Dietary Constituents: Relationship with Breast Cancer Prognostic (MCC-SPAIN Follow-Up)

Trinidad Dierssen-Sotos, Inés Gómez-Acebo, Nuria Gutiérrez-Ruiz, Nuria Aragonés, Pilar Amiano, Antonio José Molina de la Torre, Marcela Guevara, Jessica Alonso-Molero, Mireia Obon-Santacana, Guillermo Fernández-Tardón, Ana Molina-Barceló, Juan Alguacil, Rafael Marcos-Gragera, Paz Rodríguez-Cundín, Gemma Castaño-Vinyals, Rosario Canseco Fernandez, Jesús Castilla, Amaia Molinuevo, Beatriz Pérez-Gómez, Manolis Kogevinas, Marina Pollán and Javier Llorca
Additional contact information
Trinidad Dierssen-Sotos: Consortium for Biomedical Research in Epidemiology and Public Health (CIBER de Epidemiología Y Salud Pública-CIBERESP), 28029 Madrid, Spain
Inés Gómez-Acebo: Consortium for Biomedical Research in Epidemiology and Public Health (CIBER de Epidemiología Y Salud Pública-CIBERESP), 28029 Madrid, Spain
Nuria Gutiérrez-Ruiz: Faculty of Medicine, University of Cantabria, 39011 Santander, Spain
Nuria Aragonés: Consortium for Biomedical Research in Epidemiology and Public Health (CIBER de Epidemiología Y Salud Pública-CIBERESP), 28029 Madrid, Spain
Pilar Amiano: Consortium for Biomedical Research in Epidemiology and Public Health (CIBER de Epidemiología Y Salud Pública-CIBERESP), 28029 Madrid, Spain
Antonio José Molina de la Torre: Consortium for Biomedical Research in Epidemiology and Public Health (CIBER de Epidemiología Y Salud Pública-CIBERESP), 28029 Madrid, Spain
Marcela Guevara: Consortium for Biomedical Research in Epidemiology and Public Health (CIBER de Epidemiología Y Salud Pública-CIBERESP), 28029 Madrid, Spain
Jessica Alonso-Molero: Consortium for Biomedical Research in Epidemiology and Public Health (CIBER de Epidemiología Y Salud Pública-CIBERESP), 28029 Madrid, Spain
Mireia Obon-Santacana: Consortium for Biomedical Research in Epidemiology and Public Health (CIBER de Epidemiología Y Salud Pública-CIBERESP), 28029 Madrid, Spain
Guillermo Fernández-Tardón: Consortium for Biomedical Research in Epidemiology and Public Health (CIBER de Epidemiología Y Salud Pública-CIBERESP), 28029 Madrid, Spain
Ana Molina-Barceló: Cancer and Public Health Area, FISABIO—Public Health, 46020 Valencia, Spain
Juan Alguacil: Consortium for Biomedical Research in Epidemiology and Public Health (CIBER de Epidemiología Y Salud Pública-CIBERESP), 28029 Madrid, Spain
Rafael Marcos-Gragera: Consortium for Biomedical Research in Epidemiology and Public Health (CIBER de Epidemiología Y Salud Pública-CIBERESP), 28029 Madrid, Spain
Paz Rodríguez-Cundín: IDIVAL Santander, 39011 Santander, Spain
Gemma Castaño-Vinyals: Consortium for Biomedical Research in Epidemiology and Public Health (CIBER de Epidemiología Y Salud Pública-CIBERESP), 28029 Madrid, Spain
Rosario Canseco Fernandez: Servicio de Cirugía General y del Aparato Digestivo, Complejo Asistencial Universitario de León, 24001 León, Spain
Jesús Castilla: Consortium for Biomedical Research in Epidemiology and Public Health (CIBER de Epidemiología Y Salud Pública-CIBERESP), 28029 Madrid, Spain
Amaia Molinuevo: Consortium for Biomedical Research in Epidemiology and Public Health (CIBER de Epidemiología Y Salud Pública-CIBERESP), 28029 Madrid, Spain
Beatriz Pérez-Gómez: Consortium for Biomedical Research in Epidemiology and Public Health (CIBER de Epidemiología Y Salud Pública-CIBERESP), 28029 Madrid, Spain
Manolis Kogevinas: Consortium for Biomedical Research in Epidemiology and Public Health (CIBER de Epidemiología Y Salud Pública-CIBERESP), 28029 Madrid, Spain
Marina Pollán: Consortium for Biomedical Research in Epidemiology and Public Health (CIBER de Epidemiología Y Salud Pública-CIBERESP), 28029 Madrid, Spain
Javier Llorca: Consortium for Biomedical Research in Epidemiology and Public Health (CIBER de Epidemiología Y Salud Pública-CIBERESP), 28029 Madrid, Spain

IJERPH, 2020, vol. 18, issue 1, 1-17

Abstract: The aim of this study was to characterize the relationship between the intake of the major nutrients and prognosis in breast cancer. A cohort based on 1350 women with invasive (stage I-IV) breast cancer (BC) was followed up. Information about their dietary habits before diagnosis was collected using a semi-quantitative Food Frequency Questionnaire. Participants without FFQ or with implausible energy intake were excluded. The total amount consumed of each nutrient (Kcal/day) was divided into tertiles, considering as “high intakes” those above third tertile. The main effect studied was overall survival. Cox regression was used to assess the association between death and nutrient intake. During a median follow-up of 6.5 years, 171 deaths were observed. None of the nutrients analysed was associated with mortality in the whole sample. However, in normal-weight women (BMI 18.5–25 kg/m 2 ) a high intake of carbohydrates (≥809 Kcal/day), specifically monosaccharides (≥468 Kcal/day), worsened prognostic compared to lowest (≤352 Kcal/day). Hazard Ratios (HRs) for increasing tertiles of intake were HR:2.22 95% CI (1.04 to 4.72) and HR:2.59 95% CI (1.04 to 6.48), respectively ( p trend = 0.04)). Conversely, high intakes of polyunsaturated fats (≥135 Kcal/day) improved global survival (HR: 0.39 95% CI (0.15 to 1.02) p -trend = 0.05) compared to the lowest (≤92.8 kcal/day). In addition, a protective effect was found substituting 100 kcal of carbohydrates with 100 kcal of fats in normal-weight women (HR: 0.76 95% CI (0.59 to 0.98)). Likewise, in premenopausal women a high intake of fats (≥811 Kcal/day) showed a protective effect (HR:0.20 95% CI (0.04 to 0.98) p trend = 0.06). Finally, in Estrogen Receptors (ER) negative tumors, we found a protective effect of high intake of animal proteins (≥238 Kcal/day, HR: 0.24 95% CI (0.06 to 0.98). According to our results, menopausal status, BMI and ER status could play a role in the relationship between diet and BC survival and must be taken into account when studying the influence of different nutrients.

Keywords: breast cancer; dietary nutrients; overall survival; prognosis; mortality (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:18:y:2020:i:1:p:84-:d:467774

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