Diet and lung cancer mortality: a 1987 National Health Interview Survey cohort study

Objectives: To study the association between diet and lung cancer mortality in the United States. Methods: Records from 20,195 participants with usable dietary data in the 1 987 National Health Interview Survey were linked to the National Death Inde x. Baseline diet was assessed with a 59-item food-frequency questionnaire. Food groups (fruits, vegetables, total meat/poultry/fish, red meats, proces sed meats, dairy products, breakfast cereals, other starches, added fats, a nd alcohol) were analyzed in cause-specific Cox proportional hazard regress ion models adjusted for age, gender and smoking. Results: There were 158 deaths from lung cancer (median follow-up 8.5 years ). Frequencies of meat/poultry/fish intake (relative risk [RR] (highest com pared to lowest quartile) = 2.0; 95% confidence interval [CI] 1.2-3.5, p fo r trend [p] < 0.027), and red meat intake (RR = 1.6; CI 1.0-2.6, p < 0.014) , were positively and significantly associated with lung cancer mortality. Specifically, the red meats, including pork (RR = 1.6; CI 1.0-2.7, p < 0.02 8), and ground beef (RR = 2.0; CI 1.1-3.5, p < 0.096) were associated with increased risk, although for ground beef the trend was not significant. Dai ry products (RR = 0.5; CI 0.3-0.8, p < 0.009) were inversely associated wit h lung cancer mortality. There was no statistically significant association between intake of fruits and vegetables and lung cancer mortality. Conclusions: In this nationally representative study, intake of red meats w as positively associated with lung cancer mortality while intake of dairy p roducts was inversely associated. While smoking is the major risk for lung cancer mortality, diet may have a contributory role.