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Flore G, Deledda A, Lombardo M, Armani A, Velluzzi F. Effects of Functional and Nutraceutical Foods in the Context of the Mediterranean Diet in Patients Diagnosed with Breast Cancer. Antioxidants (Basel) 2023; 12:1845. [PMID: 37891924 PMCID: PMC10603973 DOI: 10.3390/antiox12101845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023] Open
Abstract
Several studies report that breast cancer survivors (BCS) tend to have a poor diet, as fruit, vegetable, and legume consumption is often reduced, resulting in a decreased intake of nutraceuticals. Moreover, weight gain has been commonly described among BCS during treatment, increasing recurrence rate and mortality. Improving lifestyle and nutrition after the diagnosis of BC may have important benefits on patients' general health and on specific clinical outcomes. The Mediterranean diet (MD), known for its multiple beneficial effects on health, can be considered a nutritional pool comprising several nutraceuticals: bioactive compounds and foods with anti-inflammatory and antioxidant effects. Recent scientific advances have led to the identification of nutraceuticals that could amplify the benefits of the MD and favorably influence gene expression in these patients. Nutraceuticals could have beneficial effects in the postdiagnostic phase of BC, including helping to mitigate the adverse effects of chemotherapy and radiotherapy. Moreover, the MD could be a valid and easy-to-follow option for managing excess weight. The aim of this narrative review is to evaluate the recent scientific literature on the possible beneficial effects of consuming functional and nutraceutical foods in the framework of MD in BCS.
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Affiliation(s)
- Giovanna Flore
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.F.); (A.D.); (F.V.)
| | - Andrea Deledda
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.F.); (A.D.); (F.V.)
| | - Mauro Lombardo
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166 Rome, Italy;
| | - Andrea Armani
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166 Rome, Italy;
- Laboratory of Cardiovascular Endocrinology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele, 00166 Rome, Italy
| | - Fernanda Velluzzi
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.F.); (A.D.); (F.V.)
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Ahmed SBM, Radwan N, Amer S, Saheb Sharif-Askari N, Mahdami A, Samara KA, Halwani R, Jelinek HF. Assessing the Link between Diabetic Metabolic Dysregulation and Breast Cancer Progression. Int J Mol Sci 2023; 24:11816. [PMID: 37511575 PMCID: PMC10380477 DOI: 10.3390/ijms241411816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 07/19/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023] Open
Abstract
Diabetes mellitus is a burdensome disease that affects various cellular functions through altered glucose metabolism. Several reports have linked diabetes to cancer development; however, the exact molecular mechanism of how diabetes-related traits contribute to cancer progression is not fully understood. The current study aimed to explore the molecular mechanism underlying the potential effect of hyperglycemia combined with hyperinsulinemia on the progression of breast cancer cells. To this end, gene dysregulation induced by the exposure of MCF7 breast cancer cells to hyperglycemia (HG), or a combination of hyperglycemia and hyperinsulinemia (HGI), was analyzed using a microarray gene expression assay. Hyperglycemia combined with hyperinsulinemia induced differential expression of 45 genes (greater than or equal to two-fold), which were not shared by other treatments. On the other hand, in silico analysis performed using a publicly available dataset (GEO: GSE150586) revealed differential upregulation of 15 genes in the breast tumor tissues of diabetic patients with breast cancer when compared with breast cancer patients with no diabetes. SLC26A11, ALDH1A3, MED20, PABPC4 and SCP2 were among the top upregulated genes in both microarray data and the in silico analysis. In conclusion, hyperglycemia combined with hyperinsulinemia caused a likely unique signature that contributes to acquiring more carcinogenic traits. Indeed, these findings might potentially add emphasis on how monitoring diabetes-related metabolic alteration as an adjunct to diabetes therapy is important in improving breast cancer outcomes. However, further detailed studies are required to decipher the role of the highlighted genes, in this study, in the pathogenesis of breast cancer in patients with a different glycemic index.
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Affiliation(s)
- Samrein B M Ahmed
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates
- College of Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates
- College of Health, Wellbeing and Life Sciences, Department of Biosciences and Chemistry, Sheffield Hallam University, Sheffield S1 1WB, UK
| | - Nada Radwan
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Sara Amer
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Narjes Saheb Sharif-Askari
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates
- College of Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Amena Mahdami
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Kamel A Samara
- College of Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Rabih Halwani
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates
- College of Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Herbert F Jelinek
- Department of Biomedical Engineering and Health Engineering Innovation Center, Khalifa University, Abu Dhabi 127788, United Arab Emirates
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Becerra‐Tomás N, Balducci K, Abar L, Aune D, Cariolou M, Greenwood DC, Markozannes G, Nanu N, Vieira R, Giovannucci EL, Gunter MJ, Jackson AA, Kampman E, Lund V, Allen K, Brockton NT, Croker H, Katsikioti D, McGinley‐Gieser D, Mitrou P, Wiseman M, Cross AJ, Riboli E, Clinton SK, McTiernan A, Norat T, Tsilidis KK, Chan DSM. Postdiagnosis dietary factors, supplement use and breast cancer prognosis: Global Cancer Update Programme (CUP Global) systematic literature review and meta-analysis. Int J Cancer 2023; 152:616-634. [PMID: 36279902 PMCID: PMC10092903 DOI: 10.1002/ijc.34321] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 09/20/2022] [Accepted: 09/23/2022] [Indexed: 02/01/2023]
Abstract
Little is known about how diet might influence breast cancer prognosis. The current systematic reviews and meta-analyses summarise the evidence on postdiagnosis dietary factors and breast cancer outcomes from randomised controlled trials and longitudinal observational studies. PubMed and Embase were searched through 31st October 2021. Random-effects linear dose-response meta-analysis was conducted when at least three studies with sufficient information were available. The quality of the evidence was evaluated by an independent Expert Panel. We identified 108 publications. No meta-analysis was conducted for dietary patterns, vegetables, wholegrains, fish, meat, and supplements due to few studies, often with insufficient data. Meta-analysis was only possible for all-cause mortality with dairy, isoflavone, carbohydrate, dietary fibre, alcohol intake and serum 25-hydroxyvitamin D (25(OH)D), and for breast cancer-specific mortality with fruit, dairy, carbohydrate, protein, dietary fat, fibre, alcohol intake and serum 25(OH)D. The results, with few exceptions, were generally null. There was limited-suggestive evidence that predefined dietary patterns may reduce the risk of all-cause and other causes of death; that isoflavone intake reduces the risk of all-cause mortality (relative risk (RR) per 2 mg/day: 0.96, 95% confidence interval (CI): 0.92-1.02), breast cancer-specific mortality (RR for high vs low: 0.83, 95% CI: 0.64-1.07), and recurrence (RR for high vs low: 0.75, 95% CI: 0.61-0.92); that dietary fibre intake decreases all-cause mortality (RR per 10 g/day: 0.87, 95% CI: 0.80-0.94); and that serum 25(OH)D is inversely associated with all-cause and breast cancer-specific mortality (RR per 10 nmol/L: 0.93, 95% CI: 0.89-0.97 and 0.94, 95% CI: 0.90-0.99, respectively). The remaining associations were graded as limited-no conclusion.
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Affiliation(s)
- Nerea Becerra‐Tomás
- Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonLondonUK
| | - Katia Balducci
- Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonLondonUK
| | - Leila Abar
- Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonLondonUK
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonLondonUK
- Department of NutritionBjørknes University CollegeOsloNorway
- Department of EndocrinologyMorbid Obesity and Preventive Medicine, Oslo University HospitalOsloNorway
- Unit of Cardiovascular and Nutritional EpidemiologyInstitute of Environmental Medicine, Karolinska InstitutetStockholmSweden
| | - Margarita Cariolou
- Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonLondonUK
| | - Darren C. Greenwood
- Leeds Institute for Data Analytics, Faculty of Medicine and HealthUniversity of LeedsLeedsUK
| | - Georgios Markozannes
- Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonLondonUK
- Department of Hygiene and EpidemiologyUniversity of Ioannina Medical SchoolIoanninaGreece
| | - Neesha Nanu
- Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonLondonUK
| | - Rita Vieira
- Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonLondonUK
| | - Edward L. Giovannucci
- Department of EpidemiologyHarvard T.H. Chan School of Public HealthBostonMassachusettsUSA
- Department of NutritionHarvard T.H. Chan School of Public HealthBostonMassachusettsUSA
| | - Marc J. Gunter
- Nutrition and Metabolism SectionInternational Agency for Research on CancerLyonFrance
| | - Alan A. Jackson
- Faculty of Medicine, School of Human Development and HealthUniversity of SouthamptonSouthamptonUK
- National Institute of Health Research Cancer and Nutrition CollaborationSouthamptonUK
| | - Ellen Kampman
- Division of Human Nutrition and HealthWageningen University & ResearchWageningenThe Netherlands
| | - Vivien Lund
- World Cancer Research Fund InternationalLondonUK
| | - Kate Allen
- World Cancer Research Fund InternationalLondonUK
| | | | - Helen Croker
- World Cancer Research Fund InternationalLondonUK
| | | | | | | | | | - Amanda J. Cross
- Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonLondonUK
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonLondonUK
| | - Steven K. Clinton
- Division of Medical Oncology, The Department of Internal MedicineCollege of Medicine and Ohio State University Comprehensive Cancer Center, Ohio State UniversityColumbusOhioUSA
| | - Anne McTiernan
- Division of Public Health SciencesFred Hutchinson Cancer Research CenterSeattleWashingtonUSA
| | - Teresa Norat
- Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonLondonUK
- World Cancer Research Fund InternationalLondonUK
| | - Konstantinos K. Tsilidis
- Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonLondonUK
- Department of Hygiene and EpidemiologyUniversity of Ioannina Medical SchoolIoanninaGreece
| | - Doris S. M. Chan
- Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonLondonUK
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Kokts-Porietis RL, Morielli AR, McNeil J, Courneya KS, Cook LS, Friedenreich CM. Prospective Cohort of Pre- and Post-Diagnosis Diet with Survival Outcomes: an Alberta Endometrial Cancer Cohort Study. Cancer Epidemiol Biomarkers Prev 2023; 32:242-251. [PMID: 36477189 PMCID: PMC9905303 DOI: 10.1158/1055-9965.epi-22-0906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 10/18/2022] [Accepted: 11/23/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The prognostic relationship between diet and endometrial cancer survival remains largely unknown. We sought to determine pre- and post-diagnosis dietary composition, glycemic load (GL), inflammatory potential (dietary inflammatory index) and quality [Canadian Healthy Eating Index (C-HEI) 2005] associations with disease-free (DFS) and overall survival (OS) among endometrial cancer survivors. In addition, we assessed associations between dietary changes with OS and explored obesity/physical activity effect modification. METHODS Survivors, diagnosed in Alberta, Canada between 2002 and 2006, completed past-year, food-frequency questionnaires at-diagnosis (n = 503) and 3-year follow-up (n = 395). Participants were followed to death or January 2022. Cox proportional regression estimated HR [95% confidence intervals (CI)] for dietary survival associations. RESULTS During 16.9 median years of follow-up, 138 participants had a DFS event and 120 died. Lower pre-diagnosis GL (HRT1vsT3, 0.49; 95% CI, 0.25-0.97) and greater post-diagnosis energy intakes (EI) from total- and monounsaturated-fat (HRT3vsT1, 0.48; 95% CI, 0.26-0.87) were associated with better OS. Higher pre-diagnosis C-HEI, less inflammatory diets and lower added sugar intakes were nonlinearly associated with better DFS. Consistently low pre- to post-diagnosis EI from carbohydrates and total-fats were associated with better (HR, 0.36; 95% CI, 0.18-0.72) and worse (HR, 2.26; 95% CI, 1.21-4.20) OS, respectively. Decreased pre- to post-diagnosis C-HEI was associated with worse OS. In stratified analysis, healthy diets were most beneficial for survivors with obesity and physical inactivity. CONCLUSIONS Adherence to higher quality dietary patterns were associated with better survival. IMPACT Our study provides novel evidence that both pre- and post-diagnosis diet are important prognostic factors for endometrial cancer survivors. Post-diagnosis survival associations with diet composition and quality highlight the potential for future interventions.
