Yang W, Sui J, Zhao L, et al. - Researchers used two nationwide cohorts to prospectively assess the degree to which greater inflammatory and insulinemic potential of diet and lifestyle are related to the risk of hepatocellular carcinoma (HCC). They calculated five types of pattern scores, including the empirical dietary inflammatory pattern (EDIP), empirical dietary index for hyperinsulinemia (EDIH) and insulin resistance (EDIR), empirical lifestyle pattern score for hyperinsulinemia (ELIH) and insulin resistance (ELIR). They followed-up 119,316 participants for an average of 25.6 years. An increased risk of HCC was observed in relation to higher adherence to EDIP, EDIH, and EDIR. Higher risk of developing HCC was noted in individuals with higher scores of ELIH and ELIR. The magnitude of the links was lower after additional adjustment for diabetes mellitus and/or body mass index; this suggests that the link of these patterns with HCC risk may be partially mediated by diabetes and/or adiposity. Overall, inflammation and insulin resistance/hyperinsulinemia were identified to be the potential mechanisms connecting dietary or lifestyle factors and development of HCC.