Consumption of Ultra-Processed Food and Drinks and Chronic Lymphocytic Leukemia in the MCC-Spain Study

Marta Solans, Sílvia Fernández-Barrés, Dora Romaguera, Yolanda Benavente, Rafael Marcos-Gragera, Esther Gracia-Lavedan, Laura Costas, Claudia Robles, Eva Gonzalez-Barca, Esmeralda de la Banda, Esther Alonso, Marta Aymerich, Elias Campo, Javier Llorca, Guillermo Fernández-Tardón, Rocío Olmedo-Requena, Eva Gimeno, Gemma Castaño-Vinyals, Nuria Aragonés, Manolis Kogevinas, Marina Pollán, Silvia de Sanjose, Pilar Amiano and Delphine Casabonne
Additional contact information
Marta Solans: Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), 28001 Madrid, Spain
Sílvia Fernández-Barrés: Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), 28001 Madrid, Spain
Dora Romaguera: ISGlobal, 08036 Barcelona, Spain
Yolanda Benavente: Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), 28001 Madrid, Spain
Rafael Marcos-Gragera: Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), 28001 Madrid, Spain
Esther Gracia-Lavedan: Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), 28001 Madrid, Spain
Laura Costas: Unit of Molecular and Genetic Epidemiology in Infections and Cancer (UNIC-Molecular), Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, 08908 L’Hospitalet de Llobregat, Spain
Claudia Robles: Unit of Information and Interventions in Infections and Cancer (UNIC-I&I), Cancer Epidemiology Research Programme, (IDIBELL), Catalan Institute of Oncology, 08908 L’Hospitalet de Llobregat, Spain
Eva Gonzalez-Barca: Hematology, Bellvitge Biomedical Research Institute (IDIBELL), Catalan Institute of Oncology, 08908 L’Hospitalet de Llobregat, Spain
Esmeralda de la Banda: Hematology Laboratory, Department of Pathology, Hospital Universitari de Bellvitge, 08908 L’Hospitalet de Llobregat, Spain
Esther Alonso: Hematology Laboratory, Department of Pathology, Hospital Universitari de Bellvitge, 08908 L’Hospitalet de Llobregat, Spain
Marta Aymerich: Hematopathology Section, Hospital Clinic de Barcelona, University of Barcelona, CIBERONC, 08001 Barcelona, Spain
Elias Campo: Hematopathology Section, Hospital Clinic de Barcelona, University of Barcelona, CIBERONC, 08001 Barcelona, Spain
Javier Llorca: Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), 28001 Madrid, Spain
Guillermo Fernández-Tardón: Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), 28001 Madrid, Spain
Rocío Olmedo-Requena: Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), 28001 Madrid, Spain
Eva Gimeno: Hematology Department, Hospital del Mar, 08003 Barcelona, Spain
Gemma Castaño-Vinyals: Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), 28001 Madrid, Spain
Nuria Aragonés: Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), 28001 Madrid, Spain
Manolis Kogevinas: Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), 28001 Madrid, Spain
Marina Pollán: Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), 28001 Madrid, Spain
Silvia de Sanjose: Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), 28001 Madrid, Spain
Pilar Amiano: Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), 28001 Madrid, Spain
Delphine Casabonne: Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), 28001 Madrid, Spain

IJERPH, 2021, vol. 18, issue 10, 1-12

Abstract: Chronic lymphocytic leukemia (CLL) is the most common leukemia in adults in Western countries. Its etiology is largely unknown but increasing incidence rates observed worldwide suggest that lifestyle and environmental factors such as diet might play a role in the development of CLL. Hence, we hypothesized that the consumption of ultra-processed food and drinks (UPF) might be associated with CLL. Data from a Spanish population-based case-control study (MCC-Spain study) including 230 CLL cases (recruited within three years of diagnosis) and 1634 population-based controls were used. The usual diet during the previous year was collected through a validated food frequency questionnaire and food and drink consumption was categorized using the NOVA classification scheme. Logistic regression models adjusted for potential confounders were used. Overall, no association was reported between the consumption of UPF and CLL cases (OR per each 10% increase of the relative contribution of UPF to total dietary intake = 1.09 (95% CI: 0.94; 1.25)), independently of the Rai stage at diagnosis. However, when analyses were restricted to cases diagnosed within <1 year (incident), each 10% increment in the consumption of UPF was associated with a 22% higher odds ratio of CLL (95% CI: 1.02, 1.47) suggesting that the overall results might be affected by the inclusion of prevalent cases, who might have changed their dietary habits after cancer diagnosis. Given the low number of cases in the subgroup analyses and multiple tests performed, chance findings cannot totally be ruled out. Nonetheless, positive associations found in CLL incident cases merit further research, ideally in well-powered studies with a prospective design.

Keywords: chronic lymphocytic leukemia; cancer; NOVA classification; ultra-processed food; case-control study (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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