Berkey Catherine S, Tamimi Rulla M, Willett Walter C, Rosner Bernard, Hickey Martha, Toriola Adetunji T, Frazier A Lindsay, Colditz Graham A
Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA.
Division of Epidemiology, Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA.
NPJ Breast Cancer. 2020 Nov 23;6(1):61. doi: 10.1038/s41523-020-00206-4.
Adolescent drinking is associated with higher risks of proliferative benign breast disease (BBD) and invasive breast cancer (BC). Furthermore, adolescent nut and fiber consumptions are associated with lower risks of benign lesions and premenopausal BC. We hypothesize that diet (nuts, fiber) may mitigate the elevated BBD risk associated with alcohol. A prospective cohort of 9031 females, 9-15 years at baseline, completed questionnaires in 1996-2001, 2003, 2005, 2007, 2010, 2013, and 2014. Participants completed food frequency questionnaires in 1996-2001. In 2005, participants (>=18 years) began reporting biopsy-confirmed BBD (N = 173 cases). Multivariable logistic regression estimated associations between BBD and cross-classified intakes (14-17 years) of alcohol and peanut butter/nuts (separately, total dietary fiber). Only 19% of participants drank in high school; drinking was associated with elevated BBD risk (OR = 1.75, 95% CI: 1.20-2.56; p = 0.004) compared to nondrinkers. Participants consuming any nuts/butter had lower BBD risk (OR = 0.64, 95% CI: 0.45-0.90; p = 0.01) compared to those consuming none. Participants in top 75% fiber intake had lower risk (OR = 0.57, 95% CI: 0.40-0.81; p = 0.002) compared to bottom quartile. Testing our hypothesis that consuming nuts/butter mitigates the elevated alcohol risk, analyzing alcohol and nuts combined found that those who consumed both had lower risk (RR = 0.47, 95% CI: 0.24-0.89; p = 0.02) compared to drinkers eating no nuts. Our analysis of alcohol and fiber together did not demonstrate risk mitigation by fiber. For high school females who drink, their BBD risk may be attenuated by consuming nuts. Due to modest numbers, future studies need to replicate our findings in adolescent/adult females. However, high school students may be encouraged to eat nuts and fiber, and to avoid alcohol, to reduce risk of BBD and for general health benefits.
青少年饮酒与增生性良性乳腺疾病（BBD）和浸润性乳腺癌（BC）的较高风险相关。此外，青少年食用坚果和纤维与良性病变及绝经前乳腺癌的较低风险相关。我们推测，饮食（坚果、纤维）可能会降低与酒精相关的BBD风险升高。一项前瞻性队列研究纳入了9031名女性，基线时年龄为9至15岁，她们在1996 - 2001年、2003年、2005年、2007年、2010年、2013年和2014年完成了问卷调查。参与者在1996 - 2001年完成了食物频率问卷。2005年，参与者（≥18岁）开始报告经活检确诊的BBD（共173例）。多变量逻辑回归估计了BBD与14 - 17岁时酒精和花生酱/坚果（分别为总膳食纤维）的交叉分类摄入量之间的关联。只有19%的参与者在高中时饮酒；与不饮酒者相比，饮酒与BBD风险升高相关（OR = 1.75，95% CI：1.20 - 2.56；p = 0.004）。与未食用任何坚果/黄油的参与者相比，食用任何坚果/黄油的参与者BBD风险较低（OR = 0.64，95% CI：0.45 - 0.90；p = 0.01）。膳食纤维摄入量处于前75%的参与者与处于最低四分位数的参与者相比风险较低（OR = 0.57，95% CI：0.
