9ab3af0561d039632315b9676f4acfa0 270638.pdf 3727967028618f41683a4aa39b5c79bcdb0cf8f2 270638.pdf 21def3e7ea0ec59a150a06dc7a8c1f0bbbc85e97272e425d557a629fa86e201b 270638.pdf Title: Consumption of Ultra-Processed Food and Drinks and Chronic Lymphocytic Leukemia in the MCC-Spain Study Subject: Chronic lymphocytic leukemia (CLL) is the most common leukemia in adults in Western countries. Its etiology is largely unknown but increasing incidence rates observed worldwide suggest that lifestyle and environmental factors such as diet might play a role in the development of CLL. Hence, we hypothesized that the consumption of ultra-processed food and drinks (UPF) might be associated with CLL. Data from a Spanish population-based case-control study (MCC-Spain study) including 230 CLL cases (recruited within three years of diagnosis) and 1634 population-based controls were used. The usual diet during the previous year was collected through a validated food frequency questionnaire and food and drink consumption was categorized using the NOVA classification scheme. Logistic regression models adjusted for potential confounders were used. Overall, no association was reported between the consumption of UPF and CLL cases (OR per each 10% increase of the relative contribution of UPF to total dietary intake = 1.09 (95% CI: 0.94; 1.25)), independently of the Rai stage at diagnosis. However, when analyses were restricted to cases diagnosed within <1 year (incident), each 10% increment in the consumption of UPF was associated with a 22% higher odds ratio of CLL (95% CI: 1.02, 1.47) suggesting that the overall results might be affected by the inclusion of prevalent cases, who might have changed their dietary habits after cancer diagnosis. Given the low number of cases in the subgroup analyses and multiple tests performed, chance findings cannot totally be ruled out. Nonetheless, positive associations found in CLL incident cases merit further research, ideally in well-powered studies with a prospective design. Keywords: chronic lymphocytic leukemia; cancer; NOVA classification; ultra-processed food; case-control study Author: Marta Solans, Sílvia Fernández-Barrés, Dora Romaguera, Yolanda Benavente, Rafael Marcos-Gragera, Esther Gracia-Lavedan, Laura Costas, Claudia Robles, Eva Gonzalez-Barca, Esmeralda de la Banda, Esther Alonso, Marta Aymerich, Elias Campo, Javier Llorca, Guillermo Fernández-Tardón, Rocío Olmedo-Requena, Eva Gimeno, Gemma Castaño-Vinyals, Nuria Aragonés, Manolis Kogevinas, Marina Pollán, Silvia de Sanjose, Pilar Amiano and Delphine Casabonne Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Thu May 20 08:09:45 2021 CEST ModDate: Thu May 20 08:09:45 2021 CEST Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 12 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 560049 bytes Optimized: no PDF version: 1.5 name type encoding emb sub uni object ID ------------------------------------ ----------------- 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