Intake of Fruits,Vegetables, and Soy Foods in Relation to Breast Cancer Risk in Korean Women: A Case-Control Study

We conducted a case-control study to examine the relationship between fruit, vegetable, and soy food intake and breast cancer risk in Korean women. Incident cases (n = 359) were identified through cancer biopsies between March 1999 and August 2003 at two university hospitals in Seoul, Korea. Hospital-based controls (n = 708) were selected from patients in the same hospitals during the same period. Subjects were asked by personal interview to indicate their average fruit, vegetable, and soy food intake for a 12-mo period 3 yr prior to the baseline phase. A food intake–frequency questionnaire (98 items) was given by a trained dietitian. Odds ratio (OR) and 95% confidence intervals (CIs) were calculated by unconditional logistic regression after adjustment for confounding factors and total energy intake. There was no association between the intake of total fruits, vegetables, or soy food and breast cancer risk. Increasing consumption of grapes was linked to a significant protective effect against risk of breast cancer (OR = 0.66; 95% CI = 0.41–0.86; P < 0.01). Among the vegetables, reduced risk was observed with high tomato intake (OR = 0.62; 95% CI = 0.38–0.81; P < 0.01). Among soy foods, high consumption of cooked soybeans, including yellow and black soybeans, had an association with reduced breast cancer (OR = 0.67; 95% CI = 0.45–0.91; P < 0.02). Our data suggest that increased intake of some fruits, vegetables, and soy foods may be associated with breast cancer risk reduction in Korean women.     

The association between dietary lignans, phytoestrogen-rich foods, and fiber intake and postmenopausal breast cancer risk: a German case-control study

Phytoestrogens are structurally similar to estrogens and may affect breast cancer risk by mimicking estrogenic/antiestrogenic properties. In Western societies, whole grains and possibly soy foods are rich sources of phytoestrogens. A population-based case-control study in German postmenopausal women was used to evaluate the association of phytoestrogen-rich foods and dietary lignans with breast cancer risk. Dietary data were collected from 2,884 cases and 5,509 controls using a validated food-frequency questionnaire, which included additional questions phytoestrogen-rich foods. Associations were assessed using conditional logistic regression. All analyses were adjusted for relevant risk and confounding factors. Polytomous logistic regression analysis was performed to evaluate the associations by estrogen receptor (ER) status. High and low consumption of soybeans as well as of sunflower and pumpkin seeds were associated with significantly reduced breast cancer risk compared to no consumption (OR = 0.83, 95% CI = 0.70-0.97; and OR = 0.66, 95% CI = 0.77-0.97, respectively). The observed associations were not differential by ER status. No statistically significant associations were found for dietary intake of plant lignans, fiber, or the calculated enterolignans. Our results provide evidence for a reduced postmenopausal breast cancer risk associated with increased consumption of sunflower and pumpkin seeds and soybeans.     

Fruits, vegetables, soy foods and breast cancer in pre- and postmenopausal Korean women: a case-control study

We carried out a case-control study to examine the relationship between fruits, vegetables, and soy foods intake with breast cancer risk in Korean women. Incident cases (n = 359) were identified through cancer biopsies and hospital-based controls (n = 708) were selected in the same hospitals. Subjects were asked to indicate usual dietary habits, which were assessed using a semi-quantitative food frequency questionnaire (98 items). Odds ratio (OR) and 95% confidence intervals (95% CI) were calculated by unconditional logistic regression after adjustment for additional confounding factors according to the menopausal status. High grape intake showed an inverse association of breast cancer in postmenopausal women (OR = 0.59, 95% CI = 0.35-0.95; p for trend = 0.05). High tomato intake was associated with reduced breast cancer risk in premenopausal women (OR = 0.59, 95% CI = 0.38-0.89, p for trend = 0.04). In postmenopausal women, green pepper intake showed an inverse association of breast cancer risk (OR = 0.60, 95% CI = 0.43-0.96, p for trend = 0.03). High soybean intake showed an inverse association of breast cancer in postmenopausal women (OR = 0.61, 95% CI = 0.34-0.89, p for trend = 0.02). Our study suggests that high intake of some fruits, vegetables, and soybeans may be associated with a reduced breast cancer risk.     

