Abstract
BackgroundPrevious studies on the link between macronutrients and breast cancer have mostly focused on individual macronutrients rather than their combination. This study investigates the association between adherence to a low carbohydrate diet and odds of breast cancer among women.MethodsThis hospital-based case-control study was carried out on 412 women with pathologically confirmed breast cancer within the past year and 456 apparently healthy controls that were matched in terms of age and residential place. Dietary data was collected using a 168-item validated FFQ. Participants were classified in terms of quintiles of percentages of energy intake from carbohydrates, proteins, and fats. Then, individuals in the highest quintile of fat and protein intake were given a score of 5 and those in the lowest quintile of these macronutrients were given a score of 1. Participants in the other quintiles of these macronutrients were given the corresponding score. In terms of carbohydrate intake, those in the highest quintile received a score of 1 and those in the lowest quintile received 5. The scores were then summed up to calculate the total low carbohydrate diet (LCD) score, which varied from 3 to 15. A higher score meant greater adherence to a low carbohydrate diet.ResultsThe mean age of study participants was 45.2 y and mean BMI was 28.4 kg/m2. Mean LCD score of participants was 8.9 ± 2.5 (8.9 ± 2.6 in cases and 9.0 ± 2.5 in controls). Although no significant association was observed between adherence to the LCD score and odds of breast cancer in the study population, a trend toward significant positive association was seen between consumption of LCD and odds of breast cancer in postmenopausal women; after controlling for several potential confounders, individuals in the third quartile of LCD score were 1.94 times more likely to have breast cancer than those in the lowest quartile (95% CI: 1.00, 3.76). This association strengthened after controlling for dietary variables (2.50; 1.18–5.32). Even after further adjustment for BMI, this association remained significant (2.64, 1.23–5.67). No significant relationship was observed in premenopausal women, either before or after controlling for confounders.ConclusionAdherence to LCD may be associated with increased odds of breast cancer in postmenopausal women. Prospective cohort studies are needed to confirm these findings.
Highlights
Low- carbohydrate diets (LCD) are popular diets, and studies have reported beneficial effects on several chronic diseases, including obesity [1], diabetes [2], epilepsy [3, 4], cardiovascular diseases [5] and some cancers [6, 7]
In a published study from the Nurses’ Health Study, consumption of a low carbohydrate diet was associated with reduced risk of breast cancer in postmenopausal women who were estrogen receptor-negative [17]
No significant association was observed between adherence to low carbohydrate diet (LCD) and odds of breast cancer in the whole study population, a trend toward significant positive association was seen between consumption of LCD and odds of breast cancer in postmenopausal women; after controlling for several potential confounders, individuals in the third quartile of LCD score were 1.94 times more likely to have breast cancer than those in the lowest quartile
Summary
Low- carbohydrate diets (LCD) are popular diets, and studies have reported beneficial effects on several chronic diseases, including obesity [1], diabetes [2], epilepsy [3, 4], cardiovascular diseases [5] and some cancers [6, 7]. Consumption of low carbohydrate diets has been linked with elevated concentrations of inflammatory biomarkers [9,10,11], which could be underlying factors for cancer [12]. An inverse association was reported between adherence to LCD and risk of mortality from all causes, and from cancer and cardiovascular disease [13,14,15,16,17]. In a published study from the Nurses’ Health Study, consumption of a low carbohydrate diet was associated with reduced risk of breast cancer in postmenopausal women who were estrogen receptor-negative [17]. This study investigates the association between adherence to a low carbohydrate diet and odds of breast cancer among women
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