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00925njm 22002777a 4500 dc Dierssen-Sotos, Trinidad author Gómez-Acebo, Inés author Gutiérrez-Ruiz, Nuria author Aragones, Nuria author Amiano, Pilar author Molina de la Torre, Antonio José author Guevara, Marcela author Alonso-Molero, Jéssica author Obón-Santacana, Mireia author Fernández-Tardón, Guillermo author Molina-Barceló, Ana author Alguacil, Juan author Marcos-Gragera, Rafael author Rodríguez-Cundín, Paz author Castaño-Vinyals, Gemma author Canseco Fernandez, Rosario author Castilla Catalán, Jesús author Molinuevo, Amaia author Perez-Gomez, Beatriz author Kogevinas, Manolis author Pollan-Santamaria, Marina author Llorca, Javier author 2020-12-24 The aim of this study was to characterize the relationship between the intake of the major nutrients and prognosis in breast cancer. A cohort based on 1350 women with invasive (stage I-IV) breast cancer (BC) was followed up. Information about their dietary habits before diagnosis was collected using a semi-quantitative Food Frequency Questionnaire. Participants without FFQ or with implausible energy intake were excluded. The total amount consumed of each nutrient (Kcal/day) was divided into tertiles, considering as "high intakes" those above third tertile. The main effect studied was overall survival. Cox regression was used to assess the association between death and nutrient intake. During a median follow-up of 6.5 years, 171 deaths were observed. None of the nutrients analysed was associated with mortality in the whole sample. However, in normal-weight women (BMI 18.5-25 kg/m2) a high intake of carbohydrates (≥809 Kcal/day), specifically monosaccharides (≥468 Kcal/day), worsened prognostic compared to lowest (≤352 Kcal/day). Hazard Ratios (HRs) for increasing tertiles of intake were HR:2.22 95% CI (1.04 to 4.72) and HR:2.59 95% CI (1.04 to 6.48), respectively (p trend = 0.04)). Conversely, high intakes of polyunsaturated fats (≥135 Kcal/day) improved global survival (HR: 0.39 95% CI (0.15 to 1.02) p-trend = 0.05) compared to the lowest (≤92.8 kcal/day). In addition, a protective effect was found substituting 100 kcal of carbohydrates with 100 kcal of fats in normal-weight women (HR: 0.76 95% CI (0.59 to 0.98)). Likewise, in premenopausal women a high intake of fats (≥811 Kcal/day) showed a protective effect (HR:0.20 95% CI (0.04 to 0.98) p trend = 0.06). Finally, in Estrogen Receptors (ER) negative tumors, we found a protective effect of high intake of animal proteins (≥238 Kcal/day, HR: 0.24 95% CI (0.06 to 0.98). According to our results, menopausal status, BMI and ER status could play a role in the relationship between diet and BC survival and must be taken into account when studying the influence of different nutrients. Int J Environ Res Public Health. 2020 Dec 24;18(1):84 http://hdl.handle.net/20.500.12105/11769 33374289 10.3390/ijerph18010084 1660-4601 International journal of environmental research and public health Breast cancer Dietary nutrients Mortality Overall survival Prognosis Dietary Constituents: Relationship with Breast Cancer Prognostic (MCC-SPAIN Follow-Up)