Evidence map›Paper›PMID 40658296›Full record

ArticleEuropean journal of epidemiology2025

Plant-based dietary patterns and breast cancer risk in the European prospective investigation into cancer and nutrition (EPIC) study.

Sanam Shah, Nasser Laouali, Yahya Mahamat-Saleh, Carine Biessy, Geneviève Nicolas, Sabina Rinaldi, Raul Zamora-Ros, Nikos Papadimitriou, Fernanda Morales-Berstein, Christina C Dahm and 24 more

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Article in European journal of epidemiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

34 authors.

Sanam ShahNutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, (IARC-WHO), 25 Avenue Tony Garnier, Lyon CEDEX 07, 69366, France. sanam.sha@hotmail.com.ORCID http://orcid.org/0000-0002-2469-6765
Nasser LaoualiInstitute of Biological Sciences (ISSB), UM6P Faculty of Medical Sciences, Mohammed VI Polytechnic University, Ben Guerir, Morocco.
Yahya Mahamat-SalehNutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, (IARC-WHO), 25 Avenue Tony Garnier, Lyon CEDEX 07, 69366, France.
Carine BiessyNutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, (IARC-WHO), 25 Avenue Tony Garnier, Lyon CEDEX 07, 69366, France.
Geneviève NicolasNutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, (IARC-WHO), 25 Avenue Tony Garnier, Lyon CEDEX 07, 69366, France.
Sabina RinaldiNutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, (IARC-WHO), 25 Avenue Tony Garnier, Lyon CEDEX 07, 69366, France.
Raul Zamora-RosUnit of Nutrition and Cancer, Cancer Epidemiology and Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.
Nikos PapadimitriouNutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, (IARC-WHO), 25 Avenue Tony Garnier, Lyon CEDEX 07, 69366, France.
Fernanda Morales-BersteinMRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.
Christina C DahmDepartment of Public Health, Aarhus University, Aarhus, Denmark.
Anne Kristine Lundgård ChristensenDepartment of Public Health, Aarhus University, Aarhus, Denmark.
Lene MellemkjaerDanish Cancer Institute, Diet, Cancer and Health, Strandboulevarden 49, Copenhagen, 2100, Denmark.
Anne Marie Overgaard NielsenDanish Cancer Institute, Diet, Cancer and Health, Strandboulevarden 49, Copenhagen, 2100, Denmark.
Francesca Romana ManciniParis-Saclay University, UVSQ, Inserm, Gustave Roussy, CESP, Villejuif, France.
Xuan RenParis-Saclay University, UVSQ, Inserm, Gustave Roussy, CESP, Villejuif, France.
Chloé MarquesParis-Saclay University, UVSQ, Inserm, Gustave Roussy, CESP, Villejuif, France.
Verena KatzkeDivision of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Charlotte Le CornetDivision of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Christine El-KhouryDepartment of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
Matthias B SchulzeDepartment of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
Claudia AgnoliEpidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian, 1, Milan, 20133, Italy.
Vittorio SimeonMedical Statistics Unit, University of Naples "L.Vanvitelli", Naples, Italy.
Rosario TuminoHyblean Association for Epidemiology Research, AIRE ONLUS, Ragusa, Italy.
Lorenzo MilaniCentre for Biostatistics, Epidemiology, and Public Health, Department of Clinical and Biological Sciences, University of Turin, Orbassano, Turin, Italy.
Carlota Castro-EspinNutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, (IARC-WHO), 25 Avenue Tony Garnier, Lyon CEDEX 07, 69366, France.
Maria-Jose SánchezEscuela Andaluza de Salud Pública (EASP), Granada, 18011, Spain.
Amaia AizpuruaMinistry of Health of the Basque Government, Sub Directorate for Public Health and Addictions of Gipuzkoa, San Sebastian, Spain.
Sandra M Colorado-YoharCentro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, 28029, Spain.
Marcela GuevaraCentro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, 28029, Spain.
Alicia HeathCancer Epidemiology and Prevention Research Unit, School of Public Health, Imperial College London, London, UK.
Dagfinn AuneCancer Epidemiology and Prevention Research Unit, School of Public Health, Imperial College London, London, UK.
Heinz FreislingNutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, (IARC-WHO), 25 Avenue Tony Garnier, Lyon CEDEX 07, 69366, France.
Inge HuybrechtsNutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, (IARC-WHO), 25 Avenue Tony Garnier, Lyon CEDEX 07, 69366, France.
Laure DossusNutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, (IARC-WHO), 25 Avenue Tony Garnier, Lyon CEDEX 07, 69366, France.

