Spanish Mediterranean diet and other dietary patterns and breast cancer risk: Case-control EpiGEICAM study
Open accessAbstract
BACKGROUND: Although there are solid findings regarding the detrimental effect of alcohol consumption, the existing evidence on the effect of other dietary factors on breast cancer (BC) risk is inconclusive. This study aimed to evaluate the association between dietary patterns and risk of BC in Spanish women, stratifying by menopausal status and tumour subtype, and to compare the results with those of Alternate Healthy Index (AHEI) and Alternate Mediterranean Diet Score (aMED). METHODS: We recruited 1017 incident BC cases and 1017 matched healthy controls of similar age (±5 years) without a history of BC. The association between 'a priori' and 'a posteriori' developed dietary patterns and BC in general and according to menopausal status and intrinsic tumour subtypes (ER+/PR+ and HER2-; HER2+; and ER-/PR- and HER2-) was evaluated using logistic and multinomial regression models. RESULTS: Adherence to the Western dietary pattern was related to higher risk of BC (OR for the top vs the bottom quartile 1.46 (95% CI 1.06-2.01)), especially in premenopausal women (OR=1.75; 95% CI 1.14-2.67). In contrast, the Mediterranean pattern was related to a lower risk (OR for the top quartile vs the bottom quartile 0.56 (95% CI 0.40-0.79)). Although the deleterious effect of the Western pattern was similarly observed in all tumour subtypes, the protective effect of our Mediterranean pattern was stronger for triple-negative tumours (OR=0.32; 95% CI 0.15-0.66 and Pheterogeneity=0.04). No association was found between adherence to the Prudent pattern and BC risk. The associations between 'a priori' indices and BC risk were less marked (OR for the top vs the bottom quartile of AHEI=0.69; 95% CI 0.51-0.94 and aMED=0.74; 95% CI 0.46-1.18)). CONCLUSIONS: Our results confirm the harmful effect of a Western diet on BC risk, and add new evidence on the benefits of a diet rich in fruits, vegetables, legumes, oily fish and vegetable oils for preventing all BC subtypes, and particularly triple-negative tumours.
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In the same Spanish case-control study, adherence to a Western dietary pattern was associated with higher breast cancer risk (OR 1.46, 95% CI 1.06-2.01), especially in premenopausal women.
“whereas adherence to a Western dietary pattern was related to a higher risk [OR for the top vs the bottom quartile 1.46 (95% CI 1.06–2.01)], especially in premenopausal women.”
From Mediterranean diet nutrients to turn the tide against insulin resistance and related diseases (2020) · cites this paper as [158]
In a Spanish case-control study, adherence to the MedDiet was associated with lower breast cancer risk (OR 0.56, 95% CI 0.40-0.79 for top vs bottom quartile).
“In a case-control Spanish study [158], adherence to the MedDiet was related to a lower risk [odds ratio (OR) for the top quartile vs. the bottom quartile 0.56 (95% confidence interval (CI) 0.40–0.79)] of breast cancer/overall risk for the top quartile vs. the bottom quartile 0.56 (95% CI 0.40–0.79)”
From Mediterranean diet nutrients to turn the tide against insulin resistance and related diseases (2020) · cites this paper as [158]
Higher consumption of fruits, vegetables, legumes, oily fish, and EVOO significantly decreased the risk of mammary neoplasms, particularly the triple-negative (ER-, PR-, HER2-) subtype.
“Higher consumption of fruits, vegetables, legumes, oily fish, and EVOO significantly decreased the risk of mammary neoplasms, and in particular the most aggressive triple-negative (ER-, PR- and HER2-) subtype [158].”
From Mediterranean diet nutrients to turn the tide against insulin resistance and related diseases (2020) · cites this paper as [158]
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References 46 · Cited by 182
- Authors
- Castelló, A., Pollán, M., Buijsse, B., Ruiz, A., Casas, A. M., Baena-Cañada, J. M., Lope, V, Antolín, S., Ramos, M., Muñoz, M., Lluch, A., de Juan-Ferré, A., Jara, C., Jimeno, M. A., Rosado, P., Díaz, E., Guillem, V, Carrasco, E., Pérez-Gómez, B., Vioque, J., Boeing, H., & Martín, M.
- Affiliations
- Instituto de Salud Carlos III (ES)
- German Institute of Human Nutrition (DE)
- Hospital Universitario Virgen del Rocío (ES)
- Hospital Universitario Puerta del Mar (ES)
- Complexo Hospitalario Universitario A Coruña (ES)
- Centro Oncológico de Galicia (ES)
- Universitat de València (ES)
- Hospital Universitario Fundación Alcorcón (ES)
- GEICAM – Spanish Breast Cancer Group (ES)
- Universidad Complutense de Madrid (ES)
- Corresponding author
- Pollán, M
- ORCID
- Venue
- British Journal of Cancer
- Published
- 2014-08-07
- Volume
- 111
- Issue
- 7
- Pages
- 1454-1462
- ISSN
- 0007-0920 (ISSN-L)
- 1532-1827
- PMC
- PMC4183855
- OpenAlex
- W1986766753
- Cited by
- 182
- References
- 46
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 12 · 2023: 18 · 2022: 22 · 2021: 19 · 2020: 21 · 2019: 15 · 2018: 20 · 2017: 14 · 2016: 10 · 2015: 17 · 2014: 2
- FWCI
- 14.20
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- British Journal of Cancer (publishedVersion, cc-by-nc-sa)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-sa)
- PubMed Central (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, cc-by-nc-sa)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, other-oa)
- Repository of Digital Objects for Teaching Research and Culture (University of Valencia) (submittedVersion, cc-by-nc)
- RUNA. Repositorio Institucional del Sergas (Servicio Gallego de Salud (SERGAS)) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Oncology › Cancer Risks and Factors
- Health Sciences › Medicine › Physiology › Dietary Effects on Health
- Keywords
- breast cancer risk, dietary habits, Mediterranean diet, Western diet, prudent diet, Alternative Healthy Eating Index, alternate Mediterranean diet score, menopausal status, triple-negative breast cancer, breast cancer subtypes, alcohol consumption, dietary prevention, Spanish women, Fabaceae, oily fish, vegetable oils, fruits and vegetables, hormone receptor status, HER2 status
- MeSH terms
- Female, Humans, Risk, Spain, Incidence, Case-Control Studies, Diet, Mediterranean, Triple Negative Breast Neoplasms
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