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Affiliation(s)
- Renée L Kokts-Porietis
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Andria R Morielli
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Jessica McNeil
- Department of Kinesiology, Faculty of Health and Human Sciences, University of North Carolina Greensboro, Greensboro, North Carolina
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Linda S Cook
- Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, Colorado.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Hardt L, Mahamat-Saleh Y, Aune D, Schlesinger S. Plant-Based Diets and Cancer Prognosis: a Review of Recent Research. Curr Nutr Rep 2022; 11:695-716. [PMID: 36138327 PMCID: PMC9750928 DOI: 10.1007/s13668-022-00440-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2022] [Indexed: 01/31/2023]
Abstract
PURPOSE OF REVIEW Although plant-based diets are recommended for cancer prevention, their role in cancer survival is still uncertain. The purpose of this systematic review is to summarize the association between postdiagnosis plant-based diets and prognosis in cancer survivors. RECENT FINDINGS There is indication that higher intake of plant-based foods was associated with improved prognosis in cancer survivors. For colorectal cancer survival, a better prognosis was observed for a high intake of whole grains and fibre. For breast cancer survival, a higher intake of fruit, vegetable and fibre and a moderate intake of soy/isoflavone were associated with beneficial outcomes. A higher vegetable fat intake was related to improved prognosis in prostate cancer survivors. Emerging evidence suggests benefits of postdiagnosis plant-based diets on prognosis in cancer survivors. However, given the high heterogeneity between studies, further research in cancer survivors, considering clinical factors (e.g. treatment, stage) and methodological aspects (e.g. timing of dietary assessment), is needed.
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Affiliation(s)
- Luisa Hardt
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
| | | | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, Paddington, London, UK
- Department of Nutrition, Oslo New University College, Oslo, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Sabrina Schlesinger
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany.
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Xu X, Zhang J, Zhang Y, Qi H, Wang P. Associations between dietary fiber intake and mortality from all causes, cardiovascular disease and cancer: a prospective study. Lab Invest 2022; 20:344. [PMID: 35918724 PMCID: PMC9344643 DOI: 10.1186/s12967-022-03558-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 07/25/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Several studies suggest that dietary fiber intake may reduce mortality risk, but this might depend on the fiber types and the evidence regarding the role of soluble fiber or insoluble fiber on death risk remain limited and inconsistent. Therefore, this study aimed to comprehensively evaluate multiple types of dietary fiber intake on mortality from all causes, cardiovascular disease and cancer in the large-scale Prostate, Lung, Colorectal, and Ovarian Cancer (PLCO) Screening Trial. METHODS A multivariate Cox proportional hazards model was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS This study finally included 86,642 participants with 17,536 all-cause deaths, 4842 cardiovascular deaths and 5760 cancer deaths identified after a total of 1,444,068 follow-up years. After adjusting for potential confounders, dietary total fiber intake was statistically significantly inversely associated with all-cause death (Q5 vs Q1: HR 0.71, 95% CI 0.66-0.75; P for trend < 0.001), cardiovascular death (Q5 vs Q1: HR 0.73, 95% CI 0.65-0.83; P for trend < 0.001) and cancer mortality (Q5 vs Q1: HR 0.77, 95% CI 0.69-0.86; P for trend < 0.001). Similar results were observed for both insoluble and soluble fiber intake. Restricted cubic spline model analysis suggested that there was a nonlinear association of dietary fiber intake with mortality risk (all P for nonlinearity < 0.05). CONCLUSIONS In this large nationally representative sample of US adult population, intakes of total fiber, soluble fiber, and insoluble fiber were associated with lower risks of all-cause, cardiovascular and cancer mortality.
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Affiliation(s)
- Xin Xu
- Department of Urology, First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, Zhejiang, China.
| | - Junmiao Zhang
- Department of Urology, First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, Zhejiang, China
| | - Yanhui Zhang
- Department of Urology, The Second Affiliated Hospital of Medical College of Qingdao University, Qingdao, 266042, Shandong, China
| | - Honggang Qi
- Department of Urology, First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, Zhejiang, China.
| | - Ping Wang
- Department of Urology, First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, Zhejiang, China.
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Dietary glycemic index, glycemic load, and cause-specific mortality: two population-based prospective cohort studies. Eur J Clin Nutr 2022; 76:1142-1149. [PMID: 35105945 PMCID: PMC9339588 DOI: 10.1038/s41430-022-01083-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 12/31/2021] [Accepted: 01/12/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Epidemiological studies on the relationship between dietary glycemic index (GI), glycemic load (GL) and all-cause and cause-specific mortality yielded conflict results. We aimed to assess these associations in Chinese. METHODS We conducted this study based on two prospective cohort studies in Shanghai. Dietary information was collected using validated cohort-specific food frequency questionnaires. We used Cox regression model to estimate the hazard ratios (HR) for mortality associated with GI and GL. RESULTS After median follow-up periods of 12.8 years for 59,770 men and 18.2 years for 74,735 women, 8,711 deaths in men and 10,501 deaths in women were documented. After we controlled the potential confounders, dietary GI, GL, and carbohydrate intake were associated with a higher risk of cardiovascular disease (CVD) mortality (P values for trend = 0.025, 0.001, and 0.001). Dietary GI was associated with lower risk of total and cause-specific mortality in men in the second quartile (Q) (all-cause mortality: HR Q2 vs. Q1 = 0.89, 95%CI: 0.84, 0.95). Dietary GL was associated with lower risk of cancer mortality but higher risk of CVD mortality in men. In women, dietary GI was associated with mortality due to all-cause (HRMax Q4 vs. Q1 = 1.10, 95%CI: 1.04, 1.06), cancer (HRMax Q4 vs. Q1 = 1.12, 95%CI: 1.02, 1.23), and CVD (HRMax Q4 vs. Q1 = 1.10, 95%CI: 1.00, 1.22). CONCLUSIONS The present study indicates that diet with higher GI and GL was associated with an increased risk of CVD mortality in Chinese adults. The association may vary for men and women, which need further investigating in other Asian populations.
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The association of dietary insulin load and index with the risk of cancer and cancer mortality: a systematic review and meta-analysis. J Diabetes Metab Disord 2022; 21:1105-1118. [PMID: 35673451 PMCID: PMC9167375 DOI: 10.1007/s40200-022-01013-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 02/21/2022] [Indexed: 10/19/2022]
Abstract
Purpose Insulin levels play an important role in cancer development. However, the link between an insulinogenic diet and cancer is still unclear. Therefore, we performed a systematic review with meta-analysis to investigate the association between dietary insulin index (II) and load (IL) with cancer risk and mortality. Methods A comprehensive search between electronic databases (Web of Science, PubMed/Medline, Scopus, and Google Scholar) was conducted to identify relevant studies up to January 2022. The relative risks (RR) and Odds ratios (OR) were extracted from eligible studies, and meta-analysis was performed to calculate the pooled effect size. Result 12 papers including 14 studies (10 cohorts and 4 case-control) were included for the meta-analysis. Among them, 10 studies reported effect size for the risk of cancer, and 4 studies reported effect size for cancer mortality. We observed no significant association between II and IL with cancer overall (RRII: 1.03, 95%CI: 0.91-1.17, RRIL: 1.16, 95%CI: 0.94-1.42) and in cohort studies, however, in case-control studies was related with higher odds of cancer (ORII: 2.30, 95%CI: 1.21-4.38, ORIL: 2.57, 95%CI: 1.64-4.02). Higher II and IL scores were associated with the increased risk of total (RRII: 1.29, 95%CI: 1.02-1.63) and (RRIL: 1.39, 95%CI: 1.06-1.83) and colorectal cancer mortality (RRII: 1.29, 95%CI: 1.13-1.48) and (RRIL: 1.37, 95%CI: 1.18-1.60). Conclusion Higher dietary II and IL were not associated with cancer risk in overall and cohort studies, whereas related with a higher risk of cancer in case-control studies. We observed a significant positive relation of II and IL with cancer mortality, especially CRC mortality. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-022-01013-3.
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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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Park SH, Hoang T, Kim J. Dietary Factors and Breast Cancer Prognosis among Breast Cancer Survivors: A Systematic Review and Meta-Analysis of Cohort Studies. Cancers (Basel) 2021; 13:cancers13215329. [PMID: 34771493 PMCID: PMC8582373 DOI: 10.3390/cancers13215329] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/20/2021] [Accepted: 10/21/2021] [Indexed: 12/12/2022] Open
Abstract
Simple Summary While most systematic reviews have focused on the association between dietary factors and breast cancer incidence, this current study focuses on the association between comprehensive dietary factors and breast cancer prognosis among breast cancer survivors by systematic review and meta-analysis. We reviewed a total of 63 cohort studies to assess the association between dietary factors and breast cancer prognosis by subgroup analysis with prediagnostic or postdiagnostic dietary intake, menopausal status, and dietary or supplementary micronutrient intake. We found that unhealthy dietary patterns, including the intake of beer and saturated fat, exacerbated the risk of breast cancer prognosis; however, the supplementation of most vitamins was desirable for breast cancer prognosis. Therefore, this study’s systematic review and meta-analysis provide useful dietary information for the development of dietary guidelines/recommendations to improve prognosis among breast cancer survivors. Abstract Few studies have summarized the association between dietary factors and breast cancer (BC) prognosis among breast cancer survivors (BCS). Therefore, we carried out a systematic review and meta-analysis to determine the associations between dietary factors and BC prognosis among BCS. We performed a literature search in PubMed and Embase to investigate the association between dietary factors and BC prognosis. We applied a random-effects model to compute the hazard ratio/relative risk and their 95% confidence intervals and heterogeneity (Higgins I2) and to generate forest plots using STATA. Among the 2279 papers identified, 63 cohort studies were included in the systematic review and meta-analysis. Our main finding was that higher consumption of beer and saturated fat negatively affected BC prognosis. However, the intake of lignans, fiber, multivitamins, and antioxidants was negatively associated with the risk of mortality. Furthermore, we performed subgroup analyses by menopausal status and dietary or supplementary micronutrient intake. Most trends were similar to the main findings; in particular, the vitamin C, vitamin D, and vitamin E supplements decreased the risk of mortality. This study’s current systematic review and meta-analysis provide comprehensive dietary information for the development of dietary guidelines/recommendations to improve prognosis among BCS.
