Abstract
Background
A healthy Nordic dietary pattern has shown beneficial effects in relation to several chronic diseases. However, no study has evaluated the association between a healthy Nordic food index (HNFI) and risk of breast cancer.
Methods
We conducted a prospective cohort study including 44,296 women, aged 29–49 at baseline in 1991–1992, who completed a food frequency questionnaire at baseline, and have been followed up ever since, through the Swedish Cancer Registry and Cause of Death Registry. Each woman was assigned a HNFI score ranging from 0 to 6. We calculated multivariable relative risks (RRs) and 95 % confidence intervals (CIs) using Poisson regression models with attained age as the underlying timescale. The association between the HNFI and risk of breast cancer was assessed both overall, by menopausal status and by hormone receptor status.
Results
A total of 1,464 breast cancer cases were diagnosed during a median follow-up time of 20 years. A higher adherence to the HNFI was not associated with a lower risk of breast cancer overall, nor of varied hormone receptor status, or when we examining premenopausal and postmenopausal women separately. The multivariable RRs (95 % CI) for breast cancer per 1-point increment in the HNFI were 1.02 (95 % CI 0.98–1.06) for all women, 1.01 (95 % CI 0.95–1.08) for premenopausal women, and 1.02 (95 % CI 0.97–1.07) for postmenopausal women.
Conclusion
Adherence to a HNFI was not associated with breast cancer incidence in this cohort of relatively young women, regardless of menopausal status or hormone receptor status.
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References
Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, Rosso S, Coebergh J, Comber H, Forman D, Bray F (2013) Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. Eur J Cancer 49:1374–1403
Duncan AM (2004) The role of nutrition in the prevention of breast cancer. AACN Adv Crit Care 15:119–135
Hanf V, Gonder U (2005) Nutrition and primary prevention of breast cancer: foods, nutrients and breast cancer risk. Eur J Obstet Gynecol Reprod Biol 123:139–149
Fung TT, Chiuve SE, Willett WC, Hankinson SE, Hu FB, Holmes MD (2013) Intake of specific fruits and vegetables in relation to risk of estrogen receptor-negative breast cancer among postmenopausal women. Breast Cancer Res Treat 138:925–930
World Cancer Research Fund / American Institute for Cancer Research (2010) Continuous update report summary: food, nutrition, physical activity, and the prevention of breast cancer
Hu FB (2002) Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol 13:3–9
Buckland G, Travier N, Cottet V, González C, Luján-Barroso L, Agudo A, Trichopoulou A, Lagiou P, Trichopoulos D, Peeters P (2013) Adherence to the mediterranean diet and risk of breast cancer in the European prospective investigation into cancer and nutrition cohort study. Int J Cancer 132:2918–2927
Brennan SF, Cantwell MM, Cardwell CR, Velentzis LS, Woodside JV (2010) Dietary patterns and breast cancer risk: a systematic review and meta-analysis. Am J Clin Nutr 91:1294–1302
Sofi F, Abbate R, Gensini GF, Casini A (2010) Accruing evidence on benefits of adherence to the Mediterranean diet on health: an updated systematic review and meta-analysis. Am J Clin Nutr 92:1189–1196
Mithril C, Dragsted LO, Meyer C, Blauert E, Holt MK, Astrup A (2012) Guidelines for the new Nordic diet. Public Health Nutr 15:1941–1947
Bere E, Brug J (2009) Towards health-promoting and environmentally friendly regional diets—a Nordic example. Public Health Nutr 12:91–96
Olsen A, Egeberg R, Halkjær J, Christensen J, Overvad K, Tjønneland A (2011) Healthy aspects of the Nordic diet are related to lower total mortality. J Nutr 141:639–644
Hillesund ER, Øverby NC, Engel SM, Klungsøyr K, Harmon QE, Haugen M, Bere E (2014) Associations of adherence to the New Nordic Diet with risk of preeclampsia and preterm delivery in the Norwegian Mother and Child Cohort Study (MoBa). Eur J Epidemiol 29:753–765
Kanerva N, Loo B-M, Eriksson JG, Leiviskä J, Kaartinen NE, Jula A, Männistö S (2014) Associations of the Baltic Sea diet with obesity-related markers of inflammation. Ann Med 46:90–96
Kanerva N, Kaartinen NE, Schwab U, Lahti-Koski M, Männistö S (2013) Adherence to the Baltic Sea diet consumed in the Nordic countries is associated with lower abdominal obesity. Br J Nutr 109:520–528
Colditz GA, Rosner BA, Chen WY, Holmes MD, Hankinson SE (2004) Risk factors for breast cancer according to estrogen and progesterone receptor status. J Natl Cancer Inst 96:218–228
Brinton LA, Richesson D, Leitzmann MF, Gierach GL, Schatzkin A, Mouw T, Hollenbeck AR, Lacey JV (2008) Menopausal hormone therapy and breast cancer risk in the NIH-AARP Diet and Health Study Cohort. Cancer Epidemiol Biomarkers Prev 17:3150–3160
Kumle M, Weiderpass E, Braaten T, Persson I, Adami H-O, Lund E (2002) Use of oral contraceptives and breast cancer risk the Norwegian-Swedish women’s lifestyle and Health Cohort Study. Cancer Epidemiol Biomarkers Prev 11:1375–1381
