Aktuelle Ernährungsmedizin 2021; 46(01): 27-35
DOI: 10.1055/a-1176-9682
Übersicht

Einfluss der mediterranen Ernährung auf das Brustkrebsrisiko: Welche Rolle spielt das Mikrobiom?

Effect of the Mediterranean Diet on Breast Cancer Risk: What Role does the Microbiome Play?
Benjamin Seethaler*
1   Universität Hohenheim, Institut für Ernährungsmedizin, Stuttgart
,
Michelle Beutel*
1   Universität Hohenheim, Institut für Ernährungsmedizin, Stuttgart
,
Maryam Basrai
1   Universität Hohenheim, Institut für Ernährungsmedizin, Stuttgart
,
Marion Kiechle
2   Technische Universität München, Klinik und Poliklinik für Frauenheilkunde, München
,
Stephan C. Bischoff
1   Universität Hohenheim, Institut für Ernährungsmedizin, Stuttgart
› Author Affiliations

Zusammenfassung

Zahlreiche Studien haben gezeigt, dass die mediterrane Ernährung vor ernährungsmitbedingten Erkrankungen wie Übergewicht, Diabetes mellitus Typ 2, Herz-Kreislauf-Erkrankungen und verschiedenen Krebsentitäten, einschließlich Brustkrebs, schützen kann. Die zugrunde liegenden Mechanismen sind jedoch weitgehend unklar. Bislang wurde vor allem die Rolle antiinflammatorischer Fettsäuren diskutiert. In der vorliegenden Übersichtsarbeit soll am Beispiel des genetisch determinierten sowie des sporadischen Brustkrebses der Frage nachgegangen werden, welche Rolle das Darmmikrobiom spielen könnte, dessen Zusammensetzung und Funktion durch die mediterrane Ernährung verändert wird.

Abstract

Numerous studies have shown that the Mediterranean diet can protect against diet-related diseases such as obesity, type 2 diabetes mellitus, cardiovascular diseases and various cancer entities, including breast cancer. However, the underlying mechanisms are largely unclear. So far, mainly the role of anti-inflammatory fatty acids has been discussed. In the present review, using the example of genetically determined and sporadic breast cancer, the question will be addressed, what role the gut microbiome plays, since it’s composition and function is modulated by the Mediterranean diet.

* Diese Autoren haben zu gleichen Teilen zu der Arbeit beigetragen.




