Dietary Constituents : Relationship with Breast Cancer Prognostic (MCC-SPAIN Follow-Up)
Dierssen-Sotos, Trinidad (Faculty of Medicine, University of Cantabria)
Gomez-Acebo, Ines (Universidad de Cantabria)
Gutiérrez-Ruiz, Nuria (Universidad de Cantabria)
Aragonés, Nuria (Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública)
Amiano, Pilar (Biodonostia Osasun Ikerketako Institutura (País Basc))
Molina de la Torre, Antonio José (Universidad de León. Instituto de Biomedicina)
Guevara, Marcela (Instituto de Investigación Sanitaria de Navarra)
Alonso-Molero, Jessica (Universidad de Cantabria)
Obón-Santacana, Mireia (Institut d'Investigació Biomèdica de Bellvitge)
Fernández-Tardon, Guillermo (Universidad de Oviedo)
Molina-Barceló, Ana (Fundación para la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO))
Alguacil, Juan (Universidad de Huelva)
Marcos-Gragera, Rafael (Institut Català d'Oncologia)
Rodríguez-Cundín, Paz (Hospital Universitario Marqués de Valdecilla (Santander, Cantabria))
Castaño-Vinyals, Gemma (Institut Hospital del Mar d'Investigacions Mèdiques)
Canseco Fernandez, Rosario (Servicio de Cirugía General y del Aparato Digestivo, Complejo Asistencial Universitario de León)
Castilla, Jesus (Instituto de Investigación Sanitaria de Navarra)
Molinuevo, Amaia (Biodonostia Osasun Ikerketako Institutura (País Basc))
Pérez-Gómez, Beatriz (Centro Nacional de Epidemiología (Madrid))
Kogevinas, Manolis (Institut Hospital del Mar d'Investigacions Mèdiques)
Pollán, Marina (Centro Nacional de Epidemiología (Madrid))
Llorca, Javier (Universidad de Cantabria)
Universitat Autònoma de Barcelona

Date:	2020
Abstract:	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/m 2) 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.
Grants:	Agència de Gestió d'Ajuts Universitaris i de Recerca 2014/SGR-647 Instituto de Salud Carlos III PI08/1777 Instituto de Salud Carlos III PI08/0533 Instituto de Salud Carlos III PI08/1359 Instituto de Salud Carlos III PI09/00773 Instituto de Salud Carlos III PI09/01286 Instituto de Salud Carlos III PI09/01903 Instituto de Salud Carlos III PI09/02078 Instituto de Salud Carlos III PI09/01662 Ministerio de Ciencia e Innovación PI11/01403 Ministerio de Ciencia e Innovación PI11/01889 Ministerio de Ciencia e Innovación PI11/00226 Ministerio de Ciencia e Innovación PI11/01810 Ministerio de Ciencia e Innovación PI11/02213 Instituto de Salud Carlos III PI12/00488 Instituto de Salud Carlos III PI12/00265 Instituto de Salud Carlos III PI12/01270 Instituto de Salud Carlos III PI12/00715 Instituto de Salud Carlos III PI12/00150 Ministerio de Economía y Competitividad PI14/01219 Ministerio de Economía y Competitividad PI14/00613 Ministerio de Economía y Competitividad PI15/00069
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Breast cancer ; Dietary nutrients ; Overall survival ; Prognosis ; Mortality
Published in:	International journal of environmental research and public health, Vol. 18 (december 2020) , ISSN 1660-4601

DOI: 10.3390/ijerph18010084
PMID: 33374289

17 p, 2.0 MB

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