Table 2.

Association of postdiagnosis E-DII with all-cause mortality, breast cancer–specific mortality, and CVD mortality among 2,150 women diagnosed with invasive breast cancer in the WHI-DM and OS

Most anti-inflammatory dietMost pro-inflammatory diet
E-DII score quartile 1 (−6.81, −4.49)E-DII score quartile 2 (−4.48, −3.46)E-DII score quartile 3 (−3.45, −2.01)E-DII score quartile 4 (−2.00, 3.79)Ptrenda
N538537538537
Death from any cause (n)130148141161
 Age- and energy-adjusted HR (95% CI)0.67 (0.53–0.85)0.81 (0.65–1.01)0.77 (0.62–0.97)1.00 (referent)0.0003
 Multivariable-adjusted HR (95% CI)b0.82 (0.63–1.05)0.96 (0.76–1.22)0.86 (0.68–1.08)1.00 (referent)0.17
Death from breast cancer (n)46585751
 Age- and energy-adjusted HR (95% CI)0.81 (0.54–1.22)1.06 (0.73–1.55)1.09 (0.74–1.59)1.00 (referent)0.43
 Multivariable-adjusted HR (95% CI)c0.96 (0.62–1.49)1.20 (0.80–1.80)1.18 (0.80–1.76)1.00 (referent)0.96
Death from CVD (n)18262633
 Age- and energy-adjusted HR (95% CI)0.44 (0.24–0.78)0.67 (0.40–1.12)0.65 (0.39–1.08)1.00 (referent)0.002
 Multivariable-adjusted HR (95% CI)d0.44 (0.24–0.82)0.69 (0.40–1.20)0.66 (0.38–1.12)1.00 (referent)0.005
  • aPtrend was calculated using the continuous E-DII in the Cox proportional hazards regression model.

  • bStratified by age group at diagnosis (≤66 years old, >66 years old), ER status (positive, negative, others), race/ethnicity (white non-Hispanic, Hispanic/Latino, black/African American, other), and PR status (positive, negative, others) due to PH assumption violation and was adjusted for WHI component (OS, DM intervention, DM control), smoking status at baseline (never smoked, past smoker, current smoker, missing), income levels (<20,000, 20,000–49,999, ≥50,000, missing), cancer stage (localized, regional, distant, unknown), education (high school or below, some college, college, postgraduate, missing), years from cancer diagnosis to FFQ (continuous), baseline physical activity in MET-h/week (0, 0–3, 3–9, 9+), total energy intake per day (continuous), BMI at baseline (underweight, normal, overweight, obese, missing), hormone replacement use status at baseline (never used, current user, and past user), with the covariate of time-dependent status before and after postdiagnosis FFQ.

  • cStratified by education and PR status due to PH assumption violation and adjusted for other covariates listed in b.

  • dStratified by ER status due to PH assumption violation and adjusted for other covariates listed in b.