Breast Cancer Research and Treatment

, Volume 145, Issue 2, pp 461–470 | Cite as

Adolescent dietary fiber, vegetable fat, vegetable protein, and nut intakes and breast cancer risk

  • Ying Liu
  • Graham A. Colditz
  • Michelle Cotterchio
  • Beatrice A. Boucher
  • Nancy Kreiger


The importance of early-life exposures in breast cancer development is increasingly recognized. However, limited research has evaluated the relationship between adolescent diet and subsequent risk of breast cancer and reported inconsistent results. This population-based case–control study investigated the associations of dietary fiber, vegetable protein, vegetable fat, and nuts consumed during adolescence with adult breast cancer risk. Women, ages 25–74 years, who were diagnosed with first primary breast cancer between 2002 and 2003, were identified using the Ontario Cancer Registry. Controls were identified through random-digit dialing and age-frequency matched to cases. Diet at ages 10–15 was assessed with a 55-item food frequency questionnaire among 2,865 cases and 3,299 controls. Logistic regression was performed to estimate odds ratios (ORs) and 95 % confidence intervals (CIs). Inverse associations were found between intakes of dietary fiber, vegetable protein, vegetable fat, and nuts during adolescence and breast cancer risk, which persisted after controlling for adult intakes. The ORs (95 % CI) for the highest versus the lowest quintile of intake were 0.66 (0.55–0.78; P trend < 0.0001) for fiber, 0.80 (0.68–0.95; P trend = 0.01) for vegetable protein, 0.74 (0.63–0.87; P trend = 0.002) for vegetable fat, and 0.76 (0.61–0.95 for ≥1 serving/day vs. <1 serving/month intake; P trend = 0.04) for nuts. The reduced risk for adolescent intakes of fiber, vegetable protein, and nuts was largely limited to postmenopausal women (P interaction ≤ 0.05). Dietary fiber, vegetable protein, vegetable fat, and nuts consumed during adolescence were associated with reduced breast cancer risk.


Breast cancer Diet Adolescence Nutrition 



YL and GAC are supported by the Barnes-Jewish Hospital Foundation, St. Louis, Missouri. GAC is also supported by the Breast Cancer Research Foundation. This research was funded by the Canadian Breast Cancer Research Alliance with special funding support of the Canadian Breast Cancer Foundation Ontario Chapter (CBCRA Grant No. 13572 to M. Cotterchio).

