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Br J Cancer. 2014 Sep 23;111(7):1454-62. doi: 10.1038/bjc.2014.434. Epub 2014 Aug 7.

Spanish Mediterranean diet and other dietary patterns and breast cancer risk: case-control EpiGEICAM study.

Author information

  • 11] Cancer Epidemiology Unit, National Center for Epidemiology, Instituto de Salud Carlos III, Av/Monforte de Lemos, 5, 28029 Madrid, Spain [2] Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Carlos III Institute of Health, Av/Monforte de Lemos, 5, 28029 Madrid, Spain [3] Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany.
  • 21] Cancer Epidemiology Unit, National Center for Epidemiology, Instituto de Salud Carlos III, Av/Monforte de Lemos, 5, 28029 Madrid, Spain [2] Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Carlos III Institute of Health, Av/Monforte de Lemos, 5, 28029 Madrid, Spain.
  • 3Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany.
  • 4Medical Oncology Unit, Instituto Valenciano de Oncología, C/Profesor Beltrán Baguena 19, 46009 Valencia, Spain.
  • 5Medical Oncology Unit, Hospital Virgen del Rocío, Avenida Maneul Siurot S/N, 41013 Sevilla, Spain.
  • 6Medical Oncology Unit, Hospital Puerta del Mar, Avenida Ana De Viya 21, 11009 Cádiz, Spain.
  • 7Medical Oncology Unit, Complejo Hospitalario Universitario, Calle Xubias De Arriba, 84, 15006 A Coruña, Spain.
  • 8Medical Oncology Unit, Centro Oncológico de Galicia, Avenida Monsterrat S/N, 15009 A Coruña, Spain.
  • 9Medical Oncology Unit, Hospital Clinic I Provincial de Barcelona, Calle Villaroel 170, 08036 Barcelona, Spain.
  • 10Hematology-Oncology Department, Hospital Clínico Universitario de Valencia / INCLIVA, Universidad de Valencia, Avenida Blasco Ibáñez, 17, 46010 Valencia, Spain.
  • 11Medical Oncology Unit, Hospital Marqués de Valdecilla, Avenida De Valdecilla S/N, 39008 Santander, Spain.
  • 12Medical Oncology Unit, Fundación Hospitalaria de Alcorcón, Calle Budapest 1, 28922 Alcorcón, Madrid, Spain.
  • 13Spanish Breast Cancer Research Group (GEICAM) Headquarters, Avenida De los Pirineos 7, 28703 San Sebastián de los Reyes, Madrid, Spain.
  • 141] Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Carlos III Institute of Health, Av/Monforte de Lemos, 5, 28029 Madrid, Spain [2] Department of Public Health, Universidad Miguel Hernandez, Ctra. Alicante-Valencia, Km. 87, 03550 Sant Joan D'Alacant, Spain.
  • 151] Medical Oncology Unit, Hospital Clínico Universitario San Carlos, Calle Profesor Martín Lagos, S/N, 28040 Madrid, Spain [2] Health Research Institute Gregorio Marañón, Universidad Complutense, Calle Doctor Esquerdo 46, 28007 Madrid, Spain.

Abstract

BACKGROUND:

Although there are solid findings regarding the detrimental effect of alcohol consumption, the existing evidence on the effect of other dietary factors on breast cancer (BC) risk is inconclusive. This study aimed to evaluate the association between dietary patterns and risk of BC in Spanish women, stratifying by menopausal status and tumour subtype, and to compare the results with those of Alternate Healthy Index (AHEI) and Alternate Mediterranean Diet Score (aMED).

METHODS:

We recruited 1017 incident BC cases and 1017 matched healthy controls of similar age (±5 years) without a history of BC. The association between 'a priori' and 'a posteriori' developed dietary patterns and BC in general and according to menopausal status and intrinsic tumour subtypes (ER+/PR+ and HER2-; HER2+; and ER-/PR- and HER2-) was evaluated using logistic and multinomial regression models.

RESULTS:

Adherence to the Western dietary pattern was related to higher risk of BC (OR for the top vs the bottom quartile 1.46 (95% CI 1.06-2.01)), especially in premenopausal women (OR=1.75; 95% CI 1.14-2.67). In contrast, the Mediterranean pattern was related to a lower risk (OR for the top quartile vs the bottom quartile 0.56 (95% CI 0.40-0.79)). Although the deleterious effect of the Western pattern was similarly observed in all tumour subtypes, the protective effect of our Mediterranean pattern was stronger for triple-negative tumours (OR=0.32; 95% CI 0.15-0.66 and Pheterogeneity=0.04). No association was found between adherence to the Prudent pattern and BC risk. The associations between 'a priori' indices and BC risk were less marked (OR for the top vs the bottom quartile of AHEI=0.69; 95% CI 0.51-0.94 and aMED=0.74; 95% CI 0.46-1.18)).

CONCLUSIONS:

Our results confirm the harmful effect of a Western diet on BC risk, and add new evidence on the benefits of a diet rich in fruits, vegetables, legumes, oily fish and vegetable oils for preventing all BC subtypes, and particularly triple-negative tumours.

PMID:
25101568
[PubMed - indexed for MEDLINE]
PMCID:
PMC4183855
Free PMC Article
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