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Hasani M, Ghasemi H, Khodabakhshi A. Diabetes Risk Reduction Diet (DRRD) and Breast Cancer Risk: A Review. Nutr Cancer 2024:1-7. [PMID: 38795042 DOI: 10.1080/01635581.2024.2355686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 05/10/2024] [Indexed: 05/27/2024]
Abstract
BACKGROUND Considering the significant involvement of insulin resistance in various forms of cancer, it is postulated that the implementation of a diabetic diet, which effectively mitigates insulin resistance, may potentially decrease the susceptibility to breast cancer among female individuals. METHODS In this literature review, a comprehensive electronic search of different databases was done using the keywords "Breast cancer" OR "breast tumor" OR "Breast Neoplasms" AND "diet" OR "diabetic diet" OR "Low Carbohydrate Diet" OR "Carbohydrate restricted diet" OR "High-Protein Low-Carbohydrate Diet" OR "diabetes risk reduction diet" OR "DRRD" as the main keywords. RESULTS Research has shown that the DRRD score is inversely correlated with breast cancer risk. In fact, for every three-point increase in the DRRD score, the risk of breast cancer decreases by 7%. Studies have shown that higher DRRD scores in breast cancer patients are associated with a reduced risk of cancer and a higher chance of survival. CONCLUSION The results of this study indicate a positive correlation between a higher level of adherence to the diabetes risk reduction diet (DRRD) and improved survival rates. This suggests that breast cancer survivors may benefit from making dietary modifications in line with a diabetic diet following their diagnosis.
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Affiliation(s)
- Motahareh Hasani
- Department of Nutrition, School of Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Haniyeh Ghasemi
- Department of Nutrition, Faculty of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Adeleh Khodabakhshi
- Department of Nutrition, Faculty of Public Health, Kerman University of Medical Sciences, Kerman, Iran
- Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
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2
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Jenkins DJA, Willett WC, Yusuf S, Hu FB, Glenn AJ, Liu S, Mente A, Miller V, Bangdiwala SI, Gerstein HC, Sieri S, Ferrari P, Patel AV, McCullough ML, Le Marchand L, Freedman ND, Loftfield E, Sinha R, Shu XO, Touvier M, Sawada N, Tsugane S, van den Brandt PA, Shuval K, Khan TA, Paquette M, Sahye-Pudaruth S, Patel D, Siu TFY, Srichaikul K, Kendall CWC, Sievenpiper JL. Association of glycaemic index and glycaemic load with type 2 diabetes, cardiovascular disease, cancer, and all-cause mortality: a meta-analysis of mega cohorts of more than 100 000 participants. Lancet Diabetes Endocrinol 2024; 12:107-118. [PMID: 38272606 DOI: 10.1016/s2213-8587(23)00344-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 01/27/2024]
Abstract
BACKGROUND There is debate over whether the glycaemic index of foods relates to chronic disease. We aimed to assess the associations between glycaemic index (GI) and glycaemic load (GL) and type 2 diabetes, cardiovascular disease, diabetes-related cancers, and all-cause mortality. METHODS We did a meta-analysis of large cohorts (≥100 000 participants) identified from the Richard Doll Consortium. We searched the Cochrane Library, MEDLINE, PubMed, Embase, Web of Science, and Scopus for cohorts that prospectively examined associations between GI or GL and chronic disease outcomes published from database inception to Aug 4, 2023. Full-article review and extraction of summary estimates data were conducted by three independent reviewers. Primary outcomes were incident type 2 diabetes, total cardiovascular disease (including mortality), diabetes-related cancers (ie, bladder, breast, colorectal, endometrial, hepatic, pancreatic, and non-Hodgkin lymphoma), and all-cause mortality. We assessed comparisons between the lowest and highest quantiles of GI and GL, adjusting for dietary factors, and pooling their most adjusted relative risk (RR) estimates using a fixed-effects model. We also assessed associations between diets high in fibre and whole grains and the four main outcomes. The study protocol is registered with PROSPERO, CRD42023394689. FINDINGS From ten prospective large cohorts (six from the USA, one from Europe, two from Asia, and one international), we identified a total of 48 studies reporting associations between GI or GL and the outcomes of interest: 34 (71%) on various cancers, nine (19%) on cardiovascular disease, five (10%) on type 2 diabetes, and three (6%) on all-cause mortality. Consumption of high GI foods was associated with an increased incidence of type 2 diabetes (RR 1·27 [95% CI 1·21-1·34]; p<0·0001), total cardiovascular disease (1·15 [1·11-1·19]; p<0·0001), diabetes-related cancer (1·05 [1·02-1·08]; p=0·0010), and all-cause mortality (1·08 [1·05-1·12]; p<0·0001). Similar associations were seen between high GL and diabetes (RR 1·15 [95% CI 1·09-1·21]; p<0·0001) and total cardiovascular disease (1·15 [1·10-1·20]; p<0·0001). Associations between diets high in fibre and whole grains and the four main outcomes were similar to those for low GI diets. INTERPRETATION Dietary recommendations to reduce GI and GL could have effects on health outcomes that are similar to outcomes of recommendations to increase intake of fibre and whole grain. FUNDING Banting and Best and the Karuna Foundation.
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Affiliation(s)
- David J A Jenkins
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada; Clinical Nutrition & Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada; Division of Endocrinology and Metabolism, St Michael's Hospital, Toronto, ON, Canada; Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Toronto, ON, Canada.
| | - Walter C Willett
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA; Department of Nutrition, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Salim Yusuf
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada; Department of Medicine, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Frank B Hu
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA; Department of Nutrition, Harvard T H Chan School of Public Health, Boston, MA, USA; Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Andrea J Glenn
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Toronto, ON, Canada; Department of Nutrition, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Simin Liu
- Center for Global Cardiometabolic Health, Department of Epidemiology, Department of Medicine, and Department of Surgery, Brown University, Providence, RI, USA
| | - Andrew Mente
- Department of Medicine, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Victoria Miller
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada; Department of Medicine, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Shrikant I Bangdiwala
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Hertzel C Gerstein
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Sabina Sieri
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Pietro Ferrari
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Alpa V Patel
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
| | | | - Loïc Le Marchand
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Neal D Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Erikka Loftfield
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Rashmi Sinha
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Xiao-Ou Shu
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Mathilde Touvier
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and Statistics, Nutritional Epidemiology Research Team, Bobigny, France; French Network for Nutrition and Cancer Research, Jouy-en-Josas, France
| | - Norie Sawada
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Shoichiro Tsugane
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan; International University of Health and Welfare Graduate School of Public Health, Tokyo, Japan
| | - Piet A van den Brandt
- GROW School for Oncology and Developmental Biology, and Department of Epidemiology, Care and Public Health Research Institute-School for Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, Netherlands
| | | | - Tauseef Ahmad Khan
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Toronto, ON, Canada
| | - Melanie Paquette
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Clinical Nutrition & Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada
| | - Sandhya Sahye-Pudaruth
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Clinical Nutrition & Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada
| | - Darshna Patel
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Clinical Nutrition & Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada
| | - Teenie Fei Yi Siu
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Clinical Nutrition & Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada
| | - Korbua Srichaikul
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Clinical Nutrition & Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada
| | - Cyril W C Kendall
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Toronto, ON, Canada; College of Pharmacy and Nutrition, University of Saskatchewan, SK, Canada
| | - John L Sievenpiper
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada; Clinical Nutrition & Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada; Division of Endocrinology and Metabolism, St Michael's Hospital, Toronto, ON, Canada; Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Toronto, ON, Canada
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Peppa M, Manta A, Mavroeidi I, Nastos C, Pikoulis E, Syrigos K, Bamias A. Dietary Approach of Patients with Hormone-Related Cancer Based on the Glycemic Index and Glycemic Load Estimates. Nutrients 2023; 15:3810. [PMID: 37686842 PMCID: PMC10490329 DOI: 10.3390/nu15173810] [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: 08/03/2023] [Revised: 08/21/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
Hormone-related cancers, namely breast, endometrial, cervical, prostate, testicular, and thyroid, constitute a specific group of cancers dependent on hormone levels that play an essential role in cancer growth. In addition to the traditional risk factors, diet seems to be an important environmental factor that partially explains the steadily increased prevalence of this group of cancer. The composition of food, the dietary patterns, the endocrine-disrupting chemicals, and the way of food processing and preparation related to dietary advanced glycation end-product formation are all related to cancer. However, it remains unclear which specific dietary components mediate this relationship. Carbohydrates seem to be a risk factor for cancer in general and hormone-related cancers, in particular, with a difference between simple and complex carbohydrates. Glycemic index and glycemic load estimates reflect the effect of dietary carbohydrates on postprandial glucose concentrations. Several studies have investigated the relationship between the dietary glycemic index and glycemic load estimates with the natural course of cancer and, more specifically, hormone-related cancers. High glycemic index and glycemic load diets are associated with cancer development and worse prognosis, partially explained by the adverse effects on insulin metabolism, causing hyperinsulinemia and insulin resistance, and also by inflammation and oxidative stress induction. Herein, we review the existing data on the effect of diets focusing on the glycemic index and glycemic load estimates on hormone-related cancers.