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Affiliation(s)
- Sin-Hye Park
- Department of Food Science and Nutrition, Hallym University, Chuncheon 24252, Kangwon-do, Korea;
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang 10408, Gyeonggi-do, Korea;
| | - Tung Hoang
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang 10408, Gyeonggi-do, Korea;
| | - Jeongseon Kim
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang 10408, Gyeonggi-do, Korea;
- Correspondence:
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Kok DE, Arron MNN, Huibregtse T, Kruyt FM, Bac DJ, van Halteren HK, Kouwenhoven EA, Wesselink E, Winkels RM, van Zutphen M, van Duijnhoven FJB, de Wilt JHW, Kampman E. Association of Habitual Preoperative Dietary Fiber Intake With Complications After Colorectal Cancer Surgery. JAMA Surg 2021; 156:2781033. [PMID: 34132738 PMCID: PMC8209565 DOI: 10.1001/jamasurg.2021.2311] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 03/31/2021] [Indexed: 02/04/2023]
Abstract
IMPORTANCE Postoperative complications are associated with increased morbidity and mortality among patients with colorectal cancer. As a modifiable factor associated with gut health, dietary fiber intake is of interest with regard to the risk of complications after surgery for colorectal cancer. OBJECTIVE To examine the association between preoperative dietary fiber intake and risk of complications after surgery for colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This cohort study used data from the Colorectal Longitudinal, Observational Study on Nutritional and Lifestyle Factors (COLON) study, which recruited adult patients with colorectal cancer at any stage at diagnosis from 11 hospitals in the Netherlands between August 2010 and December 2017. The present study included patients with stage I to IV colorectal cancer who underwent elective abdominal surgery. Data were analyzed between December 2019 and September 2020. EXPOSURES Habitual dietary fiber intake was assessed at diagnosis using a 204-item food frequency questionnaire. MAIN OUTCOMES AND MEASURES Any complications, surgical complications, and anastomotic leakage occurring during the 30 days after surgery for colorectal cancer. The association between fiber intake and risk of postoperative complications was assessed using logistic regression analyses. Additional analyses stratified by sex, tumor location, and fiber source were performed. RESULTS Among the 1399 patients included in the analysis, the median age at inclusion was 66 years (interquartile range, 61-72 years) and 896 (64%) were men. Any complications occurred in 397 patients (28%), and surgical complications occurred in 235 patients (17%). Of 1237 patients with an anastomosis, 67 (5%) experienced anastomotic leakage. Higher dietary fiber intake (per 10 g per day) was associated with a lower risk of any complications (odds ratio [OR], 0.75; 95% CI, 0.62-0.92) and surgical complications (OR, 0.76; 95% CI, 0.60-0.97), whereas no association with anastomotic leakage was found (OR, 0.97; 95% CI, 0.66-1.43). Among women, higher dietary intake was associated with any complications (OR, 0.64; 95% CI, 0.44-0.94), whereas there was no association among men (OR, 0.79; 95% CI, 0.63-1.01). Fiber intake from vegetables (per 1 g per day) was inversely associated with any (OR, 0.90; 95% CI, 0.83-0.99) and surgical (OR, 0.87; 95% CI, 0.78-0.97) complications. CONCLUSIONS AND RELEVANCE In this cohort study, higher habitual dietary fiber intake before surgery was associated with a lower risk of postoperative complications among patients with colorectal cancer. The findings suggest that improving preoperative dietary fiber intake may be considered in future prehabilitation programs for patients undergoing surgery for colorectal cancer.
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Affiliation(s)
- Dieuwertje E. Kok
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - Melissa N. N. Arron
- Department of Surgery, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Tess Huibregtse
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - Flip M. Kruyt
- Department of Surgery, Hospital Gelderse Vallei, Ede, the Netherlands
| | - Dirk Jan Bac
- Department of Gastroenterology and Hepatology, Hospital Gelderse Vallei, Ede, the Netherlands
| | - Henk K. van Halteren
- Department of Internal Medicine, Admiraal de Ruyter Hospital, Goes, the Netherlands
| | | | - Evertine Wesselink
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - Renate M. Winkels
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - Moniek van Zutphen
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | | | | | - Ellen Kampman
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
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12
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Koyratty N, McCann SE, Millen AE, Nie J, Trevisan M, Freudenheim JL. Sugar-Sweetened Soda Consumption and Total and Breast Cancer Mortality: The Western New York Exposures and Breast Cancer (WEB) Study. Cancer Epidemiol Biomarkers Prev 2021; 30:945-952. [PMID: 33653812 DOI: 10.1158/1055-9965.epi-20-1242] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 11/09/2020] [Accepted: 02/23/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND There is growing evidence of an association between sugar-sweetened beverages (SSB) and increased risk of mortality in various populations. However, SSB influence on mortality among patients with breast cancer is unknown. METHODS We assessed the relationship between sugar-sweetened soda and both all-cause and breast cancer mortality among women with incident, invasive breast cancer from the Western New York Exposures and Breast Cancer Study. Breast cancer cases were followed for a median of 18.7 years, with ascertainment of vital status via the National Death Index. Frequency of sugar-sweetened soda consumption was determined via dietary recall using a food frequency questionnaire. Cox proportional hazards, adjusting for relevant variables, were used to estimate HRs and 95% confidence intervals (CI). RESULTS Of the 927 breast cancer cases, 386 (54.7%) had died by the end of follow-up. Compared with never/rarely sugar-sweetened soda drinkers, consumption at ≥5 times per week was associated with increased risk of both total (HR = 1.62; 95% CI, 1.16-2.26; P trend < 0.01) and breast cancer mortality (HR = 1.85; 95% CI, 1.16-2.94; P trend < 0.01). Risk of mortality was similarly increased among ER-positive, but not ER-negative patients; among women with body mass index above the median, but not below the median; and among premenopausal, but not postmenopausal women for total mortality only. CONCLUSIONS Reported higher frequency of sugar-sweetened soda intake was associated with increased risks of both total and breast cancer mortality among patients with breast cancer. IMPACT These results support existing guidelines on reducing consumption of SSB, including for women with a diagnosis of breast cancer.
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Affiliation(s)
- Nadia Koyratty
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York.
| | - Susan E McCann
- Division of Cancer Prevention and Population Sciences, Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Amy E Millen
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York
| | - Jing Nie
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York
| | | | - Jo L Freudenheim
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York
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13
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Lee JE. Diet Before and After Breast Cancer. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1187:545-566. [PMID: 33983599 DOI: 10.1007/978-981-32-9620-6_29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The incidence of breast cancer has dramatically increased recently in several Asian countries. This region has experienced rapid economic growth and demographic and environmental changes. Breast cancer rates vary substantially among countries, with a lower incidence in developing countries than that in Western countries. Given the upward trend of breast cancer incidence in Asian countries and the large variation in incidence around the world, dietary changes may contribute to breast cancer development. In particular, nutrients and foods from animal sources have drawn attention as potential causes of breast cancer given that obesity and energy balance appear to be important factors associated with breast cancer risk. However, prospective cohort and intervention studies do not support the hypothesis that diet in middle life influences breast cancer development. However, recent studies have provided better insight into the roles of dietary factors in specific types of breast cancers, such as estrogen receptor-negative (ER-) breast cancer. Some studies suggest that diet in early life may play a substantial role in breast cancer development, but data and evidence remain limited.Although etiologic and epidemiologic studies have long studied modifiable risk factors for breast cancer incidence, much remains to be explored regarding the role of diet after a breast cancer diagnosis. Several epidemiologic studies have explored the factors that improve breast cancer survival rates, including diet, physical activity, and body mass index (BMI). While there is evidence of the effect of BMI on breast cancer mortality, the effects of changing dietary habits after a breast cancer diagnosis on survival or recurrence are less clear. A report of the World Cancer Research Fund stated that evidence was not sufficient to draw firm conclusions about the effect of diet and nutrition on breast cancer prognosis, but it did suggest a link between diet and breast cancer survival.The global burden of breast cancer is increasing and breast cancer is a major and emerging health problem in both developed and developing countries. For example, the five-year survival rate for Korean breast cancer patients has improved from 78.0% in 1993-1995 to 92.7% in 2012-2016. This improvement emphasizes the importance of supportive care, diet, and quality of life for breast cancer survivors. However, we have limited data of non-Western breast cancer survivors. There is a need to examine the role of diet in breast cancer survival in both Western and non-Western regions.
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Affiliation(s)
- Jung Eun Lee
- Department of Food and Nutrition, Seoul National University, Seoul, South Korea.
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14
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Vegunta S, Lester SP, Pruthi S, Mussallem DM. Effects of major lifestyle factors on breast cancer risk: impact of weight, nutrition, physical activity, alcohol and tobacco. BREAST CANCER MANAGEMENT 2020. [DOI: 10.2217/bmt-2020-0033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Breast cancer (BC) is the most commonly diagnosed cancer and second most common cause of cancer death in US women. Family history and genetics are well-known BC risk factors, but they only account for 15–20% of BC cases. Therefore, in addition to family history, healthcare providers must consider a woman’s modifiable and nonmodifiable personal risk factors that are associated with an increase in BC risk. The World Cancer Research Fund/American Institute for Cancer Research estimate that 30% of BC cases in the US are preventable. Lifestyle education is imperative given the magnitude of BC occurrence. Evidence supports prevention as an effective, long-term strategy for reducing risk. Healthcare providers are key stakeholders in empowering patients to adopt a healthy lifestyle for primary BC prevention. In this paper, we review the available evidence on modifiable BC risk including weight management, nutrition, physical activity, alcohol and tobacco use and provide strategies to counsel patients on lifestyle modifications.
