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Stasiewicz B, Wadolowska L, Biernacki M, Slowinska MA, Stachowska E. Compliance with the WCRF/AICR Recommendations in Qualitative Adaptation and the Occurrence of Breast Cancer: A Case-Control Study. Cancers (Basel) 2024; 16:468. [PMID: 38275908 PMCID: PMC11154306 DOI: 10.3390/cancers16020468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/15/2024] [Accepted: 01/19/2024] [Indexed: 01/27/2024] Open
Abstract
PURPOSE The aim of the study was twofold: (1) the qualitative adaptation of the 2018 WCRF/AICR (QAd-WCRF/AICR) score, and (2) the assessment of the association between the level of compliance with the WCRF/AICR recommendations and the occurrence of breast cancer in peri- and postmenopausal women. METHODS This case-control study involved 420 women, aged 40-79 years, from northeastern Poland, including 190 newly diagnosed breast cancer cases. Data related to the WCRF/AICR recommendations were collected in face-to-face interviews with 409 women, including 179 women with breast cancer. The frequency of food consumption data were collected using the FFQ-6® and KomPAN® questionnaires. Body weight, height, and waist circumference were measured. The QAd-WCRF/AICR score (range: 0-8 points) was calculated on the basis of eight components, including two components from to the WCRF/AICR recommendations: (1) body mass index (BMI), and (2) waist circumference, with six components expressed qualitatively: (3) overall physical activity, as well as the frequency of the consumption of (4) vegetables/fruits/whole grains/nuts/seeds/legumes, (5) highly processed foods, including fast foods/sweets/instant soups, (6) red/processed meat, (7) sweetened/energy drinks, and (8) alcohol. Logistic regression analysis was performed to assess the occurrence of breast cancer. RESULTS The moderate (4-5 points) and maximal (6-8 points) compliance with the qualitative adaptation of the WRCF/AICR recommendations reduced the odds of breast cancer by 54% and 72%, respectively, compared to the results noted for minimal compliance (≤3 points). Lower odds of breast cancer were associated with moderate or high physical activity, consumption of a minimum of four serving per day of vegetables/fruits/whole grains/nuts/seeds/legumes, and limiting the consumption of highly processed food/fast foods and red/processed meat to a maximum of 1-3 times/month. Higher odds of breast cancer were associated with a higher waist circumference and alcohol abstinence. CONCLUSIONS These findings may prove useful in establishing cancer prevention recommendations based on simple suggestions regarding the frequency of food consumption.
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Affiliation(s)
- Beata Stasiewicz
- Department of Human Nutrition, Faculty of Food Sciences, University of Warmia and Mazury in Olsztyn, Sloneczna 45f, 10-718 Olsztyn, Poland; (L.W.); (M.A.S.)
| | - Lidia Wadolowska
- Department of Human Nutrition, Faculty of Food Sciences, University of Warmia and Mazury in Olsztyn, Sloneczna 45f, 10-718 Olsztyn, Poland; (L.W.); (M.A.S.)
| | - Maciej Biernacki
- Department of General and Minimally Invasive Surgery, University of Warmia and Mazury in Olsztyn, 10-045 Olsztyn, Poland;
| | - Malgorzata Anna Slowinska
- Department of Human Nutrition, Faculty of Food Sciences, University of Warmia and Mazury in Olsztyn, Sloneczna 45f, 10-718 Olsztyn, Poland; (L.W.); (M.A.S.)
