Adela Castelló1, Elena Boldo2, Beatriz Pérez-Gómez3, Virginia Lope4, Jone M Altzibar5, Vicente Martín6, Gemma Castaño-Vinyals7, Marcela Guevara8, Trinidad Dierssen-Sotos9, Adonina Tardón10, Víctor Moreno11, Montserrat Puig-Vives12, Cristóbal Llorens-Ivorra13, Juan Alguacil14, Inés Gómez-Acebo15, Jesús Castilla16, Esther Gràcia-Lavedán17, Verónica Dávila-Batista18, Manolis Kogevinas19, Nuria Aragonés20, Pilar Amiano21, Marina Pollán22. 1. Cancer Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain; Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Manuel de Falla 1, 28222, Madrid, Spain. Electronic address: acastello@isciii.es. 2. Cancer Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain; Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Manuel de Falla 1, 28222, Madrid, Spain. Electronic address: eiboldo@isciii.es. 3. Cancer Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain; Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Manuel de Falla 1, 28222, Madrid, Spain. Electronic address: bperez@isciii.es. 4. Cancer Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain; Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Manuel de Falla 1, 28222, Madrid, Spain. Electronic address: vicarvajal@isciii.es. 5. Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain; Breast Cancer Screening Program, Osakidetza-Health Basque Region Service, Avenida Navarra, 4, 20013, San Sebastián, Spain. Electronic address: JONEMIREN.ALTZIBARAROTZENA@osakidetza.eus. 6. Grupo de Investigación en Interacciones Gen-Ambiente y Salud, Universidad de León, Campus Vegazana, s/n, 24071, León, Spain. Electronic address: vicente.martin@unileon.es. 7. Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain; ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Carrer del Doctor Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Carrer del Doctor Aiguader 88, 08003, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Carrer del Doctor Aiguader 88, 08003, Barcelona, Spain. Electronic address: gemma.castano@isglobal.orgl. 8. Early Detection Section, Public Health Institute of Navarra, Calle Leyre 15, 31003, Pamplona, Spain. Electronic address: mguevare@cfnavarra.es. 9. Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain; Universidad de Cantabria - IDIVAL, Avenida Cardenal Herrera Oria s/n, 39011 Santander, Spain. Electronic address: dierssent@unican.es. 10. Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain; Instituto Universitario de Oncología, Universidad de Oviedo, Facultad de Medicina, Planta 7, Campus de El Cristo B, 33006, Oviedo, Spain. Electronic address: atardon@uniovi.es. 11. Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain; IDIBELL-Catalan Institute of Oncology, Gran Via km 2.7, 08907, L'Hospitalet de Llobregat, Spain; Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Campus de Bellvitge, Pavelló de Govern, Feixa Llarga s/n, 08907, L'Hospitalet del Llobregat, Spain. Electronic address: v.moreno@iconcologia.net. 12. Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Girona Biomedical Research Institute (IdiBGi), Carrer del Sol 15, 17004 Girona, Spain. Electronic address: mpuig.icogirona@gmail.com. 13. Centro de Salud Pública de Dénia, Consellería de Sanidad Universal y Salud Pública, Plaza Jaime I, 5, 03700, Denia, Spain; Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (FISABIO), Avda. Cataluña, 21, 46020, Valencia, Spain. Electronic address: llorens_cri@gva.es. 14. Centro de Investigación en Salud y Medio Ambiente (CYSMA), Universidad de Huelva, Campus Universitario de El Carmen, 21071, Huelva, Spain. Electronic address: alguacil@dbasp.uhu.es. 15. Universidad de Cantabria - IDIVAL, Avenida Cardenal Herrera Oria s/n, 39011 Santander, Spain. Electronic address: ines.gomez@unican.es. 16. Early Detection Section, Public Health Institute of Navarra, Calle Leyre 15, 31003, Pamplona, Spain. Electronic address: jesus.castilla.catalan@cfnavarra.es. 17. Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain; ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Carrer del Doctor Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Carrer del Doctor Aiguader 88, 08003, Barcelona, Spain. Electronic address: esther.gracia@isglobal.org. 18. Grupo de Investigación en Interacciones Gen-Ambiente y Salud, Universidad de León, Campus Vegazana, s/n, 24071, León, Spain. Electronic address: vdavb@unileon.es. 19. Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain; ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Carrer del Doctor Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Carrer del Doctor Aiguader 88, 08003, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Carrer del Doctor Aiguader 88, 08003, Barcelona, Spain. Electronic address: manolis.kogevinas@isglobal.org. 20. Cancer Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain; Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Manuel de Falla 1, 28222, Madrid, Spain. Electronic address: naragones@isciii.es. 21. Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain; Public Health Department of Gipuzkoa, Government of the Basque Country, Avenida Navarra, 4, 20013, San Sebastian, Spain; Biodonostia Research Institute, Paseo Dr Beguiristain s/n, 20014, San Sebastian, Spain. Electronic address: epicss-san@ej-gv.es. 22. Cancer Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain; Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Manuel de Falla 1, 28222, Madrid, Spain. Electronic address: mpollan@isciii.es.
