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The effects of a low-fat dietary intervention and tamoxifen adjuvant therapy on the serum estrogen and sex hormone-binding globulin concentrations of postmenopausal breast cancer patients

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Summary

The purpose of the study was to determine the effect of a low-fat dietary intervention, with or without concomitant tamoxifen adjuvant therapy, on serum estrogen and sex hormone-binding globulin (SHBG) levels in postmenopausal patients with resected breast cancer. Ninety-three patients were randomized to either reduce their fat intake to 15–20% of total calories, or to a dietary control group. Serum estradiol, estrone, estrone sulfate, and SHBG concentrations were assayed at baseline, and at 6, 12, and 18 months thereafter. In 19% of patients, the preintervention serum estradiol levels were below the sensitivity of the assay (5 pg/ml). Tamoxifen had no significant effect on serum estrogen levels, but produced an elevation in SHBG. Patients with reliably quantifiable preintervention estradiol concentrations (≥ 10 pg/ml) showed a significant reduction in serum estradiol after 6 months on the low-fat diet (average, 20%; p < 0.005); this was sustained over the 18 month study period. Serum SHBG levels were increased by tamoxifen therapy, but were reduced significantly (p = 0.01) after 12 months on the low-fat diet in patients not receiving tamoxifen. No changes in serum estrone or estrone sulfate resulted from the dietary intervention. While the low-fat diet produced significant weight loss, patients treated with tamoxifen without dietary intervention showed a gain in body weight. These weight changes produced disruptions in the normal positive correlation between body weight and serum estrone sulfate, and the negative correlation with SHBG concentration.

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Authors and Affiliations

  1. Division of Nutrition and Endocrinology, American Health Foundation, 1 Dana Road, 10595, Valhalla, NY, USA

    David P. Rose, Jeanne M. Connolly & Ernst L. Wynder

  2. Harbor-UCLA Medical Center, Torrance, CA, USA

    Rowan T. Chlebowski

  3. University of Minnesota School of Public Health, Minneapolis, MN, USA

    I. Marilyn Buzzard

Authors
  1. David P. Rose
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  2. Jeanne M. Connolly
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  3. Rowan T. Chlebowski
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  4. I. Marilyn Buzzard
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  5. Ernst L. Wynder
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Rose, D.P., Connolly, J.M., Chlebowski, R.T. et al. The effects of a low-fat dietary intervention and tamoxifen adjuvant therapy on the serum estrogen and sex hormone-binding globulin concentrations of postmenopausal breast cancer patients. Breast Cancer Res Tr 27, 253–262 (1993). https://doi.org/10.1007/BF00665695

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