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Fiber intake modulates the association of alcohol intake with breast cancer

Romieu I 1 , Ferrari P 1 , Chajès V 1 , de Batlle J 1 , Biessy C 1 , Scoccianti C 1 Show all authors , Dossus L 2 , Christine Boutron M 2 , Bastide N 2 , Overvad K 3 , Olsen A 4 , Tjønneland A 4 , Kaaks R 5 , Boeing H 6 , Trichopoulou A 7 , Lagiou P 8 , Trichopoulos D 9 , Palli D 10 , Sieri S 11 , Tumino R 12 , Vineis P 13 , Panico S 14 , Bueno-de-Mesquita HB 15 , Gils CH 16 , Peeters PH 16 , Lund E 17 , Skeie G 17 , Weiderpass E 18 , Ramón Quirós J 19 , Chirlaque MD 20 , Ardanaz E 21 , Sánchez MJ 22 , Duell EJ 23 , Amiano Etxezarreta P 24 , Borgquist S 25 , Hallmans G 26 , Johansson I 27 , Maria Nilsson L 28 , Khaw KT 29 , Wareham N 30 , Key TJ 31 , Travis RC 31 , Murphy N 32 , Wark PA 32 , Riboli E 32

Affiliations 

  • 1 International Agency for Research on Cancer (IARC), Lyon, France
  • 2 Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health team, Villejuif, F-94805, France
  • 3 Department of Epidemiology, School of Public Health, Aarhus University, Aarhus, Denmark
  • 4 Research Diet, Genes and Environment Danish Cancer Society Research Center Strandboulevarden, Copenhagen, Denmark
  • 5 Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
  • 6 Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke German, Institute of Human Nutrition Potsdam-Rehbrücke
  • 7 Hellenic Health Foundation, 13 Kaisareias Street, Athens, GR-115 27, Greece
  • 8 WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece
  • 9 Department of Epidemiology, Harvard School of Public Health, Boston
  • 10 Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy
  • 11 Epidemiology and Prevention Unit, Department of Preventive & Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
  • 12 Cancer Registry and Histopathology Unit, "Civic - M.P.Arezzo" Hospital, ASP Ragusa, Italy
  • 13 School of Public Health, Imperial College London, London, HuGeF Foundation Torino Italy
  • 14 Dipartimento di Medicina Clinica e Chirurgia Federico II University, Naples, Italy
  • 15 National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
  • 16 Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
  • 17 Department of community medicine, University of Tromsø - the Arctic University of Norway, Tromsø, Norway
  • 18 Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
  • 19 Public Health Directorate, Asturias, Spain
  • 20 Department of Epidemiology, Murcia Regional Health Authority, Murcia, Spain, CIBER Epidemiology and Public Health CIBERESP, Spain
  • 21 Navarre Public Health Institute, Pamplona, Spain, CIBER Epidemiology and Public Health CIBERESP, Spain
  • 22 Escuela Andaluza de Salud Pública, Granada, Spain, CIBERESP, Spain, Instituto de Investigación Biosanitaria de Granada, Granada, Spain
  • 23 Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
  • 24 Public Health Division of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain
  • 25 Division of Oncology, Department of Clinical Sciences, Lund University Lund, Sweden
  • 26 Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, Sweden
  • 27 Department of Odontology, Umeå University, Umeå, Sweden
  • 28 Public Health and Clinical Medicine/Nutritional research, Umeå university, Umeå, Sweden
  • 29 University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
  • 30 MRC Epidemiology Unit and University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
  • 31 Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
  • 32 Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
Int J Cancer, 2017 Jan 15;140(2):316-321.
PMID: 27599758 DOI: 10.1002/ijc.30415

Abstract

Alcohol intake has been related to an increased risk of breast cancer (BC) while dietary fiber intake has been inversely associated to BC risk. A beneficial effect of fibers on ethanol carcinogenesis through their impact on estrogen levels is still controversial. We investigated the role of dietary fiber as a modifying factor of the association of alcohol and BC using data from the European Prospective Investigation into Cancer and Nutrition (EPIC). This study included 334,850 women aged 35-70 years at baseline enrolled in the ten countries of the EPIC study and followed up for 11.0 years on average. Information on fiber and alcohol intake at baseline and average lifetime alcohol intake were calculated from country-specific dietary and lifestyle questionnaires. Hazard ratios (HR) of developing invasive BC according to different levels of alcohol and fiber intake were computed. During 3,670,439 person-years, 11,576 incident BC cases were diagnosed. For subjects with low intake of fiber (<18.5 g/day), the risk of BC per 10 g/day of alcohol intake was 1.06 (1.03-1.08) while among subjects with high intake of fiber (>24.2 g/day) the risk of BC was 1.02 (0.99-1.05) (test for interaction p = 0.011). This modulating effect was stronger for fiber from vegetables. Our results suggest that fiber intake may modulate the positive association of alcohol intake and BC. Alcohol is well known to increase the risk for BC, while a fiber-rich diet has the opposite effect. Here the authors find a significant interaction between both lifestyle factors indicating that high fiber intake can ease the adverse effects associated with alcohol consumption. Consequently, women with high alcohol intake and low fiber intake (<18.5 g/day) had the highest risk for BC. Specific benefits were associated with fibers from vegetable, warranting further investigations into specific fiber sources and their mechanistic interactions with alcohol-induced BC risk.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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