Association between healthy lifestyle score and breast cancer

Batoul Ghosn; Sanaz Benisi-Kohansal; Soraiya Ebrahimpour-Koujan; Leila Azadbakht; Ahmad Esmaillzadeh

doi:10.1186/s12937-020-0520-9

Association between healthy lifestyle score and breast cancer

Nutr J. 2020 Jan 14;19(1):4. doi: 10.1186/s12937-020-0520-9.

Authors

Batoul Ghosn¹, Sanaz Benisi-Kohansal¹, Soraiya Ebrahimpour-Koujan¹, Leila Azadbakht¹, Ahmad Esmaillzadeh^{2

3

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Affiliations

¹ Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran.
² Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran. a-esmaillzadeh@tums.ac.ir.
³ Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular- Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. a-esmaillzadeh@tums.ac.ir.
⁴ Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran. a-esmaillzadeh@tums.ac.ir.

Abstract

Background: Majority of earlier studies have assessed the association between individual lifestyle factors and the risk of breast cancer (BC); however, limited information is available linking the whole lifestyle factors to BC. We aimed to examine the association between combined lifestyle score (diet, physical activity (PA) and smoking) and risk of BC in Iranian population.

Methods: This population-based case-control study included 350 newly diagnosed cases of BC and 700 healthy controls randomly selected from adult women. Dietary intakes, PA and smoking status of study participants were examined using validated questionnaires. The lifestyle risk factors examined in this study included cigarette smoking, physical inactivity, and Healthy Eating Index-2010 (HEI-2010). The lifestyle score ranged from zero (non-healthy) to 3 (most healthy) points. Logistic regression models were fitted to investigate the association between combined lifestyle scores and odds of BC.

Results: Mean age and body mass index (BMI) of study participants were 62.4 years and 24.3 kg/m², respectively. In the whole study population, individuals with the highest healthy lifestyle score (HLS) were 0.38 times less likely to have BC than those with the lowest score (OR: 0.62; 95% CI: 0.40, 0.93, P_trend = 0.01). The analysis by menopausal status showed that postmenopausal women with the highest HLS had 44% lower odds of BC compared with those with the lowest score (OR: 0.56; 95% CI: 0.36, 0.88, P _trend = 0.004). Such association was not seen in premenopausal women. After analyzing each component of HLS, we found that individuals with the highest HEI score were 46% less likely to have BC than those with the lowest score (OR: 0.54; 95% CI: 0.35, 0.82, P_trend < 0.001). No other significant associations were found between PA and smoking and risk of BC.

Conclusions: Significant inverse associations were found between HLS and HEI with BC especially among postmenopausal women. Prospective studies are required to confirm these findings.

Keywords: Breast cancer; Diet; Lifestyle; Physical activity; Smoking.

MeSH terms

Aged
Breast Neoplasms / epidemiology*
Case-Control Studies
Diet / methods*
Diet / statistics & numerical data
Exercise*
Female
Healthy Lifestyle*
Humans
Iran / epidemiology
Middle Aged
Risk Factors
Smoking / epidemiology*