Abstract
Objective: The impact, if any, on breast cancer risk of modifying adult dietary intake is an area of much interest. We take the opportunity to address the relationship between recent adult diet and breast cancer risk during the first two years of follow-up of the large California Teachers Study cohort. Methods: Of the 111,526 at-risk cohort members who resided in California and completed a baseline dietary assessment, 711 were diagnosed with invasive breast cancer after joining the cohort and before January 1998. Average daily nutrient intake was computed based on a food-frequency questionnaire assessing usual dietary intake and portion size during the year prior to joining the cohort. Incident breast cancers were identified through the California Cancer Registry and follow-up for death and confirmation of continued California residence utilized a variety of data sources. Cox proportional hazards models were used to calculate relative hazards. Results: The following components of recent dietary intake were not associated with breast cancer risk: energy, fat, fiber, antioxidant vitamins, and phytoestrogens. Only recent average alcohol consumption of 20 or more grams per day (approximately two or more glasses of wine) was associated with increased risk (RR = 1.5, 95% CI: 1.2–2.0 compared to non-drinkers; p trend = 0.01 across quintiles). Conclusion: With the exception of alcohol consumption, this study provides no evidence that recent macro- or micronutrient composition of adult diet is likely to have a direct effect on breast cancer risk. Some reduction of alcohol consumption among those consuming more than one drink per day may be beneficial.
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References
The Women's Health Initiative Study Group (1998) Design of the Women's Health Initiative clinical trial and observational study. Control Clin Trials 19: 61-109. 414 P.L. Horn-Ross et al.
Boyd NF, Greenberg C, Lockwood G, et al. (1997) Effects at two years of a low-fat, high-carbohydrate diet on radiologic features of the breast: results from a randomized trial. Canadian Diet and Breast Cancer Prevention Study Group. J Natl Cancer Inst 89: 488-496.
Reynolds R, Elkin SP, Layefsky ME, Lee GM (1999) Cancer in California school employees, 1988-1992. Am J Industrial Med 36: 271-278.
Bernstein L, Anton-Culver H, Deapen D, et al. High breast cancer rates in teachers: results from the California Teachers Study. (Submitted).
Block G, Hartman AM, Dresser CM, Carroll MD, Gannon J, Gardner L (1986) A data-based approach to diet questionnaire design and testing. Am J Epidemiol 124: 453-469.
Block G, Woods M, Potosky A, Clifford C (1990) Validation of a self-administered diet history questionnaire using multiple diet records. J Clin Epidemiol 43: 1327-1335.
Block G, Subar AF (1992) Estimates of nutrient intake from a food frequency questionnaire: the 1987 National Health Interview Survey. J Am Diet Assoc 92: 969-977.
Block G, Thompson FE, Hartman AM, Larkin FA, Guire KE (1992) Comparison of two dietary questionnaires validated against multiple dietary records collected during a 1-year period. J Am Diet Assoc 92: 686-693.
USDA nutrient database website: http//www.nal.usda.gov/fnic/ foodcomp/.
USDA-NCC carotenoid database website: http//www.nal.usda. gov/fnic/foodcomp/data/car98/car98.html.
Pennington JAT, Schoen SA, Salmon GD, Young B, Johnson RD, Marts RW (1995) Composition of core foods of the U.S. food supply, 1982-1991. J Food Composition Anal 8: 171-217.
Cao G, Sofic E, Prior RL (1996) Antioxidant capacity of tea and common vegetables. J Agric Food Chem 44: 3428-3431.
Wang H, Cao G, Prior RL (1996) Total antioxidant capacity of fruits. J Agric Food Chem 44: 701-705.
Horn-Ross PL, Barnes S, Lee M, et al. (2000) Assessing phytoestrogen exposure in epidemiologic studies: development of a database (United States). Cancer Causes Control 11: 289-298.
Kleinbaum DG, Kupper LL, Morgenstern H (1982) Epidemiologic Research: Principles and Quantitative Methods. Belmont, CA: Lifetime Learning Publications.
Breslow NE, Day NE (1987) Statistical Methods in Cancer Research. Vol. II: The Design and Analysis of Cohort Studies. Lyon: International Agency for Research on Cancer.
Walter S, Holford T (1978) Additive, multiplicative, and other models for disease risk. Am J Epidemiol 108: 341-346.
Block G, Sinha R, Gridley G (1994) Collection of dietarysupplement data and implications for analysis. Am J Clin Nutr 59: 232S-239S.
Smith-Warner SA, Spiegelman D, Yaun SS, et al. (1998) Alcohol and breast cancer in women: a pooled analysis of cohort studies. J Am Med Assoc 279: 535-540.
