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Am J Clin Nutr. 2013 Dec;98(6):1524-32. doi: 10.3945/ajcn.113.061184. Epub 2013 Oct 9.

Dietary patterns and breast cancer risk in the California Teachers Study cohort.

Author information

1
From Cancer Epidemiology, Mailman School of Public Health, Columbia University, New York, NY (LBL); the Cancer Prevention Institute of California, Fremont, CA (AJC, CAC, and PLH-R); the Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (CAC and PLH-R); the Division of Cancer Etiology, Department of Population Sciences, Beckman Research Institute, City of Hope, Duarte, CA (LB); the Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA (DOS and GU); the Cancer Registry of Norway, Oslo, Norway (GU); and the Department of Nutrition, University of Oslo, Oslo, Norway (GU).

Abstract

BACKGROUND:

Evidence that diet is associated with breast cancer risk is inconsistent. Most studies have examined risks associated with specific foods and nutrients, rather than measures of overall diet.

OBJECTIVE:

This study aimed to evaluate dietary patterns and their relation to breast cancer risk in a large cohort of women.

DESIGN:

Data from 91,779 women in the California Teachers Study cohort were analyzed, including data from 4140 women with a diagnosis of invasive breast cancer made between 1995 and 2009. Five predominant dietary patterns were identified by using principal components factor analysis: a plant-based diet, high in fruit and vegetables; a high-protein, high-fat diet, high in meats, eggs, fried foods, and high-fat condiments; a high-carbohydrate diet, high in convenience foods, pasta, and bread products; an ethnic diet, high in legumes, soy-based foods, rice, and dark-green leafy vegetables; and a salad and wine diet, high in lettuce, fish, wine, low-fat salad dressing, and coffee and tea.

RESULTS:

The plant-based pattern was associated with a reduction in breast cancer risk (RR: 0.85; 95% CI: 0.76, 0.95 for the highest compared with the lowest consumption quintile; P-trend = 0.003); risk reduction was greater for estrogen receptor-negative progesterone receptor-negative (ER-PR-) tumors (RR: 0.66; 95% CI: 0.48, 0.91; P-trend = 0.03). The salad and wine pattern was associated with an increased risk of estrogen receptor-positive progesterone receptor-positive tumors (RR: 1.29; 95% CI: 1.12, 1.49); this effect was only slightly attenuated after adjustment for alcohol consumption.

CONCLUSION:

The finding that greater consumption of a plant-based dietary pattern is associated with a reduced breast cancer risk, particularly for ER-PR- tumors, offers a potential avenue for prevention.

PMID:
24108781
PMCID:
PMC3831538
DOI:
10.3945/ajcn.113.061184
[Indexed for MEDLINE]
Free PMC Article

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