Publication History

Article published online:
15 February 2021

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  • Literatur

  • 1 Willett WC, Sacks F, Trichopoulou A. et al. Mediterranean diet pyramid: a cultural model for healthy eating. Am J Clin Nutr 1995; 61: 1402S-1406S
  • 2 Keys A, Menotti A, Karvonen MJ. et al. The diet and 15-year death rate in the seven countries study. Am J Epidemiol 1986; 124: 903-915
  • 3 Bach-Faig A, Berry EM, Lairon D. et al. Mediterranean diet pyramid today. Science and cultural updates. Public Health Nutr 2011; 14: 2274-2284
  • 4 Anderson JJB, Nieman DC. Diet Quality – The Greeks Had It Right!. Nutrients 2016; 8: 1-7
  • 5 Trichopoulou A, Costacou T, Bamia C. et al. Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med 2003; 348: 2599-2608
  • 6 Trichopoulou A, Bamia C, Trichopoulos D. Anatomy of health effects of Mediterranean diet: Greek EPIC prospective cohort study. The BMJ 2009; 338: 1-8
  • 7 Sofi F, Macchi C, Abbate R. et al. Mediterranean diet and health status: an updated meta-analysis and a proposal for a literature-based adherence score. Public Health Nutr 2013; 17: 2769-2782
  • 8 Dinu M, Pagliai G, Casini A. et al. Mediterranean diet and multiple health outcomes: an umbrella review of meta-analyses of observational studies and randomised trials. Eur J Clin Nutr 2017; 72: 30-43
  • 9 de Lorgeril M, Salen P, Martin J-L. et al. Mediterranean Dietary Pattern in a Randomized Trial: Prolonged Survival and Possible Reduced Cancer Rate. Arch Intern Med 1998; 158: 1181-1187
  • 10 Schwingshackl L, Schwedhelm C, Galbete C. et al. Adherence to Mediterranean Diet and Risk of Cancer: An Updated Systematic Review and Meta-Analysis. Nutrients 2017; 9: 1-24
  • 11 La Vecchia C. Mediterranean diet and cancer. Public Health Nutr 2004; 7: 965-968
  • 12 Benetou V, Trichopoulou A, Orfanos P. et al. Conformity to traditional Mediterranean diet and cancer incidence: the Greek EPIC cohort. Br J Cancer 2008; 99: 191-195
  • 13 Trichopoulou A, Lagiou P, Kuper H. et al. Cancer and Mediterranean Dietary Traditions. Cancer Epidemiol Prev Biomark 2000; 9: 869-873
  • 14 Wu AH, Yu MC, Tseng C-C. et al. Dietary patterns and breast cancer risk in Asian American women. Am J Clin Nutr 2009; 89: 1145-1154
  • 15 Toledo E, Salas-Salvadó J, Donat-Vargas C. et al. Mediterranean Diet and Invasive Breast Cancer Risk Among Women at High Cardiovascular Risk in the PREDIMED Trial: A Randomized Clinical Trial. JAMA Intern Med 2015; 175: 1752-1760
  • 16 Bloomfield HE, Koeller E, Greer N. et al. Effects on Health Outcomes of a Mediterranean Diet With No Restriction on Fat Intake: A Systematic Review and Meta-analysis. Ann Intern Med 2016; 165: 491-500
  • 17 Del Chierico F, Vernocchi P, Dallapiccola B. et al. Mediterranean Diet and Health: Food Effects on Gut Microbiota and Disease Control. Int J Mol Sci 2014; 15: 11678-11699
  • 18 Giacosa A, Barale R, Bavaresco L. et al. Cancer prevention in Europe: the Mediterranean diet as a protective choice. Eur J Cancer Prev 2012; 22: 90-95
  • 19 Heath AK. Nutrient-wide association study of 92 foods and nutrients and breast cancer risk. Breast Cancer Res 2020; 22: 5
  • 20 Robert Koch-Institut. Bericht zum Krebsgeschehen in Deutschland. 2016. www.bundesgesundheitsministerium.de/fileadmin/Dateien/3_Downloads/K/Krebs/Krebsgeschehen_RKI.pdf Stand: 27.05.2020
  • 21 Arbeitsgemeinschaft Gynäkologische Onkologie e. V. (AGO). Brustkrebs Patientenratgeber zu den AGO Empfehlungen (2019). Im Internet: Stand: 27.05.2020 www.brustkrebsdeutschland.de/wp-content/uploads/2019/04/AGO_Brustkrebs_2019_Brustkrebs-Deutschland.pdf
  • 22 Leitlinienprogramm Onkologie. Interdisziplinäre S3-Leitlinie für die Früherkennung, Diagnostik, Therapie und Nachsorge des Mammakarzinoms. (Februar 2020). Im Internet: Stand: 27.05.20 www.leitlinienprogramm-onkologie.de/fileadmin/user_upload/Downloads/Leitlinien/Mammakarzinom_4_0/Version_4.3/LL_Mammakarzinom_Langversion_4.3.pdf
