Garlic, onion and cereal fibre as protective factors for breast cancer: A French case–control study


The role of diet on breast cancer risk was investigated in a case–control study of 345 patients diagnosed with primary breast carcinoma between 1986 and 1989 in the north-east of France (Lorraine). For each case, one control was matched for age (+/−3years) and socio-economic status. The dietary history questionnaire consisted of a self-administered food frequency questionnaire, a 6-day food diary and an energy expenditure record. It also elicited personal characteristics and medical history. While taking into account total caloric intake and established risk factors, breast cancer risk was shown to decrease as consumption of fibre (p value for trend=0.03), and garlic and onions (p value for trend<10−6) increased. This study also supports the epidemiologic evidence that saturated fat intake and breast cancer risk are associated in post-menopausal women (p value for trend=0.03). Conversely, it suggests that unsaturated fat intake could lower the risk in the same subgroup (p value for trend = 0.03). Our findings on protective factors of breast cancer could induce effective preventive measures and warrant further experimental investigations to isolate specific subfractions.

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  1. 1.

    Tomatis L. Cancer: Causes, occurrence and control. IARC Scientific Publications no. 100. Lyon:IARC,1990.

  2. 2.

    Hunter DJ, Willett WC. Diet, body size, and breast-cancer. Epidemiol Rev 1993; 15: 110-132.

    Google Scholar 

  3. 3.

    Henderson BE, Pike MC, Bernstein L, Ross RK. Breast cancer. In: Schottenfeld D, Fraumeni JF Jr (eds), Cancer, epidemiology and prevention. New York/ Oxford: Oxford University Press, 1996: 1022-1039.

    Google Scholar 

  4. 4.

    Howe GR, Hirohata T, Hislopt G, et al. Dietary fac-tors and risk of breast cancer: Combined analysis of 12 case-control studies. JNCI 1990; 82: 561-569.

    Google Scholar 

  5. 5.

    Boyd NF, Martin LJ, Noffel M, Lockwood GA, Trichtler DL. A meta-analysis of studies of dietary fat and breast cancer risk. Br J Cancer 1993; 68: 627-636.

    Google Scholar 

  6. 6.

    van Poppel G, Goldbohm RA. Epidemiologic evidence for beta-carotene and cancer prevention. Am J Clin Nutr 1995; 62: 1393S-1402S.

    Google Scholar 

  7. 7.

    Viel JF, Perarnau JM, Challier B, Faivre-Nappez I. Alcoholic calories, red wine consumption and breast cancer among premenopausal women. Eur J Epidemiol 1997; 13: 639-643.

    Google Scholar 

  8. 8.

    Michaud C, Bovi M, Lion G, Toupnot T, Verez B, Mejean L. The “Algrange project”: A pilot community experience of nutrition education. Presentation, pri-mary dietary survey and evaluation of actions. Méde-cine Nutr 1991; 26: 216-227.

    Google Scholar 

  9. 9.

    Spitzer-Hettinger. Tafeln fü r den Kalorienumsatz bei Kö rperlicher Arbeit (4th ed.) Berlin: Beuth-Vertrieb GMBH, 1964.

    Google Scholar 

  10. 10.

    Passemore R, Durnin JVGA. Human energy expendi-ture. Physiol Rev 1955; 35: 801-832.

    Google Scholar 

  11. 11.

    Paul AA, Southgate DAT. In: McCance, Widdowson's (eds), The composition of food (4th ed.) London: HMSO, 1978.

    Google Scholar 

  12. 12.

    Randoin L, Le Gallic P, Dupuis Y, Bernardin J. Tables de composition des Aliments. Institut Scientifique d'Hygiè ne Alimentaire. Paris: Jacques Lanore, 1985.

    Google Scholar 

  13. 13.

    Renaud S, Godsey F, Ortchanian E, Baudier F. Ta-ble de composition des aliments. Paris: Astra-Calvé, 1979.

  14. 14.

    Enig MG, Pallansch LA, Sampugna J, Keeney M. Fatty acid composition of the fat in selected food items with emphasis on trans components. J Am Oil Chem Soc 1983; 60: 1788-1795.

    Google Scholar 

  15. 15.

    Friedenreich CM, Slimani N, Riboli E. Measurement of past diet: Review of previous and proposed methods. Epidemiol Rev 1992; 14: 177-196.

    Google Scholar 

  16. 16.

    Willett WC. Total energy intake and nutrients com-position: Dietary recommendations for epidemiolo-gists. Int J Cancer 1990; 46: 770-771.

    Google Scholar 

  17. 17.

