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  1. Al Pater posted [1], a study single-blind clinical trial comparing breast cancer rates among subjects assigned to two version of a Mediterranean diet (one supplemented with EVOO and one supplemented with nuts) or to a "low-fat" control diet. Actually the controls only received advice to reduce dietary fat. They didn't actually comply, since (from supplemental material) the end of trial fat intake as a percentage of total cal: Med-EVOO 41%, Med-Nut 39%, Control Diet 37%. So its really comparing a breast cancer risk between a Mediterranean diet with nuts or EVOO to a standard crappy diet. What they found was that women on either the Med-EVOO diet or the Med-Nut diet had a lower risk of breast cancer, but only the Med-EVOO groups risk reduction (0.32, 95% CI, 0.13-0.79) was statistically significant. The Med-Nut group's risk was 0.59 (95% CI, 0.26-1.35) compared with controls. So once again, a Mediterranean diet is shown to be good for avoiding cancer, this time breast cancer. --Dean ---------- [1] JAMA Intern Med. 2015 Nov 1;175(11):1752-60. doi: 10.1001/jamainternmed.2015.4838. Mediterranean Diet and Invasive Breast Cancer Risk Among Women at High Cardiovascular Risk in the PREDIMED Trial: A Randomized Clinical Trial. Toledo E, Salas-Salvadó J, Donat-Vargas C, Buil-Cosiales P, Estruch R, Ros E, Corella D, Fitó M, Hu FB, Arós F, Gómez-Gracia E, Romaguera D, Ortega-Calvo M, Serra-Majem L, Pintó X, Schröder H, Basora J, Sorlí JV, Bulló M, Serra-Mir M, Martínez-González MA. Full text via sci-hub.io: http://archinte.jamanetwork.com.sci-hub.io/article.aspx?articleid=2434738 Abstract IMPORTANCE: Breast cancer is the leading cause of female cancer burden, and its incidence has increased by more than 20% worldwide since 2008. Some observational studies have suggested that the Mediterranean diet may reduce the risk of breast cancer. OBJECTIVE: To evaluate the effect of 2 interventions with Mediterranean diet vs the advice to follow a low-fat diet (control) on breast cancer incidence. DESIGN, SETTING, AND PARTICIPANTS: The PREDIMED study is a 1:1:1 randomized, single-blind, controlled field trial conducted at primary health care centers in Spain. From 2003 to 2009, 4282 women aged 60 to 80 years and at high cardiovascular disease risk were recruited after invitation by their primary care physicians. INTERVENTIONS: Participants were randomly allocated to a Mediterranean diet supplemented with extra-virgin olive oil, a Mediterranean diet supplemented with mixed nuts, or a control diet (advice to reduce dietary fat). MAIN OUTCOMES AND MEASURES: Breast cancer incidence was a prespecified secondary outcome of the trial for women without a prior history of breast cancer (n = 4152). RESULTS: After a median follow-up of 4.8 years, we identified 35 confirmed incident cases of breast cancer. Observed rates (per 1000 person-years) were 1.1 for the Mediterranean diet with extra-virgin olive oil group, 1.8 for the Mediterranean diet with nuts group, and 2.9 for the control group. The multivariable-adjusted hazard ratios vs the control group were 0.32 (95% CI, 0.13-0.79) for the Mediterranean diet with extra-virgin olive oil group and 0.59 (95% CI, 0.26-1.35) for the Mediterranean diet with nuts group. In analyses with yearly cumulative updated dietary exposures, the hazard ratio for each additional 5% of calories from extra-virgin olive oil was 0.72 (95% CI, 0.57-0.90). CONCLUSIONS AND RELEVANCE: This is the first randomized trial finding an effect of a long-term dietary intervention on breast cancer incidence. Our results suggest a beneficial effect of a Mediterranean diet supplemented with extra-virgin olive oil in the primary prevention of breast cancer. These results come from a secondary analysis of a previous trial and are based on few incident cases and, therefore, need to be confirmed in longer-term and larger studies. PMID: 26365989
