Serum 'Vitamin-Mineral' Profiles: Associations with Postmenopausal Breast Cancer Risk Including Dietary Patterns and Supplementation. A Case-Control Study.

Breast cancer is the most prevalent cancer in females worldwide. Studies evaluating the blood vitamins and minerals status in the breast cancer etiology are limited, and the results are inconclusive. This study analyzed the association between serum vitamin-mineral profiles (V-MPs) and breast cancer (BC) risk with including dietary patterns (DPs) and the use of supplements. This case-control study involved 420 women aged 40-79 years from north-eastern Poland, including 190 newly diagnosed breast cancer cases. The fasting serum concentrations of vitamins (folate, cobalamin, 25(OH) vitamin D) and minerals (iron, calcium, magnesium) were measured in 129 post-menopausal women, including 82 controls and 47 cases. Three V-MPs were derived with a Principal Component Analysis (PCA). A logistic regression analysis was performed to estimate the odds ratio (OR) and 95% confidence interval (95% CI) of the breast cancer risk associated with serum V-MPs and serum levels of single biomarkers. The risk of BC was lower by 88% (OR: 0.12; 95% Cl: 0.02-0.88; p < 0.05) in the upper tertile of the serum 'Iron-Calcium' profile compared to the bottom tertile, lower by 67% (OR: 0.33; 95% Cl: 0.11-0.97; p < 0.05) at the level of serum 25(OH) vitamin D ≥24.6 ng/mL and lower by 68% (OR: 0.32; 95% Cl: 0.11-0.91; p < 0.05) at the level of serum calcium ≥9.6 mg/dL. There was an inverse association of the serum 'Magnesium' profile or serum level of iron with the risk of BC, which disappeared after adjustment for the set of confounders accounted for: age, body mass index (BMI), socioeconomic status, overall physical activity, smoking status, age at menarche, number of full-term pregnancies, oral contraceptive use, hormone-replacement therapy use, family history of breast cancer, vitamin/mineral supplement use, the molecular subtype of breast cancer, and dietary patterns. No significant association was found between BC risk and the serum 'Folate-Cobalamin-Vitamin D' profile or serum folate, cobalamin or magnesium considered separately. These findings highlight that a higher-normal serum level of both iron and calcium, considered together as the serum profile, as well as a higher-normal serum level of calcium, considered separately, and a slightly below the normal range of serum vitamin D level may protect against breast cancer among postmenopausal women, independent of dietary patterns or the use of vitamin/mineral supplements. Therefore, the maintenance of the adequate status of vitamins and minerals and the regular monitoring of their blood markers should be included in breast cancer prevention.

Associations of Dietary Patterns and Metabolic-Hormone Profiles with Breast Cancer Risk: A Case-Control Study.

Breast cancer is the most diagnosed cancer in women worldwide. Studies regarding complex breast cancer aetiology are limited and the results are inconclusive. We investigated the associations between dietary patterns (DPs), metabolic-hormone profiles (M-HPs), and breast cancer risk. This case-control study involved 420 women aged 40⁻79 years from north-eastern Poland, including 190 newly-diagnosed breast cancer cases. The serum concentration of lipid components, glucose, and hormones (oestradiol, progesterone, testosterone, prolactin, cortisol, insulin) was marked in 129 post-menopausal women (82 controls, 47 cases). The food frequency consumption was collected using a validated 62-item food frequency questionnaire. A posteriori DPs or M-HPs were derived with a Principal Component Analysis (PCA). Three DPs: 'Non-Healthy', 'Prudent', and 'Margarine and Sweetened Dairy' and two M-HPs: 'Metabolic-Syndrome' and 'High-Hormone' were identified. The 'Polish-adapted Mediterranean Diet' ('Polish-aMED') score was calculated. The risk of breast cancer risk was three-times higher (odds ratio (OR): 2.90; 95% confidence interval (95% Cl): 1.62⁻5.21; p < 0.001) in the upper tertile of the 'Non-Healthy' pattern (reference: bottom tertile) and five-times higher (OR: 5.34; 95% Cl: 1.84⁻15.48; p < 0.01) in the upper tertile of the 'High-Hormone' profile (reference: bottom tertile). There was a positive association of 'Metabolic-Syndrome' profile and an inverse association of 'Polish-aMED' score with the risk of breast cancer, which disappeared after adjustment for confounders. No significant association between 'Prudent' or 'Margarine and Sweetened Dairy' DPs and cancer risk was revealed. Concluding, a pro-healthy diet is insufficient to reduce the risk of breast cancer in peri- and postmenopausal women. The findings highlight the harmful effect of the 'High-Hormone' profile and the 'Non-Healthy' dietary pattern on breast cancer risk. In breast cancer prevention, special attention should be paid to decreasing the adherence to the 'Non-Healthy' pattern by reducing the consumption of highly processed food and foods with a high content of sugar and animal fat. There is also a need to monitor the concentration of multiple sex hormones in the context of breast cancer risk.