| | - Ewa Stachowska
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University, 71-460 Szczecin, Poland
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Malcomson FC, Parra-Soto S, Ho FK, Celis-Morales C, Sharp L, Mathers JC. Abbreviated Score to Assess Adherence to the 2018 WCRF/AICR Cancer Prevention Recommendations and Risk of Cancer in the UK Biobank. Cancer Epidemiol Biomarkers Prev 2024; 33:33-42. [PMID: 37909916 PMCID: PMC10774737 DOI: 10.1158/1055-9965.epi-23-0923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 10/11/2023] [Accepted: 10/30/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND The World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) Cancer Prevention Recommendations are lifestyle-based guidelines which aim to reduce cancer risk. This study investigated, in the UK Biobank, associations between an abbreviated score to assess adherence to these Recommendations and the risk of all cancers combined and of 14 cancers for which there is strong evidence for links with diet, adiposity, and physical activity. METHODS We used data from 288,802 UK Biobank participants (mean age 56.2 years), cancer-free at baseline. An abbreviated version of the 2018 WCRF/AICR Score was calculated to assess adherence to five Recommendations on (i) body weight, (ii) physical activity, (iii) fruits, vegetables, and dietary fiber, (iv) red and processed meat, and (v) alcohol. Multivariable Cox proportional hazards models were used to analyze associations between the abbreviated score (range, 0-5 points) and cancer incidence, adjusting for confounders. RESULTS During a median follow-up of 8.2 years (interquartile range, 7.4-8.9), 23,448 participants were diagnosed with cancer. The abbreviated score was inversely associated with risk of cancer overall [HR: 0.93; 95% confidence interval (CI): 0.92-0.95 per 1-point increment], and breast (HR: 0.90; 95% CI: 0.87-0.94), colorectal (HR: 0.86; 95% CI: 0.83-0.90), lung (HR: 0.89; 95% CI: 0.84-0.94), kidney (HR: 0.83; 95% CI: 0.76-0.90), pancreatic (HR: 0.86; 95% CI: 0.79-0.94), uterine (HR: 0.79; 95% CI: 0.73-0.86), esophageal (HR: 0.82; 95% CI: 0.75-0.90), stomach (HR: 0.89; 95% CI: 0.79-0.99), and liver (HR: 0.80; 95% CI: 0.72-0.90) cancers. CONCLUSIONS Greater adherence to the Cancer Prevention Recommendations, assessed using an abbreviated score, was associated with reduced risk of all cancers combined and of nine site-specific cancers. IMPACT Our findings support compliance to these Recommendations for cancer prevention.
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Affiliation(s)
- Fiona C. Malcomson
- Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- Centre for Cancer, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Solange Parra-Soto
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
- School of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
- Department of Nutrition and Public Health, Universidad del Bío-Bío, Chillan, Chile
| | - Frederick K. Ho
- School of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Carlos Celis-Morales
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
- School of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
- Human Performance Lab, Education, Physical Activity and Health Research Unit, University Católica del Maule, Talca, Chile
| | - Linda Sharp
- Centre for Cancer, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - John C. Mathers
- Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
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Malcomson FC, Parra-Soto S, Ho FK, Lu L, Celis-Morales C, Sharp L, Mathers JC. Adherence to the 2018 World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) Cancer Prevention Recommendations and risk of 14 lifestyle-related cancers in the UK Biobank prospective cohort study. BMC Med 2023; 21:407. [PMID: 38012714 PMCID: PMC10683228 DOI: 10.1186/s12916-023-03107-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 10/05/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND The World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) Cancer Prevention Recommendations are lifestyle-based recommendations which aim to reduce cancer risk. This study investigated associations between adherence, assessed using a standardised scoring system, and the risk of all cancers combined and of 14 cancers for which there is strong evidence for links with aspects of lifestyle in the UK. METHODS We used data from 94,778 participants (53% female, mean age 56 years) from the UK Biobank. Total adherence scores (range 0-7 points) were derived from dietary, physical activity, and anthropometric data. Associations between total score and cancer risk (all cancers combined; and prostate, breast, colorectal, lung, uterine, liver, pancreatic, stomach, oesophageal, head and neck, ovarian, kidney, bladder, and gallbladder cancer) were investigated using Cox proportional hazard models, adjusting for age, sex, deprivation index, ethnicity, and smoking status. RESULTS Mean total score was 3.8 (SD 1.0) points. During a median follow-up of 8 years, 7296 individuals developed cancer. Total score was inversely associated with risk of all cancers combined (HR: 0.93; 95%CI: 0.90-0.95 per 1-point increment), as well as breast (HR: 0.90; 95%CI: 0.86-0.95), colorectal (HR: 0.90; 95%CI: 0.84-0.97), kidney (HR: 0.82; 95%CI: 0.72-0.94), oesophageal (HR: 0.84; 95%CI: 0.71-0.98), ovarian (HR: 0.76; 95%CI: 0.65-0.90), liver (HR: 0.78; 95%CI: 0.63-0.97), and gallbladder (HR: 0.70; 95%CI: 0.53-0.93) cancers. CONCLUSIONS Greater adherence to lifestyle-based recommendations was associated with reduced risk of all cancers combined and of breast, colorectal, kidney, oesophageal, ovarian, liver, and gallbladder cancers. Our findings support compliance with the Cancer Prevention Recommendations for cancer prevention in the UK.
