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Dietary patterns and breast cancer risk in Asian American women

¹ From the Department of Preventive Medicine and Obstetrics and Gynecology, University of Southern California Keck School of Medicine, Los Angeles, CA (AHW, C-CT, FZS, and MCP), and the Cancer Center, University of Minnesota, Minneapolis, MN (MCY).

² Supported by grants 1RB-0287, 3PB-0102, 5PB-0018, and 10PB-0098 from the California Breast Cancer Research Program.

³ Reprints not available. Address correspondence to AH Wu, Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA 90089. E-mail: annawu{at}usc.edu.

Background: The role of diet as a cause of breast cancer in Asian Americans has not been adequately studied.

Objective: We investigated the association between dietary patterns and breast cancer risk in Asian Americans.

Design: This population-based case-control study in Los Angeles County compared dietary patterns between 1248 Asian American women with incident breast cancer and 1148 age-, ethnicity-, and neighborhood-matched controls. The relation between dietary patterns and serum concentrations of estrogens, androgens, and sex hormone–binding globulin (SHBG) was investigated in 2172 postmenopausal control women.

Results: We used a scoring method proposed by Trichopoulou et al (1) and found that adherence to a Mediterranean diet was inversely associated with risk; the odds ratio (OR) was 0.65 (95% CI: 0.44, 0.95) in women with the highest scores (8; most adherent) compared with those with the lowest scores (0–3; P for trend = 0.009), after adjustment for key covariates. We also used factor analysis and identified 3 dietary patterns (Western-meat/starch, ethnic-meat/starch, and vegetables/soy). In a combined index of the 3 patterns, women who were high consumers of Western and ethnic meat/starch and low consumers of the vegetables/soy diets showed the highest risk (OR: 2.19; 95% CI: 1.40, 3.42; P for trend = 0.0005). SHBG concentrations were 23% lower in women with a high intake of the meat/starch pattern and a low intake of the vegetables/soy pattern than in those with a low intake of the meat/starch pattern and a high intake of the vegetables/soy pattern (P for trend = 0.069).

Conclusion: Our results suggest that a diet characterized by a low intake of meat/starches and a high intake of legumes is associated with a reduced risk of breast cancer in Asian Americans.

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