Table 2.
Associations between fatty acid intake and breast cancer risk among female VITAL study participants (n = 30,252).
| Fat Category | Cases n = 772 N (%) |
Non-Cases n = 29480 N (%) |
Age-Adjusted HR (95% CI) | Multivariable-Adjusted HR (95% CI)a,b |
|---|---|---|---|---|
| Total Fat (g/day) | ||||
| < 32.6 | 155 (20.08) | 5896 (20.00) | 1.00 (reference) | 1.00 (reference) |
| 32.6 – < 43.9 | 152 (19.69) | 5897 (20.00) | 0.99 (0.80, 1.25) | 1.16 (0.90, 1.49) |
| 43.9 – < 56.2 | 143 (18.52) | 5908 (20.04) | 0.94 (0.75, 1.18) | 1.12 (0.83, 1.51) |
| 56.2 – < 73.9 | 163 (21.11) | 5887 (19.98) | 1.08 (0.87, 1.35) | 1.30 (0.92, 1.81) |
| ≥73.9 | 159 (20.60) | 5892 (19.99) | 1.08 (0.86, 1.34) | 1.43 (0.95, 2.14) |
| P Trend | 0.37 | 0.10 | ||
| Total MUFAa,c (g/day) | ||||
| < 12.1 | 144 (18.65) | 5907 (20.04) | 1.00 (reference) | 1.00 (reference) |
| 12.1 – < 16.4 | 159 (20.60) | 5890 (19.98) | 1.12 (0.89, 1.41) | 1.32 (1.02, 1.70) |
| 16.4 – < 21.0 | 146 (18.91) | 5905 (20.02) | 1.03 (0.82, 1.30) | 1.28 (0.95, 1.72) |
| 21.0 – < 27.8 | 164 (21.24) | 5886 (19.97) | 1.17 (0.93, 1.46) | 1.49 (1.07, 2.08) |
| ≥27.8 | 159 (20.60) | 5892 (19.99) | 1.16 (0.92, 1.45) | 1.61 (1.08, 2.38) |
| P Trend | 0.20 | 0.02 | ||
| MUFA 18:1 oleic acid (g/day) | ||||
| < 11.2 | 146 (18.91) | 5905 (20.03) | 1.00 (reference) | 1.00 (reference) |
| 11.2 – < 15.1 | 161 (20.85) | 5889 (19.98) | 1.12 (0.90, 1.40) | 1.30 (1.01, 1.67) |
| 15.1 – < 19.4 | 143 (18.52) | 5907 (20.04) | 1.00 (0.79, 1.25) | 1.19 (0.89, 1.59) |
| 19.4 – < 25.7 | 166 (21.50) | 5884 (19.96) | 1.16 (0.93, 1.45) | 1.41 (1.02, 1.95) |
| ≥25.7 | 156 (20.21) | 5895 (20.00) | 1.12 (0.89, 1.40) | 1.44 (0.97, 2.12) |
| P Trend | 0.32 | 0.08 | ||
| Total SFAa,d (g/day) | ||||
| < 9.9 | 152 (19.69) | 5898 (20.01) | 1.00 (reference) | 1.00 (reference) |
| 9.9 – < 13.6 | 157 (20.34) | 5893 (19.99) | 1.05 (0.84, 1.31) | 1.15 (0.90, 1.48) |
| 13.6 – < 17.8 | 146 (18.91) | 5906 (20.03) | 0.99 (0.79, 1.25) | 1.14 (0.85, 1.52) |
| 17.8 – < 24.0 | 152 (19.69) | 5897 (20.00) | 1.04 (0.83, 1.30) | 1.22 (0.88, 1.69) |
| ≥24.0 | 165 (21.37) | 5886 (19.97) | 1.15 (0.93, 1.44) | 1.47 (1.00, 2.15) |
| P Trend | 0.28 | 0.09 | ||
| SFA 16:0 palmitic acid (g/day) | ||||
| < 5.5 | 148 (19.17) | 5903 (20.02) | 1.00 (reference) | 1.00 (reference) |
| 5.5 – < 7.4 | 161 (20.85) | 5889 (19.98) | 1.10 (0.86, 1.38) | 1.26 (0.98, 1.63) |