  • 23 The Endogenous Hormones and Breast Cancer Collaborative Group. Endogenous Sex Hormones and Breast Cancer in Postmenopausal Women: Reanalysis of Nine Prospective Studies. J Natl Cancer Inst 2002; 94: 606-616
  • 24 Woolcott CG, Shvetsov YB, Stanczyk FZ. et al. Plasma sex hormone concentrations and the risk of breast cancer in postmenopausal women: the Multiethnic Cohort Study. Endocr Relat Cancer 2010; 17: 125-134
  • 25 Kwa M, Plottel CS, Blaser MJ. et al. The Intestinal Microbiome and Estrogen Receptor-Positive Female Breast Cancer. J Natl Cancer Inst 2016; 108: 1-10
  • 26 Berrino F, Villarini A, Petris MD. et al. Adjuvant Diet to Improve Hormonal and Metabolic Factors Affecting Breast Cancer Prognosis. Ann N Y Acad Sci 2006; 1089: 110-118
  • 27 Egli A. Das Mikrobiom – ein neues Organ?. Rosenfluh Publ AG 2016; 16: 20-26
  • 28 Flint HJ, Scott KP, Louis P. et al. The role of the gut microbiota in nutrition and health. Nat Rev Gastroenterol Hepatol 2012; 9: 577-589
  • 29 Gentile CL, Weir TL. The gut microbiota at the intersection of diet and human health. Science 2018; 362: 776-780
  • 30 Ercolini D, Fogliano V. Food Design To Feed the Human Gut Microbiota. J Agric Food Chem 2018; 66: 3754-3758
  • 31 Braakhuis AJ, Campion P, Bishop KS. Reducing Breast Cancer Recurrence: The Role of Dietary Polyphenolics. Nutrients 2016; 8: 1-15
  • 32 Heiman ML, Greenway FL. A healthy gastrointestinal microbiome is dependent on dietary diversity. Mol Metab 2016; 5: 317-320
  • 33 Valdes AM, Walter J, Segal E. et al. Role of the gut microbiota in nutrition and health. The BMJ 2018; 361: 36-44
  • 34 Le Chatelier E, Nielsen T, Qin J. et al. Richness of human gut microbiome correlates with metabolic markers. Nature 2013; 500: 541-546
  • 35 Duda-Chodak A, Tarko T, Satora P. et al. Interaction of dietary compounds, especially polyphenols, with the intestinal microbiota: a review. Eur J Nutr 2015; 54: 325-341
  • 36 Ríos-Covián D, Ruas-Madiedo P, Margolles A. et al. Intestinal Short Chain Fatty Acids and their Link with Diet and Human Health. Front Microbiol 2016; 7: 1-9
  • 37 Peng M, Biswas D. Short chain and polyunsaturated fatty acids in host gut health and foodborne bacterial pathogen inhibition. Crit Rev Food Sci Nutr 2017; 57: 3987-4002
  • 38 Rowland I, Gibson G, Heinken A. et al. Gut microbiota functions: metabolism of nutrients and other food components. Eur J Nutr 2018; 57: 1-24
  • 39 Klement RJ, Pazienza V. Impact of Different Types of Diet on Gut Microbiota Profiles and Cancer Prevention and Treatment. Medicina (Mex) 2019; 55: 1-10
  • 40 Dandamudi A, Tommie J, Nommsen-Rivers L. et al. Dietary Patterns and Breast Cancer Risk: A Systematic Review. Anticancer Res 2018; 38: 3209-3222
  • 41 Schwingshackl L, Hoffmann G. Does a Mediterranean-Type Diet Reduce Cancer Risk?. Curr Nutr Rep 2016; 5: 9-17
  • 42 Toklu H, Nogay NH. Effects of dietary habits and sedentary lifestyle on breast cancer among women attending the oncology day treatment center at a state university in Turkey. Niger J Clin Pract 2018; 21: 1576-1584
  • 43 La Vecchia C, Bosetti C. Diet and cancer risk in Mediterranean countries: open issues. Public Health Nutr 2006; 9: 1077-1082
  • 44 Zheng J-S, Hu X-J, Zhao Y-M. et al. Intake of fish and marine n-3 polyunsaturated fatty acids and risk of breast cancer: meta-analysis of data from 21 independent prospective cohort studies. BMJ 2013; 346: 1-10
  • 45 Surh Y-J. Cancer chemoprevention with dietary phytochemicals. Nat Rev Cancer 2003; 3: 768-780
  • 46 Toufektsian M-C, Salen P, Laporte F. et al. Dietary Flavonoids Increase Plasma Very Long-Chain (n-3) Fatty Acids in Rats. J Nutr  2011; 141: 37-41
  • 47 de Lorgeril M, Salen P, Martin J-L. et al. Interactions of wine drinking with omega-3 fatty acids in patients with coronary heart disease: A fish-like effect of moderate wine drinking. Am Heart J 2008; 155: 7
  • 48 di Giuseppe R, de Lorgeril M, Salen P. et al. Alcohol consumption and n-3 polyunsaturated fatty acids in healthy men and women from 3 European populations. Am J Clin Nutr 2009; 89: 354-362
