Adherence to the mediterranean diet and risk of breast cancer in the European prospective investigation into cancer and nutrition cohort study

Buckland, Genevieve; Travier, Noémie; Cottet, Vanessa; González, Carlos A.; Luján-Barroso, Leila; Agudo, Antonio; Trichopoulou, Antonia; Λάγιου, Παγώνα; Trichopoulos, D; Peeters, Petra H.M.; May, Anne M.; Bueno-De-Mesquita, H. Bas; Duijnhoven, Fränzel J.B. van; Key, Tim; Allen, Naomi E.; Khaw, Kay Tee; Wareham, Nick; Romieu, Isabelle; McCormack, Valerie; Boutron‐Ruault, Marie‐Christine; Clavel-Chapelon, F.; Panico, Salvatore; Agnoli, Claudia; Palli, Domenico; Tumino, Rosario; Víneis, Paolo; Amiano, Pilar; Barricarte, Aurelio; Rodríguez, Laudina; Sánchez, María José; Chirlaque, M. D.; Kaaks, Rudolf; Teucher, Birgit; Boeing, Heiner; Bergmann, Manuela M.; Overvad, Kim; Dahm, Christina C.; Tjønneland, Anne; Olsen, Anja; Manjer, Jonas; Wirfält, Elisabet; Hallmans, Göran; Johansson, Ingegerd; Lund, Eiliv; Hjartåker, Anette; Skeie, Guri; Vergnaud, Anne Claire; Norat, Teresa; Romaguera, Dora; Riboli, Elio

doi:10.1002/ijc.27958

Cited by 188 publications

(208 citation statements)

References 41 publications

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“…27 Since pre-and postmenopausal breast cancers are often considered as different disease entities, separate Cox models were fitted. 28 As data on menopausal status at diagnosis were lacking, age at time of breast cancer diagnosis (50 versus Figure 1. Overview of EPIC-PANACEA (N 5 205,723).…”

Section: Discussionmentioning

confidence: 99%

Weight change in middle adulthood and breast cancer risk in the EPIC-PANACEA study

et al. 2014

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Long‐term weight gain (i.e., weight gain since age 20) has been related to higher risk of postmenopausal breast cancer, but a lower risk of premenopausal breast cancer. The effect of weight change in middle adulthood is unclear. We investigated the association between weight change in middle adulthood (i.e., women aged 40–50 years) and the risk of breast cancer before and after the age of 50. We included female participants of the European Prospective Investigation into Cancer and Nutrition cohort, with information on anthropometric measures at recruitment and after a median follow‐up of 4.3 years. Annual weight change was categorized using quintiles taking quintile 2 and 3 as the reference category (−0.44 to 0.36 kg/year). Multivariable Cox proportional hazards regression analysis was used to examine the association. 205,723 women were included and 4,663 incident breast cancer cases were diagnosed during a median follow‐up of 7.5 years (from second weight assessment onward). High weight gain (Q5: 0.83–4.98 kg/year) was related to a slightly, but significantly higher breast cancer risk (HRQ5_versus_Q2/3: 1.09, 95% CI: 1.01−1.18). The association was more pronounced for breast cancer diagnosed before or at age 50 (HRQ5_versus_Q2/3: 1.37, 95% CI: 1.02−1.85). Weight loss was not associated with breast cancer risk. There was no evidence for heterogeneity by hormone receptor status. In conclusion, high weight gain in middle adulthood increases the risk of breast cancer. The association seems to be more pronounced for breast cancer diagnosed before or at age 50. Our results illustrate the importance of avoiding weight gain in middle adulthood.

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Section: Discussionmentioning

confidence: 99%

Weight change in middle adulthood and breast cancer risk in the EPIC-PANACEA study

et al. 2014

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“…The updated search from recent years resulted in the identification of eighteen additional prospective studies published up to June 2013 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24) . Characteristics of these recent studies are displayed in Table 3.…”

Section: Updated Systematic Review and Meta-analysismentioning

confidence: 99%

“…3), a greater adherence to the Mediterranean diet still determined a significant protection, to a similar extent as the previous meta-analysis (RR 5 0?96; 95 % CI 0?95, 0?97; P , 0?00001), with evidence of significant heterogeneity across the studies (I 2 5 65 %; P , 0?0 0 1). The heterogeneity seems to be determined by the recent studies investigating breast and colorectal cancer (21)(22)(23) . After exclusion of these three studies, the statistical heterogeneity disappeared (I 2 5 36 %; P 5 0?10), with no modification (10) van den Brandt (2011) (11) Literature-based adherence score to the Mediterranean diet Characteristics of the studies included for this analysis are reported in Tables 1 and 2 for men and women, respectively.…”

Section: Updated Systematic Review and Meta-analysismentioning

confidence: 99%

Mediterranean diet and health status: an updated meta-analysis and a proposal for a literature-based adherence score

Sofi

Macchi

Abbate

et al. 2013

Public Health Nutr.

