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Adherence to the World Cancer Research Fund/American Institute for Cancer Research Recommendations and the Risk of Breast Cancer.

  • Turati F Unit of Medical Statistics and Biometry, Fondazione IRCCS Istituto Nazionale Dei Tumori Di Milano, Via Venezian 1, 20133 Milan, Italy.
  • Dalmartello M Department of Clinical Sciences and Community Health, Università degli studi di Milano, Via A. Vanzetti 5, 20133 Milan, Italy.
  • Bravi F Department of Clinical Sciences and Community Health, Università degli studi di Milano, Via A. Vanzetti 5, 20133 Milan, Italy.
  • Serraino D Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, IRCCS, via F. Gallini 2, 33080 Aviano, Italy.
  • Augustin L Unit of Epidemiology, National Cancer Institute, G. Pascale Foundation, Via M. Semmola 1, 80131 Naples, Italy.
  • Giacosa A Department of Gastroenterology and Clinical Nutrition, Policlinico di Monza, via Amati 111, 20900 Monza, Italy.
  • Negri E Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Via G.B. Grassi 74, 20157 Milan, Italy.
  • Levi F Institute of Social and Preventive Medicine (IUMSP), Unisanté, University of Lausanne, Route de la Corniche 10, 1010 Lausanne, Switzerland.
  • La Vecchia C Department of Clinical Sciences and Community Health, Università degli studi di Milano, Via A. Vanzetti 5, 20133 Milan, Italy.
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  • 2020-03-01
Published in:
  • Nutrients. - 2020
breast cancer
diet
guideline adherence
lifestyle
nutrition
prevention
English The World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) introduced in 2007, and updated in 2018, nutrition-related recommendations for cancer prevention. Previous studies generally reported inverse associations of breast cancer with the 2007 recommendations, while no study has yet evaluated the association with the 2018 guidelines. We investigated the association between adherence to the 2018 WCRF/AICR recommendations and breast cancer risk in a case-control study from Italy and Switzerland (1991-2008) including 3034 incident histologically-confirmed breast cancer cases and 3392 hospital controls. Adherence to the 2018 guidelines was summarized through a score incorporating eight recommendations (body fatness, physical activity, consumption of wholegrains/vegetables/fruit/beans, "fast foods" and other processed foods high in fat, starches, or sugars, red/processed meat, sugar-sweetened drinks, alcohol, breastfeeding), with higher scores indicating higher adherence. Odds ratios (OR) were estimated using multiple logistic regression models. We also conducted a meta-analysis including 15 additional studies using random-effects models. In our case-control study, adherence to the 2018 WCRF/AICR guidelines was inversely associated with breast cancer, with ORs of 0.60 (95% confidence interval (CI), 0.51-0.70) for a score ≥5.5 vs. ≤4.25, and of 0.83 (95% CI, 0.79-0.88) for a 1-point increment. In our study, 25% of breast cancers were attributable to low-to-moderate guideline adherence. In the meta-analysis, the pooled relative risks (RRs) were 0.73 (95% CI, 0.65-0.82, p heterogeneity among studies< 0.001) for the highest vs. the lowest WCRF/AICR score category, and 0.91 (95% CI, 0.88-0.94, p heterogeneity < 0.001) for a 1-point increment. This work provides quantitative evidence that higher adherence to the WCRF/AICR recommendations reduces the risk of breast cancer, thus opening perspectives for prevention.
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  • English
Open access status
gold
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https://folia.unifr.ch/global/documents/186213
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