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Affiliation(s)
- Fiona C Malcomson
- Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
- Centre for Cancer, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Solange Parra-Soto
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
- School of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
- Department of Nutrition and Public Health, Universidad del Bío-Bío, Chillan, Chile
| | - Frederick K Ho
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Liya Lu
- Centre for Cancer, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Carlos Celis-Morales
- School of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
- Human Performance Lab, Education, Physical Activity and Health Research Unit, University Católica del Maule, Talca, Chile
| | - Linda Sharp
- Centre for Cancer, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - John C Mathers
- Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK.
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Tageza Ilala T, Teku Ayano G, Ahmed Kedir Y, Tamiru Mamo S. Evidence-Based Guideline on the Prevention and Management of Perioperative Pain for Breast Cancer Peoples in a Low-Resource Setting: A Systematic Review Article. Anesthesiol Res Pract 2023; 2023:5668399. [PMID: 37953883 PMCID: PMC10637850 DOI: 10.1155/2023/5668399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 05/03/2023] [Accepted: 10/24/2023] [Indexed: 11/14/2023] Open
Abstract
Background Breast surgery for breast cancer is associated with significant acute and persistent postoperative pain. Surgery is the primary type of treatment, but up to 60% of breast cancer patients experience persistent pain after surgery, and 40% of them develop acute postmastectomy pain syndrome. Preoperative stress, involvement of lymph nodes while dissecting, and the postoperative psychological state of the patients play vital roles in managing the postoperative pain of the patients. The objective of this study is to develop evidence-based guideline on the prevention and management of perioperative pain for breast cancer surgical patients. Methods An exhaustive literature search was made from PubMed, Cochrane Review, PubMed, Google Scholar, Hinari, and CINAHIL databases that are published from 2012 to 2022 by setting the inclusion and exclusion criteria. After data extraction, filtering was made based on the methodological quality, population data, interventions, and outcome of interest. Finally, one guideline, two meta-analyses, ten systematic reviews, 25 randomized clinical trials and ten observational studies are included in this review, and a conclusion was made based on their level of evidence and grade of recommendation. Results A total of 38 studies were considered in this evaluation. The development of this guideline was based on different studies performed on the diagnosis, risk stratification and risk reduction, prevention of postoperative pain, and treatments of postoperative pain. Conclusion The management of postoperative pain can be categorized as risk assessment, minimizing risk, early diagnosis, and treatment. Early diagnosis is the mainstay to identify and initiate treatment. The perioperative use of a nonpharmacological approach (including preoperative positive inspirational words and positive expectation) as an adjunct to the intraoperative regional anesthetic technique with general anesthesia with proper dosage of the standard pharmacological multimodal regimens is the first-line treatment. For postoperative analgesia, an extended form of intraoperative regional technique, nonpharmacologic technique, and NSAIDs can be used with the opioid-sparing anesthesia technique.