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Affiliation(s)
- Suneela Vegunta
- Division of Women’s Health Internal Medicine, Mayo Clinic, Scottsdale, AZ, USA
| | - Sara P Lester
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Sandhya Pruthi
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Dawn M Mussallem
- Jacoby Center for Breast Health, Mayo Clinic, Jacksonville, FL, USA
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15
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Farvid MS, Tamimi RM, Poole EM, Chen WY, Rosner BA, Willett WC, Holmes MD, Eliassen AH. Postdiagnostic Dietary Glycemic Index, Glycemic Load, Dietary Insulin Index, and Insulin Load and Breast Cancer Survival. Cancer Epidemiol Biomarkers Prev 2020; 30:335-343. [PMID: 33219162 DOI: 10.1158/1055-9965.epi-20-0764] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 09/01/2020] [Accepted: 11/16/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND We investigated the associations of postdiagnostic dietary glycemic index (GI), glycemic load (GL), insulin index (II), and insulin load (IL) with breast cancer-specific and all-cause mortality. METHODS Among 8,932 women with stage I-III breast cancer identified in the Nurses' Health Study (NHS; 1980-2010) and NHSII (1991-2011), we prospectively evaluated the associations between postdiagnostic GI, GL, II, and IL, and breast cancer-specific and all-cause mortality. Participants completed a validated food frequency questionnaire every 4 years after diagnosis. RESULTS During follow-up by 2014 in the NHS and 2015 in the NHSII, 2,523 deaths, including 1,071 from breast cancer, were documented. Higher postdiagnostic GL was associated with higher risk of both breast cancer-specific mortality [HRQ5vsQ1 = 1.33; 95% confidence interval (CI) = 1.09-1.63; P trend = 0.008] and all-cause mortality (HRQ5vsQ1 = 1.26; 95% CI = 1.10-1.45; P trend = 0.0006). Higher all-cause mortality was also observed with higher postdiagnostic GI (HRQ5vsQ1 = 1.23; 95% CI = 1.08-1.40; P trend = 0.001), II (HRQ5vsQ1 = 1.20; 95% CI = 1.04-1.38; P trend = 0.005), and IL (HRQ5vsQ1 = 1.23; 95% CI = 1.07-1.42; P trend = 0.0003). The associations were not modified by insulin receptor or estrogen receptor status of the tumor, or body mass index. CONCLUSIONS We found that higher dietary GL, reflecting postprandial glucose response, after a breast cancer diagnosis was associated with higher risk of breast cancer-specific mortality. Higher dietary GI, GL, II, and IL after a breast cancer diagnosis were associated with higher risk of death from any cause. IMPACT These results suggest that carbohydrate quantity and quality may be important in breast cancer prognosis.See related commentary by McTiernan, p. 252.
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Affiliation(s)
- Maryam S Farvid
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
| | - Rulla M Tamimi
- Department of Epidemiology, 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 Population Health Sciences, Weill Cornell Medicine, New York, New York
| | - Elizabeth M Poole
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.,Global Medical Affairs, Bluebird Bio, Cambridge, 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
| | - Bernard A Rosner
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Walter C Willett
- Department of Epidemiology, 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 Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Michelle D Holmes
- Department of Epidemiology, 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
| | - A Heather Eliassen
- Department of Epidemiology, 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
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16
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Farvid MS, Holmes MD, Chen WY, Rosner BA, Tamimi RM, Willett WC, Eliassen AH. Postdiagnostic Fruit and Vegetable Consumption and Breast Cancer Survival: Prospective Analyses in the Nurses' Health Studies. Cancer Res 2020; 80:5134-5143. [PMID: 33188079 PMCID: PMC7932849 DOI: 10.1158/0008-5472.can-18-3515] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 04/22/2020] [Accepted: 09/01/2020] [Indexed: 01/10/2023]
Abstract
Fruits and vegetables contain many bioactive components that may contribute to improved survival after diagnosis of breast cancer, however, evidence to date is insufficient. We prospectively assessed the associations of postdiagnostic fruit and vegetable consumption with breast cancer-specific and all-cause mortality among 8,927 women with stage I-III breast cancer identified during follow-up of the Nurses' Health Study (NHS; 1980-2010) and NHSII (1991-2011), using a validated food frequency questionnaire completed every 4 years after diagnosis. We prospectively documented 2,521 deaths, including 1,070 from breast cancer through follow-up until 2014 in the NHS and 2015 in the NHSII. Total fruit and vegetable and total vegetable consumption was related to lower all-cause [HRQ5vsQ1, 0.82; 95% confidence interval (CI), 0.71-0.94; P trend = 0.004, and HRQ5vsQ1, 0.84; 95% CI, 0.72-0.97; P trend = 0.001, respectively], but not breast cancer-specific mortality. Total fruit consumption was not related to breast cancer-specific or all-cause mortality. Greater intake of green leafy and cruciferous vegetables was associated with lower all-cause mortality. Each 2 servings/week of blueberries was associated with a 25% (HR, 0.75; 95% CI, 0.60-0.94) lower breast cancer-specific and a 17% (HR, 0.83; 95% CI, 0.72-0.96) lower all-cause mortality. In contrast, higher fruit juice consumption was associated with higher breast cancer-specific (HRQ5vsQ1, 1.33; 95% CI, 1.09-1.63; P trend = 0.002) and all-cause mortality (HRQ5vsQ1, 1.19; 95% CI, 1.04-1.36; P trend = 0.003). Apple juice largely accounted for these higher risks and orange juice was not associated with risk. Higher postdiagnostic fruit and vegetable consumption among breast cancer survivors was not associated with breast cancer-specific mortality. However, our findings suggest that higher vegetable consumption, particularly green leafy and cruciferous vegetables, was associated with better overall survival among patients with breast cancer. Higher fruit juice consumption, but not orange juice, was associated with poorer breast cancer-specific and all-cause survival. SIGNIFICANCE: A large-scale study shows that high fruit and vegetable consumption may be associated with better overall survival among breast cancer patients, while high fruit juice consumption may be associated with poorer porgnosis.
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Affiliation(s)
- Maryam S Farvid
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
| | - Michelle D Holmes
- Department of Epidemiology, 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
| | - Bernard A Rosner
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Rulla M Tamimi
- Department of Epidemiology, 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 Population Health Sciences, Weill Cornell Medicine, New York, New York
| | - Walter C Willett
- Department of Epidemiology, 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 Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - A Heather Eliassen
- Department of Epidemiology, 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
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17
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Jayedi A, Emadi A, Khan TA, Abdolshahi A, Shab-Bidar S. Dietary Fiber and Survival in Women with Breast Cancer: A Dose-Response Meta-Analysis of Prospective Cohort Studies. Nutr Cancer 2020; 73:1570-1580. [PMID: 32795218 DOI: 10.1080/01635581.2020.1803928] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
We aimed to investigate the association of dietary fiber consumption with mortality risk in women with breast cancer. A systematic search was undertaken in PubMed, Scopus, and ISI Web of Science till March 2020 to find cohort studies investigating the association of dietary fiber consumption with mortality risk in women with breast cancer. A random-effects model was used to combine study-specific results. The quality of evidence was rated by NutriGrade score. Seven prospective cohort studies with 1,426 cases of all-cause mortality and 679 cases of breast cancer-specific mortality among 11,295 patients with breast cancer were included. The relative risks for the highest compared to the lowest category of dietary fiber consumption were 0.63 (95%CI: 0.52, 0.77; I2 = 0%, n = 5) for all-cause mortality, and 0.72 (95%CI: 0.54, 0.96; I2 = 0%, n = 5) for breast cancer-specific mortality. There was a strong linear association between fiber intake and all-cause mortality risk. The quality of evidence was rated moderate for all-cause mortality, and low for breast cancer-specific mortality. Higher dietary fiber consumption may improve survival in patients with breast cancer. More research is needed to confirm the present results, considering types of fiber consumed and tumor estrogen receptor status.
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Affiliation(s)
- Ahmad Jayedi
- Food Safety Research Center (salt), Semnan University of Medical Sciences, Semnan, Iran.,Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Emadi
- Deputy of Research and Technology, Semnan University of Medical Sciences, Semnan, Iran
| | - Tauseef A Khan
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Risk Factor Modification Centre, St Michael's Hospital, Toronto, Ontario, Canada
| | - Anna Abdolshahi
- Food Safety Research Center (salt), Semnan University of Medical Sciences, Semnan, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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18
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Dominguez LJ, Barbagallo M. Dietary fiber intake and the Mediterranean population. THE MEDITERRANEAN DIET 2020:257-265. [DOI: 10.1016/b978-0-12-818649-7.00023-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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19
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Pre- and post-diagnostic intake of whole grain and dairy products and breast cancer prognosis: the Danish Diet, Cancer and Health cohort. Breast Cancer Res Treat 2019; 179:743-753. [PMID: 31773360 DOI: 10.1007/s10549-019-05497-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 11/08/2019] [Indexed: 12/24/2022]
Abstract
PURPOSE Fiber rich foods and dairy products have been suggested to be associated with breast cancer prognosis, though existing research is limited and either report on pre- or post-diagnostic dietary intake in relation to breast cancer prognosis. We investigated the associations between intake of whole grain (WG) and dairy products assessed both pre- and post-diagnostically in relation to breast cancer prognosis. METHODS A total of 1965 women from the Diet, Cancer and Health cohort who were diagnosed with breast cancer between baseline (1993-1997) and December 2013 were included and followed for a median of 7 years after diagnosis. During follow-up, 309 women experienced breast cancer recurrence and 460 women died, of whom 301 died from breast cancer. Dietary assessment by food frequency questionnaires was obtained up to three times, pre- and post-diagnostic, over a period of 18 years. Cox proportional hazard models were used to estimate hazard ratios. RESULTS No associations were observed between pre- or post-diagnostic intake of total WG or total dairy products and breast cancer prognosis. A high pre-diagnostic intake of oatmeal/muesli was associated with lower all-cause mortality (HR 0.76, 95% CI 0.59-0.99), whereas high post-diagnostic intake of rye bread was associated with higher breast cancer-specific mortality (HR 1.29, 95% CI 1.02-1.63). A generally high intake of cheese was associated with a higher recurrence rate. CONCLUSION Pre-diagnostic intake of oatmeal/muesli was associated with lower all-cause mortality, and post-diagnostic intake of rye bread was associated with higher breast cancer specific mortality.
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20
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Shahdadian F, Saneei P, Milajerdi A, Esmaillzadeh A. Dietary glycemic index, glycemic load, and risk of mortality from all causes and cardiovascular diseases: a systematic review and dose-response meta-analysis of prospective cohort studies. Am J Clin Nutr 2019; 110:921-937. [PMID: 31187856 DOI: 10.1093/ajcn/nqz061] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 03/25/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Previous findings on the association of dietary glycemic index (GI) and glycemic load (GL) with mortality are conflicting. OBJECTIVES The aim of this study was to summarize earlier findings on the association between dietary GI and GL and the risk of cardiovascular disease (CVD) and all-cause mortality. METHODS A comprehensive literature search was performed of electronic databases, including MEDLINE (PubMed), Scopus, ISI Web of Science, EMBASE, and Google scholar, up to September 2018. Prospective cohort studies that reported GI and GL as the exposure and all-cause or CVD mortality as the outcome were included in the analysis. The random-effects model was used to estimate pooled RR and 95% CIs of all-cause and CVD mortality. RESULTS Eighteen cohort studies with a total of 251,497 participants, reporting 14,774 cases of all-cause mortality and 3658 cases of CVD mortality, were included in the present analysis. No significant association was found between dietary GI and all-cause mortality (RR: 1.07; 95% CI: 0.96, 1.19) and CVD mortality (RR: 1.02; 95% CI: 0.87, 1.20). In addition, dietary GL was not associated with all-cause mortality (RR: 1.08; 95% CI: 0.93, 1.27) or CVD mortality (RR: 1.07; 95% CI: 0.92, 1.25). However, the highest dietary GI, in comparison to the lowest one, significantly increased the risk of all-cause mortality in women (RR: 1.17; 95% CI: 1.02, 1.35). No evidence for a nonlinear association between dietary GI or GL and all-cause and CVD mortality was found (P > 0.05). CONCLUSIONS This meta-analysis of prospective cohort studies showed no significant association between either dietary GI or GL and all-cause and CVD mortality in men, but a positive association of GI with all-cause mortality in women.