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Colditz GA, Frazier AL (1995) Models of breast cancer show that risk is set by events of early life: prevention efforts must shift focus. Cancer Epidemiol Biomarkers Prev 4:567–571PubMedGoogle Scholar
  2. 2.
    Land CE, Tokunaga M, Koyama K, Soda M, Preston DL, Nishimori I, Tokuoka S (2003) Incidence of female breast cancer among atomic bomb survivors, Hiroshima and Nagasaki, 1950–1990. Radiat Res 160:707–717PubMedCrossRefGoogle Scholar
  3. 3.
    Trichopoulos D, Adami HO, Ekbom A, Hsieh CC, Lagiou P (2008) Early life events and conditions and breast cancer risk: from epidemiology to etiology. Int J Cancer 122:481–485PubMedCrossRefGoogle Scholar
  4. 4.
    Wu AH, Wan P, Hankin J, Tseng CC, Yu MC, Pike MC (2002) Adolescent and adult soy intake and risk of breast cancer in Asian-Americans. Carcinogenesis 23:1491–1496PubMedCrossRefGoogle Scholar
  5. 5.
    Colditz GA, Rosner B (2000) Cumulative risk of breast cancer to age 70 years according to risk factor status: data from the Nurses’ Health Study. Am J Epidemiol 152:950–964PubMedCrossRefGoogle Scholar
  6. 6.
    Pike MC, Krailo MD, Henderson BE, Casagrande JT, Hoel DG (1983) ‘Hormonal’ risk factors, ‘breast tissue age’ and the age-incidence of breast cancer. Nature 303:767–770PubMedCrossRefGoogle Scholar
  7. 7.
    Rosner B, Colditz GA (1996) Nurses’ health study: log-incidence mathematical model of breast cancer incidence. J Natl Cancer Inst 88:359–364PubMedCrossRefGoogle Scholar
  8. 8.
    Rosner B, Colditz GA, Willett WC (1994) Reproductive risk factors in a prospective study of breast cancer: the Nurses’ Health Study. Am J Epidemiol 139:819–835PubMedGoogle Scholar
  9. 9.
    Anderson LN, Cotterchio M, Boucher BA, Kreiger N (2013) Phytoestrogen intake from foods, during adolescence and adulthood, and risk of breast cancer by estrogen and progesterone receptor tumor subgroup among Ontario women. Int J Cancer 132:1683–1692PubMedCrossRefGoogle Scholar
  10. 10.
    Lee SA, Shu XO, Li H, Yang G, Cai H, Wen W, Ji BT, Gao J, Gao YT, Zheng W (2009) Adolescent and adult soy food intake and breast cancer risk: results from the Shanghai Women’s Health Study. Am J Clin Nutr 89:1920–1926PubMedCentralPubMedCrossRefGoogle Scholar
  11. 11.
    Liu Y, Colditz GA, Rosner B, Berkey CS, Collins LC, Schnitt SJ, Connolly JL, Chen WY, Willett WC, Tamimi RM (2013) Alcohol intake between menarche and first pregnancy: a prospective study of breast cancer risk. J Natl Cancer Inst 105:1571–1578PubMedCentralPubMedCrossRefGoogle Scholar
  12. 12.
    Maruti SS, Willett WC, Feskanich D, Rosner B, Colditz GA (2008) A prospective study of age-specific physical activity and premenopausal breast cancer. J Natl Cancer Inst 100:728–737PubMedCentralPubMedCrossRefGoogle Scholar
  13. 13.
    Russo IH, Russo J (2011) Pregnancy-induced changes in breast cancer risk. J Mammary Gland Biol Neoplasia 16:221–233PubMedCrossRefGoogle Scholar
  14. 14.
    Meier-Abt F, Milani E, Roloff T, Brinkhaus H, Duss S, Meyer DS, Klebba I, Balwierz PJ, van Nimwegen E, Bentires-Alj M (2013) Parity induces differentiation and reduces Wnt/Notch signaling ratio and proliferation potential of basal stem/progenitor cells isolated from mouse mammary epithelium. Breast Cancer Res 15:R36PubMedCentralPubMedCrossRefGoogle Scholar
  15. 15.
    Medina D (2013) Pregnancy protection of breast cancer: new insights reveal unanswered questions. Breast Cancer Res 15:103PubMedCentralPubMedCrossRefGoogle Scholar
  16. 16.
    Bernstein L, Pike MC, Ross RK, Judd HL, Brown JB, Henderson BE (1985) Estrogen and sex hormone-binding globulin levels in nulliparous and parous women. J Natl Cancer Inst 74:741–745PubMedGoogle Scholar
