Adherence to the mediterranean diet and risk of breast cancer in the European prospective investigation into cancer and nutrition cohort study

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

  • G Buckland
  • ,
  • N Travier
  • ,
  • V Cottet
  • ,
  • Ca González
  • ,
  • L Luján-Barroso
  • ,
  • A Agudo
  • ,
  • A Trichopoulou
  • ,
  • P Lagiou
  • ,
  • D Trichopoulos
  • ,
  • P H Peeters
  • ,
  • A May
  • ,
  • H B Bueno-de-Mesquita
  • ,
  • F J B van Duijnhoven
  • ,
  • T J Key
  • ,
  • N Allen
  • ,
  • K T Khaw
  • ,
  • N Wareham
  • ,
  • I Romieu
  • ,
  • V McCormack
  • ,
  • M Boutron-Ruault
  • ,
  • F Clavel-Chapelon
  • ,
  • S Panico
  • ,
  • C Agnoli
  • ,
  • D Palli
  • ,
  • R Tumino
  • ,
  • P Vineis
  • ,
  • P Amiano
  • ,
  • A Barricarte
  • ,
  • L Rodríguez
  • ,
  • M J Sanchez
  • ,
  • M D Chirlaque
  • ,
  • R Kaaks
  • ,
  • B Teucher
  • ,
  • H Boeing
  • ,
  • M M Bergmann
  • ,
  • K Overvad
  • Christina Catherine Dahm
  • A Tjønneland
  • ,
  • A Olsen
  • J Manjer
  • ,
  • E Wirfält
  • ,
  • G Hallmans
  • ,
  • I Johansson
  • ,
  • E Lund
  • ,
  • A Hjartåker
  • ,
  • G Skeie
  • ,
  • A C Vergnaud
  • ,
  • T Norat
  • ,
  • D Romaguera
  • ,
  • E Ríboli
Epidemiological evidence suggests the Mediterranean diet (MD) could reduce risk of breast cancer (BC). Since evidence from prospective studies is still scarce and conflicting, we investigated the association between adherence to the MD and risk of BC among 335,062 women recruited from 1992-2000, in 10 European countries, and followed for 11 years on average. Adherence to the MD was estimated through an adapted relative Mediterranean diet (arMED) score excluding alcohol. Cox proportional hazards regression models were used while adjusting for BC risk factors. A total of 9,009 postmenopausal and 1,216 premenopausal first primary incident invasive BC were identified (5,862 estrogen or progesterone receptor positive (ER+/PR+) and 1,018 estrogen and progesterone receptor negative (ER-PR-)). The arMED was inversely associated with risk of BC overall and in postmenopausal women (high versus low arMED score; HR 0.94 (95% CI: 0.88, 1.00) p(trend) =0.048, and HR 0.93 (95% CI: 0.87, 0.99) p(trend) =0.037, respectively). The association was more pronounced in ER-PR- tumors (HR 0.80 (95% CI: 0.65, 0.99) p(trend) =0.043). The arMED score was not associated with BC in premenopausal women. Our findings show that adherence to a MD excluding alcohol was related to a modest reduced risk of BC in postmenopausal women, and this association was stronger in receptor negative tumors. The results support the potential scope for BC prevention through dietary modification. © 2012 Wiley Periodicals, Inc.
Original languageEnglish
JournalInternational Journal of Cancer
Volume132
Issue12
Pages (from-to)2918-27
Number of pages10
ISSN0020-7136
DOIs
Publication statusPublished - 15 Jun 2013

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