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Affiliation(s)
- Farnaz Shahdadian
- Students' Scientific Research Center.,Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parvane Saneei
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Milajerdi
- Students' Scientific Research Center.,Department of Community Nutrition, School of Nutritional Sciences and Dietetics
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics.,Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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21
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Nutrition and Breast Cancer: A Literature Review on Prevention, Treatment and Recurrence. Nutrients 2019; 11:nu11071514. [PMID: 31277273 PMCID: PMC6682953 DOI: 10.3390/nu11071514] [Citation(s) in RCA: 185] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 06/28/2019] [Accepted: 07/01/2019] [Indexed: 12/13/2022] Open
Abstract
Breast cancer (BC) is the second most common cancer worldwide and the most commonly occurring malignancy in women. There is growing evidence that lifestyle factors, including diet, body weight and physical activity, may be associated with higher BC risk. However, the effect of dietary factors on BC recurrence and mortality is not clearly understood. Here, we provide an overview of the current evidence obtained from the PubMed databases in the last decade, assessing dietary patterns, as well as the consumption of specific food-stuffs/food-nutrients, in relation to BC incidence, recurrence and survival. Data from the published literature suggest that a healthy dietary pattern characterized by high intake of unrefined cereals, vegetables, fruit, nuts and olive oil, and a moderate/low consumption of saturated fatty acids and red meat, might improve overall survival after diagnosis of BC. BC patients undergoing chemotherapy and/or radiotherapy experience a variety of symptoms that worsen patient quality of life. Studies investigating nutritional interventions during BC treatment have shown that nutritional counselling and supplementation with some dietary constituents, such as EPA and/or DHA, might be useful in limiting drug-induced side effects, as well as in enhancing therapeutic efficacy. Therefore, nutritional intervention in BC patients may be considered an integral part of the multimodal therapeutic approach. However, further research utilizing dietary interventions in large clinical trials is required to definitively establish effective interventions in these patients, to improve long-term survival and quality of life.
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Dominguez LJ, Bes-Rastrollo M, Toledo E, Gea A, Fresán U, Barbagallo M, Martínez-González MA. Dietary fiber intake and mortality in a Mediterranean population: the "Seguimiento Universidad de Navarra" (SUN) project. Eur J Nutr 2018; 58:3009-3022. [PMID: 30367237 DOI: 10.1007/s00394-018-1846-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 10/17/2018] [Indexed: 01/08/2023]
Abstract
PURPOSE To prospectively assess the association of dietary fiber intake (from different dietary sources) with all-cause mortality in a Mediterranean cohort. METHODS We assessed 19,703 participants of the SUN (Seguimiento Universidad de Navarra) cohort (mean follow-up: 10.1 years). A validated 136-item FFQ was administered at baseline. We used Cox proportional hazards models adjusted for multiple socio-demographic, anthropometric, lifestyle factors, and prevalent conditions at baseline. RESULTS We observed 323 deaths during 198,341 person-years of follow-up. A significantly inverse linear trend in Cox models was observed for the association of total dietary fiber intake and all-cause mortality after adjustment for confounders (p for trend 0.017). Each additional intake of 5 g/1000 kcal of dietary fiber was associated with a 9% relative reduction in all-cause mortality risk (HR 0.91, 95% CI 0.84-0.99). Considering separate dietary sources in separate models, a significant inverse trend was apparent for fiber derived from vegetables (p for trend 0.001), but it was non-significant for fiber derived from fruit, legumes, cereals, or other sources. Soluble fiber was significantly inversely associated with all-cause mortality in the fully adjusted model (p for trend 0.007), and insoluble fiber was marginally significant (p for trend 0.08). CONCLUSIONS A higher intake of total dietary fiber, and particularly fiber from vegetables, was related to a reduced all-cause mortality in our Mediterranean cohort. Dietary messages to increase the consumption of dietary patterns rich in fiber-rich foods should be broadly disseminated to decrease the alarming rate of chronic diseases and its derived mortality.
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Affiliation(s)
- Ligia J Dominguez
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Viale F. Scaduto 6/c, 90144, Palermo, Italy.
| | - Maira Bes-Rastrollo
- Department of Preventive Medicine and Public Health, University of Navarra-IDISNA, Pamplona, Spain.,CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Estefania Toledo
- Department of Preventive Medicine and Public Health, University of Navarra-IDISNA, Pamplona, Spain.,CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Alfredo Gea
- Department of Preventive Medicine and Public Health, University of Navarra-IDISNA, Pamplona, Spain.,CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Ujue Fresán
- Environmental Nutrition Group, School of Public Health, Loma Linda University, Loma Linda, USA
| | - Mario Barbagallo
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Viale F. Scaduto 6/c, 90144, Palermo, Italy
| | - Miguel A Martínez-González
- Department of Preventive Medicine and Public Health, University of Navarra-IDISNA, Pamplona, Spain.,CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain.,Department of Nutrition, Harvard TH Chan School of Public Health, Boston, USA
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Weigl J, Hauner H, Hauner D. Can Nutrition Lower the Risk of Recurrence in Breast Cancer? Breast Care (Basel) 2018; 13:86-91. [PMID: 29887784 PMCID: PMC5981678 DOI: 10.1159/000488718] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND The impact of diet on breast cancer prognosis is poorly understood. Therefore, we conducted a literature search summarizing the current evidence on the effect of diet on breast cancer recurrence and mortality. METHODS The PubMed database was searched for original studies, reviews, and meta-analyses published between 2010 and 2017. Studies related to diet, dietary patterns, special diets or specific dietary factors, and breast cancer recurrence or mortality were included. RESULTS Adherence to high diet quality indices (relative risk (RR) 0.74, 95% confidence interval (CI) 0.60-0.90) and a prudent/healthy dietary pattern (RR 0.76, 95% CI 0.60-0.95) may have a beneficial effect on breast cancer prognosis, whereas a Western/unhealthy diet is associated with poorer overall mortality (RR 1.44, 95% CI 1.17-1.77). For low-fat diets, the findings are inconsistent. A positive effect of the Mediterranean Diet was found for all-cause mortality, but no beneficial effect from other diets such as low-carbohydrate, ketogenic or vegetarian/vegan diets was observed. Alcohol consumption was associated with an increased risk for breast cancer recurrence. No general recommendation for soy exists, but occasional intake seems to be acceptable, whereas the use of other supplements is not justified. CONCLUSION Adherence to high-quality diets and a prudent/healthy dietary pattern seem to be beneficial for breast cancer prognosis. No clear evidence for a benefit from special diets, soy products, or other supplements was found.
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Affiliation(s)
| | - Hans Hauner
- Institute for Nutritional Medicine, Else Kröner-Fresenius-Center for Nutritional Medicine, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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Ferreira IB, Marinho EDC, Custódio IDD, Gontijo CA, Paiva CE, Crispim CA, Maia YCDP. Food intake and the nutritional status of women undergoing chemotherapy. CIENCIA & SAUDE COLETIVA 2018; 21:2209-18. [PMID: 27383354 DOI: 10.1590/1413-81232015217.05412015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 08/24/2015] [Indexed: 11/22/2022] Open
Abstract
The objective behind this study was the analysis of food intake and the nutritional status of women with breast cancer (BC) undergoing chemotherapy (CT). The quantitative dietary evaluation was performed in accordance with Dietary Reference Intakes (DRI), whereas the qualitative evaluation was performed through the Brazilian Healthy Eating Index - Revised (BHEI-R).From among the total number of patients (n = 20), 60% (n = 12) presented waist circumference, equal to or higher than 88cm. It was noted that 75% (n = 15) individuals were overweight. The average intake for calcium, copper, iron, dietary fiber, magnesium, potassium, vitamin A, niacin, vitamin B6 and zinc, were found to be below adequate intake levels, while the intake of vitamin C, phosphorus, manganese, sodium and thiamine were all found to be above DRIs recommendations. As for the analysis of the BHEI-R, 80% (n = 16) of the patients presented a "diet that needs modifications", while 20% (n = 4) presented a "healthy diet". Noted from these observations was the presence of a high overweight rate, a discrepancy in the intake of micronutrients and a diet that needed improvements. In this manner, the establishment and use of a nutritional intervention protocol are very important when it comes to the improvement of the diet in patients with BC and who are undergoing CT.
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Affiliation(s)
- Isabela Borges Ferreira
- Curso de Nutrição, Universidade Federal de Uberlândia. Av. Pará 1720, Campus Umuarama. 38405-320 Uberlândia MG Brasil.
| | - Eduarda da Costa Marinho
- Curso de Nutrição, Universidade Federal de Uberlândia. Av. Pará 1720, Campus Umuarama. 38405-320 Uberlândia MG Brasil.
| | - Isis Danyelle Dias Custódio
- Curso de Nutrição, Universidade Federal de Uberlândia. Av. Pará 1720, Campus Umuarama. 38405-320 Uberlândia MG Brasil.
| | - Cristiana Araújo Gontijo
- Curso de Nutrição, Universidade Federal de Uberlândia. Av. Pará 1720, Campus Umuarama. 38405-320 Uberlândia MG Brasil.
| | - Carlos Eduardo Paiva
- Departamento de Oncologia Clínica, Hospital de Câncer de Barretos. Barretos SP Brasil
| | - Cibele Aparecida Crispim
- Curso de Nutrição, Universidade Federal de Uberlândia. Av. Pará 1720, Campus Umuarama. 38405-320 Uberlândia MG Brasil.
| | - Yara Cristina de Paiva Maia
- Curso de Nutrição, Universidade Federal de Uberlândia. Av. Pará 1720, Campus Umuarama. 38405-320 Uberlândia MG Brasil.