  17. 17.
    Musey VC, Collins DC, Musey PI, Martino-Saltzman D, Preedy JR (1987) Long-term effect of a first pregnancy on the secretion of prolactin. N Engl J Med 316:229–234PubMedCrossRefGoogle Scholar
  18. 18.
    Frazier AL, Li L, Cho E, Willett WC, Colditz GA (2004) Adolescent diet and risk of breast cancer. Cancer Causes Control 15:73–82PubMedCrossRefGoogle Scholar
  19. 19.
    Frazier AL, Ryan CT, Rockett H, Willett WC, Colditz GA (2003) Adolescent diet and risk of breast cancer. Breast Cancer Res 5:R59–R64PubMedCentralPubMedCrossRefGoogle Scholar
  20. 20.
    Berkey CS, Willett WC, Tamimi RM, Rosner B, Frazier AL, Colditz GA (2013) Vegetable protein and vegetable fat intakes in pre-adolescent and adolescent girls, and risk for benign breast disease in young women. Breast Cancer Res Treat 141:299–306PubMedCrossRefGoogle Scholar
  21. 21.
    Su X, Tamimi RM, Collins LC, Baer HJ, Cho E, Sampson L, Willett WC, Schnitt SJ, Connolly JL, Rosner BA, Colditz GA (2010) Intake of fiber and nuts during adolescence and incidence of proliferative benign breast disease. Cancer Causes Control 21:1033–1046PubMedCentralPubMedCrossRefGoogle Scholar
  22. 22.
    Baer HJ, Schnitt SJ, Connolly JL, Byrne C, Cho E, Willett WC, Colditz GA (2003) Adolescent diet and incidence of proliferative benign breast disease. Cancer Epidemiol Biomarkers Prev 12:1159–1167PubMedGoogle Scholar
  23. 23.
    Cotterchio M, Boucher BA, Kreiger N, Mills CA, Thompson LU (2008) Dietary phytoestrogen intake—lignans and isoflavones—and breast cancer risk (Canada). Cancer Causes Control 19:259–272PubMedCrossRefGoogle Scholar
  24. 24.
    Thanos J, Cotterchio M, Boucher BA, Kreiger N, Thompson LU (2006) Adolescent dietary phytoestrogen intake and breast cancer risk (Canada). Cancer Causes Control 17:1253–1261PubMedCrossRefGoogle Scholar
  25. 25.
    U.S. Department of Agriculture, Agricultural Research Service (2007) USDA National Nutrient Database for Standard Reference, Release 25. Nutrient Data Laboratory Home Page. Accessed 14 June 2013
  26. 26.
    Anderson LN, Cotterchio M, Vieth R, Knight JA (2010) Vitamin D and calcium intakes and breast cancer risk in pre- and postmenopausal women. Am J Clin Nutr 91:1699–1707PubMedCrossRefGoogle Scholar
  27. 27.
    Boucher B, Cotterchio M, Kreiger N, Nadalin V, Block T, Block G (2006) Validity and reliability of the Block98 food-frequency questionnaire in a sample of Canadian women. Public Health Nutr 9:84–93PubMedCrossRefGoogle Scholar
  28. 28.
    Thompson FE, Subar AF (2001) Dietary assessment methodology. In: Coulston AM, Rock CL, Monsen ER (eds) Nutrition in the prevention and treatment of disease, 2nd edn. Academic Press, San DiegoGoogle Scholar
  29. 29.
    Linos E, Willett WC, Cho E, Frazier L (2010) Adolescent diet in relation to breast cancer risk among premenopausal women. Cancer Epidemiol Biomarkers Prev 19:689–696PubMedCentralPubMedCrossRefGoogle Scholar
  30. 30.
    Pryor M, Slattery ML, Robison LM, Egger M (1989) Adolescent diet and breast cancer in Utah. Cancer Res 49:2161–2167PubMedGoogle Scholar
  31. 31.
    Aune D, Chan DS, Greenwood DC, Vieira AR, Rosenblatt DA, Vieira R, Norat T (2012) Dietary fiber and breast cancer risk: a systematic review and meta-analysis of prospective studies. Ann Oncol 23:1394–1402PubMedCrossRefGoogle Scholar
  32. 32.
    Forman MR (2007) Changes in dietary fat and fiber and serum hormone concentrations: nutritional strategies for breast cancer prevention over the life course. J Nutr 137:170S–174SPubMedGoogle Scholar
  33. 33.
