Association of a healthy lifestyle index with risk of breast cancer among women with normal body mass index in the UK Biobank.

Title
Association of a healthy lifestyle index with risk of breast cancer among women with normal body mass index in the UK Biobank.
Publication type
Journal Article
Year of Publication
2021
Journal
Cancer Epidemiol Biomarkers Prev
Date published
2021 Dec 21
ISSN
1538-7755
Abstract

BACKGROUND: A high healthy lifestyle index (HLI), a composite score based on good diet quality, low alcohol consumption, no smoking, moderate to high physical activity, and waist circumference <80cm, has been consistently associated with a reduced risk of breast cancer (BC). Recently, high levels of body fat were found to be associated with an elevated risk of BC in postmenopausal women with a normal body mass index (BMI) (18.5-<25 kg/m2). Whether the HLI is associated with BC risk in women with normal BMI is unknown.

METHODS: We studied 102,572 women aged 40-69 years with a normal BMI at enrollment into the UK Biobank cohort study. The HLI was created by assigning to each component higher scores for healthier behaviors and then summing the scores. The HLI was categorized by tertiles and age- and multivariable-adjusted hazard ratios (HRs) for the association of the HLI with BC risk by menopausal status were estimated using Cox proportional hazards models.

RESULTS: In postmenopausal women, compared to a low HLI, higher scores were associated with a reduced risk of BC (HRHLI-3rd tertile 0.76; 95% CI, 0.64-0.91). Findings were similar for premenopausal women, although they did not reach statistical significance, except when smoking status was excluded from the HLI score (HLIwithout smoking: HR3rd tertile, 0.71; 95% CI, 0.56-0.90).

CONCLUSIONS: In normal BMI postmenopausal women, a high HLI score was associated with a reduced risk of BC.

IMPACT: Following a healthy lifestyle may reduce the risk of BC among normal weight postmenopausal women.