Evidence map›Paper›PMID 34293086›Full record

ArticleThe American journal of clinical nutrition2021

Unrestrained eating behavior and risk of digestive system cancers: a prospective cohort study.

Yin Zhang, Mingyang Song, Andrew T Chan, Eva S Schernhammer, Brian M Wolpin, Meir J Stampfer, Jeffrey A Meyerhardt, Charles S Fuchs, Susan B Roberts, Walter C Willett and 3 more

Open access · bronzeAbstract read
In one paragraph

Article in The American journal of clinical nutrition, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
2.6field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Common Risk Factors in Gastrointestinal Cancers: A Narrative Review.Medical principles and practice : international journal of the Kuwait University, Health Science Centre · 2025
    Review
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Practical Considerations in Diagnosing and Managing Early-Onset GI Cancers.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2022
    Article
  10. Article
  11. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors at 5 institutions in 2 countries.

Yin ZhangDepartment of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA.ORCID 0000-0001-6367-6583
Mingyang SongDepartment of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.ORCID 0000-0002-4780-4642
Andrew T ChanChanning Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Eva S SchernhammerChanning Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Brian M WolpinDepartment of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA.
Meir J StampferChanning Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Jeffrey A MeyerhardtDepartment of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA.ORCID 0000-0002-1120-0898
Charles S FuchsDepartment of Medical Oncology, Smilow Cancer Hospital and Yale Cancer Center, New Haven, CT, USA.ORCID 0000-0003-1582-9842
Susan B RobertsUSDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA.
Walter C WillettDepartment of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.ORCID 0000-0003-1458-7597
Frank B HuChanning Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.ORCID 0000-0002-8233-6274
Edward L GiovannucciChanning Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Kimmie NgDepartment of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA.
Brigham and Women's Hospital · USHarvard University · USBroad Institute · USTufts University · USYale Cancer Center · US

Funding

Statistical MethodsP01CA087969 · NCI · BRIGHAM AND WOMEN'S HOSPITAL · PI ROSNER, BERNARD A · 2000 to 2019
$77.8M
Tissue and Pathology ResourcesP50CA127003 · NCI · DANA-FARBER CANCER INST · PI BASS, ADAM JOEL · 2007 to 2023
$33.2M
Long Term Multidisciplinary Study of Cancer in Women: The Nurses Health StudyUM1CA186107 · NCI · BRIGHAM AND WOMEN'S HOSPITAL · PI ELIASSEN, A. HEATHER, STAMPFER, MEIR · 2014 to 2023
$22.3M
Circulating Biomarker Consortium for Pancreatic Cancer Early DetectionU01CA210171 · NCI · DANA-FARBER CANCER INST · PI Michael H. Rosenthal, Brian Matthew Wolpin · 2016 to 2026
$8.7M
Precision Prevention Research ProgramR35CA253185 · NCI · MASSACHUSETTS GENERAL HOSPITAL · PI Andrew T Chan · 2020 to 2026
$6.9M
Inflammation and Colorectal NeoplasiaR01CA137178 · NCI · MASSACHUSETTS GENERAL HOSPITAL · PI CHAN, ANDREW T · 2009 to 2019
$6.5M
Novel randomized controlled trials of vitamin D supplementation in patients with colorectal cancer: Impact on survival and biologyR01CA205406 · NCI · DANA-FARBER CANCER INST · PI Kimmie Ng · 2017 to 2026
$4.9M
Minimizing Cancer Risk in Shift WorkersR01OH009803 · OH · BRIGHAM AND WOMEN'S HOSPITAL · PI SCHERNHAMMER, EVA S · 2010 to 2018
$4.5M
Mentored Patient-Oriented Research in Digestive DiseasesK24DK098311 · NIDDK · MASSACHUSETTS GENERAL HOSPITAL · PI CHAN, ANDREW T · 2013 to 2017
$930k
Integrated Micro Scale transcriptional profiling of cell communication networksR33CA160344 · NCI · UNIVERSITY OF WISCONSIN-MADISON · PI ALARID, ELAINE T, BEEBE, DAVID J · 2011 to 2013
$818k
Marine Omega-3 Polyunsaturated Fatty Acid, Gut Microbiome, and Colorectal Cancer PreventionR00CA215314 · NCI · HARVARD SCHOOL OF PUBLIC HEALTH · PI SONG, MINGYANG · 2018 to 2020
$679k
NCI NIH HHS P01 CA087969NCI NIH HHS P50 CA127003NCI NIH HHS R00 CA215314NCI NIH HHS R01 CA137178NCI NIH HHS R01 CA205406NCI NIH HHS R33 CA160344NCI NIH HHS R35 CA253185NCI NIH HHS U01 CA210171NCI NIH HHS UM1 CA186107NIDDK NIH HHS K24 DK098311NIH HHS UM1 CA186107NIOSH CDC HHS R01 OH009803
6 · The paper itself

Abstract

backgroundUnrestrained eating behavior, as a potential proxy for diet frequency, timing, and caloric intake, has been questioned as a plausible risk factor for digestive system cancers, but epidemiological evidence remains sparse.

objectivesWe investigated prospectively the associations between unrestrained eating behavior and digestive system cancer risk.

methodsParticipants in the Nurses' Health Study who were free of cancer and reported dietary information in 1994 were followed for ≤18 y. Cox models were used to estimate HRs and 95% CIs for unrestrained eating (eating anything at any time, no concern with figure change, or both) and risk of digestive system cancers.

resultsDuring follow-up, 2064 digestive system cancer cases were documented among 70,450 eligible participants in analyses of eating anything at any time, In total, 2081 digestive system cancer cases were documented among 72,468 eligible participants in analyses of no concern with figure change. In fully adjusted analyses, women with the behavior of eating anything at any time had a higher risk of overall digestive system cancer (HR: 1.22; 95% CI: 1.10, 1.35), overall gastrointestinal tract cancer ((HR: 1.33; 95% CI: 1.18, 1.50), buccal cavity and pharynx cancer (HR: 1.50; 95% CI: 1.02, 2.21), esophageal cancer (HR: 1.62; 95% CI: 1.01, 2.62), small intestine cancer (HR: 1.92; 95% CI: 1.02,3. 59), and colorectal cancer (HR: 1.20; 95% CI: 1.04, 1.38), and a non-statistically significant increased risk of stomach cancer (HR: 1.54; 95% CI: 0.96,2.48), compared with women without this behavior. No statistically significant association was observed for pancreatic cancer and liver and gallbladder cancer. The combined effect of eating anything at any time and having no concern with figure change was associated with a significantly increased risk of overall digestive system cancer (HR: 1.27; 95% CI: 1.10, 1.46), overall gastrointestinal tract cancer (HR: 1.45; 95% CI: 1.23, 1.71), and colorectal cancer (HR: 1.34; 95% CI: 1.11, 1.63), compared with women exhibiting the opposite.

conclusionsUnrestrained eating behavior was independently associated with increased risk of gastrointestinal tract cancers. The potential importance of unrestrained eating behavior modification in preventing gastrointestinal tract cancers should be noted.

Indexed as

Feeding BehaviorAgedBody Mass IndexDigestive System NeoplasmsExerciseHumansMiddle AgedProspective StudiesRisk Factorsbuccal cavity and pharynx cancercohort studycolorectal cancerdigestive system canceresophageal cancergastrointestinal tract cancerpancreatic cancersmall intestine cancerstomach cancerUnrestrained eating behavior

Identifiers

PMID34293086
PMCPMC8588850
OpenAlexW3186907592

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.