Abstract
OBJECTIVES: Dietary Approaches to Stop Hypertension (DASH) pattern has been found to aid in the reduction of obesity, oxidative stress, and chronic inflammation, which are all strongly linked to the development of head and neck cancer (HNC). Nevertheless, no epidemiological studies have investigated the association between this dietary pattern and HNC risk. This study was conducted with the purpose of bridging this gap in knowledge. DESIGN: A prospective cohort study involving 98,459 American adults aged 55 years and older. SETTING AND PARTICIPANTS: Data were drawn from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Trial. In the present study, participants with dependable energy intake data who furnished baseline and dietary history information were identified as the study population. METHODS: Diet was assessed by food frequency questionnaires and the DASH score was calculated to assess each participant's adherence to DASH eating pattern. Cox proportional hazards models were used to calculate multivariable adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the occurrence of HNC. To visualize the variation in cancer risk for HNC and its subtypes across the entire spectrum of DASH scores, restricted cubic spline plots were utilized. Additionally, a series of predefined subgroup analyses were performed to identify potential effect modifiers, and several sensitivity analyses were conducted to assess the stability of the findings. RESULTS: During a follow-up period of 871,879.6 person-years, 268 cases of HNC were identified, comprising 161 cases pertaining to oral cavity and pharynx cancers, as well as 96 cases of larynx cancer. In the fully adjusted model, adherence to the DASH diet was associated with a remarkable 57% reduction in the risk of HNC when comparing extreme quartiles (HR quartile 4 vs 1: 0.43; 95% CI: 0.28, 0.66; P for trend < 0.001). The restricted cubic spline plots demonstrated a linear dose-response relationship between the DASH score and the risk of HNC as well as its subtypes. Subgroup analysis revealed that the protective effect of the DASH diet against HNC was particularly pronounced in individuals with lower daily energy intake. The primary association remained robust in the sensitivity analysis. CONCLUSIONS: In American middle-aged and older population, adherence to the DASH diet may help prevent HNC, particularly for individuals with lower daily energy intake.