Dietary Constituents: Relationship with Breast Cancer Prognostic (MCC-SPAIN Follow-Up)

Dierssen-Sotos, Trinidad; Gómez-Acebo, Inés; Gutiérrez-Ruiz, Nuria; Aragonés, Nuria; Amiano, Pilar; Molina de la Torre, Antonio José; Guevara, Marcela; Alonso-Molero, Jessica; Obon-Santacana, Mireia; Fernández-Tardón, Guillermo; Molina-Barceló, Ana; Alguacil, Juan; Marcos-Gragera, Rafael; Rodríguez-Cundín, Paz; Castaño-Vinyals, Gemma; Canseco Fernandez, Rosario; Castilla, Jesús; Molinuevo, Amaia; Pérez-Gómez, Beatriz; Kogevinas, Manolis; Pollán, Marina; Llorca, Javier

doi:10.3390/ijerph18010084

Open AccessArticle

Dietary Constituents: Relationship with Breast Cancer Prognostic (MCC-SPAIN Follow-Up)

by

Trinidad Dierssen-Sotos

^1,2,3,*,

Inés Gómez-Acebo

^1,2,3

,

Nuria Gutiérrez-Ruiz

³,

Nuria Aragonés

^1,4,

Pilar Amiano

^1,5,

Antonio José Molina de la Torre

^1,6

,

Marcela Guevara

^1,7,8

,

Jessica Alonso-Molero

^1,3

,

Mireia Obon-Santacana

^1,9,10,

Guillermo Fernández-Tardón

^1,11

,

Ana Molina-Barceló

¹²

,

Juan Alguacil

^1,13,

Rafael Marcos-Gragera

^1,14,15

,

Paz Rodríguez-Cundín

^2,16,

Gemma Castaño-Vinyals

^1,17,18,19

,

Rosario Canseco Fernandez

²⁰,

Jesús Castilla

^1,7,8

,

Amaia Molinuevo

^1,5

,

Beatriz Pérez-Gómez

^1,21

,

Manolis Kogevinas

^1,17,18,19,

Marina Pollán

^1,21 and

Javier Llorca

^1,2,3 Show full author list Hide full author list

¹

Consortium for Biomedical Research in Epidemiology and Public Health (CIBER de Epidemiología Y Salud Pública-CIBERESP), 28029 Madrid, Spain

²

IDIVAL Santander, 39011 Santander, Spain

³

Faculty of Medicine, University of Cantabria, 39011 Santander, Spain

⁴

Epidemiology Section, Public Health Division, Department of Health of Madrid, 28009 Madrid, Spain

⁵

Public Health Division of Gipuzkoa, Health Department, BioDonostia Research Institute, 20014 San Sebastian, Spain

⁶

Grupo de Investigación en Interacciones Gen-Ambiente y Salud (GIIGAS), Instituto de Biomedicina (IBIOMED), Universidad de León, 24071 León, Spain

⁷

Navarra Public Health Institute, 31003 Pamplona, Spain

⁸

IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain

⁹

Unit of Biomarkers and Susceptibility, Oncology Data Analytics Program, Catalan Institute of Oncology (ICO), Hospitalet de Llobregat, 08908 Barcelona, Spain

¹⁰

Colorectal Cancer Group, ONCOBELL Program, Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, 08908 Barcelona, Spain

¹¹

Health Research Institute of the Principality of Asturias, Oncology Institute, University of Oviedo, 33006 Oviedo, Spain

¹²

Cancer and Public Health Area, FISABIO—Public Health, 46020 Valencia, Spain

¹³

Centro de Investigación en Recursos Naturales, Salud y Medio Ambiente (RENSMA), Universidad de Huelva, 21007 Huelva, Spain

¹⁴

Research Group on Statistics, Econometrics and Health (GRECS), Universitat de Girona, 17071 Girona, Spain

¹⁵

Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, 17007 Girona, Spain

¹⁶

Preventive Medicine, Hospital Universitario Marqués de Valdecilla, 39011 Santander, Spain

¹⁷

ISGlobal, 08036 Barcelona, Spain

¹⁸

Department of Public Health, Universitat Pompeu Fabra (UPF), 08002 Barcelona, Spain

¹⁹

IMIM (Hospital Del Mar Medical Research Institute), 08003 Barcelona, Spain

²⁰

Servicio de Cirugía General y del Aparato Digestivo, Complejo Asistencial Universitario de León, 24001 León, Spain

²¹

Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, 28029 Madrid, Spain

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^*

Author to whom correspondence should be addressed.

