@article{3156619,
    title = "Dietary fiber intake and risk of hormonal receptor-defined breast cancer
in the European Prospective Investigation into Cancer and Nutrition
study",
    author = "Ferrari, Pietro and Rinaldi, Sabina and Jenab, Mazda and Lukanova, and Annekatrin and Olsen, Anja and Tjonneland, Anne and Overvad, Kim and and Clavel-Chapelon, Francoise and Fagherazzi, Guy and Touillaud, Marina and and Kaaks, Rudolf and von Ruesten, Anne and Boeing, Heiner and Trichopoulou, and Antonia and Lagiou, Pagona and Benetou, Vassiliki and Grioni, Sara and and Panico, Salvatore and Masala, Giovanna and Tumino, Rosario and Polidoro, and Silvia and Bakker, Marije F. and van Gils, Carla H. and Ros, Martine M. and and Bueno-de-Mesquita, H. Bas and Krum-Hansen, Sanda and Engeset, Dagrun and and Skeie, Guri and Pilar, Amiano and Sanchez, Maria-Jose and Buckland, and Genevieve and Ardanaz, Eva and Chirlaque, Dolores and Rodriguez, Laudina and and Travis, Ruth and Key, Tim and Khaw, Kay-Tee and Wareham, Nicholas J. and and Sund, Malin and Lenner, Per and Slimani, Nadia and Norat, Teresa and and Aune, Dagfinn and Riboli, Elio and Romieu, Isabelle",
    journal = "AMERICAN JOURNAL OF CLINICAL NUTRITION",
    year = "2013",
    volume = "97",
    number = "2",
    pages = "344-353",
    publisher = "Oxford University Press",
    issn = "0002-9165",
    doi = "10.3945/ajcn.112.034025",
    abstract = "Background: Limited scientific evidence has characterized the
association between dietary fiber intake and risk of breast cancer (BC)
by menopausal status and hormone receptor expression in tumors. ‘
Objective: We investigated the relation between total dietary fiber and
its main food sources (vegetables, fruit, cereals, and legumes) and BC
risk by using data from the European Prospective Investigation into
Cancer and Nutrition (EPIC).
Design: A total of 11,576 invasive BC cases in 334,849 EPIC women mostly
aged 35-70 y at baseline were identified over a median follow-up of 11.5
y. Dietary fiber was estimated from country-specific dietary
questionnaires. Multivariable Cox proportional hazards regression models
were used to quantify the association between dietary variables and BC
risk with energy adjustment by using the residual method. Subgroup
analyses were performed by menopausal status and estrogen receptor (ER)
and progesterone receptor (PR) expression in tumors.
Results: BC risk was inversely associated with intakes of total dietary
fiber [hazard ratio comparing fifth quintile to first quintile
(HRQ5-Q1): 0.95; 95% CI: 0.89, 1.01; P-trend = 0.03] and fiber from
vegetables (0.90; 0.84, 0.96; P-trend < 0.01) but not with fiber from
fruit, cereals, or legumes. Overall, associations were homogeneous by
menopausal status and ER and PR expression in tumors. For vegetable
fiber, stronger associations were observed for estrogen
receptor-negative and progesterone receptor-negative (HRQ5-Q1: 0.74;
95% CI: 0.59, 0.93; P-trend = 0.01) than for estrogen receptor-positive
and progesterone receptor-positive tumors (0.92: 0.81, 1.03; P-trend =
0.05), with P-heterogeneity = 0.09.
Conclusion: Diets rich in dietary fiber and, particularly, fiber from
vegetables may be associated with a small reduction in risk of BC,
independently of menopausal status. Am J Clin Nutr 2013;97:344-53."
}