    Dorgan JF, Hunsberger SA, McMahon RP, Kwiterovich PO Jr, Lauer RM, Van Horn L, Lasser NL, Stevens VJ, Friedman LA, Yanovski JA, Greenhut SF, Chandler DW, Franklin FA, Barton BA, Buckman DW, Snetselaar LG, Patterson BH, Schatzkin A, Taylor PR (2003) Diet and sex hormones in girls: findings from a randomized controlled clinical trial. J Natl Cancer Inst 95:132–141PubMedCrossRefGoogle Scholar
  34. 34.
    Dorgan JF, Liu L, Klifa C, Hylton N, Shepherd JA, Stanczyk FZ, Snetselaar LG, Van Horn L, Stevens VJ, Robson A, Kwiterovich PO Jr, Lasser NL, Himes JH, Pettee Gabriel K, Kriska A, Ruder EH, Fang CY, Barton BA (2010) Adolescent diet and subsequent serum hormones, breast density, and bone mineral density in young women: results of the Dietary Intervention Study in Children follow-up study. Cancer Epidemiol Biomarkers Prev 19:1545–1556PubMedCentralPubMedCrossRefGoogle Scholar
  35. 35.
    Kerver JM, Gardiner JC, Dorgan JF, Rosen CJ, Velie EM (2010) Dietary predictors of the insulin-like growth factor system in adolescent females: results from the Dietary Intervention Study in Children (DISC). Am J Clin Nutr 91:643–650PubMedCentralPubMedCrossRefGoogle Scholar
  36. 36.
    Korde LA, Wu AH, Fears T, Nomura AM, West DW, Kolonel LN, Pike MC, Hoover RN, Ziegler RG (2009) Childhood soy intake and breast cancer risk in Asian American women. Cancer Epidemiol Biomarkers Prev 18:1050–1059PubMedCrossRefGoogle Scholar
  37. 37.
    Kris-Etherton PM, Hu FB, Ros E, Sabate J (2008) The role of tree nuts and peanuts in the prevention of coronary heart disease: multiple potential mechanisms. J Nutr 138:1746S–1751SPubMedGoogle Scholar
  38. 38.
    Sonestedt E, Borgquist S, Ericson U, Gullberg B, Landberg G, Olsson H, Wirfalt E (2008) Plant foods and oestrogen receptor alpha- and beta-defined breast cancer: observations from the Malmo Diet and Cancer cohort. Carcinogenesis 29:2203–2209PubMedCrossRefGoogle Scholar
  39. 39.
    Frazier AL, Willett WC, Colditz GA (1995) Reproducibility of recall of adolescent diet: Nurses’ Health Study (United States). Cancer Causes Control 6:499–506PubMedCrossRefGoogle Scholar
  40. 40.
    Maruti SS, Feskanich D, Rockett HR, Colditz GA, Sampson LA, Willett WC (2006) Validation of adolescent diet recalled by adults. Epidemiology 17:226–229PubMedCrossRefGoogle Scholar
  41. 41.
    Keast DR, Fulgoni VL 3rd, Nicklas TA, O’Neil CE (2013) Food sources of energy and nutrients among children in the United States: National Health and Nutrition Examination Survey 2003–2006. Nutrients 5:283–301PubMedCentralPubMedCrossRefGoogle Scholar
  42. 42.
    Phillips S, Jacobs Starkey L, Gray-Donald K (2004) Food habits of Canadians: food sources of nutrients for the adolescent sample. Can J Diet Pract Res 65:81–84PubMedCrossRefGoogle Scholar
  43. 43.
    Kushi LH, Doyle C, McCullough M, Rock CL, Demark-Wahnefried W, Bandera EV, Gapstur S, Patel AV, Andrews K, Gansler T (2012) American Cancer Society Guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. CA Cancer J Clin 62:30–67PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Ying Liu
    • 1
  • Graham A. Colditz
    • 1
    • 2
  • Michelle Cotterchio
    • 3
    • 4
  • Beatrice A. Boucher
    • 3
    • 5
  • Nancy Kreiger
    • 3
    • 4
    • 5
  1. 1.Division of Public Health Sciences, Department of SurgeryWashington University School of MedicineSt. LouisUSA
  2. 2.Alvin J. Siteman Cancer Center at Barnes-Jewish HospitalWashington University School of MedicineSt. LouisUSA
  3. 3.Prevention and Cancer ControlCancer Care OntarioTorontoCanada
  4. 4.Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada
  5. 5.Department of Nutritional SciencesUniversity of TorontoTorontoCanada

Personalised recommendations