Abstract
OBJECTIVE: To externally validate the previously identified effect on breast cancer risk of the Western, Prudent and Mediterranean dietary patterns. STUDY DESIGN: MCC-Spain is a multicase-control study that collected epidemiological information on 1181 incident cases of female breast cancer and 1682 healthy controls from 10 Spanish provinces. Three dietary patterns derived in another Spanish case-control study were analysed in the MCC-Spain study. These patterns were termed Western (high intakes of fatty and sugary products and red and processed meat), Prudent (high intakes of low-fat dairy products, vegetables, fruits, whole grains and juices) and Mediterranean (high intake of fish, vegetables, legumes, boiled potatoes, fruits, olives, and vegetable oil, and a low intake of juices). Their association with breast cancer was assessed using logistic regression models with random province-specific intercepts considering an interaction with menopausal status. Risk according to tumour subtypes - based on oestrogen (ER), progesterone (PR) and human epidermal growth factor 2 (HER2) receptors (ER+/PR+ & HER2-; HER2+; ER-/PR- & HER2-) - was evaluated with multinomial regression models. MAIN OUTCOME MEASURES: Breast cancer and histological subtype. RESULTS: Our results confirm most of the associations found in the previous case-control study. A high adherence to the Western dietary pattern seems to increase breast cancer risk in both premenopausal women (OR4thvs.1stquartile (95% CI):1.68 (1.02;2.79); OR1SD-increase (95% CI):1.19 (1.02;1.40)) and postmenopausal women (OR4thvs.1stquartile(95% CI):1.48(1.07;2.05); OR1SD-increase(95% CI): 1.14 (1.01;1.29)). While high adherence to the Prudent pattern did not show any effect on breast cancer, the Mediterranean dietary pattern seemed to be protective, but only among postmenopausal women (OR4thvs.1stquartile (95% CI): 0.72 (95% CI 0.53;0.98); p-int=0.075). There were no significant differences by tumour subtype. CONCLUSION: Dietary recommendations based on a departure from the Western dietary pattern in favour of the Mediterranean diet could reduce breast cancer risk in the general population.
OBJECTIVE: To externally validate the previously identified effect on breast cancer risk of the Western, Prudent and Mediterranean dietary patterns. STUDY DESIGN: MCC-Spain is a multicase-control study that collected epidemiological information on 1181 incident cases of female breast cancer and 1682 healthy controls from 10 Spanish provinces. Three dietary patterns derived in another Spanish case-control study were analysed in the MCC-Spain study. These patterns were termed Western (high intakes of fatty and sugary products and red and processed meat), Prudent (high intakes of low-fat dairy products, vegetables, fruits, whole grains and juices) and Mediterranean (high intake of fish, vegetables, legumes, boiled potatoes, fruits, olives, and vegetable oil, and a low intake of juices). Their association with breast cancer was assessed using logistic regression models with random province-specific intercepts considering an interaction with menopausal status. Risk according to tumour subtypes - based on oestrogen (ER), progesterone (PR) and human epidermal growth factor 2 (HER2) receptors (ER+/PR+ & HER2-; HER2+; ER-/PR- & HER2-) - was evaluated with multinomial regression models. MAIN OUTCOME MEASURES: Breast cancer and histological subtype. RESULTS: Our results confirm most of the associations found in the previous case-control study. A high adherence to the Western dietary pattern seems to increase breast cancer risk in both premenopausal women (OR4thvs.1stquartile (95% CI):1.68 (1.02;2.79); OR1SD-increase (95% CI):1.19 (1.02;1.40)) and postmenopausal women (OR4thvs.1stquartile(95% CI):1.48(1.07;2.05); OR1SD-increase(95% CI): 1.14 (1.01;1.29)). While high adherence to the Prudent pattern did not show any effect on breast cancer, the Mediterranean dietary pattern seemed to be protective, but only among postmenopausal women (OR4thvs.1stquartile (95% CI): 0.72 (95% CI 0.53;0.98); p-int=0.075). There were no significant differences by tumour subtype. CONCLUSION: Dietary recommendations based on a departure from the Western dietary pattern in favour of the Mediterranean diet could reduce breast cancer risk in the general population.
Authors: Jessica Alonso-Molero; Antonio J Molina; Jose Juan Jiménez-Moleón; Beatriz Pérez-Gómez; Vicente Martin; Victor Moreno; Pilar Amiano; Eva Ardanaz; Silvia de Sanjose; Inmaculada Salcedo; Guillermo Fernandez-Tardon; Juan Alguacil; Dolores Salas; Rafael Marcos-Gragera; Maria Dolores Chirlaque; Nuria Aragonés; Gemma Castaño-Vinyals; Marina Pollán; Manolis Kogevinas; Javier Llorca Journal: BMJ Open Date: 2019-11-21 Impact factor: 2.692
Authors: María Ángeles Ávila-Gálvez; Juan Antonio Giménez-Bastida; Juan Carlos Espín; Antonio González-Sarrías Journal: Int J Mol Sci Date: 2020-08-10 Impact factor: 5.923