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25
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Playdon MC, Nagle CM, Ibiebele TI, Ferrucci LM, Protani MM, Carter J, Hyde SE, Neesham D, Nicklin JL, Mayne ST, Webb PM. Pre-diagnosis diet and survival after a diagnosis of ovarian cancer. Br J Cancer 2017; 116:1627-1637. [PMID: 28463959 PMCID: PMC5518850 DOI: 10.1038/bjc.2017.120] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 04/05/2017] [Accepted: 04/06/2017] [Indexed: 12/12/2022] Open
Abstract
Background: The relationship between diet and survival after ovarian cancer diagnosis is unclear as a result of a limited number of studies and inconsistent findings. Methods: We examined the association between pre-diagnostic diet and overall survival in a population-based cohort (n=811) of Australian women diagnosed with invasive epithelial ovarian cancer between 2002 and 2005. Diet was measured by validated food frequency questionnaire. Deaths were ascertained up to 31 August 2014 via medical record review and Australian National Death Index linkage. We conducted Cox proportional hazards regression analysis, controlling for diagnosis age, tumour stage, grade and subtype, residual disease, smoking status, body mass index, physical activity, marital status, and energy intake. Results: We observed improved survival with highest compared with lowest quartile of fibre intake (hazard ratio (HR)=0.69, 95% CI: 0.53–0.90, P-trend=0.002). There was a suggestion of better survival for women with highest compared with lowest intake category of green leafy vegetables (HR=0.79, 95% CI: 0.62–0.99), fish (HR=0.74, 95% CI: 0.57–0.95), poly- to mono-unsaturated fat ratio (HR=0.76, 95% CI: 0.59–0.98), and worse survival with higher glycaemic index (HR=1.28, 95% CI: 1.01–1.65, P-trend=0.03). Conclusions: The associations we observed between healthy components of diet pre-diagnosis and ovarian cancer survival raise the possibility that dietary choices after diagnosis may improve survival.
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Affiliation(s)
- Mary C Playdon
- Yale School of Public Health, Department of Chronic Disease Epidemiology, Yale University, 60 College Street, New Haven, CT 06520, USA
| | - Christina M Nagle
- Gynaecological Cancers Group, QIMR Berghofer Institute of Medical Research, 300 Herston Road, Herston, Queensland 4006, Australia
| | - Torukiri I Ibiebele
- Gynaecological Cancers Group, QIMR Berghofer Institute of Medical Research, 300 Herston Road, Herston, Queensland 4006, Australia
| | - Leah M Ferrucci
- Yale School of Public Health, Department of Chronic Disease Epidemiology, Yale University, 60 College Street, New Haven, CT 06520, USA
| | - Melinda M Protani
- Gynaecological Cancers Group, QIMR Berghofer Institute of Medical Research, 300 Herston Road, Herston, Queensland 4006, Australia.,School of Public Health, University of Queensland Public Health Building, Herston Road, Queensland 4006, Australia
| | - Jonathan Carter
- Department of Gynaecological Oncology, The University of Sydney, Sydney, New South Wales 2006, Australia.,Lifehouse Gynaecologic Oncology Group, Lifehouse, Royal Prince Alfred Hospital, Camperdown, New South Wales 2050, Australia
| | - Simon E Hyde
- Mercy Hospital for Women, Department of Gynaecological Oncology, Studley Road, Heidelberg, Victoria 3084, Australia
| | - Deborah Neesham
- Oncology/Dysplasia Unit, The Royal Women's Hospital, Flemington Road, Parkville, Victoria 3052, Australia
| | - James L Nicklin
- Queensland Centre for Gynaecological Cancer, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Queensland 4029, Australia.,School of Medicine, Department of Obstetrics and Gynaecology, The University of Queensland, Herston, Queensland 4006, Australia
| | - Susan T Mayne
- Yale School of Public Health, Department of Chronic Disease Epidemiology, Yale University, 60 College Street, New Haven, CT 06520, USA.,Yale Cancer Center, New Haven, CT 06520, USA.,U.S. Food and Drug Administration, College Park, MD, USA
| | - Penelope M Webb
- Gynaecological Cancers Group, QIMR Berghofer Institute of Medical Research, 300 Herston Road, Herston, Queensland 4006, Australia.,School of Public Health, University of Queensland Public Health Building, Herston Road, Queensland 4006, Australia
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Racial and Ethnic Differences in Dietary Intake, Physical Activity, and Body Mass Index (BMI) Among Cancer Survivors: 2005 and 2010 National Health Interview Surveys (NHIS). J Racial Ethn Health Disparities 2017; 4:1138-1146. [PMID: 28078657 DOI: 10.1007/s40615-016-0319-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 11/10/2016] [Accepted: 11/14/2016] [Indexed: 10/20/2022]
Abstract
INTRODUCTION This paper reports racial/ethnic differences in mean dietary and alcohol intake, physical activity, and body mass index (BMI) among cancer survivors and examines adherence to the American Cancer Society and the US Dietary Guidelines for Americans. METHODS Data are from the cross-sectional 2005 and 2010 National Health Interview Surveys (NHIS). The total sample of cancer survivors (N = 3367) included non-Hispanic Whites (NHW; N = 2698), non-Hispanic Blacks (NHBs; N = 379), and Hispanics (N = 290). We compared mean reported dietary intake, moderate/vigorous physical activity, and BMI among racial/ethnic groups. Predicted marginals and multivariate logistic regression analysis were used to compare prevalence of non-adherence with recommendations among groups. RESULTS Among the three racial/ethnic groups, Hispanics had the highest mean intake of vegetables, fiber, and calcium (p = 0.0003; p < 0.0001; p = 0.001). In the logistic regression model adjusting for sociodemographic covariates, smoking and BMI, Hispanics had lower non-adherence to fiber guidelines (OR = 0.38; CI = 0.24-0.58) than NHWs. NHBs had significantly higher non-adherence to vegetable guidelines (OR = 1.63; CI = 1.07-2.47). NHBs and Hispanics had lower non-adherence with alcohol guidelines than NHWs (OR = 0.35 and 0.38; CI = 0.18-0.69 and 0.19-0.76, respectively). NHBs and Hispanics were more likely to be overweight/obese (OR = 1.66 and 1.57; CI = 1.24-2.23 and CI = 1.11-2.21, respectively). CONCLUSIONS There are racial/ethnic differences in certain health behaviors of cancer survivors. However, non-adherence to guidelines is high in all three racial/ethnic groups. Achieving the recommended guidelines for diet, physical activity, and a healthy BMI is a concern for all cancer survivors, indicating the need for intervention among this growing group of at-risk individuals.
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27
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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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28
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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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Yang Y, Zhao LG, Wu QJ, Ma X, Xiang YB. Association between dietary fiber and lower risk of all-cause mortality: a meta-analysis of cohort studies. Am J Epidemiol 2015; 181:83-91. [PMID: 25552267 DOI: 10.1093/aje/kwu257] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Although in vitro and in vivo experiments have suggested that dietary fiber might have beneficial effects on health, results on the association between fiber intake and all-cause mortality in epidemiologic studies have been inconsistent. Therefore, we conducted a meta-analysis of prospective cohort studies to quantitatively assess this association. Pertinent studies were identified by searching articles in PubMed and Web of Knowledge through May 2014 and reviewing the reference lists of the retrieved articles. Study-specific risk estimates were combined using random-effects models. Seventeen prospective studies (1997-2014) that had a total of 67,260 deaths and 982,411 cohort members were included. When comparing persons with dietary fiber intakes in the top tertile with persons whose intakes were in the bottom tertile, we found a statistically significant inverse association between fiber intake and all-cause mortality, with an overall relative risk of 0.84 (95% confidence interval: 0.80, 0.87; I(2) = 41.2%). There was a 10% reduction in risk for per each 10-g/day increase in fiber intake (relative risk = 0.90; 95% confidence interval: 0.86, 0.94; I(2) = 77.2%). The combined estimate was robust across subgroup and sensitivity analyses. No publication bias was detected. A higher dietary fiber intake was associated with a reduced risk of death. These findings suggest that fiber intake may offer a potential public health benefit in reducing all-cause mortality.
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Cho J, Jung SY, Lee JE, Shim EJ, Kim NH, Kim Z, Sohn G, Youn HJ, Kim KS, Kim H, Lee JW, Lee MH. A review of breast cancer survivorship issues from survivors' perspectives. J Breast Cancer 2014; 17:189-99. [PMID: 25320616 PMCID: PMC4197348 DOI: 10.4048/jbc.2014.17.3.189] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 08/26/2014] [Indexed: 11/30/2022] Open
Abstract
Despite the fact that more breast cancer survivors are currently enjoying longer lifespans, there remains limited knowledge about the factors and issues that are of greatest significance for these survivors, particularly from their perspectives. This review was based on the concept that the topics addressed should focus on the perspectives of current survivors and should be extended to future modalities, which physicians will be able to use to gain a better understanding of the hidden needs of these patients. We intended to choose and review dimensions other than the pathology and the disease process that could have been overlooked during treatment. The eight topics upon which we focused included: delay of treatment and survival outcome; sexual well-being; concerns about childbearing; tailored follow-up; presence of a family history of breast cancer; diet and physical activity for survivors and their families; qualitative approach toward understanding of breast cancer survivorship, and; mobile health care for breast cancer survivors. Through this review, we aimed to examine the present clinical basis of the central issues noted from the survivors' perspectives and suggest a direction for future survivorship-related research.
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Affiliation(s)
- Jihyoung Cho
- Department of Surgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - So-Youn Jung
- Breast Cancer Center, National Cancer Center, Goyang, Korea
| | - Jung Eun Lee
- Department of Food and Nutrition, Sookmyung Women's University, Seoul, Korea
| | - Eun-Jung Shim
- Department of Psychology, Pusan National University School of Medicine, Busan, Korea
| | - Nam Hyoung Kim
- Department of Advertising and Branding, Kaywon University of Art and Design, Uiwang, Korea
| | - Zisun Kim
- Department of Surgery, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Guiyun Sohn
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyun Jo Youn
- Department of Surgery, Chonbuk National University Medical School, Jeonju, Korea
| | - Ku Sang Kim
- Department of Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Hanna Kim
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ; Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - Jong Won Lee
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Min Hyuk Lee
- Department of Surgery, Soonchunhyang University College of Medicine, Seoul, Korea
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Castro-Quezada I, Sánchez-Villegas A, Estruch R, Salas-Salvadó J, Corella D, Schröder H, Álvarez-Pérez J, Ruiz-López MD, Artacho R, Ros E, Bulló M, Covas MI, Ruiz-Gutiérrez V, Ruiz-Canela M, Buil-Cosiales P, Gómez-Gracia E, Lapetra J, Pintó X, Arós F, Fiol M, Lamuela-Raventós RM, Martínez-González MÁ, Serra-Majem L. A high dietary glycemic index increases total mortality in a Mediterranean population at high cardiovascular risk. PLoS One 2014; 9:e107968. [PMID: 25250626 PMCID: PMC4176720 DOI: 10.1371/journal.pone.0107968] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 08/21/2014] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE Different types of carbohydrates have diverse glycemic response, thus glycemic index (GI) and glycemic load (GL) are used to assess this variation. The impact of dietary GI and GL in all-cause mortality is unknown. The objective of this study was to estimate the association between dietary GI and GL and risk of all-cause mortality in the PREDIMED study. MATERIAL AND METHODS The PREDIMED study is a randomized nutritional intervention trial for primary cardiovascular prevention based on community-dwelling men and women at high risk of cardiovascular disease. Dietary information was collected at baseline and yearly using a validated 137-item food frequency questionnaire (FFQ). We assigned GI values of each item by a 5-step methodology, using the International Tables of GI and GL Values. Deaths were ascertained through contact with families and general practitioners, review of medical records and consultation of the National Death Index. Cox regression models were used to estimate multivariable-adjusted hazard ratios (HR) and their 95% CI for mortality, according to quartiles of energy-adjusted dietary GI/GL. To assess repeated measures of exposure, we updated GI and GL intakes from the yearly FFQs and used Cox models with time-dependent exposures. RESULTS We followed 3,583 non-diabetic subjects (4.7 years of follow-up, 123 deaths). As compared to participants in the lowest quartile of baseline dietary GI, those in the highest quartile showed an increased risk of all-cause mortality [HR = 2.15 (95% CI: 1.15-4.04); P for trend = 0.012]. In the repeated-measures analyses using as exposure the yearly updated information on GI, we observed a similar association. Dietary GL was associated with all-cause mortality only when subjects were younger than 75 years. CONCLUSIONS High dietary GI was positively associated with all-cause mortality in elderly population at high cardiovascular risk.
