Diet in the epidemiology of endometrial cancer in Western New York (United States)
ABSTRACT Objectives: We examined diet and risk of endometrial cancer among women in the Western New York Diet Study (1986–1991).
Methods: Self-reported frequency of use of 172 foods and beverages during the 2 years before the interview and other relevant data were collected by detailed interviews from 232 endometrial cancer cases and 639 controls, frequency-matched for age and county of residence. Odds ratios (OR) and 95% confidence intervals (CI) were estimated by unconditional logistic regression, adjusting for age, education, body mass index (BMI), smoking history, hypertension, diabetes, age at menarche, parity, oral contraceptive use, menopausal status, menopausal estrogen use, and energy.
Results: Risks were reduced for women in the highest quartiles of intake of protein (OR 0.4, 95% CI: 0.2–0.9), dietary fiber (OR 0.5, 95% CI: 0.3–1.0), phytosterols (OR 0.6, 95% CI: 0.3–1.0), vitamin C (OR 0.5, 95% CI: 0.3–0.8) folate (OR 0.4, 95% CI: 0.2–0.7), alpha-carotene (OR 0.6, 95% CI: 0.4–1.0), beta-carotene (OR 0.4, 95% CI: 0.2–0.6), lycopene (OR 0.6, 95% CI: 0.4–1.0), lutein + zeaxanthin (OR 0.3, 95% CI: 0.2–0.5) and vegetables (OR 0.5, 95% CI: 0.3–0.9), but unrelated to energy (OR 0.9, 95% CI: 0.6–1.5) or fat (OR 1.6, 95% CI: 0.7–3.4).
Conclusions: Our results support previous findings of reduced endometrial cancer risks associated with a diet high in plant foods.
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ABSTRACT: Given the international variations in breast cancer incidence rates and the changes in breast cancer incidence among migrant populations, it has been hypothesized that diet is a factor influencing risk of this disease. Many studies indicate that a diet high in vegetables and fruits may protect against breast cancer. We conducted a case-control study of diet, including the intake of non-food supplements, and premenopausal breast cancer risk. We evaluated in detail usual intake of vegetables and fruits (each measured as the total reported grams consumed for all queried vegetables and fruit), vitamins C and E, folic acid, individual carotenoids, and dietary fiber with its components. Case patients (n=297) were identified through pathology records from hospitals in Erie and Niagara counties in western New York. They consisted of premenopausal women 40 years of age or oder who were diagnosed with breast cancer from November 1986 through April 1991. Control subjects (n=311), frequency-matched to case patients on the basis of age and county of residence, were randomly selected from New York State Department of Motor Vehicles records. In-person interviews included detailed reports of usual diet in the period 2 years before the interview. Unconditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). There was a reduction in risk associated with high intake of several nutrients. With the lowest quartile of intake as the referent, adjusted ORs for the highest quartile of intake for specific nutrients were as follows: vitamin C (OR=0.53; 95% CI=0.33-0.86), alpha-tocopheral (OR=0.55; 95% CI=0.34-0.88), folic acid (OR=0.50; 95% CI=0.31-0.82), alpha-carotene (OR=0.67; 95% CI=0.42-1.08) and beta-carotene (OR=0.46; 95% CI=0.28-0.74), lutein + zeaxanthin (OR=0.47; 95% CI=0.28.0-77), and dietary fiber from vegetables and fruits (OR=0.48; 95% CI=0.30-0.78). No association with risk was found for beta-cryptoxanthin, lycopene, or grain fiber. Fruits were weakly associated with a reduction in risk (fourth quartile OR=0.67; 95% CI=0.42-1.09). No association was found between breast cancer risk and intake of vitamins C and E and folic acid taken as supplements. A strong inverse association between total vegetable intake and risk was observed (fourth quartile OR=0.46; 95% CI=0.28-0.74). This inverse association was found to be independent of vitamin C,alpha-tocopherol, folic acid, dietary fiber, and alpha-carotene. Adjusting for beta-carotene or lutein + zeaxanthin somewhat attenuated the inverse association with vegetable intake. In this population, intake of vegetables appears to decrease premenopausal breast cancer risk. This effect may be related, in part, to beta-carotene and lutein + zeaxanthin in vegetables. It appears, however, that, of the nutrients and food components examined, no single dietary factor explains the effect. Evaluated components found together in vegetables may have a synergistic effect on breast cancer risk; alternatively, other unmeasured factors in these foods may also influence risk.JNCI Journal of the National Cancer Institute 04/1996; 88(6):340-8. · 14.34 Impact Factor
