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Canadian Journal of Public Health

, Volume 107, Issue 1, pp e49–e55 | Cite as

Dietary patterns and the risk of female breast cancer among participants of the Canadian National Enhanced Cancer Surveillance System

  • Keith Van Ryswyk
  • Paul J. VilleneuveEmail author
  • Kenneth C. Johnson
  • The Canadian Cancer Registries Epidemiology Research Group
Quantitative Research
  • 1 Downloads

Abstract

OBJECTIVES: The role of diet in the etiology of breast cancer is not well understood despite extensive research. In the majority of this work, a single nutrientbased approach has been used which does not take into account combinations of food that are consumed. An alternative to the single nutrient approach is to identify patterns in the dietary intake information and relate these patterns to disease incidence. This investigation characterized dietary patterns among participants of a Canadian case-control study and related these dietary patterns to the incidence of breast cancer.

METHODS: Dietary and other risk factor data from cases and controls of the Canadian National Enhanced Cancer Surveillance System were collected using self-administered questionnaires. Principal component factor analysis was used to classify individuals based on their dietary patterns. The relationship between these dietary patterns and breast cancer was evaluated using logistic regression. The derived odds ratios and their 95% confidence limits were adjusted for several factors, such as smoking, alcohol intake, environmental tobacco smoke exposure and obesity.

RESULTS: In the 2,009 cases and 2,086 controls, three dietary patterns were identified: western, healthy and vitamin. The highest quartile of the “healthy” dietary pattern was related to a 22% decrease in breast cancer risk (95% CI: 0.61–1.00), relative to the lowest quartile. The fourth quartile of the “vitamin” dietary pattern was associated with a 14% decrease in breast cancer risk (95% CI: 0.70–1.04) relative to the first. No statistically significant associations between the “western” dietary pattern and breast cancer were found. These associations were neither confounded nor modified by menopausal status.

CONCLUSION: Our analyses reveal that individual dietary items tend to cluster together in such a way that there are three distinct dietary patterns in this sample of Canadian women. Some of these patterns, in turn, were associated with the risk of breast cancer.

Key Words

Breast cancer case-control study principal factor component analysis dietary patterns 

Résumé

OBJECTIFS: On connaît mal le rôle du régime dans l’étiologie du cancer du sein malgré le grand nombre d’études sur le sujet. Dans la majorité de ces études, on utilise une démarche axée sur un nutriment particulier, ce qui ne tient pas compte des combinaisons d’aliments qui sont consommées. Une option de rechange à la démarche axée sur un seul nutriment consiste à repérer les grandes tendances de l’information sur les apports alimentaires et à les lier aux structures d’incidence des maladies. Notre enquête a caractérisé les schémas alimentaires des participantes d’une étude castémoins canadienne et les ont liés à l’incidence du cancer du sein.

MÉTHODE: Des données sur le régime alimentaire et d’autres facteurs de risque provenant de cas et de témoins du Système national de surveillance accrue du cancer ont été recueillies à l’aide de questionnaires à remplir soimême. Nous avons utilisé l’analyse factorielle en composantes principales pour classifier les répondantes d’après leurs habitudes alimentaires. Nous avons évalué la relation entre ces schémas alimentaires et le cancer du sein au moyen d’analyses de régression logistique. Les rapports de cotes dérivés et leurs intervalles de confiance de 95 % ont été ajustés selon plusieurs facteurs, dont le tabagisme, la consommation d’alcool, l’exposition à la fumée secondaire du tabac et l’obésité.

RÉSULTATS: Chez les 2 009 cas et les 2 086 témoins, nous avons défini trois schémas alimentaires: occidental, sain et vitaminé. Le quartile supérieur du schéma alimentaire «sain» était lié à une réduction de 22 % du risque de cancer du sein (IC de 95 %: 0,61–1,00), comparativement au quartile inférieur. Le quatrième quartile du schéma alimentaire «vitaminé» était associé à une réduction de 14 % du risque de cancer du sein (IC de 95 %: 0,70–1,04) comparativement au premier. Nous n’avons trouvé aucune association significative entre le schéma alimentaire «occidental» et le cancer du sein. Ces associations n’étaient ni faussées, ni modifiées par le statut ménopausique.

CONCLUSION: Nos analyses révèlent que les choix alimentaires individuels ont tendance à former des grappes qui dessinent trois schémas alimentaires distincts dans cet échantillon de Canadiennes. Certains de ces schémas étaient à leur tour associés au risque de cancer du sein.

