Skip to main content

Advertisement

Log in

Pre- and post-diagnostic intake of whole grain and dairy products and breast cancer prognosis: the Danish Diet, Cancer and Health cohort

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Purpose

Fiber rich foods and dairy products have been suggested to be associated with breast cancer prognosis, though existing research is limited and either report on pre- or post-diagnostic dietary intake in relation to breast cancer prognosis. We investigated the associations between intake of whole grain (WG) and dairy products assessed both pre- and post-diagnostically in relation to breast cancer prognosis.

Methods

A total of 1965 women from the Diet, Cancer and Health cohort who were diagnosed with breast cancer between baseline (1993–1997) and December 2013 were included and followed for a median of 7 years after diagnosis. During follow-up, 309 women experienced breast cancer recurrence and 460 women died, of whom 301 died from breast cancer. Dietary assessment by food frequency questionnaires was obtained up to three times, pre- and post-diagnostic, over a period of 18 years. Cox proportional hazard models were used to estimate hazard ratios.

Results

No associations were observed between pre- or post-diagnostic intake of total WG or total dairy products and breast cancer prognosis. A high pre-diagnostic intake of oatmeal/muesli was associated with lower all-cause mortality (HR 0.76, 95% CI 0.59–0.99), whereas high post-diagnostic intake of rye bread was associated with higher breast cancer-specific mortality (HR 1.29, 95% CI 1.02–1.63). A generally high intake of cheese was associated with a higher recurrence rate.

Conclusion

Pre-diagnostic intake of oatmeal/muesli was associated with lower all-cause mortality, and post-diagnostic intake of rye bread was associated with higher breast cancer specific mortality.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 68(6):394–424. https://doi.org/10.3322/caac.21492

    Article  PubMed  Google Scholar 

  2. World Cancer Research Fund International/American Institute for Cancer Research (2014) Continuous update project report: diet, nutrition, physical activity and breast cancer survivors 2014. Available at: www.wcrf.org/sites/default/files/Breast-Cancer-Survivors-2014-Report.pdf

  3. Flachs EM, Eriksen L, Koch MB, Ryd JT, Dibba E, Skov-Ettrup L, Juel K. Statens Institut for Folkesundhed,Syddansk Universitet (2015) Sygdomsbyrden i Danmark – sygdomme. Sundhedsstyrelsen, København

  4. GLOBOCAN 2018: Denmark cancer fact sheet (2018) https://gco.iarc.fr/today/data/factsheets/populations/208-denmark-fact-sheets.pdf

  5. Key TJ, Verkasalo PK, Banks E (2001) Epidemiology of breast cancer. Lancet Oncol 2(3):133–140. https://doi.org/10.1016/S1470-2045(00)00254-0

    Article  PubMed  CAS  Google Scholar 

  6. Russo J, Russo IH (2006) The role of estrogen in the initiation of breast cancer. J Steroid Biochem Mol Biol 102(1–5):89–96. https://doi.org/10.1016/j.jsbmb.2006.09.004

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  7. Key TJ (2011) Endogenous oestrogens and breast cancer risk in premenopausal and postmenopausal women. Steroids 76(8):812–815. https://doi.org/10.1016/j.steroids.2011.02.029

    Article  PubMed  CAS  Google Scholar 

  8. World Cancer Research Fund/American Institute for Cancer Research (2018) Diet, nutrition, physical activity and cancer: a global perspective. Continous Update Project Expert Report 2018. Available at https://dietandcancerreport.org

  9. Slavin JL (2000) Mechanisms for the impact of whole grain foods on cancer risk. J Am Coll Nutr 19(3 Suppl):300S–307S

    Article  CAS  Google Scholar 

  10. Arts CJ, Govers CA, van den Berg H, Wolters MG, van Leeuwen P, Thijssen JH (1991) In vitro binding of estrogens by dietary fiber and the in vivo apparent digestibility tested in pigs. J Steroid Biochem Mol Biol 38(5):621–628

    Article  CAS  Google Scholar 

  11. Rose DP, Goldman M, Connolly JM, Strong LE (1991) High-fiber diet reduces serum estrogen concentrations in premenopausal women. Am J Clin Nutr 54(3):520–525. https://doi.org/10.1093/ajcn/54.3.520

    Article  PubMed  CAS  Google Scholar 

  12. Aune D, Chan DS, Greenwood DC, Vieira AR, Rosenblatt DA, Vieira R, Norat T (2012) Dietary fiber and breast cancer risk: a systematic review and meta-analysis of prospective studies. Ann Oncol 23(6):1394–1402. https://doi.org/10.1093/annonc/mdr589

