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Dietary Energy Density and Postmenopausal Breast Cancer Incidence in the Cancer Prevention Study II Nutrition Cohort.
J Nutr 2016; 146(10):2045-2050JN

Abstract

BACKGROUND

Dietary energy density (ED) is a measure of diet quality that estimates the amount of energy per unit of food (kilocalories per gram) consumed. Low-ED diets are generally high in fiber and fruits and vegetables and low in fat. Dietary ED has been positively associated with body mass index (BMI) and other risk factors for postmenopausal breast cancer.

OBJECTIVE

We evaluated the associations of total dietary ED and energy-dense (high-ED) foods with postmenopausal breast cancer incidence.

METHODS

Analyses included 56,795 postmenopausal women from the Cancer Prevention Study II Nutrition Cohort with no previous history of breast or other cancers and who provided information on diet, lifestyle, and medical history in 1999. Multivariable-adjusted breast cancer incidence rate ratios (RRs and 95% CIs) were estimated for quintiles of total dietary ED and for the consumption of high-ED foods in Cox proportional hazards regression models.

RESULTS

During a median follow-up of 11.7 y, 2509 invasive breast cancer cases were identified, including 1857 estrogen receptor-positive and 277 estrogen receptor-negative tumors. Median dietary ED was 1.5 kcal/g (IQR: 1.3-1.7 kcal/g). After adjusting for age, race, education, reproductive characteristics, and family history, high compared with low dietary ED was associated with a statistically significantly higher risk of breast cancer (RR for fifth quintile compared with first quintile: 1.20; 95% CI: 1.05, 1.36; P-trend = 0.03). The association between the amount of high-ED foods consumed and breast cancer risk was not statistically significant. We observed no differences by estrogen receptor status or effect modification by BMI, age, or physical activity.

CONCLUSION

These results suggest a modest positive association between total dietary ED and risk of postmenopausal breast cancer.

Authors+Show Affiliations

Department of Epidemiology, Rollins School of Public Health, Winship Cancer Institute, Emory University, Atlanta, GA; and tjhartm@emory.edu.Epidemiology Research Program, American Cancer Society, Atlanta, GA.Epidemiology Research Program, American Cancer Society, Atlanta, GA.Epidemiology Research Program, American Cancer Society, Atlanta, GA.Department of Epidemiology, Rollins School of Public Health, Winship Cancer Institute, Emory University, Atlanta, GA; and.Epidemiology Research Program, American Cancer Society, Atlanta, GA.Epidemiology Research Program, American Cancer Society, Atlanta, GA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27629577

Citation

Hartman, Terryl J., et al. "Dietary Energy Density and Postmenopausal Breast Cancer Incidence in the Cancer Prevention Study II Nutrition Cohort." The Journal of Nutrition, vol. 146, no. 10, 2016, pp. 2045-2050.
Hartman TJ, Gapstur SM, Gaudet MM, et al. Dietary Energy Density and Postmenopausal Breast Cancer Incidence in the Cancer Prevention Study II Nutrition Cohort. J Nutr. 2016;146(10):2045-2050.
Hartman, T. J., Gapstur, S. M., Gaudet, M. M., Shah, R., Flanders, W. D., Wang, Y., & McCullough, M. L. (2016). Dietary Energy Density and Postmenopausal Breast Cancer Incidence in the Cancer Prevention Study II Nutrition Cohort. The Journal of Nutrition, 146(10), pp. 2045-2050.
Hartman TJ, et al. Dietary Energy Density and Postmenopausal Breast Cancer Incidence in the Cancer Prevention Study II Nutrition Cohort. J Nutr. 2016;146(10):2045-2050. PubMed PMID: 27629577.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dietary Energy Density and Postmenopausal Breast Cancer Incidence in the Cancer Prevention Study II Nutrition Cohort. AU - Hartman,Terryl J, AU - Gapstur,Susan M, AU - Gaudet,Mia M, AU - Shah,Roma, AU - Flanders,W Dana, AU - Wang,Ying, AU - McCullough,Marjorie L, Y1 - 2016/09/14/ PY - 2016/05/09/received PY - 2016/08/04/accepted PY - 2016/9/16/pubmed PY - 2017/6/2/medline PY - 2016/9/16/entrez KW - breast cancer KW - diet KW - energy density KW - obesity KW - postmenopausal women SP - 2045 EP - 2050 JF - The Journal of nutrition JO - J. Nutr. VL - 146 IS - 10 N2 - BACKGROUND: Dietary energy density (ED) is a measure of diet quality that estimates the amount of energy per unit of food (kilocalories per gram) consumed. Low-ED diets are generally high in fiber and fruits and vegetables and low in fat. Dietary ED has been positively associated with body mass index (BMI) and other risk factors for postmenopausal breast cancer. OBJECTIVE: We evaluated the associations of total dietary ED and energy-dense (high-ED) foods with postmenopausal breast cancer incidence. METHODS: Analyses included 56,795 postmenopausal women from the Cancer Prevention Study II Nutrition Cohort with no previous history of breast or other cancers and who provided information on diet, lifestyle, and medical history in 1999. Multivariable-adjusted breast cancer incidence rate ratios (RRs and 95% CIs) were estimated for quintiles of total dietary ED and for the consumption of high-ED foods in Cox proportional hazards regression models. RESULTS: During a median follow-up of 11.7 y, 2509 invasive breast cancer cases were identified, including 1857 estrogen receptor-positive and 277 estrogen receptor-negative tumors. Median dietary ED was 1.5 kcal/g (IQR: 1.3-1.7 kcal/g). After adjusting for age, race, education, reproductive characteristics, and family history, high compared with low dietary ED was associated with a statistically significantly higher risk of breast cancer (RR for fifth quintile compared with first quintile: 1.20; 95% CI: 1.05, 1.36; P-trend = 0.03). The association between the amount of high-ED foods consumed and breast cancer risk was not statistically significant. We observed no differences by estrogen receptor status or effect modification by BMI, age, or physical activity. CONCLUSION: These results suggest a modest positive association between total dietary ED and risk of postmenopausal breast cancer. SN - 1541-6100 UR - https://www.unboundmedicine.com/medline/citation/27629577/Dietary_Energy_Density_and_Postmenopausal_Breast_Cancer_Incidence_in_the_Cancer_Prevention_Study_II_Nutrition_Cohort_ L2 - https://academic.oup.com/jn/article-lookup/doi/10.3945/jn.116.234344 DB - PRIME DP - Unbound Medicine ER -