Funding

Agence Nationale de la Recherche ANR-10-COHO-0006Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy Associazione Italiana per la Ricerca sul Cancro-AIRC-ItalyCancer Research UK C864/A14136 to EPIC-Norfolk; C8221/A29017Compagnia di San Paolo Compagnia di San PaoloDanish Cancer Society Danish Cancer SocietyEurope against Cancer Europe against CancerFederal Ministry of Education and Research Federal Ministry of Education and ResearchGerman Cancer Aid German Cancer AidGerman Institute of Human Nutrition Potsdam-Rehbruecke German Institute of Human Nutrition Potsdam-RehbrueckeHealth Research Fund (FIS) - Instituto de Salud Carlos III (ISCIII) Health Research Fund (FIS) - Instituto de Salud Carlos III (ISCIII)Heidelberger Zentrum für Personalisierte Onkologie Deutsches Krebsforschungszentrum In Der Helmholtz-Gemeinschaft Heidelberger Zentrum für Personalisierte Onkologie Deutsches Krebsforschungszentrum In Der Helmholtz-GemeinschaftIARC IARCImperial College London Imperial College LondonINSERM INSERMInstitut Gustave-Roussy Institut Gustave-RoussyInstituto Nacional de Ciência e Tecnologia em Entomologia Molecular, Universidade Federal do Rio de Janeiro 224982/Z/22/ZItalian Ministry of Health Italian Ministry of HealthItalian Ministry of University and Research Italian Ministry of University and ResearchLigue Contre le Cancer Ligue Contre le CancerMedical Research Council MR/N003284/1, MC-UU_12015/1, MR/Y013662/1 and MC_UU_00006/1Ministère de l'Enseignement Supérieur et de la Recherche Ministère de l'Enseignement Supérieur et de la RechercheMinisterie van Volksgezondheid, Welzijn en Sport Ministerie van Volksgezondheid, Welzijn en SportMutuelle Générale de l'Education Nationale Mutuelle Générale de l'Education NationaleRegional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra, and the Catalan Institute of Oncology - ICO (Spain) Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra, and the Catalan Institute of Oncology - ICO (Spain)Swedish Cancer Society Swedish Cancer SocietySwedish Research Council and County Councils of Skåne and Västerbotten (Sweden) Swedish Research Council and County Councils of Skåne and Västerbotten (Sweden)the Netherlands Organisation for Health Research and Development (ZonMW) the Netherlands Organisation for Health Research and Development (ZonMW)UiT The Arctic University of Norway UiT The Arctic University of NorwayWorld Cancer Research Fund (WCRF) World Cancer Research Fund (WCRF)World Health Organization 001
6 · The paper itself

Abstract

While previous literature suggests that plant-based diets may be associated with a lower risk of breast cancer, evidence remains inconsistent. In this study, we investigated the association between adherence to plant-based diets and breast cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Overall plant-based diet index (PDI), healthful (hPDI), and unhealthful PDI (uPDI) were calculated, and multivariable Cox models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) of breast cancer for the three indices. Mediation analysis was performed to assess the role of body mass index (BMI) and waist circumference (WC) in the association between hPDI and postmenopausal breast cancer risk. Over a median follow-up of 14.9 years, 10,805 incident invasive breast cancer cases were identified among 258,343 women. In the multivariable model, not adjusted for BMI, higher adherence to hPDI was inversely associated with breast cancer risk, with HR per 1-SD increase [95% (CI)] of 0.97 (0.94, 0.99). The corresponding HRs (95% CI) per 1-SD increase for overall PDI and uPDI were 0.98 (0.96, 1.00) and 1.01 (0.99, 1.03), respectively. The associations between hPDI and postmenopausal breast cancer were partly explained by BMI and WC, which mediated 30% and 52% of this association, respectively. Higher adherence to hPDI was associated with a slightly lower total breast cancer risk. For postmenopausal breast cancer, this association was partly explained by lower BMI or WC. These findings suggest that promoting healthful plant-based diets could support breast cancer risk reduction.

Indexed as

Breast NeoplasmsDiet, VegetarianAdultAgedBody Mass IndexEuropeFemaleHumansMiddle AgedPostmenopauseProportional Hazards ModelsProspective StudiesRisk FactorsWaist CircumferenceBody mass indexBreast cancerDietary patternMediationPlant-based dietProspective study

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.