    Article  PubMed  CAS  Google Scholar 

  13. Zang J, Shen M, Du S, Chen T, Zou S (2015) The association between dairy intake and breast cancer in western and asian populations: a systematic review and meta-analysis. J Breast Cancer 18(4):313–322. https://doi.org/10.4048/jbc.2015.18.4.313

    Article  PubMed  PubMed Central  Google Scholar 

  14. Holmes MD, Pollak MN, Willett WC, Hankinson SE (2002) Dietary correlates of plasma insulin-like growth factor I and insulin-like growth factor binding protein 3 concentrations. Cancer Epidemiol Biomark Prev 11(9):852–861

    CAS  Google Scholar 

  15. Brinkman MT, Baglietto L, Krishnan K, English DR, Severi G, Morris HA, Hopper JL, Giles GG (2010) Consumption of animal products, their nutrient components and postmenopausal circulating steroid hormone concentrations. Eur J Clin Nutr 64(2):176–183. https://doi.org/10.1038/ejcn.2009.129

    Article  PubMed  CAS  Google Scholar 

  16. Xie SP, James SY, Colston KW (1997) Vitamin D derivatives inhibit the mitogenic effects of IGF-I on MCF-7 human breast cancer cells. J Endocrinol 154(3):495–504

    Article  CAS  Google Scholar 

  17. Cui Y, Rohan TE (2006) Vitamin D, calcium, and breast cancer risk: a review. Cancer Epidemiol Biomark Prev 15(8):1427–1437. https://doi.org/10.1158/1055-9965.EPI-06-0075

    Article  CAS  Google Scholar 

  18. Shin MH, Holmes MD, Hankinson SE, Wu K, Colditz GA, Willett WC (2002) Intake of dairy products, calcium, and vitamin D and risk of breast cancer. J Natl Cancer Inst 94(17):1301–1311

    Article  CAS  Google Scholar 

  19. Grimberg A (2003) Mechanisms by which IGF-I may promote cancer. Cancer Biol Ther 2(6):630–635

    Article  CAS  Google Scholar 

  20. Kroenke CH, Kwan ML, Sweeney C, Castillo A, Caan BJ (2013) High- and low-fat dairy intake, recurrence, and mortality after breast cancer diagnosis. J Natl Cancer Inst 105(9):616–623. https://doi.org/10.1093/jnci/djt027

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  21. Holmes MD, Stampfer MJ, Colditz GA, Rosner B, Hunter DJ, Willett WC (1999) Dietary factors and the survival of women with breast carcinoma. Cancer 86(5):826–835

    Article  CAS  Google Scholar 

  22. World Cancer Research Fund/American Institute for Cancer Research (2018) Continous update project report: diet, nutrition, physical activity and breast cancer 2018. ​Available at www.dietandcancerreport.org

  23. Pedersen AN, Christensen T, Matthiessen J, Knudsen VK, Rosenlund-Sørensen M, Biltoft-Jensen A, Hinsch HJ, Ygil KH, Kørup K, Saxholt E, Trolle E, Sødergaard AB, Fagt S (2015) Danskernes Kostvaner 2011–2013. 1. Udgave edn. DTU Fødevareinstituttet, Copenhagen

    Google Scholar 

  24. Saxe GA, Rock CL, Wicha MS, Schottenfeld D (1999) Diet and risk for breast cancer recurrence and survival. Breast Cancer Res Treat 53(3):241–253

    Article  CAS  Google Scholar 

  25. Buck K, Zaineddin AK, Vrieling A, Heinz J, Linseisen J, Flesch-Janys D, Chang-Claude J (2011) Estimated enterolignans, lignan-rich foods, and fibre in relation to survival after postmenopausal breast cancer. Br J Cancer 105(8):1151–1157. https://doi.org/10.1038/bjc.2011.374

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  26. Beasley JM, Newcomb PA, Trentham-Dietz A, Hampton JM, Bersch AJ, Passarelli MN, Holick CN, Titus-Ernstoff L, Egan KM, Holmes MD, Willett WC (2011) Post-diagnosis dietary factors and survival after invasive breast cancer. Breast Cancer Res Treat 128(1):229–236. https://doi.org/10.1007/s10549-010-1323-z

