Background: The reasons for the increasing breast cancer incidence in indigenous Maori compared to non-Maori\r\nNew Zealand women are unknown. The aim of this study was to assess the association of an index of combined\r\nhealthy lifestyle behaviours with the risk of breast cancer in Maori and non-Maori women.\r\nMethods: A population-based caseââ?¬â??control study was conducted, including breast cancer cases registered in New\r\nZealand from 2005ââ?¬â??2007. Controls were matched by ethnicity and 5-year age bands. A healthy lifestyle index score\r\n(HLIS) was generated for 1093 cases and 2118 controls, based on public health and cancer prevention recommendations.\r\nThe HLIS was constructed from eleven factors (limiting red meat, cream, and cheese; consuming more white meat, fish,\r\nfruit and vegetables; lower alcohol consumption; not smoking; higher exercise levels; lower body mass index; and longer\r\ncumulative duration of breastfeeding). Equal weight was given to each factor. Logistic regression was used to estimate\r\nthe associations between breast cancer and the HLIS for each ethnic group stratified by menopausal status.\r\nResults: Among Maori, the mean HLIS was 5.00 (range 1ââ?¬â??9); among non-Maori the mean was 5.43 (range 1.5-10.5). There\r\nwas little evidence of an association between the HLIS and breast cancer for non-Maori women. Among postmenopausal\r\nMaori, those in the top HLIS tertile had a significantly lower odds of breast cancer (Odds Ratio 0.47, 95% confidence\r\ninterval 0.23-0.94) compared to those in the bottom tertile.\r\nConclusion: These findings suggest that healthy lifestyle recommendations could be important for reducing breast\r\ncancer risk in postmenopausal Maori women.
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