Adherence to the Vegetable-Fruit-Soy Dietary Pattern, a Reference From Mediterranean Diet, Protects Against Postmenopausal Breast Cancer Among Chinese Women

Abstract

BackgroundThe diet-center hypothesis has gained much support from the apparent protective effect of the Mediterranean diet on breast cancer. However, the evidence of the association between Mediterranean diet adherence and breast cancer molecular subtypes remains small, especially in non-Mediterranean populations.MethodsThe subjects from the Chinese Wuxi Exposure and Breast Cancer Study, a population-based case-control study, included 818 patients and 935 healthy controls. A validated food frequency questionnaire used for diet assessment and a modified version of the alternate Mediterranean Diet Score, which is called the alternate Chinese Diet Score, was developed to assess adherence to a migrated Chinese version of the Mediterranean diet, which we called the vegetable-fruit-soy dietary pattern. Soy foods, rapeseed oil, and coarse cereals replaced legumes, olive oil, and whole grains reflecting the cuisine of the region. We examined the association between the vegetable-fruit-soy diet adherence and breast cancer risk, stratified by menopause status (pre- or postmenopausal) and receptor status [estrogen-receptor (ER), progesterone-receptor (PR) status, and human epidermal growth factor 2 (HER2)] oncogene expression, followed by five specific combinations (ER+, ER–, ER+/PR+,ER–/PR–, and ER–/PR–/HER2–).ResultsThe results suggest that the vegetable-fruit-soy dietary pattern was inversely associated with postmenopausal breast cancer risk [4th vs. 1st quartile, odds ratio (OR) = 0.57, 95%CI = 0.41, 0.80; P trend < 0.001] and that the inverse association was somewhat stronger to detect among ER- subtypes (OR = 0.63; 95%CI = 0.37, 0.94; P trend = 0.003) and ER–/PR–subtypes (OR = 0.64; 95%CI = 0.41, 0.93; P trend = 0.012). We did not observe any significant association between the vegetable-fruit-soy diet characteristics and ER+ subtype, as well as between PR+ and ER+/PR+ subtypes.ConclusionThe favorable influence from the Mediterranean diet may also apply to Chinese women. The vegetable-fruit-soy dietary pattern may reduce the risk of postmenopausal breast cancer, particularly among ER- subtype, and ER–/PR–subtype.

Dietary patterns and breast cancer risk, prognosis, and quality of life: A systematic review

“…Another study in Iran found a significant positive correlation between dietary glycemic index and the incidence rate of BC (26), while high dietary fiber intake, such as beans and grains, was shown to reduce the risk of estrogen receptor negative (ER-) and progesterone receptor negative (PR-) BC in the United States (27). Meat and processed meat diets were associated with a higher risk of BC in a Chinese study (28), while the consumption of vegetables, fruit, and soybeans reduced the risk of postmenopausal BC, especially ER-and ER-/PR-subtypes (9). The consumption of fresh fruit and nuts was negatively correlated with the risk of menopausal BC, and foods with a high sodium content were positively correlated with the risk of menopausal BC in a South African study (29), and a multigrain diet reduced the risk of BC in a South Korean study (30).…”

“…A Mediterranean-style diet has been shown to reduce the risk of BC (9), while a low-fat diet reduced mortality in post-menopausal patients (10), and healthy eating patterns improved the quality of life of patients with BC (11). However, the role of dietary patterns in populations with specific BCs is inconclusive.…”

Soy Product Consumption and the Risk of Cancer: A Systematic Review and Meta-Analysis of Observational Studies

“…After the layers of screening, a total of 52 studies (35 articles were case-control studies [11][12][13][14][15][16]18,38,39,[41][42][43][44][45][46][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70][71][72][73][74][75]] and 17 articles were cohort studies [17,19,20,[34][35][36][37]40,47,[76][77][78][79][80][81][82][83]) we...…”

“…Furthermore, the meta-regression analysis results showed a statistical difference between China and Japan (p-difference = 0.022). Twenty-five studies [15,16,[18][19][20][35][36][37][39][40][41]60,61,[72][73][74]80,83] were included in the dose-response analysis for total soy product consumption and risk of cancer, and there was a nonlinear relationship between them (p-nonlinear = 0.0028) (Figure 3A,B). When an additional 54 g of total soy product was consumed daily, the cancer risk began to decline (RR: 0.89; 95% CI: 0.79, 0.99).…”

The Risk of Breast Cancer between Western and Mediterranean Dietary Patterns

“…A dietary pattern rich in fruits, soy, and vegetables was associated with a reduced risk of postmenopausal breast cancer in Chinese women, particularly in those with ERsubtypes [101]. This Mediterranean-style diet, observed in an Asian population, is defined by the consumption of plentiful plant-based foods, which is a fundamental component of the traditional Mediterranean diet known for its potential anticancer, anti-inflammatory, and antioxidant effects [102].…”