Modeling the Nutritional Adjuvance for Breast Cancer on a Basis of Population-Specific Risk Factors: A Pilot Study

Abstract

INTRODUCTION: In recent years scientific studies are showing the advantages of an adequate complementary diet for those women who were diagnosed with a breast cancer (BC), regarding the disease-free survival and the overall survival. In addition, some communications reported an improvement when nutritional guidelines were followed focusing on the management of overweight and obesity and also including physical activity. METHODOLOGY: We have recently proposed a preventive BC risk profile, which was based on items drawn from data obtained in local epidemiologic studies. The change in the profile is an attempt to modify the ratios of urine 2/16-a-OH estrogen metabolites and dietary O-6/O-3 fatty acids, as well as the body composition and other relevant nutritional features, in order to improve the patient’s hormonal, metabolic and immunity status. We have selected the following variables as the most relevant for being taken into account for a change: intake of red meat, white meat, dairy foods, oils and fats, high glycemic load foods, vegetables and fruits; alcohol consumption; physical activity; psychosocial stressors; metabolic disturbances; fat-to-muscle ratio; serum vitamin D level; urine 2/16-a-OH estrogen ratio; serum triglycerides/HDL ratio and fasting insulinemia. The assignment of a low, medium or high risk value for each variable was done depending on the variable nature and its association to the risk of BC. Unlike some laboratory results, the cut-off points used for classification might represent population-specific features. RESULTS: The method implies modifying each selected term, upwards or downwards and according to the risk or protective nature of the item, towards the putative low-risk threshold or zone. For example, regarding the analysis of red meat intake (a risk factor among Uruguayan women) the low-risk category comprises up to 1 serving/week. On the contrary, for a putative protective factor in the same population like citrus fruits, the highest intake category includes >=8 units/week (oranges, orange juice servings, i.e.). CONCLUSION: We propose to make a nutritional equalization, that is, change the exposure to the putative risk and protective factors to the lowest possible risk level in a tailored way. Although generalization is limited by the local value of certain variables, methodology is feasible elsewhere from a practical viewpoint. Each country or region could construct its own reference values, since some items (diet, anthropometry) may be population-specific. Instead of giving vague and inaccurate recommendations, we attempt to give guidelines with precise low or high limits. Because no studies indicate that a prudent diet is pejorative for health, we are trying to change an inadequate nutritional pattern into an adequate one in order to make feasible a subsequent change of the prognosis.