Associations of Mediterranean Diet and a Posteriori Derived Dietary Patterns with Breast and Lung Cancer Risk: A Case-Control Study.

Lung cancer in men and breast cancer in women are the most commonly diagnosed cancers in Poland and worldwide. Results of studies involving dietary patterns (DPs) and breast or lung cancer risk in European countries outside the Mediterranean Sea region are limited and inconclusive. This study aimed to develop a 'Polish-adapted Mediterranean Diet' ('Polish-aMED') score, and then study the associations between the 'Polish-aMED' score and a posteriori-derived dietary patterns with breast or lung cancer risk in adult Poles. This pooled analysis of two case-control studies involved 560 subjects (280 men, 280 women) aged 40-75 years from Northeastern Poland. Diagnoses of breast cancer in 140 women and lung cancer in 140 men were found. The food frequency consumption of 21 selected food groups was collected using a 62-item Food Frequency Questionnaire (FFQ)-6. The 'Polish-adapted Mediterranean Diet' score which included eight items-vegetables, fruit, whole grain, fish, legumes, nuts and seeds-as well as the ratio of vegetable oils to animal fat and red and processed meat was developed (range: 0-8 points). Three DPs were identified in a Principal Component Analysis: 'Prudent', 'Non-healthy', 'Dressings and sweetened-low-fat dairy'. In a multiple logistic regression analysis, two models were created: crude, and adjusted for age, sex, type of cancer, Body Mass Index (BMI), socioeconomic status (SES) index, overall physical activity, smoking status and alcohol abuse. The risk of breast or lung cancer was lower in the average (3-5 points) and high (6-8 points) levels of the 'Polish-aMED' score compared to the low (0-2 points) level by 51% (odds ratio (OR): 0.49; 95% confidence interval (Cl): 0.30-0.80; p < 0.01; adjusted) and 63% (OR: 0.37; 95% Cl: 0.21-0.64; p < 0.001; adjusted), respectively. In the middle and upper tertiles compared to the bottom tertile of the 'Prudent' DP, the risk of cancer was lower by 38-43% (crude) but was not significant after adjustment for confounders. In the upper compared to the bottom tertile of the 'Non-healthy' DP, the risk of cancer was higher by 65% (OR: 1.65; 95% Cl: 1.05-2.59; p < 0.05; adjusted). In conclusion, the Polish adaptation of the Mediterranean diet could be considered for adults living in non-Mediterranean countries for the prevention of the breast or lung cancers. Future studies should explore the role of a traditional Mediterranean diet fitted to local dietary patterns of non-Mediterranean Europeans in cancer prevention.

Fibre-Related Dietary Patterns: Socioeconomic Barriers to Adequate Fibre Intake in Polish Adolescents. A Short Report.

