Nutrient-Wide Association Study of 92 Foods and Nutrients and Breast Cancer Risk

Alicia K. Heath; David C. Muller; Piet A. van den Brandt; Nikos Papadimitriou; Elena Critselis; Marc Gunter; Paolo Vineis; Elisabete Weiderpass; Guy Fagherazzi; Heiner Boeing; Pietro Ferrari; Anja Olsen; Anne Tjønneland; Patrick Arveux; Marie-Christine Boutron-Ruault; Francesca Romana Mancini; Tilman Kühn; Renée Turzanski-Fortner; Matthias B. Schulze; Anna Karakatsani; Paschalis Thriskos; Antonia Trichopoulou; Giovanna Masala; Paolo Contiero; Fulvio Ricceri; Salvatore Panico; Bas Bueno-de-Mesquita; Marije F. Bakker; Carla H. van Gils; Karina Standahl Olsen; Guri Skeie; Cristina Lasheras; Antonio Agudo; Miguel Rodríguez-Barranco; Maria-José Sánchez; Pilar Amiano; María-Dolores Chirlaque; Aurelio Barricarte; Isabel Drake; Ulrika Ericson; Ingegerd Johansson; Anna Winkvist; Tim Key; Heinz Freisling; Mathilde His; Inge Huybrechts; Sofia Christakoudi; Merete Ellingjord-Dale; Elio Riboli; Konstantinos K. Tsilidis; Ioanna Tzoulaki


Breast Cancer Res. 2020;22(5) 

In This Article

Abstract and Introduction


Background: Several dietary factors have been reported to be associated with risk of breast cancer, but to date, unequivocal evidence only exists for alcohol consumption. We sought to systematically assess the association between intake of 92 foods and nutrients and breast cancer risk using a nutrient-wide association study.

Methods: Using data from 272,098 women participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, we assessed dietary intake of 92 foods and nutrients estimated by dietary questionnaires. Cox regression was used to quantify the association between each food/nutrient and risk of breast cancer. A false discovery rate (FDR) of 0.05 was used to select the set of foods and nutrients to be replicated in the independent Netherlands Cohort Study (NLCS).

Results: Six foods and nutrients were identified as associated with risk of breast cancer in the EPIC study (10,979 cases). Higher intake of alcohol overall was associated with a higher risk of breast cancer (hazard ratio (HR) for a 1 SD increment in intake = 1.05, 95% CI 1.03–1.07), as was beer/cider intake and wine intake (HRs per 1 SD increment = 1.05, 95% CI 1.03–1.06 and 1.04, 95% CI 1.02–1.06, respectively), whereas higher intakes of fibre, apple/pear, and carbohydrates were associated with a lower risk of breast cancer (HRs per 1 SD increment = 0.96, 95% CI 0.94–0.98; 0.96, 95% CI 0.94–0.99; and 0.96, 95% CI 0.95–0.98, respectively). When evaluated in the NLCS (2368 cases), estimates for each of these foods and nutrients were similar in magnitude and direction, with the exception of beer/cider intake, which was not associated with risk in the NLCS.

Conclusions: Our findings confirm a positive association of alcohol consumption and suggest an inverse association of dietary fibre and possibly fruit intake with breast cancer risk.