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@ARTICLE{Cairat:294053,
      author       = {M. Cairat and S. Yammine and T. Fiolet and A. Fournier and
                      M.-C. Boutron-Ruault and N. Laouali and F. R. Mancini and G.
                      Severi and F. M. Berstein and F. Rauber and R. B. Levy and
                      G. Skeie and K. B. Borch and A. Tjønneland and L.
                      Mellemkjær and Y. Borné and A. H. Rosendahl and G. Masala
                      and M. T. Giraudo and M. S. de Magistris and V. Katzke$^*$
                      and R. Bajracharya$^*$ and C. Santiuste and P. Amiano and S.
                      Bodén and C. Castro-Espin and M.-J. Sánchez and M. Touvier
                      and M. Deschasaux-Tanguy and B. Srour and M. B. Schulze and
                      M. Guevara and N. Kliemann and J. B. Lopez and A. Al Nahas
                      and K. Chang and E. P. Vamos and C. Millett and E. Riboli
                      and A. K. Heath and C. Biessy and V. Viallon and C.
                      Casagrande and G. Nicolas and M. J. Gunter and I.
                      Huybrechts},
      title        = {{D}egree of food processing and breast cancer risk: a
                      prospective study in 9 {E}uropean countries.},
      journal      = {Food production, processing and nutrition},
      volume       = {6},
      number       = {1},
      issn         = {2661-8974},
      address      = {[London]},
      publisher    = {Biomed Central},
      reportid     = {DKFZ-2024-02077},
      pages        = {89},
      year         = {2024},
      abstract     = {Recent epidemiological studies have suggested a positive
                      association between ultra-processed food consumption and
                      breast cancer risk, although some studies also reported no
                      association. Furthermore, the evidence regarding the
                      associations between intake of food with lower degrees of
                      processing and breast cancer risk is limited. Thus, we
                      investigated the associations between dietary intake by
                      degree of food processing and breast cancer risk, overall
                      and by breast cancer subtypes in the European Prospective
                      Investigation into Cancer and Nutrition (EPIC) study.
                      Dietary intake of EPIC participants was assessed via
                      questionnaires at baseline. More than 11,000 food
                      ingredients were classified into four groups of food
                      processing levels using the NOVA classification system:
                      unprocessed/minimally processed (NOVA 1), culinary
                      ingredients (NOVA 2), processed (NOVA 3) and ultra-processed
                      (NOVA 4). Cox proportional hazards models were used to
                      estimate hazard ratios (HRs) and $95\%$ confidence intervals
                      (CIs) of breast cancer per standard deviation increase in
                      daily consumption (grams) of foods from each NOVA group. The
                      current analysis included 14,933 breast cancer cases,
                      diagnosed among the 318,686 EPIC female participants,
                      (median follow-up of 14.9 years). No associations were found
                      between breast cancer risk and the level of dietary intake
                      from NOVA 1 [HR per 1 SD=0.99 $(95\%$ CI 0.97 - 1.01)], NOVA
                      2 [HR per 1 SD =1.01 $(95\%$ CI 0.98 - 1.03)] and NOVA 4 [HR
                      per 1 SD =1.01 $(95\%$ CI 0.99 - 1.03)] foods. However, a
                      positive association was found between NOVA 3 and breast
                      cancer risk [HR per 1 SD =1.05 $(95\%$ CI 1.03 - 1.07)]
                      which became non-significant after adjustment for alcohol
                      intake [HR per 1 SD =1.01 $(95\%$ CI 0.98 - 1.05)] or when
                      beer and wine were excluded from this group [HR per 1 SD
                      =0.99 $(95\%$ CI 0.97 - 1.01)]. The associations did not
                      differ by breast cancer subtype, menopausal status or body
                      mass index. Findings from this large-scale prospective study
                      suggest that the positive association between processed food
                      intake and breast cancer risk was likely driven by alcoholic
                      beverage consumption.The online version contains
                      supplementary material available at
                      10.1186/s43014-024-00264-2.},
      keywords     = {Breast cancer (Other) / Epidemiology (Other) / Food
                      processing (Other) / NOVA classification (Other) /
                      Prospective study (Other)},
      cin          = {C020},
      ddc          = {640},
      cid          = {I:(DE-He78)C020-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:39399144},
      pmc          = {pmc:PMC11468235},
      doi          = {10.1186/s43014-024-00264-2},
      url          = {https://inrepo02.dkfz.de/record/294053},
}