Dietary Factors Reduce Risk of Acute Pancreatitis in a Large Multiethnic Cohort

• Published in: Clinical gastroenterology and hepatology Vol. 15; no. 2; pp. 257 - 265.e3
• Main Authors: Setiawan, Veronica Wendy, Pandol, Stephen J, Porcel, Jacqueline, Wei, Pengxiao C, Wilkens, Lynne R, Le Marchand, Loïc, Pike, Malcolm C, Monroe, Kristine R
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2017
• Subjects: Aged; Diet - methods; Epidemiology; Feeding Behavior; Female; Gastroenterology and Hepatology; Humans; Male; Middle Aged; Pancreas; Pancreatitis, Acute Necrotizing - prevention & control; Population; Prospective Studies; Risk Assessment; Surveys and Questionnaires; United States - epidemiology; epidemiology; pancreas; population; RAP; SCP; QFFQ; CI; HR; MEC; GS; Epidemiology; CP; AP; ICD-9; Population; CHDD; Pancreas
• ISSN: 1542-3565; 1542-7714
• DOI: 10.1016/j.cgh.2016.08.038

Abstract Background & Aims Pancreatitis is a source of substantial morbidity and health cost in the United States. Little is known about how diet might contribute its pathogenesis. To characterize dietary factors that are associated with risk of pancreatitis, by disease subtype, we conducted a prospective analysis of 145,886 African Americans, Native Hawaiians, Japanese Americans, Latinos, and whites in the Multiethnic Cohort. Methods In the Multiethnic Cohort (45–75 years old at baseline), we identified cases of pancreatitis using hospitalization claim files from 1993 through 2012. Patients were categorized as having gallstone-related acute pancreatitis (AP) (n=1210), AP not related to gallstones (n=1222), or recurrent acute pancreatitis or suspected chronic pancreatitis (n=378). Diet information was obtained from a questionnaire administered when the study began. Associations were estimated by hazard ratios and 95% CIs using Cox proportional hazard models adjusted for confounders. Results Dietary intakes of saturated fat ( P trend=.0011) and cholesterol ( P trend=.0008) and their food sources, including red meat ( P trend<.0001) and eggs ( P trend=.0052), were positively associated with gallstone-related AP. Fiber intake, however, was inversely associated with gallstone-related AP ( P trend=.0005) and AP not related to gallstones ( P trend=.0035). Vitamin D, mainly from milk, was inversely associated with gallstone-related AP ( P trend=.0015) whereas coffee consumption protected against AP not related to gallstones ( P trend<.0001). With the exception of red meat, no other dietary factors were associated with recurrent acute or suspected pancreatitis. Conclusions Associations between dietary factors and pancreatitis were mainly observed for gallstone-related AP. Interestingly, dietary fiber protected against AP, related and unrelated to gallstones. Coffee drinking protected against AP not associated with gallstones. Further studies are warranted to confirm our findings.