Causal relationship between dietary factors and breast cancer risk: A Mendelian randomization study

BACKGROUND: Previous studies have discovered an association between dietary factors and breast cancer. However, few studies have used Mendelian randomization (MR) to assess the potential causal relationship between dietary factors and breast cancer. METHODS: The exposure datasets for fresh fruit intake, dried fruit intake, salad/raw vegetable intake, cooked vegetable intake, oily fish intake, non-oily fish intake, cheese intake, and bread intake were obtained from the UK Biobank. The outcome dataset was extracted from the Breast Cancer Association Consortium (BCAC). We used the inverse variance weighted (IVW) method as the primary approach for the two-sample MR analysis. To ensure the accuracy of the results, we conducted heterogeneity and horizontal pleiotropy analyses. Additionally, multivariable MR analysis was conducted to ensure the stability of the results. RESULTS: Dried fruit intake was found to be a protective factor for overall breast cancer (outliers excluded: OR: 0.549; 95 % CI: 0.429–0.702; p = 1.75 × 10(−6)). Subtype analyses showed that dried fruit intake was inversely associated with both estrogen receptor-positive (ER+) breast cancer (outliers excluded: OR: 0.669; 95 % CI: 0.512–0.875; p = 0.003) and ER-negative (ER−) breast cancer (OR: 0.559; 95 % CI: 0.379–0.827; p = 0.004), while fresh fruit intake was inversely associated with ER− breast cancer (excluded outliers: OR: 0.510; 95 % CI: 0.308–0.846; p = 0.009). No significant causal relationship was found between other dietary intakes and breast cancer. After adjusting for the effects of possible confounders, the causal relationships found by the two-sample MR analysis remained. CONCLUSION: Our study provides evidence that dried fruit intake may reduce the risk of both ER+ and ER− breast cancer, and fresh fruit intake may reduce the risk of ER− breast cancer. Other factors included in this study were not linked to breast cancer.