Diet, Obesity, and Sedentary Lifestyle as Risk Factor of Breast Cancer among Women at Yogyakarta Province in Indonesia

Solikhah Solikhah; Dyah Perwitasari; Tria Astika Endah Permatasari; Rosyida Awalia Safitri

doi:10.3889/oamjms.2022.7228

Authors

Solikhah Solikhah Faculty of Public Health, Universitas Ahmad Dahlan, Yogyakarta, Indonesia
Dyah Perwitasari Faculty of Pharmacy, Universitas Ahmad Dahlan, Yogyakarta, Indonesia
Tria Astika Endah Permatasari Department of Nutrition, Faculty of Medicine and Health, Universitas Muhammadiyah Jakarta, Central Jakarta, Indonesia https://orcid.org/0000-0001-9589-3814
Rosyida Awalia Safitri Department of Nutrition, Faculty of Public Health, Universitas Ahmad Dahlan, Yogyakarta, Indonesia https://orcid.org/0000-0002-0898-4281

DOI:

https://doi.org/10.3889/oamjms.2022.7228

Keywords:

Breast cancer, Obesity, Diet, Sedentary lifestyle, Indonesian women

Abstract

BACKGROUND: Breast cancer prevalence remains high worldwide, including in Indonesia. Studies examining relationship between obesity, dietary habit, sedentary lifestyle, and breast cancer development are largely inconclusive.

AIM: This study aimed to determine relationship between obesity, dietary habit, sedentary lifestyle, and breast cancer risk among women at Yogyakarta Province in Indonesia.

METHODS: This was a cross-sectional study on 135 women selected purposively during March–May 2019. Binary logistic regression models were employed in the analysis with 0.05 considered significant.

RESULTS: Among study subjects, 54.07% and 40% were, respectively, ≥40 years old and smokers. About 53.33% consumed preserved food 3–6 times/week, and 49% and 50.37% consumed sweet food and beverage >1 time/ day, respectively. High body mass index (BMI) and physical inactivity were associated with 93% and 85% breast cancer risk reductions (adjusted odds ratio [AOR]: 0.07, 95% confidence interval [CI]: 0.01–0.45, p < 0.01 and AOR: 0.15, 95% CI: 0.05–0.47, p < 0.001). Smoking showed no significant relationship. A waist circumference (WC) of ≤80 was linked to 78% breast cancer risk reduction. Sweet food, sweet beverage, and energy drink consumption of >1 time/day led to 96%, 36%, and 84% reductions of invasive breast cancer risks. Meanwhile, consumption of preserved food 3–6 times/weeks and soft drinks >1 time/day correlated with an increased risk of breast cancer.

CONCLUSION: High BMI, physical inactivity, and lower WC were associated with the lower breast cancer risk, while preserved food and soft drink consumption significantly increase the risk. Although sedentary lifestyle seems to have a small protective effect, healthy lifestyle should be encouraged and effective strategies are required to encourage women to adopt healthy lifestyle.

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References

Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424. https://doi.org/10.3322/caac.21492 PMid:30207593 DOI: https://doi.org/10.3322/caac.21492

Schwingshackl L, Schwedhelm C, Galbete C, Hoffmann G. Adherence to mediterranean diet and risk of cancer: An updated systematic review and meta-analysis. Nutrients. 2017;9(10):1063. https://doi.org/10.3390/nu9101063 PMid:28954418 DOI: https://doi.org/10.3390/nu9101063

Sun YS, Zhao Z, Yang ZN, Xu F, Lu HJ, Zhu ZY, et al. Risk factors and preventions of breast cancer. Int J Biol Sci. 2017;13(11):1387-97. PMid:29209143 DOI: https://doi.org/10.7150/ijbs.21635

Arthur RS, Wang T, Xue X, Kamensky V, Rohan TE. Genetic factors, adherence to healthy lifestyle behavior, and risk of invasive breast cancer among women in the UK Biobank. J Natl Cancer Inst. 2020;112(9):893-901. https://doi.org/10.1093/jnci/djz241 PMid:31899501 DOI: https://doi.org/10.1093/jnci/djz241

Argolo DF, Hudis CA, Iyengar NM. The impact of obesity on breast cancer. Curr Oncol Rep. 2018;20(6):47. https://doi.org/10.1007/s11912-018-0688-8 PMid:29644507 DOI: https://doi.org/10.1007/s11912-018-0688-8

Lee K, Kruper L, Dieli-Conwright CM, Mortimer JE. The impact of obesity on breast cancer diagnosis and treatment. Curr Oncol Rep. 2019;21(5):41. https://doi.org/10.1007/s11912-019-0787-1 PMid:30919143 DOI: https://doi.org/10.1007/s11912-019-0787-1

