title: Diet quality indices and postmenopausal breast cancer survival.
abstract: Research on diet in breast cancer survival has been focused on single nutrients or foods, particularly dietary fat, fruits, vegetables, fiber, and alcohol. We hypothesized that diet quality indices decrease the risk of total and non-breast-cancer-related deaths in women diagnosed with breast cancer. We evaluated 4 dietary quality scores: Alternate Healthy Eating Index (AHEI), Diet Quality Index-Revised (DQIR), Recommended Food Score (RFS), and the alternate Mediterranean Diet Score (aMED), among 2,729 women from the Nurses' Health Study with invasive Stage 1-3 breast cancer diagnosed between 1978 and 1998 with follow-up through 2004. In multivariate adjusted analyses, no association was found between diet quality indices and either total or non-breast-cancer-related deaths. However, a higher aMED score was associated with a lower risk of non-breast-cancer death in women with low physical activity; the RR comparing the highest to lowest tertile was 0.39 (95% CI, 0.20-0.75, P trend = 0.0004). Our results suggest that a higher-quality diet after breast cancer diagnosis does not considerably change the risk of death from breast cancer. However, healthy dietary choices may be important because women are at risk of death from non-breast-cancer-related causes affected by diet.
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts 02115, USA. ehjkim@post.harvard.edu
authors.forename: Esther H J
authors.initials: EH
authors.lastname: Kim
authors.forename: Walter C
authors.initials: WC
authors.lastname: Willett
authors.forename: Teresa
authors.initials: T
authors.lastname: Fung
authors.forename: Bernard
authors.initials: B
authors.lastname: Rosner
authors.forename: Michelle D
authors.initials: MD
authors.lastname: Holmes
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000401:mortality*; D004032:Diet; D038441:Diet, Mediterranean; D004041:Dietary Fats / Q000008:administration & dosage*; D004043:Dietary Fiber / Q000008:administration & dosage*; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D005638:Fruit; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D017698:Postmenopause; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D014675:Vegetables
chemical_list: D004041:Dietary Fats; D004043:Dietary Fiber