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Dietary fat and fiber in relation to risk of breast cancer. An 8-year follow-up.

Abstract

OBJECTIVE

To address the hypotheses that dietary fat increases and fiber decreases the risk of breast cancer.

DESIGN

Prospective cohort study with dietary assessment at baseline, using a validated, self-administered food frequency questionnaire.

SETTING/PARTICIPANTS

89,494 women in the Nurses' Health Study who were 34 through 59 years of age in 1980 and who were followed up for 8 years (> 95% complete).

RESULTS

1439 incident cases of breast cancer were diagnosed, including 774 among postmenopausal women. After adjustment for age, established risk factors, and total energy intake, we observed no evidence of any positive association between total fat intake and breast cancer incidence (relative risks [RRs] for increasing quintiles of fat intake were 1.0, 0.85, 0.96, 0.91, and 0.90; 95% confidence interval for highest vs lowest quintile, 0.77 to 1.07). Among postmenopausal women alone, corresponding RRs were 1.0, 0.89, 1.00, 0.95, and 0.91. Comparing extreme deciles of total fat intake (> or = 49% vs < 29% of total energy intake), the RR was 0.86 (95% confidence interval, 0.67 to 1.08). A similar absence of any positive association was observed without adjustment for energy intake; for tumors less than 2 cm as well as 2 cm or greater in diameter; for saturated, monounsaturated, and polyunsaturated fat; and after excluding the first 4 years of follow-up. Also, we found no suggestion of any positive association when using a more detailed and precise dietary questionnaire completed in 1984 (666 subsequent cases), even when women consuming less than 25% of energy from fat were used as the comparison group. No suggestion of a protective effect of dietary fiber was observed (RRs for increasing quintiles were 1.0, 0.95, 0.93, 1.02, and 1.02).

CONCLUSIONS

These data provide evidence against both an adverse influence of fat intake and a protective effect of fiber consumption by middle-aged women on breast cancer incidence over 8 years. Nevertheless, the positive association between intake of animal fat and risk of colon cancer observed in many studies provides ample reason to limit this source of energy.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02215.

    , , , , , , ,

    Source

    JAMA 268:15 1992 Oct 21 pg 2037-44

    MeSH

    Adult
    Bias
    Breast Neoplasms
    Cohort Studies
    Dietary Fats
    Dietary Fiber
    Female
    Follow-Up Studies
    Humans
    Incidence
    Middle Aged
    Prospective Studies
    Risk Factors
    United States

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    1328696

    Citation

    Willett, W C., et al. "Dietary Fat and Fiber in Relation to Risk of Breast Cancer. an 8-year Follow-up." JAMA, vol. 268, no. 15, 1992, pp. 2037-44.
    Willett WC, Hunter DJ, Stampfer MJ, et al. Dietary fat and fiber in relation to risk of breast cancer. An 8-year follow-up. JAMA. 1992;268(15):2037-44.
    Willett, W. C., Hunter, D. J., Stampfer, M. J., Colditz, G., Manson, J. E., Spiegelman, D., ... Speizer, F. E. (1992). Dietary fat and fiber in relation to risk of breast cancer. An 8-year follow-up. JAMA, 268(15), pp. 2037-44.
    Willett WC, et al. Dietary Fat and Fiber in Relation to Risk of Breast Cancer. an 8-year Follow-up. JAMA. 1992 Oct 21;268(15):2037-44. PubMed PMID: 1328696.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Dietary fat and fiber in relation to risk of breast cancer. An 8-year follow-up. AU - Willett,W C, AU - Hunter,D J, AU - Stampfer,M J, AU - Colditz,G, AU - Manson,J E, AU - Spiegelman,D, AU - Rosner,B, AU - Hennekens,C H, AU - Speizer,F E, PY - 1992/10/21/pubmed PY - 1992/10/21/medline PY - 1992/10/21/entrez SP - 2037 EP - 44 JF - JAMA JO - JAMA VL - 268 IS - 15 N2 - OBJECTIVE: To address the hypotheses that dietary fat increases and fiber decreases the risk of breast cancer. DESIGN: Prospective cohort study with dietary assessment at baseline, using a validated, self-administered food frequency questionnaire. SETTING/PARTICIPANTS: 89,494 women in the Nurses' Health Study who were 34 through 59 years of age in 1980 and who were followed up for 8 years (> 95% complete). RESULTS: 1439 incident cases of breast cancer were diagnosed, including 774 among postmenopausal women. After adjustment for age, established risk factors, and total energy intake, we observed no evidence of any positive association between total fat intake and breast cancer incidence (relative risks [RRs] for increasing quintiles of fat intake were 1.0, 0.85, 0.96, 0.91, and 0.90; 95% confidence interval for highest vs lowest quintile, 0.77 to 1.07). Among postmenopausal women alone, corresponding RRs were 1.0, 0.89, 1.00, 0.95, and 0.91. Comparing extreme deciles of total fat intake (> or = 49% vs < 29% of total energy intake), the RR was 0.86 (95% confidence interval, 0.67 to 1.08). A similar absence of any positive association was observed without adjustment for energy intake; for tumors less than 2 cm as well as 2 cm or greater in diameter; for saturated, monounsaturated, and polyunsaturated fat; and after excluding the first 4 years of follow-up. Also, we found no suggestion of any positive association when using a more detailed and precise dietary questionnaire completed in 1984 (666 subsequent cases), even when women consuming less than 25% of energy from fat were used as the comparison group. No suggestion of a protective effect of dietary fiber was observed (RRs for increasing quintiles were 1.0, 0.95, 0.93, 1.02, and 1.02). CONCLUSIONS: These data provide evidence against both an adverse influence of fat intake and a protective effect of fiber consumption by middle-aged women on breast cancer incidence over 8 years. Nevertheless, the positive association between intake of animal fat and risk of colon cancer observed in many studies provides ample reason to limit this source of energy. SN - 0098-7484 UR - https://www.unboundmedicine.com/medline/citation/1328696/Dietary_fat_and_fiber_in_relation_to_risk_of_breast_cancer__An_8_year_follow_up_ L2 - https://jamanetwork.com/journals/jama/fullarticle/vol/268/pg/2037 DB - PRIME DP - Unbound Medicine ER -