Andrea Romanos-Nanclares1, Alfredo Gea2, Miguel Ángel Martínez-González3, Itziar Zazpe4, Itziar Gardeazabal5, Cesar I Fernandez-Lazaro1, Estefanía Toledo6. 1. University of Navarra, Department of Preventive Medicine and Public Health, Pamplona, Spain; Navarra Institute for Health Research (IdisNA), Pamplona, Spain. 2. University of Navarra, Department of Preventive Medicine and Public Health, Pamplona, Spain; Navarra Institute for Health Research (IdisNA), Pamplona, Spain; CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III (ISCIII), Madrid, Spain. Electronic address: ageas@unav.es. 3. University of Navarra, Department of Preventive Medicine and Public Health, Pamplona, Spain; Navarra Institute for Health Research (IdisNA), Pamplona, Spain; CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III (ISCIII), Madrid, Spain; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, USA. 4. University of Navarra, Department of Preventive Medicine and Public Health, Pamplona, Spain; Navarra Institute for Health Research (IdisNA), Pamplona, Spain; CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III (ISCIII), Madrid, Spain; Department of Nutrition and Food Sciences and Physiology, University of Navarra, Pamplona, Spain. 5. Department of Medical Oncology, Marqués de Valdecilla University Hospital, Santander, Spain. 6. University of Navarra, Department of Preventive Medicine and Public Health, Pamplona, Spain; Navarra Institute for Health Research (IdisNA), Pamplona, Spain; CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III (ISCIII), Madrid, Spain.
Abstract
BACKGROUND & AIMS: Beyond the quantity of carbohydrate intake, further research is needed on the relevance of carbohydrate quality. Thus, we evaluated the association between an a priori defined carbohydrate quality index (CQI) and the incidence of breast cancer (BC) in a Mediterranean cohort study. METHODS: We used a validated semi-quantitative 136-item food-frequency questionnaire (FFQ) in a prospective follow-up study of 10,812 middle-aged women. We evaluated at baseline the CQI following 4 criteria: dietary fiber intake, glycemic index, whole-grain:total-grain carbohydrates ratio and the solid carbohydrate:total carbohydrate ratio. Subjects were classified into quartiles according to the final CQI score. RESULTS: During a median follow-up of 11.8 years, we confirmed 101 incident cases of BC. Our study suggests that a higher quality of carbohydrate intake, as measured by the baseline CQI, was associated with a lower risk of BC [HR Q4 vs. Q1 0.39 (95% CI 0.17, 0.87)]. Particularly, a higher whole-grain:total-grain carbohydrates ratio was associated with lower risk of BC [HR T3 vs. T1 0.56 (0.34, 0.90)]. When we stratified by menopausal status, we found an inverse association between CQI and BC in the comparison of extreme quartiles among premenopausal women. CONCLUSIONS: In this Mediterranean cohort, a better quality of dietary carbohydrate intake showed a significant inverse association with the incidence of BC, which suggests that strategies for cancer prevention should highlight the quality of this macronutrient.
BACKGROUND & AIMS: Beyond the quantity of carbohydrate intake, further research is needed on the relevance of carbohydrate quality. Thus, we evaluated the association between an a priori defined carbohydrate quality index (CQI) and the incidence of breast cancer (BC) in a Mediterranean cohort study. METHODS: We used a validated semi-quantitative 136-item food-frequency questionnaire (FFQ) in a prospective follow-up study of 10,812 middle-aged women. We evaluated at baseline the CQI following 4 criteria: dietary fiber intake, glycemic index, whole-grain:total-grain carbohydrates ratio and the solid carbohydrate:total carbohydrate ratio. Subjects were classified into quartiles according to the final CQI score. RESULTS: During a median follow-up of 11.8 years, we confirmed 101 incident cases of BC. Our study suggests that a higher quality of carbohydrate intake, as measured by the baseline CQI, was associated with a lower risk of BC [HR Q4 vs. Q1 0.39 (95% CI 0.17, 0.87)]. Particularly, a higher whole-grain:total-grain carbohydrates ratio was associated with lower risk of BC [HR T3 vs. T1 0.56 (0.34, 0.90)]. When we stratified by menopausal status, we found an inverse association between CQI and BC in the comparison of extreme quartiles among premenopausal women. CONCLUSIONS: In this Mediterranean cohort, a better quality of dietary carbohydrate intake showed a significant inverse association with the incidence of BC, which suggests that strategies for cancer prevention should highlight the quality of this macronutrient.
Authors: Rocío Zamanillo-Campos; Alice Chaplin; Dora Romaguera; Itziar Abete; Jordi Salas-Salvadó; Vicente Martín; Ramón Estruch; Josep Vidal; Miguel Ruiz-Canela; Nancy Babio; Francisca Fiol; José Antonio de Paz; Rosa Casas; Romina Olbeyra; Miguel A Martínez-González; Jesús F García-Gavilán; Albert Goday; Cesar I Fernandez-Lazaro; J Alfredo Martínez; Frank B Hu; Jadwiga Konieczna Journal: Clin Nutr Date: 2022-08-20 Impact factor: 7.643
Authors: Cesar I Fernandez-Lazaro; Miguel Ángel Martínez-González; Inmaculada Aguilera-Buenosvinos; Alfredo Gea; Miguel Ruiz-Canela; Andrea Romanos-Nanclares; Estefanía Toledo Journal: Antioxidants (Basel) Date: 2021-02-24