Mots Clés

tumeurs du sein études cas-témoins analyse factorielle en composantes principales habitudes alimentaires 

References

  1. 1.
    DeSantis CE, Bray F, Ferlay J, Lortet-Tieulent J, Anderson BO, Jemal A. International variation in female breast cancer incidence and mortality rates. Cancer Epidemiol Biomarkers Prev 2015;24(10):1495–506. PMID: 26359465. doi: 10.1158/1055-9965.EPI-15-0535.CrossRefGoogle Scholar
  2. 2.
    Ellison L, Wilkins K. Canadian Trends in Cancer Prevalence. Statistics Canada, Health Reports, Vol. 23, no. 1, 2012; Catalogue no. 82-003-XPE.Google Scholar
  3. 3.
    World Cancer Research Fund/American Institute for Cancer Research. Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective. American Institute for Cancer Research, 2007.Google Scholar
  4. 4.
    Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin 2005;55(2):74–108. PMID: 15761078. doi: 10.3322/canjclin.55.2.74.CrossRefGoogle Scholar
  5. 5.
    Andreeva VA, Unger JB, Pentz MA. Breast cancer among immigrants: A systematic review and new research directions. J Immigr Minor Health 2007; 9(4):307–22. doi: 10.1007/s10903-007-9037-y.CrossRefGoogle Scholar
  6. 6.
    Chajes V, Romieu I. Nutrition and breast cancer. Maturitas 2014;77(1):7–11. PMID: 24215727. doi: 10.1016/j.maturitas.2013.10.004.CrossRefGoogle Scholar
  7. 7.
    Key TJ, Schatzkin A, Willett WC, Allen NE, Spencer EA, Travis RC. Diet, nutrition and the prevention of cancer. Public Health Nutr 2004;7(1a):187–200. doi: 10.1079/PHN2003588.CrossRefGoogle Scholar
  8. 8.
    Feigelson HS, Calle EE, Robertson AS, Wingo PA, Thun MJ. Alcohol consumption increases the risk of fatal breast cancer (United States). Cancer Causes Control 2001;12(10):895–902. PMID: 11808708. doi: 10.1023/A: 1013737616987.CrossRefGoogle Scholar
  9. 9.
    Petri AL, Tjonneland A, Gamborg M, Johansen D, Hoidrup S, Sorensen TI, et al. Alcohol intake, type of beverage, and risk of breast cancer in pre- and postmenopausal women. Alcohol Clin Exp Res 2004;28(7):1084–90. PMID: 15252295. doi: 10.1097/01.ALC.0000130812.85638.E1.CrossRefGoogle Scholar
  10. 10.
    Lenz SK, Goldberg MS, Labreche F, Parent ME, Valois MF. Association between alcohol consumption and postmenopausal breast cancer: Results of a case-control study in Montreal, Quebec, Canada. Cancer Causes Control 2002; 13(8):701–10. doi: 10.1023/A:1020296905208.CrossRefGoogle Scholar
  11. 11.
    Brennan SF, Cantwell MM, Cardwell CR, Velentzis LS, Woodside JV. Dietary patterns and breast cancer risk: A systematic review and meta-analysis. Am J Clin Nutr 2010;91(5):1294–302. PMID: 20219961. doi: 10.3945/ajcn.2009. 28796.CrossRefGoogle Scholar
  12. 12.
    Edefonti V, Randi G, La Vecchia C, Ferraroni M, Decarli A. Dietary patterns and breast cancer: A review with focus on methodological issues. Nutr Rev 2009;67(6):297–314. doi: 10.1111/nure.2009.67.issue-6.CrossRefGoogle Scholar
  13. 13.
    Mourouti N, Kontogianni MD, Papavagelis C, Panagiotakos DB. Diet and breast cancer: A systematic review. Int J Food Sci Nutr 2015;66(1):1–42. PMID: 25198160. doi: 10.3109/09637486.2014.950207.CrossRefGoogle Scholar
  14. 14.
    Johnson KC, Mao Y, Argo J, Dubois S, Semenciw R, Lava J. The National Enhanced Cancer Surveillance System: A case-control approach to environment-related cancer surveillance in Canada. Environmetrics 1998; 9(5):495–504. doi: 10.1002/(ISSN)1099-095X.CrossRefGoogle Scholar
  15. 15.
    Johnson KC, Hu J, Mao Y, Canadian Cancer Registries Epidemiology Research Group. Passive and active smoking and breast cancer risk in Canada, 1994–97. Cancer Causes Control 2000;11(3):211–21. PMID: 10782655. doi: 10.1023/A: 1008906105790.CrossRefGoogle Scholar
  16. 16.
    Block G, Hartman AM, Naughton D. A reduced dietary questionnaire: Development and validation. Epidemiology 1990;1(1):58–64. PMID: 2081241. doi: 10.1097/00001648-199001000-00013.CrossRefGoogle Scholar
  17. 17.
