Original Article

Fat or fit: The joint effects of physical activity, weight gain, and body size on breast cancer risk

  1. Lauren E. McCullough MSPH1,†,*,
  2. Sybil M. Eng PhD, MPH2,
  3. Patrick T. Bradshaw PhD1,
  4. Rebecca J. Cleveland PhD3,
  5. Susan L. Teitelbaum PhD4,
  6. Alfred I. Neugut MD, PhD2,5,
  7. Marilie D. Gammon PhD1

Article first published online: 25 JUN 2012

DOI: 10.1002/cncr.27433

Issue

Cancer

Cancer

Volume 118, Issue 19, pages 4860–4868, 1 October 2012

Additional Information

How to Cite

McCullough, L. E., Eng, S. M., Bradshaw, P. T., Cleveland, R. J., Teitelbaum, S. L., Neugut, A. I. and Gammon, M. D. (2012), Fat or fit: The joint effects of physical activity, weight gain, and body size on breast cancer risk. Cancer, 118: 4860–4868. doi: 10.1002/cncr.27433

Author Information

  1. 1

    Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina

  2. 2

    Department of Epidemiology, Columbia University, New York, New York

  3. 3

    Department of Medicine, University of North Carolina, Chapel Hill, North Carolina

  4. 4

    Department of Community Medicine and Prevention, Mount Sinai School of Medicine, New York, New York

  5. 5

    Department of Medicine, Columbia University, New York, New York

  1. †

    Fax: (919) 966-2089

*Department of Epidemiology, CB #7435, McGavran-Greenberg Hall, University of North Carolina, Chapel Hill, NC 27599-7435

  1. †

    Fax: (919) 966-2089

Publication History

  1. Issue published online: 19 SEP 2012
  2. Article first published online: 25 JUN 2012
  3. Manuscript Accepted: 19 DEC 2011
  4. Manuscript Revised: 12 NOV 2011
  5. Manuscript Received: 23 AUG 2011

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Keywords:

  • Breast cancer;
  • physical activity;
  • weight gain;
  • body mass index;
  • epidemiology

Abstract

BACKGROUND:

Although physical activity reduces breast cancer risk, issues critical to providing clear public health messages remain to be elucidated. These include the minimum duration and intensity necessary for risk reduction and the optimal time period for occurrence, as well as subgroup effects, particularly with regard to tumor heterogeneity and body size.

METHODS:

This study investigated the relationship between recreational physical activity (RPA) and breast cancer risk, in addition to characterizing the joint effects of activity level, weight gain, and body size, through use of a population-based sample of 1504 cases (N = 233 in situ, N = 1271 invasive) and 1555 controls (aged 20-98 years) from the Long Island Breast Cancer Study Project, in Long Island, New York.

RESULTS:

A nonlinear dose-response association was observed between breast cancer risk and RPA during the reproductive period and after menopause. Women in the third quartile of activity experienced the greatest benefit with an approximate 30% risk reduction for reproductive (odds ratio = 0.67; 95% confidence interval = 0.48-0.94) and postmenopausal activity (odds ratio = 0.70; 95% confidence interval = 0.52-0.95). Little to no difference was observed regarding intensity of activity or hormone receptor status. Joint assessment of RPA, weight gain, and body size revealed that women with unfavorable energy balance profiles were at increased breast cancer risk. A significant multiplicative interaction was observed between RPA and adult weight gain (P = .033).

CONCLUSIONS:

RPA at any intensity level during the reproductive and postmenopausal years have the greatest benefit for reducing breast cancer risk. Substantial postmenopausal weight gain may eliminate the benefits of regular activity. Cancer 2012. © 2012 American Cancer Society.

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