Healthful and unhealthful provegetarian food patterns and the incidence of breast cancer: Results from a Mediterranean cohort

Romanos-Nanclares, Andrea; Toledo, Estefanía; Sánchez-Bayona, Rodrigo; Sánchez-Quesada, Cristina; Martínez‐González, Miguel Ángel; Gea, Alfredo

doi:10.1016/j.nut.2020.110884

Cited by 17 publications

(19 citation statements)

References 37 publications

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“…Moreover, pro-vegetarian dietary patterns are predominantly plant-based or plant-forward but not fully vegetarian or vegan. A large prospective study conducted on a Mediterranean cohort described that a moderate adherence to pro-vegetarian dietary patterns might decrease the risk of breast cancer [ 57 ]. Interestingly, Farvid et al (2019) evaluated a plant-based diet and the risk of breast cancer through repeated measures over 30 years.…”

Section: Current State Of Clinical Evidence On the Effectiveness Of P...mentioning

confidence: 99%

Anti-breast cancer effects of phytochemicals: primary, secondary, and tertiary care

et al. 2022

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Breast cancer incidence is actually the highest one among all cancers. Overall breast cancer management is associated with challenges considering risk assessment and predictive diagnostics, targeted prevention of metastatic disease, appropriate treatment options, and cost-effectiveness of approaches applied. Accumulated research evidence indicates promising anti-cancer effects of phytochemicals protecting cells against malignant transformation, inhibiting carcinogenesis and metastatic spread, supporting immune system and increasing effectiveness of conventional anti-cancer therapies, among others. Molecular and sub-/cellular mechanisms are highly complex affecting several pathways considered potent targets for advanced diagnostics and cost-effective treatments. Demonstrated anti-cancer affects, therefore, are clinically relevant for improving individual outcomes and might be applicable to the primary (protection against initial cancer development), secondary (protection against potential metastatic disease development), and tertiary (towards cascading complications) care. However, a detailed data analysis is essential to adapt treatment algorithms to individuals’ and patients’ needs. Consequently, advanced concepts of patient stratification, predictive diagnostics, targeted prevention, and treatments tailored to the individualized patient profile are instrumental for the cost-effective application of natural anti-cancer substances to improve overall breast cancer management benefiting affected individuals and the society at large.

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Section: Current State Of Clinical Evidence On the Effectiveness Of P...mentioning

confidence: 99%

Anti-breast cancer effects of phytochemicals: primary, secondary, and tertiary care

et al. 2022

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“…Notably, a small number of cancer deaths could undermine statistical power to detect any small association in this regard. In another cohort study of 10,812 Spanish women, the investigators reported inverse associations between moderate adherence to overall pro-vegetarian dietary patterns (PVG) and BC risk, but the healthful PVG (hPVG) and unhealthful PVG (uPVG) had no association with BC risk 51 . Our findings were comparable with those from several investigations evaluating the association between BC risk and: (1) overall diet, encompasses plant-based and animal components, determined by a priori (dietary patterns) or posteriori (dietary scores) procedures, or (2) vegetarian and/or vegan diets.…”

Section: Discussionmentioning

confidence: 99%

The association between plant-based dietary patterns and risk of breast cancer: a case–control study

