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Red and processed meat, nitrite, and heme iron intakes and postmenopausal breast cancer risk in the NIH-AARP Diet and Health Study.

Abstract

Previous studies have shown inconsistent associations between red and processed meat intake and breast cancer risk. N-nitroso compounds and heme iron have been hypothesized as contributing factors. We followed 193,742 postmenopausal women in the NIH-AARP Diet and Health Study and identified 9,305 incident breast cancers (1995-2006). Dietary intake was assessed using a food frequency questionnaire at baseline. We adjusted daily intakes of meat, nitrite and heme iron for energy intake using the nutrient density method. We estimated multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) by quintiles of dietary exposures for all breast cancer, by stage (in-situ, localized, regional/distant) and by estrogen/progesterone receptor (ER/PR) status using Cox proportional hazards regression. Total red meat intake was positively associated with risk of regional/distant cancer (p-trend = 0.02). The risk was 25% higher in the highest vs. lowest intake quintile (95% CI = 1.03-1.52). Higher processed red meat intake (Q5 vs. Q1) was associated with 27% higher risk of localized breast cancer (95% CI = 1.01-1.27, p-trend = 0.03) and a 19% higher risk of regional/distant cancer (95% CI = 0.98-1.44, p-trend = 0.10). In addition, higher nitrite intake from processed red meat was positively associated with localized cancer (HR for Q5 vs. Q1 = 1.23, 95% CI = 1.09-1.39, p-trend < 0.0001). Heme iron intake was positively associated with breast cancer risk overall and all cancer stages (p-trend = 0.02-0.05). No heterogeneity was observed in risk associations by hormone receptor status. Our findings suggest that high consumption of red meat and processed meat may increase risk of postmenopausal breast cancer. Added nitrite and heme iron may partly contribute to these observed associations.

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  • Authors+Show Affiliations

    ,

    Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD. Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD.

    ,

    Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD.

    ,

    Hormonal and Reproductive Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD.

    Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD.

    Source

    International journal of cancer 138:7 2016 Apr 01 pg 1609-18

    MeSH

    Aged
    Breast Neoplasms
    Cohort Studies
    Diet
    Diet Surveys
    Female
    Heme
    Humans
    Incidence
    Iron, Dietary
    Meat Products
    Middle Aged
    Nitrites
    Odds Ratio
    Postmenopause
    Proportional Hazards Models
    Red Meat
    Risk Factors

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Intramural

    Language

    eng

    PubMed ID

    26505173

    Citation

    Inoue-Choi, Maki, et al. "Red and Processed Meat, Nitrite, and Heme Iron Intakes and Postmenopausal Breast Cancer Risk in the NIH-AARP Diet and Health Study." International Journal of Cancer, vol. 138, no. 7, 2016, pp. 1609-18.
    Inoue-Choi M, Sinha R, Gierach GL, et al. Red and processed meat, nitrite, and heme iron intakes and postmenopausal breast cancer risk in the NIH-AARP Diet and Health Study. Int J Cancer. 2016;138(7):1609-18.
    Inoue-Choi, M., Sinha, R., Gierach, G. L., & Ward, M. H. (2016). Red and processed meat, nitrite, and heme iron intakes and postmenopausal breast cancer risk in the NIH-AARP Diet and Health Study. International Journal of Cancer, 138(7), pp. 1609-18. doi:10.1002/ijc.29901.
    Inoue-Choi M, et al. Red and Processed Meat, Nitrite, and Heme Iron Intakes and Postmenopausal Breast Cancer Risk in the NIH-AARP Diet and Health Study. Int J Cancer. 2016 Apr 1;138(7):1609-18. PubMed PMID: 26505173.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Red and processed meat, nitrite, and heme iron intakes and postmenopausal breast cancer risk in the NIH-AARP Diet and Health Study. AU - Inoue-Choi,Maki, AU - Sinha,Rashmi, AU - Gierach,Gretchen L, AU - Ward,Mary H, Y1 - 2015/11/20/ PY - 2015/08/03/received PY - 2015/09/30/revised PY - 2015/10/16/accepted PY - 2015/10/28/entrez PY - 2015/10/28/pubmed PY - 2016/6/10/medline KW - breast cancer KW - heme iron KW - nitrite KW - processed meat KW - red meat SP - 1609 EP - 18 JF - International journal of cancer JO - Int. J. Cancer VL - 138 IS - 7 N2 - Previous studies have shown inconsistent associations between red and processed meat intake and breast cancer risk. N-nitroso compounds and heme iron have been hypothesized as contributing factors. We followed 193,742 postmenopausal women in the NIH-AARP Diet and Health Study and identified 9,305 incident breast cancers (1995-2006). Dietary intake was assessed using a food frequency questionnaire at baseline. We adjusted daily intakes of meat, nitrite and heme iron for energy intake using the nutrient density method. We estimated multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) by quintiles of dietary exposures for all breast cancer, by stage (in-situ, localized, regional/distant) and by estrogen/progesterone receptor (ER/PR) status using Cox proportional hazards regression. Total red meat intake was positively associated with risk of regional/distant cancer (p-trend = 0.02). The risk was 25% higher in the highest vs. lowest intake quintile (95% CI = 1.03-1.52). Higher processed red meat intake (Q5 vs. Q1) was associated with 27% higher risk of localized breast cancer (95% CI = 1.01-1.27, p-trend = 0.03) and a 19% higher risk of regional/distant cancer (95% CI = 0.98-1.44, p-trend = 0.10). In addition, higher nitrite intake from processed red meat was positively associated with localized cancer (HR for Q5 vs. Q1 = 1.23, 95% CI = 1.09-1.39, p-trend < 0.0001). Heme iron intake was positively associated with breast cancer risk overall and all cancer stages (p-trend = 0.02-0.05). No heterogeneity was observed in risk associations by hormone receptor status. Our findings suggest that high consumption of red meat and processed meat may increase risk of postmenopausal breast cancer. Added nitrite and heme iron may partly contribute to these observed associations. SN - 1097-0215 UR - https://www.unboundmedicine.com/medline/citation/26505173/full_citation L2 - https://doi.org/10.1002/ijc.29901 DB - PRIME DP - Unbound Medicine ER -