Hormones and Cancer

, Volume 1, Issue 5, pp 265–276 | Cite as

Dietary Fat, Fiber, and Carbohydrate Intake and Endogenous Hormone Levels in Premenopausal Women

  • Xiaohui Cui
  • Bernard Rosner
  • Walter C. Willett
  • Susan E. Hankinson


The authors conducted a cross-sectional study to investigate the associations of fat, fiber, and carbohydrate intake with endogenous estrogen, androgen, and insulin-like growth factor (IGF) levels among 595 premenopausal women. Overall, no significant associations were found between dietary intake of these macronutrients and plasma sex steroid hormone levels. Dietary fat intake was inversely associated with IGF-I and IGF-binding protein 3 (IGFBP-3) levels. When substituting 5% of energy from total fat for the equivalent amount of energy from carbohydrate or protein intake, the plasma levels of IGF-I and IGFBP-3 were 2.8% (95% confidence interval [CI] 0.3, 5.3) and 1.6% (95% CI 0.4, 2.8) lower, respectively. Animal fat, saturated fat, and monounsaturated fat intakes also were inversely associated with IGFBP-3 levels (P < 0.05). Carbohydrates were positively associated with plasma IGF-I level. When substituting 5% of energy from carbohydrates for the equivalent amount of energy from fat or protein intake, the plasma IGF-I level was 2.0% (95% CI 0.1, 3.9%) higher. No independent associations between fiber intake and hormone levels were observed. The results suggest that a low-fat/high-fiber or carbohydrate diet is not associated with endogenous levels of sex steroid hormones, but it may modestly increase IGF-I and IGFBP-3 levels among premenopausal women.


Gonadal steroid hormones Insulin-like growth factor I Insulin-like growth factor binding protein 3 Dietary fats Dietary fiber Dietary carbohydrates 



Body mass index


Confidence interval




DHEA sulfate


Food frequency questionnaire


Insulin-like growth factor


IGF-binding protein


Nurses’ health study


Sex hormone binding globulin



The work was supported by the National Institutes of Health (grant numbers CA50385 and CA67262).

Conflict of Interest

The authors declare that they have no conflict of interest.


