Nyligen publicerades resultaten av den hittills största metaanalysen – av åtta kohortstudier – som undersökte sambandet mellan kostförändring och dödlighet efter att man fått diagnosen invasiv bröstcancer.
Tidigare data tyder på att de flesta kvinnor inte väsentligt ändrar ätmönster efter en cancerdiagnos. Exempelvis hade 72 % av postmenopausala kvinnor i Women’s Health Initiative en relativt oförändrad kost efter sin diagnos, medan 19 % förbättrade kostkvalitet och 9 % försämrade sin kostkvalitet, enligt Healthy Eating Index (HEI). Men det saknas tydliga och specifika kostriktlinjer för bröstcancer.
Resultaten av den här nya studien/ metaanalysen visade att en ökning av kostkvaliteten efter diagnos kan minska risken för dödlighet (alla orsaker) med 21 %, och dödlighet specifikt i bröstcancer med 15 %.
Bland de kostkvalitetsindex som granskats i metaanalysen var DASH (Dietary Approach to Stop Hypertension) och CHFP (Chinese Food Pagoda guidelines) associerade med den största minskningen av dödligheten i bröstcancer. Dessutom var en kostförbättring enligt HEI och medelhavsdieten (tillsammans med DASH och CHFP) associerad med minskad dödlighet alla orsaker.
Särskild nytta av kostomläggning verkar finnas bl.a. hos äldre kvinnor och de med ER-positiva tumörer.
Ida är ju ett mycket tydligt exempel på kostens betydelse vid en cancerdiagnos. Lyssna på henne här: https://4health.se/272-bekampa-cancer-ida-johnssons-resa-fran-stadium-iv-cancer
Ur studien:
Healthy Eating and Mortality among Breast Cancer Survivors: A Systematic Review and Meta-Analysis of Cohort Studies
This systematic review examined the effect of diet quality, defined as adherence to healthy dietary recommendations, on all-cause and breast cancer-specific mortality. Web of Science, Medline, CINAHL, and PsycINFO databases were searched to identify eligible studies published by May 2021. We used a random-effects model meta-analysis in two different approaches to estimate pooled hazard ratio (HR) and 95% confidence interval (CI) for highest and lowest categories of diet quality: (1) each dietary quality index as the unit of analysis and (2) cohort as the unit of analysis. Heterogeneity was examined using Cochran’s Q test and inconsistency I2 statistics. The risk of bias was assessed by the Newcastle-Ottawa Scale for cohort studies, and the quality of evidence was investigated by the GRADE tool. The analysis included 11 publications from eight cohorts, including data from 27,346 survivors and seven dietary indices. Both approaches yielded a similar effect size, but cohort-based analysis had a wider CI. Pre-diagnosis diet quality was not associated with both outcomes. However, better post-diagnosis diet quality significantly reduced all-cause mortality by 21% (HR = 0.79, 95% CI = 0.70, 0.89, I2 = 16.83%, n = 7) and marginally reduced breast cancer-specific mortality by 15% (HR = 0.85, 95% CI = 0.62, 1.18, I2 = 57.4%, n = 7). Subgroup analysis showed that adhering to the Diet Approaches to Stop Hypertension and Chinese Food Pagoda guidelines could reduce breast cancer-specific mortality. Such reduction could be larger for older people, physically fit individuals, and women with estrogen receptor-positive, progesterone receptor-negative, or human epidermal growth factor receptor 2-positive tumors. The risk of bias in the selected studies was low, and the quality of evidence for the identified associations was low or very low due to imprecision of effect estimation, inconsistent results, and publication bias. More research is needed to precisely estimate the effect of diet quality on mortality. Healthcare providers can encourage breast cancer survivors to comply with healthy dietary recommendations to improve overall health.
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