Fayanju OM, Hall CS, Bauldry JB, Karhade M, Valad LM, Kuerer HM, et al. Body mass index mediates the prognostic significance of circulating tumor cells in inflammatory breast cancer. Am J Surg. 2017;214(4):666-71. https://doi.org/10.1016/j.amjsurg.2017.06.005 PMid:28720217 DOI: https://doi.org/10.1016/j.amjsurg.2017.06.005

Blair CK, Wiggins CL, Nibbe AM, Storlie CB, Prossnitz ER, Royce M, et al. Obesity and survival among a cohort of breast cancer patients is partially mediated by tumor characteristics. NPJ Breast Cancer. 2019;5:33. https://doi.org/10.1038/s41523-019-0128-4 PMid:31602394 DOI: https://doi.org/10.1038/s41523-019-0128-4

Pizot C, Boniol M, Mullie P, Koechlin A, Boniol M, Boyle P, et al. Physical activity, hormone replacement therapy and breast cancer risk: A meta-analysis of prospective studies. Eur J Cancer. 2016;52:138-54. https://doi.org/10.1016/j.ejca.2015.10.063 PMid:26687833 DOI: https://doi.org/10.1016/j.ejca.2015.10.063

McTiernan A, Friedenreich CM, Katzmarzyk PT, Powell KE, Macko R, Buchner D, et al. Physical activity in cancer prevention and survival: A systematic review. Med Sci Sports Exerc. 2019;51(6):1252-61. https://doi.org/10.1249/mss.0000000000001937 PMid:31095082 DOI: https://doi.org/10.1249/MSS.0000000000001937

Skouroliakou M, Grosomanidis D, Massara P, Kostara C, Papandreou P, Ntountaniotis D, et al. Serum antioxidant capacity, biochemical profile and body composition of breast cancer survivors in a randomized Mediterranean dietary intervention study. Eur J Nutr. 2018;57(6):2133-45. https://doi.org/10.1007/s00394-017-1489-9 PMid:28634625 DOI: https://doi.org/10.1007/s00394-017-1489-9

Guo J, Wei W, Zhan L. Red and processed meat intake and risk of breast cancer: A meta-analysis of prospective studies. Breast Cancer Res Treat. 2015;151(1):191-8. https://doi.org/10.1007/s10549-015-3380-9 PMid:25893586 DOI: https://doi.org/10.1007/s10549-015-3380-9

Taha Z, Eltom SE. The role of diet and lifestyle in women with breast cancer: An update review of related research in the middle east. Biores Open Access. 2018;7(1):73-80. https://doi.org/10.1089/biores.2018.0004 PMid:29862141 DOI: https://doi.org/10.1089/biores.2018.0004

Chan DS, Abar L, Cariolou M, Nanu N, Greenwood DC, Bandera EV, et al. World cancer research fund international: Continuous update project-systematic literature review and meta-analysis of observational cohort studies on physical activity, sedentary behavior, adiposity, and weight change and breast cancer risk. Cancer Causes Control. 2019;30(11):1183-200. https://doi.org/10.1007/s10552-019-01223-w PMid:31471762 DOI: https://doi.org/10.1007/s10552-019-01223-w

Gui Y, Pan Q, Chen X, Xu S, Luo X, Chen L. The association between obesity related adipokines and risk of breast cancer: A meta-analysis. Oncotarget. 2017;8(43):75389-99. https://doi.org/10.18632/oncotarget.17853 PMid:29088874 DOI: https://doi.org/10.18632/oncotarget.17853

Engin A. Obesity-associated breast cancer: Analysis of risk factors. In: Engin AB, Engin A, editors. Obesity and Lipotoxicity. Cham: Springer International Publishing; 2017. p. 571-606. https://doi.org/10.1007/978-3-319-48382-5_25 DOI: https://doi.org/10.1007/978-3-319-48382-5_25

Adams ML, Katz DL, Shenson D. A healthy lifestyle composite measure: Significance and potential uses. Prev Med. 2016;84:41-7. https://doi.org/10.1016/j.ypmed.2015.12.005 PMid:26724520 DOI: https://doi.org/10.1016/j.ypmed.2015.12.005

Li Y, Pan A, Wang DD, Liu X, Dhana K, Franco OH, et al. Impact of healthy lifestyle factors on life expectancies in the US population. Circulation. 2018;138(4):345-55. https://doi.org/10.1161/circulationaha.117.032047 PMid:29712712 DOI: https://doi.org/10.1161/CIRCULATIONAHA.117.032047

WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363(9403):157-63. https://doi.org/10.1016/s0140-6736(03)15268-3 PMid:14726171 DOI: https://doi.org/10.1016/S0140-6736(03)15268-3

Liu K, Zhang W, Dai Z, Wang M, Tian T, Liu X, et al. Association between body mass index and breast cancer risk: Evidence based on a dose-response meta-analysis. Cancer Manag Res. 2018;10:143-51. https://doi.org/10.2147/cmar.s144619 PMid:29403312 DOI: https://doi.org/10.2147/CMAR.S144619

Seiler A, Chen MA, Brown RL, Fagundes CP. Obesity, dietary factors, nutrition, and breast cancer risk. Curr Breast Cancer Rep. 2018;10(1):14-27. https://doi.org/10.1007/s12609-018-0264-0 PMid:30662586 DOI: https://doi.org/10.1007/s12609-018-0264-0

Dal Maso L, Zucchetto A, Talamini R, Serraino D, Stocco CF, Vercelli M, et al. Effect of obesity and other lifestyle factors on mortality in women with breast cancer. Int J Cancer. 2008;123(9):2188-94. https://doi.org/10.1002/ijc.23747 PMid:18711698 DOI: https://doi.org/10.1002/ijc.23747

Godinho-Mota JC, Gonçalves LV, Mota JF, Soares LR, Schincaglia RM, Martins KA, et al. Sedentary behavior and alcohol consumption increase breast cancer risk regardless of menopausal status: A case-control study. Nutrients. 2019;11(8):1871. https://doi.org/10.3390/nu11081871 PMid:31408930 DOI: https://doi.org/10.3390/nu11081871

Iyengar NM, Arthur R, Manson JE, Chlebowski RT, Kroenke CH, Peterson L, et al. Association of body fat and risk of breast cancer in postmenopausal women with normal body mass index: A secondary analysis of a randomized clinical trial and observational study. JAMA Oncol. 2019;5(2):155-63. https://doi.org/10.1001/jamaoncol.2018.5327 PMid:30520976 DOI: https://doi.org/10.1001/jamaoncol.2018.5327

Gómez-Ambrosi J, Silva C, Catalán V, Rodríguez A, Galofré JC, Escalada J, et al. Clinical usefulness of a new equation for estimating body fat. Diabetes Care. 2012;35(2):383-8. https://doi.org/10.2337/dc11-1334 PMid:22179957 DOI: https://doi.org/10.2337/dc11-1334

Bosomworth NJ. Normal-weight central obesity: Unique hazard of the toxic waist. Can Fam Physician. 2019;65(6):399-408. PMid:31189627

Kerlikowske K, Gard CC, Tice JA, Ziv E, Cummings SR, Miglioretti DL, et al. Risk factors that increase risk of estrogen receptor-positive and-negative breast cancer. J Natl Cancer Inst. 2016;109(5):djw276. https://doi.org/10.1093/jnci/djw276 PMid:28040694 DOI: https://doi.org/10.1093/jnci/djw276

Physical Activity Guidelines Advisory Committee. 2018 Physical Activity Guidelines Advisory Committee Scientific Report. Washington, DC: US Department of Health and Human Services; 2018. https://doi.org/10.1037/e525442010-001 DOI: https://doi.org/10.1037/e525442010-001

Steindorf K, Ritte R, Eomois PP, Lukanova A, Tjonneland A, Johnsen NF, et al. Physical activity and risk of breast cancer overall and by hormone receptor status: The European prospective investigation into cancer and nutrition. Int J Cancer. 2013;132(7):1667-78. https://doi.org/10.1002/ijc.27778 PMid:22903273 DOI: https://doi.org/10.1002/ijc.27778

Niehoff NM, Nichols HB, Zhao S, White AJ, Sandler DP. Adult physical activity and breast cancer risk in women with a family history of breast cancer. Cancer Epidemiol Biomarkers Prev. 2019;28(1):51-8. https://doi.org/10.1158/1055-9965.epi-18-0674 PMid:30333218 DOI: https://doi.org/10.1158/1055-9965.EPI-18-0674

Huneidi SA, Wright NC, Atkinson A, Bhatia S, Singh P. Factors associated with physical inactivity in adult breast cancer survivors-A population-based study. Cancer Med. 2018;7(12):6331-9. https://doi.org/10.1002/cam4.1847 PMid:30358141 DOI: https://doi.org/10.1002/cam4.1847