  1. 1.
    Potischman NR, Hoover N, Brinton LA, Siiteri P, Dorgan JF, Swanson CA, Berman ML et al (1996) Case–control study of endogenous steroid hormones and endometrial cancer. J Natl Cancer Inst 88(16):1127–1135CrossRefPubMedGoogle Scholar
  2. 2.
    Austin H, Austin JM Jr, Partridge EE, Hatch KD, Shingleton HM (1991) Endometrial cancer, obesity, and body fat distribution. Cancer Res 51(2):568–572PubMedGoogle Scholar
  3. 3.
    Mollerstrom G, Carlstrom K, Lagrelius A, Einhorn N (1993) Is there an altered steroid profile in patients with endometrial carcinoma? Cancer 72(1):173–181CrossRefPubMedGoogle Scholar
  4. 4.
    Kaaks R, Lukanova A, Kurzer MS (2002) Obesity, endogenous hormones, and endometrial cancer risk: a synthetic review. Cancer Epidemiol Biomark Prev 11(12):1531–1543Google Scholar
  5. 5.
    Zeleniuch-Jacquotte A, Shore RE, Koenig KL, Akhmedkhanov A, Afanasyeva Y, Kato I, Kim MY, Rinaldi S, Kaaks R, Toniolo P (2004) Postmenopausal levels of oestrogen, androgen, and SHBG and breast cancer: long-term results of a prospective study. Br J Cancer 90(1):153–159CrossRefPubMedGoogle Scholar
  6. 6.
    ESHRE Capri Workshop Group (2004) Hormones and breast cancer. Hum Reprod Update 10(4):281–293CrossRefGoogle Scholar
  7. 7.
    Bernstein L (2002) Epidemiology of endocrine-related risk factors for breast cancer. J Mammary Gland Biol Neoplasia 7(1):3–15CrossRefPubMedGoogle Scholar
  8. 8.
    Key T, Appleby P, Barnes I, Reeves G (2002) Endogenous sex hormones and breast cancer in postmenopausal women: reanalysis of nine prospective studies. J Natl Cancer Inst 94(8):606–616PubMedGoogle Scholar
  9. 9.
    Missmer SA, Eliassen AH, Barbieri RL, Hankinson SE (2004) Endogenous estrogen, androgen, and progesterone concentrations and breast cancer risk among postmenopausal women. J Natl Cancer Inst 96(24):1856–1865CrossRefPubMedGoogle Scholar
  10. 10.
    Kaaks R, Rinaldi S, Key TJ, Berrino F, Peeters PH, Biessy C, Dossus L et al (2005) Postmenopausal serum androgens, oestrogens and breast cancer risk: the European prospective investigation into cancer and nutrition. Endocr Relat Cancer 12(4):1071–1082CrossRefPubMedGoogle Scholar
  11. 11.
    Eliassen AH, Missmer SA, Tworoger SS, Spiegelman D, Barbieri RL, Dowsett M, Hankinson SE (2006) Endogenous steroid hormone concentrations and risk of breast cancer among premenopausal women. J Natl Cancer Inst 98(19):1406–1415CrossRefPubMedGoogle Scholar
  12. 12.
    Kaaks R, Berrino F, Key T, Rinaldi S, Dossus L, Biessy C, Secreto G et al (2005) Serum sex steroids in premenopausal women and breast cancer risk within the European Prospective Investigation into Cancer and Nutrition (EPIC). J Natl Cancer Inst 97(10):755–765. doi: 97/10/755[pii]10.1093/jnci/dji132 CrossRefPubMedGoogle Scholar
  13. 13.
    Riman T, Nilsson S, Persson IR (2004) Review of epidemiological evidence for reproductive and hormonal factors in relation to the risk of epithelial ovarian malignancies. Acta Obstet Gynecol Scand 83(9):783–795PubMedGoogle Scholar
  14. 14.
    Risch HA (1998) Hormonal etiology of epithelial ovarian cancer, with a hypothesis concerning the role of androgens and progesterone. J Natl Cancer Inst 90(23):1774–1786CrossRefPubMedGoogle Scholar
  15. 15.
    Tentori L, Graziani G (2007) Doping with growth hormone/IGF-1, anabolic steroids or erythropoietin: is there a cancer risk? Pharmacol Res 55(5):359–369CrossRefPubMedGoogle Scholar
  16. 16.
    Jenkins PJ, Mukherjee A, Shalet SM (2006) Does growth hormone cause cancer? Clin Endocrinol (Oxf) 64(2):115–121CrossRefGoogle Scholar
  17. 17.
    Moschos SJ, Mantzoros CS (2002) The role of the IGF system in cancer: from basic to clinical studies and clinical applications. Oncology 63(4):317–332CrossRefPubMedGoogle Scholar
  18. 18.
    Furstenberger G, Senn HJ (2002) Insulin-like growth factors and cancer. Lancet Oncol 3(5):298–302CrossRefPubMedGoogle Scholar
  19. 19.
