Sangrajrang Suleeporn, Chaiwerawattana Arkom, Ploysawang Pattama, Nooklang Kanjamad, Jamsri Paphawin, Somharnwong Sopittra
Research Division, National Cancer Institute, Bangkok, Thailand E-mail :
Asian Pac J Cancer Prev. 2013;14(11):7023-7. doi: 10.7314/apjcp.2013.14.11.7023.
To evaluate the relationship between obesity, diet, physical activity and breast cancer in Thai women, we conducted a case control study with 1,130 cases and 1,142 controls. Informed consent was obtained from all participants and a structured questionnaire was performed by trained interviewers to collect information on demographic and anthropometric data, reproductive and medical history, residential history, physical activity and occupation as well as dietary habits. A significant positive association with an increased risk of breast cancer was observed in women body mass index (BMI) of ≥ 25 mg/m2 (OR=1.33, 95%CI 1.07-1.65), the risk being higher in postmenopausal women (OR=1.67, 95%CI 1.24-2.25). In addition, underweight BMI at ages 10 and 20 years showed an inverse association in all women (OR=0.70, 95%CI 0.56-0.88 and OR=0.74, 95%CI 0.59-0.93, respectively) and in those with a premenopausal status (OR=0.69, 95%CI 0.51-0.93 and OR=0.76, 95%CI 0.56- 0.99, respectively). Regular exercise was associated with a decreased risk of breast cancer (OR=0.78, 95%CI 0.68-0.98). Interestingly, analysis by type of activity revealed significant protective effects for women who reported the highest levels of walking for shopping (OR=0.58, 95%CI 0.38-0.88). High consumption of vegetables and fruit were associated with a decreased risk of breast cancer, while high consumption of animal fat showed an increased risk in postmenopausal women. In conclusion, our results indicate that obesity and high consumption of animal fat are associated with breast cancer risk, particularly in postmenopausal women, while recreational physical activity has protective effects. It seems that primary prevention of breast cancer should be promoted in an integrated manner. Effective strategies need to be identified to engage women in healthy lifestyles.
为评估泰国女性肥胖、饮食、身体活动与乳腺癌之间的关系,我们开展了一项病例对照研究,研究对象包括1130例病例和1142例对照。所有参与者均签署了知情同意书,由经过培训的访谈员使用结构化问卷收集有关人口统计学和人体测量数据、生殖和病史、居住史、身体活动和职业以及饮食习惯的信息。在体重指数(BMI)≥25 mg/m2的女性中观察到与乳腺癌风险增加存在显著正相关(OR=1.33,95%CI 1.07-1.65),绝经后女性的风险更高(OR=1.67,95%CI 1.24-2.25)。此外,10岁和20岁时体重过轻的BMI在所有女性中均呈负相关(分别为OR=0.70,95%CI 0.56-0.88和OR=0.74,95%CI 0.59-0.93),在绝经前女性中也是如此(分别为OR=0.69,95%CI 0.51-0.93和OR=0.76,95%CI 0.56-0.99)。经常锻炼与乳腺癌风险降低相关(OR=0.78,95%CI 0.68-0.98)。有趣的是,按活动类型进行分析发现,报告购物步行量最高的女性具有显著的保护作用(OR=0.58,95%CI 0.38-0.88)。大量食用蔬菜和水果与乳腺癌风险降低相关,而大量食用动物脂肪在绝经后女性中显示出风险增加。总之,我们的结果表明,肥胖和大量食用动物脂肪与乳腺癌风险相关,尤其是在绝经后女性中,而休闲体育活动具有保护作用。似乎应综合促进乳腺癌的一级预防。需要确定有效的策略,使女性参与健康的生活方式。