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00925njm 22002777a 4500 dc Solans, Marta author Fernández-Barrés, Sílvia author Romaguera, Dora author Benavente, Yolanda author Marcos-Gragera, Rafael author Gràcia-Lavedan, Esther author Costas, Laura author Robles, Claudia author Gonzalez-Barca, Eva author de la Banda, Esmeralda author Alonso, Esther author Aymerich, Marta author Campo, Elias author Llorca, Javier author Fernández-Tardón, Guillermo author Olmedo-Requena, Rocío author Gimeno, Eva author Castaño-Vinyals, Gemma author Aragones, Nuria author Kogevinas, Manolis author Pollan-Santamaria, Marina author de Sanjose, Silvia author Amiano, Pilar author Casabonne, Delphine author 2021-05-20 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. Int J Environ Res Public Health. 2021 May 20;18(10):5457. 10.3390/ijerph18105457 1660-4601 International Journal of Environmental Research and Public Health https://hdl.handle.net/20.500.13003/19513 34065213 L2007238563 2-s2.0-85106031676 http://hdl.handle.net/20.500.12105/13873 654961900001 NOVA classification Cancer Case-control study Chronic lymphocytic leukemia Ultra-processed food Consumption of Ultra-Processed Food and Drinks and Chronic Lymphocytic Leukemia in the MCC-Spain Study