836

650

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Objective: To update previous meta-analyses of cohort studies that investigated the association between the Mediterranean diet and health status and to utilize data coming from all of the cohort studies for proposing a literature-based adherence score to the Mediterranean diet. Design: We conducted a comprehensive literature search through all electronic databases up to June 2013. Setting: Cohort prospective studies investigating adherence to the Mediterranean diet and health outcomes. Cut-off values of food groups used to compute the adherence score were obtained. Subjects: The updated search was performed in an overall population of 4 172 412 subjects, with eighteen recent studies that were not present in the previous meta-analyses. Results: A 2-point increase in adherence score to the Mediterranean diet was reported to determine an 8 % reduction of overall mortality (relative risk 5 0?92; 95 % CI 0?91, 0?93), a 10 % reduced risk of CVD (relative risk 5 0?90; 95 % CI 0?87, 0?92) and a 4 % reduction of neoplastic disease (relative risk 5 0?96; 95 % CI 0?95, 0?97). We utilized data coming from all cohort studies available in the literature for proposing a literature-based adherence score. Such a score ranges from 0 (minimal adherence) to 18 (maximal adherence) points and includes three different categories of consumption for each food group composing the Mediterranean diet. Conclusions: The Mediterranean diet was found to be a healthy dietary pattern in terms of morbidity and mortality. By using data from the cohort studies we proposed a literature-based adherence score that can represent an easy tool for the estimation of adherence to the Mediterranean diet also at the individual level.

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“…A recent study of the California Teachers Cohort identified a plant-based pattern, which was related to a reduction of BC risk (67) . In parallel, increasing evidence is accumulating that adherence to the a priori defined Mediterranean pattern is associated with a decreased BC risk (68)(69)(70) , although results from these studies are not totally consistent, particularly for premenopausal women (70,71) . The dimension reduction techniques used herein were applied to nutrient densities.…”

Section: Discussionmentioning

confidence: 99%

“…TT and PCA provided overall consistent findings in terms of pattern identification and amount of total variability explained. (58,67,70,75) . Indeed, Fung et al found that a prudent dietary pattern was linked with decreased ER − risk (relative risk = 0·62, 95 % CI 0·45, 0·91) (76) .…”

Section: Discussionmentioning

confidence: 99%

A treelet transform analysis to relate nutrient patterns to the risk of hormonal receptor-defined breast cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Assi

Moskal

Slimani

et al. 2015

Public Health Nutr.

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Pattern analysis has emerged as a tool to depict the role of multiple nutrients/foods in relation to health outcomes. The present study aimed at extracting nutrient patterns with respect to breast cancer (BC) aetiology. Nutrient patterns were derived with treelet transform (TT) and related to BC risk. TT was applied to twenty-three log-transformed nutrient densities from dietary questionnaires. Hazard ratios (HR) and 95 % confidence intervals computed using Cox proportional hazards models quantified the association between quintiles of nutrient pattern scores and risk of overall BC, and by hormonal receptor and menopausal status. Principal component analysis was applied for comparison. The European Prospective Investigation into Cancer and Nutrition (EPIC). Women (n 334 850) from the EPIC study. The first TT component (TC1) highlighted a pattern rich in nutrients found in animal foods loading on cholesterol, protein, retinol, vitamins B12 and D, while the second TT component (TC2) reflected a diet rich in β-carotene, riboflavin, thiamin, vitamins C and B6, fibre, Fe, Ca, K, Mg, P and folate. While TC1 was not associated with BC risk, TC2 was inversely associated with BC risk overall (HRQ5 v. Q1=0·89, 95 % CI 0·83, 0·95, Ptrend<0·01) and showed a significantly lower risk in oestrogen receptor-positive (HRQ5 v. Q1=0·89, 95 % CI 0·81, 0·98, Ptrend=0·02) and progesterone receptor-positive tumours (HRQ5 v. Q1=0·87, 95 % CI 0·77, 0·98, Ptrend<0·01). TT produces readily interpretable sparse components explaining similar amounts of variation as principal component analysis. Our results suggest that participants with a nutrient pattern high in micronutrients found in vegetables, fruits and cereals had a lower risk of BC

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Adherence to the mediterranean diet and risk of breast cancer in the European prospective investigation into cancer and nutrition cohort study

Cited by 188 publications

References 41 publications

Weight change in middle adulthood and breast cancer risk in the EPIC-PANACEA study

Weight change in middle adulthood and breast cancer risk in the EPIC-PANACEA study

Mediterranean diet and health status: an updated meta-analysis and a proposal for a literature-based adherence score

A treelet transform analysis to relate nutrient patterns to the risk of hormonal receptor-defined breast cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC)

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