Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
BMC Womens Health. 2024 Feb 16;24(1):121. doi: 10.1186/s12905-024-02959-7.
Evidence from recent studies suggested that variation in the quantity and quality of macronutrients in the diet may potentially play a role in predicting the risk of breast cancer (BC). In the current study, we aimed to assess the association of different high-protein diet scores and replacing fats and carbohydrate (CHO) with protein in the diet with the BC risk among Iranian women.
The current hospital-based case-control study was conducted on 401 participants, aged ≥ 30 years old, including 134 women in the case group who had been diagnosed with histologically confirmed BC and 267 women in the control group. Dietary intake data was collected using a validated food frequency questionnaire, and high protein diet scores were determined. Logistic regression models were used to determine the odds ratios (OR) and 95% confidence interval (CI) of BC across tertiles of high protein diet scores. Also, we assessed how substituting protein with other macronutrients affected BC odds while adjusting for the various confounding variables.
Participants' mean ± SD of age and body mass index were 47.9 ± 10.3 years and 29.4 ± 5.5 kg/m, respectively. The scores of high-protein-low-CHO and fat diet, high-protein and CHO-low-fat diet, and high-protein and fat-low-CHO diet in participants were 16.5 ± 3.8, 16.5 ± 6.7, and 16.4 ± 5.9, respectively. In the multivariable model, individuals in the highest tertile of high-protein-low-CHO and fat diet score (OR:0.71;95%CI:0.56-0.90) and high-protein and CHO-low-fat diet (OR:0.76;95%CI:0.60-0.97) had lower odds of BC compared to those in the lowest tertile (P < 0.05). However, no significant association was found between high-protein and fat-low-CHO diet and BC risk. Our results showed that replacing fat by protein (OR:-0.40;95%CI:-0.73,-0.07) and also replacing refined-CHO by plant protein (OR:-0.66;95%CI:-1.26,-0.07) in the diet are associated inversely with risk of BC(P < 0.05).
The results of our study suggested that higher adherence to a high-protein-low-CHO and fat diet, characterized by a higher intake of plant proteins and a lower intake of refined grains and saturated fat can play a protective role against the odds of BC.
最近的研究证据表明，饮食中宏量营养素的数量和质量的变化可能在预测乳腺癌（BC）风险方面发挥作用。在目前的研究中，我们旨在评估不同高蛋白饮食评分以及用蛋白质替代脂肪和碳水化合物（CHO）与伊朗女性 BC 风险之间的关联。
本项基于医院的病例对照研究纳入了 401 名年龄≥30 岁的参与者，其中 134 名女性为经组织学证实的 BC 患者（病例组），267 名女性为对照组。使用经过验证的食物频率问卷收集饮食摄入数据，并确定高蛋白饮食评分。使用逻辑回归模型确定高蛋白饮食评分三分位数与 BC 的比值比（OR）和 95%置信区间（CI）。还评估了用其他宏量营养素替代蛋白质如何影响 BC 的几率，同时调整了各种混杂变量。
参与者的平均年龄和体重指数分别为 47.9±10.3 岁和 29.4±5.5kg/m。参与者的高蛋白低 CHO 和高脂肪饮食评分、高蛋白和 CHO 低脂肪饮食评分以及高蛋白和高脂肪低 CHO 饮食评分分别为 16.5±3.8、16.5±6.7 和 16.4±5.9。在多变量模型中，与最低三分位相比，高蛋白低 CHO 和高脂肪饮食评分最高三分位（OR：0.71；95%CI：0.56-0.90）和高蛋白和 CHO 低脂肪饮食（OR：0.76；95%CI：0.60-0.97）的个体患 BC 的几率较低（P<0.05）。然而，高蛋白和高脂肪低 CHO 饮食与 BC 风险之间没有显著关联。我们的结果表明，用蛋白质代替脂肪（OR：-0.40；95%CI：-0.73，-0.07）和用植物蛋白代替精制 CHO（OR：-0.66；95%CI：-1.26，-0.07）与 BC 风险呈负相关（P<0.05）。
本研究结果表明，较高的高蛋白低 CHO 和高脂肪饮食依从性，其特点是植物蛋白摄入较高，精制谷物和饱和脂肪摄入较低，可能对降低 BC 的几率起到保护作用。