| 7.4 – < 9.6 | 141 (18.26) | 5909 (20.04) | 0.98 (0.78, 1.24) | 1.20 (0.89, 1.62) |
| 9.6 – < 12.7 | 157 (20.34) | 5893 (19.99) | 1.10 (0.88, 1.38) | 1.40 (1.00, 1.95) |
| ≥12.7 | 165 (21.37) | 5886 (19.97) | 1.18 (0.95, 1.48) | 1.68 (1.13, 2.50) |
| P Trend | 0.20 | 0.02 | ||
| SFA 18:0 stearic acid (g/day) | ||||
| < 2.5 | 146 (18.91) | 5905 (20.03) | 1.00 (reference) | 1.00 (reference) |
| 2.5 – < 3.5 | 165 (21.37) | 5884 (19.96) | 1.15 (0.92, 1.43) | 1.26 (0.98, 1.61) |
| 3.5 – < 4.6 | 140 (18.13) | 5912 (20.05) | 0.98 (0.77, 1.23) | 1.17 (0.88, 1.57) |
| 4.6 – < 6.2 | 155 (20.08) | 5895 (20.00) | 1.09 (0.87, 1.37) | 1.37 (0.99, 1.89) |
| ≥6.2 | 166 (21.50) | 5884 (19.96) | 1.20 (0.96, 1.49) | 1.65 (1.12, 2.43) |
| P Trend | 0.22 | 0.03 | ||
| Total TFAa,e (g/day) | ||||
| < 1.64 | 145 (18.78) | 5906 (20.03) | 1.00 (reference) | 1.00 (reference) |
| 1.64 – < 2.36 | 147 (19.04) | 5902 (20.02) | 1.01 (0.81, 1.28) | 1.11 (0.86, 1.42) |
| 2.36 – < 3.22 | 165 (21.37) | 5887 (19.97) | 1.13 (0.90, 1.41) | 1.35 (1.04, 1.75) |
| 3.22 – < 4.58 | 165 (21.37) | 5885 (19.96) | 1.13 (0.90, 1.41) | 1.33 (1.00, 1.77) |
| ≥4.58 | 150 (19.43) | 5900 (20.01) | 1.03 (0.82, 1.30) | 1.27 (0.92, 1.78) |
| P Trend | 0.45 | 0.08 | ||
| TFA 18:1 (g/day) | ||||
| < 1.40 | 144 (18.65) | 5907 (20.04) | 1.00 (reference) | 1.00 (reference) |
| 1.40 – <2.03 | 147 (19.04) | 5903 (20.02) | 1.02 (0.81, 1.28) | 1.14 (0.89, 1.46) |
| 2.03 – <2.78 | 165 (21.37) | 5886 (19.97) | 1.13 (0.91, 1.42) | 1.37 (1.06, 1.78) |
| 2.78 – <4.00 | 167 (21.63) | 5882 (19.95) | 1.15 (0.92, 1.44) | 1.36 (1.02, 1.81) |
| ≥4.00 | 149 (19.30) | 5902 (20.02) | 1.03 (0.82, 1.30) | 1.30 (0.94, 1.80) |
| P Trend | 0.48 | 0.07 | ||
| TFA 18:2 f (g/day) | ||||
| < 0.19 | 139 (18.01) | 5911 (20.05) | 1.00 (reference) | 1.00 (reference) |
| 0.19 – < 0.27 | 150 (19.43) | 5901 (20.02) | 1.09 (0.86, 1.37) | 1.23 (0.96, 1.59) |
| 0.27 – < 0.35 | 170 (22.02) | 5881 (19.95) | 1.22 (0.97, 1.53) | 1.52 (1.16, 2.00) |
| 0.35 – < 0.49 | 158 (20.47) | 5891 (19.98) | 1.14 (0.91, 1.43) | 1.40 (1.03, 1.91) |
| ≥0.49 | 155 (20.08) | 5896 (20.00) | 1.13 (0.90, 1.42) | 1.53 (1.07, 2.19) |
| P Trend | 0.28 | 0.02 | ||
| Total PUFAa,g (g/day) | ||||
| < 7.10 | 152 (19.69) | 5899 (20.01) | 1.00 (reference) | 1.00 (reference) |
| 7.10 – < 9.70 | 160 (20.73) | 5889 (19.98) | 1.06 (0.85, 1.32) | 1.13 (0.89, 1.45) |