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Affiliation(s)
- Tajera Tageza Ilala
- Department of Anesthesia, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Gudeta Teku Ayano
- Department of Anesthesia, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Yesuf Ahmed Kedir
- Department of Anesthesia, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Selam Tamiru Mamo
- Department of Anesthesia, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
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Malcomson FC, Wiggins C, Parra-Soto S, Ho FK, Celis-Morales C, Sharp L, Mathers JC. Adherence to the 2018 World Cancer Research Fund/American Institute for Cancer Research Cancer Prevention Recommendations and cancer risk: A systematic review and meta-analysis. Cancer 2023; 129:2655-2670. [PMID: 37309215 DOI: 10.1002/cncr.34842] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/28/2023] [Accepted: 04/06/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND The World Cancer Research Fund/American Institute for Cancer Research Cancer Prevention Recommendations are lifestyle-based guidelines that aim to reduce cancer risk. A systematic review and meta-analysis of studies investigating associations between a score for adherence to the 2018 Cancer Prevention Recommendations and cancer risk was conducted. METHODS MEDLINE, Embase, Web of Science, and Scopus were searched for studies published to November 28, 2022. In meta-analysis, the estimated risk ratios and 95% CIs for adherence score as a continuous (per 1-point increment) and categorical (highest vs. lowest score category) variable using random-effects models were estimated. RESULTS Eighteen studies (11 cohort; seven case-control) were included investigating incidence of breast (n = 7), colorectal (n = 5), prostate (n = 2), lung (n = 2), pancreatic (n = 1), endometrial (n = 1), unknown primary cancer (n = 1), chronic lymphocytic leukemia (n = 1), and overall (any) cancer (n = 1). The summary risk ratio per 1-point increment in adherence score was 0.89 (95% CI, 0.85-0.93; I2 = 76.5%; n = 7) for breast cancer, 0.88 (95% CI, 0.84-0.91; I2 = 26.2%; n = 4) for colorectal cancer, and 0.92 (95% CI, 0.86-0.98, I2 = 66.0%; n = 2) for lung cancer. There were no significant associations with prostate or other cancers. Meta-analysis results using categorical adherence score variables were consistent with these findings. CONCLUSIONS Greater adherence to the 2018 World Cancer Research Fund/American Institute for Cancer Research Cancer Prevention Recommendations was associated with lower risk of breast, colorectal, and lung cancers. Future studies investigating associations with risk of other forms of cancer are warranted. PROSPERO REGISTRATION NUMBER CRD42022313327.
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Affiliation(s)
- Fiona C Malcomson
- Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Christopher Wiggins
- Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Solange Parra-Soto
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
- Department of Nutrition and Public Health, Universidad del Bío-Bío, Chillan, Chile
| | - Frederick K Ho
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Carlos Celis-Morales
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- Human Performance Lab, Education, Physical Activity and Health Research Unit, University Católica del Maule, Talca, Chile
| | - Linda Sharp
- Centre for Cancer, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - John C Mathers
- Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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Zhang J, Lu Y, Zhang N, Yu Z, Li H, He R, Mao Y, Zhu B. Global burden of female breast cancer and its association with socioeconomic development status, 1990-2044. Cancer Rep (Hoboken) 2023; 6 Suppl 1:e1827. [PMID: 37095062 PMCID: PMC10440843 DOI: 10.1002/cnr2.1827] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/06/2023] [Accepted: 04/13/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Breast cancer is a widespread disease in women worldwide. AIM We aimed to explore the global epidemiological trends of female breast cancer (FBC) between 1990 and 2044. METHODS AND RESULTS Disease burden, population, and socio-demographic index (SDI) data were obtained from the Global Health Data Exchange (GHDx) database. We analyzed temporal trends, age differences, risk factors, and geographic patterns of FBC disease burden globally and explored the association between age-standardized incidence rate (ASIR) of FBC and SDI. Bayesian age-period-cohort model was also performed to predict the changes in FBC incidence worldwide from 2020 to 2044. First, the global ASIR of FBC increased by 14.31% from 1990 to 2019 (95% Uncertainty Interval 4.75% to 23.98%). The death rate presented a falling trend. Second, alcohol use is the most-highlighted risk factor for FBC in some high-income regions such as Europe. A high fasting plasma glucose levels is the most prominent risk factor for FBC in Latin America and Africa. Third, the ASIR of the FBC increases with the SDI. Fourth, the incidence is expected to increase faster among women aged 35-60 years and fastest for those aged 50-54 years from 2020 to 2044. Countries with a high incidence of FBC that is expected to increase significantly include Barbados, Burkina Faso, Senegal, Monaco, Lebanon, Togo, and Uganda. CONCLUSION The disease burden of FBC varies worldwide; the findings suggest attaching importance to the control of middle and low-middle SDI regions. Public health as well as cancer prevention experts should pay more attention to regions and populations at an increased risk of developing FBC, focusing on their prevention and rehabilitation while conducting further epidemiological studies to investigate the risk factors of their increase.
