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Dietary Inflammatory Index and risk of breast cancer: evidence from a prospective cohort of 67,879 women followed for 20 years in France

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European Journal of Nutrition Aims and scope Submit manuscript

Abstract

Background

Inflammation is implicated in breast cancer development, and diet is one of the modifiable risk factors involved in the regulation of chronic inflammation. Previous studies on the association between breast cancer risk and Dietary Inflammatory Indexes (DII) derived from food frequency questionnaires and data on inflammatory potential of dietary components have reported inconsistent results.

Objective

To investigate the association between the DII and the risk of breast cancer using data from a large population-based cohort study.

Design

A total of 67,879 women from the E3N cohort were followed from 1993 to 2014. A total of 5686 breast cancer cases were diagnosed during the follow-up. The food frequency questionnaire administered at baseline in 1993 was used to calculate an adapted DII. Cox proportional hazard models using age as the time scale were used to estimate hazard ratios (HR) and 95% confidence intervals (CI). Spline regression was used to determine any dose–response relationship. We also evaluated effect modification by menopausal status, body mass index, smoking status and alcohol consumption.

Results

The median DII score of the study population was slightly pro-inflammatory (DII = + 0.39); ranged from – 4.68 in the lowest quintile to + 4.29 in the highest quintile. The HR increased linearly with the DII (HR per 1SD = 1.04 [95% CI: 1.01, 1.07]), and reached 1.13 [95% CI: 1.04, 1.23] in the 5th quintile group as compared to the first. A positive linear dose–response relationship was also observed when modeling DII with spline functions. Slightly higher HRs were observed in non-smokers (HR for 1-SD increase 1.06 [95% CI: 1.02, 1.10]; p trend = 0.001) and in low-alcohol consumers (≤ 1 glass/day) (HR for 1-SD increase 1.05 [95% CI: 1.01, 1.08]; p trend = 0.002).

Conclusion

Our results suggest a positive association between DII and breast cancer risk. Consequently, the promotion of anti-inflammatory diet may contribute to breast cancer prevention.

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Data availability

Data described in the manuscript, code book, and analytic code will be made available upon request pending application and approval.

Abbreviations

DII:

Dietary Inflammatory Index

BMI:

Body mass index

MHT:

Menopausal hormone therapy

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Acknowledgements

The authors are indebted to the E3N study participants for providing data and to practitioners for providing pathology reports. They are also grateful to all members of the E3N study group.

Funding

The E3N cohort is being carried out with the financial support of the “Mutuelle Générale de l’Education Nationale” (MGEN); European Community; French League against Cancer (LNCC); Gustave Roussy Institute (IGR); French Institute of Health and Medical Research (INSERM).

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Author notes

  1. Pascal Guénel and Francesca Romana Mancini have contributed equally to this work.

Authors and Affiliations

  1. Center for Research in Epidemiology and Population Health (CESP), Team Exposome and Heredity, U1018 Inserm, Institut Gustave Roussy, Espace Maurice Tubiana, University Paris-Saclay, 114 Rue Edouard Vaillant, 94805, Villejuif Cedex, France

    Mariem Hajji-Louati, Amandine Gelot, Pauline Frenoy, Pascal Guénel & Francesca Romana Mancini

  2. Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA

    Nasser Laouali

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Contributions

FRM, PG: designed and conducted the research; AG, NL, PF, MH-L: provided essential materials; MH-L, PF, NL: performed the statistical analysis; MH-L, FMR, PG: wrote the manuscript; PG and FMR: have primary responsibility for the final content; and all authors read and approved the final manuscript.

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Correspondence to Francesca Romana Mancini.

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Hajji-Louati, M., Gelot, A., Frenoy, P. et al. Dietary Inflammatory Index and risk of breast cancer: evidence from a prospective cohort of 67,879 women followed for 20 years in France. Eur J Nutr 62, 1977–1989 (2023). https://doi.org/10.1007/s00394-023-03108-w

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