    Kaaks R (2004) Nutrition, insulin, IGF-1 metabolism and cancer risk: a summary of epidemiological evidence. Novartis Found Symp 262:247–260, discussion 260–268CrossRefPubMedGoogle Scholar
  20. 20.
    Chan JM, Stampfer MJ, Giovannucci E, Gann PH, Ma J, Wilkinson P, Hennekens CH, Pollak M (1998) Plasma insulin-like growth factor-I and prostate cancer risk: a prospective study. Science 279(5350):563–566CrossRefPubMedGoogle Scholar
  21. 21.
    Monti S, Proietti-Pannunzi L, Sciarra A, Lolli F, Falasca P, Poggi M, Celi FS, Toscano V (2007) The IGF axis in prostate cancer. Curr Pharm Des 13(7):719–727CrossRefPubMedGoogle Scholar
  22. 22.
    Giovannucci E (1999) Insulin-like growth factor-I and binding protein-3 and risk of cancer. Horm Res 51(Suppl 3):34–41CrossRefPubMedGoogle Scholar
  23. 23.
    Roddam AW, Allen NE, Appleby P, Key TJ, Ferrucci L, Carter HB, Metter EJ et al (2008) Insulin-like growth factors, their binding proteins, and prostate cancer risk: analysis of individual patient data from 12 prospective studies. Ann Intern Med 149(7):461–471, W483–468PubMedGoogle Scholar
  24. 24.
    Shi R, Yu H, McLarty J, Glass J (2004) IGF-I and breast cancer: a meta-analysis. Int J Cancer 111(3):418–423CrossRefPubMedGoogle Scholar
  25. 25.
    Hankinson SE, Willett WC, Colditz GA, Hunter DJ, Michaud DS, Deroo B, Rosner B, Speizer FE, Pollak M (1998) Circulating concentrations of insulin-like growth factor-I and risk of breast cancer. Lancet 351(9113):1393–1396CrossRefPubMedGoogle Scholar
  26. 26.
    Renehan AG, Zwahlen M, Minder C, O’Dwyer ST, Shalet SM, Egger M (2004) Insulin-like growth factor (IGF)-I, IGF binding protein-3, and cancer risk: systematic review and meta-regression analysis. Lancet 363(9418):1346–1353CrossRefPubMedGoogle Scholar
  27. 27.
    Fletcher O, Gibson L, Johnson N, Altmann DR, Holly JM, Ashworth A, Peto J, Silva Idos S (2005) Polymorphisms and circulating levels in the insulin-like growth factor system and risk of breast cancer: a systematic review. Cancer Epidemiol Biomark Prev 14(1):2–19Google Scholar
  28. 28.
    Lann D, LeRoith D (2008) The role of endocrine insulin-like growth factor-I and insulin in breast cancer. J Mammary Gland Biol Neoplasia 13(4):371–379CrossRefPubMedGoogle Scholar
  29. 29.
    Ma J, Pollak MN, Giovannucci E, Chan JM, Tao Y, Hennekens CH, Stampfer MJ (1999) Prospective study of colorectal cancer risk in men and plasma levels of insulin-like growth factor (IGF)-I and IGF-binding protein-3. J Natl Cancer Inst 91(7):620–625CrossRefPubMedGoogle Scholar
  30. 30.
    Giovannucci E, Pollak MN, Platz EA, Willett WC, Stampfer MJ, Majeed N, Colditz GA, Speizer FE, Hankinson SE (2000) A prospective study of plasma insulin-like growth factor-1 and binding protein-3 and risk of colorectal neoplasia in women. Cancer Epidemiol Biomark Prev 9(4):345–349Google Scholar
  31. 31.
    Gunter MJ, Hoover DR, Yu H, Wassertheil-Smoller S, Rohan TE, Manson JE, Li J et al (2009) Insulin, insulin-like growth factor-I, and risk of breast cancer in postmenopausal women. J Natl Cancer Inst 101(1):48–60PubMedGoogle Scholar
  32. 32.
    Yu H, Spitz MR, Mistry J, Gu J, Hong WK, Wu X (1999) Plasma levels of insulin-like growth factor-I and lung cancer risk: a case–control analysis. J Natl Cancer Inst 91(2):151–156CrossRefPubMedGoogle Scholar
  33. 33.
    Bohlke K, Cramer DW, Trichopoulos D, Mantzoros CS (1998) Insulin-like growth factor-I in relation to premenopausal ductal carcinoma in situ of the breast. Epidemiology 9(5):570–573CrossRefPubMedGoogle Scholar
  34. 34.
    Lukanova A, Lundin E, Micheli A, Arslan A, Ferrari P, Rinaldi S, Krogh V et al (2004) Circulating levels of sex steroid hormones and risk of endometrial cancer in postmenopausal women. Int J Cancer 108(3):425–432CrossRefPubMedGoogle Scholar
  35. 35.
    Bandera EV, Kushi LH, Moore DF, Gifkins DM, McCullough ML (2007) Association between dietary fiber and endometrial cancer: a dose–response meta-analysis. Am J Clin Nutr 86(6):1730–1737PubMedGoogle Scholar
