Table 3.

HRs (95% CI) for breast cancer–specific events by dietary recommendation adherence scores.a

Quartile of dietary recommendation adherence scores
Dietary recommendations1 (low)234By 5-point increasebPtrend
CHFP-2007 score14.5–31.631.6–35.635.6–39.239.2–45.014.5–45.0
 No. of participants7697687587933,088
 No. of events84574146228
 Age- and energy-adjusted HRc1.00 (Ref.)0.71 (0.51–1.00)0.53 (0.37–0.78)0.59 (0.41–0.85)0.83 (0.73–0.93)0.002
 Multivariable-adjusted HRd1.00 (Ref.)0.77 (0.54–1.08)0.55 (0.38–0.81)0.64 (0.44–0.93)0.84 (0.74–0.95)0.01
CHFP-2016 score14.0–27.927.9–31.731.7–35.735.7–44.614.0–44.6
 No. of participants7737597797773,088
 No. of events79663944228
 Age- and energy-adjusted HRc1.00 (Ref.)0.93 (0.67–1.29)0.55 (0.37–0.82)0.62 (0.43–0.91)0.82 (0.73–0.93)0.001
 Multivariable-adjusted HRd1.00 (Ref.)0.98 (0.70–1.37)0.58 (0.39–0.87)0.67 (0.45–0.99)0.84 (0.74–0.95)0.01
DASH score10.0–38.238.2–44.144.1–49.349.3–67.710.0–67.7
 No. of participants7007177017423,088
 No. of events71645538228
 Age- and energy-adjusted HRc1.00 (Ref.)0.92 (0.65–1.29)0.83 (0.58–1.18)0.57 (0.38–0.84)0.90 (0.84–0.98)0.01
 Multivariable-adjusted HRd1.00 (Ref.)0.96 (0.68–1.36)0.88 (0.61–1.26)0.60 (0.40–0.90)0.92 (0.85–0.99)0.03
HEI-2015 score38.0–58.758.7–61.961.9–65.865.8–78.538.0–78.5
 No. of participants7807667577853,088
 No. of events68625147228
 Age- and energy-adjusted HRc1.00 (Ref.)1.05 (0.74–1.49)0.88 (0.61–1.28)0.82 (0.55–1.21)0.91 (0.80–1.03)0.12
 Multivariable-adjusted HRd1.00 (Ref.)1.06 (0.74–1.52)0.90 (0.61–1.32)0.89 (0.59–1.33)0.92 (0.81–1.05)0.23
  • Abbreviations: CHFP-2007, Chinese Food Pagoda 2007; CHFP-2016, Chinese Food Pagoda 2016; CI, confidence interval; DASH, Dietary Approaches to Stop Hypertension; HEI-2015, Healthy Eating Index 2015; HR, hazard ratio; No., number.

  • aBreast cancer–specific events were defined as recurrence or metastasis of breast cancer and deaths from breast cancer. Participants who had recurrence or metastasis of breast cancer before dietary survey (N = 175) or participants who were lost to follow-up at 10-year in-person follow-up and did not die from breast cancer (N = 189) were excluded from the analyses, resulting in 3,088 participants and 228 events.

  • bLinearity of associations between dietary scores and breast cancer–specific events was tested using restricted cubic spline function. The Plinearity values for CHFP-2007, CHFP-2016, DASH, and HEI-2015 scores were 0.54, 0.75, 0.42, and 0.10, respectively.

  • cCox regression model was adjusted for age at 60-month survey, intervals between diagnosis and 60-month survey, and total energy intake.

  • dCox regression model was additionally adjusted for income, education, marriage, menopausal status at diagnosis, BMI at 60-month survey, physical activity at 60-month survey, ER, PR, HER2, TNM stages, comorbidity, chemotherapy, radiotherapy, and immunotherapy.