Food patterns and risk of breast cancer: A factor analysis study in Uruguay
Alvaro L. Ronco
Departamento de Epidemiología, Sección de Radiología, Centro Hospitalario Pereira Rossell, Montevideo, Uruguay
Search for more papers by this authorCorresponding Author
Eduardo De Stefani
Grupo de Epidemiología, Departamento de Anatomía Patológica, Hospital de Clínicas, Facultad de Medicina, Montevideo, Uruguay
Fax: +598-2-304-36-78.
Avenida Brasil 3080 dep. 402, 11300 Montevideo, UruguaySearch for more papers by this authorPaolo Boffetta
International Agency for Research on Cancer, Lyon, France
Search for more papers by this authorHugo Deneo-Pellegrini
Grupo de Epidemiología, Departamento de Anatomía Patológica, Hospital de Clínicas, Facultad de Medicina, Montevideo, Uruguay
Search for more papers by this authorGiselle Acosta
Grupo de Epidemiología, Departamento de Anatomía Patológica, Hospital de Clínicas, Facultad de Medicina, Montevideo, Uruguay
Search for more papers by this authorMaría Mendilaharsu
Grupo de Epidemiología, Departamento de Anatomía Patológica, Hospital de Clínicas, Facultad de Medicina, Montevideo, Uruguay
Search for more papers by this authorAlvaro L. Ronco
Departamento de Epidemiología, Sección de Radiología, Centro Hospitalario Pereira Rossell, Montevideo, Uruguay
Search for more papers by this authorCorresponding Author
Eduardo De Stefani
Grupo de Epidemiología, Departamento de Anatomía Patológica, Hospital de Clínicas, Facultad de Medicina, Montevideo, Uruguay
Fax: +598-2-304-36-78.
Avenida Brasil 3080 dep. 402, 11300 Montevideo, UruguaySearch for more papers by this authorPaolo Boffetta
International Agency for Research on Cancer, Lyon, France
Search for more papers by this authorHugo Deneo-Pellegrini
Grupo de Epidemiología, Departamento de Anatomía Patológica, Hospital de Clínicas, Facultad de Medicina, Montevideo, Uruguay
Search for more papers by this authorGiselle Acosta
Grupo de Epidemiología, Departamento de Anatomía Patológica, Hospital de Clínicas, Facultad de Medicina, Montevideo, Uruguay
Search for more papers by this authorMaría Mendilaharsu
Grupo de Epidemiología, Departamento de Anatomía Patológica, Hospital de Clínicas, Facultad de Medicina, Montevideo, Uruguay
Search for more papers by this authorAbstract
To generate broad eating patterns, which could explain more adequately the breast cancer etiology, we conducted an exploratory factor analysis in Montevideo, Uruguay. The study included 442 newly diagnosed and microscopically confirmed cases with breast cancer and 442 hospitalized controls, with non-neoplastic diseases. Factor analysis (principal components) was conducted in the control series, and as a result, 6 factors were extracted. These factors were labeled as traditional, healthy, western, stew, high-fat and drinker. The model explained 58.3% of the variance. After scoring the rotated factors, the relations between scores and breast cancer risk factors were analyzed by using Pearson correlation coefficients. After this step, the odds ratios of breast cancer for continuous scores of the rotated factors were carefully analyzed. The highest risk was directly associated with the western diet (OR 1.31, 95% CI 1.13–1.51), whereas the traditional (OR 0.77, 95% CI 0.64–0.93), healthy (OR 0.84, 95% CI 0.73–0.98) and stew (OR 0.83, 95% CI 0.71–0.98) diets were significantly protective. Women who reported a history of breast cancer among mother and sisters displayed strong elevations in risk for western (OR 2.03, 95% CI 1.11–3.72) and high-fat (OR 2.72, 95%CI 1.16–6.37) dietary patterns. This finding could suggest that gene–dietary interaction could play an important role in breast carcinogenesis. © 2006 Wiley-Liss, Inc.
References
- 1 DM Parkin, SL Whelan, J Ferlay, L Teppo, DB Thomas (eds). Cancer incidence in five continents, vol. VIII. IARC Scientific Publications No. 155. Lyon: International Agency for Research on Cancer (IARC), 2002.
- 2 World Cancer Research Fund. Food, nutrition, and the prevention of cancer: a global perspective. Washington, DC: American Institute of Cancer Research, 1997.
- 3 Matos E, Brandani A. Review on meat consumption and cancer in South America. Mutat Res 2002; 506/507: 243–9.
- 4 Hunter DJ, Willett WC. Nutrition and breast cancer. Cancer Causes Control 1996; 7: 56–68.
- 5 IARC Handbooks of Cancer Prevention, vol. 8: Fruit and vegetables. Lyon, France: IARC, 2003.
- 6 Terry P, Suzuki R, Hu FB, Wolk A. A prospective study of major dietary patterns of the risk of breast cancer. Cancer Epidemiol Biomarkers Prev 2001; 10: 1281–5.
