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Dietary Inflammatory Index, Dietary Non-Enzymatic Antioxidant Capacity, and Colorectal and Breast Cancer Risk (MCC-Spain Study).

Mireia Obón-Santacana, Dora Romaguera, Esther Gracia-Lavedan, Amaia Molinuevo, Esther Molina-Montes, Nitin Shivappa, James R Hebert, Adonina Tardón, Gemma Castaño-Vinyals, Ferran Moratalla, Elisabet Guinó, Rafael Marcos-Gragera, Mikel Azpiri, Leire Gil, Rocío Olmedo-Requena, Macarena Lozano-Lorca, Juan Alguacil, Tania Fernández-Villa, Vicente Martín, Antonio J Molina, María Ederra, Conchi Moreno-Iribas, Beatriz Perez, Nuria Aragonés, Adela Castello, José Mª Huerta, Trinidad Dierssen-Sotos, Inés Gómez-Acebo, Ana Molina-Barceló, Marina Pollán, Manolis Kogevinas, Victor Moreno, Pilar Amiano

Journal: Nutrients 2020;11(6):1406

PMID: 31234427

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This study aims to correlate the risk factors of inflammation and antioxidant capacity in cases of colon and breast cancer, using data from a large Spanish case-controlled study (1852 colon cancer subjects, 1567 breast cancer subjects and a total 4933 controls). The role of diet in colon cancer is widely accepted, however it is more controversial with breast cancer where genetic mutations and other lifestyle factors are cited as primary risk factors. What unites these cancers is the inter-related presence of both inflammation and oxidative stress. The dietary inflammatory index (DII®) and non-enzymatic antioxidant capacity (NEAC) were used to evaluate inflammation and oxidative stress using 30 nutrient parameters and 6 inflammatory blood markers. The results showed that colon cancer subjects typically ate a more pro-inflammatory diet compared to controls, with a higher odds ratio of men to women, and tended to be older, heavier and less physically active. The breast cancer subjects also had higher inflammatory scores versus controls but demographically were younger, premenopausal, frequently with a first-degree family link to breast cancer, and including a higher percentage of smokers. For both cancers, inflammation significantly and statistically increased risk factors. Adding in oxidative stress results showed a statistically higher risk of developing colon cancer whilst in breast cancer subjects the risk was increased but non-statistically valid. They did report that meat-eaters had a relative 9% increased risk of Breast cancer. Overall the study concluded that dietary components of inflammation and oxidative stress increased risk of colon cancer but were not statistically valid for breast cancer.

Abstract

Inflammation and antioxidant capacity have been associated with colorectal and breast cancer. We computed the dietary inflammatory index (DII), and the total dietary non-enzymatic antioxidant capacity (NEAC) and associated them with colorectal and breast cancer risk in the population-based multi case-control study in Spain (MCC-Spain). We included 1852 colorectal cancer and 1567 breast cancer cases, and 3447 and 1486 population controls, respectively. DII score and NEAC were derived using data from a semi-quantitative validated food frequency questionnaire. Unconditional logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (95%CI) for energy-adjusted DII (E-DII), and a score combining E-DII and NEAC. E-DII was associated with colorectal cancer risk (OR = 1.93, highest quartile versus lowest, 95%CI:1.60-2.32; -trend: <0.001); this increase was observed for both colon and rectal cancer. Less pronounced increased risks were observed for breast cancer (OR = 1.22, highest quartile versus lowest, 95%CI:0.99-1.52, -trend: >0.10). The combined score of high E-DII scores and low antioxidant values were associated with colorectal cancer risk (OR = 1.48, highest quartile versus lowest, 95%CI: 1.26-1.74; -trend: <0.001), but not breast cancer. This study provides evidence that a pro-inflammatory diet is associated with increased colorectal cancer risk while findings for breast cancer were less consistent.

