Researchers analyzed data from two cohorts: the UK Biobank and the Chinese Longitudinal Healthy Longevity Survey (CLHLS). The UK Biobank sample included 67,045 cancer-free participants and 3,397 women with breast cancer at baseline. Plant-based diet adherence was measured using the Healthful Plant-Based Diet Index (HPDI) and the Alternate Mediterranean Diet (AMED) score.
In the UK Biobank, women in the highest HPDI tertile were 11% less likely to develop breast cancer compared to those in the lowest tertile. Among women already diagnosed, those with the highest HPDI adherence had a 28% lower risk of all-cause mortality. Each standard deviation increase in HPDI was associated with a 4% lower incidence risk and an 11% reduction in mortality risk.
Micronutrient analyses revealed that higher intakes of calcium, magnesium, copper, and vitamin C were associated with lower breast cancer risk. Among patients, greater intake of calcium, phosphorus, magnesium, and vitamin B2 was linked to reduced mortality. In contrast, higher sodium intake increased mortality risk by 15% per standard deviation increase.
Predictive modeling showed modest accuracy overall. Micronutrients were better predictors of incidence, while HPDI more strongly predicted five-year mortality. Combined models performed best at 10 years.
Although the study benefits from large sample sizes and advanced statistical methods, its observational design limits causal interpretation. Dietary data were collected at baseline only, and some risk factors were unavailable. Larger and longer studies are needed to clarify clinical implications.
REFERENCE: Xu, W., Gu, W., Huang, Y., Li, S., Liu, H., Zhu, X. (2026). Plant-based dietary patterns, micronutrient status and breast cancer outcomes: a joint analysis of UK Biobank and Chinese longitudinal healthy longevity survey. Frontiers in Nutrition, 12. DOI: 10.3389/fnut.2025.1748611, https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2025.1748611/full
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