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Affiliation(s)
- Melpomeni Peppa
- Endocrine Unit, 2nd Propaedeutic Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12641 Athens, Greece; (A.M.); (I.M.)
| | - Aspasia Manta
- Endocrine Unit, 2nd Propaedeutic Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12641 Athens, Greece; (A.M.); (I.M.)
| | - Ioanna Mavroeidi
- Endocrine Unit, 2nd Propaedeutic Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12641 Athens, Greece; (A.M.); (I.M.)
| | - Constantinos Nastos
- 3rd Department of Surgery, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12641 Athens, Greece; (C.N.); (E.P.)
| | - Emmanouil Pikoulis
- 3rd Department of Surgery, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12641 Athens, Greece; (C.N.); (E.P.)
| | - Konstantinos Syrigos
- 3rd Department of Internal Medicine, Sotiria Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Aristotelis Bamias
- 2nd Propaedeutic Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12641 Athens, Greece;
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Flores-García MK, Mérida-Ortega Á, Denova-Gutiérrez E, Rothenberg SJ, López-Carrillo L. "Western" and "Prudent" dietary patterns are associated with breast cancer among Mexican pre- and post-menopausal women. Nutr Res 2022; 105:138-146. [DOI: 10.1016/j.nutres.2022.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 06/24/2022] [Accepted: 06/25/2022] [Indexed: 11/24/2022]
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Abstract
OBJECTIVE Previous studies on the association between glycaemic index (GI) and glycaemic load (GL) in relation to breast cancer risk are contradictory. The aim of this study was to examine the association between dietary GI and GL and risk of breast cancer in Iranian women. DESIGN Population-based case-control study. Dietary GI and GL were assessed using a validated Willett-format 106-item semi-quantitative FFQ. SETTING Isfahan, Iran. PARTICIPANTS Cases were 350 patients with newly diagnosed stage I-IV breast cancer, for whom the status of breast cancer was confirmed by physical examination and mammography. Controls were 700 age-matched apparently healthy individuals who were randomly selected from general population. RESULTS After controlling for potential confounders, individuals in the highest tertile of dietary GI had 47 % higher odds of breast cancer than women in the lowest tertile (OR: 1·47; (95 % CI 1·02, 2·12)). Stratified analysis by menopausal status showed such association among postmenopausal women (OR: 1·51; (95 % CI 1·02, 2·23)). We found no significant association between dietary GL and odds of breast cancer either before (OR: 1·35; (95 % CI 0·99, 1·84)) or after adjustment for potential confounders (OR: 1·24; (95 % CI 0·86, 1·79)). In addition, stratified analysis by menopausal status revealed no significant association between dietary GL and odds of breast cancer. CONCLUSIONS Our findings showed a significant positive association between dietary GI and odds of breast cancer. However, we observed no significant association between dietary GL and odds of breast cancer.
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Li N, Guo X, Sun C, Lowe S, Su W, Song Q, Wang H, Liang Q, Liang M, Ding X, Qu G, Ma S, Liu H, Sun Y. Dietary carbohydrate intake is associated with a lower risk of breast cancer: a meta-analysis of cohort studies. Nutr Res 2022; 100:70-92. [DOI: 10.1016/j.nutres.2022.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 01/25/2022] [Accepted: 01/27/2022] [Indexed: 10/19/2022]
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Xu K, Sun Q, Shi Z, Zou Y, Jiang X, Wang Y, Chong F, Song C. A Dose-Response Meta-Analysis of Dietary Fiber Intake and Breast Cancer Risk. Asia Pac J Public Health 2022; 34:331-337. [DOI: 10.1177/10105395211072997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Whether dietary fiber intake could reduce the risk of breast cancer (BC) is still controversial. The articles related to breast cancer and dietary fiber were retrieved through PubMed and Web of Science database. Summary relative risk (RR) and attributable risk percentage (ARP) for dietary fiber intake on the development of breast cancer were calculated. Dose-response meta-analysis modeled the relationship between dietary fiber intake and breast cancer risk. A total of 10 studies were included in this study. Meta-analysis showed that dietary fiber intake was negatively associated with breast cancer (RR = 0.83, 95% confidence interval [CI] [0.74, 0.93]). In dose-response analysis, the risk of breast cancer showed a statistically significant linear trend with increasing dietary fiber dose: when adding 10 g per day, the risk decreased by 4.7% (RR = 0.95, 95% CI [0.93, 0.98]). The ARP results demonstrated that the breast cancer dietary fiber–attributed percentage was 33.33% in Asia, which was higher than 16.28% in North America and 9.89% in Europe. In conclusion, dietary fiber intake may have a positive effect on reducing breast cancer risk, especially in high doses.
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Affiliation(s)
- Kedi Xu
- Department of Epidemiology and Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Tumor Epidemiology, Zhengzhou University, Zhengzhou, China
| | - Qiuyu Sun
- Department of Epidemiology and Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Tumor Epidemiology, Zhengzhou University, Zhengzhou, China
| | - Ziang Shi
- Department of Clinical Medicine, Zhengzhou University, Zhengzhou, China
| | - Yuanlin Zou
- Department of Epidemiology and Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Tumor Epidemiology, Zhengzhou University, Zhengzhou, China
| | - Xiaoru Jiang
- Department of Epidemiology and Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Tumor Epidemiology, Zhengzhou University, Zhengzhou, China
| | - Yanli Wang
- Zhengzhou people’s Hospital, Zhengzhou, China
| | - Feifei Chong
- Department of Clinical Nutrition, Daping Hospital, Army Medical University (The Third Military Medical University), Chongqing, China
| | - Chunhua Song
- Department of Epidemiology and Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Tumor Epidemiology, Zhengzhou University, Zhengzhou, China
- State Key Laboratory of Esophageal Cancer Prevention & Treatment, Zhengzhou University, Zhengzhou, China
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Raychaudhuri S, Dieli-Conwright CM, Cheng RK, Barac A, Reding KW, Vasbinder A, Cook KL, Nair V, Desai P, Simon MS. A review of research on the intersection between breast cancer and cardiovascular research in the Women's Health Initiative (WHI). Front Oncol 2022; 12:1039246. [PMID: 37025252 PMCID: PMC10071996 DOI: 10.3389/fonc.2022.1039246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 11/29/2022] [Indexed: 04/08/2023] Open
Abstract
Both obesity and metabolic syndrome are linked to increased incidence of type 2 diabetes, cardiovascular disease (CVD), and cancers of the breast (post-menopausal), and other obesity-related cancers. Over the past 50 years, the worldwide prevalence of obesity and metabolic syndrome has increased, with a concomitant higher incidence of associated co-morbidities and mortality. The precise mechanism linking metabolic syndrome to increased cancer incidence is incompletely understood, however, individual components of metabolic syndrome have been linked to increased breast cancer incidence and worse survival. There is a bidirectional relationship between the risk of CVD and cancer due to a high burden of shared risk factors and higher rates of CVD among cancer survivors, which may be impacted by the pro-inflammatory microenvironment associated with metabolic syndrome and cancer-directed therapies. The Women's Health Initiative (WHI) is an excellent resource to study a dual relationship between cancer and CVD (cardio-oncology) with extensive information on risk factors and long-term outcomes. The purpose of this review is to provide an overview of research on cardio-oncology conducted utilizing WHI data with focus on studies evaluating both breast cancer and CVD including shared risk factors and outcomes after cancer. The review also includes results on other obesity related cancers which were included in the analyses of breast cancer, articles looking at cancer after heart disease (reverse cardio-oncology) and the role of Clonal Hematopoiesis of Indeterminate Potential (CHIP) as a shared risk factor between CVD and cancer. A summary of pertinent WHI literature helps to delineate the direction of future research evaluating the relationship between CVD and other cancer sites, and provides information on the opportunity for other novel analyses within the WHI.
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Affiliation(s)
- Sreejata Raychaudhuri
- Department of Oncology, Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
- *Correspondence: Sreejata Raychaudhuri,
| | | | - Richard K. Cheng
- Division of Cardiology, University of Washington, Seattle, WA, United States
| | - Ana Barac
- MedStar Heart and Vascular Institute, Georgetown University, Washington, DC, United States
| | - Kerryn W. Reding
- Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, WA, United States
| | - Alexi Vasbinder
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Katherine L. Cook
- Department of Surgery, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Vidhya Nair
- Department of Hematology/Oncology, Ascension Providence Hospital/Michigan State University College of Human Medicine, Southfield, MI, United States
| | - Pinkal Desai
- Department of Oncology, Weill Cornell Medical College, New York, NY, United States
| | - Michael S. Simon
- Department of Oncology, Karmanos Cancer Institute at Wayne State University, Detroit, MI, United States
- Population Studies and Disparities Research Program, Karmanos Cancer Institute, Detroit, MI, United States
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Sasanfar B, Toorang F, Mohebbi E, Zendehdel K, Azadbakht L. Dietary carbohydrate quality and risk of breast cancer among women. Nutr J 2021; 20:93. [PMID: 34823559 PMCID: PMC8620945 DOI: 10.1186/s12937-021-00752-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 11/10/2021] [Indexed: 12/31/2022] Open
Abstract
Background A few studies have examined the relationship between carbohydrate quality index (CQI) and risk of breast cancer (BC) among women in Middle Eastern countries. We studied the associations between carbohydrate quality index and the risk of BC in overall and by menopausal status. Methods In this case-control study, dietary intake of 461 women with pathologically confirmed BC within the past year were examined. The same information were collected for 495 apparently healthy controls using a 168-item validated FFQ. Carbohydrate quality was determined by considering four criteria including: ratio of solid carbohydrates to total carbohydrates, dietary fiber intake, GI and the ratio of whole grains to total grains. Results Mean GI and GL of participants were totally 57.5 ± 7.2 and 245.7 ± 64.7, respectively. A trend toward significant association was seen between GI and odds of BC in the whole population; such that after stratifying analysis by menopausal status, premenopausal women in the highest quartile of GI were 1.85 times higher likely to have BC than those in the lowest quartile (95% CI: 1.12, 3.07, P = 0.01). We found that women with the greatest CQI had lower odds for BC, compared with those with the lowest CQI (0.63; 95% CI: 0.43–0.94, P = 0.03). This association was remained after stratifying analysis by menopausal status in premenopausal (0.55; 95% CI: 0.34–0.90, P = 0.04). Conclusion We found that GI was directly and CQI inversely associated with odds of BC. In order to determine the effects of dietary carbohydrate quality prospective cohort studies are needed.