Howe G, Rohan T, Decarli A, et al. (1991) The association between alcohol and breast cancer risk: evidence from the combined analysis of six dietary case-control studies. Int J Cancer 47: 707-710.
Longnecker MP (1994) Alcoholic beverage consumption in relation to risk of breast cancer: meta-analysis and review. Cancer Causes Control 5: 73-82.
Ellison RC, Zhang Y, McLennan CE, Rothman KJ (2001) Exploring the relation of alcohol consumption to risk of breast cancer. Am J Epidemiol 154: 740-747.
World Cancer Research Fund and the American Institute for Cancer Rearch (1997) Food, Nutrition and the Prevention of Cancer: A Global Perspective. Washington, DC: American Institute for Cancer Research.
Hunter DJ, Spiegelman D, Adami HO, et al. (1996) Cohort studies of fat intake and the risk of breast cancer-a pooled analysis. N Engl J Med 334: 356-361.
Lee MM, Lin SS (2000) Dietary fat and breast cancer. Annu Rev Nutr 20: 221-248.
Adlercreutz H (1990) Western diet and Western diseases: some hormonal and biochemical mechanisms and associations. Scand J Clin Lab Invest Suppl 201: 3-23.
Kaaks R (1996) Nutrition, hormones, and breast cancer: is insulin the missing link? Cancer Causes Control 7: 605-625.
Wu F, Ames R, Evans MC, France JT, Reid IR (2001) Determinants of sex hormone-binding globulin in normal postmenopausal women. Clin Endocrinol (Oxf ) 54: 81-87.
Adlercreutz H, Fotsis T, Hockerstedt K, et al. (1989) Diet and urinary estrogen profile in premenopausal omnivorous and vegetarian women and in premenopausal women with breast cancer. J Steroid Biochem 34: 527-530.
Howe GR, Hirohata T, Hislop TG, et al. (1990) Dietary factors and risk of breast cancer: combined analysis of 12 case-control studies. J Natl Cancer Inst 82: 561-569.
Messina MJ, Persky V, Setchell KDR, Barnes S (1994) Soy intake and cancer risk: a review of the in vitro and in vivo data. Nutr Cancer 21: 113-131.
Rose DP (1992) Dietary fiber, phytoestrogens, and breast cancer. Nutrition 8: 47-51.
Steinmetz KA, D PJ (1991) Vegetables, fruit, and cancer: II. Mechanisms. Cancer Causes Control 2: 427-442.
Messina M, Barnes S (1991) The role of soy products in reducing risk of cancer. J Natl Cancer Inst 83: 541-546.
Adlercreutz H, Mousavi Y, Clark J (1992) Dietary phytoestrogens and cancer: in vitro and in vivo studies. J Steroid Biochem Mol Biol 41: 331-337.
Petrakis NL, Barnes S, King EB, et al. (1996) Stimulatory influence of soy protein isolate on breast secretion in pre-and postmenopausal women. Cancer Epidemiol Biomarkers Prev 5: 785-94.
Lee HP, Gourley L, Duffy SW, Esteve J, Lee J, Day NE (1992) Risk factors for breast cancer by age and menopausal status: a case-control study in Singapore. Cancer Causes Control 3: 313-322.
Wu AH, Ziegler RG, Horn-Ross PL, et al. (1996) Tofu and risk of breast cancer in Asian-Americans. Cancer Epidemiol Biomarkers Prev 5: 901-906.
Hirose K, Tajima K, Hamajima N, et al. (1995) A large-scale, hospital-based case-control study of risk factors of breast cancer according to menopausal status. Jpn J Cancer Res 86: 146-154.
Horn-Ross PL, John EM, Lee M, et al. (2001) Phytoestrogen consumption and breast cancer risk in a multiethnic population: the Bay Area Breast Cancer Study. Am J Epidemiol 154: 434-441.
Munger RA, Folsom AR, Kushi KH, et al. (1992) Dietary assessment of older Iowa women with a food frequency questionnaire: nutrient intake, reproducibility, and comparison with 24-hour dietary recall interviews. Am J Epidemiol 136: 192-200.
Patterson RE, Kristal AR, Tinker LF, et al. (1999) Measurement characteristics of the Women's Health Initiative food frequency questionnaire. Ann Epidemiol 9: 178-187.
Willett W, Lenart E (1998) Reproducibility and validity of foodfrequency questionnaires. In: Willett W, ed. Nutritional Epidemiology. New York: Oxford University Press, pp. 101-147.
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Horn-Ross, P.L., Hoggatt, K., West, D.W. et al. Recent diet and breast cancer risk: the California Teachers Study (USA). Cancer Causes Control 13, 407–415 (2002). https://doi.org/10.1023/A:1015786030864
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DOI: https://doi.org/10.1023/A:1015786030864