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Affiliation(s)
- Itandehui Castro-Quezada
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Almudena Sánchez-Villegas
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
| | - Ramón Estruch
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Department of Internal Medicine, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain
| | - Jordi Salas-Salvadó
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Human Nutrition Department, School of Medicine, University Rovira i Virgili, Reus, Tarragona, Spain
| | - Dolores Corella
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Department of Preventive Medicine, School of Medicine, University of Valencia, Valencia, Spain
| | - Helmut Schröder
- Cardiovascular Risk and Nutrition Research Group, Institut Municipal d'Investigació Medica (IMIM)-Institut de Recerca del Hospital del Mar, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
| | - Jacqueline Álvarez-Pérez
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
| | - María Dolores Ruiz-López
- Department of Nutrition and Food Science, School of Pharmacy, University of Granada, Granada, Spain
- Institute of Nutrition and Food Technologies, University of Granada. Armilla, Granada, Spain
| | - Reyes Artacho
- Department of Nutrition and Food Science, School of Pharmacy, University of Granada, Granada, Spain
| | - Emilio Ros
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clinic, l'Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Mónica Bulló
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Human Nutrition Department, School of Medicine, University Rovira i Virgili, Reus, Tarragona, Spain
| | - María-Isabel Covas
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Cardiovascular Risk and Nutrition Research Group, Institut Municipal d'Investigació Medica (IMIM)-Institut de Recerca del Hospital del Mar, Barcelona, Spain
| | - Valentina Ruiz-Gutiérrez
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Group of Nutrition and Lipid Metabolism, Instituto de la Grasa (CSIC), Seville, Spain
| | - Miguel Ruiz-Canela
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Department of Preventive Medicine and Public Health, School of Medicine – Clinica Universitaria de Navarra, University of Navarra, Pamplona, Navarra, Spain
| | - Pilar Buil-Cosiales
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Department of Preventive Medicine and Public Health, School of Medicine – Clinica Universitaria de Navarra, University of Navarra, Pamplona, Navarra, Spain
| | - Enrique Gómez-Gracia
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Department of Preventive Medicine, School of Medicine, University of Malaga, Malaga, Spain
| | - José Lapetra
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain
| | - Xavier Pintó
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Internal Medicine Service, Hospital of Bellvitge, Barcelona, Spain
| | - Fernando Arós
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Department of Cardiology, Hospital Txagorritxu, Vitoria, Alava, Spain
| | - Miquel Fiol
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- University Institute for Health Sciences Investigation, University of Balearic Islands, Palma de Mallorca, Spain
- Department of Cardiology, Hospital Son Espases, Palma de Mallorca, Spain
| | - Rosa María Lamuela-Raventós
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Department of Nutrition and Bromatology, School of Pharmacy, University of Barcelona, Barcelona, Spain
| | - Miguel Ángel Martínez-González
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Department of Preventive Medicine and Public Health, School of Medicine – Clinica Universitaria de Navarra, University of Navarra, Pamplona, Navarra, Spain
| | - Lluís Serra-Majem
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
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Park M, Hwang E, Moon HG, Noh DY, Lee JE. Dietary Intake Status among Korean Female Breast Cancer Survivors. ACTA ACUST UNITED AC 2014. [DOI: 10.5720/kjcn.2014.19.2.163] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Myungsook Park
- Department of Food and Nutrition, Sookmyung Women's University, Seoul, Korea
| | - Eunkyung Hwang
- Breast Care Center, Seoul National University Hospital, Seoul, Korea
| | - Hyeong-Gon Moon
- Breast Care Center, Seoul National University Hospital, Seoul, Korea
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Dong-Young Noh
- Breast Care Center, Seoul National University Hospital, Seoul, Korea
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jung Eun Lee
- Department of Food and Nutrition, Sookmyung Women's University, Seoul, Korea
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Deschasaux M, Zelek L, Pouchieu C, His M, Hercberg S, Galan P, Latino-Martel P, Touvier M. Prospective association between dietary fiber intake and breast cancer risk. PLoS One 2013; 8:e79718. [PMID: 24244548 PMCID: PMC3828192 DOI: 10.1371/journal.pone.0079718] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 10/03/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Mechanistic hypotheses suggest a potential effect of dietary fiber on breast carcinogenesis through the modulation of insulin-like growth factor bioactivity, estrogen metabolism and inflammation. An association between dietary fiber intake and breast cancer risk has been suggested in epidemiological studies but remains inconclusive. In particular, data is lacking regarding the different types of dietary fibers. OBJECTIVE The objective was to investigate the prospective relationship between dietary fiber intake and breast cancer risk, taking into account different types of dietary fiber (overall, insoluble, soluble and from different food sources: cereals, vegetables, fruits and legumes). DESIGN 4684 women from the SU.VI.MAX cohort were included in this analysis as they completed at least three 24h-dietary records within the first two years of follow-up. Among them, 167 incident invasive breast cancers were diagnosed during a median follow-up of 12.6 years (between 1994 and 2007). The associations between quartiles of dietary fiber intake and breast cancer risk were characterized using multivariate Cox proportional hazards models. RESULTS Total fiber intake was not associated with breast cancer risk (HR(Quartile4vs.Quartile1) = 1.29 (95%CI 0.66-2.50), P-trend = 0.5), nor was fiber intake from cereals (P-trend = 0.1), fruits (P-trend = 0.9) and legumes (P-trend = 0.3). In contrast, vegetable fiber intake was related to a decreased risk of breast cancer (HR(Q4vs.Q1) = 0.50 (0.29-0.88), P-trend = 0.03). Overall vegetable intake (in g/day) was not associated with breast cancer risk (P-trend = 0.2). CONCLUSION This prospective study suggests that vegetable fiber intake may contribute to reduce breast cancer risk, in line with experimental mechanistic data.
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Affiliation(s)
- Mélanie Deschasaux
- Nutritional Epidemiology Research Team, Sorbonne Paris Cité Research Center, Inserm (U557), Inra (U1125), Cnam, Paris 13 University, SMBH Paris 13, Bobigny, France
| | - Laurent Zelek
- Nutritional Epidemiology Research Team, Sorbonne Paris Cité Research Center, Inserm (U557), Inra (U1125), Cnam, Paris 13 University, SMBH Paris 13, Bobigny, France
- Oncology Department, Avicenne Hospital, Bobigny, France
| | - Camille Pouchieu
- Nutritional Epidemiology Research Team, Sorbonne Paris Cité Research Center, Inserm (U557), Inra (U1125), Cnam, Paris 13 University, SMBH Paris 13, Bobigny, France
| | - Mathilde His
- Nutritional Epidemiology Research Team, Sorbonne Paris Cité Research Center, Inserm (U557), Inra (U1125), Cnam, Paris 13 University, SMBH Paris 13, Bobigny, France
| | - Serge Hercberg
- Nutritional Epidemiology Research Team, Sorbonne Paris Cité Research Center, Inserm (U557), Inra (U1125), Cnam, Paris 13 University, SMBH Paris 13, Bobigny, France
- Public Health Department, Avicenne Hospital, Bobigny, France
| | - Pilar Galan
- Nutritional Epidemiology Research Team, Sorbonne Paris Cité Research Center, Inserm (U557), Inra (U1125), Cnam, Paris 13 University, SMBH Paris 13, Bobigny, France
| | - Paule Latino-Martel
- Nutritional Epidemiology Research Team, Sorbonne Paris Cité Research Center, Inserm (U557), Inra (U1125), Cnam, Paris 13 University, SMBH Paris 13, Bobigny, France
| | - Mathilde Touvier
- Nutritional Epidemiology Research Team, Sorbonne Paris Cité Research Center, Inserm (U557), Inra (U1125), Cnam, Paris 13 University, SMBH Paris 13, Bobigny, 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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Contiero P, Berrino F, Tagliabue G, Mastroianni A, Di Mauro MG, Fabiano S, Annulli M, Muti P. Fasting blood glucose and long-term prognosis of non-metastatic breast cancer: a cohort study. Breast Cancer Res Treat 2013; 138:951-9. [PMID: 23568483 DOI: 10.1007/s10549-013-2519-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Accepted: 04/01/2013] [Indexed: 10/27/2022]
Abstract
High circulating glucose has been associated with increased risk of breast cancer (BC). There may also be a link between serum glucose and prognosis in women treated for BC. We assessed the effect of peridiagnostic fasting blood glucose and body mass index (BMI) on long-term BC prognosis. We retrospectively investigated 1,261 women diagnosed and treated for stage I-III BC at the National Cancer Institute, Milan, in 1996, 1999 and 2000. Data on blood tests and follow-up were obtained by linking electronic archives, with follow-up to end of 2009. Multivariate Cox modelling estimated hazard ratios (HR) with 95 % confidence intervals (CI) for distant metastasis, recurrence and death (all causes) in relation to categorized peridiagnostic fasting blood glucose and BMI. Mediation analysis investigated whether blood glucose mediated the BMI-breast cancer prognosis association. The risks of distant metastasis were significantly higher for all other quintiles compared to the lowest glucose quintile (reference <87 mg/dL) (respective HRs: 1.99 95 % CI 1.23-3.24, 1.85 95 % CI 1.14-3.0, 1.73 95 % CI 1.07-2.8, and 1.91 95 % CI 1.15-3.17). The risk of recurrence was significantly higher for all other glucose quintiles compared to the first. The risk of death was significantly higher than reference in the second, fourth and fifth quintiles. Women with BMI ≥ 25 kg/m(2) had significantly greater risks of recurrence and distant metastasis than those with BMI < 25 kg/m(2), irrespective of blood glucose. The increased risks remained invariant over a median follow-up of 9.5 years. Mediation analysis indicated that glucose and BMI had independent effects on BC prognosis. Peridiagnostic high fasting glucose and obesity predict worsened short- and long-term outcomes in BC patients. Maintaining healthy blood glucose levels and normal weight may improve prognosis.
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Affiliation(s)
- Paolo Contiero
- Cancer Registry and Environmental Epidemiology Division, Scientific Directorate, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy.