  36. 36.
    Xu WH, Dai Q, Xiang YB, Zhao GM, Ruan ZX, Cheng JR, Zheng W, Shu XO (2007) Nutritional factors in relation to endometrial cancer: a report from a population-based case–control study in Shanghai, China. Int J Cancer 120(8):1776–1781CrossRefPubMedGoogle Scholar
  37. 37.
    Littman AJ, Beresford SA, White E (2001) The association of dietary fat and plant foods with endometrial cancer (United States). Cancer Causes Control 12(8):691–702CrossRefPubMedGoogle Scholar
  38. 38.
    Zhang M, Lee AH, Binns CW (2004) Reproductive and dietary risk factors for epithelial ovarian cancer in China. Gynecol Oncol 92(1):320–326CrossRefPubMedGoogle Scholar
  39. 39.
    La Vecchia C (2001) Epidemiology of ovarian cancer: a summary review. Eur J Cancer Prev 10(2):125–129CrossRefPubMedGoogle Scholar
  40. 40.
    Edefonti V, Decarli A, La Vecchia C, Bosetti C, Randi G, Franceschi S, Dal Maso L, Ferraroni M (2008) Nutrient dietary patterns and the risk of breast and ovarian cancers. Int J Cancer 122(3):609–613CrossRefPubMedGoogle Scholar
  41. 41.
    Pelucchi C, La Vecchia C, Chatenoud L, Negri E, Conti E, Montella M, Calza S, Dal Maso L, Franceschi S (2001) Dietary fibres and ovarian cancer risk. Eur J Cancer 37(17):2235–2239CrossRefPubMedGoogle Scholar
  42. 42.
    Trock B, Lanza E, Greenwald P (1990) Dietary fiber, vegetables, and colon cancer: critical review and meta-analyses of the epidemiologic evidence. J Natl Cancer Inst 82(8):650–661CrossRefPubMedGoogle Scholar
  43. 43.
    Prentice RL, Sheppard L (1990) Dietary fat and cancer: consistency of the epidemiologic data, and disease prevention that may follow from a practical reduction in fat consumption. Cancer Causes Control 1(1):81–97, discussion 99–109CrossRefPubMedGoogle Scholar
  44. 44.
    Slattery ML, Benson J, Berry TD, Duncan D, Edwards SL, Caan BJ, Potter JD (1997) Dietary sugar and colon cancer. Cancer Epidemiol Biomark Prev 6(9):677–685Google Scholar
  45. 45.
    Goldin BR, Adlercreutz H, Gorbach SL, Warram JH, Dwyer JT, Swenson L, Woods MN (1982) Estrogen excretion patterns and plasma levels in vegetarian and omnivorous women. N Engl J Med 307(25):1542–1547CrossRefPubMedGoogle Scholar
  46. 46.
    Goldin BR, Adlercreutz H, Gorbach SL, Woods MN, Dwyer JT, Conlon T, Bohn E, Gershoff SN (1986) The relationship between estrogen levels and diets of Caucasian American and Oriental immigrant women. Am J Clin Nutr 44(6):945–953PubMedGoogle Scholar
  47. 47.
    Thissen JP, Ketelslegers JM, Underwood LE (1994) Nutritional regulation of the insulin-like growth factors. Endocr Rev 15(1):80–101PubMedGoogle Scholar
  48. 48.
    Holmes MD, Pollak MN, Willett WC, Hankinson SE (2002) Dietary correlates of plasma insulin-like growth factor I and insulin-like growth factor binding protein 3 concentrations. Cancer Epidemiol Biomark Prev 11(9):852–861Google Scholar
  49. 49.
    Kaklamani VG, Linos A, Kaklamani E, Markaki I, Koumantaki Y, Mantzoros CS (1999) Dietary fat and carbohydrates are independently associated with circulating insulin-like growth factor 1 and insulin-like growth factor-binding protein 3 concentrations in healthy adults. J Clin Oncol 17(10):3291–3298PubMedGoogle Scholar
  50. 50.
    Nagata C, Shimizu H, Takami R, Hayashi M, Takeda N, Yasuda K (2003) Dietary soy and fats in relation to serum insulin-like growth factor-1 and insulin-like growth factor-binding protein-3 levels in premenopausal Japanese women. Nutr Cancer 45(2):185–189CrossRefPubMedGoogle Scholar
  51. 51.
    Norat T, Dossus L, Rinaldi S, Overvad K, Gronbaek H, Tjonneland A, Olsen A et al (2007) Diet, serum insulin-like growth factor-I and IGF-binding protein-3 in European women. Eur J Clin Nutr 61(1):91–98CrossRefPubMedGoogle Scholar
  52. 52.
