Supplementation of Mediterranean diet with olive oil associated with lower incidence of invasive breast cancer among women at risk of cardiovascular disease

Tuesday, September 22, 2015

A trial reported on September 14, 2015 in JAMA Internal Medicine found a significantly lower risk of invasive breast cancer among women who consumed a Mediterranean diet supplemented with extra-virgin olive oil in comparison with women assigned to a reduced fat control diet. "No prior nutrition intervention trial has addressed the effect of the Mediterranean diet specifically on breast cancer," authors Estefania Toledo, MD, MPH, PhD, and colleagues announce.

The trial included 4,282 women between the ages of 60 and 80 years enrolled in the multicenter Prevención con Dieta Mediterránea (PREDIMED) study who were at increased cardiovascular disease risk due to the presence of type 2 diabetes or other risk factors. Subjects were randomized to a Mediterranean diet (which is high in plant foods, fish and other healthy foods) supplemented with olive oil or nuts, or a control diet.

After a median follow-up period of 4.8 years, 35 cases of invasive breast cancer were identified. While both Mediterranean diets were associated with a significantly reduced risk of the disease, the diet supplemented with olive oil was associated with the lowest risk, which was 67% less (after adjustment) than the control group. Restriction of the analysis to women with estrogen receptor-positive malignancies further improved the protective effect of the olive-oil supplemented diet.

The authors suggest several mechanisms for extra virgin olive oil's anticarcinogenic effect. They observe that while all olive oil provides a high amount of monounsaturated fatty acids (mainly oleic acid) as well as squalene, extra virgin olive oil also provides biologically active compounds that include the polyphenols oleocanthal, oleuropein, hydroxytyrosol and lignans. The combined effects of oleic acid's antiproliferative property, squalene's beneficial effect on intracellular oxidative stress, and polyphenols' varying anticancer properties could be responsible for the protection associated with olive oil observed in this study.

"Preventive strategies represent the most sensible approach against cancer," the authors conclude. "The intervention paradigm implemented in the PREDIMED trial provides a useful scenario for breast cancer prevention because it is conducted in primary health care centers and also offers beneficial effects on a wide variety of health outcomes. Nevertheless, these results need confirmation by long-term studies with a higher number of incident cases."

What's Hot

Luteolin may protect against breast cancer in women treated with synthetic HRT

An article published on August 22, 2015 in the journal Springer Plus reveals a protective effect for luteolin, a compound that occurs in such plant foods as celery, broccoli, thyme and parsley, in women at increased risk of breast cancer due to the use of the synthetic hormone progestin.

When administered to cultured breast cancer cells, luteolin resulted in a reduction in breast cancer cell viability. The researchers also observed a decrease in the secretion of progestin-dependent vascular endothelial growth factor (VEGF, which is involved in angiogenesis: the formation of new blood vessels). Luteolin additionally blocked the acquisition in breast cancer cells of progestin-induced stem cell-like properties that make these cancer cells more resistant to destruction.

When progestin-dependent tumors were grafted into mice, luteolin decreased VEGF and blood vessel density.

"Most older women normally have benign lesions in breast tissue," observed lead researcher Salman Hyder, who is the Zalk Endowed Professor in Tumor Angiogenesis and professor of biomedical sciences in the College of Veterinary Medicine and the Dalton Cardiovascular Research Center at the University of Missouri. "These lesions typically don't form tumors until they receive the 'trigger'-- in this case, progestin--that attracts blood vessels to cells essentially feeding the lesions causing them to expand."

Dr Hyder and his colleagues plan additional studies of luteolin which they hope will provide enough evidence to warrant human trials of the compound in women who have used synthetic hormone replacement. "Our studies provide evidence that luteolin has the potential to disrupt angiogenesis and thereby prevent the growth development of progestin-driven tumors," they conclude. "It is therefore essential that we further investigate the mechanisms by which luteolin moderates progestin effects in order to fully exploit its therapeutic potential."

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Health Concern

Breast Cancer

A wide variety of factors may influence an individual's likelihood of developing breast cancer; these factors are referred to as risk factors. The established risk factors for breast cancer include: female gender, age, previous breast cancer, benign breast disease, hereditary factors (family history of breast cancer), early age at menarche (first menstrual period), late age at menopause, late age at first full-term pregnancy, obesity, low physical activity, use of postmenopausal hormone replacement therapy, use of oral contraceptives, exposure to low-dose ionizing radiation in midlife and exposure to high-dose ionizing radiation early in life.

Estrogen is a growth factor for most breast cancers. High-fat diets and associated increases in fat tissue can increase estrogen availability in a number of ways:

Fat tissue is a major source of estrogen production in postmenopausal women. Therefore, there is an association between high body weight and decreased survival in breast cancer patients.
Obesity and possibly insulin resistance can decrease the levels of sex hormone binding globulin (SHBG) in both men and women and increase breast cancer risk or cancer progression. This is an important factor in estrogen-dependent breast cancer cells because it is adequate levels of SHBG that act as an anti-proliferative and provides an anti-estrogenic effect.
Obesity can alter liver metabolism of estrogen, allowing the retention of high estrogen byproducts with high estrogenic activity within the body.
High-fat diets may reduce the amount of estrogen excreted in the feces. In contrast, low-fat/high-fiber diets can reduce circulating estrogen.

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References:
1. Circulation. 2014 Jan 21;129(3):e28-e292.
2. Heart Disease and Stroke Statistics — 2006 update. Dallas, TX: American Heart Association; 2006.
3. Circulation. 1997 Jan 7;95(1):69-75.

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