  • 49 de Lorgeril M, Salen P. New insights into the health effects of dietary saturated and omega-6 and omega-3 polyunsaturated fatty acids. BMC Med 2012; 10: 1-5
  • 50 Eliassen AH, Liao X, Rosner B. et al. Plasma carotenoids and risk of breast cancer over 20 y of follow-up. Am J Clin Nutr 2015; 101: 1197-1205
  • 51 Bondonno NP, Dalgaard F, Kyrø C. et al. Flavonoid intake is associated with lower mortality in the Danish Diet Cancer and Health Cohort. Nat Commun 2019; 10: 1-10
  • 52 Pasanisi P, Bruno E, Venturelli E. et al. A Dietary Intervention to Lower Serum Levels of IGF-I in BRCA Mutation Carriers. Cancers 2018; 10: 1-14
  • 53 Bruno E, Manoukian S, Venturelli E. et al. Adherence to Mediterranean Diet and Metabolic Syndrome in BRCA Mutation Carriers. Integr Cancer Ther 2018; 17: 153-160
  • 54 Nkondjock A, Ghadirian P. Diet quality and BRCA-associated breast cancer risk. Breast Cancer Res Treat 2007; 103: 361-369
  • 55 David LA, Maurice CF, Carmody RN. et al. Diet rapidly and reproducibly alters the human gut microbiome. Nature 2014; 505: 559-563
  • 56 Johnson AJ, Vangay P, Al-Ghalith GA. et al. Daily Sampling Reveals Personalized Diet-Microbiome Associations in Humans. Cell Host Microbe 2019; 25: 789-802.e5
  • 57 Gutiérrez-Díaz I, Fernández-Navarro T, Sánchez B. et al. Mediterranean diet and faecal microbiota: a transversal study. Food Funct 2016; 7: 2347-2356
  • 58 Mitsou EK, Kakali A, Antonopoulou S. et al. Adherence to the Mediterranean diet is associated with the gut microbiota pattern and gastrointestinal characteristics in an adult population. Br J Nutr 2017; 117: 1645-1655
  • 59 Garcia-Mantrana I, Selma-Royo M, Alcantara C. et al. Shifts on Gut Microbiota Associated to Mediterranean Diet Adherence and Specific Dietary Intakes on General Adult Population. Front Microbiol 2018; 9: 1-11
  • 60 Filippis FD, Pellegrini N, Vannini L. et al. High-level adherence to a Mediterranean diet beneficially impacts the gut microbiota and associated metabolome. Gut 2016; 65: 1812-1821
  • 61 Gutiérrez-Díaz I, Fernández-Navarro T, Salazar N. et al. Adherence to a Mediterranean Diet Influences the Fecal Metabolic Profile of Microbial-Derived Phenolics in a Spanish Cohort of Middle-Age and Older People. J Agric Food Chem 2016; 65: 586-595
  • 62 Soverini M, Turroni S, Biagi E. et al. Variation of Carbohydrate-Active Enzyme Patterns in the Gut Microbiota of Italian Healthy Subjects and Type 2 Diabetes Patients. Front Microbiol 2017; 8: 1-8
  • 63 Bowyer RCE, Jackson MA, Pallister T. et al. Use of dietary indices to control for diet in human gut microbiota studies. Microbiome 2018; 6: 1-11
  • 64 De Filippo C, Cavalieri D, Di Paola M. et al. Impact of diet in shaping gut microbiota revealed by a comparative study in children from Europe and rural Africa. Proc Natl Acad Sci U S A 2010; 107: 14691-14696
  • 65 Graf D, Di Cagno R, Fåk F. et al. Contribution of diet to the composition of the human gut microbiota. Microb Ecol Health Dis 2015; 26: 1-11
  • 66 Singh RK, Chang H-W, Yan D. et al. Influence of diet on the gut microbiome and implications for human health. J Transl Med 2017; 15: 1-17
  • 67 Castro-Barquero S, Lamuela-Raventós RM, Doménech M. et al. Relationship between Mediterranean Dietary Polyphenol Intake and Obesity. Nutrients 2018; 10: 1-13
  • 68 Lopez-Legarrea P, Fuller NR, Zulet MA. et al. The Influence of Mediterranean, Carbohydrate and High Protein Diets on Gut Microbiota Composition in the Treatment of Obesity and Associated Inflammatory State. Asia Pac J Clin Nutr 2014; 23: 360-368
  • 69 Zhu J, Liao M, Yao Z. et al. Breast cancer in postmenopausal women is associated with an altered gut metagenome. Microbiome 2018; 6: 1-13
  • 70 Velicer CM, Heckbert SR, Lampe JW. et al. Antibiotic Use in Relation to the Risk of Breast Cancer. JAMA 2004; 291: 827-835
  • 71 Braakhuis A, Campion P, Bishop K. The Effects of Dietary Nutrition Education on Weight and Health Biomarkers in Breast Cancer Survivors. Med Sci 2017; 5: 1-8
