A nationwide cross-sectional study investigating adherence to the Mediterranean diet, smoking, alcohol and work habits, hormonal dynamics between breast cancer cases and healthy subjects

Background & Aims: Despite substantial efforts in promoting prevention and the advancements in surgical and minimally invasive techniques, breast cancer remains a leading cause of mortality among women worldwide. Genetics and risk factors, including diet and lifestyle, play a critical role in determining the susceptibility to this neoplasm. The primary objective of this study is to investigate the pivotal role of adherence to the Mediterranean diet in breast cancer prevention. Additionally, we assessed differences in diet, Body Mass Index (BMI), smoking and alcohol habits, work shifts, exposure to environmental pollutants, and hormonal factors between patients with previously diagnosed breast cancer and healthy subjects. Methods: The validated CREA questionnaire, alongside additional inquiries, was administered to the Italian population. Adherence to the Mediterranean diet was examined, and respondents were categorized into two groups: the general population and patients with a previous cancer diagnosis. Descriptive and inferential statistics were applied to assess all risk factors among these groups. Results: Results revealed low adherence to the Mediterranean diet, particularly among less educated individuals, those engaged in 24-hour shift work, smokers, and those with a high BMI. Furthermore, significant differences in working time distribution, consumption of meat, milk, and alcohol, as well as significant differences in hormonal factors such as age of menarche and menopause, age of first pregnancy, number of children and abortions, breastfeeding time, and contraceptive use were observed between these groups. Conclusions: These findings underscore the importance of targeted interventions and personalized strategies to address specific risk factors and enhance preventive measures for individuals at risk.