Adherence to the mediterranean diet and risk of breast cancer in the European prospective investigation into cancer and nutrition cohort study
Adherence to the mediterranean diet and risk of breast cancer in the European prospective investigation into cancer and nutrition cohort study
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DOI：
10.1002/ijc.27958
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发表时间：
2013-06-15
影响因子：
6.4
通讯作者：
Riboli, E.
中科院分区：
文献类型：
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作者：
Buckland, G.;Travier, N.;Riboli, E.
流行病学证据表明，地中海饮食（MD）可以降低乳腺癌（BC）的风险。由于来自前瞻性研究的证据仍然缺乏且相互矛盾，我们调查了1992年至2000年在10个欧洲国家招募的335，062名女性中坚持MD与BC风险之间的关系，并平均随访11年。通过不含酒精的调整相对地中海饮食（arMED）评分来估计对MD的遵守情况。在调整BC风险因素时，使用考克斯比例风险回归模型。共确定了9，009例绝经后和1，216例绝经前首次原发性侵袭性BC（5，862例雌激素或孕激素受体阳性[ER+/PR+]和1，018例雌激素和孕激素受体阴性[ER/PR]）。arMED与总体和绝经后女性的BC风险呈负相关（高与低arMED评分;风险比[HR] = 0.94 [95%置信区间[CI]：0.88，1.00] ptrend = 0.048，HR = 0.93 [95% CI：0.87，0.99] ptrend = 0.037）。ER/PR肿瘤中的相关性更明显（HR = 0.80 [95% CI：0.65，0.99] ptrend = 0.043）。在绝经前妇女中，arMED评分与BC无关。我们的研究结果表明，坚持不饮酒的MD与绝经后妇女BC风险的适度降低有关，并且这种关联在受体阴性肿瘤中更强。结果支持通过饮食调整预防BC的潜在范围。
Epidemiological evidence suggests that the Mediterranean diet (MD) could reduce the risk of breast cancer (BC). As evidence from the prospective studies remains scarce and conflicting, we investigated the association between adherence to the MD and risk of BC among 335,062 women recruited from 1992 to 2000, in ten European countries, and followed for 11 years on average. Adherence to the MD was estimated through an adapted relative Mediterranean diet (arMED) score excluding alcohol. Cox proportional hazards regression models were used while adjusting for BC risk factors. A total of 9,009 postmenopausal and 1,216 premenopausal first primary incident invasive BC were identified (5,862 estrogen or progesterone receptor positive [ER+/PR+] and 1,018 estrogen and progesterone receptor negative [ER/PR]). The arMED was inversely associated with the risk of BC overall and in postmenopausal women (high vs. low arMED score; hazard ratio [HR] = 0.94 [95% confidence interval [CI]: 0.88, 1.00] ptrend = 0.048, and HR = 0.93 [95% CI: 0.87, 0.99] ptrend = 0.037, respectively). The association was more pronounced in ER/PR tumors (HR = 0.80 [95% CI: 0.65, 0.99] ptrend = 0.043). The arMED score was not associated with BC in premenopausal women. Our findings show that adherence to a MD excluding alcohol was related to a modest reduced risk of BC in postmenopausal women, and this association was stronger in receptor-negative tumors. The results support the potential scope for BC prevention through dietary modification.