Farvid Maryam S, Eliassen A Heather, Cho Eunyoung, Liao Xiaomei, Chen Wendy Y, Willett Walter C
Departments of Nutrition,
Epidemiology, and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts;
Pediatrics. 2016 Mar;137(3):e20151226. doi: 10.1542/peds.2015-1226. Epub 2016 Feb 1.
We evaluated fiber intake during adolescence and early adulthood in relation to breast cancer (BC) risk in the Nurses' Health Study II.
Among 90,534 premenopausal women who completed a dietary questionnaire in 1991, we documented 2833 invasive BC cases during 20 years of follow-up. In 1998, 44,263 of these women also completed a questionnaire about their diet during high school; among these women, we documented 1118 cases of BC by end of follow-up. Multivariable-adjusted Cox proportional hazards regression was used to model relative risks (RRs) and 95% confidence intervals (CIs) for BC across categories of dietary fiber.
Among all women, early adulthood total dietary fiber intake was associated with significantly lower BC risk (RR for highest versus lowest quintile 0.81; 95% CI 0.72-0.91; Ptrend = .002). Higher intakes of soluble fiber (RR for highest versus lowest quintile 0.86; 95% CI 0.77-0.97; Ptrend = .02) and insoluble fiber (RR for highest versus lowest quintile 0.80; 95% CI 0.71-0.90; Ptrend < .001) were each associated with lower BC risk. Total dietary fiber intake in adolescence was also associated with lower BC risk (RR for highest versus lowest quintile 0.84; 95% CI 0.70-1.01; Ptrend = .04). For the average of fiber intake during adolescence and early adult life, the RR comparing highest with lowest quintiles was 0.75 (95% CI 0.62-0.91, Ptrend = .004).
Our findings support the hypothesis that higher fiber intakes reduce BC risk and suggest that intake during adolescence and early adulthood may be particularly important.
在护士健康研究II中，我们评估了青春期和成年早期的纤维摄入量与乳腺癌（BC）风险之间的关系。
在1991年完成饮食问卷的90534名绝经前女性中，我们在20年的随访期间记录了2833例浸润性BC病例。1998年，这些女性中的44263人还完成了一份关于她们高中时期饮食的问卷；在这些女性中，我们在随访结束时记录了1118例BC病例。多变量调整的Cox比例风险回归用于对不同膳食纤维类别下BC的相对风险（RRs）和95%置信区间（CIs）进行建模。
在所有女性中，成年早期的总膳食纤维摄入量与显著降低的BC风险相关（最高五分位数与最低五分位数的RR为0.81；95%CI为0.72 - 0.91；P趋势 = 0.002）。较高的可溶性纤维摄入量（最高五分位数与最低五分位数的RR为0.86；95%CI为0.77 - 0.97；P趋势 = 0.02）和不溶性纤维摄入量（最高五分位数与最低五分位数的RR为0.80；95%CI为0.71 - 0.90；P趋势 < 0.001）均与较低的BC风险相关。青春期的总膳食纤维摄入量也与较低的BC风险相关（最高五分位数与最低五分位数的RR为0.84；95%CI为0.70 - 1.01；P趋势 = 0.04）。对于青春期和成年早期的平均纤维摄入量，最高五分位数与最低五分位数相比的RR为0.75（95%CI为0.62 - 0.91，P趋势 = 0.004）。
我们的研究结果支持高纤维摄入量可降低BC风险的假设，并表明青春期和成年早期的摄入量可能尤为重要。
