Association of Mediterranean diet, dietary supplements and alcohol consumption with breast density among women in South Germany: a cross-sectional study

BMC Public Health

Gabriele Nagel³  Birke Arand¹  Christian Billich²  Olga Voevodina³ 

[1] Clinic Ludwigsburg, Posilipostr. 4, Ludwigsburg, 71640, Germany;Departement of Diagnostic and Interventional Radiology, Ulm University, Prittwitzstrasse 43, Ulm, 89075, Germany;Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstr. 22, Ulm 89081, Germany

关键词: Breast cancer;    Alcohol;    Supplements;    Diet;    Mammographic breast density;   

Others  :  1162476
DOI  :  10.1186/1471-2458-13-203

 received in 2012-06-27, accepted in 2013-02-27,  发布年份 2013

【 摘 要 】

Background

Effects of dietary factors, such as adherence to Mediterranean diet, multivitamin-multimineral supplements use and alcohol consumption on mammographic breast density, an important biomarker of breast cancer risk, are not sufficiently consistent to elaborate preventive recommendations. This study aims to investigate the association between current diet and mammographic density.

Methods

We performed a cross-sectional study in 424 pre- and post-menopausal women aged 21 to 84 years. Current Mediterranean dietary pattern, multivitamin-multimineral supplements use, alcohol consumption and potential confounders were assessed with a self-administered questionnaire in the University Hospital Ulm (2007–2008). Radiologists evaluated mammographic density according to the American College of Radiology (ACR) classification, which was summarized in low = ACR1/2 and high = ACR3/4 mammographic density. Logistic regression models were used to assess the association between current diet and mammographic density.

Results

Adherance to Mediterranean dietary pattern was inversely associated with mammographic density in the models adjusted for age and BMI (per 1 unit increase of score OR 0.95; 95%CI 0.90–0.997). Current use of multivitamin-multimineral supplements was also inversely associated with mammographic density (OR 0.53; 95%CI 0.34–0.83). Further adjustment revealed similar point estimates but the associations were no longer statistically significant. Compared to non-drinkers, excessive alcohol consumption (<10 g/d) was positively associated with mammographic density (OR 1.47; 95%CI 0.82-2.63).

Conclusions

Our results show that dietary factors are associated with mammographic density. Adherence to Mediterranean diet and current use of multivitamin-multimineral supplements could be inversely associated with mammographic density and may suggest a protective effect against breast cancer, whereas high alcohol consumption was associated with increased mammographic density.