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ABSTRACT: The risk of endometrial cancer in relation to nutrition and frequency of consumption of a few selected dietary items was evaluated in a case-control study of 206 patients with endometrial cancer and 206 control subjects with acute conditions unrelated to any of the established or potential risk factors for endometrial cancer. Obesity was strongly and positively associated with the risk of endometrial cancer, and several conditions related to body weight, such as early menarche, diabetes mellitus, or hypertension were more common in cases. The risk of endometrial cancer was elevated in subjects reporting (on a subjective basis) greater fat (butter, margarine, and oil) intake (relative risk estimate for the higher compared to the lower scores equals 5.65, with 95% confidence interval of 2.76-11.55). Cases reported less frequent intake of green vegetables, fruit, and whole-grain foods: thus, the risk of endometrial cancer appeared inversely related to indices of beta-carotene and fiber intake. Furthermore, cases consumed milk, liver and fish less frequently than controls. No significant difference was noted between cases and controls in the frequency of intake of carrots, meat, eggs, ham, and cheese. Alcohol consumption was somewhat larger among the cases, but this trend in risk was not significant. Dietary information collected in this study probably is too limited and inconsistent to permit analysis of biologic correlates of these findings or discussion of their potential implications in terms of prevention on a public health scale. Nonetheless, the mere existence of differences in reported diet between endometrial cancer cases and controls is of interest, and may warrant further, more detailed investigation.Cancer 04/1986; 57(6):1248-53. · 5.20 Impact Factor
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ABSTRACT: Background: In the United States, 5-year survival rates of 69% and 84%, respectively, have recently been reported for African-American and Caucasian women diagnosed with breast cancer. Differences in the levels of endogenous sex hormones in these populations could explain some of the variation in survival rates, since estrogen is recognized as a risk factor for this type of cancer. Purpose: Dietary factors are known to affect endogenous hormone levels; therefore, our study was designed to determine the serum hormone levels of African-American women consuming a typical North American diet, to determine the effect of a low-fat and high-fiber diet on their serum hormone levels, and to compare the base-line serum hormone levels in the African-American women with hormone data from our study of Caucasian women (n = 68) consuming the same control diet. Methods: Twenty-one healthy, premenopausal, African-American women who agreed to eat only food prepared in a clinical study unit were recruited into the study. The control diet was similar to their usual diet, being high in fat (40% of calories from fat) and low in fiber (12 g/day), and was consumed on average for 3 weeks. The concentrations of estrone (E 1 ), estrone sulfate (E 1 SO 4 ), estradiol (E 2 ), free E 2 , androstenedione, and sex hormone-binding globulin (SHBG) in serum samples obtained from the participants during the last week of the control diet and during the follicular phase of their menstrual cycle were determined. The women were then switched to a diet low in fat (20% of calories as fat) and high in fiber (40 g/day); they consumed this diet for two menstrual cycles before blood samples were collected for determination of serum hormone levels. Repeated-measures regression modeling was used to investigate the relationship between diet and hormone levels in African-American and Caucasian women. All P values resulted from two-sided statistical tests. Results: Analysis of serum hormone levels in the African-American women indicated that the change in diet caused a significant decrease in E 2 (−8.5%; 95% confidence interval [CI] = −16.1% to −0.3%; P ≤.03) and E 1 SO 4 (−16.2%; 95% CI = −22.1% to −9.8%; P <.0001) and a significant increase in androstenedione levels (+18.3%; 95% CI = +10.3% to +26.8%; P <.0001). SHBG levels of the African-American women were 5.6% (95% CI = −14.0% to +3.7%) lower for those on the experimental diet compared with those on the control diet, but the difference was not statistically significant. Comparison of control serum hormone values in the African-American women in this study with those in Caucasian women previously studied indicated that the Caucasian women had statistically significant lower levels of E 1 (−37%; 95% CI = −61.2% to −16.4%; P ≤.0002), E 2 (−54.5%; 95% CI = −90.9% to −25.1%; P≤.0001), free E 2 (−30.2%; 95% CI = −65.7% to −2.3%; P <.03), and androstenedione (−48.3%; 95% CI = −83.7% to −19.7%; P ≤.0004). Conclusion: African-American women appear to have higher levels of serum hormones than Caucasian women, and dietary modification can result in a lowering of serum estrogens.JNCI Journal of the National Cancer Institute 11/1996; · 14.34 Impact Factor