There is no complete explanation for the association between socioeconomic status (SES), fibre, and whole diet described by dietary patterns. The aim of this short report was to increase the understanding of adolescent dietary patterns related to fibre in their social context. A cross-sectional study was conducted involving 1176 adolescents aged 13-18 years from central and north-eastern Poland. The overall SES was composed of five single factors: place of residence, self-declared economic situation of family, self-declared economic situation of household, paternal and maternal education. The consumption frequency of nine dietary fibre sources was collected using Block's questionnaire and was expressed in points. Fibre dietary patterns (DPs) were drawn by cluster analysis and odds ratios (ORs) adjusted for age, sex, and BMI were calculated. Three fibre-related DPs were identified: "High-fibre" (mean frequency of total fibre intake 22.7 points; range: 0-36), "Average-fibre" (17.7 points), "Low-fibre" (14.6 points). The "High-fibre" DP was characterized by a relatively higher frequency consumption of white bread, fruit, fruit or vegetable juices, potatoes, green salad and prepared vegetables, and a moderate frequency consumption of high-fibre or bran cereals and wholegrain bread compared to the "Low-fibre" DP. The "Average-fibre" DP was characterized by a relatively higher frequency consumption of wholegrain bread and high-fibre or bran cereals and a moderate frequency consumption of fruit, fruit or vegetable juices, green salad and prepared vegetables compared to the "Low-fibre" DP. Less likely to adhere to the "High-fibre" DP were adolescents with low SES (OR: 0.55, 95% CI: 0.39-0.77) or average SES (0.58, 95% CI: 0.41-0.81) in comparison with high SES (reference) as a result of elementary or secondary paternal or maternal education, rural residence, and lower household economic situation. Similar associations were found for the "Average-fibre" DP. Low and average socioeconomic status resulting from lower parents' education, rural residence, and lower economic situation were inversely associated with achieving a relatively high fibre intake in Polish adolescents. Consuming single high-fibre foods was not sufficient to achieve a high-fibre diet in Polish adolescents. These data suggest that the consumption of a wide variety of dietary fibre sources-both relatively high-fibre and low-fibre foods-may help Polish adolescents in achieving a relatively high-fibre diet.

Dietary fiber sources consumption and overweight among Polish male students. A cross-sectional study

Background: There has been an increase in the prevalence of overweight and obesity in adolescents and young adults, especially in men than women. Many adolescents have a sedentary lifestyle and consume more processed, low-fiber foods. Objective: The aim of this study was to assess the frequency of fiber intake and its selected dietary source consumption in relation to the overweight among Polish male students. Material and Methods: This cross-sectional study involved 1,233 male students aged 13.0-24.9 years from northern, eastern and central Poland. The respondents completed a self-administered Block Screening Questionnaire for Fruit/Vegetable/Fiber Intake and measurements of their body mass and height were performed. The overweight and obesity prevalence was assessed using international standards. Results: The most frequently consumed foods by students included: white bread and potatoes, fruit and fruit or vegetable juices. The odds of overweight (including obesity) were lower from 28% (OR=0.72; 95%CI:0.56-0.93) to 31% (OR=0.69; 95%CI:0.50-0.95) with a daily consumption of white bread compared to non-daily consumption of white bread. Consumption ≥4 times/week of prepared vegetables (cooked, preserved or marinated) was associated with 51% lower odds of overweight (OR=0.49; 95%CI:0.27-0.97) compared to consumption less than 4 times/week of these foods. The odds of overweight for the level of fiber intake was insignificant. Conclusions: This study provides surprising insights regarding high-fiber and low-fiber food consumption and overweight in Polish male students. A lower odds of overweight was associated with a higher frequency consumption of relatively low in fiber foods as white bread and cooked, preserved or marinated vegetables. Most of the students consumed fiber at an unacceptable level, so a beneficial impact of high-fiber foods on overweight prevalence was not shown.

Dietary patterns and breast or lung cancer risk: A pooled analysis of 2 case-control studies in north-eastern Poland.

