Dietary Fat, Fiber, Vegetable, and Micronutrients Are Associated With Overall Survival in Postmenopausal Women Diagnosed With Breast Cancer

Abstract

Relatively few studies have assessed the relationship between dietary intakes and survival after breast cancer diagnosis. We investigated the influence of diet, including dietary fat (percentage energy), fiber, vegetable, and fruit intakes, and micronutrients (folate, carotenoids, and vitamin C) on overall survival in women diagnosed with breast cancer. Subjects were postmenopausal women diagnosed with breast cancer (N = 516) between 1994 and 1995 with a mean survival time of 80 mo (SD: 18). Subjects completed a food frequency questionnaire for the year prior to diagnosis. Cox proportional hazards models were used to measure the relationship between dietary intakes and death due to any cause after breast cancer diagnosis. In the multivariate analysis, we found that the hazard ratio [HR and 95% confidence interval (CI)] of dying in the highest tertile compared to the lowest tertile of total fat, fiber, vegetable, and fruit was 3.12 (95% CI = 1.79-5.44), 0.48 (95% CI = 0.27-0.86), 0.57 (95% CI = 0.35-0.94), and 0.63 (95% CI = 0.38-1.05), respectively (P <or= 0.05 for trend, except for fruit intake). Other nutrients including folate, vitamin C, and carotenoid intakes were also significantly associated with reduced mortality (P <or= 0.05 for trend). These results suggest that in postmenopausal women diagnosed with breast cancer, reduced dietary fat and increased fiber, vegetable, fruit, and other nutrient intakes associated with a plant-based, high-fiber diet improves overall survival after breast cancer diagnosis.

Consumption of vegetables and fruits and breast cancer survival: a systematic review and meta-analysis

“…Table 1 summarizes the characteristics of these 10 articles (9 cohort studies 5–8,10–14 and 1 randomized control trial [RCT] 9 ). Overall, 10 articles reported on OS 5–14 and 5 on BCSS 7,10–12,14 .…”

“…Studies were conducted in the following geographic regions: 7 from the United States, 3 from Europe (UK, Italy and Germany). Five studies 6–8,10,12 collected information on dietary intake before diagnosis. In one study 7 , diet was assessed on average 3 months after diagnosis when 2/3 of the patients had not started chemotherapy treatment.…”

“…The majority of these studies 6,7,9,11,12 have reported a non-significant inverse association between VF intake and overall (OS) or breast cancer-specific survival (BCSS). However, two studies 8,10 reported inverse associations of consumption of vegetables and fruits with all-cause mortality, and a trend for this relationship was observed in another study 5 . One study 10 also found the inverse association with breast cancer-specific mortality.…”

Alcohol Consumption and Survival after a Breast Cancer Diagnosis: A Literature-Based Meta-analysis and Collaborative Analysis of Data for 29,239 Cases

“…One study reported a protective effect of alcohol but provided HRs without 95% CIs and an overall P value across multiple levels of exposure (15). Another study reported no association for a comparison of drinkers with nondrinkers (3). Two studies (9, 11) modeled alcohol intake as a continuous variable, one of which used data from SEARCH that we have updated in the new analysis reported in this paper (11).…”

Changes in vitamin and mineral supplement use after breast cancer diagnosis in the Pathways Study: a prospective cohort study

“…The majority of studies have not found dietary supplements to improve breast cancer prognosis [5,14,15], with some showing benefit [4,6,16] and some showing harm [4]. Controversy exists regarding use of antioxidant supplements during treatment due to potential interactions with conventional therapy [17,18] and lack of clear evidence-based clinical guidelines.…”