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Nutrient-wide association study of 92 foods and nutrients and breast cancer risk

Heath AK 1 , Muller DC 2 , van den Brandt PA 3 , Papadimitriou N 4 , Critselis E 5 , Gunter M 2 Show all authors , Vineis P 2 , Weiderpass E 6 , Fagherazzi G 7 , Boeing H 8 , Ferrari P 9 , Olsen A 10 , Tjønneland A 10 , Arveux P 7 , Boutron-Ruault MC 7 , Mancini FR 7 , Kühn T 11 , Turzanski-Fortner R 11 , Schulze MB 12 , Karakatsani A 13 , Thriskos P 13 , Trichopoulou A 13 , Masala G 14 , Contiero P 15 , Ricceri F 16 , Panico S 17 , Bueno-de-Mesquita B 2 , Bakker MF 18 , van Gils CH 18 , Olsen KS 19 , Skeie G 19 , Lasheras C 20 , Agudo A 21 , Rodríguez-Barranco M 22 , Sánchez MJ 22 , Amiano P 23 , Chirlaque MD 23 , Barricarte A 23 , Drake I 24 , Ericson U 24 , Johansson I 25 , Winkvist A 26 , Key T 27 , Freisling H 9 , His M 9 , Huybrechts I 9 , Christakoudi S 2 , Ellingjord-Dale M 2 , Riboli E 2 , Tsilidis KK 2 , Tzoulaki I 2

Affiliations 

  • 1 Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG, UK. a.heath@imperial.ac.uk
  • 2 Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG, UK
  • 3 Department of Epidemiology, Maastricht University Medical Centre, Maastricht, the Netherlands
  • 4 Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
  • 5 Proteomics Facility, Center for Systems Biology, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
  • 6 International Agency for Research on Cancer, World Health Organization, Lyon, France
  • 7 Center of Research in Epidemiology and Population Health (CESP), Inserm U1018, Paris-South Paris-Saclay University, Gustave Roussy, Villejuif, France
  • 8 Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
  • 9 Nutrition and Metabolism Section, International Agency for Research on Cancer, World Health Organization, Lyon, France
  • 10 Danish Cancer Society Research Center, Copenhagen, Denmark
  • 11 Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
  • 12 Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
  • 13 Hellenic Health Foundation, Athens, Greece
  • 14 Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
  • 15 Environmental Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
  • 16 Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
  • 17 Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
  • 18 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
  • 19 Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
  • 20 Functional Biology Department, School of Medicine, University of Oviedo, Asturias, Spain
  • 21 Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology - ICO, Group of Research on Nutrition and Cancer, Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet of Llobregat, Barcelona, Spain
  • 22 Andalusian School of Public Health (EASP), Granada, Spain
  • 23 CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
  • 24 Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
  • 25 Department of Odontology, Umeå University, Umeå, Sweden
  • 26 Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
  • 27 Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
Breast Cancer Res, 2020 01 13;22(1):5.
PMID: 31931881 DOI: 10.1186/s13058-019-1244-7

Abstract

BACKGROUND: Several dietary factors have been reported to be associated with risk of breast cancer, but to date, unequivocal evidence only exists for alcohol consumption. We sought to systematically assess the association between intake of 92 foods and nutrients and breast cancer risk using a nutrient-wide association study.

METHODS: Using data from 272,098 women participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, we assessed dietary intake of 92 foods and nutrients estimated by dietary questionnaires. Cox regression was used to quantify the association between each food/nutrient and risk of breast cancer. A false discovery rate (FDR) of 0.05 was used to select the set of foods and nutrients to be replicated in the independent Netherlands Cohort Study (NLCS).

RESULTS: Six foods and nutrients were identified as associated with risk of breast cancer in the EPIC study (10,979 cases). Higher intake of alcohol overall was associated with a higher risk of breast cancer (hazard ratio (HR) for a 1 SD increment in intake = 1.05, 95% CI 1.03-1.07), as was beer/cider intake and wine intake (HRs per 1 SD increment = 1.05, 95% CI 1.03-1.06 and 1.04, 95% CI 1.02-1.06, respectively), whereas higher intakes of fibre, apple/pear, and carbohydrates were associated with a lower risk of breast cancer (HRs per 1 SD increment = 0.96, 95% CI 0.94-0.98; 0.96, 95% CI 0.94-0.99; and 0.96, 95% CI 0.95-0.98, respectively). When evaluated in the NLCS (2368 cases), estimates for each of these foods and nutrients were similar in magnitude and direction, with the exception of beer/cider intake, which was not associated with risk in the NLCS.

CONCLUSIONS: Our findings confirm a positive association of alcohol consumption and suggest an inverse association of dietary fibre and possibly fruit intake with breast cancer risk.

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

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