BACKGROUND: Breast cancer in women and lung cancer in men are the most prevalent cancers in Poland and worldwide. Evidence of the impact of food groups and nutrients on the risk of breast and lung cancer is limited and lacking conclusions. Studies on food consumption and breast or lung cancer are limited. OBJECTIVES: Assessment of the association between dietary patterns and the prevalence of breast and lung cancers in adult Poles. MATERIAL AND METHODS: The study involved a pooled analysis of 2 case-control studies on 320 subjects aged 50-70 years from north-eastern Poland (160 women, 160 men). Breast cancer cases in 80 women and lung cancer cases in 80 men were diagnosed. The food consumption frequency for 21 selected foods was collected using the Questionnaire of Eating Behaviors (QEB). Principal component analysis and multiple logistic regression analysis were used. The odds ratio (OR) and 95% confidence interval (95% CI) were calculated. RESULTS: Three dietary patterns (DPs) were identified: 'Prudent', 'Processed & fast food', and 'Traditional Polish'. In the pooled analysis for both cancers, the ORs were from 0.35 (95% CI: 0.20-0.61; p < 0.05 with adjustment for age) to 0.48 (95% CI: 0.26-0.88; p < 0.05 with adjustment for age, socioeconomic status index, physical activity, smoking, and abuse of alcohol) in the upper tertile of the 'Prudent' DP in comparison to the absence of cancers (OR = 1.00). The ORs of both cancers were 1.83 (95% CI: 1.06-3.16; p < 0.05 with adjustment for age) in the upper tertile of the 'Processed & fast food' DP. The ORs of both cancers for the 'Traditional Polish' DP were insignificant. CONCLUSIONS: In the pooled analysis, a strong inverse relation was found between the 'Prudent' dietary pattern, characterized by higher frequency of dairy, fruit, vegetables, wholemeal bread, fish and juices consumption, and breast or lung cancer prevalence, irrespective of age, socioeconomic status, physical activity, smoking, alcohol abuse, and type of cancer in Polish adults from north-eastern Poland.

Nutritional knowledge, diet quality and breast or lung cancer risk: a case-control study of adults from Warmia and Mazury region in Poland.

BACKGROUND: Knowledge on proper nutrition favours the creation of pro-healthy nutritional behaviours of people. Studies related to the nutritional knowledge of adults, diet quality and incidence of breast or lung cancers are limited. OBJECTIVE: Analysis of the relationship between the level of nutritional knowledge, diet quality and risk of breast cancer in women or lung cancer in men from the Warmia and Mazury region in Poland. MATERIAL AND METHODS: The study was carried out in 202 subjects aged 23-80 years, including 107 women (17 cases of breast cancer) and 95 men (54 cases of lung cancer) from the Warmia and Mazury region in Poland. Nutritional knowledge was evaluated with the Questionnaire of Eating Behaviours (QEB), including 25 statements. Based on the frequency of the consumption of 16 food items, two diet quality indices were created: the pro-Healthy-Diet-Index-8 (pHDI-8) and the non-Healthy-Diet-Index-8 (nHDI-8). The values of pHDI-8 and nHDI-8 were calculated on the basis of the sum of the daily frequency of consumption of the selected food items and expressed as times/day. The Odds Ratio (OR) of both breast cancer or lung cancer in relation to the level of nutritional knowledge was calculated based on a logistic regression analysis. RESULTS: The incidence of breast or lung cancer in the bottom, middle and upper tertile of nutritional knowledge was 57.6%, 32.6% and 15.8%, respectively. As nutritional knowledge grew in the subsequent tertiles, pHDI-8 was on the increase (2.63 vs. 3.78 vs. 4.22 times/day) and n-HDI-8 was on the decrease (1.32 vs. 1.21 vs. 0.94 times/day). In the upper tertile of nutritional knowledge, the Odds Ratio for the incidence of breast or lung cancers varied from 0.06 (95% CI: 0.02; 0.17; p<0.05, with adjustment for cancer type and age) to 0.17 (95% CI: 0.04; 0.69; p<0.05, with adjustment for age and sex) when compared to the bottom tertile (OR=1.00). In the middle tertile of nutritional knowledge, the Odds Ratio of both cancers varied from 0.27 (95% CI: 0.12; 0.62, p<0.05, with adjustment for cancer type and age) to 0.35 (95% CI: 0.18; 0.71, p<0.05, variables without adjustment) when compared to the bottom tertile. CONCLUSIONS: A higher level of nutritional knowledge was associated with the higher quality of a pro-healthy diet and lower risk of breast cancer in women or lung cancer in men. In contrast, a lower level of nutritional knowledge was associated with a lower diet quality and a higher risk of both types of cancers.