Role of dietary patterns and acculturation in cancer risk and mortality among postmenopausal Hispanic women: results from the Women's Health Initiative (WHI)

Aim To investigate the association between dietary patterns and total and obesity-related cancer risk as well as to examine if acculturation modifies this relationship. Subjects and methods Dietary intake of postmenopausal Hispanic women (N = 5,482) enrolled in the Women's Health Initiative was estimated from a Food Frequency Questionnaire and used to calculate dietary pattern scores: Healthy Eating Index-2015 (HEI-2015), Mexican Diet (MexD) score, alternate Mediterranean Diet Score (aMED), and the energy adjusted Dietary Inflammatory Index (E-DII (TM)). Associations were evaluated using Cox proportional hazard regression models. Results Six hundred thirty-one cancers and 396 obesity-related cancers were diagnosed over a mean follow-up of 12 years. Across dietary scores, there were no significant associations with cancer risk or mortality. Trend analysis suggested a potentially lower risk for total cancer mortality related to the highest MexD score (HR 0.68, 95% CI 0.45-1.04,P-trend = 0.03) and lower risk for obesity-related cancer mortality related to the highest score category for MexD (HR 0.65, 95% CI 0.37-1.16,P-trend = 0.02) and aMED (HR 0.87, 95% CI 0.45-1.67,P-trend = 0.04). Further analysis suggested less acculturated women with higher MexD scores had a 56% lower risk for any cancer (HR 0.44, 95% CI 0.22-0.88,P-trend = 0.03) and 83% lower risk for cancer mortality (HR 0.17, 95% CI 0.04-0.76,P-trend = 0.01) compared to more acculturated Hispanic women. Conclusions Dietary patterns were not associated with cancer risk and mortality in postmenopausal Hispanic women. Less acculturated, Spanish-preferred speakers who report consuming a more traditional Mexican diet may experience a lower risk of cancer and cancer mortality.