  • 72 de Lorgeril M, Salen P. Helping women to good health: breast cancer, omega-3/omega-6 lipids, and related lifestyle factors. BMC Med 2014; 12: 1-5
  • 73 Haro C, Garcia-Carpintero S, Alcala-Diaz JF. et al. The gut microbial community in metabolic syndrome patients is modified by diet. J Nutr Biochem 2016; 27: 27-31
  • 74 Dao MC, Everard A, Aron-Wisnewsky J. et al. Akkermansia muciniphila and improved metabolic health during a dietary intervention in obesity: relationship with gut microbiome richness and ecology. Gut 2016; 65: 426-436
  • 75 Carruba G, Granata OM, Pala V. et al. A Traditional Mediterranean Diet Decreases Endogenous Estrogens in Healthy Postmenopausal Women. Nutr Cancer 2006; 56: 253-259
  • 76 Sonestedt E, Wirfält E. Enterolactone and breast cancer: methodological issues may contribute to conflicting results in observational studies. Nutr Res 2010; 30: 667-677
  • 77 Shapira I, Sultan K, Lee A. et al. Evolving Concepts: How Diet and the Intestinal Microbiome Act as Modulators of Breast Malignancy. ISRN Oncol 2013; 2013: 1-10
  • 78 Fuhrman BJ, Feigelson HS, Flores R. et al. Associations of the Fecal Microbiome With Urinary Estrogens and Estrogen Metabolites in Postmenopausal Women. J Clin Endocrinol Metab 2014; 99: 4632-4640
  • 79 Dallal CM, Tice JA, Buist DSM. et al. Estrogen metabolism and breast cancer risk among postmenopausal women: a case-cohort study within B~FIT. Carcinogenesis 2014; 35: 346-355
  • 80 Plottel CS, Blaser MJ. Microbiome and Malignancy. Cell Host Microbe 2011; 10: 324-335
  • 81 Fernández MF, Reina-Pérez I, Astorga JM. et al. Breast Cancer and Its Relationship with the Microbiota. Int J Environ Res Public Health 2018; 15: 1-20
  • 82 Shahanavaj K, Gil-Bazo I, Castiglia M. et al. Cancer and the microbiome: potential applications as new tumor biomarker. Expert Rev Anticancer Ther 2014; 15: 1-14
  • 83 Dzutsev A, Goldszmid RS, Viaud S. et al. The role of the microbiota in inflammation, carcinogenesis, and cancer therapy. Eur J Immunol 2014; 45: 17-31
  • 84 Soldati L, Di Renzo L, Jirillo E. et al. The influence of diet on anti-cancer immune responsiveness. J Transl Med 2018; 16: 1-18
  • 85 Ostan R, Lanzarini C, Pini E. et al. Inflammaging and Cancer: A Challenge for the Mediterranean Diet. Nutrients 2015; 7: 2589-2621
  • 86 Monagas M, Khan N, Andrés-Lacueva C. et al. Dihydroxylated phenolic acids derived from microbial metabolism reduce lipopolysaccharide-stimulated cytokine secretion by human peripheral blood mononuclear cells. Br J Nutr 2009; 102: 201-206
  • 87 Deiana M, Serra G, Corona G. Modulation of intestinal epithelium homeostasis by extra virgin olive oil phenolic compounds. Food Funct 2018; 9: 4085-4099
  • 88 Rea D, Coppola G, Palma G. et al. Microbiota effects on cancer: from risks to therapies. Oncotarget 2018; 9: 17915-17927
  • 89 Biolato M, Manca F, Marrone G. et al. Intestinal permeability after Mediterranean diet and low-fat diet in non-alcoholic fatty liver disease. World J Gastroenterol 2019; 25: 509-520
  • 90 Guerreiro CS, Calado Â, Sousa J. et al. Diet, Microbiota, and Gut Permeability – The Unknown Triad in Rheumatoid Arthritis. Front Med 2018; 5. Epub ahead of print 14 December DOI: 10.3389/fmed.2018.00349.
  • 91 Zhang LS, Davies SS. Microbial metabolism of dietary components to bioactive metabolites: opportunities for new therapeutic interventions. Genome Med 2016; 8: 1-18
  • 92 Thirunavukkarasan M, Wang C, Rao A. et al. Short-chain fatty acid receptors inhibit invasive phenotypes in breast cancer cells. PLoS ONE 2017; 12: 1-16
  • 93 Salimi V, Shahsavari Z, Safizadeh B. et al. Sodium butyrate promotes apoptosis in breast cancer cells through reactive oxygen species (ROS) formation and mitochondrial impairment. Lipids Health Dis 2017; 16: 1-11
  • 94 Kiechle M, Engel C, Berling A. et al. Effects of lifestyle intervention in BRCA1/2 mutation carriers on nutrition, BMI, and physical fitness (LIBRE study): study protocol for a randomized controlled trial. Trials 2016; 17: 1-9