Cohort studies of fat intake and the risk of breast cancer - A pooled analysis
Cohort studies of fat intake and the risk of breast cancer - A pooled analysis
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DOI：
10.1056/nejm199602083340603
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发表时间：
1996-02-08
影响因子：
158.5
通讯作者：
Willett, W
中科院分区：
文献类型：
--
作者：
Hunter, DJ;Spiegelman, D;Willett, W
背景资料。动物实验、国际相关性比较和病例对照研究支持饮食脂肪摄入量与乳腺癌发病率之间的联系。大多数队列研究都没有证实这种联系，但它们因涉及少量病例、均匀的脂肪摄入量以及脂肪摄入量估计中的测量误差而受到批评。我们在四个国家确定了七项符合特定标准的前瞻性研究，并以标准化的方式分析了主要数据。计算脂肪摄入量与乳腺癌风险关系的综合估计，并使用研究特定验证研究的数据来调整测量误差的结果。从包括337,819名妇女在内的研究中获得了4980例的信息。当将能量调整后总脂肪摄入量中最高五分之一的女性与最低五分之一的女性进行比较时，乳腺癌的多变量合并相对风险为1.05(95%可信区间为0.94至1.16)。分别考虑饱和脂肪、单不饱和脂肪和多不饱和脂肪以及胆固醇的相对风险也接近统一。从脂肪中摄取能量的百分比与乳腺癌风险之间总体上几乎没有关联，即使是在从脂肪中摄取的能量低于20%的女性中也是如此。纠正营养摄入量测量中的错误并没有实质性地改变这些发现。我们没有发现饮食总脂肪摄入量与乳腺癌风险之间存在正相关的证据。即使是从脂肪中摄取的能量不到总能量摄入量的20%的女性，风险也没有降低。在西方生活方式的背景下，减少中年脂肪的总摄入量不太可能大幅降低乳腺癌的风险。
Background. Experiments in animals, international correlation comparisons, and case-control studies support an association between dietary fat intake and the incidence of breast cancer. Most cohort studies do not corroborate the association, but they have been criticized for involving small numbers of cases, homogeneous fat intake, and measurement errors in estimates of fat intake.Methods. We identified seven prospective studies in four countries that met specific criteria and analyzed the primary data in a standardized manner. Pooled estimates of the relation of fat intake to the risk of breast cancer were calculated, and data from study-specific validation studies were used to adjust the results for measurement error.Results. Information about 4980 cases from studies including 337,819 women was available. When women in the highest quintile of energy-adjusted total fat intake were compared with women in the lowest quintile, the multivariate pooled relative risk of breast cancer was 1.05 (95 percent confidence interval, 0.94 to 1.16). Relative risks for saturated, monounsaturated, and polyunsaturated fat and for cholesterol, considered individually, were also close to unity. There was little overall association between the percentage of energy intake from fat and the risk of breast cancer, even among women whose energy intake from fat was less than 20 percent. Correcting for error in the measurement of nutrient intake did not materially alter these findings.Conclusions. We found no evidence of a positive association between total dietary fat intake and the risk of breast cancer. There was no reduction in risk even among women whose energy intake from fat was less than 20 percent of total energy intake. in the context of the Western lifestyle, lowering the total intake of fat in midlife is unlikely to reduce the risk of breast cancer substantially.