Types of dietary fat and breast cancer: A pooled analysis of cohort studies

Authors

  • Stephanie A. Smith-Warner,

    Corresponding author
    1. Department of Nutrition, Harvard School of Public Health, Boston, MA, USA
    • Harvard School of Public Health, Department of Nutrition, 665 Huntington Ave., Boston, MA 02115, USA.
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    • Fax: +617-432-2435

  • Donna Spiegelman,

    1. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
    2. Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA
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  • Hans-Olov Adami,

    1. Department of Medical Epidemiology, Karolinska Institutet, Stockholm, Sweden
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  • W. Lawrence Beeson,

    1. The Center for Health Research, Loma Linda University School of Medicine, Loma Linda, CA, USA
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  • Piet A. van den Brandt,

    1. Department of Epidemiology, University of Maastricht, Maastricht, The Netherlands
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  • Aaron R. Folsom,

    1. Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, MN, USA
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  • Gary E. Fraser,

    1. The Center for Health Research, Loma Linda University School of Medicine, Loma Linda, CA, USA
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  • Jo L. Freudenheim,

    1. Department of Social and Preventive Medicine, University at Buffalo, State University of New York, Buffalo, NY, USA
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  • R. Alexandra Goldbohm,

    1. Department of Epidemiology, TNO Nutrition and Food Research Institute, Zeist, The Netherlands
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  • Saxon Graham,

    1. Department of Social and Preventive Medicine, University at Buffalo, State University of New York, Buffalo, NY, USA
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  • Lawrence H. Kushi,

    1. Health and Behavior Studies, Teachers College, Columbia University, New York, NY, USA
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  • Anthony B. Miller,

    1. Division of Clinical Epidemiology, Deutsches Krebsforschungszentrum, Heidelberg, Germany
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  • Thomas E. Rohan,

    1. Department of Epidemiology and Social Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
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  • Frank E. Speizer,

    1. Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA
    2. Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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  • Paolo Toniolo,

    1. Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY, USA
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  • Walter C. Willett,

    1. Department of Nutrition, Harvard School of Public Health, Boston, MA, USA
    2. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
    3. Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
    4. Harvard Center for Cancer Prevention, Harvard School of Public Health, Boston, MA, USA
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  • Alicja Wolk,

    1. Department of Medical Epidemiology, Karolinska Institutet, Stockholm, Sweden
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  • Anne Zeleniuch-Jacquotte,

    1. Nelson Institute of Environmental Medicine, New York University School of Medicine, New York, NY, USA
    2. Kaplan Cancer Center, New York University School of Medicine, New York, NY, USA
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  • David J. Hunter

    1. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
    2. Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
    3. Harvard Center for Cancer Prevention, Harvard School of Public Health, Boston, MA, USA
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Abstract

Recently, there has been interest in whether intakes of specific types of fat are associated with breast cancer risk independently of other types of fat, but results have been inconsistent. We identified 8 prospective studies that met predefined criteria and analyzed their primary data using a standardized approach. Holding total energy intake constant, we calculated relative risks for increments of 5% of energy for each type of fat compared with an equivalent amount of energy from carbohydrates or from other types of fat. We combined study-specific relative risks using a random effects model. In the pooled database, 7,329 incident invasive breast cancer cases occurred among 351,821 women. The pooled relative risks (95% confidence intervals [CI]) for an increment of 5% of energy were 1.09 (1.00–1.19) for saturated, 0.93 (0.84–1.03) for monounsaturated and 1.05 (0.96–1.16) for polyunsaturated fat compared with equivalent energy intake from carbohydrates. For a 5% of energy increment, the relative risks were 1.18 (95% CI 0.99–1.42) for substituting saturated for monounsaturated fat, 0.98 (95% CI 0.85–1.12) for substituting saturated for polyunsaturated fat and 0.87 (95% CI 0.73–1.02) for substituting monounsaturated for polyunsaturated fat. No associations were observed for animal or vegetable fat intakes. These associations were not modified by menopausal status. These data are suggestive of only a weak positive association with substitution of saturated fat for carbohydrate consumption; none of the other types of fat examined was significantly associated with breast cancer risk relative to an equivalent reduction in carbohydrate consumption. © 2001 Wiley-Liss, Inc.

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