- 7 Sieri S, Krogh V, Pala V, Muti P, Micheli A, Evangelista A, Tagliablue G, Berrino F. Dietary patterns and risk of breast cancer in the ORDET cohort. Cancer Epidemiol Biomarkers Prev 2004; 13: 567–72.
- 8 Fung TT, Hu FB, Holmes MD, Rosner BA, Hunter DJ, Colditz GA, Willett WC. Dietary patterns and the risk of postmenopausal breast cancer. Int J Cancer 2005; 116: 116–21.
- 9 Spearman C. General intelligence, objectively determined and measured. Am J Psychol 1904; 15: 201–93.
- 10 Harman HH. Modern factor analysis, 3rd edn. Chicago: University of Chicago Press, 1976.
- 11 Randall E, Marshall JR, Brasure J, Graham S. Dietary patterns and colon cancer in Western New York. Nutr Cancer 1992; 18: 265–76.
- 12 Slattery ML, Boucher KM, Caan BJ, Potter JD, Ma Y. Eating patterns and risk of colon cancer. Am J Epidemiol 1998; 148: 4–16.
- 13 Terry P, Hu FB, Hansen H, Wolk A. Prospective study of major dietary patterns and colorectal cancer risk in women. Am J Epidemiol 2001; 154: 1143–9.
- 14 De Stefani E, Correa P, Boffetta P, Deneo-Pellegrini H, Ronco AL, Mendilaharsu M. Dietary patterns and risk of gastric cancer: a case-control study in Uruguay. Gastric Cancer 2004; 7: 211–20.
- 15 Palli D, Russo A, Decarli A. Dietary patterns, nutrient intake and gastric cancer in a high-risk area of Italy. Cancer Causes Control 2001; 12: 163–72.
- 16 De Stefani E, Boffetta P, Ronco AL, Correa P, Oreggia F, Deneo-Pellegrini H, Mendilaharsu M, Leiva J. Dietary patterns and risk of cancer of the oral cavity and pharynx in Uruguay. Nutr Cancer 2005; 51: 132–9.
- 17 Balder HF, Goldbohm RA, van den Brandt PA. Dietary patterns associated with male lung cancer risk in the Netherlands Cohort Study. Cancer Epidemiol Biomarkers Prev 2005; 14: 483–90.
- 18 Kline P. An easy guide to factor analysis. New York: Routledge, 2002.
- 19 Kim J-O, Mueller CW. Factor analysis. Statistical methods and practical issues. California, USA: Sage Publications, 1978.
- 20 Thurstone LL. Multiple factor analysis: a development and expansion of vectors of the mind. Chicago: University of Chicago Press, 1947.
- 21 STATA. Stata user's guide and reference manual. Release 6. College Station: Texas Stata Press, 1999.
- 22 Breslow NE, Day NE. Statistical methods in cancer research, vol. 1:The analysis of case-control studies. IARC Scientific Publication No. 32. Lyon, France: IARC, 1980.
- 23 Harris PJ, Triggs CM, Roberton AM, Watson ME, Ferguson LR. The adsorption of heterocyclic aromatic amines by model dietary fibres with contrasting compositions. Chem Biol Interact 1996; 100: 13–25.
- 24 Ben-Amotz A, Fishler R. Analysis of carotenoids with emphasis on 9-cisβ-carotene in vegetables and fruits commonly consumed in Israel. Food Chem 1998; 62: 515–20.
- 25 Shannon J, Cook LS, Stanford JL. Dietary intake and risk of postmenopausal breast cancer (United States). Cancer Causes Control 2003; 14: 19–27.
- 26 Hermann S, Linseisen J, Chang-Claude J. Nutrition and breast cancer risk by age 50: a population-based case-control study in Germany. Nutr Cancer 2002; 44: 23–34.
- 27 Ronco AL, De Stefani E, Fabra A. White meat intake and the risk of breast cancer: a case-control study in Montevideo, Uruguay. Nutr Res 2003; 22: 1–12.
- 28 Sinha R. An epidemiologic approach to studying heterocyclic amines. Mutat Res 2002; 506/507: 197–204.
- 29 Smith-Warner SA, Spiegelman D, Yaun SS, Adami HO, Beeson WL, van den Brandt PA, Folsom AR, Fraser GE, Freudenheim JL, Goldbohm RA, Graham S, Miller, AB et al. Intake of fruits and vegetables and risk of breast cancer: a pooled analysis of cohort studies. J Am Med Assoc 2001; 285: 769–76.
- 30 van Gils CH, Peeters PH, Bueno-de-Mesquita HB, Boshuizen HC, Lahmann PH, Clavel-Chapelon F, Thiebaut A, Kesse E, Sieri S, Palli D, Tumino R, Panico S et al. Consumption of vegetables and fruits and risk of breast cancer. J Am Med Assoc 2005; 293: 183–93.
- 31 Zhang SM, Willett WC, Selhub J, Hunter DJ, Giovannucci EL, Holmes MD, Colditz GA, Hankinson SE. Plasma folate, vitamin B6, vitamin B12, homocysteine, and risk of breast cancer. J Natl Cancer Inst 2003; 95: 373–80.