Int. J. Environ. Res. Public Health 2021, 18(1), 84; https://doi.org/10.3390/ijerph18010084

Submission received: 6 November 2020 / Revised: 20 December 2020 / Accepted: 21 December 2020 / Published: 24 December 2020

(This article belongs to the Special Issue Cancer Causes and Control)

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Abstract

The aim of this study was to characterize the relationship between the intake of the major nutrients and prognosis in breast cancer. A cohort based on 1350 women with invasive (stage I-IV) breast cancer (BC) was followed up. Information about their dietary habits before diagnosis was collected using a semi-quantitative Food Frequency Questionnaire. Participants without FFQ or with implausible energy intake were excluded. The total amount consumed of each nutrient (Kcal/day) was divided into tertiles, considering as “high intakes” those above third tertile. The main effect studied was overall survival. Cox regression was used to assess the association between death and nutrient intake. During a median follow-up of 6.5 years, 171 deaths were observed. None of the nutrients analysed was associated with mortality in the whole sample. However, in normal-weight women (BMI 18.5–25 kg/m²) a high intake of carbohydrates (≥809 Kcal/day), specifically monosaccharides (≥468 Kcal/day), worsened prognostic compared to lowest (≤352 Kcal/day). Hazard Ratios (HRs) for increasing tertiles of intake were HR:2.22 95% CI (1.04 to 4.72) and HR:2.59 95% CI (1.04 to 6.48), respectively (p trend = 0.04)). Conversely, high intakes of polyunsaturated fats (≥135 Kcal/day) improved global survival (HR: 0.39 95% CI (0.15 to 1.02) p-trend = 0.05) compared to the lowest (≤92.8 kcal/day). In addition, a protective effect was found substituting 100 kcal of carbohydrates with 100 kcal of fats in normal-weight women (HR: 0.76 95% CI (0.59 to 0.98)). Likewise, in premenopausal women a high intake of fats (≥811 Kcal/day) showed a protective effect (HR:0.20 95% CI (0.04 to 0.98) p trend = 0.06). Finally, in Estrogen Receptors (ER) negative tumors, we found a protective effect of high intake of animal proteins (≥238 Kcal/day, HR: 0.24 95% CI (0.06 to 0.98). According to our results, menopausal status, BMI and ER status could play a role in the relationship between diet and BC survival and must be taken into account when studying the influence of different nutrients.

Keywords: breast cancer; dietary nutrients; overall survival; prognosis; mortality

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MDPI and ACS Style

Dierssen-Sotos, T.; Gómez-Acebo, I.; Gutiérrez-Ruiz, N.; Aragonés, N.; Amiano, P.; Molina de la Torre, A.J.; Guevara, M.; Alonso-Molero, J.; Obon-Santacana, M.; Fernández-Tardón, G.; et al. Dietary Constituents: Relationship with Breast Cancer Prognostic (MCC-SPAIN Follow-Up). Int. J. Environ. Res. Public Health 2021, 18, 84. https://doi.org/10.3390/ijerph18010084

AMA Style

Dierssen-Sotos T, Gómez-Acebo I, Gutiérrez-Ruiz N, Aragonés N, Amiano P, Molina de la Torre AJ, Guevara M, Alonso-Molero J, Obon-Santacana M, Fernández-Tardón G, et al. Dietary Constituents: Relationship with Breast Cancer Prognostic (MCC-SPAIN Follow-Up). International Journal of Environmental Research and Public Health. 2021; 18(1):84. https://doi.org/10.3390/ijerph18010084

Chicago/Turabian Style

Dierssen-Sotos, Trinidad, Inés Gómez-Acebo, Nuria Gutiérrez-Ruiz, Nuria Aragonés, Pilar Amiano, Antonio José Molina de la Torre, Marcela Guevara, Jessica Alonso-Molero, Mireia Obon-Santacana, Guillermo Fernández-Tardón, and et al. 2021. "Dietary Constituents: Relationship with Breast Cancer Prognostic (MCC-SPAIN Follow-Up)" International Journal of Environmental Research and Public Health 18, no. 1: 84. https://doi.org/10.3390/ijerph18010084

APA Style

Dierssen-Sotos, T., Gómez-Acebo, I., Gutiérrez-Ruiz, N., Aragonés, N., Amiano, P., Molina de la Torre, A. J., Guevara, M., Alonso-Molero, J., Obon-Santacana, M., Fernández-Tardón, G., Molina-Barceló, A., Alguacil, J., Marcos-Gragera, R., Rodríguez-Cundín, P., Castaño-Vinyals, G., Canseco Fernandez, R., Castilla, J., Molinuevo, A., Pérez-Gómez, B., ... Llorca, J. (2021). Dietary Constituents: Relationship with Breast Cancer Prognostic (MCC-SPAIN Follow-Up). International Journal of Environmental Research and Public Health, 18(1), 84. https://doi.org/10.3390/ijerph18010084

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Dietary Constituents: Relationship with Breast Cancer Prognostic (MCC-SPAIN Follow-Up)

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