Frazier A Lindsay, Li Lisa, Cho Eunyong, Willett Walter C, Colditz Graham A
Division of Pediatric Oncology, Dana-Farber Cancer Institute, Harvard Medical School, USA.
Cancer Causes Control. 2004 Feb;15(1):73-82. doi: 10.1023/B:CACO.0000016617.57120.df.
To investigate the components of adolescent diet that may influence risk of breast cancer as an adult.
Retrospective cohort study among 47,355 participants in the Nurses Health Study II who answered a 131-item food frequency questionnaire about diet during high school. Cox proportional hazards regression was used to estimate relative risks and 95% confidence intervals among incident cases of breast cancer between 1989 (inception of the study) and 1998 (when high school diet was assessed).
Intakes of fat and fiber were not significantly related to risk of breast cancer in multivariate analysis, but increased intake of vegetable fat ( Q (5) versus Q (1) multivariate RR = 0.58, 95% CI (0.38-0.86); test for trend p = 0.005) and vitamin E ( Q (5) versus Q (1) multivariate RR = 0.61, 95% CI (0.42-0.89); test for trend p = 0.003) were associated with a lower risk. A higher dietary glycemic index ( Q (5) versus Q (1) multivariate RR = 1.47, 95% CI (1.04-2.08); test for trend p = 0.01) was associated with increased risk of breast cancer.
The apparent protective effects of vegetable fat and vitamin E and adverse effect of high glycemic foods on risk of breast cancer need confirmation in prospective analyses.
研究青少年饮食中可能影响成年后患乳腺癌风险的成分。
对护士健康研究II中的47355名参与者进行回顾性队列研究，这些参与者回答了一份关于高中时期饮食的包含131个条目的食物频率问卷。采用Cox比例风险回归来估计1989年（研究开始）至1998年（评估高中饮食时）乳腺癌发病病例之间的相对风险和95%置信区间。
在多变量分析中，脂肪和纤维的摄入量与乳腺癌风险无显著相关性，但植物脂肪摄入量增加（第5分位数与第1分位数相比，多变量RR = 0.58，95%CI（0.38 - 0.86）；趋势检验p = 0.005）和维生素E摄入量增加（第5分位数与第1分位数相比，多变量RR = 0.61，95%CI（0.42 - 0.89）；趋势检验p = 0.003）与较低风险相关。较高的饮食血糖指数（第5分位数与第1分位数相比，多变量RR = 1.47，95%CI（1.04 - 2.08）；趋势检验p = 0.01）与乳腺癌风险增加相关。
植物脂肪和维生素E对乳腺癌风险的明显保护作用以及高血糖食物的不良作用需要在前瞻性分析中得到证实。