Associations of weight,weight change,and body mass with breast cancer risk in Hispanic and non-Hispanic white women

PURPOSE: A wealth of studies have examined the effects of weight, weight gain, and obesity on breast cancer risk; however, few have examined this relationship in Hispanic white women, a population with the highest rate of obesity in the U.S. METHODS: A population-based case-control study was conducted in New Mexico of Hispanic (n = 694) and non-Hispanic (n = 813) white women with incident breast cancer during the period of January 1, 1992 through December 31, 1994. Conditional logistic regression models were fitted to estimate the relative risk of breast cancer for levels of weight, weight change, and body mass index (BMI) and to assess differences in the effects by ethnicity, menopausal status, early life BMI, and estrogen receptor/progesterone receptor (ER/PR) expression in tumors. RESULTS: Weight change from age 18 to usual adult weight was associated with increased risk of breast cancer among Hispanics [4th quartile vs. baseline, odds ratio (OR): 2.41; 95% confidence interval (CI): 1.45-4.03] with no substantial variation by menopausal status. In non-Hispanic white women, weight change was a risk factor for those in the post-menopausal group (4th quartile vs. baseline, OR: 2.27; 95% CI: 1.09-4.73). The effect of usual BMI (test for interaction p = 0.04) and weight change (test for interaction p = 0.03) differed by ethnicity. Increased risk from weight gain was largely restricted to women who were lean at age 18 and those with ER(+)/PR(+) tumors. Height, weight at age 18, and BMI at age 18 were not associated with risk in either ethnic group. CONCLUSIONS: Weight change and obesity are risk factors for breast cancer in both Hispanic and non-Hispanic white women. However, the risk for Hispanic women is evident independent of menopausal status, while the risk for non-Hispanics is apparent in post-menopausal women. Due to the increasing prevalence of adult obesity, particularly among Hispanic women, adult weight gain may be an important modifiable risk factor for the primary prevention of breast cancer among Hispanic populations.     

Lifetime alcohol intake and breast cancer risk

PURPOSE: Moderate alcohol intake of one to two drinks per day has been consistently associated with a 30-50% increase in breast cancer. Despite the consistency in the overall association, several important questions remain, including whether the association between alcohol intake and breast cancer risk is affected by the timing of alcohol exposure, modified by other risk factors such as body mass index (BMI), menopausal status, and hormone replacement therapy (HRT), or more pronounced among hormone receptor positive tumors or invasive rather than in situ disease. METHODS: To address these questions, we conducted a large population-based study (1508 cases and 1556 controls) that collected detailed information on alcohol and other exposures throughout the lifecourse. RESULTS: Consumption of 15-30 grams/day (approximately one to two drinks) throughout life was associated with a modest 33% increase in risk (odds ratio [OR] = 1.33, 95% confidence interval (CI) = 1.01-1.74), but heavier consumption (> or = 30 grams per day) was not. Risk did not vary with alcohol type (beer, wine, or hard liquor) or by patterns of use, such as recent use, intake prior to age 20 years, or whether use began at an early age. The association with lifetime intake was limited to women with a BMI < 25 (OR = 2.13, 95% CI = 1.29-3.54). Alcohol consumption of approximately one drink per day was associated with estrogen receptor positive tumors among women with a BMI < 25, but not among women BMI > or = 25. Also, the elevated OR was observed only among women diagnosed with invasive (OR = 1.56, 95% CI = 1.11-2.18), but not in situ breast tumors. CONCLUSIONS: These data give added support that moderate alcohol consumption over the life course increases breast cancer risk, particularly among women with low BMI and those diagnosed with estrogen receptor positive tumors or with invasive rather than in situ disease. Risk is confined to moderate intake and does not vary with the timing of use, with heavier doses, or with the type of alcohol consumed.     

Dietary intakes of total and specific lignans are associated with clinical breast tumor characteristics

