Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.
Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts.
Cancer Epidemiol Biomarkers Prev. 2018 Apr;27(4):454-463. doi: 10.1158/1055-9965.EPI-17-0569. Epub 2018 Jan 22.
Inflammation is important in chronic disease and can be modulated by dietary exposures. Our aim was to examine whether the inflammatory potential of diet after cancer diagnosis, assessed using the dietary inflammatory index (DII), is associated with all-cause and cause-specific mortality among women diagnosed with invasive breast cancer in the Women's Health Initiative (WHI). Our analytic cohort included 2,150 postmenopausal women, ages 50 to 79 years at baseline, who developed invasive breast cancer during follow-up and completed a food frequency questionnaire (FFQ) on average 1.5 years after diagnosis. Women were followed from breast cancer diagnosis until death or the end of follow-up by October 2014. Energy-adjusted DII (E-DII) scores were calculated from food plus supplements using a nutrient-density approach. Cox proportional hazards models were fit to estimate multivariable-adjusted HRs and 95% confidence intervals (CIs) for all-cause, breast cancer-specific, and cardiovascular disease (CVD) mortality. After a median 13.3 years of follow-up, 580 deaths from any cause occurred, including 212 breast cancer deaths and 103 CVD deaths. Lower (i.e., more anti-inflammatory) E-DII scores were associated with a lower risk of CVD mortality (HR = 0.44; 95% CI, 0.24-0.82; = 0.005), but not with breast cancer-specific mortality (HR = 0.96; 95% CI, 0.62-1.49; = 0.96) or all-cause mortality (HR = 0.82; 95% CI, 0.63-1.05; = 0.17). Consuming a more anti-inflammatory diet after breast cancer diagnosis may be a means for reducing risk of death from CVD. Survival after invasive breast cancer diagnosis may be improved by consumption of an anti-inflammatory diet. .
炎症在慢性病中很重要,可以通过饮食暴露来调节。我们的目的是研究癌症诊断后饮食的炎症潜力(使用饮食炎症指数[DII]评估)是否与女性中浸润性乳腺癌患者的全因和病因特异性死亡率相关。在妇女健康倡议(WHI)中,我们的分析队列包括 2150 名绝经后妇女,基线时年龄在 50 至 79 岁之间,在随访期间被诊断患有浸润性乳腺癌,并在诊断后平均 1.5 年完成了食物频率问卷(FFQ)。从乳腺癌诊断开始,女性将一直随访到死亡或 2014 年 10 月随访结束。使用营养密度法从食物和补充剂中计算出能量调整的 DII(E-DII)评分。使用 Cox 比例风险模型来估计多变量调整的 HR 和 95%置信区间(CI),以评估全因、乳腺癌特异性和心血管疾病(CVD)死亡率。在中位随访 13.3 年后,发生了 580 例任何原因导致的死亡,包括 212 例乳腺癌死亡和 103 例 CVD 死亡。较低(即更抗炎)的 E-DII 评分与 CVD 死亡率降低相关(HR = 0.44;95%CI,0.24-0.82;P = 0.005),但与乳腺癌特异性死亡率无关(HR = 0.96;95%CI,0.62-1.49;P = 0.96)或全因死亡率无关(HR = 0.82;95%CI,0.63-1.05;P = 0.17)。在诊断出乳腺癌后,食用更抗炎的饮食可能是降低 CVD 死亡风险的一种方法。食用抗炎饮食可能会改善浸润性乳腺癌诊断后的生存。