    Hankinson SE, London SJ, Chute CG, Barbieri RL, Jones L, Kaplan LA, Sacks FM, Stampfer MJ (1989) Effect of transport conditions on the stability of biochemical markers in blood. Clin Chem 35(12):2313–2316PubMedGoogle Scholar
  53. 53.
    Schernhammer ES, Holly JM, Hunter DJ, Pollak MN, Hankinson SE (2006) Insulin-like growth factor-I, its binding proteins (IGFBP-1 and IGFBP-3), and growth hormone and breast cancer risk in the nurses health study II. Endocr Relat Cancer 13(2):583–592CrossRefPubMedGoogle Scholar
  54. 54.
    Tworoger SS, Sluss P, Hankinson SE (2006) Association between plasma prolactin concentrations and risk of breast cancer among predominately premenopausal women. Cancer Res 66(4):2476–2482CrossRefPubMedGoogle Scholar
  55. 55.
    Eliassen AH, Missmer SA, Tworoger SS, Hankinson SE (2006) Endogenous steroid hormone concentrations and risk of breast cancer: does the association vary by a woman’s predicted breast cancer risk? J Clin Oncol 24(12):1823–1830CrossRefPubMedGoogle Scholar
  56. 56.
    Tworoger SS, Missmer SA, Eliassen AH, Spiegelman D, Folkerd E, Dowsett M, Barbieri RL, Hankinson SE (2006) The association of plasma DHEA and DHEA sulfate with breast cancer risk in predominantly premenopausal women. Cancer Epidemiol Biomark Prev 15(5):967–971CrossRefGoogle Scholar
  57. 57.
    Missmer SA, Spiegelman D, Bertone-Johnson ER, Barbieri RL, Pollak MN, Hankinson SE (2006) Reproducibility of plasma steroid hormones, prolactin, and insulin-like growth factor levels among premenopausal women over a 2- to 3-year period. Cancer Epidemiol Biomark Prev 15(5):972–978CrossRefGoogle Scholar
  58. 58.
    Salvini S, Hunter DJ, Sampson L, Stampfer MJ, Colditz GA, Rosner B, Willett WC (1989) Food-based validation of a dietary questionnaire: the effects of week-to-week variation in food consumption. Int J Epidemiol 18(4):858–867CrossRefPubMedGoogle Scholar
  59. 59.
    Willett W (1998) Nutritional epidemiology, 2nd edn. Oxford University Press, New YorkGoogle Scholar
  60. 60.
    Rimm EB, Giovannucci EL, Stampfer MJ, Colditz GA, Litin LB, Willett WC (1992) Reproducibility and validity of an expanded self-administered semiquantitative food frequency questionnaire among male health professionals. Am J Epidemiol 135(10):1114–1126, discussion 1127–1136PubMedGoogle Scholar
  61. 61.
    Holmes MD, Spiegelman D, Willett WC, Manson JE, Hunter DJ, Barbieri RL, Colditz GA, Hankinson SE (2000) Dietary fat intake and endogenous sex steroid hormone levels in postmenopausal women. J Clin Oncol 18(21):3668–3676PubMedGoogle Scholar
  62. 62.
    Haytowitz DB (1995) Information from USDA’s nutrient data bank. J Nutr 125(7):1952–1955PubMedGoogle Scholar
  63. 63.
    Rosner B (1983) Percentage points for a generalized ESD many-outlier procedure. Technometrics 25:165–172CrossRefGoogle Scholar
  64. 64.
    Wu AH, Pike MC, Stram DO (1999) Meta-analysis: dietary fat intake, serum estrogen levels, and the risk of breast cancer. J Natl Cancer Inst 91(6):529–534CrossRefPubMedGoogle Scholar
  65. 65.
    Holmes MD, Schisterman EF, Spiegelman D, Hunter DJ, Willett WC (1999) Re: meta-analysis: dietary fat intake, serum estrogen levels, and the risk of breast cancer. J Natl Cancer Inst 91(17):1511–1512CrossRefPubMedGoogle Scholar
  66. 66.
    Rose DP, Goldman M, Connolly JM, Strong LE (1991) High-fiber diet reduces serum estrogen concentrations in premenopausal women. Am J Clin Nutr 54(3):520–525PubMedGoogle Scholar
  67. 67.
    Gann PH, Chatterton RT, Gapstur SM, Liu K, Garside D, Giovanazzi S, Thedford K, Van Horn L (2003) The effects of a low-fat/high-fiber diet on sex hormone levels and menstrual cycling in premenopausal women: a 12-month randomized trial (the diet and hormone study). Cancer 98(9):1870–1879CrossRefPubMedGoogle Scholar
  68. 68.
    Brown BD, Thomas W, Hutchins A, Martini MC, Slavin JL (2002) Types of dietary fat and soy minimally affect hormones and biomarkers associated with breast cancer risk in premenopausal women. Nutr Cancer 43(1):22–30CrossRefPubMedGoogle Scholar