Wolk A, Bergström R, Hunter D, Willett W, Ljung H, Holmberg L, Bergkvist L, Bruce Å, Adami H-O (1998) A prospective study of association of monounsaturated fat and other types of fat with risk of breast cancer. Arch Intern Med 158:41–45
Bergström L, Kylberg E, Hagman U, Erikson H, Bruce Å (1991) The food composition database KOST: the National Administration’s information system for nutritive values of food. Vår föda 43:439–447
Roswall N, Eriksson U, Sandin S, Löf M, Olsen A, Skeie G, Adami HO, Weiderpass E (2015) Adherence to the healthy Nordic Food Index, dietary composition, and lifestyle among Swedish women. Food Nutr Res. doi:10.3402/fnr.v59.26336
Weiderpass E, Sandin S, Lof M, Oh J-K, Inoue M, Shimazu T, Tsugane S, Adami H-O (2014) Endometrial cancer in relation to coffee, tea, and caffeine consumption: a prospective cohort study among middle-aged women in Sweden. Nutr Cancer 66:1132–1143
Sieri S, Krogh V, Pala V, Muti P, Micheli A, Evangelista A, Tagliabue G, Berrino F (2004) Dietary patterns and risk of breast cancer in the ORDET cohort. Cancer Epidemiol Biomarkers Prev 13:567–572
Hirose K, Matsuo K, Iwata H, Tajima K (2007) Dietary patterns and the risk of breast cancer in Japanese women. Cancer Sci 98:1431–1438
Ronco AL, De Stefani E, Boffetta P, Deneo-Pellegrini H, Acosta G, Mendilaharsu M (2006) Food patterns and risk of breast cancer: a factor analysis study in Uruguay. Int J Cancer 119:1672–1678
Velie EM, Schairer C, Flood A, He J-P, Khattree R, Schatzkin A (2005) Empirically derived dietary patterns and risk of postmenopausal breast cancer in a large prospective cohort study. Am J Clin Nutr 82:1308–1319
Fung TT, Hu FB, Holmes MD, Rosner BA, Hunter DJ, Colditz GA, Willett WC (2005) Dietary patterns and the risk of postmenopausal breast cancer. Int J Cancer 116:116–121
Zhang C-X, Ho SC, Fu J-H, Cheng S-Z, Chen Y-M, Lin F-Y (2011) Dietary patterns and breast cancer risk among Chinese women. Cancer Cause Control 22:115–124
Cottet V, Touvier M, Fournier A, Touillaud M, Lafay L, Clavel-Chapelon F, Boutron-Ruault M (2009) Postmenopausal breast cancer risk and dietary patterns in the E3N-EPIC prospective cohort study. Am J Epidemiol 170:1257–1267
Ma H, Bernstein L, Pike MC, Ursin G (2006) Reproductive factors and breast cancer risk according to joint estrogen and progesterone receptor status: a meta-analysis of epidemiological studies. Breast Cancer Res 8:R43
Link LB, Canchola AJ, Bernstein L, Clarke CA, Stram DO, Ursin G, Horn-Ross PL (2013) Dietary patterns and breast cancer risk in the California Teachers Study cohort. Am J Clin Nutr 98:1524–1532
Baglietto L, Krishnan K, Severi G, Hodge A, Brinkman M, English D, McLean C, Hopper J, Giles G (2010) Dietary patterns and risk of breast cancer. Br J Cancer 104:524–531
Michels KB, Mohllajee AP, Roset-Bahmanyar E, Beehler GP, Moysich KB (2007) Diet and breast cancer. Cancer 109:2712–2749
Borneo R, León AE (2012) Whole grain cereals: functional components and health benefits. Food Funct 3:110–119
Egeberg R, Olsen A, Loft S, Christensen J, Johnsen NF, Overvad K, Tjønneland A (2009) Intake of whole grain products and risk of breast cancer by hormone receptor status and histology among postmenopausal women. Int J Cancer 124:745–750
Higdon JV, Delage B, Williams DE, Dashwood RH (2007) Cruciferous vegetables and human cancer risk: epidemiologic evidence and mechanistic basis. Pharmacol Res 55:224–236
Johnson IT (2007) Phytochemicals and cancer. Proc Nutr Soc 66:207–215
Zheng J-S, Hu X-J, Zhao Y-M, Yang J, Li D (2013) Intake of fish and marine n-3 polyunsaturated fatty acids and risk of breast cancer: meta-analysis of data from 21 independent prospective cohort studies. BMJ 346:f3706
Couto E, Sandin S, Löf M, Ursin G, Adami H-O, Weiderpass E (2013) Mediterranean dietary pattern and risk of breast cancer. PLoS One 8:e55374
Thiebaut AC, Freedman LS, Carroll RJ, Kipnis V (2007) Is it necessary to correct for measurement error in nutritional epidemiology? Ann Intern Med 146:65–67
Alexander DD, Morimoto LM, Mink PJ, Cushing CA (2010) A review and meta-analysis of red and processed meat consumption and breast cancer. Nutr Res Rev 23:349–365
Åkesson A, Andersen LF, Kristjánsdottir AG, Roos E, Trolle E, Voutilainen E, Wirfält E (2013) Health effects associated with foods characteristic of the Nordic diet: a systematic literature review. Food Nutr Res. doi:10.3402/fnr.v57i0.22790
Willett WC, Stampfer MJ (2013) Current evidence on healthy eating. Annu Rev Public Health 34:77–95
Acknowledgments
This study was funded by the Swedish Cancer Society and the Swedish Research Council (Vetenskapsrådet) Grant K2012-69X-22062-01-3. The authors wish to thank data managers Pouran Almstedt for database administration.
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The authors declare that they have no conflict of interest.
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Li, Y., Roswall, N., Sandin, S. et al. Adherence to a healthy Nordic food index and breast cancer risk: results from a Swedish cohort study. Cancer Causes Control 26, 893–902 (2015). https://doi.org/10.1007/s10552-015-0564-x
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DOI: https://doi.org/10.1007/s10552-015-0564-x