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Nutritional Epidemiology (Poster Session)

(P17-034-25) Adherence to the Portfolio Dietary Pattern and Associated Risk of Cancer Mortality: A Prospective Cohort Study in US Adults

Sunday, June 1, 2025
11:45 AM - 12:45 PM ET
Location: Poster Board A-33

    Presenting Author(s)

  • Meaghan E. Kavanagh, PhD

    Postdoctoral Fellow
    University of Toronto
    Toronto, Ontario, Canada

    • Co-Author(s)

  • Andreea Zurbau, PhD RD

    Postdoctoral Fellow
    University of Toronto
    Toronto, Ontario, Canada

  • AG

    Andrea J. Glenn

    Harvard T.H. Chan School of Public Health, United States

  • CS

    Constança Silva

    University of Toronto, Ontario, Canada

  • Laura Chiavaroli, MSc, PhD (she/her/hers)

    Assistant Professor
    University of Toronto
    Toronto, Ontario, Canada

  • CK

    Cyril W. Kendall, PhD

    University of Toronto
    Toronto, Ontario, Canada

  • DJ

    David J. Jenkins

    Professor
    Department of Nutritional Sciences and Medicine, Temerty, Faculty of Medicine, University of Toronto, Toronto, Canada 5 Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada 6 Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, Canada 7 Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Canada
    Toronto, Ontario, Canada

  • John L. Sievenpiper, MD, PhD, FRCPC

    Associate Professor
    University of Toronto
    Toronto, Ontario, Canada

Disclosure(s):
Meaghan E. Kavanagh, PhD: No relevant financial relationship(s) with ineligible companies to disclose.


Objectives: The Portfolio Diet, a plant-based dietary pattern of cholesterol-lowering foods, has been shown to improve cancer risk factors in clinical trials including c-reactive protein (CRP), a marker of chronic low-grade inflammation. However, evidence on the Portfolio Diet and cancer mortality is limited. Therefore the objective of this research was to examine the association of the Portfolio dietary pattern with cancer mortality in an adult US population.

Methods: A total of 14,264 US adults without previous history of cancer from the National Health and Nutrition Examination Survey, NHANES (1988-1994) were included. Diet was assessed at baseline by a 24-hour dietary recall supplemented with a food frequency questionnaire using the Portfolio Diet Score (PDS), with positive points for nuts, plant protein, viscous fiber, phytosterols, and plant monounsaturated fatty acid sources, and negative points for foods high in saturated fat and cholesterol (range, 6-30 points). The PDS was treated as a continuous variable using 33% increments (8-points) and separately as a categorical variable using tertiles.  Weighted Cox proportional hazards regression models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs). Mortality data were obtained from National Death Index records until 31 December 2019. Mortality outcomes included cancer mortality and all-cause mortality.

Results: During 22 years of follow-up, 1,214 cancer deaths and 5,814 all-cause deaths were documented. At baseline, higher adherence to the Portfolio dietary pattern was associated with lower CRP. An increase in PDS by 8-points was associated with a 19% (HR: 0.81 [95% CI: 0.69, 0.95]) and 10% (0.90 [0.83, 0.98]) lower risk of cancer and all-cause mortality after adjustments for known risk factors. Comparing the highest to lowest tertiles of the PDS, higher PDS was associated with 16% (0.84 [0.68, 0.98]), and 11% (0.89 [0.80, 0.99]) lower risk of cancer and all-cause mortality.

Conclusions: Among a national cohort of adults in the US, higher adherence to the Portfolio dietary pattern was associated with lower CRP and was prospectively associated with lower risk of cancer mortality and all-cause mortality.

Funding Sources: Canadian Institutes of Health Research