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Degree of food processing and breast cancer risk : a prospective study in 9 European countries

Cairat, Manon ; Yammine, Sahar ; Fiolet, Thibault ; Fournier, Agnès ; Boutron-Ruault, Marie Christine ; Laouali, Nasser ; Mancini, Francesca Romana ; Severi, Gianluca ; Berstein, Fernanda Morales and Rauber, Fernanda , et al. (2024) In Food Production, Processing and Nutrition 6. p.1-13
Abstract

Recent epidemiological studies have suggested a positive association between ultra-processed food consumption and breast cancer risk, although some studies also reported no association. Furthermore, the evidence regarding the associations between intake of food with lower degrees of processing and breast cancer risk is limited. Thus, we investigated the associations between dietary intake by degree of food processing and breast cancer risk, overall and by breast cancer subtypes in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Dietary intake of EPIC participants was assessed via questionnaires at baseline. More than 11,000 food ingredients were classified into four groups of food processing levels using... (More)

Recent epidemiological studies have suggested a positive association between ultra-processed food consumption and breast cancer risk, although some studies also reported no association. Furthermore, the evidence regarding the associations between intake of food with lower degrees of processing and breast cancer risk is limited. Thus, we investigated the associations between dietary intake by degree of food processing and breast cancer risk, overall and by breast cancer subtypes in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Dietary intake of EPIC participants was assessed via questionnaires at baseline. More than 11,000 food ingredients were classified into four groups of food processing levels using the NOVA classification system: unprocessed/minimally processed (NOVA 1), culinary ingredients (NOVA 2), processed (NOVA 3) and ultra-processed (NOVA 4). Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of breast cancer per standard deviation increase in daily consumption (grams) of foods from each NOVA group. The current analysis included 14,933 breast cancer cases, diagnosed among the 318,686 EPIC female participants, (median follow-up of 14.9 years). No associations were found between breast cancer risk and the level of dietary intake from NOVA 1 [HR per 1 SD=0.99 (95% CI 0.97 – 1.01)], NOVA 2 [HR per 1 SD =1.01 (95% CI 0.98 – 1.03)] and NOVA 4 [HR per 1 SD =1.01 (95% CI 0.99 – 1.03)] foods. However, a positive association was found between NOVA 3 and breast cancer risk [HR per 1 SD =1.05 (95% CI 1.03 – 1.07)] which became non-significant after adjustment for alcohol intake [HR per 1 SD =1.01 (95% CI 0.98 – 1.05)] or when beer and wine were excluded from this group [HR per 1 SD =0.99 (95% CI 0.97 – 1.01)]. The associations did not differ by breast cancer subtype, menopausal status or body mass index. Findings from this large-scale prospective study suggest that the positive association between processed food intake and breast cancer risk was likely driven by alcoholic beverage consumption. Graphical Abstract: (Figure presented.)

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Breast cancer, Epidemiology, Food processing, NOVA classification, Prospective study
in
Food Production, Processing and Nutrition
volume
6
article number
89
pages
1 - 13
publisher
BioMed Central (BMC)
external identifiers
  • pmid:39399144
  • scopus:85205943045
DOI
10.1186/s43014-024-00264-2
language
English
LU publication?
yes
additional info
Publisher Copyright: © The Author(s) 2024.
id
db163604-3883-454a-9d0d-bd3b92651fe7
date added to LUP
2024-11-20 11:08:37
date last changed
2025-07-03 19:41:12
@article{db163604-3883-454a-9d0d-bd3b92651fe7,
  abstract     = {{<p>Recent epidemiological studies have suggested a positive association between ultra-processed food consumption and breast cancer risk, although some studies also reported no association. Furthermore, the evidence regarding the associations between intake of food with lower degrees of processing and breast cancer risk is limited. Thus, we investigated the associations between dietary intake by degree of food processing and breast cancer risk, overall and by breast cancer subtypes in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Dietary intake of EPIC participants was assessed via questionnaires at baseline. More than 11,000 food ingredients were classified into four groups of food processing levels using the NOVA classification system: unprocessed/minimally processed (NOVA 1), culinary ingredients (NOVA 2), processed (NOVA 3) and ultra-processed (NOVA 4). Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of breast cancer per standard deviation increase in daily consumption (grams) of foods from each NOVA group. The current analysis included 14,933 breast cancer cases, diagnosed among the 318,686 EPIC female participants, (median follow-up of 14.9 years). No associations were found between breast cancer risk and the level of dietary intake from NOVA 1 [HR <sub>per 1 SD</sub>=0.99 (95% CI 0.97 – 1.01)], NOVA 2 [HR <sub>per 1 SD</sub> =1.01 (95% CI 0.98 – 1.03)] and NOVA 4 [HR <sub>per 1 SD</sub> =1.01 (95% CI 0.99 – 1.03)] foods. However, a positive association was found between NOVA 3 and breast cancer risk [HR <sub>per 1 SD</sub> =1.05 (95% CI 1.03 – 1.07)] which became non-significant after adjustment for alcohol intake [HR <sub>per 1 SD</sub> =1.01 (95% CI 0.98 – 1.05)] or when beer and wine were excluded from this group [HR <sub>per 1 SD</sub> =0.99 (95% CI 0.97 – 1.01)]. The associations did not differ by breast cancer subtype, menopausal status or body mass index. Findings from this large-scale prospective study suggest that the positive association between processed food intake and breast cancer risk was likely driven by alcoholic beverage consumption. Graphical Abstract: (Figure presented.)</p>}},
  author       = {{Cairat, Manon and Yammine, Sahar and Fiolet, Thibault and Fournier, Agnès and Boutron-Ruault, Marie Christine and Laouali, Nasser and Mancini, Francesca Romana and Severi, Gianluca and Berstein, Fernanda Morales and Rauber, Fernanda and Levy, Renata Bertazzi and Skeie, Guri and Borch, Kristin Benjaminsen and Tjønneland, Anne and Mellemkjær, Lene and Borné, Yan and Rosendahl, Ann H. and Masala, Giovanna and Giraudo, Maria Teresa and de Magistris, Maria Santucci and Katzke, Verena and Bajracharya, Rashmita and Santiuste, Carmen and Amiano, Pilar and Bodén, Stina and Castro-Espin, Carlota and Sánchez, Maria Jose and Touvier, Mathilde and Deschasaux-Tanguy, Mélanie and Srour, Bernard and Schulze, Matthias B. and Guevara, Marcela and Kliemann, Nathalie and Lopez, Jessica Blanco and Al Nahas, Aline and Chang, Kiara and Vamos, Eszter P. and Millett, Christopher and Riboli, Elio and Heath, Alicia K. and Biessy, Carine and Viallon, Vivian and Casagrande, Corinne and Nicolas, Genevieve and Gunter, Marc J. and Huybrechts, Inge}},
  keywords     = {{Breast cancer; Epidemiology; Food processing; NOVA classification; Prospective study}},
  language     = {{eng}},
  pages        = {{1--13}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{Food Production, Processing and Nutrition}},
  title        = {{Degree of food processing and breast cancer risk : a prospective study in 9 European countries}},
  url          = {{http://dx.doi.org/10.1186/s43014-024-00264-2}},
  doi          = {{10.1186/s43014-024-00264-2}},
  volume       = {{6}},
  year         = {{2024}},
}