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

doi:10.1038/bjc.2016.98

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

^*Corresponding author for this work

Preventive Medicine

Research output: Contribution to journal › Article › peer-review

88 Scopus citations

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 (HR Q5vsQ1, 0.99; 95% CI, 0.91-1.07; P trend =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 (HR Q5vsQ1, 1.33; 95% CI, 1.01-1.76; P trend =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.

Original language	English (US)
Pages (from-to)	1277-1285
Number of pages	9
Journal	British Journal of Cancer
Volume	114
Issue number	11
DOIs	https://doi.org/10.1038/bjc.2016.98
State	Published - May 24 2016

Funding

This project was supported by the Prevent Cancer Foundation Living in Pink grant. Dr Tabung was supported by the University of South Carolina's (USC) Office of the Vice President for Research under the SPARC grant, and by an award from the National Cancer Institute (NCI) of the National Institutes of Health (NIH) F31CA177255. Dr Hébert was supported by an NCI Award K05 CA136975. The National Institutes of Health and the US. Department of Health and Human Services funded the WHI program through Contracts HHSN268201100046C, HHSN268 201100001C, HHSN268201100002C, HHSN268201100003C, HHSN268201100004C, and HHSN271201100004C. This project was supported by the Prevent Cancer Foundation Living in Pink grant. Dr Tabung was supported by the University of South Carolina's (USC) Office of the Vice President for Research under the SPARC grant, and by an award from the National Cancer Institute (NCI) of the National Institutes of Health (NIH) F31CA177255. Dr H?bert was supported by an NCI Award K05 CA136975. The National Institutes of Health and the US. Department of Health and Human Services funded the WHI program through Contracts HHSN268201100046C, HHSN268 201100001C, HHSN268201100002C, HHSN268201100003C, HHSN268201100004C, and HHSN271201100004C.

Keywords

Women's Health Initiative
breast cancer
dietary inflammatory index
incidence
mortality

ASJC Scopus subject areas

Oncology
Cancer Research

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1038/bjc.2016.98

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Tabung, F. K., Steck, S. E., Liese, A. D., Zhang, J., Ma, Y., Caan, B., Chlebowski, R. T., Freudenheim, J. L., Hou, L., Mossavar-Rahmani, Y., Shivappa, N., Vitolins, M. Z., Wactawski-Wende, J., Ockene, J. K., & Hébert, J. R. (2016). Association between dietary inflammatory potential and breast cancer incidence and death: Results from the Women's Health Initiative. British Journal of Cancer, 114(11), 1277-1285. https://doi.org/10.1038/bjc.2016.98

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title = "Association between dietary inflammatory potential and breast cancer incidence and death: Results from the Women's Health Initiative",

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 (HR Q5vsQ1, 0.99; 95% CI, 0.91-1.07; P trend =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 (HR Q5vsQ1, 1.33; 95% CI, 1.01-1.76; P trend =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.",

keywords = "Women's Health Initiative, breast cancer, dietary inflammatory index, incidence, mortality",

author = "Tabung, {Fred K.} and Steck, {Susan E.} and Liese, {Angela D.} and Jiajia Zhang and Yunsheng Ma and Bette Caan and Chlebowski, {Rowan T.} and Freudenheim, {Jo L.} and Lifang Hou and Yasmin Mossavar-Rahmani and Nitin Shivappa and Vitolins, {Mara Z.} and Jean Wactawski-Wende and Ockene, {Judith K.} and H{\'e}bert, {James R.}",

note = "Funding Information: This project was supported by the Prevent Cancer Foundation Living in Pink grant. Dr Tabung was supported by the University of South Carolina's (USC) Office of the Vice President for Research under the SPARC grant, and by an award from the National Cancer Institute (NCI) of the National Institutes of Health (NIH) F31CA177255. Dr H{\'e}bert was supported by an NCI Award K05 CA136975. The National Institutes of Health and the US. Department of Health and Human Services funded the WHI program through Contracts HHSN268201100046C, HHSN268 201100001C, HHSN268201100002C, HHSN268201100003C, HHSN268201100004C, and HHSN271201100004C. Funding Information: This project was supported by the Prevent Cancer Foundation Living in Pink grant. Dr Tabung was supported by the University of South Carolina's (USC) Office of the Vice President for Research under the SPARC grant, and by an award from the National Cancer Institute (NCI) of the National Institutes of Health (NIH) F31CA177255. Dr H?bert was supported by an NCI Award K05 CA136975. The National Institutes of Health and the US. Department of Health and Human Services funded the WHI program through Contracts HHSN268201100046C, HHSN268 201100001C, HHSN268201100002C, HHSN268201100003C, HHSN268201100004C, and HHSN271201100004C. Publisher Copyright: {\textcopyright} 2016 Cancer Research UK.",

year = "2016",

month = may,

day = "24",

doi = "10.1038/bjc.2016.98",

language = "English (US)",

volume = "114",

pages = "1277--1285",

journal = "British Journal of Cancer",

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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, vol. 114, no. 11, pp. 1277-1285. https://doi.org/10.1038/bjc.2016.98

TY - JOUR

T1 - Association between dietary inflammatory potential and breast cancer incidence and death

T2 - Results from the Women's Health Initiative

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.

N1 - Funding Information: This project was supported by the Prevent Cancer Foundation Living in Pink grant. Dr Tabung was supported by the University of South Carolina's (USC) Office of the Vice President for Research under the SPARC grant, and by an award from the National Cancer Institute (NCI) of the National Institutes of Health (NIH) F31CA177255. Dr Hébert was supported by an NCI Award K05 CA136975. The National Institutes of Health and the US. Department of Health and Human Services funded the WHI program through Contracts HHSN268201100046C, HHSN268 201100001C, HHSN268201100002C, HHSN268201100003C, HHSN268201100004C, and HHSN271201100004C. Funding Information: This project was supported by the Prevent Cancer Foundation Living in Pink grant. Dr Tabung was supported by the University of South Carolina's (USC) Office of the Vice President for Research under the SPARC grant, and by an award from the National Cancer Institute (NCI) of the National Institutes of Health (NIH) F31CA177255. Dr H?bert was supported by an NCI Award K05 CA136975. The National Institutes of Health and the US. Department of Health and Human Services funded the WHI program through Contracts HHSN268201100046C, HHSN268 201100001C, HHSN268201100002C, HHSN268201100003C, HHSN268201100004C, and HHSN271201100004C. Publisher Copyright: © 2016 Cancer Research UK.

PY - 2016/5/24

Y1 - 2016/5/24

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 (HR Q5vsQ1, 0.99; 95% CI, 0.91-1.07; P trend =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 (HR Q5vsQ1, 1.33; 95% CI, 1.01-1.76; P trend =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.

AB - 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 (HR Q5vsQ1, 0.99; 95% CI, 0.91-1.07; P trend =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 (HR Q5vsQ1, 1.33; 95% CI, 1.01-1.76; P trend =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.

KW - Women's Health Initiative

KW - breast cancer

KW - dietary inflammatory index

KW - incidence

KW - mortality

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DO - 10.1038/bjc.2016.98

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SN - 0007-0920

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EP - 1285

JO - British Journal of Cancer

JF - British Journal of Cancer

IS - 11

ER -

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

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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