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Dietary insulin index and load with risk of breast cancer in a case-control study.

Akbari et al,

2021

Int J Clin Pract

A case-control study of 250 breast cancer patients and 250 controls found that women consuming diets that trigger higher insulin responses after meals—measured by dietary insulin index (DII) and dietary insulin load (DIL)—had 46-87% increased odds of breast cancer compared to those with lower scores. These high insulin-stimulating diets were more common among overweight women and those with family histories of cancer, suggesting that dietary patterns affecting blood insulin levels may be a modifiable risk factor for breast cancer. The findings support reducing consumption of foods that spike insulin levels—typically refined carbohydrates and high-glycemic foods—as a potential dietary strategy for breast cancer prevention, particularly for women at higher risk.

Mendelian randomization analyses of 23 known and suspected risk factors and biomarkers for breast cancer overall and by molecular subtypes.

Chen et al,

2022

Int J Cancer

A comprehensive two-sample Mendelian randomization study using Breast Cancer Association Consortium data examined potential causal associations of 23 risk factors and biomarkers with breast cancer risk overall and by molecular subtypes, identifying significant associations for 15 traits including reproductive factors (age at menarche/menopause), anthropometric measures (BMI, waist-to-hip ratio, height), lifestyle factors (physical activity, smoking, sleep duration, chronotype), and six blood biomarkers (estrogens, IGF-1, SHBG, telomere length, HDL-cholesterol, fasting insulin). Notably, the study revealed heterogeneous subtype-specific associations: increased SHBG reduced ER+ breast cancer risk (OR=0.83; 95% CI: 0.73-0.94) but elevated risk for ER- (OR=1.12) and triple-negative cancers (OR=1.19, p-heterogeneity=0.01), while higher fasting insulin increased HER2-negative cancer risk (OR=1.94; 95% CI: 1.18-3.20) but reduced HER2-enriched cancer risk (OR=0.46; 95% CI: 0.26-0.81, p-heterogeneity=0.006). These findings—consistent across sensitivity analyses—provide strong genetic evidence for causal relationships between multiple modifiable and biological risk factors and breast cancer, while revealing that SHBG and insulin have paradoxical opposite effects on different molecular subtypes, suggesting distinct etiologic pathways for ER+/ER- and HER2+/HER2- breast cancers that may require subtype-specific prevention strategies.

Bisphenol A exposure through receipt handling and its association with insulin resistance among female cashiers

Lee et al,

2018

Environ Int

A study of 54 female cashiers in South Korea found that handling thermal paper receipts without gloves doubled their urinary BPA levels during work shifts, but wearing gloves completely prevented this increase in exposure. Higher BPA levels were associated with elevated fasting insulin and insulin resistance, markers of metabolic dysfunction that can lead to diabetes and cardiovascular disease. The findings demonstrate that cashiers face significant occupational BPA exposure from receipt handling and that simple protective measures like wearing gloves can effectively eliminate this exposure route, offering an immediate and practical intervention to protect workers’ health.

The Impact of Obesity on Breast Cancer.

Argolo et al,

2018

Curr Oncol Rep

Obesity is now recognized as a leading preventable cause of cancer, particularly postmenopausal estrogen receptor-positive breast cancer, and is associated with worse outcomes across all breast cancer subtypes. Multiple interconnected mechanisms link obesity to breast cancer, including elevated estrogen levels, altered hormone-like molecules from fat tissue (leptin and adiponectin), disrupted insulin signaling, changes in gut bacteria, and chronic inflammation throughout the body. Understanding these complex pathways could lead to new prevention and treatment strategies to reduce the growing burden of obesity-related breast cancers worldwide.

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