Dietary lignans may affect breast cancer by modifying tumor characteristics likely to affect prognosis. We investigated usual dietary intakes of total and specific lignans with tumor characteristics in 683 women with breast cancer and 611 healthy women without breast cancer enrolled in the Data Bank and BioRepository at Roswell Park Cancer Institute (RPCI). Clinicopathologic data were abstracted from the RPCI breast cancer database. Dietary lignan intakes were calculated from FFQ. OR and 95% CI were estimated with logistic regression adjusting for potential confounders and stratified by menopausal status. Women in the highest compared to the lowest tertile of total lignan intakes had a 40-50% lower odds of breast cancer regardless of menopausal status and substantially reduced odds of an invasive tumor, especially among premenopausal women [OR 0.48 (95% CI 0.26-0.86)]. Lignan intakes were inversely associated with odds of grade 3 tumors among premenopausal women. Lignan intakes were inversely associated with risk of estrogen receptor (ER) negative (ER(-)) breast cancer among premenopausal women [OR 0.16 (95% CI 0.03-0.44)] and particularly triple negative tumors [ER(-), progesterone receptor negative, HER2 negative; OR 0.16 (95% CI 0.04-0.62)]. There were significant differences in the contribution to these effects by specific lignans, especially matairesinol and lariciresinol. In summary, in this case-control study of dietary lignan intakes and breast cancer, we found that higher lignan intakes were associated with lower risks of breast cancer with more favorable prognostic characteristics. Future investigations are warranted to explore the strong associations observed with ER(-) cancer in premenopausal women.     

Factors Associated with Adherence to the Mediterranean Diet among Adolescents Living in Sicily,Southern Italy

The present study aimed to examine the factors associated with increased Mediterranean diet (MD) adherence among a sample of Italian adolescents. A cross-sectional survey was conducted on 1135 students (13–16 years) attending 13 secondary schools of Sicily, southern Italy. Validated instruments were used for dietary assessment and the KIDMED score to assess adolescents’ adherence to the MD. A higher adherence to the MD was associated with high socioeconomic status (Odds Ratio [OR] 1.53, 95% Confidence Interval [CI]: 1.03–2.26) and high physical activity (OR 1.19, 95% CI: 1.02–1.70), whereas lower adherence was associated with living in an urban environment (OR 0.65, 95% CI: 0.44–0.97) and being obese (OR 0.59, 95% CI: 0.37–0.94). The adolescents’ KIDMED scores were inversely associated with adolescents’ intake of sweets, fast foods, fried foods, and sugary drinks, and directly with fruit, vegetables, pasta, fish, and cheese intakes. Urban-living adolescents were less likely to eat fruit and more prone to consume meat, sugary drinks, and fast food than rural-living adolescents. The latter were more likely to eat sweets and snacks. A general poor quality of food consumption in Italian adolescents away from the MD was reported, especially among those living in urban areas.     

Dietary Mushroom Intake and the Risk of Breast Cancer Based on Hormone Receptor Status

Although many studies have documented the antitumor activities of mushrooms, the association between mushroom intake and breast cancer, defined by hormone receptor status, has received minimal empirical investigation. This study evaluated the association between mushroom intake and the risk of breast cancer according to hormone receptor status among Korean women. Mushroom intake and breast cancer risk were examined among 358 breast cancer patients and 360 cancer-free controls. Intake of mushrooms was assessed using a quantitative food frequency questionnaire. Greater mushroom intake was related to lower risk of breast cancers among premenopausal women (odds ratio [OR] = 0.35, 95% confidence interval [CI] = 0.13–0.91 for the highest vs. the lowest quartile intake). The association was stronger for premenopausal women with estrogen receptor (ER)+/progesterone receptor (PR) + tumors (OR = 0.30, 95% CI = 0.11–0.79 for the highest vs. the lowest quartile intake) than those with ER–/PR– tumors. Our results suggest that high consumption of mushrooms might be related to lower risks for breast cancers among premenopausal women; this association may be more robust among women with hormone receptor positive tumors.     

Intake of fruits, vegetables, and soy foods in relation to breast cancer risk in Korean women: a case-control study

We conducted a case-control study to examine the relationship between fruit, vegetable, and soy food intake and breast cancer risk in Korean women. Incident cases (n=359) were identified through cancer biopsies between March 1999 and August 2003 at two university hospitals in Seoul, Korea. Hospital-based controls (n=708) were selected from patients in the same hospitals during the same period. Subjects were asked by personal interview to indicate their average fruit, vegetable, and soy food intake for a 12-mo period 3 yr prior to the baseline phase. A food intake-frequency questionnaire (98 items) was given by a trained dietitian. Odds ratio (OR) and 95% confidence intervals (CIs) were calculated by unconditional logistic regression after adjustment for confounding factors and total energy intake. There was no association between the intake of total fruits, vegetables, or soy food and breast cancer risk. Increasing consumption of grapes was linked to a significant protective effect against risk of breast cancer (OR=0.66; 95% CI=0.41-0.86; P<0.01). Among the vegetables, reduced risk was observed with high tomato intake (OR=0.62; 95% CI=0.38-0.81; P<0.01). Among soy foods, high consumption of cooked soybeans, including yellow and black soybeans, had an association with reduced breast cancer (OR=0.67; 95% CI=0.45-0.91; P<0.02). Our data suggest that increased intake of some fruits, vegetables, and soy foods may be associated with breast cancer risk reduction in Korean women.     

