0c82ffc76381ebe31ca0a65e703b41cb pmc_33374289.pdf 8642ca11d2be18ab09f2361b964c9bc254d3a3a9 pmc_33374289.pdf 9391c7834b384691d628db41fd738a383d67cc5929a7189656c74b521286db3b pmc_33374289.pdf Title: Dietary Constituents: Relationship with Breast Cancer Prognostic (MCC-SPAIN Follow-Up) Subject: The aim of this study was to characterize the relationship between the intake of the major nutrients and prognosis in breast cancer. A cohort based on 1350 women with invasive (stage I-IV) breast cancer (BC) was followed up. Information about their dietary habits before diagnosis was collected using a semi-quantitative Food Frequency Questionnaire. Participants without FFQ or with implausible energy intake were excluded. The total amount consumed of each nutrient (Kcal/day) was divided into tertiles, considering as “high intakes” those above third tertile. The main effect studied was overall survival. Cox regression was used to assess the association between death and nutrient intake. During a median follow-up of 6.5 years, 171 deaths were observed. None of the nutrients analysed was associated with mortality in the whole sample. However, in normal-weight women (BMI 18.5–25 kg/m2) a high intake of carbohydrates (809 Kcal/day), specifically monosaccharides (468 Kcal/day), worsened prognostic compared to lowest (352 Kcal/day). Hazard Ratios (HRs) for increasing tertiles of intake were HR:2.22 95% CI (1.04 to 4.72) and HR:2.59 95% CI (1.04 to 6.48), respectively (p trend = 0.04)). Conversely, high intakes of polyunsaturated fats (135 Kcal/day) improved global survival (HR: 0.39 95% CI (0.15 to 1.02) p-trend = 0.05) compared to the lowest (92.8 kcal/day). In addition, a protective effect was found substituting 100 kcal of carbohydrates with 100 kcal of fats in normal-weight women (HR: 0.76 95% CI (0.59 to 0.98)). Likewise, in premenopausal women a high intake of fats (811 Kcal/day) showed a protective effect (HR:0.20 95% CI (0.04 to 0.98) p trend = 0.06). Finally, in Estrogen Receptors (ER) negative tumors, we found a protective effect of high intake of animal proteins (238 Kcal/day, HR: 0.24 95% CI (0.06 to 0.98). According to our results, menopausal status, BMI and ER status could play a role in the relationship between diet and BC survival and must be taken into account when studying the influence of different nutrients. Keywords: breast cancer; dietary nutrients; overall survival; prognosis; mortality Author: Trinidad Dierssen-Sotos, Inés Gómez-Acebo, Nuria Gutiérrez-Ruiz, Nuria Aragonés, Pilar Amiano, Antonio José Molina de la Torre, Marcela Guevara, Jessica Alonso-Molero, Mireia Obon-Santacana, Guillermo Fernández-Tardón, Ana Molina-Barceló, Juan Alguacil, Rafael Marcos-Gragera, Paz Rodríguez-Cundín, Gemma Castaño-Vinyals, Rosario Canseco Fernandez, Jesús Castilla, Amaia Molinuevo, Beatriz Pérez-Gómez, Manolis Kogevinas, Marina Pollán and Javier Llorca Creator: LaTeX with hyperref package Producer: pdfTeX-1.40.18 CreationDate: Sun Jan 3 06:05:09 2021 CET ModDate: Sun Jan 3 06:22:30 2021 CET Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 17 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 2149275 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- XCDPUH+VnURWPalladioL Type 1 Custom yes yes no 10 0 YIOJUL+URWPalladioL-Ital Type 1 Custom yes yes no 15 0 VHTMPH+URWPalladioL-Bold Type 1 Custom yes yes no 20 0 ROUBJA+URWPalladioL-Roma Type 1 Custom yes yes no 24 0 DGBDNV+VnURWPalladioL-Bold Type 1 Custom yes yes no 28 0 LWQXII+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 36 0 IRWHZX+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 39 0 MCBCCI+SourceSansRoman-Regular Type 1C Custom yes yes no 61 0 MCBCCM+SourceSansRoman.613wght Type 1C Custom yes yes no 65 0 MCBCCO+SourceSansRoman-Bold Type 1C Custom yes yes no 69 0 VBAQIR+CMSY10 Type 1 Builtin yes yes no 81 0 CRJHCU+PazoMath-Italic Type 1 Builtin yes yes no 97 0 RFLZJB+CMR10 Type 1 Builtin yes yes no 101 0 WBVKDJ+URWPalladioL-BoldItal Type 1 Custom yes yes no 111 0 ABCDEE+Calibri TrueType WinAnsi yes yes no 123 0 ABCDEE+Calibri TrueType WinAnsi yes yes no 138 0 ABCDEE+Calibri TrueType WinAnsi yes yes no 153 0 SYVAVM+VnURWPalladioL-Italic Type 1 Custom yes yes no 179 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-01-31 02:33:39 CET RepresentationInformation: pmc_33374289.