Farvid Maryam S, Cho Eunyoung, Chen Wendy Y, Eliassen A Heather, Willett Walter C
Department of Nutrition, Harvard School of Public Health, Boston, MA; Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Int J Cancer. 2015 Apr 15;136(8):1909-20. doi: 10.1002/ijc.29218. Epub 2014 Oct 3.
The breast is particularly vulnerable to carcinogenic influences during adolescence due to rapid proliferation of mammary cells and lack of terminal differentiation. We investigated consumption of adolescent red meat and other protein sources in relation to breast cancer risk in the Nurses' Health Study II cohort. We followed prospectively 44,231 women aged 33-52 years who, in 1998, completed a detailed questionnaire about diet during adolescence. Relative risks (RR) and 95% confidence intervals (95%CI) were estimated using Cox proportional hazard regression. We documented 1132 breast cancer cases during 13-year follow-up. In multivariable Cox regression models with major breast cancer risk factors adjustment, greater consumption of total red meat in adolescence was significantly associated with higher premenopausal breast cancer risk (highest vs. lowest quintiles, RR, 1.43; 95%CI, 1.05-1.94; Ptrend = 0.007), but not postmenopausal breast cancer. Adolescent intake of poultry was associated with lower risk of breast cancer overall (RR, 0.76; 95%CI, 0.60-0.97; for each serving/day). Adolescent intakes of iron, heme iron, fish, eggs, legumes and nuts were not associated with breast cancer. Replacement of one serving/day of total red meat with one serving of combination of poultry, fish, legumes, and nuts was associated with a 15% lower risk of breast cancer overall (RR, 0.85; 95%CI, 0.74-0.96) and a 23% lower risk of premenopausal breast cancer (RR, 0.77; 95%CI, 0.64-0.92). In conclusion, higher consumption of red meat during adolescence was associated with premenopausal breast cancer. Substituting other dietary protein sources for red meat in adolescent diet may decrease premenopausal breast cancer risk.
由于乳腺细胞快速增殖且缺乏终末分化,青春期乳房特别容易受到致癌因素的影响。我们在护士健康研究II队列中调查了青少年时期红肉及其他蛋白质来源的摄入量与乳腺癌风险之间的关系。我们前瞻性地跟踪了44231名年龄在33至52岁之间的女性,她们在1998年完成了一份关于青春期饮食的详细问卷。使用Cox比例风险回归估计相对风险(RR)和95%置信区间(95%CI)。在13年的随访期间,我们记录了1132例乳腺癌病例。在对主要乳腺癌风险因素进行调整的多变量Cox回归模型中,青少年时期总红肉摄入量较高与绝经前乳腺癌风险较高显著相关(最高五分位数与最低五分位数相比,RR为1.43;95%CI为1.0--1.94;P趋势=0.007),但与绝经后乳腺癌无关。青少年时期摄入家禽肉与总体乳腺癌风险较低相关(RR为0.76;95%CI为0.60-0.97;每增加一份/天)。青少年时期铁、血红素铁、鱼、蛋、豆类和坚果的摄入量与乳腺癌无关。用一份家禽肉、鱼、豆类和坚果的组合替代每天一份总红肉,总体乳腺癌风险降低15%(RR为0.85;95%CI为0.74-0.96),绝经前乳腺癌风险降低23%(RR为0.77;95%CI为0.64-0.92)。总之,青少年时期红肉摄入量较高与绝经前乳腺癌有关。在青少年饮食中用其他膳食蛋白质来源替代红肉可能会降低绝经前乳腺癌风险。