Address: Oncology Data Analytics Program (ODAP), Catalan Institute of Oncology (ICO), L'Hospitalet del Llobregat, 08908 Barcelona, Spain. [email protected].; ONCOBELL Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain. [email protected].; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. [email protected].; Instituto de Salud Global de Barcelona (ISGlobal), 08036 Barcelona, Spain. [email protected].; Instituto de Investigación Sanitaria Illes Balears (IdISBa), 07120 Palma de Mallorca, Spain. [email protected].; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 28029 Madrid, Spain. [email protected].; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. [email protected].; Instituto de Salud Global de Barcelona (ISGlobal), 08036 Barcelona, Spain. [email protected].; Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra (UPF), 08002 Barcelona, Spain. [email protected].; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. [email protected].; Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (CNIO), 28029 Madrid, Spain. [email protected].; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029 Madrid, Spain. [email protected].; Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA. [email protected].; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA. [email protected].; Department of Nutrition, Connecting Health Innovations LLC (CHI), Columbia, SC 29201, USA. [email protected].; Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA. [email protected].; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA. [email protected].; Department of Nutrition, Connecting Health Innovations LLC (CHI), Columbia, SC 29201, USA. [email protected].; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. [email protected].; Department of Medicine, University of Oviedo, 33006 Oviedo, Spain. [email protected].; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. [email protected].; Instituto de Salud Global de Barcelona (ISGlobal), 08036 Barcelona, Spain. [email protected].; Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra (UPF), 08002 Barcelona, Spain. [email protected].; , IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain. [email protected].; Oncology Data Analytics Program (ODAP), Catalan Institute of Oncology (ICO), L'Hospitalet del Llobregat, 08908 Barcelona, Spain. [email protected].; ONCOBELL Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain. [email protected].; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. [email protected].; Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, 08007 Barcelona, Spain. [email protected].; Oncology Data Analytics Program (ODAP), Catalan Institute of Oncology (ICO), L'Hospitalet del Llobregat, 08908 Barcelona, Spain. [email protected].; ONCOBELL Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain. [email protected].; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. [email protected].; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. [email protected].; Genetics and Cancer Prevention Group, Epidemiology Unit and Girona Cancer Registry, Descriptive Epidemiology, IdIbGi, Catalan Institute of Oncology, 17007 Girona, Spain. [email protected].; Public Health Division of Gipuzkoa, 20003 San Sebastian, Spain. [email protected].; Biodonostia Research Institute, 20014 San Sebastian, Spain. [email protected].; Public Health Division of Gipuzkoa, 20003 San Sebastian, Spain. [email protected].; Biodonostia Research Institute, 20014 San Sebastian, Spain. [email protected].; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. [email protected].; Department of Preventive Medicine and Public Health, School of Medicine, University of Granada, 18016 Granada, Spain. [email protected].; Instituto de Investigación Biosanitaria de Granada ibs.GRANADA, 18014 Granada, Spain. [email protected].; Department of Preventive Medicine and Public Health, School of Medicine, University of Granada, 18016 Granada, Spain. [email protected].; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. [email protected].; Centro de Investigación en Recursos Naturales, Salud y Medio Ambiente (RENSMA), Universidad de Huelva, 21071Huelva, Spain. [email protected].; The Research Group in Gene - Environment and Health Interactions (GIIGAS) / Institut of Biomedicine (IBIOMED), Universidad de León, 24071 León, Spain. [email protected].; Faculty of Health Sciences, Department of Biomedical Sciences, Area of Preventive Medicine and Public Health, Universidad de León, 24071 León, Spain. [email protected].; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. [email protected].; The Research Group in Gene - Environment and Health Interactions (GIIGAS) / Institut of Biomedicine (IBIOMED), Universidad de León, 24071 León, Spain. [email protected].; Faculty of Health Sciences, Department of Biomedical Sciences, Area of Preventive Medicine and Public Health, Universidad de León, 24071 León, Spain. [email protected].; The Research Group in Gene - Environment and Health Interactions (GIIGAS) / Institut of Biomedicine (IBIOMED), Universidad de León, 24071 León, Spain. [email protected].; Faculty of Health Sciences, Department of Biomedical Sciences, Area of Preventive Medicine and Public Health, Universidad de León, 24071 León, Spain. [email protected].; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. [email protected].; Navarra Public Health Institute, 31003 Pamplona, Spain. [email protected].; Navarra Institute for Health Research (IdiSNA), 31003 Pamplona, Spain. [email protected].; Navarra Public Health Institute, 31003 Pamplona, Spain. [email protected].; Navarra Institute for Health Research (IdiSNA), 31003 Pamplona, Spain. [email protected].; REDISSEC Red de Investigación en Servicios de Salud en Enfermedades Crónicas, 28029 Madrid, Spain. [email protected].; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. [email protected].; Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, 28029 Madrid, Spain. [email protected].; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. [email protected].; Department of Health of Madrid, Cancer Epidemiology Section, Public Health Division, 28029 Madrid, Spain. [email protected].; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. [email protected].; Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, 28029 Madrid, Spain. [email protected].; Department of Surgery and Medical and Social Sciences. Alcalá de Henares University, 28801 Alcalá de Henares, Madrid, Spain. [email protected].; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. [email protected].; Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, 30008 Murcia, Spain. [email protected].; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. [email protected].; Preventive Medicine, Universidad de Cantabria-IDIVAL, 39011 Santander, Spain. [email protected].; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. [email protected].; Preventive Medicine, Universidad de Cantabria-IDIVAL, 39011 Santander, Spain. [email protected].; Cancer and Public Health Area, FISABIO-Public Health, 46020 Valencia, Spain. [email protected].; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. [email protected].; Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, 28029 Madrid, Spain. [email protected].; Department of Health of Madrid, Cancer Epidemiology Section, Public Health Division, 28029 Madrid, Spain. [email protected].; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. [email protected].; Instituto de Salud Global de Barcelona (ISGlobal), 08036 Barcelona, Spain. [email protected].; Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra (UPF), 08002 Barcelona, Spain. [email protected].; , IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain. [email protected].; Oncology Data Analytics Program (ODAP), Catalan Institute of Oncology (ICO), L'Hospitalet del Llobregat, 08908 Barcelona, Spain. [email protected].; ONCOBELL Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain. [email protected].; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. [email protected].; Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, 08007 Barcelona, Spain. [email protected].; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. [email protected].; Public Health Division of Gipuzkoa, 20003 San Sebastian, Spain. [email protected].; Biodonostia Research Institute, 20014 San Sebastian, Spain. [email protected].
DOI: 10.3390/nu11061406

Patient Centred Factor

Mediators: Dietary inflammatory index/colorectal and breast cancer

Clinical Imbalances

Immune and inflammation

Laboratory Testing

Blood

Modifiable Lifestyle Factors

Diet Exercise and movement

Jadad Score

3

Nutrition Evidence Keywords

Inflammation Colon cancer Nutrition Oxidative stress Breast cancer Inflammatory cytokines Diet Antioxidant capacity Inflammatory diet

Bioactive Substances

Antioxidants Nutrients Minerals Inflammatory cytokines Vitamins Isoflavones

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MeSH Terms: Antioxidants, Breast Neoplasms, Case-Control Studies, Colorectal Neoplasms, Diet, Female, Humans, Inflammation, Male, Oxidation-Reduction, Prognosis, Protective Factors, Risk Assessment, Risk Factors, Spain
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