    Richardson S, Gerber M, Genne S. The role of fat, animal protein and some vitamin consumption in breast cancer: A case-control study in southern France. Int J Cancer 1991; 48: 1-9.

    Google Scholar 

  18. 18.

    Zaridze D, Lifanova Y, Maximovitch D, Day NE, Duffy SW. Diet, alcohol consumption and reproductive factors in a case-control study of breast cancer in Moscow. Int J Cancer 1991; 48: 493-501.

    Google Scholar 

  19. 19.

    Morabia A, Flandre P. Misclassification bias related to definition of menopausal status in case-control studies of breast cancer. Int J Epidemiol 1992; 21: 222-228.

    Google Scholar 

  20. 20.

    Kune GA, Kune S. Observations on the reliability and validity of the design and diet history method in the Melbourne colorectal cancer study. Nutr Cancer 1987; 9: 5-20.

    Google Scholar 

  21. 21.

    Heck KE, Pamuk ER. Explaining the relation between education and postmenopausal breast cancer. Am J Epidemiol 1997; 145: 366-372.

    Google Scholar 

  22. 22.

    Howe GR, Friedenreich CM, Jain M, Miller A. A co-hort study of fat intake and risk of breast cancer. JNCI 1991; 83: 336-340.

    Google Scholar 

  23. 23.

    Lubin F, Way Y, Madan B. Role of fat, animal protein, and dietary fibre in breast cancer etiology: A case-control study. JNCI 1986; 77: 605-612.

    Google Scholar 

  24. 24.

    Rohan TE, McMichael AJ, Baghurst PA. A popula-tion-based case-control study of diet and breast cancer in Australia. Am J Epidemiol 1988; 128: 478-479.

    Google Scholar 

  25. 25.

    Van't Veer P, Kolb CM, Verhoef P, et al. Dietary fibre, betacarotene and breast cancer: Results from a case-control study. Int J Cancer 1990; 45: 825-828.

    Google Scholar 

  26. 26.

    Graham S, Hellman R, Marshall J, et al. Nutritional epidemiology of postmenopausal breast cancer in western New-York. Am J Epidemiol 1991; 134: 552-566.

    Google Scholar 

  27. 27.

    Rohan TE, Howe GR, Friedenreich M, Jain M, Miller AB. Dietary fibre, vitamins A, C, and E, and risk of breast cancer: A cohort study. Cancer Causes Control 1993; 4: 29-37.

    Google Scholar 

  28. 28.

    Rose DP. Dietary fibre, phytoestrogens, and breast cancer. Nutrition 1992; 8: 47-51.

    Google Scholar 

  29. 29.

    La Vecchia C, Decarli A, Franceschi S, Gentile A, Negri E, Parazzini F. Dietary factors and the risk of breast cancer. Nutr Cancer 1987; 10: 205-214.

    Google Scholar 

  30. 30.

    Ingram DM, Nottage E, Roberts T. The role of diet in the development of breast cancer: A case-control study of patients with breast cancer, benign epithelial hy-perplasia, and fibrocystic disease of the breast. Br J Cancer 1991; 64: 187-191.

    Google Scholar 

  31. 31.

    London SJ, Stein EA, Henderson IC, et al. Caroten-oids, retinol, and vitamin E and risk of proliferative benign breast disease and breast cancer. Cancer Causes Control 1992; 3: 503-512.

    Google Scholar 

  32. 32.

    Kushi LH, Fee RM, Sellers TA, Zheng W, Folsom AR. Intake of vitamins A, C and E and post menopausal breast cancer. The Iowa Women's Health Study. Am J Epidemiol 1996; 144: 165-174.

    Google Scholar 

  33. 33.

    Verhoeven DTH, Assen N, Goldbohm RA, et al. Vi-tamins C and E, retinol, beta-carotene and dietary fibre in relation to breast cancer risk: A prospective cohort study. Br J Cancer 1997; 75: 149-155.

    Google Scholar 

  34. 34.

    Schatzkin A, Greenwald P, Byar DP, Clifford CK. The dietary fat-breast cancer hypothesis is alive. JAMA 1989; 261: 3284-3287.

    Google Scholar 

  35. 35.

    Carroll KK. Dietary fat and breast cancer. Lipids 1992; 27: 793-797.

    Google Scholar 

  36. 36.

    Dao TL, Hilf R. Dietary fat and breast cancer: A search for mechanisms. In: Jacobs MM (ed) Exercise, calories, fat and cancer. New York: Plenum Press, 1992.

    Google Scholar 

  37. 37.

    Howe GR. Re: “Nutritional epidemiology of post-menopausal breast cancer in Western New York” (Letter). Am J Epidemiol 1993; 137: 249-250.

