Association between dietary inflammatory potential and breast cancer incidence and death: results from the Women’s Health Initiative

Fred K. Tabung, Susan E. Steck, Angela D. Liese, Jiajia Zhang, Yunsheng Ma, Bette Caan, Rowan T. Chlebowski, Jo L. Freudenheim, Lifang Hou, Yasmin Mossavar-Rahmani, Nitin Shivappa, Mara Z. Vitolins, Jean Wactawski-Wende, Judith K. Ockene, James R. Hébert

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Abstract

Background:Diet modulates inflammation and inflammatory markers have been associated with cancer outcomes. In the Women’s Health Initiative, we investigated associations between a dietary inflammatory index (DII) and invasive breast cancer incidence and death.Methods:The DII was calculated from a baseline food frequency questionnaire in 122 788 postmenopausal women, enrolled from 1993 to 1998 with no prior cancer, and followed until 29 August 2014. With median follow-up of 16.02 years, there were 7495 breast cancer cases and 667 breast cancer deaths. We used Cox regression to estimate multivariable-adjusted hazards ratios (HRs) and 95% confidence intervals (95% CIs) by DII quintiles (Q) for incidence of overall breast cancer, breast cancer subtypes, and deaths from breast cancer. The lowest quintile (representing the most anti-inflammatory diet) was the reference.Results:The DII was not associated with incidence of overall breast cancer (HRQ5vsQ1, 0.99; 95% CI, 0.91–1.07; Ptrend=0.83 for overall breast cancer). In a full cohort analysis, a higher risk of death from breast cancer was associated with consumption of more pro-inflammatory diets at baseline, after controlling for multiple potential confounders (HRQ5vsQ1, 1.33; 95% CI, 1.01–1.76; Ptrend=0.03).Conclusions:Future studies are needed to examine the inflammatory potential of post-diagnosis diet given the suggestion from the current study that dietary inflammatory potential before diagnosis is related to breast cancer death.British Journal of Cancer advance online publication 21 April 2016; doi:10.1038/bjc.2016.98 www.bjcancer.com.

Original languageEnglish (US)
JournalBritish Journal of Cancer
DOIs
StateAccepted/In press - Apr 21 2016

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Inflammatory Breast Neoplasms
Women's Health
Breast Neoplasms
Incidence
Diet
Confidence Intervals
Neoplasms
Publications

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Association between dietary inflammatory potential and breast cancer incidence and death : results from the Women’s Health Initiative. / Tabung, Fred K.; Steck, Susan E.; Liese, Angela D.; Zhang, Jiajia; Ma, Yunsheng; Caan, Bette; Chlebowski, Rowan T.; Freudenheim, Jo L.; Hou, Lifang; Mossavar-Rahmani, Yasmin; Shivappa, Nitin; Vitolins, Mara Z.; Wactawski-Wende, Jean; Ockene, Judith K.; Hébert, James R.

In: British Journal of Cancer, 21.04.2016.