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Eight ways to stay healthy after cancer: an evidence-based message. Cancer Causes Control 2013; 24:827-37. [PMID: 23479430 PMCID: PMC3631124 DOI: 10.1007/s10552-013-0179-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Accepted: 02/23/2013] [Indexed: 10/27/2022]
Abstract
PURPOSE Since 1999, in conjunction with the internationally known and award-winning Your Disease Risk ( yourdiseaserisk.org ) risk assessment tool, the "Eight Ways to Stay Healthy and Prevent Cancer" message campaign has provided an evidence-based, but user-friendly, approach to cancer prevention. The scientific evidence behind the campaign is robust and while not a complete list, provides a great deal of benefit in the reduction of cancer risk. With 12 million cancer survivors in the United States, there is a need for a parallel set of recommendations that oncologists and primary care providers may routinely use for individuals following a cancer diagnosis focused on improving the quantity and quality of life after diagnosis. With increasing survival rates and many cancer survivors dying from noncancer causes, survivorship care necessarily focuses on more than just risk of cancer recurrence and cancer-related mortality. METHODS To provide a foundation for living a healthy life after a cancer diagnosis, we developed a set of evidence-based health messages for cancer survivors. "Cancer Survivors' Eight Ways to Stay Healthy After Cancer," published by the Siteman Cancer Center at Washington University School of Medicine and Barnes Jewish Hospital, documents both the evidence supporting the recommendations as well as tips for implementing them. RESULTS The one-line summary messages are: (1) don't smoke, (2) avoid secondhand smoke, (3) exercise regularly, (4) avoid weight gain, (5) eat a healthy diet, (6) drink alcohol in moderation, if at all, (7) stay connected with friends, family, and other survivors, (8) get screening tests and go to your regular checkups. CONCLUSIONS The cancer survivors' eight ways are the foundation for an evidence-based health promotion program for survivors.
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Ellsworth RE, Valente AL, Shriver CD, Bittman B, Ellsworth DL. Impact of lifestyle factors on prognosis among breast cancer survivors in the USA. Expert Rev Pharmacoecon Outcomes Res 2013; 12:451-64. [PMID: 22971032 DOI: 10.1586/erp.12.37] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Advances in diagnostic screening and adjuvant therapy have dramatically increased the number of breast cancer survivors in the USA, who may face changes in physical and mental health, social support, quality of life and economics. Women living with breast cancer are increasingly interested in lifestyle modification to decrease the risk of recurrence and mortality while increasing physical and emotional wellbeing. Although organizations such as the American Cancer Society support a healthy diet, frequent physical activity and stress reduction for decreasing breast cancer risk, studies examining the effects of lifestyle on clinical outcomes including survival and prognosis have been inconclusive. With the number of breast cancer survivors predicted to increase to 3.4 million by 2015, it is important to develop effective treatment paradigms that overcome barriers to behavioral modification to improve clinical outcomes and survivorship in breast cancer patients.
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Affiliation(s)
- Rachel E Ellsworth
- Clinical Breast Care Project, Henry M Jackson Foundation for the Advancement of Military Medicine, Windber, PA 15963, USA
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Abstract
BACKGROUND Breast cancer is the most commonly diagnosed cancer among women in the United States. Extensive research has been completed to evaluate the relationship between dietary factors and breast cancer risk and survival after breast cancer; however, a summary report with clinical inference is needed. Materials and METHODS This review summarizes the current epidemiological and clinical trial evidence relating diet to breast cancer incidence, recurrence, survival, and mortality. The review includes emerging epidemiological studies that assess risk within breast cancer subtypes as well as a summary of previous and ongoing dietary intervention trials designed to modify breast cancer risk. RESULTS The available literature suggests that both low-fat and high-fiber diets may be weakly protective against breast cancer, whereas total energy intake and alcohol appear to be positively associated. Fiber may be weakly protective possibly through modulation of estrogen, whereas fruit and vegetable intake is not clearly associated with risk. Obesity is a risk factor for postmenopausal disease, and adult weight gain should be avoided to reduce risk. In survivors, diet has the greatest potential influence on overall mortality rather than breast cancer-specific events. CONCLUSION Diet is modestly associated with breast cancer risk; associations appear more pronounced for postmenopausal disease, and healthy choices after diagnosis and treatment likely support longevity more so than reduced risk for recurrent disease.
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Affiliation(s)
- Cynthia A Thomson
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA.
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Kampman E, Vrieling A, van Duijnhoven FJ, Winkels RM. Impact of Diet, Body Mass Index, and Physical Activity on Cancer Survival. Curr Nutr Rep 2012; 1:30-36. [PMID: 24392267 PMCID: PMC3873012 DOI: 10.1007/s13668-011-0004-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
With the increase in the number of cancer patients worldwide in the coming years, the need for knowledge on the influence of lifestyle factors on cancer survival is increasing. In this paper, the current knowledge on diet, body mass index, and physical activity in relation to cancer outcome is summarized. Also, challenges are identified to be addressed to provide evidence-based recommendations for cancer patients. Studies in patients with breast, colorectal, or prostate cancer show that the influence of dietary factors on survival remains to be determined. Adiposity and a lack of physical activity, however, appear to influence cancer outcome negatively. Subsequent studies should focus on more detailed aspects of these lifestyle factors, such as body composition and dose of exercise, and on the timing with respect to diagnosis and treatment. Research should be directed toward investigating diet and physical activity simultaneously and on how changes in health behavior can be established.
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Affiliation(s)
- Ellen Kampman
- Division of Human Nutrition, Wageningen University, Bomenweg 4, 6703 HD Wageningen, The Netherlands
- University Medical Centre St. Radboud Nijmegen, and VU University Amsterdam, Amsterdam, The Netherlands
| | - Alina Vrieling
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, Heidelberg, Germany
| | - Fränzel J. van Duijnhoven
- Division of Human Nutrition, Wageningen University, Bomenweg 4, 6703 HD Wageningen, The Netherlands
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Renate M. Winkels
- Division of Human Nutrition, Wageningen University, Bomenweg 4, 6703 HD Wageningen, The Netherlands
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Thompson HJ, Sedlacek SM, Paul D, Wolfe P, McGinley JN, Playdon MC, Daeninck EA, Bartels SN, Wisthoff MR. Effect of dietary patterns differing in carbohydrate and fat content on blood lipid and glucose profiles based on weight-loss success of breast-cancer survivors. Breast Cancer Res 2012; 14:R1. [PMID: 22225711 PMCID: PMC3496116 DOI: 10.1186/bcr3082] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Revised: 01/03/2012] [Accepted: 01/06/2012] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Healthy body weight is an important factor for prevention of breast cancer recurrence. Yet, weight loss and weight gain are not currently included in clinical-practice guidelines for posttreatment of breast cancer. The work reported addresses one of the questions that must be considered in recommending weight loss to patients: does it matter what diet plan is used, a question of particular importance because breast cancer treatment can increase risk for cardiovascular disease. METHODS Women who completed treatment for breast cancer were enrolled in a nonrandomized, controlled study investigating effects of weight loss achieved by using two dietary patterns at the extremes of macronutrient composition, although both diet arms were equivalent in protein: high fat, low carbohydrate versus low fat, high carbohydrate. A nonintervention group served as the control arm; women were assigned to intervention arms based on dietary preferences. During the 6-month weight-loss program, which was menu and recipe defined, participants had monthly clinical visits at which anthropometric data were collected and fasting blood was obtained for safety monitoring for plasma lipid profiles and fasting glucose. Results from 142 participants are reported. RESULTS Adverse effects on fasting blood lipids or glucose were not observed in either dietary arm. A decrease in fasting glucose was observed with progressive weight loss and was greater in participants who lost more weight, but the effect was not statistically significant, even though it was observed across both diet groups (P = 0.21). Beneficial effects of weight loss on cholesterol (4.7%; P = 0.001), triglycerides (21.8%; P = 0.01), and low-density lipoprotein (LDL) cholesterol (5.8%; P = 0.06) were observed in both groups. For cholesterol (P = 0.07) and LDL cholesterol (P = 0.13), greater reduction trends were seen on the low-fat diet pattern; whereas, for triglycerides (P = 0.01) and high-density lipoprotein (HDL) cholesterol (P = 0.08), a decrease or increase, respectively, was greater on the low-carbohydrate diet pattern. CONCLUSIONS Because an individual's dietary preferences can affect dietary adherence and weight-loss success, the lack of evidence of a negative effect of dietary pattern on biomarkers associated with cardiovascular risk is an important consideration in the development of breast cancer practice guidelines for physicians who recommend that their patients lose weight. Whether dietary pattern affects biomarkers that predict long-term survival is a primary question in this ongoing clinical trial.
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Affiliation(s)
- Henry J Thompson
- Cancer Prevention Laboratory, Colorado State University, Fort Collins, CO 80523, USA.
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Davies NJ, Batehup L, Thomas R. The role of diet and physical activity in breast, colorectal, and prostate cancer survivorship: a review of the literature. Br J Cancer 2011; 105 Suppl 1:S52-73. [PMID: 22048034 PMCID: PMC3251953 DOI: 10.1038/bjc.2011.423] [Citation(s) in RCA: 178] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Evidence for the role of diet and physical activity in cancer incidence is well documented, but owing to increased cancer survivorship, an understanding of these lifestyle factors after a cancer diagnosis is of crucial importance. The purpose of this review was to update the literature in a review undertaken for the National Cancer Survivorship Initiative and to include observational studies that were not included in the WCRF survivorship systematic review. METHODS Evidence was initially gathered from pre-defined searches of the Cochrane Library Database and PubMed from March 2006 to February 2010. After a comprehensive review regarding lifestyle and cancer, for the purpose of this article, any studies not related to diet and physical activity, prognostic outcomes, and breast, colorectal or prostate cancers were excluded. Another search of 2011 literature was conducted to update the evidence. RESULTS A total of 43 records were included in this review. Evidence from observational studies suggests that a low-fat, high-fibre diet might be protective against cancer recurrence and progression. However, there is a paucity of RCTs substantiating this. There is more support for physical activity, with a dose response for better outcomes. When synthesized with findings from the World Cancer Research Fund review of RCTs investigating the effect of diet and physical activity interventions on cancer survival, evidence suggests that the mechanism of benefit from diet and physical activity pertains to body weight, with excess body weight being a risk factor, which is modifiable through lifestyle. IMPLICATIONS Cancer survivors would like to have a more active role in their health care and to know how to look after themselves after diagnosis, including what diet and lifestyle changes they should make. The challenge is in integrating lifestyle support into standardised models of aftercare.
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Affiliation(s)
- N J Davies
- Self-Management Support Programme, National Cancer Survivorship Initiative, Macmillan Cancer Support, 89 Albert Embankment, London SE1 7UQ, UK
| | - L Batehup
- Self-Management Support Programme, National Cancer Survivorship Initiative, Macmillan Cancer Support, 89 Albert Embankment, London SE1 7UQ, UK
| | - R Thomas
- Bedford Hospital and Addenbrooke's Hospital Cambridge University NHS Trusts, c/o The Primrose Unit, Bedford Hospital, Bedford MK42 9DJ, UK
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