Hyperinsulinemic and Pro-Inflammatory Dietary Patterns and Metabolomic Profiles Are Associated with Increased Risk of Total and Site-Specific Cancers among Postmenopausal Women

Sep 24, 2026

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Evaluates associations among Empirical Dietary Index for Hyperinsulinemia (EDIH), Empirical Dietary Inflammatory Pattern (EDIP), and Healthy Eating Index (HEI-2015) and corresponding metabolomics profiles with risk of total and site-specific cancers. Baseline food-frequency questionnaires were used for 112,468 postmenopausal women in the Women’s Health Initiative; multivariable-adjusted Cox models estimated hazard ratios and 95% confidence intervals. Metabolomic scores were derived using elastic-net regression with leave-one-out cross validation, with 18,768 incident invasive cancers over 17.8 years.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages24

Reading Time1 h 0 min

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Abstract and Study Overview

Dietary Scores and Metabolomic Profiling

Outcomes and Statistical Analysis

cancers Article Hyperinsulinemic and Pro-Inﬂammatory Dietary Patterns and Metabolomic Proﬁles Are Associated with Increased Risk of Total and Site-Speciﬁc Cancers among Postmenopausal Women Qi Jin 1, Ni Shi 2, Dong Hoon Lee 3,4, Kathryn M. Rexrode 5, JoAnn E. Manson 5,6, Raji Balasubramanian 7, Xuehong Zhang 3,5, Marian L. Neuhouser 8, Melissa Lopez-Pentecost 9, Cynthia A. Thomson 10, Suzanna M. Zick 11, Ashley S. Felix 2,12, Daniel G. Stover 13, Sagar D. Sardesai 13, Ashwini Esnakula 14, Xiaokui Mo 2,15, Steven K. Clinton 1,2,13 and Fred K. Tabung 1,2,3,12,13, * Citation: Jin, Q.; Shi, N.; Lee, D.H.; Rexrode, K.M.; Manson, J.E.; Balasubramanian, R.; Zhang, X.; Neuhouser, M.L.; Lopez-Pentecost, M.; Thomson, C.A.; et al. Hyperinsulinemic and Pro-Inﬂammatory Dietary Patterns and Metabolomic Proﬁles Are Associated with Increased Risk of Total and Site-Speciﬁc Cancers among Postmenopausal Women. Cancers 2023, 15, 1756. [https://](https://)[ ](https://)[doi.org/10.3390/cancers15061756](doi.org/10.3390/cancers15061756) Academic Editor: Alina Vrieling Received: 14 February 2023 Revised: 2 March 2023 Accepted: 8 March 2023 Published: 14 March 2023 Copyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) . 1 Interdisciplinary Ph.D. Program in Nutrition, The Ohio State University, Columbus, OH 43210, USA 2 Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA 3 Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA 4 Department of Sport Industry Studies, Yonsei University, Seoul 03722, Republic of Korea 5 Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA 6 Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA 7 Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts at Amherst, Amherst, MA 01003, USA 8 Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA 9 Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA 10 Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85721, USA 11 Department of Family Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI 48109, USA 12 Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH 43210, USA 13 Division of Medical Oncology, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH 43210, USA 14 Department of Pathology, College of Medicine, The Ohio State University, Columbus, OH 43210, USA 15 Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, OH 43210, USA * Correspondence: [fred.tabung@osumc.edu](fred.tabung@osumc.edu) Simple Summary: We investigated whether dietary patterns of insulinemia, inﬂammation and overall dietary quality are associated with the risk of total cancer, site-speciﬁc cancers, and pathological subtypes among postmenopausal women. We followed 112,468 women, 50–79 years of age, in the Women's Health Initiative for a median of 17.8 years, documenting 18,768 incident invasive cancers. A higher overall dietary quality was associated with lower risk of total cancer and colorectal cancer. The potential of the dietary pattern to contribute to higher insulinemia and inﬂammation was associated with greater risk of total cancer, colorectal cancer and more strongly associated with risk of endometrial cancer and breast cancer (including triple negative breast cancer) than

FAQs

Which dietary indices were examined for cancer risk in postmenopausal women?

The study evaluated EDIH (hyperinsulinemia-related), EDIP (inflammatory dietary pattern), and HEI-2015 (overall dietary quality), along with their metabolomics profiles.

How were dietary patterns and metabolomics profiles measured?

Dietary scores were calculated from baseline food frequency questionnaires. Metabolomic profile scores were generated using elastic-net regression with leave-one-out cross validation.

What was the general direction of association between the dietary indices and cancer risk?

Higher EDIH and EDIP scores were associated with greater total cancer risk, while higher HEI-2015 was associated with lower risk. Associations were also reported for colorectal cancer and for endometrial and breast cancer.

Sep 24, 2026

Uploaded by Patrick