Manon Cairat, Sahar Yammine, Thibault Fiolet, Agnès Fournier, Marie-Christine Boutron-Ruault, Nasser Laouali, Francesca Romana Mancini, Gianluca Severi, Fernanda Morales Berstein, Fernanda Rauber, Renata Bertazzi Levy, Guri Skeie, Kristin Benjaminsen Borch, Anne Tjønneland, Lene Mellemkjær, Yan Borné, Ann H Rosendahl, Giovanna Masala, Maria Teresa Giraudo, Maria Santucci de Magistris, Verena Katzke, Rashmita Bajracharya, Carmen Santiuste, Pilar Amiano, Stina Bodén, Carlota Castro-Espin, Maria-Jose Sánchez, Mathilde Touvier, Mélanie Deschasaux-Tanguy, Bernard Srour, Matthias B Schulze, Marcela Guevara, Nathalie Kliemann, Jessica Blanco Lopez, Aline Al Nahas, Kiara Chang, Eszter P Vamos, Christopher Millett, Elio Riboli, Alicia K Heath, Carine Biessy, Vivian Viallon, Corinne Casagrande, Genevieve Nicolas, Marc J Gunter, Inge Huybrechts
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Furthermore, the evidence regarding the associations between intake of food with lower degrees of processing and breast cancer risk is limited. Thus, we investigated the associations between dietary intake by degree of food processing and breast cancer risk, overall and by breast cancer subtypes in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Dietary intake of EPIC participants was assessed via questionnaires at baseline. More than 11,000 food ingredients were classified into four groups of food processing levels using the NOVA classification system: unprocessed/minimally processed (NOVA 1), culinary ingredients (NOVA 2), processed (NOVA 3) and ultra-processed (NOVA 4). Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of breast cancer per standard deviation increase in daily consumption (grams) of foods from each NOVA group. The current analysis included 14,933 breast cancer cases, diagnosed among the 318,686 EPIC female participants, (median follow-up of 14.9 years). No associations were found between breast cancer risk and the level of dietary intake from NOVA 1 [HR <sub>per 1 SD</sub>=0.99 (95% CI 0.97 - 1.01)], NOVA 2 [HR <sub>per 1 SD</sub> =1.01 (95% CI 0.98 - 1.03)] and NOVA 4 [HR <sub>per 1 SD</sub> =1.01 (95% CI 0.99 - 1.03)] foods. However, a positive association was found between NOVA 3 and breast cancer risk [HR <sub>per 1 SD</sub> =1.05 (95% CI 1.03 - 1.07)] which became non-significant after adjustment for alcohol intake [HR <sub>per 1 SD</sub> =1.01 (95% CI 0.98 - 1.05)] or when beer and wine were excluded from this group [HR <sub>per 1 SD</sub> =0.99 (95% CI 0.97 - 1.01)]. The associations did not differ by breast cancer subtype, menopausal status or body mass index. 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引用次数: 0
摘要
最近的流行病学研究表明，食用超加工食品与患乳腺癌的风险呈正相关，但也有一些研究报告称两者之间没有关联。此外，有关摄入加工程度较低的食物与乳腺癌风险之间关系的证据也很有限。因此，我们在欧洲癌症与营养前瞻性调查（EPIC）研究中调查了按食品加工程度划分的膳食摄入量与乳腺癌风险之间的关系，包括总体风险和乳腺癌亚型风险。EPIC 参与者的膳食摄入量在基线时通过问卷进行评估。采用NOVA分类系统将11000多种食品成分按食品加工程度分为四组：未加工/微加工（NOVA 1）、烹饪成分（NOVA 2）、加工（NOVA 3）和超加工（NOVA 4）。采用 Cox 比例危险模型估算了每增加一个标准差的 NOVA 组食品日消耗量（克）患乳腺癌的危险比 (HRs) 和 95% 置信区间 (CIs)。本次分析包括 318,686 名 EPIC 女性参与者中确诊的 14,933 例乳腺癌病例（中位数随访时间为 14.9 年）。未发现乳腺癌风险与 NOVA 1 [HR per 1 SD=0.99 (95% CI 0.97 - 1.01)]、NOVA 2 [HR per 1 SD =1.01 (95% CI 0.98 - 1.03)]和 NOVA 4 [HR per 1 SD =1.01 (95% CI 0.99 - 1.03)]食物的膳食摄入水平之间存在关联。然而，NOVA 3与乳腺癌风险之间存在正相关[HR per 1 SD =1.05 (95% CI 1.03 - 1.07)]，但在调整酒精摄入量[HR per 1 SD =1.01 (95% CI 0.98 - 1.05)]或将啤酒和葡萄酒排除在外[HR per 1 SD =0.99 (95% CI 0.97 - 1.01)]后，这种正相关变得不显著。乳腺癌亚型、绝经状态或体重指数的不同，两者之间的关系也不尽相同。这项大规模前瞻性研究的结果表明，加工食品摄入量与乳腺癌风险之间的正相关很可能是由酒精饮料摄入量引起的：在线版本包含补充材料，可查阅 10.1186/s43014-024-00264-2。
Degree of food processing and breast cancer risk: a prospective study in 9 European countries.
Recent epidemiological studies have suggested a positive association between ultra-processed food consumption and breast cancer risk, although some studies also reported no association. Furthermore, the evidence regarding the associations between intake of food with lower degrees of processing and breast cancer risk is limited. Thus, we investigated the associations between dietary intake by degree of food processing and breast cancer risk, overall and by breast cancer subtypes in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Dietary intake of EPIC participants was assessed via questionnaires at baseline. More than 11,000 food ingredients were classified into four groups of food processing levels using the NOVA classification system: unprocessed/minimally processed (NOVA 1), culinary ingredients (NOVA 2), processed (NOVA 3) and ultra-processed (NOVA 4). Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of breast cancer per standard deviation increase in daily consumption (grams) of foods from each NOVA group. The current analysis included 14,933 breast cancer cases, diagnosed among the 318,686 EPIC female participants, (median follow-up of 14.9 years). No associations were found between breast cancer risk and the level of dietary intake from NOVA 1 [HR per 1 SD=0.99 (95% CI 0.97 - 1.01)], NOVA 2 [HR per 1 SD =1.01 (95% CI 0.98 - 1.03)] and NOVA 4 [HR per 1 SD =1.01 (95% CI 0.99 - 1.03)] foods. However, a positive association was found between NOVA 3 and breast cancer risk [HR per 1 SD =1.05 (95% CI 1.03 - 1.07)] which became non-significant after adjustment for alcohol intake [HR per 1 SD =1.01 (95% CI 0.98 - 1.05)] or when beer and wine were excluded from this group [HR per 1 SD =0.99 (95% CI 0.97 - 1.01)]. The associations did not differ by breast cancer subtype, menopausal status or body mass index. Findings from this large-scale prospective study suggest that the positive association between processed food intake and breast cancer risk was likely driven by alcoholic beverage consumption.
Graphical abstract:
Supplementary information: The online version contains supplementary material available at 10.1186/s43014-024-00264-2.
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