  2. All, I personally don't do extended fasts except on rare occasions (like my last colonoscopy, when I had to go 5 days without food to clear out my colon for imaging). But I do eat in a limited time window, and fast for most of the day and night, both for convenience, and because I believe it to be healthy for a number of reasons (reduced glucose / insulin exposure, increased autophagy, etc). It looks like we can add 'reducing breast cancer recurrence' to the list of benefits of an extended overnight fast, according to a new study [1] in this month's issue of JAMA (popular press story). In a study of 2400 breast cancer survivors, researchers found that waiting more than 13 hours between her last meal or snack in the evening and her first meal in the morning resulted in a 36% reduction in a woman's risk of breast cancer recurrence relative to fasting for less than 13 hours. The women who fasted longer had better markers of glucose control (HbA1C) and increased sleep duration. The researchers think these benefits may have been at least partly responsible for the reduction in breast cancer recurrence. --Dean ------------ [1] JAMA Oncol. 2016 Mar 31. doi: 10.1001/jamaoncol.2016.0164. [Epub ahead of print] Prolonged Nightly Fasting and Breast Cancer Prognosis. Marinac CR(1), Nelson SH(2), Breen CI(3), Hartman SJ(4), Natarajan L(4), Pierce JP(4), Flatt SW(3), Sears DD(5), Patterson RE(4). Free full text: http://oncology.jamanetwork.com/article.aspx?articleid=2506710 Importance: Rodent studies demonstrate that prolonged fasting during the sleep phase positively influences carcinogenesis and metabolic processes that are putatively associated with risk and prognosis of breast cancer. To our knowledge, no studies in humans have examined nightly fasting duration and cancer outcomes. Objective: To investigate whether duration of nightly fasting predicted recurrence and mortality among women with early-stage breast cancer and, if so, whether it was associated with risk factors for poor outcomes, including glucoregulation (hemoglobin A1c), chronic inflammation (C-reactive protein), obesity, and sleep. Design, Setting, and Participants: Data were collected from 2413 women with breast cancer but without diabetes mellitus who were aged 27 to 70 years at diagnosis and participated in the prospective Women's Healthy Eating and Living study between March 1, 1995, and May 3, 2007. Data analysis was conducted from May 18 to October 5, 2015. Exposures: Nightly fasting duration was estimated from 24-hour dietary recalls collected at baseline, year 1, and year 4. Main Outcomes and Measures: Clinical outcomes were invasive breast cancer recurrence and new primary breast tumors during a mean of 7.3 years of study follow-up as well as death from breast cancer or any cause during a mean of 11.4 years of surveillance. Baseline sleep duration was self-reported, and archived blood samples were used to assess concentrations of hemoglobin A1c and C-reactive protein. Results: The cohort of 2413 women (mean [sD] age, 52.4 [8.9] years) reported a mean (SD) fasting duration of 12.5 (1.7) hours per night. In repeated-measures Cox proportional hazards regression models, fasting less than 13 hours per night (lower 2 tertiles of nightly fasting distribution) was associated with an increase in the risk of breast cancer recurrence compared with fasting 13 or more hours per night (hazard ratio, 1.36; 95% CI, 1.05-1.76). Nightly fasting less than 13 hours was not associated with a statistically significant higher risk of breast cancer mortality (hazard ratio, 1.21; 95% CI, 0.91-1.60) or a statistically significant higher risk of all-cause mortality (hazard ratio, 1.22; 95% CI, 0.95-1.56). In multivariable linear regression models, each 2-hour increase in the nightly fasting duration was associated with significantly lower hemoglobin A1c levels (β = -0.37; 95% CI, -0.72 to -0.01) and a longer duration of nighttime sleep (β = 0.20; 95% CI, 0.14-0.26). Conclusions and Relevance: Prolonging the length of the nightly fasting interval may be a simple, nonpharmacologic strategy for reducing the risk of breast cancer recurrence. Improvements in glucoregulation and sleep may be mechanisms linking nightly fasting with breast cancer prognosis. PMID: 27032109
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