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Diet Quality and Breast Cancer Incidence in the Multiethnic Cohort

European Journal of Clinical Nutrition volume 74, pages 1743–1747 (2020)Cite this article

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Abstract

This study investigated the relation of diet quality indexes (DQI) with breast cancer incidence among women from the Multiethnic Cohort (MEC). Participants completed a questionnaire with a validated food frequency questionnaire. Scores for Healthy Eating Index 2015 (HEI-2015), Alternate Healthy Eating Index 2010 (AHEI-2010), alternate Mediterranean diet score (aMED), and Dietary Approaches to Stop Hypertension (DASH) were divided into quintiles (Q1–Q5). Cox regression was applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for DQIs and breast cancer risk adjusted for known risk factors. The respective HRs for Q5 vs. Q1 were: 1.06 (95% CI, 0.98–1.14) for HEI-2015, 0.96 (95% CI, 0.90–1.04) for AHEI-2010, 1.01 (95% CI, 0.94–1.09) for aMED, and 0.95 (95% CI, 0.88–1.02) for DASH (ptrend > 0.05 for all). However, overweight and obesity were significantly associated with breast cancer incidence. Despite the null association for DQIs, diet quality may lower breast cancer risk through its positive influence on weight status.

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References

  1. Picon‐Ruiz M, Morata‐Tarifa C, Valle‐Goffin JJ, Friedman ER, Slingerland JM. Obesity and adverse breast cancer risk and outcome: mechanistic insights and strategies for intervention. CA Cancer J Clin. 2017;67:378–97. https://doi.org/10.3322/caac.21405.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Liese AD, Krebs-Smith SM, Subar AF, George SM, Harmon BE, Neuhouser ML, et al. The dietary patterns methods project: synthesis of findings across cohorts and relevance to dietary guidance. J Nutr. 2015;145:393–402. https://doi.org/10.3945/jn.114.205336.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Kant AK. Dietary patterns and health outcomes. J Am Diet Assoc. 2004;104:615–35. https://doi.org/10.1016/j.jada.2004.01.010.

    Article  PubMed  Google Scholar 

  4. Norat T, Chan D, Vingeliene S, Aune D, Polemiti E, Vieira AR, et al. World Cancer Research Fund International systematic literature review: the associations between food, nutrition and physical activity and the risk of breast cancer. Imperial College London: World Cancer Research Fund International; 2017. https://www.wcrf.org/sites/default/files/breast-cancer-slr.pdf.

  5. Harmon BE, Boushey CJ, Shvetsov YB, Ettienne R, Reedy J, Wilkens LR, et al. Associations of key diet-quality indexes with mortality in the Multiethnic Cohort: the Dietary Patterns Methods Project. Am J Clin Nutr. 2015;101:587–97. https://doi.org/10.3945/ajcn.114.090688.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Park SY, Boushey CJ, Wilkens LR, Haiman CA, Le Marchand L. High-quality diets associate with reduced risk of colorectal cancer: analyses of Diet Quality Indexes in the multiethnic cohort. Gastroenterology 2017;153:386–394.e2. https://doi.org/10.1053/j.gastro.2017.04.004.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Maskarinec G, Jacobs S, Park SY, Haiman CA, Setiawan VW, Wilkens LR, et al. Type 2 diabetes, obesity, and breast cancer risk: the multiethnic cohort. Cancer Epidemiol Biomark Prev. 2017;26:854–61. https://doi.org/10.1158/1055-9965.EPI-16-0789.

    Article  Google Scholar 

  8. Stram DO, Hankin JH, Wilkens LR, Pike MC, Monroe KR, Park S, et al. Calibration of the Dietary Questionnaire for a Multiethnic Cohort in Hawaii and Los Angeles. Am J Epidemiol. 2000;151:358–70.

    Article  CAS  Google Scholar 

  9. Haridass V, Ziogas A, Neuhausen SL, Anton-Culver H, Odegaard AO. Diet quality scores inversely associated with postmenopausal breast cancer risk are not associated with premenopausal breast cancer risk in the California teachers study. J Nutr. 2018;148:1830–7. https://doi.org/10.1093/jn/nxy187.

    Article  PubMed  Google Scholar 

  10. Turati F, Carioli G, Bravi F, Ferraroni M, Serraino D, Montella M, et al. Mediterranean diet and breast cancer risk. Nutrients. 2018;10. https://doi.org/10.3390/nu10030326.

  11. Xiao Y, Xia J, Li L, Ke Y, Cheng J, Xie Y, et al. Associations between dietary patterns and the risk of breast cancer: a systematic review and meta-analysis of observational studies. Breast Cancer Res. 2019;21. https://doi.org/10.1186/s13058-019-1096-1.

  12. Wolongevicz DM, Zhu L, Pencina MJ, Kimokoti RW, Newby PK, D’Agostino RB, et al. Diet quality and obesity in women: the Framingham Nutrition Studies. Br J Nutr. 2010;103:1223–9. https://doi.org/10.1017/S0007114509992893.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

This work was supported by the following grants from the National Cancer Institute: U01 CA164973, R03 CA223890, and U54 CA143727 (fellowship for RDC).

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Authors and Affiliations

  1. University of Hawaii Cancer Center, Honolulu, HI, USA

    Rica Dela Cruz, Song-Yi Park, Yurii B. Shvetsov, Carol J. Boushey, Loïc Le Marchand & Gertraud Maskarinec

  2. Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA

    Kristine R. Monroe

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  1. Rica Dela Cruz
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  2. Song-Yi Park
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  3. Yurii B. Shvetsov
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  4. Carol J. Boushey
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  6. Loïc Le Marchand
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  7. Gertraud Maskarinec
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Correspondence to Rica Dela Cruz.

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Dela Cruz, R., Park, SY., Shvetsov, Y.B. et al. Diet Quality and Breast Cancer Incidence in the Multiethnic Cohort. Eur J Clin Nutr 74, 1743–1747 (2020). https://doi.org/10.1038/s41430-020-0627-2

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