Dietary β-carotene, vitamin C and E intake and breast cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Institute of Epidemiology, Ulm University, Helmholtzstr.22, 89081 Ulm, Germany.
Breast Cancer Research and Treatment (Impact Factor: 3.94). 07/2009; 119(3):753-65. DOI: 10.1007/s10549-009-0444-8
Source: PubMed


So far, studies on dietary antioxidant intake, including β-carotene, vitamin C and vitamin E, and breast cancer risk are inconclusive. Thus, we addressed this question in the European Prospective Investigation into Cancer and Nutrition. During a median follow-up time of 8.8 years, 7,502 primary invasive breast cancer cases were identified. Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI). All analyses were run stratified by menopausal status at recruitment and, additionally, by smoking status, alcohol intake, use of exogenous hormones and use of dietary supplements. In the multivariate analyses, dietary intake of β-carotene, vitamin C and E was not associated with breast cancer risk in premenopausal [highest vs. lowest quintile: HR, 1.04 (95% CI, 0.85–1.27), 1.12 (0.92–1.36) and 1.11 (0.84–1.46), respectively] and postmenopausal women [0.93 (0.82–1.04), 0.98 (0.87–1.11) and 0.92 (0.77–1.11), respectively]. However, in postmenopausal women using exogenous hormones, high intake of β-carotene [highest vs. lowest quintile; HR 0.79 (95% CI, 0.66–0.96), P
trend 0.06] and vitamin C [0.88 (0.72–1.07), P
trend 0.05] was associated with reduced breast cancer risk. In addition, dietary β-carotene was associated with a decreased risk in postmenopausal women with high alcohol intake. Overall, dietary intake of β-carotene, vitamin C and E was not related to breast cancer risk in neither pre- nor postmenopausal women. However, in subgroups of postmenopausal women, a weak protective effect between β-carotene and vitamin E from food and breast cancer risk cannot be excluded.

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    • "With regards to the healthy functions of a-and b-carotenes, both play important roles in the biosynthesis of vitamin A which is an essential factor for cellular reproduction, normal development of embryo and foetus, and visual functions (Grune et al., 2010; Zile, 1998). In addition, topical application of b-carotene provided protection for the human skin when exposed to infra-red radiation (Darvin et al., 2011), and dietary intake of b-carotene was not related to breast cancer risk in neither pre-nor postmenopausal women (Nagel et al., 2010). However, a review indicated that nutritional prevention of cancer through b-carotene supplementation should not be recommended because b-carotene supplementation has not been shown to have any beneficial effect on cancer prevention or even it is associated with increased risk of lung cancer and gastric cancer under certain conditions (Druesne-Pecollo et al., 2010). "
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    ABSTRACT: Nineteen glabrous canaryseeds comprising brown- and yellow-coloured varieties were investigated to determine carotenoid content and their properties. Total carotenoid content of canaryseeds ranged from 7.57 to 11.69 mg/kg. β-Carotene, lutein, and zeaxanthin were the major carotenoids of glabrous canaryseed. β-Carotene ranged from 5291 to 6273, 4564 to 5352, and 3651 to 4428 μg/kg while lutein ranged from 2667 to 3370, 1532 to 3007, and 2042 to 2299 μg/kg, respectively in canaryseed flour, wholemeal and bran. Zeaxanthin was relatively low (⩽650 μg/kg). High β-carotene levels distinguished glabrous canaryseeds from other cereal crops as potential ingredients for carotenoid-enriched functional foods.
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    • "), and the recent European Prospective Investigation into Cancer (EPIC) analysis involving the pooling of data from 10 European countries (highest vs. lowest quintile HR = 0.98, 95% CI: 0.87–1.11) (Nagel et al 2010 "
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    ABSTRACT: Vitamin C intake has been inversely associated with breast cancer risk in case-control studies, but not in meta-analyses of cohort studies using Food Frequency Questionnaires, which can over-report fruit and vegetable intake, the main source of vitamin C. This is the first study to investigate associations between vitamin C intake and breast cancer risk using food diaries. Estimated dietary vitamin C intake was derived from 4-7 day food diaries pooled from five prospective studies in the UK Dietary Cohort Consortium. This nested case-control study of 707 incident breast cancer cases and 2144 matched controls examined breast cancer risk in relation to dietary vitamin C intake using conditional logistic regression adjusting for relevant covariates. Additionally, total vitamin C intake from supplements and diet was analysed in three cohorts. No evidence of associations was observed between breast cancer risk and vitamin C intake analysed for dietary vitamin C intake (odds ratios (OR)=0.98 per 60 mg/day, 95% confidence interval (CI): 0.88-1.09, P (trend)=0.7), dietary vitamin C density (OR=0.97 per 60 mg/day, 95% CI: 0.87-1.07, P (trend)=0.5 ) or total vitamin C intake (OR=1.01 per 60 mg/day, 95% CI: 0.99-1.03, P (trend)=0.3). Additionally, there was no significant association for post-menopausal women (OR=1.02 per 60 mg/day, 95% CI: 0.99-1.05, P (trend)=0.3). This pooled analysis of individual UK women found no evidence of significant associations between breast cancer incidence and dietary or total vitamin C intake derived uniquely from detailed diary recordings.
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    • "Although there is considerable evidence of anticancer effect of antioxidants from cell culture and animal studies, the results from observational studies and intervention trials are inconsistent [8,12,13]. A recent review conducted by Michels et al summarized the findings from prospective observational studies of the role of diet on the risk of breast cancer, including antioxidants, and found that the reported results were not consistent and sometimes controversial regarding the association between breast cancer incidence and any dietary antioxidants and blood antioxidants [2]. "
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    ABSTRACT: The effect of antioxidants on breast cancer is still controversial. Our objective was to assess the association between antioxidants and breast cancer risk in a large population-based case-control study. The study population included 2,362 cases with pathologically confirmed incident breast cancer (866 premenopausal and 1,496 postmenopausal) and 2,462 controls in Canada. Intakes of antioxidants from diet and from supplementation as well as other potential risk factors for breast cancer were collected by a self-reported questionnaire. Compared with subjects with no supplementation, 10 years or longer supplementation of zinc had multivariable-adjusted odds ratios (OR) and 95% confidence intervals (CI) of 0.46 (0.25-0.85) for premenopausal women, while supplementation of 10 years or longer of multiple vitamin, beta-carotene, vitamin C, vitamin E and zinc had multivariable-adjusted ORs (95% CIs) of 0.74 (0.59, 0.92), 0.58 (0.36, 0.95), 0.79 (0.63-0.99), 0.75 (0.58, 0.97), and 0.47 (0.28-0.78), respectively, for postmenopausal women. No significant effect of antioxidants from dietary sources (including beta-carotene, alpha-carotene, lycopene, lutein and zeaxanthin, vitamin C, vitamin E, selenium and zinc) or from supplementation less than 10 years was observed. This study suggests that supplementation of zinc in premenopausal women, and supplementation of multiple vitamin, beta-carotene, vitamin C, vitamin E and zinc in postmenopausal women for 10 or more years may protect women from developing breast cancer. However, we were unable to determine the overall effect of total dose or intake from both diet and supplement.
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