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Affiliation(s)
- Jingya Zhang
- School of Public Policy and AdministrationXi'an Jiaotong UniversityXi'anChina
| | - Yongbo Lu
- School of Public Policy and AdministrationXi'an Jiaotong UniversityXi'anChina
| | - Ning Zhang
- School of Public Policy and AdministrationXi'an Jiaotong UniversityXi'anChina
| | - Zeru Yu
- School of Public Policy and AdministrationXi'an Jiaotong UniversityXi'anChina
| | - Haorao Li
- School of Public Policy and AdministrationXi'an Jiaotong UniversityXi'anChina
| | - Rongxin He
- Vanke School of Public HealthTsinghua UniversityBeijingChina
| | - Ying Mao
- School of Public Policy and AdministrationXi'an Jiaotong UniversityXi'anChina
| | - Bin Zhu
- School of Public Health and Emergency ManagementSouthern University of Science and TechnologyShenzhenGuangdongChina
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Lee J, Shin A, Shin WK, Choi JY, Kang D, Lee JK. Adherence to the World Cancer Research Fund/American Institute for Cancer Research and Korean Cancer Prevention Guidelines and cancer risk: a prospective cohort study from the Health Examinees-Gem study. Epidemiol Health 2023; 45:e2023070. [PMID: 37536716 PMCID: PMC10667577 DOI: 10.4178/epih.e2023070] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 07/04/2023] [Indexed: 08/05/2023] Open
Abstract
OBJECTIVES The purpose of this study was to explore the association between adherence to 2 cancer prevention recommendations and cancer risk. METHODS In total, 104,386 individuals aged 40-69 years old who were recruited between 2004 and 2013 in the Health Examinees-Gem study were included. Adherence scores were constructed based on 8 items from the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) cancer prevention recommendations, including body weight, physical activity, diet, alcohol consumption and breastfeeding, and on 6 items from the Korean cancer prevention guidelines (smoking status, eating vegetables and fruits, salty foods, alcohol intake, physical activity, and body weight). A Cox proportional hazards model was used to estimate the associations between adherence scores and the risk of total and 5 major cancers. RESULTS The multivariable hazard ratio (HR) for total cancer with the high adherence score versus the lowest score (4.25-7.00 vs. 0.00-3.25) for the WCRF/AICR guidelines was 0.91 (95% confidence interval [CI], 0.82 to 1.00) in men. A reduced breast cancer risk was observed among women with the highest score. Men within the highest category of the Korean cancer prevention guideline score (3.25-6.00) had an HR of 0.80 (95% CI, 0.73 to 0.88) for developing total cancer compared to men within the lowest score (0.00-2.50). The higher adherence group among men showed lower risks of developing stomach, colorectal, and lung cancers. CONCLUSIONS Adhering to guidelines for cancer prevention can help to reduce the risk of developing cancer in Korean men. The association might differ by cancer type and gender.