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Affiliation(s)
- Bahareh Sasanfar
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, P.O.Box 13145158, Tehran, Iran
| | - Fatemeh Toorang
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, P.O.Box 13145158, Tehran, Iran.,Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran
| | - Elham Mohebbi
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, P.O.Box 13145158, Tehran, Iran.,Pathology and Stem Cell Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Kazem Zendehdel
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, P.O.Box 13145158, Tehran, Iran. .,Cancer Biology Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran. .,Breast Diseases Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran. .,Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. .,Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
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Affiliation(s)
- Julie R Nangia
- Dan L. Duncan Comprehensive Cancer Center at Baylor College of Medicine, Houston, TX
| | - Mothaffar F Rimawi
- Dan L. Duncan Comprehensive Cancer Center at Baylor College of Medicine, Houston, TX
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11
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Diet and Nutrition in Gynecological Disorders: A Focus on Clinical Studies. Nutrients 2021; 13:nu13061747. [PMID: 34063835 PMCID: PMC8224039 DOI: 10.3390/nu13061747] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/17/2021] [Accepted: 05/19/2021] [Indexed: 11/17/2022] Open
Abstract
A healthy lifestyle and a balanced diet play a paramount role in promoting and maintaining homeostatic functions and preventing an array of chronic and debilitating diseases. Based upon observational and epidemiological investigations, it is clear that nutritional factors and dietary habits play a significant role in gynecological disease development, including uterine leiomyoma, endometriosis, polycystic ovary syndrome, and gynecological malignancies. Diets rich in fruits and vegetables, Mediterranean diets, green tea, vitamin D, and plant-derived natural compounds may have a long-term positive impact on gynecological diseases, while fats, red meat, alcohol, and coffee may contribute to their development. Data regarding the association between dietary habits and gynecological disorders are, at times, conflicting, with potential confounding factors, including food pollutants, reduced physical activity, ethnic background, and environmental factors limiting overall conclusions. This review provides a synopsis of the current clinical data and biological basis of the association between available dietary and nutritional data, along with their impact on the biology and pathophysiology of different gynecological disorders, as well as an outlook on future directions that will guide further investigational research.
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Hatami Marbini M, Amiri F, Sajadi Hezaveh Z. Dietary glycemic index, glycemic load, insulin index, insulin load and risk of diabetes-related cancers: A systematic review of cohort studies. Clin Nutr ESPEN 2021; 42:22-31. [PMID: 33745582 DOI: 10.1016/j.clnesp.2021.02.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 02/05/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND & AIMS It is believed that diets high in glycemic index (GI), glycemic load (GL), Insulin index (II), and Insulin load (IL) are associated with the increased risks of certain cancers through increasing serum glucose or insulin levels. METHODS We conducted this systematic review of cohort studies to evaluate the possible relation between GI, GL, II, and IL with diabetes-related cancers, including colorectal, bladder, breast, endometrium, liver, pancreas, and prostate cancers. Two separate investigators conducted a literature search through PubMed/Medline, Scopus, and Web of Science databases up to February 2020, plus reference lists of relevant articles. RESULTS Fifty-three cohort studies with a total of 100 098 cancer cases were included in this systematic review. Fifteen out of eighteen studies among breast cancer cases reported no significant association between GI/GL and cancer risk. These numbers were 4 out of 13 for colorectal cancer, 7 out of 9 for endometrial cancer, 2 out of 3 for liver cancer, 8 out of 10 for pancreatic cancer, and 3 out of 3 for prostate cancer. Only one cohort investigated this association in terms of bladder cancer and reported a significant association. Also, five studies reported this relation in terms of II/IL, and only one cohort among endometrial cancer patients observed a significant positive association between the risk of cancer and IL. CONCLUSION We concluded a weak association between dietary GI/GL and no association between II/IL with diabetes-related cancer risk. More cohort studies are required to be performed regarding II/IL and the risk of cancer.
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Affiliation(s)
- Motahare Hatami Marbini
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemehsadat Amiri
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
| | - Zohreh Sajadi Hezaveh
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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13
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Flores-García MK, Mérida-Ortega Á, Denova-Gutiérrez E, López-Carrillo L. Dietary Patterns and Breast Cancer Risk in Women from Northern Mexico. Nutr Cancer 2020; 73:2763-2773. [PMID: 33356597 DOI: 10.1080/01635581.2020.1860241] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
We evaluated the association between dietary patterns and breast cancer (BC) subtypes among women from Northern Mexico. From a study of incident cases and population controls that was carried out from 2007 to 2011, a subsample of 509 cases matched 1:1 by age with 509 controls was selected. Information about expression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor 2 (HER2) was available from medical records to classify BC on luminal (ER + and/or PR+/HER2-), HER2+ (ER+/- and/or PR+/-/HER2+), or triple negative (ER- and PR-/HER2-). Dietary information was gathered using a semiquantitative food frequency questionnaire and a factor analysis was used to obtain dietary patterns. The association between each dietary pattern and BC molecular subtypes was assessed through conditional logistic regression models. Two dietary patterns were identified. The first (mainly characterized by meat, high fat, and sugary cereals) was positively associated with BC (odds ratio, OR = 12.62; 95% CI: 7.42, 21.45); the second (consisting of corn, legumes, and other vegetables) was inversely associated with BC (OR = 0.50; 95% CI: 0.40, 0.62). Both associations remained significant by BC molecular subtypes. These findings could contribute to the development of public health strategies for BC prevention.
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Affiliation(s)
- M Karen Flores-García
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Ángel Mérida-Ortega
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Edgar Denova-Gutiérrez
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Lizbeth López-Carrillo
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
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14
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Sreeja SR, Seo SS, Kim MK. Associations of Dietary Glycemic Index, Glycemic Load and Carbohydrate with the Risk of Cervical Intraepithelial Neoplasia and Cervical Cancer: A Case-Control Study. Nutrients 2020; 12:E3742. [PMID: 33291721 PMCID: PMC7761966 DOI: 10.3390/nu12123742] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/27/2020] [Accepted: 12/03/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The association of dietary glycemic index (GI) and glycemic load (GL) with the risk of cervical cancer has never been investigated. Thus, we aimed to find evidence of any association of GI and GL with the risk of cervical intraepithelial neoplasia (CIN) and cervical cancer. METHODS In this hospital-based case-control study, we included 1340 women (670 controls and 262, 187 and 221 patients with CIN1, CIN2/3, and cervical cancer, respectively) from the Korean human papillomavirus cohort study. Completed demographic questionnaires and semi-quantitative food-frequency questionnaires were collected. The association of dietary GI and GL with CIN and cervical cancer was estimated using a logistic regression model. RESULTS The multivariate odds ratios (OR) of the highest compared with the lowest quintile of GL for CIN1 were 2.8 (95% confidence interval (CI) = 1.33-5.88). Dietary GI and GL were not associated with CIN2/3 and cervical cancer. Stratified analyses by body mass index (BMI) indicated a positive association between GI and GL and CIN 1 risk among women with a BMI (in kg/m2) <23 (OR = 2.94; 95% CI = 1.32-6.53; p for trend = 0.031 for GI and OR = 3.15; 95% CI = 1.53-6.52; p for trend = 0.013 for GL), but not among those with a BMI of ≥23. A stratification analysis by menopausal status showed that the highest quintile of GI and GL was significantly associated with the risk of CIN1 (OR = 2.91; 95% CI = 1.43-5.96; p for trend = 0.005) (OR = 2.96; 95% CI = 1.53-5.69; p for trend = 0.023) among premenopausal women. Also, in HPV positive women, dietary GL showed significant CIN1 risk (OR = 2.61; 95% CI = 1.09-6.24; p for trend = 0.087). CONCLUSION Our case-control study supports the hypothesized associations of dietary GI and GL with increased risk of CIN1. Thus, the consumption of low GI and GL foods plays a significant role in the prevention of cervical carcinogenesis.
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Affiliation(s)
- Sundara Raj Sreeja
- Division of Cancer Epidemiology and Prevention, National Cancer Center, Ilsandong-gu, Goyang-si 10408, Korea;
| | - Sang Soo Seo
- Center for Uterine Cancer, National Cancer Center, Ilsandong-gu, Goyang-si 10408, Korea;
| | - Mi Kyung Kim
- Division of Cancer Epidemiology and Prevention, National Cancer Center, Ilsandong-gu, Goyang-si 10408, Korea;
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15
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Song M. Sugar intake and cancer risk: when epidemiologic uncertainty meets biological plausibility. Am J Clin Nutr 2020; 112:1155-1156. [PMID: 32936876 PMCID: PMC7657320 DOI: 10.1093/ajcn/nqaa261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- Mingyang Song
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
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16
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Debras C, Chazelas E, Srour B, Kesse-Guyot E, Julia C, Zelek L, Agaësse C, Druesne-Pecollo N, Galan P, Hercberg S, Latino-Martel P, Deschasaux M, Touvier M. Total and added sugar intakes, sugar types, and cancer risk: results from the prospective NutriNet-Santé cohort. Am J Clin Nutr 2020; 112:1267-1279. [PMID: 32936868 DOI: 10.1093/ajcn/nqaa246] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 08/04/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Excessive sugar intake is now recognized as a key risk factor for obesity, type 2 diabetes, and cardiovascular diseases. In contrast, evidence on the sugar-cancer link is less consistent. Experimental data suggest that sugars could play a role in cancer etiology through obesity but also through inflammatory and oxidative mechanisms and insulin resistance, even in the absence of weight gain. OBJECTIVE The objective was to study the associations between total and added sugar intake and cancer risk (overall, breast, and prostate), taking into account sugar types and sources. METHODS In total, 101,279 participants aged >18 y (median age, 40.8 y) from the French NutriNet-Santé prospective cohort study (2009-2019) were included (median follow-up time, 5.9 y). Sugar intake was assessed using repeated and validated 24-h dietary records, designed to register participants' usual consumption for >3500 food and beverage items. Associations between sugar intake and cancer risk were assessed by Cox proportional hazard models adjusted for known risk factors (sociodemographic, anthropometric, lifestyle, medical history, and nutritional factors). RESULTS Total sugar intake was associated with higher overall cancer risk (n = 2503 cases; HR for quartile 4 compared with quartile 1: 1.17; 95% CI: 1.00, 1.37; Ptrend = 0.02). Breast cancer risks were increased (n = 783 cases; HRQ4vs.Q1 = 1.51; 95% CI: 1.14, 2.00; Ptrend = 0.0007). Results remained significant when weight gain during follow-up was adjusted for. In addition, significant associations with cancer risk were also observed for added sugars, free sugars, sucrose, sugars from milk-based desserts, dairy products, and sugary drinks (Ptrend ≤ 0.01). CONCLUSIONS These results suggest that sugars may represent a modifiable risk factor for cancer prevention (breast in particular), contributing to the current debate on the implementation of sugar taxation, marketing regulation, and other sugar-related policies. This trial was registered at clinicaltrials.gov as NCT03335644.
