Hybrid Dietary-Blood Inflammatory Profiles and Postmenopausal Breast Cancer: A Case-Control Study

Abstract

The carcinogenesis process is associated with inflammation, which can be modified by diet. There is limited evidence regarding the inflammatory status and diet in association with breast cancer (BC). The aim of this study was to investigate the association of hybrid dietary-blood inflammatory profiles (HD-BIPs) with postmenopausal breast cancer occurrence. The case-control study was conducted among 420 women (230 controls, 190 primary BC cases) aged 40–79 years from north-eastern Poland. Blood levels of C-reactive protein (CRP), interleukin-6 (IL-6) and leukocyte count were marked in 129 postmenopausal women (82 controls, 47 cases). The 62-item food frequency questionnaire (FFQ-6) was used to the dietary data collection. Two HD-BIPs were found using the Principal Component Analysis (PCA). The “Pro-healthy/Neutral-inflammatory” profile was characterized by the frequent consumption of wholemeal cereals/coarse groats, legumes, vegetables, fruits, nuts/seeds and fish. The “Unhealthy/Pro-inflammatory” profile was characterized by the frequent consumption of red/processed meats, animal fats, sugar/honey/sweets, refined cereals/fine groats, and an increased concentration of CRP, IL-6 and granulocyte-to-lymphocyte ratio. The lower odds ratio (OR) of breast cancer was associated with the higher adherence to the “Pro-healthy/Neutral-inflammatory” profile (OR = 0.38; 95% Cl: 0.18–0.80; p < 0.01 for the higher level vs. lower level, crude model; OR for one-point score increment: 0.61; 95% Cl: 0.42–0.87; p < 0.01, adjusted model). The higher OR of breast cancer was associated with the higher adherence to the “Unhealthy/Pro-inflammatory” profile (OR = 3.07; 95%Cl: 1.27–7.44; p < 0.05 for the higher level v.s. lower level, adjusted model; OR for one-point score increment: 1.18; 95%Cl: 1.02–1.36; p < 0.05, adjusted model). This study revealed that the consumption of highly processed, high in sugar and animal fat foods should be avoided because this unhealthy diet was positively associated with postmenopausal breast cancer occurrence through its pro-inflammatory potential. Instead, the frequent consumption of low-processed plant foods and fish should be recommended since this pro-healthy diet was inversely associated with the cancer occurrence even though its anti-inflammatory potential has not been confirmed in this study sample.

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

“…In addition, a low-glucose diet, characterized by the intake of glucose equal to or lower than the average fasting level, improved insulin resistance (HOMA-IR) and other cancer-related serum biomarkers in some studies, thereby favorably regulating postmenopausal obesity as a postmenopausal BC prevention strategy (79). Other dietary patterns that improve the prognosis and quality of life of BC patients, such as an anti-inflammatory diet, have been shown to improve the prognosis of BC patients by reducing cardiovascular mortality (25).…”

“…In an inflammatory diet, inflammatory markers increase BC risk by stimulating angiogenesis, cell proliferation, and migration, and preventing apoptosis, while other inflammatory biomarkers may reduce quality of life. In addition, the key mediators of the inflammatory response promote tumor growth, angiogenesis, and invasion through the influence of insulin resistance and increased cytokines (25). However, results on this topic are currently lacking, and more correlation studies are needed.…”

“…Niclis et al's case-control study of inflammatory dietary patterns showed an association with disease risk, whereas Gardeazabal et al's cohort study showed no such association, which may reflect recall bias rather than a true difference (46,47). Some studies showed that inflammatory diets increased the risk of BC (ER+, PR+, HER2+), but few studies have examined hormone-negative or triple-negative BC, and the effect of diet on heterogeneous breast risk or prognosis remains unclear (25). Foroozani et al's study did not assess the role of dietary patterns based on the histological subtype of breast cancer (55).…”

“…An unhealthy diet was positively related to the occurrence of postmenopausal BC through its proinflammatory potential. In contrast, regular consumption of low-processed vegetable products and fish was negatively related to the occurrence of cancer (25). 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).…”

Does the consumption of pasta, rice and groats affect the risk of cancer of women’s reproductive organs and breast?

“…In a case-control study conducted by Stasiewicz et al, which was carried out with 420 female patients aged 40 to 79 years, it was proven that a higher odds ratio (OR) of breast cancer was associated with a higher score obtained on the basis of the FFQ questionnaire (Food Frequency Questionnaire), which in turn was associated with a higher 'proinflammatory profile' of the female patients' diet (related, inter alia, to the consumption of high glycaemic index products). On the other hand, the lower OR was associated with adherence to the pro-health diet profile, which was associated with higher consumption of low-processed plant products, including cereals [33].…”