Association between dietary inflammatory potential and breast cancer incidence and death: Results from the Women's Health Initiative

Fred K. Tabung, Susan E. Steck, Angela D. Liese, Jiajia Zhang, Yunsheng Ma, Bette Caan, Rowan T. Chlebowski, Jo L. Freudenheim, Lifang Hou, Yasmin Mossavar-Rahmani, Nitin Shivappa, Mara Z. Vitolins, Jean Wactawski-Wende, Judith K. Ockene, James R. Hébert

Research output: Contribution to journalArticlepeer-review

74 Scopus citations


Background: Diet modulates inflammation and inflammatory markers have been associated with cancer outcomes. In the Women's Health Initiative, we investigated associations between a dietary inflammatory index (DII) and invasive breast cancer incidence and death.Methods:The DII was calculated from a baseline food frequency questionnaire in 122 788 postmenopausal women, enrolled from 1993 to 1998 with no prior cancer, and followed until 29 August 2014. With median follow-up of 16.02 years, there were 7495 breast cancer cases and 667 breast cancer deaths. We used Cox regression to estimate multivariable-adjusted hazards ratios (HRs) and 95% confidence intervals (95% CIs) by DII quintiles (Q) for incidence of overall breast cancer, breast cancer subtypes, and deaths from breast cancer. The lowest quintile (representing the most anti-inflammatory diet) was the reference.Results:The DII was not associated with incidence of overall breast cancer (HR Q5vsQ1, 0.99; 95% CI, 0.91-1.07; P trend =0.83 for overall breast cancer). In a full cohort analysis, a higher risk of death from breast cancer was associated with consumption of more pro-inflammatory diets at baseline, after controlling for multiple potential confounders (HR Q5vsQ1, 1.33; 95% CI, 1.01-1.76; P trend =0.03).Conclusions:Future studies are needed to examine the inflammatory potential of post-diagnosis diet given the suggestion from the current study that dietary inflammatory potential before diagnosis is related to breast cancer death.

Original languageEnglish (US)
Pages (from-to)1277-1285
Number of pages9
JournalBritish Journal of Cancer
Issue number11
StatePublished - May 24 2016


  • Women's Health Initiative
  • breast cancer
  • dietary inflammatory index
  • incidence
  • mortality

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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