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Affiliation(s)
- Charlotte Debras
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Eloi Chazelas
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Bernard Srour
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Chantal Julia
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France.,Public Health Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Laurent Zelek
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France.,Oncology Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Cédric Agaësse
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Nathalie Druesne-Pecollo
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Pilar Galan
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Serge Hercberg
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France.,Public Health Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Paule Latino-Martel
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Mélanie Deschasaux
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
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17
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Farvid MS, Spence ND, Holmes MD, Barnett JB. Fiber consumption and breast cancer incidence: A systematic review and meta-analysis of prospective studies. Cancer 2020; 126:3061-3075. [PMID: 32249416 DOI: 10.1002/cncr.32816] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 01/12/2020] [Accepted: 01/14/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Associations between fiber intake and breast cancer risk have been evaluated in prospective studies, but overall, the evidence is inconsistent. The authors performed a systematic review and meta-analysis of prospective studies to investigate the relation between intake of total and types of fiber with breast cancer incidence. METHODS The MEDLINE and Excerpta Medica dataBASE (EMBASE) databases were searched through July 2019 for prospective studies that reported on the association between fiber consumption and incident breast cancer. The pooled relative risk (RR) and 95% confidence intervals (95% CI) were estimated comparing the highest versus the lowest category of total and types of fiber consumption, using a random-effects meta-analysis. RESULTS The authors identified 17 cohort studies, 2 nested case-control studies, and 1 clinical trial study. Total fiber consumption was associated with an 8% lower risk of breast cancer (comparing the highest versus the lowest category, pooled RR, 0.92; 95% CI, 0.88-0.95 [I2 = 12.6%]). Soluble fiber was found to be significantly inversely associated with risk of breast cancer (pooled RR, 0.90 [95% CI, 0.84-0.96; I2 = 12.6%]) and insoluble fiber was found to be suggestively inversely associated with risk of breast cancer (pooled RR, 0.93 [95% CI, 0.86-1.00; I2 = 33.4%]). Higher total fiber intake was associated with a lower risk of both premenopausal and postmenopausal breast cancers (pooled RR, 0.82 [95% CI, 0.67-0.99; I2 = 35.2%] and pooled RR, 0.91 [95% CI, 0.88-0.95; I2 = 0.0%], respectively). Furthermore, the authors observed a nonsignificant inverse association between intake of total fiber and risk of both estrogen and progesterone receptor-positive and estrogen and progesterone receptor-negative breast cancers. CONCLUSIONS A random-effects meta-analysis of prospective observational studies demonstrated that high total fiber consumption was associated with a reduced risk of breast cancer. This finding was consistent for soluble fiber as well as for women with premenopausal and postmenopausal breast cancer.
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Affiliation(s)
- Maryam S Farvid
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Nicholas D Spence
- Department of Sociology and Interdisciplinary Center for Health and Society, University of Toronto, Toronto, Ontario, Canada
| | - Michelle D Holmes
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Junaidah B Barnett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
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18
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Guerrero CH, Gamboa-Loira B, Mérida-Ortega Á, López-Carrillo L. Dietary Glycemic Index and Glycemic Load and Risk of Breast Cancer by Molecular Subtype in Mexican Women. Nutr Cancer 2019; 71:1283-1289. [PMID: 31058544 DOI: 10.1080/01635581.2019.1607408] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The objective was to estimate the risk of breast cancer (BC) molecular subtypes in relation to the average glycemic index (GI) and the dietary glycemic load (GL) in Mexican women. From 2007 to 2011, a study of incident cases and population controls was conducted in five states of northern Mexico. A subsample of 509 cases matched 1:1 by age with 509 controls was selected. With a food frequency questionnaire, information about diet was obtained, and GI and GL were calculated. The expression of human epidermal growth factor receptor 2 (HER2), and estrogen (ER) and progesterone (PR) receptors in tumors was obtained from medical records. Patients were classified as luminal A (RE+ and/or PR+/HER2-), HER2+ (RE+ and/or PR+/HER2+ and RE-/PR-/HER2+), or triple negative (TN) (RE-/PR-/HER2-). GI and GL associations with BC molecular subtypes were evaluated using conditional logistic regression models. GI was positively associated with luminal A (OR= 1.12; 95% CI: 1.03, 1.22), HER2+ (OR= 1.15; 95% CI: 1.02, 1.30), and TN (OR= 1.20; 95% CI: 1.03, 1.39) BC. GL was not associated with BC molecular subtypes. These results suggest that the type of carbohydrate consumed is associated with increased BC regardless of the luminal A, HER2+, and TN subtypes.
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Affiliation(s)
- Christian H Guerrero
- Center for Research in Health and Nutrition, National Institute of Public Health , Cuernavaca , Morelos, Mexico
| | - Brenda Gamboa-Loira
- Center for Population Health Research, National Institute of Public Health , Cuernavaca , Morelos, Mexico
| | - Ángel Mérida-Ortega
- Center for Population Health Research, National Institute of Public Health , Cuernavaca , Morelos, Mexico
| | - Lizbeth López-Carrillo
- Center for Population Health Research, National Institute of Public Health , Cuernavaca , Morelos, Mexico
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19
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Coughlin SS. Epidemiology of Breast Cancer in Women. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1152:9-29. [PMID: 31456177 DOI: 10.1007/978-3-030-20301-6_2] [Citation(s) in RCA: 173] [Impact Index Per Article: 34.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Epidemiologic studies have contributed importantly to current knowledge of environmental and genetic risk factors for breast cancer. Worldwide, breast cancer is an important cause of human suffering and premature mortality among women. In the United States, breast cancer accounts for more cancer deaths in women than any site other than lung cancer. A variety of risk factors for breast cancer have been well-established by epidemiologic studies including race, ethnicity, family history of cancer, and genetic traits, as well as modifiable exposures such as increased alcohol consumption, physical inactivity, exogenous hormones, and certain female reproductive factors. Younger age at menarche, parity, and older age at first full-term pregnancy may influence breast cancer risk through long-term effects on sex hormone levels or by other biological mechanisms. Recent studies have suggested that triple negative breast cancers may have a distinct etiology. Genetic variants and mutations in genes that code for proteins having a role in DNA repair pathways and the homologous recombination of DNA double stranded breaks (APEX1, BRCA1, BRCA2, XRCC2, XRCC3, ATM, CHEK2, PALB2, RAD51, XPD), have been implicated in some cases of breast cancer.
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Affiliation(s)
- Steven S Coughlin
- Division of Epidemiology, Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA.
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20
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Makarem N, Bandera EV, Nicholson JM, Parekh N. Consumption of Sugars, Sugary Foods, and Sugary Beverages in Relation to Cancer Risk: A Systematic Review of Longitudinal Studies. Annu Rev Nutr 2018; 38:17-39. [DOI: 10.1146/annurev-nutr-082117-051805] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
High sugar intake may increase cancer risk by promoting insulin–glucose dysregulation, oxidative stress, inflammation, and body adiposity, but epidemiologic evidence is unclear. Associations between dietary sugars and lifestyle-related cancer risk from longitudinal studies were evaluated. We systematically searched PubMed, Embase, and CINAHL and identified 37 prospective cohort studies (1990–2017) reporting multivariable adjusted risk estimates for dietary sugars in relation to cancer. Of 15 and 14 studies on total sugar and sucrose respectively, 11 reported a null association in relation to cancer. Of 14 studies on fructose, 8 reported null associations, and 2 reported protective and 4 reported detrimental associations. In two of five studies on added sugars, a 60–95% increased cancer risk was observed with higher intakes. In 8 of 15 studies on sugary foods and beverages, a 23–200% higher cancer risk was observed with higher sugary beverage consumption. In conclusion, most studies were indicative of a null association, but suggestive detrimental associations were reported for added sugars and sugary beverages.
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Affiliation(s)
- Nour Makarem
- Department of Medicine, Columbia University Medical Center, New York, NY 10032, USA
| | - Elisa V. Bandera
- Rutgers School of Public Health, The State University of New Jersey, Piscataway, New Jersey 08854, USA
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey 08903-2681, USA
| | - Joseph M. Nicholson
- NYU Health Sciences Library, New York University School of Medicine, New York, NY 10016, USA
| | - Niyati Parekh
- College of Global Public Health, New York University, New York, NY 10003, USA
- Department of Population Health, New York University Langone Health, New York, NY 10016, USA
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21
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Makarem N, Bandera EV, Lin Y, Jacques PF, Hayes RB, Parekh N. Consumption of Sugars, Sugary Foods, and Sugary Beverages in Relation to Adiposity-Related Cancer Risk in the Framingham Offspring Cohort (1991-2013). Cancer Prev Res (Phila) 2018; 11:347-358. [PMID: 29674390 DOI: 10.1158/1940-6207.capr-17-0218] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 01/02/2018] [Accepted: 04/12/2018] [Indexed: 01/09/2023]
Abstract
Background: Higher sugar consumption may increase cancer risk by promoting insulin-glucose dysregulation, oxidative stress, hormonal imbalances, and excess adiposity. This prospective study investigates the association between dietary sugars (fructose and sucrose) and sugary foods and beverages in relation to combined and site-specific (breast, prostate, colorectal) adiposity-associated cancers.Methods: The analytic sample consisted of 3,184 adults, aged 26-84 years, from the Framingham Offspring cohort. Diet data were first collected between 1991 and 1995 using a food frequency questionnaire. Intakes of fructose, sucrose, sugary foods, and sugary beverages (fruit juice and sugar-sweetened beverages) were derived. Participants were followed up until 2013 to ascertain cancer incidence; 565 doctor-diagnosed adiposity-related cancers, including 124 breast, 157 prostate, and 68 colorectal cancers occurred. Multivariable-adjusted Cox proportional hazards models were used to evaluate associations. Tests for interaction with BMI and waist circumference were conducted.Results: No associations were observed between fructose, sucrose, sugary food consumption, and combined incidence of adiposity-related cancers or the examined site-specific cancers. While total consumption of sugary beverages was not associated with site-specific cancer risk, higher intakes of fruit juice were associated with 58% increased prostate cancer risk (HR: 1.58; 95% CI, 1.04-2.41) in multivariable-adjusted models. In exploratory stratified analyses, higher sugary beverage intakes increased overall adiposity-related cancer risk by 59% in participants with excessive central adiposity (HR: 1.59; 95% CI, 1.01-2.50; Ptrend = 0.057).Conclusions: In this cohort of American adults, higher sugary beverage consumption was associated with increased cancer risk among participants with central adiposity.Impact: These analyses suggest that avoiding sugary beverages represents a simple dietary modification that may be used as an effective cancer control strategy. Cancer Prev Res; 11(6); 347-58. ©2018 AACR.