Effects of energy-dense nutrient-poor snacks on the incidence of metabolic syndrome: A prospective approach in Tehran Lipid and Glucose Study

ObjectivesIncreased consumption of energy-dense, nutrient-poor snacks is one of the major, growing concerns in relation to the alarming trend of overweight, obesity, and metabolic disorders worldwide. The aim of this study was to investigate whether consumption of energy-dense snacks could affect the occurrence of metabolic syndrome after 3 y of follow-up in adults.MethodsThis longitudinal study was conducted within the framework of the Tehran Lipid and Glucose Study between 2006 and 2008 and 2009 and 2011, on 1466 adults, ages 19 to 70 y. The usual intake of participants was measured using a validated semiquantitative food frequency questionnaire at baseline. Biochemical and anthropometric measurements were assessed at baseline and 3 y later. Multiple logistic regression models were used to estimate the occurrence of metabolic syndrome (MetS) in each quartile of energy-dense snacks.ResultsParticipants in the highest quartile of energy-dense snack consumption were significantly younger (33.8 versus 43.1 y; P < 0.01). There were non-significant increased risks for MetS in the highest quartile of biscuits and cakes (odds ratio [OR], 1.13; 95% confidence interval [CI], 0.77–1.66), and candies and chocolates (OR, 1.31; 95% CI, 0.88–1.94). The risk for MetS in participants with highest consumption of salty snacks increased more than 50% (OR, 1.56; 95% CI, 1.01–2.40). Consumption of soft drinks had a borderline effect on the risk for MetS. More than 361 kcal/d from total energy-dense snacks independently increased the occurrence of MetS in the fourth compared the first quartile category (OR, 1.53; 95% CI, 1.03–2.29).ConclusionThe findings of this study demonstrated that higher consumption of energy-dense snacks could be a dietary risk factor for development of MetS.     

Cruciferous vegetables, the GSTP1 Ile105Val genetic polymorphism, and breast cancer risk

BACKGROUND: Cruciferous vegetables are the primary source of isothiocyanates and other glucosinolate derivatives that are known to induce phase II detoxifying enzymes, including glutathione S-transferases (GSTs). OBJECTIVE: We investigated the independent and combined effects of cruciferous vegetable intake and the GSTP1 Ile(105)Val genetic polymorphism on breast cancer risk. DESIGN: Analyses included 3035 cases and 3037 population controls who were participating in the Shanghai Breast Cancer Study and for whom diet and genetic data were complete (87% of cases and 85% of controls). RESULTS: With the use of multivariate logistic regression, the GSTP1 Val/Val genotype was significantly associated with greater breast cancer risk (OR = 1.50; 95% CI: 1.12, 1.99). The association was significantly greater in premenopausal women (OR = 1.69; 95% CI: 1.17, 2.43) than in postmenopausal women (OR = 1.20; 95% CI: 0.74, 1.92). Total cruciferous vegetable intake was not significantly associated with breast cancer risk, although subjects reporting greater turnip (P for trend < 0.001) and Chinese cabbage (P for trend = 0.049) intakes had a significantly lower postmenopausal breast cancer risk. Women with the GSTP1 Val/Val genotype and low cruciferous vegetable intake had a breast cancer risk 1.74-fold (95% CI: 1.13, 2.67) that of women with the Ile/Ile or Ile/Val genotype. This effect of low cruciferous vegetable intake and the Val/Val genotype was seen predominantly among premenopausal women (OR = 2.08; 95% CI = 1.20, 3.59). CONCLUSIONS: Cruciferous vegetable intake consistent with high isothiocyanate exposure may reduce breast cancer risk. Cruciferous vegetable intake also may ameliorate the effects of the GSTP1 genotype.     

