Dietary fat and fiber in relation to risk of breast cancer. An 8-year follow-up.
Dietary fat and fiber in relation to risk of breast cancer. An 8-year follow-up.
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DOI：
10.1001/jama.1992.03490150089030
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发表时间：
1992-10
期刊：
影响因子：
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通讯作者：
W. Willett;D. Hunter;M. Stampfer;G. Colditz;J. Manson;D. Spiegelman;B. Rosner;C. Hennekens;F. Speizer
中科院分区：
文献类型：
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作者：
W. Willett;D. Hunter;M. Stampfer;G. Colditz;J. Manson;D. Spiegelman;B. Rosner;C. Hennekens;F. Speizer
目的探讨膳食脂肪增加和纤维减少乳腺癌风险的假设。设计：前瞻性队列研究，采用经验证的自我管理食物频率问卷，在基线时进行饮食评估。地点/参与者护士健康研究中的89，494名女性，1980年年龄在34岁至59岁之间，并接受了8年的随访（> 95%完成）。结果共确诊乳腺癌1439例，其中绝经后妇女774例。在调整年龄、已确定的危险因素和总能量摄入后，我们没有观察到总脂肪摄入量与乳腺癌发病率之间存在任何正相关的证据（脂肪摄入量增加的五分位数的相对风险[RR]为1.0，0.85，0.96，0.91和0.90;最高与最低五分位数的95%置信区间为0.77至1.07）。仅在绝经后女性中，相应的RR分别为1.0、0.89、1.00、0.95和0.91。比较总脂肪摄入量的极端十分位数（>或= 49% vs < 29%总能量摄入），RR为0.86（95%置信区间，0.67至1.08）。在不调整能量摄入的情况下;对于直径小于2 cm以及2 cm或更大的肿瘤;对于饱和脂肪、单不饱和脂肪和多不饱和脂肪;以及排除前4年随访后，观察到类似的无任何正相关性。此外，当使用1984年完成的更详细和精确的饮食问卷（666例后续病例）时，我们没有发现任何积极的关联，即使女性从脂肪中消耗的能量少于25%也被用作对照组。未观察到膳食纤维的保护作用（增加五分位数的RR分别为1.0、0.95、0.93、1.02和1.02）。结论：这些数据提供了证据，反对中年妇女脂肪摄入的不利影响和纤维消费对乳腺癌发病率的保护作用超过8年。尽管如此，许多研究中观察到的动物脂肪摄入量与结肠癌风险之间的正相关性为限制这种能量来源提供了充分的理由。
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.