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Affiliation(s)
- Nour Makarem
- Department of Medicine, Columbia University Medical Center, New York, New York
| | - Elisa V Bandera
- Rutgers School of Public Health, Rutgers the State University of New Jersey, Piscataway, New Jersey
| | - Yong Lin
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Paul F Jacques
- Jean Mayer USDA Human Nutrition Research Center on Aging, Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Richard B Hayes
- Department of Population Health, NYU Langone School of Medicine, New York, New York
| | - Niyati Parekh
- College of Global Public Health, New York University, New York, New York.
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22
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Schlesinger S, Chan DSM, Vingeliene S, Vieira AR, Abar L, Polemiti E, Stevens CAT, Greenwood DC, Aune D, Norat T. Carbohydrates, glycemic index, glycemic load, and breast cancer risk: a systematic review and dose-response meta-analysis of prospective studies. Nutr Rev 2018; 75:420-441. [PMID: 28969357 DOI: 10.1093/nutrit/nux010] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Context The investigation of dose-response associations between carbohydrate intake, glycemic index, glycemic load, and risk of breast cancer stratified by menopausal status, hormone receptor status, and body mass index (BMI) remains inconclusive. Objective A systematic review and dose-response meta-analyses was conducted to investigate these associations. Data Sources As part of the World Cancer Research Fund/American Institute for Cancer Research Continuous Update Project, PubMed was searched up to May 2015 for relevant studies on these associations. Study Selection Prospective studies reporting associations between carbohydrate intake, glycemic index, or glycemic load and breast cancer risk were included. Data Extraction Two investigators independently extracted data from included studies. Results Random-effects models were used to summarize relative risks (RRs) and 95%CIs. Heterogeneity between subgroups, including menopausal status, hormone receptor status, and BMI was explored using meta-regression. Nineteen publications were included. The summary RRs (95%CIs) for breast cancer were 1.04 (1.00-1.07) per 10 units/d for glycemic index, 1.01 (0.98-1.04) per 50 units/d for glycemic load, and 1.00 (0.96-1.05) per 50 g/d for carbohydrate intake. For glycemic index, the association appeared slightly stronger among postmenopausal women (summary RR per 10 units/d, 1.06; 95%CI, 1.02-1.10) than among premenopausal women, though the difference was not statistically significant (Pheterogeneity = 0.15). Glycemic load and carbohydrate intake were positively associated with breast cancer among postmenopausal women with estrogen-negative tumors (summary RR for glycemic load, 1.28; 95%CI, 1.08-1.52; and summary RR for carbohydrates, 1.13; 95%CI, 1.02-1.25). No differences in BMI were detected. Conclusions Menopausal and hormone receptor status, but not BMI, might be potential influencing factors for the associations between carbohydrate intake, glycemic index, glycemic load, and breast cancer.
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Affiliation(s)
- Sabrina Schlesinger
- Department of Epidemiology and Public Health, Imperial College London, London, United Kingdom.,Junior Research Group Systematic Reviews, Institute for Biometrics and Epidemiology, German Diabetes Center, Düsseldorf, Germany
| | - Doris S M Chan
- Department of Epidemiology and Public Health, Imperial College London, London, United Kingdom
| | - Snieguole Vingeliene
- Department of Epidemiology and Public Health, Imperial College London, London, United Kingdom
| | - Ana R Vieira
- Department of Epidemiology and Public Health, Imperial College London, London, United Kingdom
| | - Leila Abar
- Department of Epidemiology and Public Health, Imperial College London, London, United Kingdom
| | - Elli Polemiti
- Department of Epidemiology and Public Health, Imperial College London, London, United Kingdom
| | - Christophe A T Stevens
- Department of Epidemiology and Public Health, Imperial College London, London, United Kingdom
| | - Darren C Greenwood
- Department of Epidemiology and Public Health, Imperial College London, London, United Kingdom.,Division of Epidemiology and Biostatistics, School of Medicine, University of Leeds, Leeds, United Kingdom
| | - Dagfinn Aune
- Department of Epidemiology and Public Health, Imperial College London, London, United Kingdom.,Bjørknes University College, Oslo, Norway
| | - Teresa Norat
- Department of Epidemiology and Public Health, Imperial College London, London, United Kingdom
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Chen S, Chen Y, Ma S, Zheng R, Zhao P, Zhang L, Liu Y, Yu Q, Deng Q, Zhang K. Dietary fibre intake and risk of breast cancer: A systematic review and meta-analysis of epidemiological studies. Oncotarget 2018; 7:80980-80989. [PMID: 27829237 PMCID: PMC5348370 DOI: 10.18632/oncotarget.13140] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 10/27/2016] [Indexed: 12/13/2022] Open
Abstract
Current evidence from randomised controlled trials on the effects of dietary fibre intake on breast cancer risk is inconsistent. We conducted a meta-analysis to determine the effectiveness of dietary fibre intake in reducing breast cancer risk. We searched for prospective and case-control studies on dietary fibre intake and breast cancer risk in the English language through March 2016. Twenty-four epidemiologic studies obtained through the PubMed, Embase, Web of Science, and Cochrane Library databases were systematically reviewed. A random-effects model was used to compute the pooled risk estimates by extracting the risk estimate of the highest and lowest reported categories of intake from each study. The meta-analyses showed a 12% decrease in breast cancer risk with dietary fibre intake. The association between dietary fibre intake and breast cancer risk was significant when stratified according to Jadad scores, study types, and menopause status. Dose-response analysis showed that every 10 g/d increment in dietary fibre intake was associated with a 4% reduction in breast cancer risk, and little evidence of publication bias was found. Thus, dietary fibre consumption is significantly associated with a reduced risk of breast cancer, particularly in postmenopausal women.
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Affiliation(s)
- Sumei Chen
- Department of Radiation Oncology, Hangzhou Cancer Hospital, Hangzhou, Zhejiang 310002, China
| | - Yuanyuan Chen
- Department of Radiation Oncology, Hangzhou Cancer Hospital, Hangzhou, Zhejiang 310002, China
| | - Shenglin Ma
- Affiliated Hangzhou First People's Hospital, Hangzhou, Zhejiang 310006, China.,Affiliated Hangzhou Hospital of Nanjing Medical University, Hangzhou, Zhejiang 310006, China
| | - Ruzhen Zheng
- Department of Radiation Oncology, Hangzhou Cancer Hospital, Hangzhou, Zhejiang 310002, China
| | - Pengjun Zhao
- Department of Radiation Oncology, Hangzhou Cancer Hospital, Hangzhou, Zhejiang 310002, China
| | - Lidan Zhang
- Department of Radiation Oncology, Hangzhou Cancer Hospital, Hangzhou, Zhejiang 310002, China
| | - Yuehua Liu
- Department of Radiation Oncology, Hangzhou Cancer Hospital, Hangzhou, Zhejiang 310002, China
| | - Qingqing Yu
- Department of Radiation Oncology, Hangzhou Cancer Hospital, Hangzhou, Zhejiang 310002, China
| | - Qinghua Deng
- Department of Radiation Oncology, Hangzhou Cancer Hospital, Hangzhou, Zhejiang 310002, China.,Affiliated Hangzhou First People's Hospital, Hangzhou, Zhejiang 310006, China
| | - Ke Zhang
- Department of Radiation Oncology, Hangzhou Cancer Hospital, Hangzhou, Zhejiang 310002, China
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Saha SK, Lee SB, Won J, Choi HY, Kim K, Yang GM, Dayem AA, Cho SG. Correlation between Oxidative Stress, Nutrition, and Cancer Initiation. Int J Mol Sci 2017; 18:E1544. [PMID: 28714931 PMCID: PMC5536032 DOI: 10.3390/ijms18071544] [Citation(s) in RCA: 219] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 07/12/2017] [Accepted: 07/13/2017] [Indexed: 02/07/2023] Open
Abstract
Inadequate or excessive nutrient consumption leads to oxidative stress, which may disrupt oxidative homeostasis, activate a cascade of molecular pathways, and alter the metabolic status of various tissues. Several foods and consumption patterns have been associated with various cancers and approximately 30-35% of the cancer cases are correlated with overnutrition or malnutrition. However, several contradictory studies are available regarding the association between diet and cancer risk, which remains to be elucidated. Concurrently, oxidative stress is a crucial factor for cancer progression and therapy. Nutritional oxidative stress may be induced by an imbalance between antioxidant defense and pro-oxidant load due to inadequate or excess nutrient supply. Oxidative stress is a physiological state where high levels of reactive oxygen species (ROS) and free radicals are generated. Several signaling pathways associated with carcinogenesis can additionally control ROS generation and regulate ROS downstream mechanisms, which could have potential implications in anticancer research. Cancer initiation may be modulated by the nutrition-mediated elevation in ROS levels, which can stimulate cancer initiation by triggering DNA mutations, damage, and pro-oncogenic signaling. Therefore, in this review, we have provided an overview of the relationship between nutrition, oxidative stress, and cancer initiation, and evaluated the impact of nutrient-mediated regulation of antioxidant capability against cancer therapy.