    Willett W. Nutritional Epidemiology. New York: Oxford University Press, 1998.CrossRefGoogle Scholar
  18. 18.
    A Step-by-Step Approach to Using the SAS System for Factor Analysis and Structural Equation Modelling. Cary, NC: SAS Institute, Inc., 1994.Google Scholar
  19. 19.
    Albuquerque RC, Baltar VT, Marchioni DM. Breast cancer and dietary patterns: A systematic review. Nutr Rev 2014;72(1):1–17. PMID: 24330083. doi: 10.1111/nure.2014.72.issue-1.CrossRefGoogle Scholar
  20. 20.
    Fay MP, Freedman LS, Clifford CK, Midthune DN. Effect of different types and amounts of fat on the development of mammary tumors in rodents: A review. Cancer Res 1997;57(18):3979–88. PMID: 9307282.PubMedGoogle Scholar
  21. 21.
    MacLennan M, Ma DW. Role of dietary fatty acids in mammary gland development and breast cancer. Breast Cancer Res 2010;12(5):211. PMID: 21067551. doi: 10.1186/bcr2646.CrossRefGoogle Scholar
  22. 22.
    Sieri S, Krogh V, Ferrari P, Berrino F, Pala V, Thiebaut AC, et al. Dietary fat and breast cancer risk in the European Prospective Investigation into Cancer and Nutrition. Am J Clin Nutr 2008;88(5):1304–12. PMID: 18996867. doi: 10. 3945/ajcn.2008.26090.PubMedGoogle Scholar
  23. 23.
    Sieri S, Chiodini P, Agnoli C, Pala V, Berrino F, Trichopoulou A, et al. Dietary fat intake and development of specific breast cancer subtypes. J Natl Cancer Inst 2014;106(5). doi: 10.1093/jnci/dju068. PMID: 24718872.Google Scholar
  24. 24.
    Catsburg C, Kim RS, Kirsh VA, Soskolne CL, Kreiger N, Rohan TE. Dietary patterns and breast cancer risk: A study in 2 cohorts. Am J Clin Nutr 2015; 101(4):817–23. PMID: 25833979. doi: 10.3945/ajcn.114.097659.CrossRefGoogle Scholar
  25. 25.
    Toniolo PG, Levitz M, Zeleniuch-Jacquotte A, Banerjee S, Koenig KL, Shore RE, et al. A prospective study of endogenous estrogens and breast cancer in postmenopausal women. J Natl Cancer Inst 1995;87(3):190–97. PMID: 7707406. doi: 10.1093/jnci/87.3.190.CrossRefGoogle Scholar
  26. 26.
    Endogenous Hormones and Breast Cancer Collaborative Group; Key TJ, Appleby PN, Reeves GK, Roddam AW, Helzlsouer KJ, et al. Circulating sex hormones and breast cancer risk factors in postmenopausal women: Reanalysis of 13 studies. Br J Cancer 2011;105(5):709–22. PMID: 21772329. doi: 10.1038/bjc.2011.254.CrossRefGoogle Scholar
  27. 27.
    Jo EH, Kim SH, Ahn NS, Park JS, Hwang JW, Lee YS, et al. Efficacy of sulforaphane is mediated by p38 MAP kinase and caspase-7 activations in ER-positive and COX-2-expressed human breast cancer cells. Eur J Cancer Prev 2007;16(6):505–10. PMID: 18090122. doi: 10.1097/01.cej.0000243856. 97479.3b.CrossRefGoogle Scholar
  28. 28.
    Kimmick GG, Bell RA, Bostick RM. Vitamin E and breast cancer: A review. Nutr Cancer 1997;27(2):109–17. PMID: 9121936. doi: 10.1080/01635589 709514511.CrossRefGoogle Scholar
  29. 29.
    Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and hormonal contraceptives: Collaborative reanalysis of individual data on 53 297 women with breast cancer and 100 239 women without breast cancer from 54 epidemiological studies. Lancet 1996;347(9017):1713–27. PMID: 8656904. doi: 10.1016/S0140-6736(96)90806-5.CrossRefGoogle Scholar
  30. 30.
    Jung S, Spiegelman D, Baglietto L, Bernstein L, Boggs DA, van den Brandt PA, et al. Fruit and vegetable intake and risk of breast cancer by hormone receptor status. J Natl Cancer Inst 2013;105(3):219–36. PMID: 23349252. doi: 10.1093/jnci/djs635.CrossRefGoogle Scholar

Copyright information

© The Canadian Public Health Association 2016

Authors and Affiliations

  • Keith Van Ryswyk
    • 1
  • Paul J. Villeneuve
    • 1
    Email author
  • Kenneth C. Johnson
    • 2
  • The Canadian Cancer Registries Epidemiology Research Group
  1. 1.Department of Health SciencesCarleton UniversityOttawaCanada
  2. 2.School of Epidemiology, Public Health and Preventive MedicineUniversity of OttawaOttawaCanada

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