Quartiroli Martina, Roncallo Chiara, Pala Valeria, Simeon Vittorio, Ricceri Fulvio, Venturelli Elisabetta, Pattaroni Lara, Sieri Sabina, Agnoli Claudia
Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy.
Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, Vanvitelli University, 80138 Naples, Italy.
Nutrients. 2024 Apr 17;16(8):1187. doi: 10.3390/nu16081187.
Breast cancer (BC) is the most common cancer in women, with 2.3 million diagnoses in 2020. There is growing evidence that lifestyle factors, including dietary factors, particularly the complex interactions and synergies between different foods and nutrients (and not a single nutrient or food), may be associated with a higher risk of BC. The aim of this work was to evaluate how the Italian Mediterranean Index (IMI), the Greek Mediterranean Index, the DASH score, and the EAT-Lancet score can help lower the risk of BC, and analyze if chronic low-grade inflammation may be one of the possible mechanisms through which dietary patterns influence breast cancer risk. We evaluated the effect of adherence to these four dietary quality indices in the 9144 women of the ORDET cohort who completed a dietary questionnaire. The effect of adherence to dietary patterns on chronic inflammation biomarkers was evaluated on a subsample of 552 participants. Hazard ratios (HRs) with 95% confidence intervals (CIs) for BC risk in relation to the index score categories used were estimated using multivariable Cox models adjusted for potential confounders. Regression coefficients (β), with 95% CI for C-reactive protein (CRP), TNF-α, IL-6, leptin, and adiponectin levels in relation to adherence to dietary patterns were evaluated with the linear regression model adjusted for potential confounders. IMI was inversely associated with BC in all women (HR: 0.76, 95% CI: 0.60-0.97, P trend = 0.04), particularly among postmenopausal women (HR: 0.64, 95% CI: 0.42-0.98, P trend = 0.11). None of the other dietary patterns was associated with BC risk. Higher IMI and Greek Mediterranean Index scores were inversely associated with circulating CRP (β: -0.10, 95% CI: -0.18, -0.02, and β: -0.13, 95% CI: -0.21, -0.04). The higher score of the EAT-Lancet Index was instead associated with a higher concentration of circulating levels of CRP (β: 0.10, 95% CI: 0.02, 0.18). In conclusion, these results suggest that adherence to a typical Italian Mediterranean diet protects against BC development, especially among postmenopausal women, possibly through modulation of chronic low-grade inflammation.
乳腺癌（BC）是女性中最常见的癌症，2020年有230万例诊断病例。越来越多的证据表明，生活方式因素，包括饮食因素，特别是不同食物和营养素之间的复杂相互作用和协同作用（而非单一营养素或食物），可能与患BC的较高风险相关。这项工作的目的是评估意大利地中海指数（IMI）、希腊地中海指数、DASH评分和EAT-柳叶刀评分如何有助于降低BC风险，并分析慢性低度炎症是否可能是饮食模式影响乳腺癌风险的可能机制之一。我们评估了ORDET队列中9144名完成饮食问卷的女性对这四种饮食质量指数的依从性的影响。在552名参与者的子样本中评估了饮食模式依从性对慢性炎症生物标志物的影响。使用针对潜在混杂因素进行调整的多变量Cox模型估计了与所使用的指数评分类别相关的BC风险的风险比（HRs）及其95%置信区间（CIs）。使用针对潜在混杂因素进行调整的线性回归模型评估了与饮食模式依从性相关的C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、瘦素和脂联素水平的回归系数（β）及其95%CI。IMI与所有女性的BC呈负相关（HR：0.76，95%CI：0.60-0.97，P趋势=0.04），尤其是在绝经后女性中（HR：0.64，95%CI：0.42-0.98，P趋势=0.11）。其他饮食模式均与BC风险无关。较高的IMI和希腊地中海指数评分与循环中的CRP呈负相关（β：-0.10，95%CI：-0.18，-0.02，以及β：-0.13，95%CI：-0.21，-0.04）。相反，EAT-柳叶刀指数的较高评分与循环中CRP水平的较高浓度相关（β：0.10，95%CI：0.02，0.18）。总之，这些结果表明，坚持典型的意大利地中海饮食可预防BC的发生，尤其是在绝经后女性中，可能是通过调节慢性低度炎症来实现的。