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Affiliation(s)
- Subbroto Kumar Saha
- Department of Stem Cell and Regenerative Biotechnology, Incurable Disease Animal Model & Stem Cell Institute (IDASI), Konkuk University, Seoul 05029, Korea.
| | - Soo Bin Lee
- Department of Stem Cell and Regenerative Biotechnology, Incurable Disease Animal Model & Stem Cell Institute (IDASI), Konkuk University, Seoul 05029, Korea.
| | - Jihye Won
- Department of Stem Cell and Regenerative Biotechnology, Incurable Disease Animal Model & Stem Cell Institute (IDASI), Konkuk University, Seoul 05029, Korea.
| | - Hye Yeon Choi
- Department of Stem Cell and Regenerative Biotechnology, Incurable Disease Animal Model & Stem Cell Institute (IDASI), Konkuk University, Seoul 05029, Korea.
| | - Kyeongseok Kim
- Department of Stem Cell and Regenerative Biotechnology, Incurable Disease Animal Model & Stem Cell Institute (IDASI), Konkuk University, Seoul 05029, Korea.
| | - Gwang-Mo Yang
- Department of Stem Cell and Regenerative Biotechnology, Incurable Disease Animal Model & Stem Cell Institute (IDASI), Konkuk University, Seoul 05029, Korea.
| | - Ahmed Abdal Dayem
- Department of Stem Cell and Regenerative Biotechnology, Incurable Disease Animal Model & Stem Cell Institute (IDASI), Konkuk University, Seoul 05029, Korea.
| | - Ssang-Goo Cho
- Department of Stem Cell and Regenerative Biotechnology, Incurable Disease Animal Model & Stem Cell Institute (IDASI), Konkuk University, Seoul 05029, Korea.
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Hidaka BH, Kimler BF, Fabian CJ, Carlson SE. An empirically derived dietary pattern associated with breast cancer risk is validated in a nested case-control cohort from a randomized primary prevention trial. Clin Nutr ESPEN 2017; 17:8-17. [DOI: 10.1016/j.clnesp.2016.10.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 09/11/2016] [Accepted: 10/27/2016] [Indexed: 11/24/2022]
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Glycemic index, glycemic load and invasive breast cancer incidence in postmenopausal women: The PREDIMED study. Eur J Cancer Prev 2016; 25:524-32. [PMID: 26633163 DOI: 10.1097/cej.0000000000000209] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Abstract
OBJECTIVES To discuss the relationship between weight management and diet and cancer prevention, current nutritional guidelines, and evidence-based strategies to reduce cancer risk. DATA SOURCES Current nutritional guidelines, journal articles published between 2012 and 2015, and internet resources. CONCLUSION Evidence indicates that attaining and/or maintaining a healthy weight and adopting a diet that is primarily plant-based, low in red and processed meats, simple sugars, and refined carbohydrates, limits alcohol, and relies on food for nutrients can aid in preventing cancer. IMPLICATIONS FOR NURSING PRACTICE Nurses can take the lead to educate patients and families about weight management and diet and to promote adherence to nutritional guidelines.
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Thompson HJ, Neuhouser ML, Lampe JW, McGinley JN, Neil ES, Schwartz Y, McTiernan A. Effect of low or high glycemic load diets on experimentally induced mammary carcinogenesis in rats. Mol Nutr Food Res 2016; 60:1416-26. [PMID: 26778091 DOI: 10.1002/mnfr.201500864] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Revised: 01/08/2016] [Accepted: 01/10/2016] [Indexed: 01/18/2023]
Abstract
SCOPE High glycemic load diets have been associated with increased breast cancer risk in population-based studies, but the evidence is mixed. This investigation determined whether diets differing in glycemic load affected the carcinogenic process using a preclinical model. METHODS AND RESULTS Human diets, formulated to differ 2-fold in glycemic load, were evaluated in the 1-methyl-nitrosourea-induced (37.5 mg/kg) mammary carcinogenesis model. Cancer incidence (23.3 versus 50.0%, p = 0.032), multiplicity, (0.40 versus 1.03, p = 0.030) and burden, (0.62 versus 1.19 g/rat, p = 0.037) were reduced in the low versus high glycemic load diets, respectively. However, the low glycemic protective effect was attenuated when two purified diets that differed in resistant starch and simulated the glycemic effects of the human diets were fed. Protection was associated with alterations in markers of cell growth regulation. CONCLUSION Our findings show that human low or high glycemic load dietary patterns differentially affect the carcinogenic response in a nondiabetic rodent model for breast cancer. However, factors that are associated with these patterns, in addition to dietary carbohydrate availability, appear to account for the differences observed.
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Affiliation(s)
- Henry J Thompson
- Cancer Prevention Laboratory, Colorado State University, Fort Collins, CO, USA
| | | | | | - John N McGinley
- Cancer Prevention Laboratory, Colorado State University, Fort Collins, CO, USA
| | - Elizabeth S Neil
- Cancer Prevention Laboratory, Colorado State University, Fort Collins, CO, USA
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Farvid MS, Eliassen AH, Cho E, Liao X, Chen WY, Willett WC. Dietary Fiber Intake in Young Adults and Breast Cancer Risk. Pediatrics 2016; 137:e20151226. [PMID: 26908709 PMCID: PMC4771124 DOI: 10.1542/peds.2015-1226] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/12/2015] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE We evaluated fiber intake during adolescence and early adulthood in relation to breast cancer (BC) risk in the Nurses' Health Study II. METHODS Among 90,534 premenopausal women who completed a dietary questionnaire in 1991, we documented 2833 invasive BC cases during 20 years of follow-up. In 1998, 44,263 of these women also completed a questionnaire about their diet during high school; among these women, we documented 1118 cases of BC by end of follow-up. Multivariable-adjusted Cox proportional hazards regression was used to model relative risks (RRs) and 95% confidence intervals (CIs) for BC across categories of dietary fiber. RESULTS Among all women, early adulthood total dietary fiber intake was associated with significantly lower BC risk (RR for highest versus lowest quintile 0.81; 95% CI 0.72-0.91; Ptrend = .002). Higher intakes of soluble fiber (RR for highest versus lowest quintile 0.86; 95% CI 0.77-0.97; Ptrend = .02) and insoluble fiber (RR for highest versus lowest quintile 0.80; 95% CI 0.71-0.90; Ptrend < .001) were each associated with lower BC risk. Total dietary fiber intake in adolescence was also associated with lower BC risk (RR for highest versus lowest quintile 0.84; 95% CI 0.70-1.01; Ptrend = .04). For the average of fiber intake during adolescence and early adult life, the RR comparing highest with lowest quintiles was 0.75 (95% CI 0.62-0.91, Ptrend = .004). CONCLUSIONS Our findings support the hypothesis that higher fiber intakes reduce BC risk and suggest that intake during adolescence and early adulthood may be particularly important.
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Affiliation(s)
| | - A. Heather Eliassen
- Epidemiology, and,Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Eunyoung Cho
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts;,Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island; and
| | - Xiaomei Liao
- Epidemiology, and,Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts;,Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Wendy Y. Chen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts;,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Walter C. Willett
- Departments of Nutrition,,Epidemiology, and,Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
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30
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Dietary Carbohydrate, Glycemic Index, Glycemic Load, and Breast Cancer Risk Among Mexican Women. Epidemiology 2015; 26:917-24. [DOI: 10.1097/ede.0000000000000374] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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31
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Sulaiman S, Shahril MR, Wafa SW, Shaharudin SH, Hussin SNAS. Dietary carbohydrate, fiber and sugar and risk of breast cancer according to menopausal status in Malaysia. Asian Pac J Cancer Prev 2015; 15:5959-64. [PMID: 25081729 DOI: 10.7314/apjcp.2014.15.14.5959] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dietary carbohydrate, fiber and sugar intake has been shown to play a role in the etiology of breast cancer, but the findings have been inconsistent and limited to developed countries with higher cancer incidence. OBJECTIVE To examine the association of premenopausal and postmenopausal breast cancer risk with dietary carbohydrate, fiber and sugar intake. MATERIALS AND METHODS This population based case-control study was conducted in Malaysia with 382 breast cancer patients and 382 controls. Food intake pattern was assessed via an interviewer-administered food frequency questionnaire. Logistic regression was used to compute odds ratios (OR) with 95% confidence intervals (CI) and a broad range of potential confounders were included in analysis. RESULTS A significant two fold increased risk of breast cancer among premenopausal (OR Q4 to Q1=1.93, 95%CI: 1.53-2.61, p-trend=0.001) and postmenopausal (OR Q4 to Q1=1.87, 95%CI: 1.03-2.61, p-trend=0.045) women was observed in the highest quartile of sugar. A higher intake of dietary fiber was associated with a significantly lower breast cancer risk among both premenopausal (OR Q4 to Q1=0.31, 95%CI: 0.12-0.79, p-trend=0.009) and postmenopausal (OR Q4 to Q1=0.23, 95%CI: 0.07-0.76, p-trend=0.031) women. CONCLUSIONS Sugar and dietary fiber intake were independently related to pre- and postmenopausal breast cancer risk. However, no association was observed for dietary carbohydrate intake.