Rigi

Mousavi

Benisi-Kohansal

et al. 2021

Sci Rep

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Limited data are available, linking the plant-based diets to breast cancer (BC). We examined the association of overall plant-based diet index (PDI), hypothesized healthful (hPDI) and unhealthful versions of a plant-based diet index (uPDI) with BC in Iranian women. This population-based case–control study included 350 cases with newly diagnosed BC and 700 age-matched apparently healthy controls. We collected dietary data using a validated, Willett-format semi-quantitative food frequency questionnaire. Using these data, we generated a PDI by dedicating positive scores to plant foods, and reverse scores to animal foods, hPDI by assigning positive scores to healthy plant foods and reverse scores to less healthy plant foods and animal foods, and finally uPDI in which positive scores were assigned to less healthy plant foods and reverse scores to healthy plant foods and animal foods. After controlling for potential confounders, individuals in the highest quartile of PDI had 67% lower odds of BC than those in the lowest quartile (OR 0.33; 95% CI 0.22–0.50). Individuals with the greatest adherence to hPDI were 36% less likely to have BC than those with the lowest adherence, in the fully adjusted model (OR 0.64; 95% CI 0.43–0.94). In terms of uPDI, women in the top quartile had a 2.23 times greater chance of BC than those in the bottom quartile (OR 2.23; 95% CI 1.48–3.36). Greater adherence to PDI and hPDI was inversely associated with the risk of BC, whereas uPDI was associated with an increased risk.

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“…No prior study has examined plant-based diets and breast-cancer-specific outcomes such as recurrence, making direct comparison difficult, and previous studies of breast cancer incidence have had inconsistent results [8][9][10]. In the Seguimiento Universidad de Navarra cohort (SUN), they observed an inverse association between a healthful version of the pro-vegetarian diet and breast cancer incidence and a positive association between an unhealthful pro-vegetarian diet and breast cancer incidence; however, neither finding was statistically significant [8]. Other case-control studies had differing results between hPDI, uPDI, and risk of breast cancer [9,10].…”

Section: Discussionmentioning

confidence: 99%

“…To address this shortcoming, plant-based diet indices that differentiate between the consumption of healthful plants (e.g., fruits, whole grains, vegetables, legumes, nuts) and less healthful plants (e.g., refined grains, fruit juices, potatoes, sugar-sweetened beverages (SSBs)) were created [6]. A dietary pattern concordant with a healthful plantbased diet has been associated with reduced risk of coronary heart disease, type 2 diabetes, and breast cancer risk, but to the best of our knowledge, no prior study has examined breast cancer survival, as few cohorts collect dietary assessments both at and following diagnosis, and even fewer measure recurrence or breast-cancer-specific mortality [6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Plant-Based Dietary Patterns and Breast Cancer Recurrence and Survival in the Pathways Study

et al. 2021

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Plant-based diets are recommended for cancer survivors, but their relationship with breast cancer outcomes has not been examined. We evaluated whether long-term concordance with plant-based diets reduced the risk of recurrence and mortality among a prospective cohort of 3646 women diagnosed with breast cancer from 2005 to 2013. Participants completed food frequency questionnaires at diagnosis and 6-, 25-, and 72-month follow-up, from which we derived plant-based diet indices, including overall (PDI), healthful (hPDI), and unhealthful (uPDI). We observed 461 recurrences and 653 deaths over a median follow-up of 9.51 years. Using multivariable-adjusted Cox proportional hazards models, we estimated hazard ratios (HR) and 95% confidence intervals for breast cancer recurrence and all-cause, breast-cancer-specific, and non-breast-cancer mortality. Increased concordance with hPDI was associated with a reduced hazard of all-cause (HR 0.93, 95% CI: 0.83–1.05) and non-breast-cancer mortality (HR 0.83, 95% CI: 0.71–0.98), whereas increased concordance with uPDI was associated with increased hazards (HR 1.07, 95% CI: 0.96–1.2 and HR 1.20, 95% CI: 1.02–1.41, respectively). No associations with recurrence or breast-cancer-specific mortality were observed. In conclusion, healthful vs. unhealthful plant-based dietary patterns had differing associations with mortality. To enhance overall survival, dietary recommendations for breast cancer patients should emphasize healthful plant foods.

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Healthful and unhealthful provegetarian food patterns and the incidence of breast cancer: Results from a Mediterranean cohort

Cited by 17 publications

References 37 publications

Anti-breast cancer effects of phytochemicals: primary, secondary, and tertiary care

Anti-breast cancer effects of phytochemicals: primary, secondary, and tertiary care

The association between plant-based dietary patterns and risk of breast cancer: a case–control study

Plant-Based Dietary Patterns and Breast Cancer Recurrence and Survival in the Pathways Study

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