Table 2.
Multivariable hazard ratios (HR) and 95% confidence interval (95%CI) of overall and breast cancer-specific mortality according to the adherence to the Mediterranean diet measured by the arMED score
| Categories of adherence of the arMED scorea | arMED score, continuous | |||
|---|---|---|---|---|
| Low | Medium | High | 3-units increase | |
| Overall mortality | ||||
| All BC survivorsb | 1.13 (1.01–1.26) | 1.00 reference | 0.94 (0.84–1.05) | 0.92 (0.87–0.97) |
| N (deaths) | 3427 (736) | 5162 (871) | 4681 (733) | 13,270 (2340) |
| Premenopausal BC survivorsc,d | 1.21 (0.94–1.56) | 1.00 reference | 1.11 (0.89–1.38) | 0.94 (0.84–1.06) |
| N (deaths) | 613 (131) | 1152 (183) | 1305 (213) | 3070 (527) |
| Postmenopausal BC survivorsc,e | 1.10 (0.98–1.24) | 1.00 reference | 0.89 (0.78–1.01) | 0.92 (0.86–0.98) |
| N (deaths) | 2814 (605) | 4010 (688) | 3376 (520) | 10,200 (1813) |
| P value heterogeneity* | 0.437 | |||
| BC-specific mortality | ||||
| All BC survivorsb | 1.12 (0.98–1.29) | 1.00 reference | 0.99 (0.86–1.13) | 0.97 (0.90–1.04) |
| N (deaths) | 3427 (441) | 5162 (541) | 4681 (493) | 13,270 (1475) |
| Premenopausal BC survivorsc,d | 1.23 (0.92–1.63) | 1.00 reference | 1.16 (0.91–1.48) | 0.97 (0.85–1.11) |
| N (deaths) | 613 (103) | 1152 (145) | 1305 (180) | 3070 (428) |
| Postmenopausal BC survivorse | 1.10 (0.94–1.28) | 1.00 reference | 0.93 (0.78–1.09) | 0.97 (0.89–1.05) |
| N (deaths) | 2814 (338) | 4010 (396) | 3376 (313) | 10,200 (1047) |
| P value heterogeneity* | 0.992 | |||
Abbreviations: arMED Adapted relative Mediterranean diet, N Number of breast cancer cases
aCategories of arMED: low adherence, 0–5; medium adherence, 6–8; high adherence, 9–16
bModel stratified by country, stage (metastatic, non-metastatic, unknown) and menopausal status at diagnosis and adjusted for age at diagnosis, attained level of education, physical activity, body mass index (modeled as restricted cubic spline), alcohol consumption reported at recruitment, smoking habit and intensity at recruitment, ever use of hormones for menopause at diagnosis, grade of differentiation, and tumor receptor status (ER, PR, HER2)
cSame model as above without stratification for menopausal status al diagnosis
dModel premenopause: variable age into 2 categories, < 50 and > = 50, and not adjusted for every use of hormone therapy replacement for menopause
eModel postmenopause: variable age into 2 categories, < 65 and > = 65
*Pvalue for heterogeneity between pre- and postmenopausal subgroups for the association of arMED and mortality outcomes