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Affiliation(s)
- Suhaina Sulaiman
- Dietetics Programme, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia E-mail : ,
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Thompson HJ, Sedlacek SM, Playdon MC, Wolfe P, McGinley JN, Paul D, Lakoski SG. Weight loss interventions for breast cancer survivors: impact of dietary pattern. PLoS One 2015; 10:e0127366. [PMID: 26010254 PMCID: PMC4443974 DOI: 10.1371/journal.pone.0127366] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 04/09/2015] [Indexed: 11/18/2022] Open
Abstract
Body weight management is not emphasized in clinical practice guidelines for breast cancer survivors, reflecting the lack of evidence that weight loss improves prognosis. Even if this situation changes, the optimal design for weight loss interventions is unclear. We conducted a 6-month non-randomized, controlled weight loss intervention in 249 post-menopausal breast cancer survivors. This paper reports effects on two secondary endpoints, change in body weight and composition. Participants were predominantly non-Hispanic whites (89%) with a mean age of 54.9 ± 9.2 years, a mean BMI of 29.0 ± 2.6 kg/m: 2 and an average of 43 ± 5% body fat. Two dietary interventions, low fat or low carbohydrate, were investigated and consisted of a 42 day cycle of menus and recipes. Weight loss counseling and anthropometric assessment were provided at monthly clinic visits. One hundred ninety-two women completed the trial (77% retention). In comparison to the nonintervention control, both intervention arms achieved significant decreases in body weight (12.5%), body fat (27.5%), waist circumference (9.5%), and hip circumference (7.8%) (all p < 0.001) with minimal effects on lean mass (1.3% decrease). Median time to 5 and 10% weight loss was 2 (95% confidence interval = 1 to 3) and 4 (95% confidence interval = 3 to 5) months, respectively, and 23% of participants experienced ≥ 15% weight loss. Loss of body weight and fat mass was rapid and substantial irrespective of dietary approach when a structured program was provided with monthly anthropometric assessment and weight loss counseling.
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Affiliation(s)
- Henry J. Thompson
- Cancer Prevention Laboratory, Colorado State University, Fort Collins, Colorado, United States of America
- * E-mail:
| | - Scot M. Sedlacek
- Cancer Prevention Laboratory, Colorado State University, Fort Collins, Colorado, United States of America
- Rocky Mountain Cancer Centers, Denver, Colorado, United States of America
| | - Mary C. Playdon
- Cancer Prevention Laboratory, Colorado State University, Fort Collins, Colorado, United States of America
| | - Pamela Wolfe
- Colorado Biostatistics Consortium, University of Colorado Denver, Colorado, United States of America
| | - John N. McGinley
- Cancer Prevention Laboratory, Colorado State University, Fort Collins, Colorado, United States of America
| | - Devchand Paul
- Rocky Mountain Cancer Centers, Denver, Colorado, United States of America
| | - Susan G. Lakoski
- Department of Internal Medicine, University of Vermont, Burlington, Vermont, United States of America
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Farvid MS, Eliassen AH, Cho E, Chen WY, Willett WC. Adolescent and Early Adulthood Dietary Carbohydrate Quantity and Quality in Relation to Breast Cancer Risk. Cancer Epidemiol Biomarkers Prev 2015; 24:1111-20. [PMID: 25805068 DOI: 10.1158/1055-9965.epi-14-1401] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 03/14/2015] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND We investigated quantity and quality of dietary carbohydrate as well as insulin load and insulin index during adolescence and also early adulthood in relation to risk of breast cancer in the Nurses' Health Study II. METHODS During 20 years of follow-up of 90,534 premenopausal women who completed a diet questionnaire in 1991, 2,833 invasive breast cancer cases were documented. In 1998, 44,263 of these women also completed a questionnaire about their diet during high school; among these women, we documented 1,118 cases of breast cancer. Multivariable-adjusted Cox proportional hazards regression was used to model relative risks (RR) and 95% confidence intervals (95% CI) for breast cancer across categories of dietary carbohydrate, glycemic index (GI), glycemic load (GL), as well as insulin load and insulin index scores. RESULTS Adolescent or early adult intakes of GI or GL were not associated with risk of breast cancer. Comparing women in the highest versus lowest quintile, the multivariable-adjusted RRs were 1.14 (0.95-1.38) for adolescent GI scores and 1.03 (0.91-1.16) for early adulthood GI scores. We also did not observe associations with insulin index and insulin load scores in adolescence or early adulthood and breast cancer risk. CONCLUSIONS We found that diets high in GI, GL, insulin index, and insulin load during adolescence or early adulthood were not associated with an increased risk of breast cancer in this cohort study. IMPACT Diets with a high glucose or insulin response in adolescence or early adulthood were not significant predictors of breast cancer incidence.
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Affiliation(s)
- Maryam S Farvid
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - A Heather Eliassen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Eunyoung Cho
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Wendy Y Chen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Walter C Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Mullie P, Koechlin A, Boniol M, Autier P, Boyle P. Relation between Breast Cancer and High Glycemic Index or Glycemic Load: A Meta-analysis of Prospective Cohort Studies. Crit Rev Food Sci Nutr 2015; 56:152-9. [DOI: 10.1080/10408398.2012.718723] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Wu YC, Zheng D, Sun JJ, Zou ZK, Ma ZL. Meta-analysis of studies on breast cancer risk and diet in Chinese women. Int J Clin Exp Med 2015; 8:73-85. [PMID: 25784976 PMCID: PMC4358431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 12/15/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVE A meta-analysis was carried out to summarize published data on the relationship between breast cancer and dietary factors. METHODS Databases in Chinese (China National Knowledge Infrastructure [CNKI], China Biology Medicine [CBM], WanFang, VIP) and in English (PubMed and Web of Science) were searched for articles analyzing vegetable, fruit, soy food and fat consumption and breast cancer risk published through June 30, 2013. Random effects models were used to estimate summary odds ratios (OR) based on high versus low intake, and subgroup analysis was conducted according to region, study design, paper quality and adjustment for confounding factors to detect the potential source of heterogeneity. Every study was screened according to the inclusion criteria and exclusion criteria, evaluated in accordance with the Newcastle-Ottawa Scale. RevMan 5.2 software was used for analysis. RESULTS Of 785 studies retrieved, 22 met inclusion criteria (13 in Chinese and 9 in English), representing 23,201 patients: 10,566 in the experimental group and 12,635 in the control group. Thirteen included studies showed vegetables consumption to be a relevant factor in breast cancer risk, OR = 0.77 (95% CI [confidence interval] 0.62-0.96). Eleven studies showed fruits consumption to be relevant, OR = 0.68 (95% CI 0.49-0.93). Significant differences were also found between those who consumed soy foods, OR = 0.68 (95% CI 0.50-0.93) and those who ate a high-fat diet, OR = 1.15 (95% CI 1.01-1.30). CONCLUSION This analysis confirms the association between intake of vegetables, fruits, soy foods and fat and the risk of breast cancer from published sources. It's suggested that high consumption of vegetables, fruits and soy foods may reduce the risk of breast cancer, while increasing fat consumption may increase the risk.
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Affiliation(s)
- Ying-Chao Wu
- Chinese General Hospital of The Air ForceBeijing 100142, China
- Anhui Medical UniversityHefei 230001, Anhui, China
| | - Dong Zheng
- Anhui Medical UniversityHefei 230001, Anhui, China
| | - Jin-Jie Sun
- Chinese General Hospital of The Air ForceBeijing 100142, China
| | - Zhi-Kang Zou
- Chinese General Hospital of The Air ForceBeijing 100142, China
| | - Zhong-Li Ma
- Chinese General Hospital of The Air ForceBeijing 100142, China
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Mourouti N, Kontogianni MD, Papavagelis C, Panagiotakos DB. Diet and breast cancer: a systematic review. Int J Food Sci Nutr 2014; 66:1-42. [DOI: 10.3109/09637486.2014.950207] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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37
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Chajès V, Romieu I. Nutrition and breast cancer. Maturitas 2013; 77:7-11. [PMID: 24215727 DOI: 10.1016/j.maturitas.2013.10.004] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Revised: 10/03/2013] [Accepted: 10/05/2013] [Indexed: 01/27/2023]
Abstract
Breast cancer incidence is rising worldwide with an increase in aggressive neoplasias in young women. Suspected factors responsible for the global increase include lifestyle changes, notably diet. Currently accepted risk factors directly linked to diet are greater body weight and alcohol consumption. Weight gain in adulthood is associated with increased risk of breast cancer in post-menopausal women, suggesting that weight gain before and around menopausal age may be determinant for breast cancer development among postmenopausal women. Numerous studies also show an impact of specific diets and nutrients - fatty acids, carbohydrates, vitamins B, D, carotenoids, phytoestrogens, fiber - on breast cancer risk, and evidence supports a mechanistic basis for an influence of specific nutrients. However, these studies are plagued with conflicting results. In this review, a new examination of the relationship between nutrition and breast cancer is proposed in light of recent epidemiological studies. Successful development of breast cancer prevention strategies will require identification of biological markers of dietary exposure, and to coordinate worldwide research to discern the effects of diet.
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Affiliation(s)
- Véronique Chajès
- Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France
| | - Isabelle Romieu
- Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France.
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Woo HD, Park KS, Shin A, Ro J, Kim J. Glycemic Index and Glycemic Load Dietary Patterns and the Associated Risk of Breast Cancer: A Case-control Study. Asian Pac J Cancer Prev 2013; 14:5193-8. [DOI: 10.7314/apjcp.2013.14.9.5193] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Bradshaw PT, Khankari NK, Teitelbaum SL, Xu X, Fink BN, Steck SE, Gaudet MM, Kabat GC, Wolff MS, Neugut AI, Chen J, Gammon MD. Nutrient pathways and breast cancer risk: the Long Island Breast Cancer Study Project. Nutr Cancer 2013; 65:345-54. [PMID: 23530633 DOI: 10.1080/01635581.2013.767364] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The relative importance of biochemical pathways has not been previously examined when considering the influence of diet on breast cancer risk. To address this issue, we used interview data from a population-based sample of 1463 breast cancer cases and 1500 controls. Dietary intake was assessed shortly after diagnosis using a 101-item food frequency questionnaire. Age- and energy-adjusted odds ratios (ORs) for individual micro- and macronutrients were estimated with logistic regression. Hierarchical modeling was used to account for biologically plausible nutrient pathways (1-carbon metabolism, oxidative stress, glycemic control, and phytoestrogens). Effect estimates from hierarchical modeling were more precise and plausible compared to those from multivariable models. The strongest relationship observed was for the glycemic control pathway, but confidence intervals (CI) were wide [OR (95% CI): 0.86 (0.62, 1.21)]. Little or no effect was observed for the 1-carbon metabolism, oxidative stress, and phytoestrogen pathways. Associations were similar when stratified by supplement use. Our approach that emphasizes biochemical pathways, rather than individual nutrients, revealed that breast cancer risk may be more strongly associated with glycemic control factors than those from other pathways considered. Our study emphasizes the importance of accounting for multiple nutrient pathways when examining associations between dietary intake and breast cancer.
