Forman Michele R
Department of Nutrition Science, Purdue University Cancer Center, Center for Aging and the Life Course, Purdue University, West Lafayette, IN, United States.
Front Oncol. 2020 Feb 18;10:129. doi: 10.3389/fonc.2020.00129. eCollection 2020.
Breast cancer, the most common cancer in women worldwide, has recognized reproductive and anthropometric risk factors including age at menarche and adult height. Yet the age a woman attains her adult height or experiences menarche for example is simply the timing of the major life event at the end of a long trail of exposures that began . The objective of this article is to investigate through a review of the literature the role of nutrition in breast cancer prevention through three dimensions (D). Each D offers a different lens. The First D identifies of exposures or conditions that convey vulnerability or protection from breast cancer. The Second addresses the of the exposure; and the ( D) examines the pace, i.e., how rapid or slow the young woman experiences her growth and development. Birthweight illustrative of the First D reveals a strong signal across the life course on BC risk, but the risk group varies from low to high birthweight. Stressful life events like being a pubertal aged girl living in a household with an unemployed father during the Great Depression or high levels of environmental contaminants exposure are representative of the Second D. Height velocity at specific ages and weight loss in postmenopausal years are illustrative of anthropometric trajectories that reveal an adaptive biosystem that provides a contextual state to interact with the other two Ds. This article presents a new paradigm of nutrition and breast cancer prevention through the lens of three very different dimensions. It is the premise of this article that all three dimensions are essential tasks to tease apart the life course and identify windows for preventive strategies.
乳腺癌是全球女性中最常见的癌症,已确认的生殖和人体测量风险因素包括初潮年龄和成年身高。然而,例如女性达到成年身高或经历初潮的年龄,仅仅是一系列长期暴露结束时重大生活事件的发生时间,而这些暴露早在之前就已开始。本文的目的是通过文献综述,从三个维度(D)探讨营养在乳腺癌预防中的作用。每个维度提供了不同的视角。第一个维度确定了传达乳腺癌易感性或保护性的暴露因素或条件。第二个维度涉及暴露的时机;而第三个维度则考察速度,即年轻女性经历其生长发育的快慢程度。出生体重体现了第一个维度,它在整个生命过程中对乳腺癌风险发出了强烈信号,但风险群体从低出生体重到高出生体重各不相同。压力大的生活事件,比如在大萧条时期,作为一个青春期女孩生活在父亲失业的家庭中,或者高水平的环境污染物暴露,代表了第二个维度。特定年龄的身高增长速度和绝经后体重减轻体现了人体测量轨迹,揭示了一个适应性生物系统,该系统提供了一种背景状态,以便与其他两个维度相互作用。本文通过三个截然不同的维度视角,提出了一种营养与乳腺癌预防的新范式。本文的前提是,所有这三个维度都是梳理生命历程并确定预防策略窗口期的关键任务。