Adherence to the Mediterranean Diet and Mortality after Breast Cancer.
Adherence to the Mediterranean Diet and Mortality after Breast Cancer.
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DOI：
10.3390/nu12123649
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发表时间：
2020-11-27
期刊：
影响因子：
5.9
通讯作者：
Polesel J
中科院分区：
文献类型：
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作者：
Di Maso M;Dal Maso L;Augustin LSA;Puppo A;Falcini F;Stocco C;Mattioli V;Serraino D;Polesel J
坚持地中海饮食一直与普通人群死亡率降低相关，但关于女性乳腺癌患者的证据却很少。方法：对 1991 年至 1994 年间在意大利北部诊断出的 1453 名乳腺癌女性进行了为期 15 年的生命状况随访。通过结构化调查问卷评估诊断前的习惯饮食，并通过地中海饮食评分评估对地中海饮食的依从性。使用 Cox 模型估计死亡风险比 (HR) 和置信区间 (CI)，并调整潜在的混杂因素。结果：与几乎不坚持地中海饮食的女性（n = 332，22.8%）相比，高度坚持地中海饮食的女性（n = 500，34.4%）报告碳水化合物、单不饱和和多不饱和脂肪酸、维生素、叶酸和类胡萝卜素的摄入量较高，胆固醇和动物蛋白的摄入量较低。坚持地中海饮食与更好的预后相关：高坚持地中海饮食的 15 年总生存率为 63.1%，低坚持地中海饮食的 15 年总生存率为 53.6%（p = 0.013）。对于 55 岁及以上女性，全因死亡率的 HR 为 0.72（95% CI：0.57−0.92），乳腺癌死亡率的 HR 为 0.65（95% CI：0.43−0.98）。在整个队列中，乳腺癌死亡率没有显着相关性。结论：虽然乳腺癌诊断后饮食习惯可能发生变化，但这些研究结果表明，与未诊断的女性相比，在诊断前按照地中海饮食模式饮食的女性在乳腺癌诊断后可能有更大的机会获得良好的预后。
Adherence to Mediterranean diet has been consistently associated with a reduced mortality in the general population, but evidence for women with breast cancer is scanty. Methods: A cohort of 1453 women with breast cancer diagnosed between 1991 and 1994 in northern Italy was followed-up for vital status for 15 years after diagnosis. The pre-diagnostic habitual diet was assessed through a structured questionnaire and adherence to the Mediterranean diet was evaluated through the Mediterranean Diet Score. Hazard ratios (HR) of death with confidence intervals (CI) were estimated using Cox model, adjusting for potential confounders. Results: Compared to women who scarcely adhere to the Mediterranean diet (n = 332, 22.8%), those highly adherent (n = 500, 34.4%) reported higher intakes of carbohydrates, mono-unsaturated and poly-unsaturated fatty acids, vitamins, folate, and carotenoids, and lower intakes of cholesterol and animal proteins. Adherence to the Mediterranean diet was associated with a better prognosis: 15-year overall survival of 63.1% for high and 53.6% for low adherence, respectively (p = 0.013). HR for all-cause mortality was 0.72 (95% CI: 0.57−0.92) and HR for breast cancer mortality was 0.65 (95% CI: 0.43−0.98) for women 55 years and older. No significant association emerged for breast cancer mortality in the total cohort. Conclusions: Although dietary habits may have changed after breast cancer diagnosis, these findings indicate that women who ate according to the Mediterranean dietary pattern prior to their diagnosis may have greater chance of a favorable prognosis after breast cancer diagnosis compared to those who did not.