Background
Global cancer incidence continues to increase, with particularly concerning rises among younger adults. These trends emphasize the urgent need for effective and scalable cancer prevention strategies. Diet is a major modifiable determinant of cancer risk worldwide. Although obesity is a well-established mediator of diet-related cancer risk, growing evidence indicates that dietary patterns may influence cancer development through additional biological pathways that act independently of adiposity. Advancing cancer prevention therefore requires approaches that directly link diet to cancer-relevant biology across diverse populations.
Objectives
This talk will highlight recent advances in nutritional epidemiology that define dietary patterns based on underlying biological mechanisms relevant to cancer. We describe how biologically defined dietary patterns and their objective biomarker profiles can strengthen etiologic understanding, improve international comparability across studies, and lay the foundation for precision nutrition approaches to cancer prevention.
Methods
Cancer development is driven by core metabolic processes, including chronic inflammation, dysregulated insulin signaling, and altered lipid metabolism. Biologically defined dietary patterns have been developed to capture how combinations of foods influence these pathways at a molecular level. We will discuss the application of nutritional metabolomics in large prospective cohorts, controlled feeding studies, and international metabolomics consortia spanning multiple continents. These efforts enabled the derivation of objective biomarker profiles of dietary patterns related to inflammation and hyperinsulinemia, followed by external validation across populations with heterogeneous genetics, dietary behaviors, and food environments.
Results
Biologically defined dietary patterns are now consistently associated with risk of multiple cancers, with particularly strong and reproducible evidence for colorectal cancer. Objective biomarker profiles of these dietary patterns demonstrate associations with cancer risk that are comparable in magnitude to those observed using traditional self-reported dietary assessment. These findings provide clear proof of principle that small volumes of blood can yield scalable, objective measures of dietary exposure and biological response suitable for large epidemiologic studies. Emerging work extends this framework to additional pathways, including dietary patterns reflecting ceramide metabolic potential. Ceramides are key regulators of insulin resistance, inflammation, and mitochondrial function, and represent a promising biological target for understanding diet-related cancer risk.
Conclusions and Implications
These advances mark an important shift in nutritional epidemiology with direct relevance to global cancer prevention efforts. Biologically defined dietary patterns and their biomarker profiles provide a robust framework for developing tools for improved cancer risk stratification, and stronger evidence to inform prevention guidelines. Looking forward, this approach supports a precision nutrition paradigm in which objective biomarkers are used to identify individuals and populations most likely to benefit from targeted dietary interventions and to evaluate intervention response in both clinical and public health settings. Aligning dietary guidance with cancer-relevant biology offers a critical opportunity to reduce global cancer burden through evidence-based, biologically informed prevention strategies.