Fiber intake modulates the association of alcohol intake with breast cancer

Isabelle Romieu, Pietro Ferrari, Veronique Chajès, Jordi de Batlle, Carine Biessy, Chiara Scoccianti, Laure Dossus, Marie Christine Boutron, Nadia Bastide, Kim Overvad, Anja Olsen, Anne Tjønneland, Rudolf Kaaks, Heiner Boeing, Antonia Trichopoulou, Pagona Lagiou, Dimitrios Trichopoulos, Domenico Palli, Sabina Sieri, Rosario TuminoPaolo Vineis, Salvatore Panico, H. Bas Bueno-de-Mesquita, Carla H. Gils, Petra H. Peeters, Eiliv Lund, Guri Skeie, Elisabete Weiderpass, J. Ramón Quirós, María Dolores Chirlaque, Eva Ardanaz, María José Sánchez, Eric J. Duell, Pilar Amiano Etxezarreta, Signe Borgquist, Göran Hallmans, Ingegerd Johansson, Lena Maria Nilsson, Kay Tee Khaw, Nick Wareham, Timothy J. Key, Ruth C. Travis, Neil Murphy, Petra A. Wark, Elio Riboli

    Research output: Contribution to journalArticlepeer-review

    7 Citations (Scopus)


    Alcohol intake has been related to an increased risk of breast cancer (BC) while dietary fiber intake has been inversely associated to BC risk. A beneficial effect of fibers on ethanol carcinogenesis through their impact on estrogen levels is still controversial. We investigated the role of dietary fiber as a modifying factor of the association of alcohol and BC using data from the European Prospective Investigation into Cancer and Nutrition (EPIC). This study included 334,850 women aged 35–70 years at baseline enrolled in the ten countries of the EPIC study and followed up for 11.0 years on average. Information on fiber and alcohol intake at baseline and average lifetime alcohol intake were calculated from country-specific dietary and lifestyle questionnaires. Hazard ratios (HR) of developing invasive BC according to different levels of alcohol and fiber intake were computed. During 3,670,439 person-years, 11,576 incident BC cases were diagnosed. For subjects with low intake of fiber (<18.5 g/day), the risk of BC per 10 g/day of alcohol intake was 1.06 (1.03–1.08) while among subjects with high intake of fiber (>24.2 g/day) the risk of BC was 1.02 (0.99–1.05) (test for interaction p = 0.011). This modulating effect was stronger for fiber from vegetables. Our results suggest that fiber intake may modulate the positive association of alcohol intake and BC. Alcohol is well known to increase the risk for BC, while a fiber-rich diet has the opposite effect. Here the authors find a significant interaction between both lifestyle factors indicating that high fiber intake can ease the adverse effects associated with alcohol consumption. Consequently, women with high alcohol intake and low fiber intake (<18.5 g/day) had the highest risk for BC. Specific benefits were associated with fibers from vegetable, warranting further investigations into specific fiber sources and their mechanistic interactions with alcohol-induced BC risk.

    Original languageEnglish
    Pages (from-to)316-321
    Number of pages6
    JournalInternational Journal of Cancer
    Issue number2
    Early online date6 Sept 2016
    Publication statusPublished - 15 Jan 2017


    • alcohol
    • breast cancer
    • epidemiology
    • nutrition

    ASJC Scopus subject areas

    • Medicine(all)
    • Oncology
    • Cancer Research


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