| 9.70 – < 12.40 | 142 (18.39) | 5910 (20.05) | 0.94 (0.75, 1.18) | 1.06 (0.80, 1.39) |
| 12.40 – < 16.60 | 169 (21.89) | 5880 (19.95) | 1.13 (0.90, 1.40) | 1.19 (0.88, 1.60) |
| ≥16.60 | 149 (19.30) | 5902 (20.02) | 1.00 (0.80, 1.26) | 1.07 (0.76, 1.52) |
| P Trend | 0.78 | 0.62 | ||
| ω-3 PUFAs | ||||
| PUFA 18:3 alpha-linolenic acid (g/day) | ||||
| < 0.69 | 157 (20.34) | 5893 (19.99) | 1.00 (reference) | 1.00 (reference) |
| 0.69 – < 0.97 | 152 (19.69) | 5898 (20.01) | 0.97 (0.78, 1.21) | 1.00 (0.78, 1.27) |
| 0.97 – < 1.29 | 157 (20.34) | 5895 (20.00) | 1.00 (0.80, 1.25) | 1.06 (0.82, 1.37) |
| 1.29 – < 1.75 | 156 (20.21) | 5894 (19.99) | 1.00 (0.80, 1.25) | 1.01 (0.77, 1.33) |
| ≥1.75 | 150 (19.43) | 5900 (20.01) | 0.97 (0.78, 1.22) | 0.97 (0.71, 1.32) |
| P Trend | 0.93 | |||
| PUFA 20:5 eicosapentaenoic acid (diet + supplement, g/day) | ||||
| < 0.02 | 158 (20.49) | 5870 (19.99) | 1.00 (reference) | 1.00 (reference) |
| 0.02 – < 0.03 | 160 (20.75) | 5867 (19.98) | 1.00 (0.80, 1.24) | 0.96 (0.77, 1.21) |
| 0.03 – < 0.06 | 160 (20.75) | 5867 (19.98) | 1.00 (0.81, 1.25) | 0.96 (0.76, 1.22) |
| 0.06 – < 0.10 | 177 (22.96) | 5854 (19.93) | 1.12 (0.91, 1.39) | 1.04 (0.83, 1.32) |
| ≥0.10 | 116 (15.05) | 5913 (20.13) | 0.73 (0.57, 0.93) | 0.70 (0.54, 0.90) |
| P Trend | 0.03 | 0.04 | ||
| PUFA 22:6 docosahexaenoic acid (diet + supplement, g/day) | ||||
| < 0.03 | 164 (21.27) | 5865 (19.97) | 1.00 (reference) | 1.00 (reference) |
| 0.03 – < 0.07 | 165 (21.40) | 5864 (19.97) | 1.00 (0.81, 1.25) | 0.96 (0.77, 1.20) |
| 0.07 – < 0.12 | 163 (21.14) | 5865 (19.97) | 0.99 (0.80, 1.23) | 0.93 (0.74, 1.17) |
| 0.12 – < 0.21 | 159 (20.62) | 5870 (19.99) | 0.98 (0.79, 1.21) | 0.92 (0.72, 1.16) |
| ≥0.21 | 120 (15.56) | 5907 (20.11) | 0.73 (0.58, 0.93) | 0.67 (0.52, 0.87) |
| P Trend | 0.02 | 0.01 | ||
| ω-6 PUFAs | ||||
| PUFA 18:2 linoleic acid (g/day) | ||||
| < 6.09 | 152 (19.69) | 5899 (20.01) | 1.00 (reference) | 1.00 (reference) |
| 6.09 – < 8.36 | 152 (19.69) | 5898 (20.01) | 1.00 (0.80, 1.26) | 1.09 (0.85, 1.40) |
| 8.36 – < 10.85 | 151 (19.56) | 5900 (20.01) | 1.00 (0.80, 1.26) | 1.12 (0.86, 1.48) |
| 10.85 – < 14.58 | 163 (21.11) | 5886 (19.97) | 1.08 (0.87. 1.35) | 1.19 (0.89, 1.60) |
| ≥14.58 | 154 (19.95) | 5897 (20.00) | 1.04 (0.83, 1.30) | 1.18 (0.84, 1.66) |
| P Trend | 0.56 | 0.30 | ||
| PUFA 20:4 arachidonic acid (g/day) | ||||