Dieli-Conwright CM, Lee K, Kiwata JL. Reducing the risk of breast cancer recurrence: An evaluation of the effects and mechanisms of diet and exercise. Curr Breast Cancer Rep. 2016;8(3):139-50. https://doi.org/10.1007/s12609-016-0218-3 PMid:27909546 DOI: https://doi.org/10.1007/s12609-016-0218-3

de Boer MC, Wörner EA, Verlaan D, van Leeuwen PA. The mechanisms and effects of physical activity on breast cancer. Clin Breast Cancer. 2017;17(4):272-8. https://doi.org/10.1016/j.clbc.2017.01.006 PMid:28233686 DOI: https://doi.org/10.1016/j.clbc.2017.01.006

Romanos-Nanclares A, Toledo E, Gardeazabal I, Jiménez-Moleón JJ, Martínez-González MA, Gea A. Sugar-sweetened beverage consumption and incidence of breast cancer: The Seguimiento Universidad de Navarra (SUN) project. Eur J Nutr. 2019;58(7):2875-86. https://doi.org/10.1007/s00394-018-1839-2 PMid:30284064 DOI: https://doi.org/10.1007/s00394-018-1839-2

Key TJ, Bradbury KE, Perez-Cornago A, Sinha R, Tsilidis KK, Tsugane S. Diet, nutrition, and cancer risk: What do we know and what is the way forward? BMJ. 2020;368:m511. https://doi.org/10.1136/bmj.m511 PMid:32139373 DOI: https://doi.org/10.1136/bmj.m511

Hu FB, Malik VS. Sugar-sweetened beverages and risk of obesity and Type 2 diabetes: Epidemiologic evidence. Physiol Behav. 2010;100(1):47-54. https://doi.org/10.1016/j.physbeh.2010.01.036 PMid:20138901 DOI: https://doi.org/10.1016/j.physbeh.2010.01.036

Shrapnel WS, Butcher BE. Sales of sugar-sweetened beverages in Australia: A trend analysis from 1997 to 2018. Nutrients. 2020;12(4):1016. https://doi.org/10.3390/nu12041016 PMid:32272711 DOI: https://doi.org/10.3390/nu12041016

Imanningsih N, Jahari AB, Permaesih ID, Chan P, Amarra MS. Consumption and sources of added sugar in Indonesia: A review. Asia Pac J Clin Nutr. 2018;27(1):47-64. PMid:29222880

Chazelas E, Srour B, Desmetz E, Kesse-Guyot E, Julia C, Deschamps V, et al. Sugary drink consumption and risk of cancer: Results from NutriNet-Santé prospective cohort. BMJ. 2019;366:l2408. https://doi.org/10.1136/bmj.l2408 PMid:31292122 DOI: https://doi.org/10.1136/bmj.l2408

Biello F, Platini F, D’Avanzo F, Cattrini C, Mennitto A, Genestroni S, et al. Insulin/IGF axis in breast cancer: Clinical evidence and translational insights. Biomolecules. 2021;11(1):125. https://doi.org/10.3390/biom11010125 PMid:33477996 DOI: https://doi.org/10.3390/biom11010125

Fiolet T, Srour B, Sellem L, Kesse-Guyot E, Allès B, Méjean C, et al. Consumption of ultra-processed foods and cancer risk: Results from NutriNet-Santé prospective cohort. BMJ. 2018;360:k322. https://doi.org/10.1136/bmj.k322 PMid:29444771 DOI: https://doi.org/10.1136/bmj.k322

Poti JM, Mendez MA, Ng SW, Popkin BM. Is the degree of food processing and convenience linked with the nutritional quality of foods purchased by US households? Am J Clin Nutr. 2015;101(6):1251-62. https://doi.org/10.1096/fasebj.29.1_supplement.587.9 PMid:25948666 DOI: https://doi.org/10.3945/ajcn.114.100925

Javanmardi F, Rahmani J, Ghiasi F, Hashemi Gahruie H, Mousavi Khaneghah A. The association between the preservative agents in foods and the risk of breast cancer. Nutr Cancer. 2019;71(8):1229-40. https://doi.org/10.1080/01635581.2019.1608266 PMid:31044613 DOI: https://doi.org/10.1080/01635581.2019.1608266

Lofterød T, Frydenberg H, Flote V, Eggen AE, McTiernan A, Mortensen ES, et al. Exploring the effects of lifestyle on breast cancer risk, age at diagnosis, and survival: The EBBA-life study. Breast Cancer Res Treat. 2020;182(1):215-27. https://doi.org/10.1007/s10549-020-05679-2 PMid:32436147 DOI: https://doi.org/10.1007/s10549-020-05679-2