Research output: Contribution to journalArticle

Tabung, FK, Steck, SE, Liese, AD, Zhang, J, Ma, Y, Caan, B, Chlebowski, RT, Freudenheim, JL, Hou, L, Mossavar-Rahmani, Y, Shivappa, N, Vitolins, MZ, Wactawski-Wende, J, Ockene, JK & Hébert, JR 2016, 'Association between dietary inflammatory potential and breast cancer incidence and death: results from the Women’s Health Initiative', British Journal of Cancer. https://doi.org/10.1038/bjc.2016.98
Tabung, Fred K. ; Steck, Susan E. ; Liese, Angela D. ; Zhang, Jiajia ; Ma, Yunsheng ; Caan, Bette ; Chlebowski, Rowan T. ; Freudenheim, Jo L. ; Hou, Lifang ; Mossavar-Rahmani, Yasmin ; Shivappa, Nitin ; Vitolins, Mara Z. ; Wactawski-Wende, Jean ; Ockene, Judith K. ; Hébert, James R. / Association between dietary inflammatory potential and breast cancer incidence and death : results from the Women’s Health Initiative. In: British Journal of Cancer. 2016.
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abstract = "Background:Diet modulates inflammation and inflammatory markers have been associated with cancer outcomes. In the Women’s Health Initiative, we investigated associations between a dietary inflammatory index (DII) and invasive breast cancer incidence and death.Methods:The DII was calculated from a baseline food frequency questionnaire in 122 788 postmenopausal women, enrolled from 1993 to 1998 with no prior cancer, and followed until 29 August 2014. With median follow-up of 16.02 years, there were 7495 breast cancer cases and 667 breast cancer deaths. We used Cox regression to estimate multivariable-adjusted hazards ratios (HRs) and 95{\%} confidence intervals (95{\%} CIs) by DII quintiles (Q) for incidence of overall breast cancer, breast cancer subtypes, and deaths from breast cancer. The lowest quintile (representing the most anti-inflammatory diet) was the reference.Results:The DII was not associated with incidence of overall breast cancer (HRQ5vsQ1, 0.99; 95{\%} CI, 0.91–1.07; Ptrend=0.83 for overall breast cancer). In a full cohort analysis, a higher risk of death from breast cancer was associated with consumption of more pro-inflammatory diets at baseline, after controlling for multiple potential confounders (HRQ5vsQ1, 1.33; 95{\%} CI, 1.01–1.76; Ptrend=0.03).Conclusions:Future studies are needed to examine the inflammatory potential of post-diagnosis diet given the suggestion from the current study that dietary inflammatory potential before diagnosis is related to breast cancer death.British Journal of Cancer advance online publication 21 April 2016; doi:10.1038/bjc.2016.98 www.bjcancer.com.",
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AU - Tabung, Fred K.

AU - Steck, Susan E.

AU - Liese, Angela D.

AU - Zhang, Jiajia

AU - Ma, Yunsheng

AU - Caan, Bette

AU - Chlebowski, Rowan T.

AU - Freudenheim, Jo L.

AU - Hou, Lifang

AU - Mossavar-Rahmani, Yasmin

AU - Shivappa, Nitin

AU - Vitolins, Mara Z.

AU - Wactawski-Wende, Jean

AU - Ockene, Judith K.

AU - Hébert, James R.

PY - 2016/4/21

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N2 - Background:Diet modulates inflammation and inflammatory markers have been associated with cancer outcomes. In the Women’s Health Initiative, we investigated associations between a dietary inflammatory index (DII) and invasive breast cancer incidence and death.Methods:The DII was calculated from a baseline food frequency questionnaire in 122 788 postmenopausal women, enrolled from 1993 to 1998 with no prior cancer, and followed until 29 August 2014. With median follow-up of 16.02 years, there were 7495 breast cancer cases and 667 breast cancer deaths. We used Cox regression to estimate multivariable-adjusted hazards ratios (HRs) and 95% confidence intervals (95% CIs) by DII quintiles (Q) for incidence of overall breast cancer, breast cancer subtypes, and deaths from breast cancer. The lowest quintile (representing the most anti-inflammatory diet) was the reference.Results:The DII was not associated with incidence of overall breast cancer (HRQ5vsQ1, 0.99; 95% CI, 0.91–1.07; Ptrend=0.83 for overall breast cancer). In a full cohort analysis, a higher risk of death from breast cancer was associated with consumption of more pro-inflammatory diets at baseline, after controlling for multiple potential confounders (HRQ5vsQ1, 1.33; 95% CI, 1.01–1.76; Ptrend=0.03).Conclusions:Future studies are needed to examine the inflammatory potential of post-diagnosis diet given the suggestion from the current study that dietary inflammatory potential before diagnosis is related to breast cancer death.British Journal of Cancer advance online publication 21 April 2016; doi:10.1038/bjc.2016.98 www.bjcancer.com.

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