Results:

Comparing highest to lowest quintiles, HRs (95% CIs) for lung cancer were as follows: HEI-2010= 0.83 (0.77–0.89), AHEI-2010= 0.86 (0.80–0.92), aMED= 0.85 (0.79–0.91) and DASH= 0.84 (0.78–0.90). Among the individual components of the dietary indices, higher consumption of whole grains and fruits was significantly inversely associated with lung cancer risk for several of the diet indices. Total index score analyses stratified by smoking status showed inverse associations with lung cancer for former smokers; however, only HEI-2010 was inversely associated in current smokers and no index score was inversely associated among never smokers.

Conclusions:

Although smoking is the factor most strongly associated with lung cancer, this study adds to a growing body of evidence that diet may have a modest role in reducing lung cancer risk, especially among former smokers.