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2021-01-18 03:36:23 CET Size: 2149275 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 407 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Study Population Destination: subsection.2.1 Item: Title: Ethical Approval Destination: subsection.2.2 Item: Title: Dietary and Prognosis Factors Assessment Destination: subsection.2.3 Item: Title: Follow-Up and Ascertainment of Events Destination: subsection.2.4 Item: Title: Statistical Analysis Destination: subsection.2.5 Item: Title: Results Destination: section.3 Children: Item: Title: Relationship between Carbohydrate Intake and Overall Survival Destination: subsection.3.1 Item: Title: Relationship between Protein Intake and Overall Survival Destination: subsection.3.2 Item: Title: Relationship between Fat Intake and Overall Survival Destination: subsection.3.3 Item: Title: Effect of Substituting a Nutrient for Another Destination: subsection.3.4 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.5 Info: Title: Dietary Constituents: Relationship with Breast Cancer Prognostic (MCC-SPAIN Follow-Up) Author: Trinidad Dierssen-Sotos, Inés Gómez-Acebo, Nuria Gutiérrez-Ruiz, Nuria Aragonés, Pilar Amiano, Antonio José Molina de la Torre, Marcela Guevara, Jessica Alonso-Molero, Mireia Obon-Santacana, Guillermo Fernández-Tardón, Ana Molina-Barceló, Juan Alguacil, Rafael Marcos-Gragera, Paz Rodríguez-Cundín, Gemma Castaño-Vinyals, Rosario Canseco Fernandez, Jesús Castilla, Amaia Molinuevo, Beatriz Pérez-Gómez, Manolis Kogevinas, Marina Pollán and Javier Llorca Subject: The aim of this study was to characterize the relationship between the intake of the major nutrients and prognosis in breast cancer. A cohort based on 1350 women with invasive (stage I-IV) breast cancer (BC) was followed up. Information about their dietary habits before diagnosis was collected using a semi-quantitative Food Frequency Questionnaire. Participants without FFQ or with implausible energy intake were excluded. The total amount consumed of each nutrient (Kcal/day) was divided into tertiles, considering as “high intakes” those above third tertile. The main effect studied was overall survival. Cox regression was used to assess the association between death and nutrient intake. During a median follow-up of 6.5 years, 171 deaths were observed. None of the nutrients analysed was associated with mortality in the whole sample. However, in normal-weight women (BMI 18.5 25 kg/m2) a high intake of carbohydrates (809 Kcal/day), specifically monosaccharides (468 Kcal/day), worsened prognostic compared to lowest (352 Kcal/day). Hazard Ratios (HRs) for increasing tertiles of intake were HR:2.22 95% CI (1.04 to 4.72) and HR:2.59 95% CI (1.04 to 6.48), respectively (p trend = 0.04)). Conversely, high intakes of polyunsaturated fats (135 Kcal/day) improved global survival (HR: 0.39 95% CI (0.15 to 1.02) p-trend = 0.05) compared to the lowest (92.8 kcal/day). In addition, a protective effect was found substituting 100 kcal of carbohydrates with 100 kcal of fats in normal-weight women (HR: 0.76 95% CI (0.59 to 0.98)). Likewise, in premenopausal women a high intake of fats (811 Kcal/day) showed a protective effect (HR:0.20 95% CI (0.04 to 0.98) p trend = 0.06). Finally, in Estrogen Receptors (ER) negative tumors, we found a protective effect of high intake of animal proteins (238 Kcal/day, HR: 0.24 95% CI (0.06 to 0.98). According to our results, menopausal status, BMI and ER status could play a role in the relationship between diet and BC survival and must be taken into account when studying the influence of different nutrients. 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