Impact of Consumption of Vegetable,Fruit, Grain,and High Glycemic Index Foods on Aggressive Prostate Cancer Risk

Prostate cancer is a common but complex disease, and distinguishing modifiable risk factors such as diet for more aggressive disease is extremely important. Previous work has detected intriguing associations between vegetable, fruit, and grains and more aggressive prostate cancer, although these remain somewhat unclear. Here we further investigate such potential relationships with a case-control study of 982 men (470 more aggressive prostate cancer cases and 512 control subjects). Comparing the highest to lowest quartiles of intake, we found that increasing intakes of leafy vegetables were inversely associated with risk of aggressive prostate cancer [adjusted odds ratio (OR) = 0.66, 95% CI: 0.46, 0.96; P trend = 0.02], as was higher consumption of high carotenoid vegetables (OR = 0.71, 95% CI: 0.48, 1.04; P trend = 0.04). Conversely, increased consumption of high glycemic index foods were positively associated with risk of aggressive disease (OR = 1.64, 95% CI: 1.05, 2.57; P trend = 0.02). These results were driven by a number of specific foods within the food groups. Our findings support the hypothesis that diets high in vegetables and low in high glycemic index foods decrease risk of aggressive prostate cancer.     

Dietary Intake of Soy Protein and Tofu in Association With Breast Cancer Risk Based on a Case-Control Study

Soy food and its constituents may protect against breast cancer, but the association between soy intake and decreased breast cancer risk is inconsistent. We evaluated the relationship between breast cancer risk and the dietary intake of soy protein as measured by total soy food and tofu intake. Histologically confirmed cases ( n = 362) were matched to controls by age (within 2 yr) and menopausal status. High soy protein intake was associated with reduced breast cancer risk in analyses adjusted for potential confounders including dietary factors among premenopausal women (odds ratio [OR] = 0.39 in the highest quintile, 95% confidence interval [CI] = 0.22–0.93, P for trend = 0.03) and postmenopausal women (OR = 0.22, 95% CI = 0.06–0.88, P for trend = 0.16). We also found an inverse association between total tofu intake and breast cancer risk among premenopausal women (for total tofu intake, OR = 0.23 in the highest quintile, 95% CI = 0.11–0.48, P for trend < 0.01; for at least 1 serving of tofu as the main ingredient per day, OR = 0.26, 95% CI = 0.13–0.55, P for trend < 0.01). We concluded that increased regular soy food intake at a level equivalent to traditional Korean consumption levels may be associated with a reduced risk of breast cancer, and this effect is more pronounced in premenopausal women.     

Dietary intake of soy protein and tofu in association with breast cancer risk based on a case-control study

Soy food and its constituents may protect against breast cancer, but the association between soy intake and decreased breast cancer risk is inconsistent. We evaluated the relationship between breast cancer risk and the dietary intake of soy protein as measured by total soy food and tofu intake. Histologically confirmed cases (n = 362) were matched to controls by age (within 2 yr) and menopausal status. High soy protein intake was associated with reduced breast cancer risk in analyses adjusted for potential confounders including dietary factors among premenopausal women (odds ratio [OR] = 0.39 in the highest quintile, 95% confidence interval [CI] = 0.22-0.93, P for trend = 0.03) and postmenopausal women (OR = 0.22, 95% CI = 0.06-0.88, P for trend = 0.16). We also found an inverse association between total tofu intake and breast cancer risk among premenopausal women (for total tofu intake, OR = 0.23 in the highest quintile, 95% CI = 0.11-0.48, P for trend < 0.01; for at least 1 serving of tofu as the main ingredient per day, OR = 0.26, 95% CI = 0.13-0.55, P for trend < 0.01). We concluded that increased regular soy food intake at a level equivalent to traditional Korean consumption levels may be associated with a reduced risk of breast cancer, and this effect is more pronounced in premenopausal women.     

