Adherence to the South African Food Based Dietary Guidelines may reduce breast cancer risk in black South African women: The SABC study.

Objective To determine the level of adherence, and to assess the association between higher adherence to the South African Food Based Dietary Guidelines (SAFBDGs) and breast cancer risk. Design Population-based, case-control study (the South African Breast Cancer study), matched on age and demographic settings. Validated questionnaires were used to collect dietary and epidemiological data.To assess adherence to the SAFBDGs, a 9-point adherence score (out of 11 guidelines) was developed, using suggested adherence cut-points for scoring each recommendation (0 and 1). When the association between higher adherence to the SAFBDGs and breast cancer risk were assessed, data driven tertiles among controls were used as cut-points for scoring each recommendation (0, 0.5 and 1). Odds ratios and 95% confidence intervals were estimated using multivariate logistic regression models. Setting Soweto, South Africa. Population Black urban women, 396 breast cancer cases and 396 controls. Results After adjusting for potential confounders, higher adherence (>5.0) to the SAFBDGs vs. lower adherence ( 4.5) of the SAFBDGs. Conclusions Higher adherence to the SAFBDGs may reduce breast cancer risk in this population.The concerning low levels of adherence to the SAFBDGs emphasize the need for education campaigns and to create healthy food environments in South Africa to increase adherence to the SAFBDGs.