Vegetarian dietary patterns and the risk of breast cancer in a low-risk population

Abstract

Among cancers in American women, breast cancer (BC) has the second highest incidence and mortality. The association of BC with diet has been inconsistent. Studies that evaluate associations with dietary patterns are less common and reflect an individual's whole diet. We associated dietary patterns with the risk of BC in American women of the Adventist Health Study-2 (AHS-2), a prospective cohort of 96 001 subjects recruited between 2002 and 2007. Answers to a previously validated FFQ were used to classify subjects to vegan, lacto-ovo-vegetarian, pesco-vegetarian, semi-vegetarian and non-vegetarian dietary patterns. Incident BC were identified by matching AHS-2 subjects to data from forty-eight state cancer registries. Statistical analyses used proportional hazard regression analyses with covariates that were chosen a priori. From 50 404 female participants (26 193 vegetarians), we identified 892 incident BC cases, with 478 cases among vegetarians. As compared with non-vegetarians, all vegetarians combined did not have a significantly lower risk (hazard ratio (HR) 0·97; CI 0·84, 1·11; P = 0·64). However, vegans showed consistently lower (but non-significant) point estimates when compared with non-vegetarians (all cases: HR 0·78; CI 0·58, 1·05; P = 0·09). In summary, participants in this cohort who follow a vegetarian dietary pattern did not experience a lower risk of BC as compared with non-vegetarians, although lower risk in vegans is possible. These findings add to the very limited literature associating vegetarian diets with BC risk and can assist nutritionists when evaluating the impact of these diets. The findings will also motivate further evaluation of vegan diets and their special characteristics.

Vegetarianism and breast, colorectal and prostate cancer risk: an overview and meta‐analysis of cohort studies

“…1). This selection process led to the consideration of nine studies (15)(16)(17)(18)(19)(20)(21)(22)(23) to be included in this meta-analysis.…”

“…Four datasets from four studies (17,18,21,22) were analysed to test the association of vegetarian compared to a non-vegetarian diet and breast cancer risk (Fig. 2).…”

“…Subgroup analysis by menopausal status showed similar findings, with no significant results in premenopausal (RR = 0.99, 95% CI: 0.82, 1.20; I 2 = 0%, P heterogeneity = 0.63) and postmenopausal women (RR = 0.93, 95% CI: 0.81, 1.06; I 2 = 0%, P heterogeneity = 0.55). The same cohorts (17,18,21,22) also evaluated the association of pesco-vegetarian compared to a non-vegetarian diet and breast cancer risk (Fig. 2).…”

Flexitarian Diets and Health: A Review of the Evidence-Based Literature

“…One study examined vegetarian patterns in relation to breast cancer (BC) risk using data from 96,001 adults taking part in the prospective Adventist Health Study-2 (2002–2007). Findings showed that vegans had a significantly lower risk of BC compared with vegetarian and NVs (24). …”

The Potential for Plant-Based Diets to Promote Health Among Blacks Living in the United States

“…Vegetarian diets were protective against gastrointestinal cancers and vegan diets were associated with lower overall cancer incidence and female-specific cancers [121]. Separate analyses of prostate, breast, and colorectal cancers showed a trend towards lower risks for Blacks, although the results were non-significant [116,117,119].…”