| < 0.05 | 151 (19.56) | 5899 (20.01) | 1.00 (reference) | 1.00 (reference) |
| 0.05 – < 0.07 | 153 (19.82) | 5897 (20.00) | 1.02 (0.81, 1.28) | 1.00 (0.79, 1.27) |
| 0.07 – < 0.10 | 162 (20.98) | 5890 (19.98) | 1.09 (0.88, 1.37) | 1.11 (0.87, 1.42) |
| 0.10 – < 0.13 | 163 (21.11) | 5887 (19.97) | 1.11 (0.89, 1.39) | 1.10 (0.85, 1.41) |
| ≥0.13 | 143 (18.52) | 5907 (20.04) | 1.00 (0.79, 1.26) | 0.97 (0.74, 1.29) |
| P Trend | 0.72 | 0.88 | ||
| ω-3 / ω-6 PUFAs | ||||
| PUFA 20:5n-3 + PUFA 22:6n-3 / PUFA 18:2n-6 + PUFA 20:4n-6 (g/day) | ||||
| < 0.005 | 151 (19.56) | 5899 (20.01) | 1.00 (reference) | 1.00 (reference) |
| 0.005 – < 0.01 | 163 (21.11) | 5887 (19.97) | 1.07 (0.86, 1.34) | 1.03 (0.81, 1.29) |
| 0.01 – < 0.02 | 163 (21.11) | 5889 (19.98) | 1.06 (0.85, 1.33) | 1.04 (0.83, 1.31) |
| 0.02 – < 0.03 | 162 (20.98) | 5888 (19.97) | 1.07 (0.86, 1.34) | 1.02 (0.81, 1.30) |
| ≥0.03 | 133 (17.23) | 5917 (20.07) | 0.87 (0.69, 1.10) | 0.84 (0.65, 1.09) |
| P Trend | 0.32 | 0.27 | ||
a
HR, Hazards Ratio; CI, Confidence Interval; MUFA, Monounsaturated Fatty Acid; SFA, Saturated Fatty Acid, TFA, Trans Fatty Acid; PUFA, Polyunsaturated Fatty Acid;
b
adjusted for age, race, education, height, body mass index, age at menarche, age at first birth, age at menopause, history of hysterectomy, years of combined hormone therapy, years of estrogen hormone therapy, family history of breast cancer, mammography, history of benign breast biopsy, regular use of non-steroidal anti-inflammatory drugs, exercise, alcohol consumption, vegetable intake, fruit intake, and total energy
c
MUFAs: 14:1, myristoleic acid; 16:1, palitoleic acid; 18:1, oleic acid; 20:1, gadoleic acid; 22:1, erucic acid
d
SFAs: SFA 4:0 butyric acid, SFA 6:0 caproic acid, SFA 8:0 caprylic acid, SFA 10:0 capric acid, SFA 12:0 lauric acid, SFA 14:0 myristic acid, SFA 16:0 palmitic acid, SFA 17:0 margaric acid, SFA 18:0 stearic acid, SFA 20:0 arachidic acid, SFA 22:0 behenic acid
e
Trans Fatty Acids: 16:1, trans-hexadecenoic acid, 18:1, trans-octadecenoic acid (elaidic acid), 18:2 trans-octadecadienoic acid (linolelaidic acid) includes c-t, t-c, t-t
f
18:2 trans-octadecadienoic acid (linolelaidic acid) includes c-t, t-c, t-t
g
PUFAs: 18:2, linoleic acid; 18:3, alpha-linolenic acid (ALA); 18:4, parinaric acid; 20:4, arachidonic acid; 20:5, eicosapentaenoic acid (EPA); 22:5, docosapentaenoic (DPA); 22:6, docosahexaenoic acid (DHA)