Observational studyAmerican journal of epidemiology2026
Calibrated dietary patterns and cancer risk in the women's health initiative cohorts.
Observational study in American journal of epidemiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
We developed calibration equations using metabolomics from fasting blood and 24-hour urine for Healthy Eating Index 2010 (HEI-2010) and Alternative Healthy Eating Index 2010 to address measurement error from self-reported diet. We examined associations between metabolomic-calibrated dietary patterns and cancer risk in the Women's Health Initiative (WHI) (n = 108 522). Metabolomic signatures were created from a WHI Feeding (n = 153; 2010-2014) and WHI Observational Study (n = 450; 2006-2009). Dietary patterns were regressed on metabolites using the feeding study food intake records. Metabolomic-based dietary patterns were estimated from 24-hour dietary recalls, food frequency questionnaire and 4-day food record in the Observational Study using a stepwise approach. Cox regression estimated cancer risk of metabolomic-calibrated dietary patterns with a median follow-up of 15.8 years. Adjusted R2 for HEI-2010 and Alternative Healthy Eating Index 2010 calibration equations were 57.5% and 48.8% for food frequency questionnaire, 61.6% and 62.6% for 4-day food record, and 52.5% and 53.2% for dietary recalls. Without calibration, a 20% increment in HEI-2010 was associated with lower risk of colorectal (HR, 0.94; 95% CI, 0.90-0.99), lung (HR, 0.90; 95% CI, 0.86-0.94), bladder (HR, 0.86; 95% CI, 0.75-0.99), and total invasive cancers (HR, 0.98; 95% CI, 0.96-0.99). With metabolomic calibration, higher HEI-2010 was associated with lower risk of lung (HR, 0.79; 95% CI, 0.71-0.88) and total invasive cancers (HR, 0.96; 95% CI, 0.92-1.00). Metabolomic-calibrated dietary patterns might mitigate measurement errors and strengthen diet-cancer associations. Trial registration: www.whi.org.
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