Holmes M D, Hunter D J, Colditz G A, Stampfer M J, Hankinson S E, Speizer F E, Rosner B, Willett W C
Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, Mass 02115, USA.
JAMA. 1999 Mar 10;281(10):914-20. doi: 10.1001/jama.281.10.914.
High intakes of fat and specific fatty acids, including total, animal, saturated, polyunsaturated, and trans-unsaturated fats, have been postulated to increase breast cancer risk.
To determine whether intakes of fat and fatty acids are associated with breast cancer.
Cohort study (Nurses' Health Study) conducted in the United States beginning in 1976.
A total of 88795 women free of cancer in 1980 and followed up for 14 years.
Relative risk (RR) of invasive breast cancer for an incremental increase of fat intake, ascertained by food frequency questionnaire in 1980, 1984, 1986, and 1990.
A total of 2956 women were diagnosed as having breast cancer. Compared with women obtaining 30.1% to 35% of energy from fat, women consuming 20% or less had a multivariate RR of breast cancer of 1.15 (95% confidence interval [CI], 0.73-1.80). In multivariate models, the RR (95% CI) for a 5%-of-energy increase was 0.97 (0.94-1.00) for total fat, 0.98 (0.96-1.01) for animal fat, 0.97 (0.93-1.02) for vegetable fat, 0.94 (0.88-1.01) for saturated fat, 0.91 (0.79-1.04) for polyunsaturated fat, and 0.94 (0.88-1.00) for monounsaturated fat. For a 1% increase in energy from trans-unsaturated fat, the values were 0.92 (0.86-0.98), and for a 0.1% increase in energy from omega-3 fat from fish, the values were 1.09 (1.03-1.16). In a model including fat, protein, and energy, the RR for a 5% increase in total fat, which can be interpreted as the risk of substituting this amount of fat for an equal amount of energy from carbohydrate, was 0.96 (95% CI, 0.93-0.99). In similar models, no significant association of risk was evident with any major types of fat.
We found no evidence that lower intake of total fat or specific major types of fat was associated with a decreased risk of breast cancer.
据推测，高摄入脂肪及特定脂肪酸，包括总脂肪、动物脂肪、饱和脂肪、多不饱和脂肪及反式不饱和脂肪，会增加患乳腺癌的风险。
确定脂肪和脂肪酸的摄入量是否与乳腺癌相关。
始于1976年在美国进行的队列研究（护士健康研究）。
1980年共有88795名无癌症的女性，并随访了14年。
通过1980年、1984年、1986年和1990年的食物频率问卷确定，脂肪摄入量每增加，浸润性乳腺癌的相对风险（RR）。
共有2956名女性被诊断患有乳腺癌。与从脂肪中获取30.1%至35%能量的女性相比，从脂肪中获取20%或更少能量的女性患乳腺癌的多变量RR为1.15（95%置信区间[CI]，0.73 - 1.80）。在多变量模型中，总脂肪能量每增加5%的RR（95%CI）为0.97（0.94 - 1.00），动物脂肪为0.98（0.96 - 1.01），植物脂肪为0.97（0.93 - 1.02），饱和脂肪为0.94（0.88 - 1.01），多不饱和脂肪为0.91（0.79 - 1.04），单不饱和脂肪为0.94（0.88 - 1.00）。反式不饱和脂肪能量每增加1%，RR值为0.92（0.86 - 0.98），鱼类中ω-3脂肪能量每增加0.1%，RR值为1.09（1.03 - 1.16）。在一个包括脂肪、蛋白质和能量的模型中，总脂肪增加5%的RR，可解释为用等量这种脂肪替代等量碳水化合物能量的风险，为0.96（95%CI，0.93 - 0.99）。在类似模型中，未发现任何主要类型的脂肪与风险有显著关联。
我们没有发现证据表明总脂肪或特定主要类型脂肪的低摄入量与乳腺癌风险降低有关。
