Abstract
A multitude of dietary factors from dietary fat to macro and micronutrients intakes have been associated with breast cancer, yet data are still equivocal. Therefore, utilizing data from the large, multi-year, cross-sectional National Health and Nutrition Examination Survey (NHANES), we applied a novel, modern statistical shrinkage technique, logistic least absolute shrinkage and selection operator (LASSO) regression, to examine the association between dietary intakes in women, ≥50 years, with self-reported breast cancer (n = 286) compared with women without self-reported breast cancer (1144) from the 1999–2010 NHANES cycle. Logistic LASSO regression was used to examine the relationship between twenty-nine variables, including dietary variables from food, as well as well-established/known breast cancer risk factors, and to subsequently identify the most relevant variables associated with self-reported breast cancer. We observed that as the penalty factor (λ) increased in the logistic LASSO regression, well-established breast cancer risk factors, including age (β = 0.83) and parity (β = −0.05) remained in the model. For dietary macro and micronutrient intakes, only vitamin B12 (β = 0.07) was positively associated with self-reported breast cancer. Caffeine (β = −0.01) and alcohol (β = 0.03) use also continued to remain in the model. These data suggest that a diet high in vitamin B12, as well as alcohol use may be associated with self-reported breast cancer. Nonetheless, additional prospective studies should apply more recent statistical techniques to dietary data and cancer outcomes to replicate and confirm the present findings.
Highlights
In 2019, existing/prevalent cases of breast cancer in the United States reached more than 3.8 million, and approximately 42,000 women are expected to die from the disease in 2019 [1]
In the ultimate logistic least absolute shrinkage and selection operator (LASSO) regression, well-established breast cancer risk factors, including older age and lower parity were associated with increased breast cancer, and vitamin B12, and alcohol and caffeine intakes were related to self-reported breast cancer
We showed that increased alcohol consumption and reduced caffeine use were associated with an increase in breast cancer, with only vitamin B12 from diet remaining in the model
Summary
In 2019, existing/prevalent cases of breast cancer in the United States reached more than 3.8 million, and approximately 42,000 women are expected to die from the disease in 2019 [1]. Breast cancer incidence has been declining an average of 2.3% per year since 1990, 268,600 new cases of invasive breast cancer will be diagnosed in 2019, and breast cancer is still the second leading cause of cancer deaths for U.S women It is only within the last 50 years that we have begun to investigate factors, including metabolic, dietary and other behavioral factors, that may be associated with breast cancer outcomes [2]. Modifiable risk factors such as dietary intakes, weight/obesity and physical activity, as well as alcohol consumption may independently influence a woman’s risk of breast cancer diagnoses [3]. Studies suggest that a largely plant-based diet, high in vegetables, whole fruits and fiber, and low in calories, as well as lower obesity have been shown to be protective against
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