Patients with lower healthy eating index scores are more frequently diagnosed with thick melanomas (≥ 2mm) vs. those with high healthy eating index scores
Clinical Pearls
Patients with lower healthy eating index scores are more frequently diagnosed with thick melanomas (≥ 2mm) vs. those with high healthy eating index scores
Even when adjusted for frequency of skin checks and higher education, diet quality pre-diagnosis continued to remain inversely associated with thickness of melanoma at diagnosis
Decreased adherence to dietary components including increased intake of total fruit, greens and beans, whole grains, and fatty acids found in patients with the lowest healthy eating index tertile
Discussion:
There is an increasing amount of evidence of the effect of diet on a variety of diseases. Diets consisting of high fiber and low fat are known to protect against progression of breast, prostate, and colorectal cancers, however there is a paucity of data available on the effects of diet in melanoma. This study sought to assess the diets of newly diagnosed melanoma patients and thickness upon diagnosis. Using a modified healthy eating index (HEI) as a tool to comprehensively assess dietary components and thickness as defined as >2 mm in depth in lieu of survival upon diagnosis, the authors sought to identify a statistically significant association between higher HEI scores and melanoma thickness. Characteristics of the 634 patients included in the final sample included a median age of 65 years with a male predominance (59%). Unadjusted and adjusted Poisson regression models were used to assess association between HEI score and melanoma thickness.
When adjusted for age, sex, skin examination habits, education, health sector (public vs private), and energy intake, there was a significant difference among the frequency of thick melanomas (>2 mm) seen among the tertile of patients with the lowest modified HEI scores (PRadj 0.93, 95% CI 0.86-0.99, P = 0.03). Further analysis of dietary habits among the lowest HEI tertile demonstrated low adherence (<50%) to recommended components of total fruit, greens and beans, whole grains, and fatty acids. On the contrary, patients among the highest HEI tertile only had low adherence for fatty acid intake, with moderate adherence (50 to <80%) noted for greens and beans, whole grains, and dairy, and high adherence (≥ 80%) for the remaining recommended components.
While the primary limitation of this article is the use of melanoma thickness as a surrogate for survival in addition to potential for response bias due to the self-reporting survey component of this study, it offers a unique insight into the potential beneficial effects following a healthy diet may have on melanoma at diagnosis. Further prospective, longitudinal analysis is required to advance these results and to more accurately study effect of diet on survival among melanoma patients.
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