The quality of plant-based diets and liver cancer incidence and liver disease mortality in the UK Biobank

Abstract

Background & aims

Plant-based diets have been associated with a lower risk of various chronic diseases. However, their role in preventing liver cancer and liver-related death is currently unclear. We aimed to investigate the association between plant-based diets and the risk of liver cancer incidence and liver disease mortality in the UK Biobank.

Methods

We included 85,810 males and 101,971 females from the UK Biobank in our analyses. Three plant-based diet indices, including an overall plant-based diet index (PDI), a healthful plant-based diet index (hPDI), and an unhealthful plant-based diet index (uPDI), were created based on 17 food groups using data from at least one 24-hour dietary assessments. Cox proportional hazards models were used to estimate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs).

Results

During follow-up, 109 males and 68 females developed liver cancer, and 190 males and 108 females died from liver diseases. Overall PDI scores were not associated with liver cancer incidence or liver disease mortality in either males or females. However, higher hPDI scores were linked to a lower risk of liver cancer incidence (HR_{Q5 vs. Q1}: 0.47; 95%CI: 0.26, 0.85; P-trend=0.005) and liver disease mortality (HR_{Q5 vs. Q1}: 0.46; 95%CI: 0.27, 0.77; P-trend=0.011) in males. Higher uPDI scores were associated with an increased incidence of liver cancer (HR_{Q5 vs. Q1}: 1.90; 95%CI: 1.00, 3,63; P-trend=0.038) and a higher risk of liver disease-related deaths (HR_{Q5 vs. Q1}: 2.21; 95%CI: 1.37, 3.57; P-trend <0.001). However, no such associations between hPDI or uPDI and the risk of liver cancer or liver disease mortality were observed in females.

Conclusions

Our results suggest that higher adherence to plant-based diets, emphasizing healthful plant-based foods while restricting less healthful plant foods, may protect against liver cancer and liver disease-related deaths in males, but not in females.