TY - JOUR
T1 - Dietary energy density and postmenopausal breast cancer incidence in the cancer prevention study II nutrition cohort
AU - Hartman, Terryl J.
AU - Gapstur, Susan M.
AU - Gaudet, Mia M.
AU - Shah, Roma
AU - Flanders, W. Dana
AU - Wang, Ying
AU - McCullough, Marjorie L.
N1 - Funding Information:
The authors would like to acknowledge the contribution to this study from central cancer registries supported through the Centers for Disease Control and Prevention National Program of Cancer Registries, and cancer registries supported by the National Cancer Institute Surveillance Epidemiology and End Results program. TJH, SMG, and MLM designed the research; SMG, MMG, and YW provided guidance on the data analysis plans; TJH, RS, WDF, and MLM analyzed the data; SMG and MLM provided study oversight; and TJH had primary responsibility for writing the paper. All authors read and approved the final manuscript.
Publisher Copyright:
© 2016 American Society for Nutrition.
PY - 2016
Y1 - 2016
N2 - Background: Dietary energy density (ED) is a measure of diet quality that estimates the amount of energy per unit of food (kilocalories per gram) consumed. Low-ED diets are generally high in fiber and fruits and vegetables and low in fat. Dietary ED has been positively associated with body mass index (BMI) and other risk factors for postmenopausal breast cancer. Objective: We evaluated the associations of total dietary ED and energy-dense (high-ED) foods with postmenopausal breast cancer incidence. Methods: Analyses included 56,795 postmenopausal women from the Cancer Prevention Study II Nutrition Cohort with no previous history of breast or other cancers and who provided information on diet, lifestyle, and medical history in 1999. Multivariable-adjusted breast cancer incidence rate ratios (RRs and 95% CIs) were estimated for quintiles of total dietary ED and for the consumption of high-ED foods in Cox proportional hazards regression models. Results: During a median follow-up of 11.7 y, 2509 invasive breast cancer cases were identified, including 1857 estrogen receptor-positive and 277 estrogen receptor-negative tumors. Median dietary ED was 1.5 kcal/g (IQR: 1.3-1.7 kcal/g). After adjusting for age, race, education, reproductive characteristics, and family history, high compared with low dietary ED was associated with a statistically significantly higher risk of breast cancer (RR for fifth quintile compared with first quintile: 1.20; 95%CI: 1.05, 1.36; P-trend = 0.03). The association between the amount of high-ED foods consumed and breast cancer risk was not statistically significant. We observed no differences by estrogen receptor status or effect modification by BMI, age, or physical activity. Conclusion: These results suggest a modest positive association between total dietary ED and risk of postmenopausal breast cancer.
AB - Background: Dietary energy density (ED) is a measure of diet quality that estimates the amount of energy per unit of food (kilocalories per gram) consumed. Low-ED diets are generally high in fiber and fruits and vegetables and low in fat. Dietary ED has been positively associated with body mass index (BMI) and other risk factors for postmenopausal breast cancer. Objective: We evaluated the associations of total dietary ED and energy-dense (high-ED) foods with postmenopausal breast cancer incidence. Methods: Analyses included 56,795 postmenopausal women from the Cancer Prevention Study II Nutrition Cohort with no previous history of breast or other cancers and who provided information on diet, lifestyle, and medical history in 1999. Multivariable-adjusted breast cancer incidence rate ratios (RRs and 95% CIs) were estimated for quintiles of total dietary ED and for the consumption of high-ED foods in Cox proportional hazards regression models. Results: During a median follow-up of 11.7 y, 2509 invasive breast cancer cases were identified, including 1857 estrogen receptor-positive and 277 estrogen receptor-negative tumors. Median dietary ED was 1.5 kcal/g (IQR: 1.3-1.7 kcal/g). After adjusting for age, race, education, reproductive characteristics, and family history, high compared with low dietary ED was associated with a statistically significantly higher risk of breast cancer (RR for fifth quintile compared with first quintile: 1.20; 95%CI: 1.05, 1.36; P-trend = 0.03). The association between the amount of high-ED foods consumed and breast cancer risk was not statistically significant. We observed no differences by estrogen receptor status or effect modification by BMI, age, or physical activity. Conclusion: These results suggest a modest positive association between total dietary ED and risk of postmenopausal breast cancer.
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U2 - 10.3945/jn.116.234344
DO - 10.3945/jn.116.234344
M3 - Article
C2 - 27629577
AN - SCOPUS:85021849108
VL - 146
SP - 2045
EP - 2050
JO - Journal of Nutrition
JF - Journal of Nutrition
SN - 0022-3166
IS - 10
ER -