by using univariate logistic regression. Multivariate unconditional logistic regression analysis was applied to evaluate the potential interactions of variables or confounders. The consumption of fruit, eggs, and tea was inversely associated with the risk of lung cancer. As expected, cooking oil fumes and environmental tobacco exposure were positively associated with elevated risk. In addition, frequent physical activity and late age at menarche were identified as protective factors of female lung cancer. The results demonstrate that some environmental and dietary factors are related to the risk of lung cancer among the female population in southeast China.     

Dietary Intake of Soy Protein and Tofu in Association With Breast Cancer Risk Based on a Case-Control Study

Soy food and its constituents may protect against breast cancer, but the association between soy intake and decreased breast cancer risk is inconsistent. We evaluated the relationship between breast cancer risk and the dietary intake of soy protein as measured by total soy food and tofu intake. Histologically confirmed cases ( n = 362) were matched to controls by age (within 2 yr) and menopausal status. High soy protein intake was associated with reduced breast cancer risk in analyses adjusted for potential confounders including dietary factors among premenopausal women (odds ratio [OR] = 0.39 in the highest quintile, 95% confidence interval [CI] = 0.22–0.93, P for trend = 0.03) and postmenopausal women (OR = 0.22, 95% CI = 0.06–0.88, P for trend = 0.16). We also found an inverse association between total tofu intake and breast cancer risk among premenopausal women (for total tofu intake, OR = 0.23 in the highest quintile, 95% CI = 0.11–0.48, P for trend < 0.01; for at least 1 serving of tofu as the main ingredient per day, OR = 0.26, 95% CI = 0.13–0.55, P for trend < 0.01). We concluded that increased regular soy food intake at a level equivalent to traditional Korean consumption levels may be associated with a reduced risk of breast cancer, and this effect is more pronounced in premenopausal women.     

饮食与食管癌关系的病例-对照研究

本文报告的是1987年10月至1989年4月间在唐山地区进行的一次食管癌危险因素的病例-对照研究中与饮食有关部分的结果。病例(112例)为研究期间在唐山市五所医院外科及放疗科住院的新发食管癌病人。对照主要为同期上述医院外科住院的非恶性肿瘤病人。用条件Logistic回归模型对与饮食有关的因素分析表明,发霉粮食(OR=4.08)、酸菜(OR=2.57)以及热烫食物(OR=2.53)为该地区食管的危险因素。饮茶可能通过热刺激而增加食管癌的危险。蛋类(OR=0.30)及细粮(OR=0.43)则为保护性因素。     

Effect of Dietary Salt Intake on Risk of Gastric Cancer: A Systematic Review and Meta-Analysis of Case-Control Studies

Aim: The effect of dietary salt intake on the risk of gastric cancer is not clear. A meta-analysis was performed to estimate the association between dietary salt intake and the risk of gastric cancer. Methods: Three major databases were searched to retrieve case-control studies published in English before 1 July 2022. Random effects model analysis was used to obtain the pooled odds ratios (ORs) and 95% confidence intervals (CIs) of the association between dietary salt intake and risk of gastric cancer. Subgroup analyses were used to identify possible sources of heterogeneity. Results: Thirty-eight case-control studies were included in this meta-analysis (total population: n = 37,225). The pooled ORs showed a significantly positive association between high salt intake and gastric cancer compared with low salt intake (OR = 1.55, 95% CI (1.45, 1.64); p < 0.001). In subgroup meta-analysis for geographic region, estimation method for dietary salt intake and the source of controls, this association was not changed. Conclusion: Higher dietary salt intake increased the risk of gastric cancer. This study has implications for the prevention of gastric cancer.     