    Article  PubMed  PubMed Central  Google Scholar 

  27. McEligot AJ, Largent J, Ziogas A, Peel D, Anton-Culver H (2006) Dietary fat, fiber, vegetable, and micronutrients are associated with overall survival in postmenopausal women diagnosed with breast cancer. Nutr Cancer 55(2):132–140. https://doi.org/10.1207/s15327914nc5502_3

    Article  PubMed  CAS  Google Scholar 

  28. Belle FN, Kampman E, McTiernan A, Bernstein L, Baumgartner K, Baumgartner R, Ambs A, Ballard-Barbash R, Neuhouser ML (2011) Dietary fiber, carbohydrates, glycemic index, and glycemic load in relation to breast cancer prognosis in the HEAL cohort. Cancer Epidemiol Biomark Prev 20(5):890–899. https://doi.org/10.1158/1055-9965.EPI-10-1278

    Article  CAS  Google Scholar 

  29. Pedersen CB (2011) The Danish civil registration system. Scand J Public Health 39(7 Suppl):22–25. https://doi.org/10.1177/1403494810387965

    Article  PubMed  Google Scholar 

  30. Gjertstorff M (2011) The Danish cancer registry. Scand J Public Health 39:42–45

    Article  Google Scholar 

  31. ​Andersen KW, Mouridsen HT (1988) Danish Breast Cancer Cooperative Group (DBCG): a description of the register of the nation-wide programme for primary breast cancer. Acta Oncol 27(6):627–647. https://doi.org/10.3109/02841868809091763

    Article  PubMed  CAS  Google Scholar 

  32. Helweg-Larsen K (2011) The Danish register of causes of death. Scand J Public Health 39(7_Suppl):26–29

    Article  Google Scholar 

  33. Mejborn H, Ygil KH, Fagt S, Trolle E, Kørup K, Christiensen T (2014) Wholegrain intake of Danes 2011-2012

  34. Tjonneland A, Olsen A, Boll K, Stripp C, Christensen J, Engholm G, Overvad K (2007) Study design, exposure variables, and socioeconomic determinants of participation in diet, cancer and health: a population-based prospective cohort study of 57,053 men and women in Denmark. Scand J Public Health 35(4):432–441. https://doi.org/10.1080/14034940601047986

    Article  PubMed  Google Scholar 

  35. Lundqvist A, Andersson E, Ahlberg I, Nilbert M, Gerdtham U (2016) Socioeconomic inequalities in breast cancer incidence and mortality in Europe—a systematic review and meta-analysis. Eur J Pub Health 26(5):804–813. https://doi.org/10.1093/eurpub/ckw070

    Article  Google Scholar 

  36. Haraldsdottir A, Torfadottir JE, Valdimarsdottir UA, Adami HO, Aspelund T, Tryggvadottir L, Thordardottir M, Birgisdottir BE, Harris TB, Launer LJ, Gudnason V, Steingrimsdottir L (2018) Dietary habits in adolescence and midlife and risk of breast cancer in older women. PLoS ONE 13(5):e0198017. https://doi.org/10.1371/journal.pone.0198017

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  37. Wu H, Kyro C, Tjonneland A, Boll K, Olsen A, Overvad K, Landberg R (2019) Long-term whole grain wheat and rye intake reflected by adipose tissue alkylresorcinols and breast cancer: a case-cohort study. Nutrients. https://doi.org/10.3390/nu11020465

    Article  PubMed  PubMed Central  Google Scholar 

  38. Schisterman EF, Cole SR, Platt RW (2009) Overadjustment bias and unnecessary adjustment in epidemiologic studies. Epidemiology 20(4):488–495. https://doi.org/10.1097/EDE.0b013e3181a819a1

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

We thank Katja Boll and Nick Martinussen for data management and assistance and we thank Kirsten Frederiksen for statistical support.

Funding

This study was funded by the Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Julie Louise Munk Andersen.

Ethics declarations

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards by the regional ethical committees on human studies in Copenhagen and Aarhus (File (KF)11-037/01), by the Danish Data Protection Agency and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Research involving animal rights

This article does not contain any studies with animals performed by any of the authors.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Andersen, J.L.M., Hansen, L., Thomsen, B.L.R. et al. Pre- and post-diagnostic intake of whole grain and dairy products and breast cancer prognosis: the Danish Diet, Cancer and Health cohort. Breast Cancer Res Treat 179, 743–753 (2020). https://doi.org/10.1007/s10549-019-05497-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-019-05497-1

Keywords

Navigation