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Affiliation(s)
- Jeeyoo Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Aesun Shin
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
- Interdisciplinary Program in Cancer Biology Major, Seoul National University College of Medicine, Seoul, Korea
- Integrated Major in Innovative Medical Science, Seoul National University Graduate School, Seoul, Korea
- Medical Research Center, Genomic Medicine Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Woo-Kyoung Shin
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Integrated Major in Innovative Medical Science, Seoul National University Graduate School, Seoul, Korea
| | - Ji-Yeob Choi
- Cancer Research Institute, Seoul National University, Seoul, Korea
- Department of Biomedical Science, Seoul National University Graduate School, Seoul, Korea
- Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, Korea
| | - Daehee Kang
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
- Integrated Major in Innovative Medical Science, Seoul National University Graduate School, Seoul, Korea
| | - Jong-Koo Lee
- JW LEE Center for Global Medicine, Seoul National University College of Medicine, Seoul, Korea
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Jacobs I, Taljaard-Krugell C, Wicks M, Cubasch H, Joffe M, Laubscher R, Romieu I, Levy RB, Rauber F, Biessy C, Rinaldi S, Huybrechts I. Degree of food processing and breast cancer risk in black urban women from Soweto, South African: the South African Breast Cancer study. Br J Nutr 2022; 128:2278-2289. [PMID: 35109954 PMCID: PMC9346100 DOI: 10.1017/s0007114522000423] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 01/14/2022] [Accepted: 01/31/2022] [Indexed: 12/30/2022]
Abstract
This study aimed to investigate the association between consumption of ultra-processed foods, whole foods and breast cancer risk in black women from Soweto, South Africa. A population-based case (n 396)-control (n 396) study matched on age and residence, using data from the South African Breast Cancer study. Dietary intake was assessed using a validated quantified FFQ. Food items were categorised using the NOVA system ((1) unprocessed/minimally processed foods, (2) culinary ingredients, (3) processed foods and (4) ultra-processed foods). Conditional logistic regression models were used to estimate OR and 95 % CI of dietary contributions from each NOVA food group (as a percentage of total energy intake (EI)) and adjusting for potential confounders. Considering contributions to total EI per day, ultra-processed food consumption contributed to 44·8 % in cases and 47·9 % in controls, while unprocessed/minimally processed foods contributed to 38·8 % in cases and 35·2 % in controls. Unprocessed/minimally processed food consumption showed an inverse association with breast cancer risk overall (OR = 0·52, 95 % CI 0·35, 0·78), as well as in pre- and postmenopausal women separately (OR = 0·52, 95 % CI 0·27, 0·95 and OR = 0·55, 95 % CI 0·35, 0·89, respectively) and in women with progesterone positive breast cancer (OR = 0·23, 95 % CI 0·06, 0·86). There was no heterogeneity in association with breast cancer when analyses were stratified according to BMI. No significant associations were observed for the consumption of other NOVA food groups. Intake of unprocessed/minimally processed foods may reduce the risk of developing breast cancer in black women from Soweto, South Africa.
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Affiliation(s)
- Inarie Jacobs
- Centre of Excellence for Nutrition, North-West University, Private Bag X6001, Potchefstroom2520, South Africa
| | - Christine Taljaard-Krugell
- Centre of Excellence for Nutrition, North-West University, Private Bag X6001, Potchefstroom2520, South Africa
| | - Mariaan Wicks
- Centre of Excellence for Nutrition, North-West University, Private Bag X6001, Potchefstroom2520, South Africa
| | - Herbert Cubasch
- Department of Surgery, Faculty of Health Sciences, University of Witwatersrand, Private Bag X2600, Houghton, Johannesburg2041, South Africa
- Non-Communicable Diseases Research Division, Wits Health Consortium (PTY) Ltd, Parktown, Johannesburg2193, South Africa
| | - Maureen Joffe
- Non-Communicable Diseases Research Division, Wits Health Consortium (PTY) Ltd, Parktown, Johannesburg2193, South Africa
- MRC Developmental Pathways to Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of Witwatersrand, Private Bag X3, Johannesburg2050, South Africa
