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Healthy Eating Index Scores are Associated with Inflammatory Markers in Breast Cancer Survivors

Lower inflammatory markers are associated with improved survival in women diagnosed with early stage breast cancer. Our objective was to determine if diet quality was associated with inflammation in breast cancer survivors. Food frequency questionnaires from a randomized placebo‐controlled pilot study comparing omega‐3 fatty acid supplementation versus placebo in 44 postmenopausal women with breast cancer beginning aromatase inhibitor (AI) treatment were analyzed and scored for diet quality using the Healthy Eating Index 2010 (HEI). Pearson correlation coefficients (r) were used to evaluate the relationship between baseline HEI scores and inflammatory cytokines, interleukin‐6 (IL‐6), IL‐17, and tumor necrosis factor alpha receptor 2 (TNFR2), at baseline (0), 12 and 24 weeks after beginning AIs. Complete data were available for 34 women at week 24. HEI scores did not differ by randomization or chemotherapy status at baseline (P=0.23). Higher baseline HEI score (healthier diet) was associated with significantly lower IL‐6 (Week 0 and 24: r = ‐0.42 and ‐0.51 respectively; P<0.002) and TNFR‐2 (Week 0 and 24: r = ‐0.35 and ‐0.41 respectively; P<0.02) in analysis of all participants. In women who had prior chemotherapy (n=16), stronger inverse relationships between HEI, IL‐6 (Week 0 and 24: r = ‐0.62 and ‐0.84; P<0.01) and TNFR‐2 (Week 0 and 24: r = ‐0.55 and ‐0.67; P<0.03) were observed. We found no significant relationship between HEI and IL‐17. These data suggest that healthier diet quality is associated with some markers of decreased inflammation in breast cancer survivors beginning AI therapy.