  69. 69.
    Nagata C, Takatsuka N, Kawakami N, Shimizu H (2000) Total and monounsaturated fat intake and serum estrogen concentrations in premenopausal Japanese women. Nutr Cancer 38(1):37–39CrossRefPubMedGoogle Scholar
  70. 70.
    Dorgan JF, Reichman ME, Judd JT, Brown C, Longcope C, Schatzkin A, Forman M et al (1996) Relation of energy, fat, and fiber intakes to plasma concentrations of estrogens and androgens in premenopausal women. Am J Clin Nutr 64(1):25–31PubMedGoogle Scholar
  71. 71.
    Aubertin-Leheudre M, Gorbach S, Woods M, Dwyer JT, Goldin B, Adlercreutz H (2008) Fat/fiber intakes and sex hormones in healthy premenopausal women in USA. J Steroid Biochem Mol Biol 112(1–3):32–39CrossRefPubMedGoogle Scholar
  72. 72.
    Schaefer EJ, Lamon-Fava S, Spiegelman D, Dwyer JT, Lichtenstein AH, McNamara JR, Goldin BR et al (1995) Changes in plasma lipoprotein concentrations and composition in response to a low-fat, high-fiber diet are associated with changes in serum estrogen concentrations in premenopausal women. Metabolism 44(6):749–756CrossRefPubMedGoogle Scholar
  73. 73.
    Maskarinec G, Morimoto Y, Takata Y, Murphy SP, Stanczyk FZ (2006) Alcohol and dietary fibre intakes affect circulating sex hormones among premenopausal women. Public Health Nutr 9(7):875–881CrossRefPubMedGoogle Scholar
  74. 74.
    Heald AH, Golding C, Sharma R, Siddals K, Kirk S, Lawton C, Anderson S, Martin Gibson J, Cade JE (2004) A substitution model of dietary manipulation is an effective means of optimising lipid profile, reducing C-reactive protein and increasing insulin-like growth factor-1. Br J Nutr 92(5):809–818CrossRefPubMedGoogle Scholar
  75. 75.
    Al-Delaimy WK, Natarajan L, Rock CL, Sun S, Flatt SW, Pierce JP (2006) Insulin-like growth factor I, insulin-like growth factor I binding protein 1, insulin, glucose, and leptin serum levels are not influenced by a reduced-fat, high-fiber diet intervention. Cancer Epidemiol Biomark Prev 15(6):1238–1239CrossRefGoogle Scholar
  76. 76.
    Gann PH, Kazer R, Chatterton R, Gapstur S, Thedford K, Helenowski I, Giovanazzi S, Van Horn L (2005) Sequential, randomized trial of a low-fat, high-fiber diet and soy supplementation: effects on circulating IGF-I and its binding proteins in premenopausal women. Int J Cancer 116(2):297–303CrossRefPubMedGoogle Scholar
  77. 77.
    Kaaks R, Bellati C, Venturelli E, Rinaldi S, Secreto G, Biessy C, Pala V, Sieri S, Berrino F (2003) Effects of dietary intervention on IGF-I and IGF-binding proteins, and related alterations in sex steroid metabolism: the diet and androgens (DIANA) randomised trial. Eur J Clin Nutr 57(9):1079–1088CrossRefPubMedGoogle Scholar
  78. 78.
    Maskarinec G, Takata Y, Kaaks R (2005) The relation between nutritional factors and insulin-like growth factor-I in premenopausal women of different ethnicity. Eur J Nutr 44(2):105–113CrossRefPubMedGoogle Scholar
  79. 79.
    Hu FB, Stampfer MJ, Manson JE et al (1997) Dietary fat intake and the risk of coronary heart disease in women. N Engl J Med 337(21):1491–1499CrossRefPubMedGoogle Scholar
  80. 80.
    Wolk A, Manson JE, Stampfer MJ, Colditz GA, Hu FB, Speizer FE, Hennekens CH, Willett WC (1999) Long-term intake of dietary fiber and decreased risk of coronary heart disease among women. JAMA 281(21):1998–2004CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Xiaohui Cui
    • 1
  • Bernard Rosner
    • 1
    • 2
  • Walter C. Willett
    • 1
    • 3
    • 4
  • Susan E. Hankinson
    • 1
    • 3
  1. 1.Channing Laboratory, Department of MedicineBrigham and Women’s Hospital and Harvard Medical SchoolBostonUSA
  2. 2.Department of BiostatisticsHarvard School of Public HealthBostonUSA
  3. 3.Department of EpidemiologyHarvard School of Public HealthBostonUSA
  4. 4.Department of NutritionHarvard School of Public HealthBostonUSA

Personalised recommendations