title: Patterns of change over time and history of the inflammatory potential of diet and risk of breast cancer among postmenopausal women.
abstract: We utilized the dietary inflammatory index (DII) to investigate associations between patterns of change in, and history of the inflammatory potential of diet and risk of breast cancer in the Women's Health Initiative (WHI). We included 70,998 postmenopausal women aged 50-79 years recruited from 1993 to 1998 into the WHI Observational Study and Dietary Modification trial control group and followed through August 29, 2014. We utilized data from food frequency questionnaires administered at baseline and Year 3, to calculate average DII scores, patterns of change in DII, and used these measures in multivariable-adjusted Cox regression models to estimate hazards ratios (HR) and 95 % confidence intervals (CI) for incident invasive breast cancer and its subtypes. After 1,093,947 person-years of follow-up, 3471 cases of invasive breast cancer were identified. There was no substantial association between average DII scores or patterns of change in DII and risk of overall invasive breast cancer (HR, 1.03; 95 % CI, 0.90, 1.17; P-trend = 0.79; comparing extreme average DII quintiles). However, there was a significant nonlinear association between average DII scores and the ER-, PR-, HER2+, subtype (HR, 2.37; 95 % CI, 1.08, 5.20; P-trend = 0.18; comparing extreme quintiles). For patterns of change in DII, the age-adjusted association with ER-, PR-, HER2+ subtype comparing women in the proinflammatory stable to those in the anti-inflammatory stable categories (HR, 1.82; 95 % CI, 1.06, 3.13) persisted in the multivariable-adjusted model but was less precise (HR, 1.85; 95 % CI, 0.96, 3.55; P = 0.06). Dietary inflammatory potential may differentially influence the development of specific breast cancer phenotypes.
authors.affiliation: Departments of Nutrition and Epidemiology, Harvard T. H. Chan School of Public Health, Boston, USA.|Cancer Prevention and Control Program, University of South Carolina, Columbia, USA.|Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, USA.
authors.forename: Fred K
authors.initials: FK
authors.lastname: Tabung
authors.affiliation: Cancer Prevention and Control Program, University of South Carolina, Columbia, USA. ssteck@sc.edu.|Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, USA. ssteck@sc.edu.|Center for Research in Nutrition and Health Disparities, University of South Carolina, Columbia, USA. ssteck@sc.edu.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Steck
authors.affiliation: Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, USA.|Center for Research in Nutrition and Health Disparities, University of South Carolina, Columbia, USA.
authors.forename: Angela D
authors.initials: AD
authors.lastname: Liese
authors.affiliation: Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, USA.
authors.forename: Jiajia
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, USA.
authors.forename: Yunsheng
authors.initials: Y
authors.lastname: Ma
authors.affiliation: Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, USA.
authors.forename: Karen C
authors.initials: KC
authors.lastname: Johnson
authors.affiliation: Department of Family, Population and Preventive Medicine, Stony Brook University School of Medicine, New York, USA.
authors.forename: Dorothy S
authors.initials: DS
authors.lastname: Lane
authors.affiliation: Division of Biostatistics, Department of Public Health Sciences, University of California, Davis, USA.
authors.forename: Lihong
authors.initials: L
authors.lastname: Qi
authors.affiliation: Department of Epidemiology, The University of Iowa, Iowa City, USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Snetselaar
authors.affiliation: Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, USA.
authors.forename: Mara Z
authors.initials: MZ
authors.lastname: Vitolins
authors.affiliation: Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, USA.
authors.forename: Judith K
authors.initials: JK
authors.lastname: Ockene
authors.affiliation: Cancer Prevention and Control Program, University of South Carolina, Columbia, USA.|Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, USA.
authors.forename: James R
authors.initials: JR
authors.lastname: Hebert
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000209:etiology; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007249:Inflammation / Q000150:complications* / Q000209:etiology; D008875:Middle Aged; D017698:Postmenopause; D057566:Self Report
keywords: Breast cancer; Diet; Dietary patterns; Epidemiology; Inflammation