【 授权许可】

   
2013 Voevodina et al; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Breast cancer is the most frequent malignant tumor in women. http://carestream.com/Specials/tradeshow/mammoScreening/pdf/Ingrid-english.pdf webcite
• [2]Emmert B, Gerstorfer M: Maligne Mammatumoren. In Crashkurs Gynäkologie: Repetitorium mit Einarbeitung der wichtigsten Prüfungsfakten. 1st edition. Munich: Elsevier Urban&Fischer; 2005:286-287.
• [3]Boyd NF, Rommens JM, Vogt K, Lee V, Hopper JL, Yaffe MJ, Paterson AD: Mammographic breast density as an intermediate phenotype for breast cancer. Lancet Oncol 2005, 6:798-808.
• [4]Harvey JA, Bovbjerg VE: Quantitative assessment of mammographic breast density: relationship with breast cancer risk. Radiology 2004, 230:29-41.
• [5]Aitken Z, Walker K, Stegeman BH, Wark PA, Moss SM, McCormack VA, Silva Idos S: Mammographic density and markers of socioeconomic status: a cross-sectional study [abstract]. BMC Cancer 2010, 10:s35. BioMed Central Full Text
• [6]Boyd NF, Martin LJ, Bronskill M, Yaffe MJ, Duric N, Minkin S: Breast tissue composition and susceptibility to breast cancer. J Natl Cancer Inst 2010, 102:1224-1237.
• [7]Sauer G, Kreienberg R, Kurzeder C, Schreer I: Meaning of BI-RADS classification in breast diagnoses. Der Gynakologe 2006, 39:513-523.
• [8]Garrido-Estepa M, Ruiz-Perales F, Miranda J, Ascunce N, González-Román I, Sánchez-Contador C, Santamariña C, Moreo P, Vidal C, Peris M, Moreno PM, Vaquez-Carrete JA, Collado-Garcia F, Casanova F, Ederra M, Salas D, Pollan M: Evaluation of mammographic density patterns: reproducibility and concordance among scales [abstract]. BMC Cancer 2010, 10:s485.
• [9]Yaffe M, Boyd N: Mammographic breast density and cancer risk: the radiological view. Gynecol Endocrinol 2005, 21:6-11.
• [10]Vachon CM, Sellers TA, Janney CA, Brandt KR, Carlson EE, Pankratz VS, Wu FF, Therneau TM, Cerhan JR: Alcohol intake in adolescence and mammographic density. Int J Cancer 2005, 117:837-841.
• [11]Tseng M, Sellers TA, Vierkant RA, Kushi LH, Vachon CM: Mediterranean diet and breast density in the Minnesota Breast Cancer Family Study. Nutr Cancer 2008, 60:703-709.
• [12]Roddam AW, Spencer E, Banks E, Beral V, Reeves G, Appleby P, Barnes I, Whiteman DC, Keyal TJ: Reproducibility of a short semi-quantitative food group questionnaire and its performance in estimating nutrient intake compared with a 7-day diet diary in the million women study. Public Health Nutr 2005, 8:201-213.
• [13]Brisson J, Verreault R, Morrison AS, Tennina S, Meyer F: Diet, mammographic features of breast tissue, and breast cancer risk. Am J Epidemiol 1989, 130:14-24.
• [14]Nagel G: Primärprävention und Anwendung von Versorgungsleitlinien bei malignen Erkrankungen: Schwerpunkt Mammakarzinom. PhD thesis. Ulm University, Institute of Epidemiology and Medical Biometry; 2007.
• [15]Ruf T, Nagel G, Altenburg HP, Miller AB, Thorand B: Food and nutrient intake, anthropometric measurements and smoking according to alcohol consumption in the EPIC Heidelberg Study. Ann Nutr Metab 2005, 49(1):16-25.
• [16]Keil U, Chambless LE, Döring A, Filipiak B, Stieber J: The relation of alcohol intake to coronary heart disease and all-cause mortality in a beer-drinking population. Epidemiology 1997, 8:150-156.
• [17]Cottet V, Touvier M, Fournier A, Touillaud MS, Lafay L, Clavel-Chapelon F, Boutron-Ruault MC: Postmenopausal breast cancer risk and dietary patterns in the E3N-EPIC prospective cohort study. Am J Epidemiol 2009, 170:1257-1267.
• [18]Altman DG: Some common problems in medical research. In Practical Statistics for Medical Research. 1st edition. London: Chapman and Hall; 1991:396-435.
• [19]Vachon CM, Kushi LH, Cerhan JR, Kuni CC, Sellers TA: Association of diet and mammographic breast density in the Minnesota breast cancer family cohort. Cancer Epidemiol Biomarkers Prev 2000, 9:151-160.
• [20]Masala G, Ambrogetti D, Assedi M, Giorgi D, Del Turco MR, Palli D: Dietary and lifestyle determinants of mammographic breast density. A longitudinal study in a Mediterranean population. Int J Cancer 2006, 118:1782-1789.
• [21]Cade JE, Taylor EF, Burley VJ, Greenwood DC: Does the Mediterranean dietary pattern or the Healthy Diet Index influence the risk of breast cancer in a large British cohort of women? Eur J Clin Nutr 2011, 65(8):920-928.
• [22]Nagata C, Matsubara T, Fujita H, Nagao Y, Shibuya C, Kashiki Y, Shimizu H: Associations of Mammographic Density with Dietary Factors in Japanese Women. Cancer Epidemiol Biomarkers Prev 2005, 14:2877-2880.
• [23]Simopoulos AP: Essential fatty acids in health and chronic disease. Am J Clin Nutr 1999, 70:560S-569.
• [24]Nagel G, Mack U, Von Fournier D, Linseisen J: Dietary phytoestrogen intake and mammographic density – results of a pilot study. Eur J Med Res 2005, 10(9):389-94.
• [25]Bérubé S, Diorio C, Brisson J: Multivitamin-multimineral supplement use and mammographic breast density. Am J Clin Nutr 2008, 87:1400-1404.
• [26]Huang HY, Caballero B, Chang S, Alberg A, Semba R, Schneyer C, Wilson RF, Cheng TY, Prokopowicz G, Barnes GJ 2nd, Vassy J, Bass EB: Multivitamin/mineral supplements and prevention of chronic disease. Evid Rep Technol Assess 2006, 139:1-117.
• [27]Tseng M, Byrne C, Evers KA, Daly MB: Dietary intake and breast density in high-risk women: a cross-sectional study [abstract]. Breast Cancer Res 2007, 9:s72. BioMed Central Full Text
• [28]Flom JD, Ferris JS, Tehranifar P, Terry MB: Alcohol intake over the life course and mammographic density. Breast Cancer Res Treat 2009, 117:643-651.
• [29]Maskarinec G, Takata Y, Pagano I, Lurie G, Wilkens LR, Kolonel LN: Alcohol consumption and mammographic density in a multiethnic population. Int J Cancer 2006, 118:2579-2583.
• [30]Cabanes A, Pastor-Barriuso R, García-López M, Pedraz-Pingarrón C, Sánchez-Contador C, Vázquez Carrete JA, Moreno MP, Vidal C, Salas D, Miranda-García J, Peris M, Moreo P, Santamariña MC, Collado-García F, Gonzalez-Román I, Ascunce N, Pollan M: Alcohol, tobacco, and mammographic density: a population-based study. Breast Cancer Res Treat 2011, 129(1):135-147.
• [31]Gapstur SM, López P, Colangelo LA, Wolfman J, Van Horn L, Hendrick RE: Associations of breast cancer risk factors with breast density in Hispanic women. Cancer Epidemiol Biomarkers Prev 2003, 12:1074-1080.
• [32]Yu H, Berkel J: Do insulin-like growth factors mediate the effect of alcohol on breast cancer risk? Med Hypotheses 1999, 52:491-496.
• [33]Dal Maso L, La Vecchia C, Augustin LS, Mantzoros CS, Kendall CW, Franceschi S: Relationship between a wide range of alcohol consumptions, components of the insulin-like growth factor system and adiponectin. Eur J Clin Nutr 2007, 61:221-225.
• [34]Gill J: The effects of moderate alcohol consumption on female hormone levels and reproductive function. Alcohol Alcohol 2000, 35:417-423.
• [35]Yong M, Atkinson C, Newton KM, Aiello Bowles EJ, Stanczyk FZ, Westerlind KC, Holt VL, Schwartz SM, Leisenring WM, Lampe JW: Associations between endogenous sex hormone levels and mammographic and bone densities in premenopausal women. Cancer Causes Control 2009, 20:1039-1053.
• [36]Nagel G, Zoller D, Ruf T, Rohrmann S, Linseisen J: Long-term reproducibility of a food-frequency questionnaire and dietary changes in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Heidelberg cohort. Br J Nutr 2007, 98:194-200.