Willett W C, Stampfer M J, Colditz G A, Rosner B A, Hennekens C H, Speizer F E
N Engl J Med. 1987 Jan 1;316(1):22-8. doi: 10.1056/NEJM198701013160105.
Dietary fat has been suggested as a risk factor for breast cancer in women, but the available data on humans are sparse and inconsistent. In 1980, 89,538 U.S. registered nurses who were 34 to 59 years of age and had no history of cancer completed a previously validated dietary questionnaire designed to measure individual consumption of total fat, saturated fat, linoleic acid, and cholesterol, as well as other nutrients. In a subsample of 173 participants studied in detail, those in the highest quintile of fat intake consumed a mean of 44 percent of calories from fat, as compared with 32 percent for those in the lowest quintile. During four years of follow-up, 601 cases of breast cancer were diagnosed among the 89,538 nurses in the study. After adjustment for known determinants in multivariate analyses, the relative risk of breast cancer among women in the highest quintile of calorie-adjusted total fat intake, as compared with women in the lowest quintile, was 0.82 (95 percent confidence limits, 0.64 and 1.05). The corresponding relative risks were 0.84 (confidence limits, 0.66 and 1.08) for saturated fat, 0.88 (0.69 and 1.12) for linoleic acid, and 0.91 (0.70 and 1.18) for cholesterol intake. Similar results were found for both postmenopausal and premenopausal women. These data are based on a limited period of follow-up and do not exclude a possible influence of fat intake before adulthood or at levels lower than 30 percent of calories. They suggest, however, that a moderate reduction in fat intake by adult women is unlikely to result in a substantial reduction in the incidence of breast cancer.
膳食脂肪被认为是女性患乳腺癌的一个风险因素,但关于人类的现有数据稀少且不一致。1980年,89538名年龄在34至59岁之间且无癌症病史的美国注册护士完成了一份先前经过验证的膳食问卷,该问卷旨在测量个体对总脂肪、饱和脂肪、亚油酸和胆固醇以及其他营养素的摄入量。在对173名参与者进行详细研究的子样本中,脂肪摄入量最高的五分之一人群平均从脂肪中摄入44%的热量,而摄入量最低的五分之一人群为32%。在四年的随访期间,该研究中的89538名护士中诊断出601例乳腺癌病例。在多变量分析中对已知决定因素进行调整后,热量调整后的总脂肪摄入量最高的五分之一女性患乳腺癌的相对风险与最低的五分之一女性相比为0.82(95%置信区间为0.64至1.05)。饱和脂肪的相应相对风险为0.84(置信区间为0.66至1.08),亚油酸为0.88(0.69至1.12),胆固醇摄入量为0.91(0.70至1.18)。绝经后和绝经前女性均得到类似结果。这些数据基于有限的随访期,并未排除成年前或低于热量30%水平的脂肪摄入可能产生的影响。然而,它们表明成年女性适度减少脂肪摄入量不太可能导致乳腺癌发病率大幅降低。