The risk of developing polycythemia vera (PV), a myeloproliferative neoplasm (MPN), may be increased in people with a high dietary intake of sugar, according to findings published in Cancer Epidemiology, Biomarkers & Prevention.

The Philadelphia chromosome-negative MPNs (PV, essential thrombocythemia [ET], and myelofibrosis) are rare malignancies characterized by the clonal proliferation of 1 or more myeloid cell lines.

Etiological factors associated with MPNs remain poorly elucidated due in part to the rarity of these diseases, which has limited their assessment in large, population-based studies.

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This analysis, which explored the association between dietary factors and MPN, utilized data from the 490 patients who developed MPN subsequent to their enrollment in the large, prospective National Institutes of Health (NIH)-AARP Diet and Health Study. Specifically, researchers assessed self-reported consumption of carbohydrates, fats, and proteins, as well as meat, vegetables, and fruits over the last 12 months at baseline between 1995 and 1996 with respect to the incidence of MPN reported to cancer registries starting in 2000/2001.

Patients with PV (n=190) or ET (n=146) were analyzed separately given the low numbers of patients with primary myelofibrosis (n=67) and MPN-unclassifiable/not otherwise specified (n=87), although the latter 2 subgroups were included in assessments of MPN overall. Median follow-up was 15.5 years.

Findings observed on multivariable analyses adjusted for age, sex, race, education, marital status, self-reported chronic diseases, body mass index, and total calories included the following:

  • Risks of MPN overall, PV, and ET were not affected by levels of consumption of protein, vegetables, fat, meat, red meat, or processed meat
  • Compared with patients who consumed the lowest level of carbohydrates, the risk of PV (hazard ratio [HR], 1.78; 95% CI, 95% CI, 1.04–3.05: P =.04), but not MPN overall (P =.51) or ET (P =.22), was significantly increased in those who consumed the highest level of carbohydrates
  • Compared with patients who consumed the lowest level of fruit, the risk of MPN overall (HR, 1.32; 95% CI, 1.04-1.67; P =.02) and PV (HR, 2.00; 95% CI 1.35-2.95; P <.01), but not ET (P =.75), were significantly increased in those who consumed the highest level of fruit

The study investigators concluded, “our results indicate that high sugar intake is associated with an increased risk of polycythemia vera.”

Nevertheless, they cautioned that the finding of an association between high dietary sugar intake and the incidence of PV needs to be “replicated in other epidemiologic studies, preferably prospective cohorts, with adequate statistical power.”

Disclosures: Some authors have declared affiliation with or received funding from the pharmaceutical industry. Please refer to the original article for a full list of disclosures.


Podoltsev NA, Wang X, Wang R, et al. Diet and risk of myeloproliferative neoplasms in older individuals from the NIH-AARP cohort. Cancer Epidemiol Biomarkers Prev. 2020;29(11):2343-2350. doi:10.1158/1055-9965.EPI-20-0592