[Frontiers in Bioscience S4, 90-108, January 1, 2012]

Diet, obesity and breast cancer: an update

Alessandro Cappellani1, Maria Di Vita1, Antonio Zanghi1, Andrea Cavallaro1, Gaetano Piccolo1, Massimiliano Veroux2, Massimiliano Berretta3, Michele Malaguarnera4, Vincenzo Canzonieri5, Emanuele Lo Menzo6

1Department of Surgery, General Surgery and Breast Unit, University of Catania, Italy, 2Department of Surgery, Transplantation and Advanced Technologies, University of Catania, Italy, 3Department of Medical Oncology - National Cancer Institute - I.R.C.C.S. Aviano, PN, 4Department of Biochemistry, Medical Chemistry and Molecular Biology, University of Catania, Italy, 5Division of Pathology, National Cancer Institute - I.R.C.C.S. Aviano, PN, 6Division of Laparoscopic and Bariatric Surgery, University of Maryland, Baltimore, MD USA

TABLE OF CONTENTS

1. Abstract
2. Introduction
3. Methods
4. The Historical and Epidemiologic Basis
5. Obesity
6. Dairy foods
6.1. Content in Estrogens of milk and dairies
6.2. Insulin- Like growth factor (IGF)
6.3. Lactoferrin
6.4. Calcium
7. Fat
8. Meat
9. Carbohydrates
10. Fiber, fruit and vegetables
10.1. Cruciferous
10.2. Grapefruit
10.3 Phytoestrogens
10.3.1. Soy and Isoflavonoids
10.3.2. Lignans
10.3.3. Coumestans
11. Vitamins and other substances
11.1. Choline
12. Oligoelements
13. Alcohol
14. Dietary patterns and breast density
15. Studies on survival
16. Conclusions
17. Acknowledgement
18. References

1. Abstract

Numerous studies indagated the relationship between dietary pattern or specific nutrients and breast cancer (BC) risk and survival. Different ethnic o social groups show differences in breast cancer incidence that could be explained by different dietary patterns. Furthermore, many nutrients could reasonably increase the risk of cancer because of their content of carcinogens or their precursors as well as of promoting substances. However, the only convincing evidences linking life style to increased BC risk are related to obesity and moderate intake of alcohol and limited to postmenopause. Saturated fat, red meat, high temperature cooking have been indicated as possible risk factors, but adjusted analyses have not confirmed this association or have limited the relationship to specific subgroups. Even the protective effect of fiber, fruit, vegetables and phytoestrogens has been suggested but not definitively demonstrated. Thus, healthy dietary patterns, with abstention from alcohol and weight control, reduce the risk of cancer or at least improve the survival of affected women by reducing the incidence of comorbidities.