Cancer Causes & Control

, Volume 13, Issue 10, pp 937–946 | Cite as

Increased risk of early-stage breast cancer related to consumption of sweet foods among women less than age 45 in the United States

  • Nancy Potischman
  • Ralph J. Coates
  • Christine A. Swanson
  • Raymond J. Carroll
  • Janet R. Daling
  • Donna R. Brogan
  • Marilie D. Gammon
  • Douglas Midthune
  • Jane Curtin
  • Louise A. Brinton
Article

Abstract

Objectives: To evaluate the associations of dietary macronutrients, food groups, and eating patterns with risk of breast cancer in a population-based case–control study. Methods: In this study among women 20–44 years of age, 568 cases with breast cancer and 1451 population-based controls were included. They completed a detailed in-person interview, a self-administered food-frequency questionnaire and were measured for anthropometric indices. Logistic regression was used to estimate odds ratios (OR) and their 95% confidence intervals (CI) of breast cancer, adjusted for age, study site, race, education, alcohol consumption, oral contraceptive usage, smoking status, and body mass index. Results: There was no association between breast cancer risk and intake of calories, macronutrients, or types of fat. Risk of breast cancer was unrelated to intakes of a variety of food groups, including red meats, dairy, high-fat snacks and desserts, or foods high in animal fat. Increased risk was observed for high intake of a food group composed of sweet items, particularly sodas and desserts. Risk increased linearly with percent of calories from sweets and frequency of sweets intake. Consumption of sweets 9.8 or more times per week compared with <2.8 times per week was associated with an adjusted OR of 1.32 (95% CI = 1.0–1.8). This association did not appear to be due to the high-fat foods or carbonated beverages that comprised the food group. Compared with women reporting one or two meals and snacks per day, reduced risks were noted for women reporting six or more (OR = 0.69, 95% CI = 0.4–1.1). Conclusions: These data suggest a modest relationship between intakes of sweet items with risk of in-situ and localized breast cancer in young women. This relation is consistent with the hypothesized link of high insulin exposure and risk of breast cancer. There was some suggestion that women who ate many times during the day were at reduced risk of disease, which is also consistent with an insulin-related mechanism.

breast cancer diet sweet foods United States women 
This is a preview of subscription content, log in to check access

