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Sci Rep. 2019 Mar 7;9(1):3904. doi: 10.1038/s41598-019-39346-4.

Overeating, caloric restriction and breast cancer risk by pathologic subtype: the EPIGEICAM study.

Author information

1
National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.
2
Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain.
3
GEICAM Spanish Breast Cancer Group, Madrid, Spain.
4
Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain.
5
Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
6
Instituto Valenciano de Oncología, Valencia, Spain.
7
Hospital Virgen del Rocío, Sevilla, Spain.
8
Hospital Puerta del Mar, Cádiz, Spain.
9
Complejo Hospitalario Universitario A Coruña, A Coruña, Spain.
10
Centro Oncológico de Galicia, A Coruña, Spain.
11
Hospital Clínico San Carlos, Madrid, Spain.
12
Hospital Clinic i Provincial, Barcelona, Spain.
13
Hospital Clínico de Valencia, Valencia, Spain.
14
Hospital Marqués de Valdecilla, Santander, Spain.
15
Fundación Hospital de Alcorcón, Madrid, Spain.
16
Complejo Hospitalario de Jaén, Jaén, Spain.
17
Hospital Universitario Miguel Servet, Zaragoza, Spain.
18
Hospital Virgen de la Salud, Toledo, Spain.
19
Consorci Sanitari de Terrassa, Barcelona, Spain.
20
Universidad Miguel Hernández, ISABIAL, Alicante, Spain.
21
National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain. mpollan@isciii.es.
22
Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain. mpollan@isciii.es.
23
GEICAM Spanish Breast Cancer Group, Madrid, Spain. mpollan@isciii.es.

Abstract

This study analyzes the association of excessive energy intake and caloric restriction with breast cancer (BC) risk taking into account the individual energy needs of Spanish women. We conducted a multicenter matched case-control study where 973 pairs completed lifestyle and food frequency questionnaires. Expected caloric intake was predicted from a linear regression model in controls, including calories consumed as dependent variable, basal metabolic rate as an offset and physical activity as explanatory. Overeating and caloric restriction were defined taking into account the 99% confidence interval of the predicted value. The association with BC risk, overall and by pathologic subtype, was evaluated using conditional and multinomial logistic regression models. While premenopausal women that consumed few calories (>20% below predicted) had lower BC risk (OR = 0.36; 95% CI = 0.21-0.63), postmenopausal women with an excessive intake (≥40% above predicted) showed an increased risk (OR = 2.81; 95% CI = 1.65-4.79). For every 20% increase in relative (observed/predicted) caloric intake the risk of hormone receptor positive (p-trend < 0.001) and HER2+ (p-trend = 0.015) tumours increased 13%, being this figure 7% for triple negative tumours. While high energy intake increases BC risk, caloric restriction could be protective. Moderate caloric restriction, in combination with regular physical activity, could be a good strategy for BC prevention.

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