Dietary Pattern and Risk of Multiple Myeloma in Two Large Prospective US Cohort Studies

Dong Hoon Lee, Teresa T. Fung, Fred K. Tabung, Graham A. Colditz, Irene M. Ghobrial, Bernard A. Rosner, Edward L. Giovannucci, Brenda M. Birmann

Research output: Contribution to journalArticlepeer-review


Background: The limited data on specific dietary components and risk of multiple myeloma (MM) show no consistent association. Studies have not examined the association of dietary pattern with MM risk. Methods: In prospective cohorts of 69 751 women (Nurses’ Health Study, 1984–2014) and 47 232 men (Health Professionals Follow-up Study, 1986–2014), we examined the association between dietary pattern and risk of MM using Cox proportional hazard models. Diet was assessed repeatedly every 4 years with food frequency questionnaires and was used to calculate dietary patterns including the Alternate Healthy Eating Index-2010, Alternate Mediterranean Diet, Dietary Approaches to Stop Hypertension, Prudent and Western patterns, the empirical dietary inflammatory pattern (EDIP), and empirical dietary indices for insulin resistance (EDIR) and hyperinsulinemia (EDIH). Results: During 2 792 257 person-years of follow-up, we identified 478 incident MM cases (215 women, 263 men). In men, high EDIP was statistically significantly associated with a 16% increase in MM risk (hazard ratio [HR] = 1.16, 95% confidence interval [CI] = 1.02 to 1.32 per 1-SD increase). Moreover, EDIR and EDIH had a suggestive positive association (EDIR: HR = 1.09, 95% CI = 0.96 to 1.24; and EDIH: HR = 1.11, 95% CI = 0.97 to 1.28 per 1-SD increase). We observed no other associations with MM risk in men and no associations for any dietary pattern with MM risk in women. Conclusions: We present the first evidence for a role of diets with higher inflammatory or insulinemic potential in MM development. Further studies are warranted to explore these associations in other populations, including the apparent restriction to men.

Original languageEnglish
Article numberpkz025
JournalJNCI Cancer Spectrum
Issue number2
Publication statusPublished - 2019 Jun 1

Bibliographical note

Funding Information:
This work was supported by the National Institutes of Health (UM1 CA167552, R01 HL35464, UM1 CA186107, P01 CA87969, K99 CA207736, R00 CA207736, and R21 CA198239).

Publisher Copyright:
© The Author(s) 2019.

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research


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