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Hunter DJ, Willett WC (1996) Nutrition and breast cancer. Cancer Causes Control 7: 56–68.Google Scholar
  2. 2.
    Hunter DJ, Spiegelman D, Adami H-O, et al. (1996) Cohort studies of fat intake and the risk of breast cancer-a pooled analysis. N Engl J Med 334: 356–361.Google Scholar
  3. 3.
    Gandini S, Merzenich H, Robertson C, Boyle P (2000) Metaanalysis of studies on breast cancer risk and diet: the role of fruit and vegetable consumption and the intake of associated micronutrients. Eur J Cancer 36: 636–646.Google Scholar
  4. 4.
    World Cancer Research Fund, American Institute for Cancer Research (1997) Food, nutrition and the prevention of cancer: a global perspective. Washington, DC: American Institute for Cancer Research.Google Scholar
  5. 5.
    Smith-Warner SA, Spiegelman D, Yaun S-S, et al. (2001) Intake of fruits and vegetables and risk of breast cancer: a pooled analysis of cohort studies. JAMA 285: 769–776.Google Scholar
  6. 6.
    Madigan MP, Ziegler RG, Benichou J, Byrne C, Hoover RN (1995) Proportion of breast cancer cases in the United States explained by well-established risk factors. J Natl Cancer Inst 87: 1681–1685.Google Scholar
  7. 7.
    Brinton LA, Benichou J, Gammon MD, Brogan DR, Coates R, Schoenberg JB (1997) Ethnicity and variation in breast cancer incidence. Int J Cancer 73: 349–355.Google Scholar
  8. 8.
    Tavani A, Braga C, La Vecchia C, Negri E, Russo A, Franceschi S (1997) Attributable risks for breast cancer in Italy: education, family history and reproductive and hormonal factors. Int J Cancer 70: 159–163.Google Scholar
  9. 9.
    Potischman N, Carroll RJ, Iturria SJ, et al. (1999) Comparison of the 60–and 100–item NCI-block questionnaires with validation data. Nutr Cancer 34: 70–75.Google Scholar
  10. 10.
    Brinton LA, Daling JR, Liff JM, et al. (1995) Oral contraceptives and breast cancer risk amongyoung er women. J Natl Cancer Inst 87: 827–835.Google Scholar
  11. 11.
    Swanson CA, Coates RJ, Schoenberg JB, et al. (1996) Body size and breast cancer risk amongwomen under age 45 years. Am J Epidemiol 143: 698–706. 944 N. Potischman et al.Google Scholar
  12. 12.
    Swanson CA, Coates RJ, Malone KE, et al. (1997) Alcohol consumption and breast cancer risk amongwomen under age 45 years. Epidemiology 8: 231–237.Google Scholar
  13. 13.
    Waksberg J (1978) Sampling methods for random digit dialing. J Am Stat Assoc 73: 40–46.Google Scholar
  14. 14.
    Potischman N, Swanson CA, Coates RJ, et al. (1997) Dietary relationships with early onset (under age 45) breast cancer in a case-control study in the United States: influence of chemotherapy treatment. Cancer Causes Control 8: 713–721.Google Scholar
  15. 15.
    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.Google Scholar
  16. 16.
    Coates RJ, Eley JW, Block G, et al. (1991) An evaluation of a food frequency questionnaire for assessingdietary intake of specific carotenoids and vitamin E amonglow-income black women. Am J Epidemiol 134: 658–671.Google Scholar
  17. 17.
    Breslow NE, Day NE (1980) Statistical Methods in Cancer Research, Vol. I: The Analysis of Case-Control Studies. Lyon: International Agency for Research on Cancer (IARC).Google Scholar
  18. 18.
    Rosner B, Spiegelman D, Willett WC (1990) Correction of logistic regression relative risk estimates and confidence intervals for measurement error: the case of multiple covariates measured with error. Am J Epidemiol 132: 734–745.Google Scholar
  19. 19.
    Boyd NF, Martin LJ, Noffel M, Lockwood GA, Trichler DL (1993) A meta-analysis of studies of dietary fat and breast cancer risk. Br J Cancer 68: 627–636.Google Scholar
  20. 20.
    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.Google Scholar
  21. 21.
    Smith-Warner SA, Spiegelman D, Adami H-O, et al. (2001) Types of dietary fat and breast cancer: a pooled analysis of cohort studies. Int J Cancer 92: 767–774.Google Scholar
  22. 22.
    Toniolo P, Riboli E, Protta F, Charrel M, Cappa APM (1989) Calorie-providingnutrient s and risk of breast cancer. J Natl Cancer Inst 81: 278–286.Google Scholar
  23. 23.
    Katsouyanni K, Willett W, Trichopoulos D, et al. (1988) Risk of breast cancer amongGreek women in relation to nutrient intake. Cancer 61: 181–185.Google Scholar
  24. 24.
    Rohan TE, McMichael AJ, Baghurst PA (1988) A populationbased case-control study of diet and breast cancer in Australia. Am J Epidemiol 128: 478–489.Google Scholar
  25. 25.
    Trichopoulou A, Katsouyanni K, Stuver S, et al. (1995) Consumption of olive oil and specific food groups in relation to breast cancer risk in Greece. J Natl Cancer Inst 87: 110–116.Google Scholar
  26. 26.
    Hirose K, Tajima K, Hamajima N, et al. (1995) A large-scale, hospital-based case-control study of risk factors of breast cancer accordingto menopausal status. Jpn J Cancer Res 86: 146–154.Google Scholar
  27. 27.
    Lubin JH, Burns PE, Blot WJ, Ziegler RG, Lees AW (1981) Dietary factors and breast cancer risk. Int J Cancer 28: 685–689.Google Scholar
  28. 28.
    Landa M-C, Frago N, Tres A (1994) Diet and the risk of breast cancer in Spain. Eur J Cancer Prev 3: 313–320.Google Scholar
  29. 29.
    Richardson S, Gerber M, Cene´ e S (1991) The role of fat, animal protein and some vitamin consumption in breast cancer: a case control study in southern France. Int J Cancer 48: 1–9.Google Scholar
  30. 30.
    Franceschi S, Favaero A, La Vecchia C, et al. (1995) Influence of food groups and food diversity on breast cancer risk in italy. Int J Cancer 63: 785–789.Google Scholar
  31. 31.
    Franceschi S, La Vecchia C, Russo A, Negri E, Favero A, Decarli A (1997) Low-risk diet for breast cancer in Italy. Cancer Epidemiol Biomarkers Prev 6: 875–879.Google Scholar
  32. 32.
    Burley VJ (1998) Sugar consumption and human cancer in sites other than the digestive tract. Eur J Cancer Prev 7: 253–277.Google Scholar
  33. 33.
    Kaaks R (1996) Nutrition, hormones, and breast cancer: is insulin the missinglink? Cancer Causes Control 7: 605–625.Google Scholar
  34. 34.
    Kazer RR (1995) Insulin resistance, insulin-like growth factor I and breast cancer: a hypothesis. Int J Cancer 62: 403–406.Google Scholar
  35. 35.
    Stoll BA (1996) Nutrition and breast cancer risk: can an effect via insulin resistance be demonstrated? Breast Cancer Res Treat 38: 239–246.Google Scholar
  36. 36.
    Nagata C, Shimizu H, Takami R, Hayashi M, Takeda N, Yasuda K (2000) Relations of insulin resistance and serum concentrations of estradiol and sex hormone-bindingg lobulin to potential breast cancer risk factors. Jpn J Cancer Res 91: 948–953.Google Scholar
  37. 37.
    Poretsky L (1991) On the paradox of insulin-induced hyperandrogenism in insulin-resistant states. Endocr inol Rev 12: 3–13.Google Scholar
  38. 38.
    Barbieri RL, Smith S, Ryan KJ (1988) The role of hyperinsulinemia in the pathogenesis of ovarian hyperandrogenism. Fertil Steril 50: 197–212.Google Scholar
  39. 39.
    Bruning PF, Bonfrer JMG, Van Moord PAH, Hart AAM, De Jong-Bakker M, Nooijen WJ (1992) Insulin resistance and breast cancer risk. Int J Cancer 52: 511–516.Google Scholar
  40. 40.
    Del Giudice ME, Fantus IG, Ezzat S, McKeown-Eyssen G, Page D, Goodwin PJ (1998) Insulin and related factors in premenopausal breast cancer risk. Breast Cancer Res Treat 47: 111–120.Google Scholar
  41. 41.
    Toniolo P, Bruning PF, Akhmedkhanov A, et al. (2000) Serum insulin-like growth factor-I and breast cancer. Int J Cancer 88: 828–832.Google Scholar
  42. 42.
    Manjer J, Kaaks R, Riboli E, Berglund G (2001) Risk of breast cancer in relation to anthropometry, blood pressure, blood lipids and glucose metabolism: a prospective study within the MalmöPreventive Project. Eur J Cancer Prev 10: 33–42.Google Scholar
  43. 43.
    Peyrat JP, Bonneterre J, Hecquet B, et al. (1993) Plasma insulinlike growth factor-1 (IGF-1) concentrations in human breast cancer. Eur J Cancer 29A: 492–497.Google Scholar
  44. 44.
    Bruning PF, Van Doorn J, Bonfrèr JMG, et al. (1995) Insulinlike growth-factor-binding protein 3 is decreased in early-stage operable pre-menopausal breast cancer. Int J Cancer 62: 266–270.Google Scholar
  45. 45.
    Hankinson SE, Willett WC, Colditz GA, et al. (1998) Circulating concentrations of insulin-like growth factor-I and risk of breast cancer. Lancet 351: 1393–1396.Google Scholar
  46. 46.
    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: 570–573.Google Scholar
  47. 47.
    Byrne C, Colditz GA, Willett WC, Speizer FE, Pollak M, Hankinson SE (2000) Plasma insulin-like growth factor (IGF) I, IGF-bindingprotein 3, and mammographic density. Cancer Res 60: 3744–3748.Google Scholar
  48. 48.
    Giovannucci E (2001) Insulin, insulin-like growth factors and colon cancer: a review of the evidence. J Nutr 131: 3109S-3120S.Google Scholar

