Body Weight, Diet May Be Risk Factors for Non-Hodgkin Lymphoma
Body weight in young adulthood and diet appeared to be associated with the risk for non-Hodgkin lymphoma, according to results presented at the 10th AACR International Conference on Frontiers in Cancer Prevention Research, held Oct. 22-25, 2011.
“The causes of non-Hodgkin lymphoma (NHL) are poorly understood, and unfortunately, we don’t know very much about specific ways to prevent or lower the risk for this disease,” said Kimberly Bertrand, Sc.D., research fellow in the department of epidemiology at the Harvard School of Public Health.
In previous analyses of the Nurses’ Health Study at 14 years of follow-up, lead researcher Shumin Zhang, M.D., Sc.D., and colleagues reported positive associations with NHL for trans fat intake and inverse associations for vegetable intake. To expand those findings, Bertrand and colleagues evaluated the association of obesity, specific types of dietary fats and fruits and vegetables with risk for NHL.
Researchers analyzed questionnaire responses from 47,541 men followed for 22 years in the Health Professionals’ Follow-Up Study and 91,227 women followed for 28 years in the Nurses’ Health Study. Among the women, researchers confirmed 966 incident diagnoses of NHL through 2008, and among the men, they confirmed 566 cases through 2006.
“In analyses that controlled for age, race and other factors, we found that obesity in young adulthood (ages 18 to 21 years) was associated with risk for NHL later in life,” Bertrand said. “Men who were obese (body mass index [BMI] equal to or greater than 30) [in young adulthood] had a 64 percent higher risk for NHL compared with men who were lean, while obese women had a 19 percent higher risk.”
What are risk factors for non-Hodgkin’s lymphoma?
In many cases, people who develop NHL have no risk factors, and doctors seldom know why one person develops non-Hodgkin’s lymphoma and another does not.
Certain risk factors increase the chance that a person will develop this disease although most people who have these risk factors will never develop the disease.
Risk factors
Medications that suppress your immune system: Using immunosuppressive agents (such as after an organ transplant) is a risk factor as it reduces your bodies ability to fight infection.
Weakened immune system: The risk of developing lymphoma may be increased by having a weakened immune system.
Certain infections: Certain viral and bacterial infections increase the risk of NHL. Examples are HIV, hepatitis C virus, and Epstein-Barr virus. A type of bacteria sometimes linked to NHL is the ulcer-causing H. pylori.
Note: Lymphoma is not contagious. You cannot catch lymphoma from another person.
Age: Although non-Hodgkin’s lymphoma can occur in young people, the chance of developing this disease increases with age. Most people with non-Hodgkin’s lymphoma are older than 60 years of age.
Other possible links: People who work with herbicides or certain other chemicals may be at increased risk of this disease. Researchers are also looking at a possible link between using hair dyes before 1980 and non-Hodgkin’s lymphoma. None of these possible links have definitely been proven.
Note: Having one or more risk factors does not mean that a person will develop non-Hodgkin’s lymphoma. Most people who have risk factors never develop cancer.
Current BMI was also associated with risk for NHL in men but not in women. Although total and specific dietary fats were not associated with NHL risk, findings also suggested that women who consumed the highest amounts of trans fat in their diets had a nonstatistically significant increased risk for NHL overall. “We observed that women who consumed at least four servings of vegetables per day, compared with those who consumed fewer than two servings per day, had a 16 percent lower risk for developing NHL,” Bertrand said.
“The results from this study, if confirmed in other studies, suggest that body weight and dietary choices may be potentially modifiable risk factors for NHL,” she said.
Bertrand and colleagues also plan to investigate associations of obesity and dietary factors with common subtypes of NHL, to evaluate biomarkers of fatty acids related to NHL risk to obtain more information on the possible biological mechanism for these associations, and to investigate other dietary factors including red meat consumption and antioxidants.
Obesity may increase the risk for non-Hodgkin’s lymphoma (NHL) through an inflammatory pathway. We explored the relation of
NHL with body size at different times in life within the Multiethnic Cohort that includes African Americans, Caucasians, Japanese,
Latinos, and Native Hawaiians. Participants were 45 to 75 years old at recruitment in 1993 to 1996. This analysis included
87,079 men and 105,972 women with 461 male and 378 female NHL cases. We used Cox regression to model NHL risk with age as
the time metric while adjusting for age at baseline, ethnicity, education, alcohol intake, and age at first live birth. Body
weight and body mass index at age 21 were stronger predictors of NHL risk than anthropometric characteristics at baseline.
For men, being in the highest quartile of body mass index and body weight at age 21 conferred a nonsignificant 86% and 41%
higher NHL risk, respectively, whereas there was no association at baseline. For women, the risk associated with the highest
quartile of weight at age 21 was 1.6 (Ptrend = 0.04), whereas women in the highest quartile at baseline had a nonsignificant risk of 27%. Height was positively related
to NHL in men and women. Despite the small numbers, there was some consistency for risk estimates across ethnic groups and
weak evidence for an association with NHL subtypes. These findings indicate that weight at age 21 may represent lifetime adiposity
better than body weight at cohort entry. Alternatively, weight at age 21 may be more relevant for the etiology of NHL. (Cancer
Epidemiol Biomarkers Prev 2008;17(1):196–203)
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1. Gertraud Maskarinec,
2. Eva Erber,
3. Jasmeet Gill,
4. Wendy Cozen and
5. Laurence N. Kolonel
The study was supported by the American Cancer Society with funds to senior researcher, Brenda Birmann, M.Sc., Sc.D. (RSG-11-020-01-CNE), and by the National Institutes of Health (CA055075 and CA87969). Bertrand was supported by a training grant from the National Cancer Institute (R25 CA098566).
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Source: American Association for Cancer Research (AACR)