Association between healthy lifestyle score and breast cancer

Batoul Ghosn,Ahmad Esmaillzadeh,Leila Azadbakht,Soraiya Ebrahimpour-Koujan,Sanaz Benisi-Kohansal

doi:10.1186/s12937-020-0520-9

Batoul Ghosn, Ahmad Esmaillzadeh + Show 3 more

Open Access

https://doi.org/10.1186/s12937-020-0520-9

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Abstract

BackgroundMajority of earlier studies have assessed the association between individual lifestyle factors and the risk of breast cancer (BC); however, limited information is available linking the whole lifestyle factors to BC. We aimed to examine the association between combined lifestyle score (diet, physical activity (PA) and smoking) and risk of BC in Iranian population.MethodsThis population-based case-control study included 350 newly diagnosed cases of BC and 700 healthy controls randomly selected from adult women. Dietary intakes, PA and smoking status of study participants were examined using validated questionnaires. The lifestyle risk factors examined in this study included cigarette smoking, physical inactivity, and Healthy Eating Index-2010 (HEI-2010). The lifestyle score ranged from zero (non-healthy) to 3 (most healthy) points. Logistic regression models were fitted to investigate the association between combined lifestyle scores and odds of BC.ResultsMean age and body mass index (BMI) of study participants were 62.4 years and 24.3 kg/m2, respectively. In the whole study population, individuals with the highest healthy lifestyle score (HLS) were 0.38 times less likely to have BC than those with the lowest score (OR: 0.62; 95% CI: 0.40, 0.93, Ptrend = 0.01). The analysis by menopausal status showed that postmenopausal women with the highest HLS had 44% lower odds of BC compared with those with the lowest score (OR: 0.56; 95% CI: 0.36, 0.88, Ptrend = 0.004). Such association was not seen in premenopausal women. After analyzing each component of HLS, we found that individuals with the highest HEI score were 46% less likely to have BC than those with the lowest score (OR: 0.54; 95% CI: 0.35, 0.82, Ptrend < 0.001). No other significant associations were found between PA and smoking and risk of BC.ConclusionsSignificant inverse associations were found between HLS and HEI with BC especially among postmenopausal women. Prospective studies are required to confirm these findings.

Highlights

Breast cancer (BC) is highly prevalent in the world, in developing countries
We examined the contribution of whole lifestyle to the risk of breast cancer (BC) because of these important factors: (1) the different pattern of diet and physical activity (PA) in developing countries compared with those in western nations, (2) BC being the most prevalent cancer among Iranian women
As for the distribution of participants in terms of general characteristics across categories of healthy lifestyle score (HLS), subjects with the highest score were more likely to be residing in urban region, educated, have a higher body mass index (BMI) and physically active, and less likely to have poor socioeconomic status (SES) than those with the lowest score

Summary

Introduction

Breast cancer (BC) is highly prevalent in the world, in developing countries. Several modifiable risk factors including overweight or obesity [4], alcohol use [5], physical inactivity [6] and prolonged steroid hormones exposure [7] have been linked to BC. The American Cancer Society recommendations regarding healthy lifestyle include eating a healthy diet, getting at least 150 min of moderate intensity exercise each week, avoiding smoking and keeping low stress levels [11]. Majority of earlier studies have assessed the association between individual lifestyle factors and the risk of breast cancer (BC); limited information is available linking the whole lifestyle factors to BC. We aimed to examine the association between combined lifestyle score (diet, physical activity (PA) and smoking) and risk of BC in Iranian population

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