Nutrient-wide association study of 92 foods and nutrients and breast cancer risk

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Abstract
Background: Several dietary factors have been reported to be associated with risk of breast cancer, but to date, unequivocal evidence only exists for alcohol consumption. We sought to systematically assess the association between intake of 92 foods and nutrients and breast cancer risk using a nutrient-wide association study.Methods: Using data from 272,098 women participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, we assessed dietary intake of 92 foods and nutrients estimated by dietary questionnaires. Cox regression was used to quantify the association between each food/nutrient and risk of breast cancer. A false discovery rate (FDR) of 0.05 was used to select the set of foods and nutrients to be replicated in the independent Netherlands Cohort Study (NLCS).Results: Six foods and nutrients were identified as associated with risk of breast cancer in the EPIC study (10,979 cases). Higher intake of alcohol overall was associated with a higher risk of breast cancer (hazard ratio (HR) for a 1 SD increment in intake = 1.05, 95% CI 1.03–1.07), as was beer/cider intake and wine intake (HRs per 1 SD increment = 1.05, 95% CI 1.03–1.06 and 1.04, 95% CI 1.02–1.06, respectively), whereas higher intakes of fibre, apple/pear, and carbohydrates were associated with a lower risk of breast cancer (HRs per 1 SD increment = 0.96, 95% CI 0.94–0.98; 0.96, 95% CI 0.94–0.99; and 0.96, 95% CI 0.95–0.98, respectively). When evaluated in the NLCS (2368 cases), estimates for each of these foods and nutrients were similar in magnitude and direction, with the exception of beer/cider intake, which was not associated with risk in the NLCS.Conclusions: Our findings confirm a positive association of alcohol consumption and suggest an inverse association of dietary fibre and possibly fruit intake with breast cancer risk.
Funding Information
  • World Cancer Research Fund (WCRF 2014/1180)
  • European Commission (Not applicable)
  • Centre International de Recherche sur le Cancer (Not applicable)
  • Danish Cancer Society (Not applicable)
  • Ligue Contre le Cancer (Not applicable)
  • Institut Gustave-Roussy (Not applicable)
  • Mutuelle Générale de l'Education Nationale (Not applicable)
  • Institut National de la Santé et de la Recherche Médicale (Not applicable)
  • Deutsche Krebshilfe (Not applicable)
  • Deutsches Krebsforschungszentrum (Not applicable)
  • Bundesministerium für Forschung, Technologie und Raumfahrt (Not applicable)
  • Hellenic Health Foundation (Not applicable)
  • Associazione Italiana per la Ricerca sul Cancro (Not applicable)
  • Consiglio Nazionale delle Ricerche (Not applicable)
  • Ministerie van Volksgezondheid, Welzijn en Sport (Not applicable)
  • Netherlands Cancer Registry (Not applicable)
  • LK Research Funds (Not applicable)
  • Dutch Prevention Funds (Not applicable)
  • Dutch ZON (Not applicable)
  • Wereld Kanker Onderzoek Fonds (Not applicable)
  • Statistics Netherlands (Not applicable)
  • Health Research Fund (FIS) Spain (Not applicable)
  • Instituto de Salud Carlos III (Not applicable)
  • Regional Governments of Andalucía, Asturias, Basque Country, Murcia, Navarra (Not applicable)
  • Catalan Institute of Oncology (Not applicable)
  • Cancerfonden (Not applicable)
  • Vetenskapsrådet (Not applicable)
  • County Councils of Skåne and Västerbotten (Not applicable)
  • Cancer Research UK (14136, C570/A16491, C8221/A19170)
  • Medical Research Council (1000143, MR/M012190/1)

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