Department of Epidemiology, Harvard School of Public Health and Stanford University Medical Center, Stanford University Outpatient Center, 450 Broadway St., Pavillion C Second Floor, Redwood City, CA 94063, USA.
Cancer Epidemiol Biomarkers Prev. 2010 Mar;19(3):689-96. doi: 10.1158/1055-9965.EPI-09-0802. Epub 2010 Mar 3.
Although the association between adult diet and breast cancer has been investigated extensively, large prospective studies have generally not shown a direct link between intakes of carbohydrate, fat, fiber, and other nutrients and risk of breast cancer. Adolescence may be a period of increased susceptibility to risk factors that predispose to breast cancer. Dietary risk factors could therefore be more important during early life than later in adulthood.
This is a prospective observational study of 39,268 premenopausal women in the Nurses' Health Study II who completed a 124-item food frequency questionnaire on their diet during high school (HS-FFQ) in 1998, at which time participants were 34 to 53 years of age. Cox proportional hazards regression was used to estimate relative risks and 95% CIs.
Four hundred fifty-five incident cases of invasive breast cancer were diagnosed between 1998 and 2005. Compared with women in the lowest quintile of intake, the relative risk of breast cancer in the highest quintile of adolescent total fat consumption was 1.35 (95% confidence interval, 1.00-1.81). Adolescent consumption of saturated, monounsaturated, polyunsaturated, and trans fats was not significantly associated with breast cancer risk. Total dairy, milk, carbohydrate intake, glycemic index, glycemic load, and fiber consumed during adolescence were not significantly related to breast cancer incidence.
Dietary fat consumed during adolescence may be associated with an elevated risk of breast cancer. Further studies to assess this relationship among postmenopausal women, and confirm these results in premenopausal women, are needed.
尽管成人饮食与乳腺癌之间的关联已被广泛研究,但大型前瞻性研究一般并未显示碳水化合物、脂肪、纤维和其他营养素的摄入量与乳腺癌风险之间存在直接联系。青春期可能是对增加乳腺癌易感性的危险因素的一个时期。因此,饮食危险因素在生命早期可能比成年后期更为重要。
这是对参加护士健康研究 II 的 39268 名绝经前妇女进行的前瞻性观察性研究,这些妇女在 1998 年高中时期(HS-FFQ)完成了 124 项食物频率问卷,当时她们的年龄在 34 至 53 岁之间。使用 Cox 比例风险回归估计相对风险和 95%置信区间。
在 1998 年至 2005 年间诊断出 455 例浸润性乳腺癌病例。与青少年时期总脂肪摄入量最低五分位数的女性相比,最高五分位数的女性患乳腺癌的相对风险为 1.35(95%置信区间,1.00-1.81)。青少年时期摄入的饱和脂肪、单不饱和脂肪、多不饱和脂肪和反式脂肪与乳腺癌风险无显著相关性。青少年时期摄入的总乳制品、牛奶、碳水化合物、血糖指数、血糖负荷和纤维与乳腺癌发病率无显著相关性。
青春期摄入的膳食脂肪可能与乳腺癌风险升高有关。需要进一步研究绝经后妇女中这种关系,并在绝经前妇女中证实这些结果。