Environment and Breast Cancer: Science Review

Evidence From Humans
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Association of dietary intake of fat and fatty acids with risk of breast cancer
Holmes, M. D., Hunter, D. J., Colditz, G. A., Stampfer, M. J., Hankinson, S. E., Speizer, F. E., Rosner, B., Willett, W. C. JAMA. 1999. 281:10, 914-20.
Study design
Prospective cohort
Funding agency
Others: NHI, Harvard medical school, Harvard Cente
Study Participants
Menopausal Status
The menopausal status of women included in this study is listed here.
Post menopausal and premenopausal combined and separate
Number in Cohort
Cohort: 88,795
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
In: Women participating in the Nurses’ Health Study (registered nurses who were 35-55 years old when they responded to a questionnaire in 1976), who answered the 1980 diet questionnaire, who did not have implausible scores for total energy intake and who did not have diagnosed cancer (other than non-melanoma skin cancer) prior to 1980.
Comment about participation selection
Large cohort, biennial questionnaire follow-up
Exposures investigated
Energy from fat, total fat, saturated fat, monounsaturated fat, polyunsaturated fat, trans-unsaturated fat
How exposure was measured
Questionnaire, self-administered, FFQ
Exposure assessment comment
1981 FFQ with 61 food items
Statistical Analysis
Ethnic groups with separate analysis
If this study provided a separate analysis by ethnic or racial group, the groups are listed here.
Confounders considered
Other breast cancer risk factors, such as family history, age at first birth, and hormone replacement therapy use, that were taken into account in the study.
Not considered: Race
Genetic characterization included
If the study analyzed relationships between environmental factors and inherited genetic variations, this field will be marked “Yes.” “No”, if not.
Description of major analysis
Adjusted RR with 95% CI; for energy from fat: higher versus median percentage of energy obtained from fat, for fat subtypes: analysis as a continuous data: per 5% increase in intake, stratified by menopausal status, follow-up 14 years
Strength of associations reported
Premenopausal and postmenopausal: total fat: 0.97 (0.94-1.00); saturated fat: 0.94 (0.88-1.01); monounsaturated fat: 0.94 (0.88-1.00), polyunsaturated fat: 0.91 (0.79-1.04); trans-unsaturated fat: 0.92 (0.86-0.98)
Premenopausal: total fat: 0.99 (0.93-1.05); saturated fat: 0.98 (0.87-1.11); monounsaturated fat: 1.02 (0.91-1.15), polyunsaturated fat: 0.99 (0.77-1.27); trans-unsaturated fat: 1.00 (0.88-1.13)
Postmenopausal: total fat: 0.96 (0.93-1.00); saturated fat: 0.88 (0.74-1.04); monounsaturated fat: 0.93 (0.85-1.02), polyunsaturated fat: 0.91 (0.84-0.99); trans-unsaturated fat: 0.91 (0.84-0.99)
Results Comments
No evidence that higher total fat intake was associated with an increased risk of breast cancer.
Author address
Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, Mass 02115, USA.