Search

BACKGROUND: Inflammatory, insulin and oestrogenic pathways have been linked to breast cancer (BC). We aimed to examine the relationship between pre-diagnostic dietary patterns related to these mechanisms and BC survival. METHODS: The diabetes risk reduction diet (DRRD), inflammatory score of diet (ISD) and oestrogen-related dietary pattern (ERDP) were calculated using dietary data from the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Cox proportional hazards models were used to assess associations between dietary patterns and overall mortality and competing risk models for associations with BC-specific mortality. RESULTS: We included 13,270 BC cases with a mean follow-up after diagnosis of 8.6 years, representing 2340 total deaths, including 1475 BC deaths. Higher adherence to the DRRD score was associated with lower overall mortality (HR1–SD 0.92; 95%CI 0.87–0.96). Greater adherence to pro-inflammatory diets was borderline associated with 6% higher mortality HR1–SD 1.06; 95%CI 1.00–1.12. No significant association with the oestrogen-related dietary pattern was observed. None of the dietary patterns were associated with BC-specific mortality. CONCLUSIONS: Greater adherence to an anti-diabetic and anti-inflammatory diet prior to diagnosis is associated with lower overall mortality among BC survivors. Long-term adherence to these dietary patterns could be a means to improve the prognosis of BC survivors., Instituto de Salud Carlos III FI19/00197, European Social Fund (ESF), AECC Scientific Foundation PRYES211366AGUD, World Health Organization, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Danish Cancer Society, Ligue nationale contre le cancer, Institut Gustave Roussy, Mutuelle Generale de l'Education Nationale, Institut National de la Sante et de la Recherche Medicale (Inserm), Deutsche Krebshilfe Helmholtz Association German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE) Federal Ministry of Education & Research (BMBF), Fondazione AIRC per la ricerca sul cancro Compagnia di San Paolo Consiglio Nazionale delle Ricerche (CNR), Dutch Ministry of Public Health, Welfare and Sports (VWS) Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds Netherlands Organization for Scientific Research (NWO), World Cancer Research Fund International (WCRF), Netherlands Government, Health Research Fund (FIS)-Instituto de Salud Carlos III (ISCIII), Regional Governments of Andalucia, Asturias, Basque Country, Murcia and Navarra Navarra, Catalan Institute of Oncology-ICO (Spain), Swedish Cancer Society Swedish Research Council, County Councils of Skkne, Vasterbotten (Sweden), Cancer Research UK 14136 C8221/A29017, UK Research & Innovation (UKRI), Medical Research Council UK (MRC) 1000143 MR/M012190/1

Acknowledgments: The authors would like to thank the members of the Feel4Diabetes-study group (refer to online Supplementary file 1). We are also grateful for all participating schools, parents and children participated in this study and all those who were involved in data collection and processing. This study was funded by the European Union’s Horizon 2020 under grant agreement n° 643708. Financial support: The Feel4Diabetes-study was funded by the European Union’s Horizon 2020 research and innovation programme under grant agreement n° 643708. The funding body did not have any role in the design of the study and collection, analysis and interpretation of data and in writing the manuscript. The content of this article reflects only the authors’ views and the European Community is not liable for any use that may be made of the information contained therein. Conflict of interests: The authors declare that they have no conflicts of interests/ competing interests. Authorship: L.M. conducted the statistical analyses and wrote the manuscript; Y.M. coordinated the study; L.A.M., Y.M., G.C., K.M. and T.T. participated in the design of the study; E.M.G.G. and L.A.M. critically revised the manuscript and supervised all procedures; P.F.B., C.M., G.C., R.W., V.I. and N.U. provided essential intellectual input; all authors have read, revised and approved the final version of the manuscript. Ethics of human subject participation: Feel4Diabetes-study followed the conventions of the Council of Europe on human rights and biomedicine and the Declaration of Helsinki. Ethical approval was provided by the Ethical Committees (i.e. Universities and research institutions) of all participating European countries including Spain (ethical approval code: CP03/2016), Greece (code: 46/3-4-2015), Finland (code:174/1801/2015), Belgium (code: B670201524237), Bulgaria (code: 52/10-3-201r) and Hungary (code: 20095/2016/EKU). All parents were informed about the purpose of the study, and they signed a written informed consent for their participation, which gave them the chance to withdraw from the study at any point., For supplementary material/s referred to in this article, please visit https://doi.org/10.1017/S1368980022002245, Objective: To examine the parental food consumption and diet quality and its associations with children’s consumption in families at high risk for developing type 2 diabetes mellitus across Europe. Also, to compare food frequency consumption among parents and children from high-risk families to the European Dietary guidelines/recommendations. Design: Cross-sectional study using Feel4diabetes FFQ. Setting: Families completed FFQ and anthropometric measures were obtained. Linear regression analyses were applied to investigate the relations between parental food consumption and diet quality and their children’s food consumption after consideration of potential confounders. Participants: 2095 European families (74·6 % mothers, 50·9 % girls). The participants included parent and one child, aged 6–8 years. Results: Parental food consumption was significantly associated with children’s intake from the same food groups among boys and girls. Most parents and children showed under-consumption of healthy foods according to the European Dietary Guidelines. Parental diet quality was positively associated with children’s intake of ‘fruit’ (boys: β = 0·233, P < 0·001; girls: β = 0·134, P < 0·05) and ‘vegetables’ (boys: β = 0·177, P < 0·01; girls: β = 0·234, P < 0·001) and inversely associated with their ‘snacks’ consumption (boys: β = –0·143, P < 0·05; girls: β = –0·186, P < 0·01). Conclusion: The present study suggests an association between parental food consumption and diet quality and children’s food intake. More in-depth studies and lifestyle interventions that include both parents and children are therefore recommended for future research., Horizon 2020 643708