| | - Ria Laubscher
- South African Medical Research Council, PO Box 19070, Tygerberg, Cape Town, 7505South Africa
| | - Isabelle Romieu
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, CP 62100, Cuernavaca, Morelos, México
- Hubert Department of Global Health, Emory University, Atlanta, GA30329, USA
| | - Renata B. Levy
- Department of Preventive Medicine, School of Medicine, University of São Paulo (FMUSP), São Paulo, SP01246-903, Brazil
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo (Nupens/USP), São Paulo, SP01246-904, Brazil
| | - Fernanda Rauber
- Department of Preventive Medicine, School of Medicine, University of São Paulo (FMUSP), São Paulo, SP01246-903, Brazil
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo (Nupens/USP), São Paulo, SP01246-904, Brazil
| | - Carine Biessy
- International Agency for Research on Cancer, Nutrition and Metabolism Branch, IARC-WHO 150 cours Albert Thomas, 69372Lyon, France
| | - Sabina Rinaldi
- International Agency for Research on Cancer, Nutrition and Metabolism Branch, IARC-WHO 150 cours Albert Thomas, 69372Lyon, France
| | - Inge Huybrechts
- International Agency for Research on Cancer, Nutrition and Metabolism Branch, IARC-WHO 150 cours Albert Thomas, 69372Lyon, France
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Jacobs I, Taljaard-Krugell C, Wicks M, Badham JM, Cubasch H, Joffe M, Laubscher R, Romieu I, Biessy C, Gunter MJ, Rinaldi S, Huybrechts I. Adherence to the South African food based dietary guidelines may reduce breast cancer risk in black South African women: the South African Breast Cancer (SABC) study. Public Health Nutr 2021; 25:1-17. [PMID: 34839846 PMCID: PMC9991845 DOI: 10.1017/s1368980021004675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 11/20/2021] [Accepted: 11/24/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To determine the level of adherence and to assess the association between higher adherence to the South African food based dietary guidelines (SAFBDG) and breast cancer risk. DESIGN Population-based, case-control study (the South African Breast Cancer study) matched on age and demographic settings. Validated questionnaires were used to collect dietary and epidemiological data. To assess adherence to the SAFBDG, a nine-point adherence score (out of eleven guidelines) was developed, using suggested adherence cut-points for scoring each recommendation (0 and 1). When the association between higher adherence to the SAFBDG and breast cancer risk was assessed, data-driven tertiles among controls were used as cut-points for scoring each recommendation (0, 0·5 and 1). OR and 95 % CI were estimated using multivariate logistic regression models. SETTING Soweto, South Africa. PARTICIPANTS Black urban women, 396 breast cancer cases and 396 controls. RESULTS After adjusting for potential confounders, higher adherence (>5·0) to the SAFBDG v. lower adherence (<3·5) was statistically significantly inversely associated with breast cancer risk overall (OR = 0·56, 95 % CI 0·38, 0·85), among postmenopausal women (OR = 0·64, 95 % CI 0·40, 0·97) as well as for oestrogen-positive breast cancers (OR = 0·51, 95 % CI 0·32, 0·89). Only 32·3 % of cases and 39·1 % of controls adhered to at least half (a score >4·5) of the SAFBDG. CONCLUSIONS Higher adherence to the SAFBDG may reduce breast cancer risk in this population. The concerning low levels of adherence to the SAFBDG emphasise the need for education campaigns and to create healthy food environments in South Africa to increase adherence to the SAFBDG.
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Affiliation(s)
- Inarie Jacobs
- Centre of Excellence for Nutrition, North-West University, Private Bag X6001, Potchefstroom2520, South Africa
| | - Christine Taljaard-Krugell
- Centre of Excellence for Nutrition, North-West University, Private Bag X6001, Potchefstroom2520, South Africa
| | - Mariaan Wicks
- Centre of Excellence for Nutrition, North-West University, Private Bag X6001, Potchefstroom2520, South Africa
| | | | - Herbert Cubasch
- Department of Surgery, Faculty of Health Sciences, University of Witwatersrand, Houghton, Johannesburg, South Africa
- Non-Communicable Diseases Research Division, Wits Health Consortium (PTY) Ltd, Parktown, Johannesburg, South Africa
| | - Maureen Joffe
- Non-Communicable Diseases Research Division, Wits Health Consortium (PTY) Ltd, Parktown, Johannesburg, South Africa
