Premenopausal breast cancer risk and intake of vegetables, fruits, and related nutrients
Premenopausal breast cancer risk and intake of vegetables, fruits, and related nutrients
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DOI：
10.1093/jnci/88.6.340
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发表时间：
1996-03-20
影响因子：
10.3
通讯作者：
Graham, S
中科院分区：
文献类型：
--
作者：
Freudenheim, JL;Marshall, JR;Graham, S
背景资料：鉴于乳腺癌发病率的国际差异和移民人口中乳腺癌发病率的变化，人们假设饮食是影响这种疾病风险的一个因素。许多研究表明，多吃蔬菜和水果可以预防乳腺癌。目的：我们进行了一项饮食（包括非食物补充剂的摄入）与绝经前乳腺癌风险的病例对照研究。我们详细评估了蔬菜和水果的通常摄入量（每种都是所有查询的蔬菜和水果的总克数），维生素C和E，叶酸，个别类胡萝卜素和膳食纤维及其成分。方法：病例患者（n = 297）通过病理记录从纽约西部伊利和尼亚加拉县的医院确定。他们包括40岁或以上的绝经前妇女，从1986年11月到1991年4月被诊断为乳腺癌。从纽约州机动车管理局的记录中随机选择对照组（n = 311），根据年龄和居住县与病例患者频率匹配。面对面访谈包括访谈前2年期间日常饮食的详细报告。非条件Logistic回归用于估计比值比（OR）和95%置信区间（CI）。结果：与几种营养素的高摄入量相关的风险降低。以摄入量的最低四分位数作为参照，特定营养素摄入量的最高四分位数的校正OR如下：维生素C（OR = 0.53; 95% CI = 0.33-0.86），α-生育酚（OR = 0.55; 95%CI = 0.33-0.88），叶酸（OR = 0.50; 95%CI = 0.31-0.82），α-胡萝卜素（OR = 0.67; 95%CI = 0.42-1.08）和β-胡萝卜素（OR = 0.46; 95%CI = 0.28-0.74），叶黄素+玉米黄质（OR = 0.47; 95% CI = 0.28-0.77），蔬菜水果膳食纤维（OR = 0.48; 95% CI = 0.30-0.78）。没有发现隐黄质、番茄红素或谷物纤维与风险相关。水果与风险降低弱相关（第四个四分位数OR = 0.67; 95%CI = 0.32-1.09）。没有发现乳腺癌风险与维生素C和E以及叶酸补充剂的摄入量之间存在关联。观察到蔬菜总摄入量与风险之间存在强烈的负相关（第四四个四分位数OR = 0.46; 95%CI = 0.28-0.74）。这种负相关被发现是独立的维生素C，α-生育酚，叶酸，膳食纤维，和α-胡萝卜素。调整β-胡萝卜素或叶黄素+玉米黄质在一定程度上减弱了与蔬菜摄入量的负相关性。结论：在这一人群中，蔬菜的摄入量似乎可以降低绝经前乳腺癌的风险。这种效应可能与蔬菜中的β-胡萝卜素和叶黄素+玉米黄质有关。然而，在所检查的营养素和食物成分中，似乎没有单一的饮食因素可以解释这种影响。在蔬菜中发现的评估成分可能对乳腺癌风险具有协同作用;或者，这些食物中的其他未测量因素也可能影响风险。
Background: Given the international variations in breast cancer incidence rates and the changes in breast cancer incidence among migrant populations, it has been hypothesized that diet is a factor influencing risk of this disease. Many studies indicate that a diet high in vegetables and fruits may protect against breast cancer. Purpose: We conducted a case-control study of diet, including the intake of non-food supplements, and premenopausal breast cancer risk. We evaluated in detail usual intake of vegetables and fruits (each measured as the total reported grams consumed for all queried vegetables and fruit), vitamins C and E, folic acid, individual carotenoids, and dietary fiber with its components. Methods: Case patients (n = 297) were identified through pathology records from hospitals in Erie and Niagara counties in western New York. They consisted of premenopausal women 40 years of age or older who were diagnosed with breast cancer from November 1986 through April 1991. Control subjects (n = 311), frequency-matched to case patients on the basis of age and county of residence, were randomly selected from New York State Department of Motor Vehicles records. In-person interviews included detailed reports of usual diet in the period 2 years before the interview. Unconditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results: There was a reduction in risk associated with high intake of several nutrients. With the lowest quartile of intake as the referent, adjusted ORs for the highest quartile of intake for specific nutrients were as follows: vitamin C (OR = 0.53; 95% CI = 0.33-0.86), alpha-tocopherol (OR = 0.55; 95% CI = 0.33-0.88), folic acid (OR = 0.50; 95% CI = 0.31-0.82), alpha-carotene (OR = 0.67; 95% CI = 0.42-1.08) and beta-carotene (OR = 0.46; 95% CI = 0.28-0.74), lutein + zeaxanthin (OR = 0.47; 95% CI = 0.28-0.77), and dietary fiber from vegetables and fruits (OR = 0.48; 95% CI = 0.30-0.78). No association with risk was found for beta-cryptoxanthin, lycopene, or grain fiber. Fruits were weakly associated with a reduction in risk (fourth quartile OR = 0.67; 95% CI = 0.32-1.09). No association was found between breast cancer risk and intake of vitamins C and E and folic acid taken as supplements. A strong inverse association between total vegetable intake and risk was observed (fourth quartile OR = 0.46; 95% CI = 0.28-0.74). This inverse association was found to be independent of vitamin C, alpha-tocopherol, folic acid, dietary fiber, and alpha-carotene. Adjusting for beta-carotene or lutein + zeaxanthin somewhat attenuated the inverse association with vegetable intake. Conclusions: In this population, intake of vegetables appears to decrease premenopausal breast cancer risk. This effect may be related, in part, to beta-carotene and lutein + zeaxanthin in vegetables. It appears, however, that, of the nutrients and food components examined, no single dietary factor explains the effect. Evaluated components found together in vegetables may have a synergistic effect on breast cancer risk; alternatively, other unmeasured factors in these foods may also influence risk.