    Google Scholar 

  38. 38.

    Marshall JR, Graham S. Nutritional epidemiology of post-menopausal breast cancer in Western New York. Two of the authors reply (Letter). Am J Epidemiol 1993; 137: 250-252.

    Google Scholar 

  39. 39.

    Franceschi S, Favero A, Decarli A, et al. Intake of macronutrients and risk of breast cancer. Lancet 1996; 347: 1351-1356.

    Google Scholar 

  40. 40.

    Levi F, La Vecchia C, Gulie C, Negri E. Dietary factors and breast cancer risk in Vaud, Switzerland. Nutr Cancer 1993; 19: 327-335.

    Google Scholar 

  41. 41.

    Graham S, Marshall J, Mettlin C, Rzepka T, Nemoto T, Byers T. Diet in the epidemiology of breast cancer. Am J Epidemiol 1982; 116: 68-75.

    Google Scholar 

  42. 42.

    Dorant E, Van den Brandt PA, Goldbohm RA, Her-mus RJJ, Sturmans F. Garlic and its significance for the prevention of cancer in humans: A critical view. Br J Cancer 1993; 67: 424-429.42.

    Google Scholar 

  43. 43.

    Buiatti E, Palli D, Decarli A, et al. A, case-control study of gastric cancer and diet in Italy. Int J Cancer 1989; 44: 611-616.

    Google Scholar 

  44. 44.

    Perchellet JP, Perchellet EM, Belman S. Inhibition of DMBA-induced mouse skin tumorigenesis by garlic oil and inhibition of two tumor promotion stages by garlic and onion oils. Nutr Cancer 1990; 14: 183-193.

    Google Scholar 

  45. 45.

    Dwivedi C, Rohlfs S, Jarvis D, Engineer FN. Chemo-prevention of chemically induced skin tumor develop-ment by diallyl sulfide and diallyl disulfide. Pharm Res 1992; 9: 1668-1670.

    Google Scholar 

  46. 46.

    Hong JY, Wang ZY, Smith TJ, et al. Inhibitory e.ects of diallyl sulfid on the metabolism and tumorigenecity of the tobacco-specific carcinogen 4-(methylnitrosami-no)-1-(3-pyridyl)-1-butanone (NNK) in A/J mouse lung. Carcinogenesis 1992; 13: 901-904.

    Google Scholar 

  47. 47.

    Meng CL, Shyu KW. Inhibition of experimental car-cinogenesis by painting with garlic extract. Nutr Can-cer, 1990; 14: 207-217.

    Google Scholar 

  48. 48.

    Hussain SP, Jannu LN, Rao AR. Chemopreventive action of garlic on methylcholanthrene-induced carci-nogenesis in the uterine cervix of mice. Cancer Lett 1990; 49: 175-180.

    Google Scholar 

  49. 49.

    Sparnins VL, Barany G, Wattenberg LW. Effects of organosulfur compounds from garlic and onions on benzo(a) pyrene-induced neoplasia and glutathione S-transferase activity in the mouse. Carcinogenesis 1988; 9: 131-134.

    Google Scholar 

  50. 50.

    Wargovich MJ. Diallyl sulfide, a flavor component of garlic (Allium sativum), inhibits dimethylhydrazine-in-duced colon cancer. Carcinogenesis 1987; 8: 487-489.

    Google Scholar 

  51. 51.

    Marsh CL, Torrey RR, Woolley JL, Barker GR, Lau BH. Superiority of intravesical immunotherapy with Corynebacterium parvum and Allium sativum in control of murine bladder cancer. J Urol 1987; 137: 359-362.

    Google Scholar 

  52. 52.

    Sundaram SG, Milner JA. Impact of organosulfur compounds in garlic on canine mammary tumor cells in culture. Cancer Lett 1993; 74: 85-90.

    Google Scholar 

  53. 53.

    Ip C, Lisk DJ, Stoewsand GS. Mammary cancer pre-vention by regular garlic and selenium enriched garlic. Nutr Cancer 1992; 17: 279-286.

    Google Scholar 

  54. 54.

    Liu J, Lin RI, Milner JA. Inhibition of 7, 12-dimethyl-benz (a) anthracene-induced mammary tumors and DNA adducts by garlic powder. Carcinogenesis 1992; 13: 1847-1851.

    Google Scholar 

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Challier, B., Perarnau, JM. & Viel, JF. Garlic, onion and cereal fibre as protective factors for breast cancer: A French case–control study. Eur J Epidemiol 14, 737–747 (1998).

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  • Breast
  • Cancer
  • Case–control
  • France
  • Nutrition