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Intake of fish and marine n-3 polyunsaturated fatty acids and risk of breast cancer: meta-analysis of data from 21 independent prospective cohort studies.
BMJ 2013; 346:f3706BMJ

Abstract

OBJECTIVES

To investigate the association between intake of fish and n-3 polyunsaturated fatty acids (n-3 PUFA) and the risk of breast cancer and to evaluate the potential dose-response relation.

DESIGN

Meta-analysis and systematic review of prospective cohort studies.

DATA SOURCES

PubMed and Embase up to December 2012 and references of retrieved relevant articles.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Prospective cohort studies with relative risk and 95% confidence intervals for breast cancer according to fish intake, n-3 PUFA intake, or tissue biomarkers.

RESULTS

Twenty six publications, including 20,905 cases of breast cancer and 883,585 participants from 21 independent prospective cohort studies were eligible. Eleven articles (13,323 breast cancer events and 687,770 participants) investigated fish intake, 17 articles investigated marine n-3 PUFA (16,178 breast cancer events and 527,392 participants), and 12 articles investigated alpha linolenic acid (14,284 breast cancer events and 405,592 participants). Marine n-3 PUFA was associated with 14% reduction of risk of breast cancer (relative risk for highest v lowest category 0.86 (95% confidence interval 0.78 to 0.94), I(2)=54), and the relative risk remained similar whether marine n-3 PUFA was measured as dietary intake (0.85, 0.76 to 0.96, I(2)=67%) or as tissue biomarkers (0.86, 0.71 to 1.03, I(2)=8%). Subgroup analyses also indicated that the inverse association between marine n-3 PUFA and risk was more evident in studies that did not adjust for body mass index (BMI) (0.74, 0.64 to 0.86, I(2)=0) than in studies that did adjust for BMI (0.90, 0.80 to 1.01, I(2)=63.2%). Dose-response analysis indicated that risk of breast cancer was reduced by 5% per 0.1g/day (0.95, 0.90 to 1.00, I(2)=52%) or 0.1% energy/day (0.95, 0.90 to 1.00, I(2)=79%) increment of dietary marine n-3 PUFA intake. No significant association was observed for fish intake or exposure to alpha linolenic acid.

CONCLUSIONS

Higher consumption of dietary marine n-3 PUFA is associated with a lower risk of breast cancer. The associations of fish and alpha linolenic acid intake with risk warrant further investigation of prospective cohort studies. These findings could have public health implications with regard to prevention of breast cancer through dietary and lifestyle interventions.

Authors+Show Affiliations

Department of Food Science and Nutrition, Zhejiang University, Hangzhou 310058, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

Language

eng

PubMed ID

23814120

Citation

Zheng, Ju-Sheng, et al. "Intake of Fish and Marine N-3 Polyunsaturated Fatty Acids and Risk of Breast Cancer: Meta-analysis of Data From 21 Independent Prospective Cohort Studies." BMJ (Clinical Research Ed.), vol. 346, 2013, pp. f3706.
Zheng JS, Hu XJ, Zhao YM, et al. Intake of fish and marine n-3 polyunsaturated fatty acids and risk of breast cancer: meta-analysis of data from 21 independent prospective cohort studies. BMJ. 2013;346:f3706.
Zheng, J. S., Hu, X. J., Zhao, Y. M., Yang, J., & Li, D. (2013). Intake of fish and marine n-3 polyunsaturated fatty acids and risk of breast cancer: meta-analysis of data from 21 independent prospective cohort studies. BMJ (Clinical Research Ed.), 346, pp. f3706. doi:10.1136/bmj.f3706.
Zheng JS, et al. Intake of Fish and Marine N-3 Polyunsaturated Fatty Acids and Risk of Breast Cancer: Meta-analysis of Data From 21 Independent Prospective Cohort Studies. BMJ. 2013 Jun 27;346:f3706. PubMed PMID: 23814120.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intake of fish and marine n-3 polyunsaturated fatty acids and risk of breast cancer: meta-analysis of data from 21 independent prospective cohort studies. AU - Zheng,Ju-Sheng, AU - Hu,Xiao-Jie, AU - Zhao,Yi-Min, AU - Yang,Jing, AU - Li,Duo, Y1 - 2013/06/27/ PY - 2013/7/2/entrez PY - 2013/7/3/pubmed PY - 2013/9/4/medline SP - f3706 EP - f3706 JF - BMJ (Clinical research ed.) JO - BMJ VL - 346 N2 - OBJECTIVES: To investigate the association between intake of fish and n-3 polyunsaturated fatty acids (n-3 PUFA) and the risk of breast cancer and to evaluate the potential dose-response relation. DESIGN: Meta-analysis and systematic review of prospective cohort studies. DATA SOURCES: PubMed and Embase up to December 2012 and references of retrieved relevant articles. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Prospective cohort studies with relative risk and 95% confidence intervals for breast cancer according to fish intake, n-3 PUFA intake, or tissue biomarkers. RESULTS: Twenty six publications, including 20,905 cases of breast cancer and 883,585 participants from 21 independent prospective cohort studies were eligible. Eleven articles (13,323 breast cancer events and 687,770 participants) investigated fish intake, 17 articles investigated marine n-3 PUFA (16,178 breast cancer events and 527,392 participants), and 12 articles investigated alpha linolenic acid (14,284 breast cancer events and 405,592 participants). Marine n-3 PUFA was associated with 14% reduction of risk of breast cancer (relative risk for highest v lowest category 0.86 (95% confidence interval 0.78 to 0.94), I(2)=54), and the relative risk remained similar whether marine n-3 PUFA was measured as dietary intake (0.85, 0.76 to 0.96, I(2)=67%) or as tissue biomarkers (0.86, 0.71 to 1.03, I(2)=8%). Subgroup analyses also indicated that the inverse association between marine n-3 PUFA and risk was more evident in studies that did not adjust for body mass index (BMI) (0.74, 0.64 to 0.86, I(2)=0) than in studies that did adjust for BMI (0.90, 0.80 to 1.01, I(2)=63.2%). Dose-response analysis indicated that risk of breast cancer was reduced by 5% per 0.1g/day (0.95, 0.90 to 1.00, I(2)=52%) or 0.1% energy/day (0.95, 0.90 to 1.00, I(2)=79%) increment of dietary marine n-3 PUFA intake. No significant association was observed for fish intake or exposure to alpha linolenic acid. CONCLUSIONS: Higher consumption of dietary marine n-3 PUFA is associated with a lower risk of breast cancer. The associations of fish and alpha linolenic acid intake with risk warrant further investigation of prospective cohort studies. These findings could have public health implications with regard to prevention of breast cancer through dietary and lifestyle interventions. SN - 1756-1833 UR - https://www.unboundmedicine.com/medline/citation/23814120/Intake_of_fish_and_marine_n_3_polyunsaturated_fatty_acids_and_risk_of_breast_cancer:_meta_analysis_of_data_from_21_independent_prospective_cohort_studies_ L2 - http://www.bmj.com/cgi/pmidlookup?view=long&pmid=23814120 DB - PRIME DP - Unbound Medicine ER -