title: Lifelong vegetarianism and risk of breast cancer: a population-based case-control study among South Asian migrant women living in England.
abstract: To investigate the role of lifelong vegetarianism on the aetiology of female breast cancer, we conducted a population-based case-control study among South Asian migrant women from the Indian subcontinent resident in England. A total of 240 South Asian breast cancer cases were identified from 2 cancer registries during 1995-1999. For each case, 2 age-matched South Asian controls were randomly selected from the age-sex register of the case practice. Lifelong vegetarians had a slight reduction, although not statistically significant, in the odds of breast cancer relative to lifelong meat-eaters, which persisted after adjustment for socio-demographic and reproductive variables [odds ratio (OR)=0.77; 95% confidence interval (CI)=0.50-1.18]. Analysis by food group revealed no linear trend in the odds of breast cancer with increasing consumption of meat (p=0.10) but the odds were higher for women in the top 75%. In contrast, there were strong inverse trends in the odds of breast cancer with increasing intake of vegetables (p=0.005), pulses (p=0.007) and fibre [non-starch polysaccharides, NSP (p=0.02)], with women in the highest 25% of intake of these foods having about 50% of the odds of those in the lowest ones. Adjustment for intake of vegetables and pulses reverted the odds of breast cancer in lifelong vegetarians relative to lifelong meat-eaters (OR=1.04; 95% CI=0.65-1.68) and attenuated the quartile-specific estimates for meat intake, whereas the inverse trends in the odds of breast cancer with intake of vegetables and pulses remained after adjustment for type of diet or meat intake. These findings suggest that lifelong vegetarianism may be associated with a reduction in the risk of breast cancer through its association with a higher intake of vegetables and pulses. Although it is not possible to exclude the possibility that lifelong meat abstention may also play a role, the findings provide evidence that a diet rich in vegetables and pulses, such as those typically found in South Asian diets, may be protective against this cancer.
authors.affiliation: Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, England. isabel.silva@lshtm.ac.uk
authors.forename: Isabel
authors.initials: I
authors.lastname: Dos Santos Silva
authors.forename: Punam
authors.initials: P
authors.lastname: Mangtani
authors.forename: Valerie
authors.initials: V
authors.lastname: McCormack
authors.forename: Dee
authors.initials: D
authors.lastname: Bhakta
authors.forename: Leena
authors.initials: L
authors.lastname: Sevak
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: McMichael
mesh_terms: D000367:Age Factors; D001208:Asia / Q000208:ethnology; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000517:prevention & control; D016022:Case-Control Studies; D003469:Culture; D004032:Diet; D015930:Diet Records; D014676:Diet, Vegetarian; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004041:Dietary Fats / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D002149:Energy Intake; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008460:Meat; D016017:Odds Ratio; D012307:Risk Factors
chemical_list: D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004044:Dietary Proteins