Publications

Abstract Purpose: Plant-based diets have been associated with lower risk of various diseases, including type 2 diabetes, cardiovascular disease and other cardiometabolic risk factors and are recommended for both health and environmental benefits. However, the association between plant-based diet quality and breast cancer remains unclear. Therefore, we examined the associations of plant-based diet quality with risk of total and subtypes of breast cancer. Methods: We followed 74,516 women from the Nurses' Health Study (NHS, 1984-2016), and 93,915 women from the Nurses' Health Study II (NHSII, 1991-2017), without cancer at baseline. Incident invasive breast cancer cases were confirmed with medical records, and subtypes were determined by tissue microarray data and pathology reports. We assessed an overall plant-based diet index (PDI) from dietary data collected using repeated semi-quantitative food-frequency questionnaires (FFQ), by assigning positive scores to plant foods and reverse scores to animal foods. We also investigated a healthful PDI (hPDI) where healthy plant foods (whole grains, fruits/vegetables, nuts/legumes, oils, tea/coffee) received positive scores, while less healthy plant foods (juices/sweetened beverages, refined grains, potatoes/fries, sweets) and animal foods received reverse scores. We also assessed an unhealthful PDI (uPDI), assigning positive scores to less healthy plant foods, and reverse scores to healthy plant foods and animal foods. Multivariable hazard ratios (HRs) and 95% confidence intervals (CI) were calculated with Cox proportional hazards models using data pooled across cohorts, adjusting for breast cancer risk factors. Results: Over 4,193,915 person-years of follow-up, we documented 11,281 incident invasive breast cancer cases. Women with greater adherence to PDI were at modestly lower risk of breast cancer [HR Q5vsQ1 0.92; 95% CI 0.86, 0.99; p trend=0.02]. Furthermore, greater adherence to a hPDI was associated with a decreased risk of overall breast cancer [HR Q5vsQ1 0.90; 95% CI 0.85, 0.96, p trend=<0.001]. We observed significant heterogeneity by estrogen receptor (ER) status (p=0.01), with the strongest inverse association between hPDI and breast cancer observed with ER-negative tumors [HR Q5vsQ1 0.75; 95% CI 0.64, 0.89; p trend=<0.001]. Moreover, higher uPDI was positively associated with a higher risk of ER-negative breast cancer [HR Q5vsQ1 1.21; 95% CI 1.02, 1.44; p trend=0.02] (p for heterogeneity=0.03). Conclusions: This study provides evidence that adherence to a plant-based dietary pattern and, specifically, its healthful version, may reduce the risk of breast cancer, especially those that are more likely to be aggressive tumors. In contrast, a low-quality plant-based diet may be associated with an increased risk of ER-negative breast cancer. Citation Format: Andrea Romanos-Nanclares, Walter C. Willett, Bernard Rosner, Laura C. Collins, Frank B. Hu, Estefania Toledo, A. Heather Eliassen. Healthful and unhealthful plant-based diets and risk of breast cancer in U.S. women: Results from the Nurses' Health Studies [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 837.

We investigated health consequences and genetic properties associated with serum IgG concentration in a young and working age general population.Northern Finland Birth Cohort 1966 (NFBC1966, n = 12,231) health data have been collected from birth to 52 years of age. Relationships between life-long health events, medications, chronic conditions, lifestyle, and serum IgG concentration measured at age 46 years (n = 5430) were analysed. Regulatory mechanisms of serum IgG concentration were considered.Smoking and genetic variation (FCGR2B and TNFRSF13B) were the most important determinants of serum IgG concentration. Laboratory findings suggestive of common variable immunodeficiency (CVID) were 10-fold higher compared to previous reports (73.7 per 100,000 vs 0.6-6.9 per 100,000). Low IgG was associated with antibiotic use (relative risk 1.285, 95% CI 1.001-1.648; p = 0.049) and sinus surgery (relative risk 2.257, 95% CI 1.163-4.379; p = 0.016). High serum IgG was associated with at least one pneumonia episode (relative risk 1.737, 95% CI 1.032-2.922; p = 0.038) and with total number of pneumonia episodes (relative risk 2.167, 95% CI 1.443-3.254; p < 0.001).CVID-like laboratory findings are surprisingly common in our unselected study population. Any deviation of serum IgG from normal values can be harmful; both low and high serum IgG may indicate immunological insufficiency. Critical evaluation of clinical presentation must accompany immunological laboratory parameters.Oulu University Hospital VTR, CSL Behring, Foundation for Pediatric Research.

Rationale Environmental tobacco smoke exposure (ETS) increases asthma risk in children. There is limited knowledge of prenatal ETS for adult onset asthma. Objectives To determine the association between prenatal ETS and adult onset asthma. Measurements and main results Questionnaire and clinical data of 5200 people, free of physician-diagnosed asthma by the age 31 years, of Northern Finland Birth Cohort 1966 Study was used. The association of maternal smoking during the last three months of pregnancy with onset of physician-diagnosed asthma and with lung function in adult offspring were studied by adjusted multivariate regression analyses. The cumulative incidence of physician-diagnosed asthma between the ages of 31 and 46 years was 5.1% among men and 8.8% among women. Gestational smoke exposure was associated with adult onset asthma among the offspring (adjusted odds ratio 1.54, 95% confidence interval 1.04–2.29), namely among offspring who reported either past non-diagnosed asthma (odds ratio 9.63, 95% confidence interval 2.28–40.67), or past cough with wheeze (3.21, 95% CI 1.71–6.05). Significant association was detected between gestational smoke exposure and offspring9s FEV1/FVC ratio at 31 years of age. In offspring with the haplotype rs11702779-AA of RUNX1 gestational smoke exposure was associated with adult onset asthma (5.53, 95% CI 2.11–14.52, adjusted p for interaction 0.10). Conclusions Maternal smoking during pregnancy is associated with the cumulative incidence of asthma in offspring between 31 and 46 years. The association was accentuated in offspring who reported at age 31 as having past respiratory problemsand/or, who had haplotype rs11702779-AA. Also a reduction in FEV1/FVC ratio was observed at age 31 years in offspring with gestational smoke exposure. These results could reflect early vulnerability of offspring9s airways to ETS and its putative long-term effects.