Recent diet and breast cancer risk: The California Teachers Study (USA)
ABSTRACT The impact, if any, on breast cancer risk of modifying adult dietary intake is an area of much interest. We take the opportunity to address the relationship between recent adult diet and breast cancer risk during the first two years of follow-up of the large California Teachers Study cohort.
Of the 111.526 at-risk cohort members who resided in California and completed a baseline dietary assessment, 711 were diagnosed with invasive breast cancer after joining the cohort and before January 1998. Average daily nutrient intake was computed based on a food-frequency questionnaire assessing usual dietary intake and portion size during the year prior to joining the cohort. Incident breast cancers were identified through the California Cancer Registry and follow-up for death and confirmation of continued California residence utilized a variety of data sources. Cox proportional hazards models were used to calculate relative hazards.
The following components of recent dietary intake were not associated with breast cancer risk: energy, fat, fiber, antioxidant vitamins, and phytoestrogens. Only recent average alcohol consumption of 20 or more grams per day (approximately two or more glasses of wine) was associated with increased risk (RR= 1.5, 95% CI: 1.2-2.0 compared to non-drinkers; P(trend) = 0.01 across quintiles).
With the exception of alcohol consumption, this study provides no evidence that recent macro- or micronutrient composition of adult diet is likely to have a direct effect on breast cancer risk. Some reduction of alcohol consumption among those consuming more than one drink per day may be beneficial.
Full-textDOI: · Available from: Pamela L Horn-Ross, Aug 21, 2015
- SourceAvailable from: Suzanne C Ho
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- "Epidemiological studies have evaluated intake of total fiber in relation to overall breast cancer risk in a pooled analysis of 12 case–control studies conducted before 1986 (Howe et al., 1990), 12 case–control studies published recently (Van't Veer et al., 1990; Graham et al., 1991; Baghurst and Rohan, 1994; Yuan et al., 1995; Franceschi et al., 1996; Freudenheim et al., 1996; De Stefani et al., 1997a; Potischman et al., 1999; Ronco et al., 1999; Adzersen et al., 2003; Bonilla-Fernandez et al., 2003; Shaham et al., 2006) and 17 cohort studies (Graham et al., 1992; Willett et al., 1992; Rohan et al., 1993; Kushi et al., 1995; Jarvinen et al., 1997; Verhoeven et al., 1997; Horn-Ross et al., 2002; Terry et al., 2002; Cho et al., 2003; Holmes et al., 2004; Mattisson et al., 2004; Giles et al., 2006; Cade et al., 2007; Lajous et al., 2008; Suzuki et al., 2008; Park et al., 2009; Wen et al., 2009); however, the results are inconsistent. Recent studies have raised the hypothesis that the association of dietary factors with breast cancer may differ by hormone receptor status (Colditz et al., 2004; Fung et al., 2005; Zhang et al., 2005). "
ABSTRACT: There is few data on the association between dietary fiber intake and estrogen receptor (ER)/progesterone receptor (PR)-defined breast cancer risk. The present study aimed to investigate the associations between total dietary fiber and dietary fiber fractions intake and breast cancer risk by ER and PR status in a hospital-based case-control study among Chinese women. Four hundred and thirty-eight cases with primary breast cancer were consecutively recruited from June 2007 to August 2008 and frequency matched to 438 controls by age (5-year interval) and residence (rural/urban). A validated food frequency questionnaire was used to assess the dietary intake through a face-to-face interview. Unconditional logistic regression models were used to estimate odds ratios (ORs) and 95% confidence interval (CI) after adjusting for various potential confounders. A statistically significant inverse association was found between total dietary fiber and fiber fractions intake and breast cancer risk. The adjusted ORs (95% CIs) for the highest versus the lowest quartile of intake were 0.31 (0.20-0.47) for total dietary fiber, 0.73 (0.48-1.11) for soy fiber, 0.48 (0.22-0.97) for vegetable fiber and 0.54 (0.31-0.92) for fruit fiber. No association was observed for cereal fiber intake and risk. An inverse association between dietary fiber intake and breast cancer risk was observed in ER+, ER-, PR+, ER+PR+ and ER-PR+ tumors. Our results suggest that consumption of total dietary fiber and fiber from vegetable and fruit was inversely associated with breast cancer risk. These inverse associations were more prominent in some subtypes of ER and PR breast cancers.European journal of clinical nutrition 05/2011; 65(8):929-36. DOI:10.1038/ejcn.2011.57 · 2.95 Impact Factor
