Associations of Diet with Health Outcomes in the UK Biobank: A Systematic Review

Abstract

The UK Biobank is a cohort study that collects data on diet, lifestyle, biomarkers, and health to examine diet-disease associations. Based on the UK Biobank, we reviewed 36 studies on diet and three health conditions: type 2 diabetes (T2DM), cardiovascular disease (CVD), and cancer. Most studies used one-time dietary data instead of repeated 24 h recalls, which may lead to measurement errors and bias in estimating diet-disease associations. We also found that most studies focused on single food groups or macronutrients, while few studies adopted a dietary pattern approach. Several studies consistently showed that eating more red and processed meat led to a higher risk of lung and colorectal cancer. The results suggest that high adherence to "healthy" dietary patterns (consuming various food types, with at least three servings/day of whole grain, fruits, and vegetables, and meat and processed meat less than twice a week) slightly lowers the risk of T2DM, CVD, and colorectal cancer. Future research should use multi-omics data and machine learning models to account for the complexity and interactions of dietary components and their effects on disease risk.

Keywords: UK Biobank; cancer; cardiovascular diseases; diabetes mellitus; dietary assessment; food frequency questionnaire; food preference questionnaire; middle aged; online 24 h dietary assessment.

Figure 1

Selection of studies for the systematic review.

Figure 2

Summary of hazard ratio for the association between food/diet and CVD risk. The points represent different dietary patterns or food items or nutrients and types of CVD risk. The shape shows what kind of CVD outcome was studied (square for all-cause mortality; circle for CVD incidence; triangle for CVD mortality; diamond for myocardial infarction (MI) incidence). An HR of 1 (horizontal red dashed line) means no association. The colour of the points shows the significance level (grey for na = p-value not reported; red for ns = p-value ≥ 0.05; green for s = p value < 0.05).

Figure 3

Summary of hazard ratios for the association between food/diet and cancer risk. Each point represents the hazard ratio for a specific food item or dietary pattern and a type of cancer. The shape shows what kind of cancer outcome was studied (square for breast cancer; triangle for colon cancer; circle for colorectal cancer; diamond for lung cancer; square cross for overall cancer; circle plus for prostate cancer). Horizontal reference line (red dashed) set at 1 indicates no association. The significance level is indicated by the colour of the point (grey for na = p-value not reported; red for ns = p-value ≥ 0.05; green for s = p value < 0.05).

Figure 4

Summary of hazard ratio for the association between food/diet and type 2 diabetes mellitus risk. Each point corresponds to dietary pattern, food item, or nutrients. Horizontal reference line (red dashed line) set at 1 indicates no association. The significance level is shown by the colour of the point (grey for na = p-value not reported; red for ns = p-value ≥ 0.05; green for s = p value < 0.05).

Figure 5

Summary effect estimates of diet on cancer, CVD, and T2DM risk: (A) Boxplot show the median HR of healthy diet on colorectal cancer, CVD incidence, and T2DM incidence. (B) Boxplot show the median HR of processed meat and red meat consumption on colorectal and lung cancer. The median for each effect estimate is indicated by horizontal lines and the value is shown inside the boxes.