Copyright information

© Kluwer Academic Publishers 2002

Authors and Affiliations

  • Nancy Potischman
    • 1
    • 2
  • Ralph J. Coates
    • 3
  • Christine A. Swanson
    • 4
  • Raymond J. Carroll
    • 5
  • Janet R. Daling
    • 6
  • Donna R. Brogan
    • 7
  • Marilie D. Gammon
    • 8
  • Douglas Midthune
    • 9
  • Jane Curtin
    • 10
  • Louise A. Brinton
    • 11
  1. 1.Division of Cancer Control and Population StudiesCenters for Disease Control and PreventionAtlantaUSA
  2. 2.Applied Research Program, Division of Cancer Control and Population SciencesNational Cancer InstituteBethesdaUSA
  3. 3.Division of Cancer Prevention and ControlCenters for Disease Control and PreventionAtlantaUSA
  4. 4.Office of Dietary SupplementsNational Institutes of HealthBethesdaUSA
  5. 5.Department of StatisticsTexas A & M UniversityCollege StationUSA
  6. 6.Fred Hutchinson Cancer Research CenterSeattleUSA
  7. 7.Department of EpidemiologyEmory UniversityAtlantaUSA
  8. 8.Department of EpidemiologyUniversity of North CarolinaChapel HillUSA
  9. 9.Division of Cancer Prevention, Inc.Silver SpringUSA
  10. 10.Information Management Services, Inc.Silver SpringUSA
  11. 11.Division of Cancer Epidemiology and GeneticsNational Cancer InstituteBethesdaUSA

Personalised recommendations