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- "Postmenopausal: 0.72 (0.51-1.02) Age, education, parity, BMI, benign breast disease, family history of BC, energy intake, and menarche Horn-Ross et al, 2002  Prospective cohort of 111 526 American women, 711 cases (pre-and postmenopausal), 222 249 person-years of follow-up MAT, SECO MAT: 23 lg/d SECO: 85lg/d MAT: 1.1 (0.8-1.4) SECO 1.4 (1.0-1.8) "
ABSTRACT: Phytoestrogens are natural estrogen-like plant substances. The possible protective effect of phytoestrogens on cancer risk, particularly on hormone-related cancers, has been the focus of many epidemiologic studies during the last 2 decades. We performed a qualitative review of the epidemiologic literature published in the English language and identified on MEDLINE from 1966 until 24 September 2006 on (1) dietary intake of soy, isoflavones, or lignans; (2) urinary excretion of isoflavones or lignans; (3) blood measurements of isoflavones or lignans in relation to breast, prostate, and endometrial cancer risk. Epidemiologic data do seem to support a small protective effect of isoflavones on breast cancer risk, although timing of exposure and the mechanisms of isoflavones at physiologic levels need to be further explored. The epidemiologic evidence to date is conflicting regarding lignans and breast cancer, but recent studies suggest that the effect may be restricted to premenopausal women, differ by estrogen receptor status, and be modified by diet-gene interactions. The 3 case-control studies on dietary intake of phytoestrogens and endometrial cancer risk have provided some evidence for a protective effect, but more prospective data are needed. There is some epidemiologic evidence for a protective effect of soy or isoflavones on prostate cancer, but corresponding data for lignans are inconclusive. Recent data indicate that diet-gene interactions may modify the effect of phytoestrogens on prostate cancer risk. Prospective studies on dietary lignans in relation to prostate cancer risk are lacking.Nutrition Research 12/2006; 26(12):609-619. DOI:10.1016/j.nutres.2006.09.020 · 2.59 Impact Factor
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ABSTRACT: Although epidemiologic studies have shown an inverse association between isoflavones and breast cancer risk, little evidence for a dose–response relation is available. We conducted hospital-based case–control studies of patients aged 20–74years with primary, incident, histologically confirmed invasive breast cancer, and matched controls from medical checkup examinees in Nagano, Japan and from cancer-free patients in São Paulo, Brazil. A total of 850 pairs (390 Japanese, 81 Japanese Brazilians and 379 non-Japanese Brazilians) completed validated food frequency questionnaires. The odds ratio of breast cancer according to isoflavone intake was estimated using a conditional logistic regression model. We found a statistically significant inverse association between isoflavone intake and the risk of breast cancer for Japanese Brazilians and non-Japanese Brazilians. For Japanese, a non-significant inverse association was limited to postmenopausal women. In the three populations combined, breast cancer risk linearly decreased from ‘no’ to ‘moderate’ isoflavone intake and thereafter leveled off. Compared to non-consumers, adjusted odds ratios (95% confidence interval) for consumers in increasing quintile intake categories (median intake in each category: 8.7, 23.1, 33.8, 45.7, and 71.3mg/day) were 0.69 (0.44–1.09), 0.54 (0.31–0.94), 0.45 (0.26–0.77), 0.34 (0.19–0.62), and 0.43 (0.24–0.76), respectively. Overall, we found an inverse association between dietary isoflavone intake and risk of breast cancer. Our finding suggests a risk-reducing rather than risk-enhancing effect of isoflavones on breast cancer within the range achievable from dietary intake alone. In addition, women may benefit from risk reduction if they consume at least moderate amounts of isoflavones.Breast Cancer Research and Treatment 07/2009; 116(2):401-411. DOI:10.1007/s10549-008-0168-1 · 4.20 Impact Factor