Obesity and height in urban Nigerian women with breast cancer

PURPOSE: To examine the relationship between obesity, height, and breast cancer in an urban Nigerian population. METHODS: Between March 1998 and August 2000, we conducted a case-control study of hospital-based breast cancer patients (n = 234) and population-based controls (n = 273) using nurse interviewers in urban Southwestern Nigeria. RESULTS: The study did not find a significant association between obesity (BMI >/= 30) and breast cancer among all women (OR = 1.51, 95% CI = 0.87-2.62) pre- (OR = 1.21, 95% CI = 0.56-2.60) and post-menopausal breast cancer patients (OR = 1.82, 95% CI = 0.78-4.31) in multivariate logistic regression analysis, while increasing height was positively associated with the risk of breast cancer among all women (OR = 1.05, 1.01 - 1.08), pre- (1.06, 1.01-1.10) and post-menopausal women (1.07, 1.01-1.13) for each cm. Age, irregular period, and early age of onset of periods were also found to be significantly associated with breast cancer risk. CONCLUSION: This study failed to demonstrate an association between breast cancer risk and obesity while showing that height is positively associated with risk of breast cancer in urbanized Nigerian women.     

Fruit,Vegetable, and Animal Food Intake and Breast Cancer Risk by Hormone Receptor Status

The effects of diet on breast cancer are controversial and whether the effects vary with hormone receptor status has not been well investigated. This study evaluated the associations of dietary factors with risk for breast cancer overall and by the hormone receptor status of tumors among Chinese women. The Shanghai Breast Cancer Study, a large, population-based, case-control study, enrolled 3,443 cases and 3,474 controls in 1996–1998 (phase I) and 2002–2005 (phase II); 2676 cases had estrogen receptor (ER) and progesterone receptor (PR) data. Dietary intake was assessed using a validated, quantitative, food frequency questionnaire. Odds ratios (OR) and 95% confidence intervals (95% CI) were derived from multivariate, polychotomous, unconditional logistic regression models. Total vegetable intake was inversely related to breast cancer risk, with an adjusted OR for the highest quintile of 0.80 (95% CI = 0.67–0.95; P trend = 0.02). Reduced risk was also related to high intake of allium vegetables (P trend = 0.01) and fresh legumes (P trend = 0.0008). High intake of citrus fruits and rosaceae fruits were inversely associated with breast cancer risk (P trend = 0.003 and 0.004, respectively), although no consistent association was seen for total fruit intake. Elevated risk was observed for all types of meat and fish intake (all P trend < 0.05), whereas intakes of eggs and milk were associated with a decreased risk of breast cancer (both P trend <0.05). There was little evidence that associations with dietary intakes varied across the 4 tumor subtypes or between ER+/PR+ and ER-/PR- tumors (P for heterogeneity >0.05). Our results suggest that high intake of total vegetables, certain fruits, milk, and eggs may reduce the risk of breast cancer, whereas high consumption of animal-source foods may increase risk. The dietary associations did not appear to vary by ER/PR status.     

Fruit, vegetable, and animal food intake and breast cancer risk by hormone receptor status

The effects of diet on breast cancer are controversial and whether the effects vary with hormone receptor status has not been well investigated. This study evaluated the associations of dietary factors with risk for breast cancer overall and by the hormone receptor status of tumors among Chinese women. The Shanghai Breast Cancer Study, a large, population-based, case-control study, enrolled 3,443 cases and 3,474 controls in 1996-1998 (phase I) and 2002-2005 (phase II); 2676 cases had estrogen receptor (ER) and progesterone receptor (PR) data. Dietary intake was assessed using a validated, quantitative, food frequency questionnaire. Odds ratios (OR) and 95% confidence intervals (95% CI) were derived from multivariate, polychotomous, unconditional logistic regression models. Total vegetable intake was inversely related to breast cancer risk, with an adjusted OR for the highest quintile of 0.80 (95% CI = 0.67-0.95; P trend = 0.02). Reduced risk was also related to high intake of allium vegetables (P trend = 0.01) and fresh legumes (P trend = 0.0008). High intake of citrus fruits and rosaceae fruits were inversely associated with breast cancer risk (P trend = 0.003 and 0.004, respectively), although no consistent association was seen for total fruit intake. Elevated risk was observed for all types of meat and fish intake (all P trend < 0.05), whereas intakes of eggs and milk were associated with a decreased risk of breast cancer (both P trend <0.05). There was little evidence that associations with dietary intakes varied across the 4 tumor subtypes or between ER+/PR+ and ER-/PR- tumors (P for heterogeneity >0.05). Our results suggest that high intake of total vegetables, certain fruits, milk, and eggs may reduce the risk of breast cancer, whereas high consumption of animal-source foods may increase risk. The dietary associations did not appear to vary by ER/PR status.     

Cigarette smoking and breast cancer.