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Affiliation(s)
- Patrick T Bradshaw
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA.
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Glycaemic index and glycaemic load in relation to risk of diabetes-related cancers: a meta-analysis. Br J Nutr 2012; 108:1934-47. [PMID: 23167978 DOI: 10.1017/s0007114512003984] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Diets high in glycaemic index (GI) or glycaemic load (GL) have been hypothesised to increase the risks of certain cancers by increasing blood glucose or insulin concentrations. We aimed to conduct a meta-analysis of prospective cohort studies to evaluate the association between GI or GL and diabetes-related cancers (DRC), including bladder, breast, colon-rectum, endometrium, liver and pancreas, which are associated with an increased risk for diabetes, and prostate cancer, which is associated with a reduced risk for diabetes. We searched Pubmed, EMBASE and MEDLINE databases up to September 2011 and reference lists of relevant articles. Relative risks (RR) and 95 % CI for the highest v. the lowest categories were extracted and pooled using a random-effects model. Thirty-six prospective cohort studies with a total of 60 811 DRC cases were included in the present meta-analysis. In a comparison of the highest and lowest categories, the pooled RR of DRC were 1·07 (95 % CI 1·04, 1·11; n 30) for GI and 1·02 (95 % CI 0·96, 1·08; n 33) for GL. In an analysis of site-specific cancer risks, we found significant associations for GI in relation to breast cancer (RR 1·06; 95 % CI 1·02, 1·11; n 11) and colorectal cancer (RR 1·08; 95 % CI 1·00, 1·17; n 9 studies). GL was significantly associated with the risk of endometrial cancer (RR 1·21; 95 % CI 1·07, 1·37; n 5). In conclusion, the findings of the present study suggest a modest-to-weak association between a diet that induces a high glucose response and DRC risks.
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Phaseolus beans: impact on glycaemic response and chronic disease risk in human subjects. Br J Nutr 2012; 108 Suppl 1:S52-65. [DOI: 10.1017/s0007114512000761] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Consumption of Phaseolus vulgaris bean species such as pinto, black, navy or kidney may be beneficial in the prevention and treatment of chronic diseases. In particular, conditions that are promoted by increased glycaemic stress (hyperglycaemia and hyperinsulinaemia) including diabetes, CVD and cancer seem to be reduced in individuals who eat more of these beans. The present paper discusses the influence of P. vulgaris species on glycaemic response and the impact that relationship may have on the risk of developing diabetes, CVD and cancer.
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Pabona JMP, Dave B, Su Y, Montales MTE, de Lumen BO, de Mejia EG, Rahal OM, Simmen RCM. The soybean peptide lunasin promotes apoptosis of mammary epithelial cells via induction of tumor suppressor PTEN: similarities and distinct actions from soy isoflavone genistein. GENES AND NUTRITION 2012; 8:79-90. [PMID: 22864686 DOI: 10.1007/s12263-012-0307-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Accepted: 07/12/2012] [Indexed: 01/20/2023]
Abstract
Breast cancer is the leading cause of cancer deaths in women. Diet and lifestyle are major contributing factors to increased breast cancer risk. While mechanisms underlying dietary protection of mammary tumor formation are increasingly elucidated, there remains a dearth of knowledge on the nature and precise actions of specific bioactive components present in foods with purported health effects. The 43-amino acid peptide lunasin (LUN) is found in soybeans, is bioavailable similar to the isoflavone genistein (GEN), and thus may mediate the beneficial effects of soy food consumption. Here, we evaluated whether LUN displays common and distinct actions from those of GEN in non-malignant (mouse HC11) and malignant (human MCF-7) mammary epithelial cells. In MCF-7 cells, LUN up-regulated tumor suppressor phosphatase and tensin homolog deleted in chromosome ten (PTEN) promoter activity, increased PTEN transcript and protein levels and enhanced nuclear PTEN localization, similar to that shown for GEN in mammary epithelial cells. LUN-induced cellular apoptosis, akin to GEN, was mediated by PTEN, but unlike that for GEN, was p53-independent. LUN promoted E-cadherin and β-catenin non-nuclear localization similar to GEN, but unlike GEN, did not influence the proliferative effects of oncogene Wnt1 on HC11 cells. Further, LUN did not recapitulate GEN inhibitory effects on expansion of the cancer stem-like/progenitor population in MCF-7 cells. Results suggest the concerted actions of GEN and LUN on cellular apoptosis for potential mammary tumor preventive effects and highlight whole food consumption rather than intake of specific dietary supplements with limited biological effects for greater health benefits.
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Affiliation(s)
- John Mark P Pabona
- Physiology and Biophysics, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA
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Romieu I, Ferrari P, Rinaldi S, Slimani N, Jenab M, Olsen A, Tjonneland A, Overvad K, Boutron-Ruault MC, Lajous M, Kaaks R, Teucher B, Boeing H, Trichopoulou A, Naska A, Vasilopoulo E, Sacerdote C, Tumino R, Masala G, Sieri S, Panico S, Bueno-de-Mesquita HB, Van-der-A D, van Gils CH, Peeters PHM, Lund E, Skeie G, Asli LA, Rodriguez L, Navarro C, Amiano P, Sanchez MJ, Barricarte A, Buckland G, Sonestedt E, Wirfält E, Hallmans G, Johansson I, Key TJ, Allen NE, Khaw KT, Wareham NJ, Norat T, Riboli E, Clavel-Chapelon F. Dietary glycemic index and glycemic load and breast cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). Am J Clin Nutr 2012; 96:345-55. [PMID: 22760570 DOI: 10.3945/ajcn.111.026724] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The glycemic potential of a diet is associated with chronically elevated insulin concentrations, which may augment breast cancer (BC) risk by stimulating insulin receptor or by affecting insulin-like growth factor I (IGF-I)-mediated mitogenesis. It is unclear whether this effect differs by BC phenotype. OBJECTIVE The objective was to investigate the relation between glycemic index (GI), glycemic load (GL), and total carbohydrate intake with BC by using data from the European Prospective Investigation into Cancer and Nutrition (EPIC). DESIGN We identified 11,576 women with invasive BC among 334,849 EPIC women aged 34-66 y (5th to 95th percentiles) at baseline over a median follow-up of 11.5 y. Dietary GI and GL were calculated from country-specific dietary questionnaires. We used multivariable Cox proportional hazards models to quantify the association between GI, GL, and carbohydrate intake and BC risk. BC tumors were classified by receptor status. RESULTS Overall GI, GL, and carbohydrates were not related to BC. Among postmenopausal women, GL and carbohydate intake were significantly associated with an increased risk of estrogen receptor-negative (ER(-)) BC when extreme quintiles (Q) were compared [multivariable HR(Q5-Q1) (95% CI) = 1.36 (1.02, 1.82; P-trend = 0.010) and HR(Q5-Q1) = 1.41 (1.05, 1.89; P-trend = 0.009), respectively]. Further stratification by progesterone receptor (PR) status showed slightly stronger associations with ER(-)/PR(-) BC [HR(Q5-Q1) (95% CI) = 1.48 (1.07, 2.05; P-trend = 0.010) for GL and HR(Q5-Q1) = 1.62 (1.15, 2.30; P-trend = 0.005) for carbohydrates]. No significant association with ER-positive BC was observed. CONCLUSION Our results indicate that a diet with a high GL and carbohydrate intake is positively associated with an increased risk of developing ER(-) and ER(-)/PR(-) BC among postmenopausal women.
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Affiliation(s)
- Isabelle Romieu
- Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France, Barcelona, Spain.
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Aune D, Chan DSM, Greenwood DC, Vieira AR, Rosenblatt DAN, Vieira R, Norat T. Dietary fiber and breast cancer risk: a systematic review and meta-analysis of prospective studies. Ann Oncol 2012; 23:1394-402. [PMID: 22234738 DOI: 10.1093/annonc/mdr589] [Citation(s) in RCA: 141] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Evidence from case-control studies suggest that dietary fiber may be inversely related to breast cancer risk, but it is unclear if this is supported by prospective data. We conducted a systematic review and meta-analysis of the evidence from prospective studies. METHODS PubMed was searched for prospective studies of fiber intake and breast cancer risk until 31st August 2011. Random effects models were used to estimate summary relative risks (RRs). RESULTS Sixteen prospective studies were included. The summary RR for the highest versus the lowest intake was 0.93 [95% confidence interval (CI) 0.89-0.98, I(2) = 0%] for dietary fiber, 0.95 (95% CI 0.86-1.06, I(2) = 4%) for fruit fiber, 0.99 (95% CI 0.92-1.07, I(2) = 1%) for vegetable fiber, 0.96 (95% CI 0.90-1.02, I(2) = 5%) for cereal fiber, 0.91 (95% CI 0.84-0.99, I(2) = 7%) for soluble fiber and 0.95 (95% CI 0.89-1.02, I(2) = 0%) for insoluble fiber. The summary RR per 10 g/day of dietary fiber was 0.95 (95% CI 0.91-0.98, I(2) = 0%, P(heterogeneity) = 0.82). In stratified analyses, the inverse association was only observed among studies with a large range (≥13 g/day) or high level of intake (≥25 g/day). CONCLUSION In this meta-analysis of prospective studies, there was an inverse association between dietary fiber intake and breast cancer risk.
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Affiliation(s)
- D Aune
- Department of Epidemiology and Biostatistics, Imperial College, London, UK.
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