Harris Holly R, Willett Walter C, Vaidya Rita L, Michels Karin B
Department of Obstetrics, Gynecology and Reproductive Biology, Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Division of Nutritional Epidemiology, The National Institute for Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
Cancer Res. 2017 Mar 1;77(5):1179-1187. doi: 10.1158/0008-5472.CAN-16-2273.
Adolescence is a highly susceptible period for mammary carcinogenesis, but few prospective studies have examined the role of adolescent diet in breast cancer risk. Reduced rank regression has previously been used to identify a dietary pattern associated with markers of inflammation (C-reactive protein, IL6, and TNFα receptor 2). We investigated whether an adolescent and early adulthood inflammatory dietary pattern was associated with breast cancer among 45,204 women in the Nurses' Health Study II using reduced rank regression. Participants completed a food frequency questionnaire in 1998 about their high school diet (HS-FFQ) and a FFQ in 1991 when they were ages 27-44 years. Among women who completed the HS-FFQ, 1,477 cases of breast cancer were diagnosed during 22 years of follow-up. An adolescent and early adulthood dietary pattern characterized by inflammation was associated with an increased incidence of premenopausal but not postmenopausal breast cancer. Women in the fifth quintile of the inflammatory pattern score had multivariable adjusted HRs for premenopausal breast cancer of 1.35 for adolescent diet [95% confidence interval (95% CI), 1.06-1.73; = 0.002] and 1.41 for early adulthood diet (95% CI, 1.11-1.78; = 0.006) compared with women in the first quintile. The corresponding RRs for postmenopausal breast cancer were 0.84 (95% CI, 0.60-1.17) for adolescent and 0.76 (95% CI, 0.54-1.06) for adult intake. Overall, our findings support the notion that an adolescent and early adulthood diet characterized by high intake of sugar-sweetened and diet soft drinks, refined grains, red and processed meat, and margarine, and low intake of green leafy vegetables, cruciferous vegetables, and coffee may increase the incidence of premenopausal breast cancer. .
青春期是乳腺癌发生的高度易感期,但很少有前瞻性研究探讨青少年饮食在乳腺癌风险中的作用。降秩回归先前已被用于识别与炎症标志物(C反应蛋白、白细胞介素6和肿瘤坏死因子α受体2)相关的饮食模式。我们在护士健康研究II的45204名女性中,使用降秩回归研究青少年和成年早期的炎症性饮食模式是否与乳腺癌相关。参与者在1998年完成了一份关于其高中饮食的食物频率问卷(HS-FFQ),并在1991年她们27至44岁时完成了一份FFQ。在完成HS-FFQ的女性中,随访22年期间诊断出1477例乳腺癌病例。以炎症为特征的青少年和成年早期饮食模式与绝经前乳腺癌发病率增加相关,但与绝经后乳腺癌无关。炎症模式评分处于第五分位数的女性,与处于第一分位数的女性相比,青少年饮食导致绝经前乳腺癌的多变量调整风险比为1.35 [95%置信区间(95%CI),1.06 - 1.73;P = 0.002],成年早期饮食导致绝经前乳腺癌的多变量调整风险比为1.41(95%CI,1.11 - 1.78;P = 0.006)。绝经后乳腺癌的相应风险比,青少年摄入为0.84(95%CI,0.60 - 1.17),成年摄入为0.76(95%CI,0.54 - 1.06)。总体而言,我们的研究结果支持这样一种观点,即青少年和成年早期以高糖软饮料、低热量软饮料、精制谷物、红肉和加工肉以及人造黄油摄入量高,绿叶蔬菜、十字花科蔬菜和咖啡摄入量低为特征的饮食,可能会增加绝经前乳腺癌的发病率。