An epidemiological case-control study was conducted in New York State, with 1617 primary breast cancer patients and an equal number of controls, to examine the relationship between cigarette smoking and breast cancer. Results showed no overall association between ever smokers versus never smokers and breast cancer risk (odds ratio [OR] = 1.03, 95% confidence interval [CI]: 0.90-1.19), nor was there any dose response trend observed with increased levels of smoking. In addition, no association was found with risk and age started smoking, age stopped smoking, amount smoked or total years smoked. Controlling for previously identified risk factors for breast cancer in the analysis did not significantly alter these relationships. Previous studies have found a difference in menopausal age among smokers compared to nonsmokers. The mean menopausal age was only slightly lower in smokers than in never smokers for both cases and controls. Breast cancer risk was observed to be close to unity for premenopausal women (OR = 0.97, 95% CI: 0.74-1.34) and postmenopausal women (OR = 1.06, 95% CI: 0.91-1.26). A recent study suggested breast cancer risk was more strongly related to starting smoking at a young age among women who smoked at least 25 or more cigarettes per day in the most recent year of smoking. This hypothesis was not supported by these data.     

Cigarette smoking, alcohol consumption, and screening mammography among women ages 50 and older

BACKGROUND: The associations among cigarette smoking and alcohol consumption with recent screening mammograms were evaluated among women ages 50 years and older. METHODS: The sample included 946 white and African-American women ages 50 years and older from the 1995 Maryland Behavioral Risk Factor Survey. Bivariate and logistic regression analyses were performed to evaluate the associations between current cigarette smoking and alcohol consumption in the past month (none, 1-7 drinks, >7 drinks) with obtaining a screening mammogram in the past 2 years (recent mammogram), controlling for sociodemographic and health variables. RESULTS: Seventy-eight percent of respondents had recent mammograms, 15% smoked cigarettes, 18% reported 1-7 drinks, and 12% reported >7 drinks in the past month. Smokers had lower mammography rates than nonsmokers (odds ratio (OR) = 0.47, 95% confidence interval (CI) = 0.30-0.75). Women who drank alcoholic beverages had higher mammography rates than nondrinkers (OR = 1.37, 95% CI = 1.03-1.83). Smokers had the lowest mammography rates, regardless of their consumption of alcohol. An interaction was observed among white but not African-American women: nonsmokers who consumed moderate amounts of alcohol (1-7 drinks) had the highest mammography rates in this subgroup. CONCLUSIONS: To reduce breast cancer mortality, it is important to increase screening mammography among all women over age 50 and especially among smokers and the oldest women.     

Dietary glycemic index, glycemic load, and the risk of breast cancer in an Italian prospective cohort study

BACKGROUND: Interest in the roles of glycemic index (GI) and glycemic load (GL) in breast cancer etiology has been stimulated by indications that disease risk is linked to insulinemia, sex hormone bioavailability, and insulin-like growth factor 1. OBJECTIVE: We aimed to determine whether GI and GL were associated with the risk of breast cancer in a cohort of Italian women volunteers from Northern Italy, who enrolled between 1987-1992 in the Hormones and Diet in the Etiology of Breast Tumors Study (ORDET Study). DESIGN: Volunteers completed a semiquantitative food-frequency questionnaire, and anthropometric and lifestyle data were collected. Dietary GI and GL in relation to breast cancer risk were examined in 8926 cohort women, including 289 with breast cancer identified after a mean follow-up of 11.5 y. RESULTS: The relative risk (RR) of breast cancer in the highest (versus lowest) quintiles of GI and GL was 1.57 (95% CI: 1.04, 2.36; P for trend = 0.040) and 2.53 (95% CI: 1.54, 4.16; P for trend = 0.001), respectively. Total carbohydrate intake was not associated with greater breast cancer risk, but high carbohydrate from high-GI foods was. When women were categorized by baseline menopausal status and body mass index (BMI; in kg/m(2)), the increased risk of dietary GL was confined to those who were premenopausal (RR = 3.89; 95% CI: 1.81, 8.34) and who had normal BMI (ie, <25) (RR = 5.79; 95% CI: 2.60, 12.90) (P for trend = 0.001 for both). CONCLUSIONS: A high-GL diet may increase the risk of breast cancer in Italian women. The effect is particularly evident in premenopausal women and those with BMI < 25.