- MRC Developmental Pathways to Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Ria Laubscher
- Biostatistics Unit, South African Medical Research Council, Tygerberg, Cape Town, South Africa
| | - Isabelle Romieu
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
- Hubert Department of Global Health, Emory University, Atlanta, GA, USA
| | - Carine Biessy
- Nutrition and Metabolism Branch, International Agency for Research on Cancer – WHO, Albert Thomas, Lyon, France
| | - Marc J Gunter
- Nutrition and Metabolism Branch, International Agency for Research on Cancer – WHO, Albert Thomas, Lyon, France
| | - Sabina Rinaldi
- Nutrition and Metabolism Branch, International Agency for Research on Cancer – WHO, Albert Thomas, Lyon, France
| | - Inge Huybrechts
- Nutrition and Metabolism Branch, International Agency for Research on Cancer – WHO, Albert Thomas, Lyon, France
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Jacobs I, Taljaard-Krugell C, Wicks M, Cubasch H, Joffe M, Laubscher R, Romieu I, Biessy C, Rinaldi S, Huybrechts I. Dietary Patterns and Breast Cancer Risk in Black Urban South African Women: The SABC Study. Nutrients 2021; 13:4106. [PMID: 34836361 PMCID: PMC8617719 DOI: 10.3390/nu13114106] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/07/2021] [Accepted: 11/11/2021] [Indexed: 01/07/2023] Open
Abstract
A total of 396 breast cancer cases and 396 population-based controls from the South African Breast Cancer study (SABC) matched on age and demographic settings was included. Validated questionnaires were used to collect dietary and epidemiological data. Dietary patterns were derived using principal component analysis with a covariance matrix from 33 food groups. Odds ratios and 95% confidence intervals were estimated using conditional logistic regression. A traditional, a cereal-dairy breakfast and a processed food dietary pattern were identified, which together explained 40.3% of the total variance in the diet. After adjusting for potential confounders, the traditional dietary pattern and cereal-dairy breakfast dietary pattern were inversely associated with breast cancer risk (highest tertile versus lowest tertile) (OR = 0.72, 95%CI: 0.57-0.89, p-trend = 0.004 and OR = 0.73, 95%CI: 0.59-0.90, p-trend = 0.004, respectively). The processed food dietary pattern was not significantly associated with breast cancer risk. The results of this study show that a traditional dietary pattern and a cereal-dairy breakfast dietary pattern may reduce the risk of developing breast cancer in this population.
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Affiliation(s)
- Inarie Jacobs
- Centre of Excellence for Nutrition, North-West University, Potchefstroom 2531, South Africa; (C.T.-K.); (M.W.)
| | - Christine Taljaard-Krugell
- Centre of Excellence for Nutrition, North-West University, Potchefstroom 2531, South Africa; (C.T.-K.); (M.W.)
| | - Mariaan Wicks
- Centre of Excellence for Nutrition, North-West University, Potchefstroom 2531, South Africa; (C.T.-K.); (M.W.)
| | - Herbert Cubasch
- Department of Surgery, Faculty of Health Sciences, University of Witwatersrand, Houghton, Johannesburg 2041, South Africa;
- Non-Communicable Diseases Research Division, Wits Health Consortium (PTY) Ltd., Parktown, Johannesburg 2193, South Africa;
| | - Maureen Joffe
- Non-Communicable Diseases Research Division, Wits Health Consortium (PTY) Ltd., Parktown, Johannesburg 2193, South Africa;
- MRC Developmental Pathways to Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of Witwatersrand, Johannesburg 2050, South Africa
| | - Ria Laubscher
- South African Medical Research Council Tygerberg, Cape Town 7505, South Africa;
| | - Isabelle Romieu
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca 62100, Mexico;
- Hubert Department of Global Health, Emory University, Atlanta, GA 30329, USA
| | - Carine Biessy
- International Agency for Research on Cancer, Nutrition and Metabolism Branch, IARC-WHO, 150 Cours Albert Thomas, 69372 Lyon, France; (C.B.); (S.R.); (I.H.)
| | - Sabina Rinaldi
- International Agency for Research on Cancer, Nutrition and Metabolism Branch, IARC-WHO, 150 Cours Albert Thomas, 69372 Lyon, France; (C.B.); (S.R.); (I.H.)
| | - Inge Huybrechts
- International Agency for Research on Cancer, Nutrition and Metabolism Branch, IARC-WHO, 150 Cours Albert Thomas, 69372 Lyon, France; (C.B.); (S.R.); (I.H.)
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