Inverse Association between Dietary Iron Intake and Gastric Cancer: A Pooled Analysis of Case-Control Studies of the Stop Consortium

Background: Inconsistent findings have been reported regarding the relationship between dietary iron intake and the risk of gastric cancer (GC). Methods: We pooled data from 11 case-control studies from the Stomach Cancer Pooling (StoP) Project. Total dietary iron intake was derived from food frequency questionnaires combined with national nutritional tables. We derived the odds ratios (ORs) and 95% confidence intervals (CIs) for quartiles of dietary iron through multivariable unconditional logistic regression models. Secondary analyses stratified by sex, smoking status, caloric intake, anatomical subsite and histological type were performed. Results: Among 4658 cases and 12247 controls, dietary iron intake was inversely associated with GC (per quartile OR 0.88; 95% CI: 0.83–0.93). Results were similar between cardia (OR = 0.85, 95% CI = 0.77–0.94) and non-cardia GC (OR = 0.87, 95% CI = 0.81–0.94), and for diffuse (OR = 0.79, 95% CI = 0.69–0.89) and intestinal type (OR = 0.88, 95% CI = 0.79–0.98). Iron intake exerted an independent effect from that of smoking and salt intake. Additional adjustment by meat and fruit/vegetable intake did not alter the results. Conclusions: Dietary iron is inversely related to GC, with no difference by subsite or histological type. While the results should be interpreted with caution, they provide evidence against a direct effect of iron in gastric carcinogenesis.     

Plasma Carotenoids and Prostate Cancer: A Population-Based Case-Control Study in Arkansas

Carotenoids possess antioxidant properties and thus may protect against prostate cancer. Epidemiological studies of dietary carotenoids and this malignancy were inconsistent, partially due to dietary assessment error. In this study, we aimed to investigate the relation between plasma concentrations of carotenoids and the risk of prostate cancer in a population-based case-control study in Arkansas. Cases (n = 193) were men with prostate cancer diagnosed in 3 major hospitals, and controls (n = 197) were matched to cases by age, race, and county of residence. After adjustment for confounders, plasma levels of lycopene, lutein/zeaxanthin, and β -cryptoxanthin were inversely associated with prostate cancer risk. Subjects in the highest quartile of plasma lycopene (513.7 μ g/l) had a 55% lower risk of prostate cancer than those in the lowest quartile (140.5 μ g/l; P trend = 0.042). No apparent association was observed for plasma α -carotene and β -carotene. Further adjustment for the other 4 carotenoids did not materially alter the risk estimates for plasma lycopene, lutein/zeaxanthin, and β -cryptoxanthin but appeared to result in an elevated risk with high levels of plasma α -carotene and β -carotene. The results of all analyses did not vary substantially by age, race, and smoking status. This study added to the emerging evidence that high circulating levels of lycopene, lutein/zeaxanthin, and β -cryptoxanthin are associated with a low risk of prostate cancer.     

Physical Activity,Diet, and Pancreatic Cancer: A Population-Based,Case-Control Study in Minnesota

Although mounting evidence suggests that insulin resistance is involved in pancreatic carcinogenesis, few epidemiologic studies have comprehensively investigated the role of lifestyle factors influencing this metabolic disorder in the etiology of pancreatic cancer. We sought to examine this problem in a case-control study conducted in 1994–1998 in Minnesota. Cases (n = 186), aged 20 yr or older, were ascertained from all hospitals in the metropolitan area of the Twin Cities and the Mayo Clinic; from the latter, only cases residing in the Upper Midwest of the United States were recruited. Controls (n = 554) were randomly selected from the general population and frequency matched to cases by age (within 5 yr) and sex. Odds ratios (OR) and 95% confidence intervals (95% CI) were estimated using unconditional logistic regression. After adjustment for confounders, physical activity was associated with a reduced risk, but this protective effect was confined to light activity and moderate activity only (OR = 0.55, 95% CI = 0.30–0.97, P _trend = 0.038 and OR = 0.51, 95% CI = 0.28–0.93, P _trend = 0.07, for highest vs. lowest quartile, respectively). An increased risk was found for dietary intakes of energy and fat but was statistically significant for saturated and polyunsaturated fat only. Of note, no appreciable difference in the magnitude of the associations existed between saturated, monounsaturated, and polyunsaturated fat. Compared with individuals in the lowest quartile of fiber intake, the risk was approximately halved for those in the third (OR = 0.49, 95% CI = 0.26–0.94) and the highest quartile (OR = 0.52, 95% CI = 0.21–1.30). Our study lends support to the hypothesis that dietary and other lifestyle factors influencing insulin resistance modulate pancreatic cancer risk.