- 32 Ronco AL, De Stéfani E, Boffetta P, Deneo-Pellegrini H, Mendilaharsu M, Leborgne F. Vegetables, fruits, and related nutrients and risk of breast cancer: a case control study in Uruguay. Nutr Cancer 1999; 35: 111–119.
- 33 De Stéfani E, Correa P, Ronco AL, Mendilaharsu M, Guidobono M, Deneo-Pellegrini H. Dietary fiber and risk of breast cancer. A case-control study in Uruguay. Nutr Cancer 1997; 28: 14–19.
- 34 Feskanich D, Ziegler RG, Michaud DS, Giovannucci EL, Speizer FE, Willett WC, Colditz GA. Prospective study of fruit and vegetable consumption and risk of lung cancer among men and women. J Natl Cancer Inst 2000; 92: 1812–23.
- 35 Michels KB, Giovannucci E, Joshipura KJ, Rosner BA, Stampfer MJ, Fuchs CS, Speizer FE, Willett WC. Prospective study of fruit and vegetable consumption and incidence of colon and rectal cancers. J Natl Cancer Inst 2000; 92: 1740–52.
- 36
Potter JD.
Colorectal neoplasia and meat: epidemiology and mechanisms. In:
IT Johnson,
GR Fenwick, eds.
Dietary anticarcinogens and antimutagens. Chemical and Biological Aspects.
London:
Royal Society of Chemistry,
2000.
10.1533/9781845698188.1.3 Google Scholar
- 37 Zheng W, Gustafson DR, Sinha R, Cerhan JR, Moore D, Hong CP, Anderson KE, Kushi LH, Sellers TA, Folsom AR. Well-done meat intake and the risk of breast cancer. J Natl Cancer Inst 1998; 90: 1724–9.
- 38 De Stefani E, Ronco A, Mendilaharsu M, Guidobono M, Deneo-Pellegrini H. Meat intake, heterocyclic amines and risk of breast cancer: a case-control study in Uruguay. Cancer Epidemiol Biomarkers Prev 1997; 6: 573–81.
- 39
Ronco A,
De Stefani E,
Mendilaharsu M,
Deneo-Pellegrini H.
Meat, fat and risk of breast cancer: a case-control study from Uruguay.
Int J Cancer
1996;
65:
328–31.
10.1002/(SICI)1097-0215(19960126)65:3<328::AID-IJC9>3.0.CO;2-1 CAS PubMed Web of Science® Google Scholar
- 40 Snyderwine EG, Thogeirsson UP, Venugopal M, Roberts-Thomson SJ. Mammary gland carcinogenicity of 2-amino-1-methyl-6-phenylimidazol[4,5-b]pyridine in Sprague-Dawley rats on high- and low-fat diets. Nutr Cancer 1998; 31: 160–7.
- 41 Kushi L, Giovannucci E. Dietary fat and cancer. AmJ Med 2002; 113: S63–S70.
- 42 Willett WC. Dietary fat intake and cancer risk: a controversial and instructive story. Semin Cancer Biol 1998; 8: 245–53.
- 43 Prentice RL, Caan B, Chlebowski RT, Patterson R, Kuller LH, Ockene JK, Margolis KL, Limacher MC, Manson JE, Parker LM, Paskett E, Phillips L et al. Low-fat dietary pattern and risk of invasive breast cancer: the Women's Health Initiative Randomized Controlled Dietary Modification Trial. J Am Med Assoc 2006; 295: 629–42.
- 44 Thiebaut AC, Chajes V, Clavel-Chapelon F, Gerber M. Unsaturated fatty acids intake and breast cancer risk: epidemiological data review. Bull Cancer 2005; 92: 658–69 (in French).
- 45 Ronco A, De Stéfani E, Deneo-Pellegrini H, Fabra A. Polyunsaturated fatty acids consumption and risk of breast cancer: a case-control study. Rev Bras Nutr Clin 2005; 20 ( Suppl. 1): S1–S8 (in Spanish).
- 46 Weisburger JH. Comments on the history and importance of aromatic and heterocyclic amines in public health. Mutat Res 2002; 506/507: 9–20.
- 47 Smith-Warner SA, Spiegelmann D, Yaun SS, van den Brandt PA, Folsom AR, Goldbohm RA, Graham RA, Holmberg L, Howe GR, Marshall JR, Miller AB, Potter JD et al. Alcohol and breast cancer in women: a pooled analysis of cohort studies. J Am Med Assoc 1998; 279: 535–40.
- 48 Longnecker MP. Alcoholic beverage consumption in relation to risk of breast cancer: meta-analysis and review. Cancer Causes Control 1994; 5: 73–82.
- 49 Comisión Honoraria de Lucha Contra el Cáncer. Knowledge, beliefs, attitude and practices concerning cancer. Montevideo, Uruguay: Comisión Honoraria de Lucha Contra el Cáncer, 1993 (Tech Cooperation OPP/BID/PNUD) (in Spanish).