Table 2.
Percentage of calories from total fat and types of fat during adolescence and relative risks (95% confidence interval) of proliferative benign breast disease in NHSII.
| Exposures | Quintiles of percentage of calories from fat | P trend | ||||
|---|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | 5 | ||
| Total fat | ||||||
| Median intake (% of energy) | 34.8 | 38.4 | 40.7 | 42.8 | 46.0 | |
| No. of combined BBD casesa | 126 | 144 | 120 | 138 | 154 | |
| Multivariate RR (95% CI)b | 1.00 (ref) | 1.08 (0.85, 1.38) | 0.88 (0.69, 1.14) | 0.98 (0.77, 1.26) | 1.09 (0.85, 1.39) | 0.72 |
| Additional adjustment for fiber, nuts, and vitamin D | 1.00 (ref) | 1.04 (0.81, 1.32) | 0.82 (0.63, 1.06) | 0.89 (0.68, 1.15) | 0.96 (0.73, 1.25) | 0.50 |
| No. of incident BBD casesc | 25 | 31 | 28 | 29 | 29 | |
| Multivariate RR (95% CI)d | 1.00 (ref) | 1.25 (0.73, 2.14) | 1.13 (0.65, 1.96) | 1.21 (0.70, 2.10) | 1.26 (0.72, 2.19) | 0.49 |
| Additional adjustment for fiber, nuts, and vitamin D | 1.00 (ref) | 1.18 (0.69, 2.04) | 1.02 (0.57, 1.81) | 1.04 (0.58, 1.87) | 0.99 (0.54, 1.83) | 0.86 |
| Animal fat | ||||||
| Median intake (% of energy) | 18.6 | 22.6 | 25.4 | 28.5 | 32.9 | |
| No. of combined BBD casesa | 112 | 121 | 141 | 151 | 157 | |
| Multivariate RR (95% CI)b | 1.00 (ref) | 1.02 (0.78, 1.32) | 1.10 (0.84, 1.42) | 1.15 (0.89, 1.50) | 1.15 (0.88, 1.51) | 0.20 |
| Additional adjustment for vegetable fatb and fiber, nuts, and vitamin D | 1.00 (ref) | 0.96 (0.73, 1.25) | 0.98 (0.74, 1.30) | 0.99 (0.73, 1.33) | 0.95 (0.68, 1.32) | 0.82 |
| No. of incident BBD casesc | 26 | 29 | 34 | 25 | 28 | |
| Multivariate RR (95% CI)d | 1.00 (ref) | 1.25 (0.72, 2.16) | 1.47 (0.85, 2.53) | 1.01 (0.56, 1.83) | 1.19 (0.66, 2.17) | 0.83 |
| Additional adjustment for vegetable fatd and fiber, nuts, and vitamin D | 1.00 (ref) | 1.17 (0.67, 2.05) | 1.28 (0.71, 2.32) | 0.79 (0.40, 1.55) | 0.87 (0.41, 1.85) | 0.48 |
| Vegetable fat | ||||||
| Median intake (% of energy) | 9.8 | 12.6 | 14.7 | 16.8 | 20.0 | |
| No. of combined BBD casesa | 158 | 140 | 147 | 126 | 111 | |
| Multivariate RR (95% CI)b | 1.00 (ref) | 0.93 (0.74, 1.17) | 1.01 (0.80, 1.28) | 0.88 (0.69, 1.13) | 0.82 (0.63, 1.07) | 0.15 |
| Additional adjustment for animal fatb and fiber, nuts, and vitamin D | 1.00 (ref) | 0.92 (0.72, 1.17) | 0.99 (0.77, 1.28) | 0.86 (0.66, 1.13) | 0.80 (0.59, 1.09) | 0.15 |
| No. of incident BBD casesc | 30 | 26 | 35 | 22 | 29 | |
| Multivariate RR (95% CI)d | 1.00 (ref) | 0.92 (0.54, 1.56) | 1.31 (0.78, 2.17) | 0.80 (0.45, 1.42) | 1.03 (0.59, 1.81) | 0.95 |
| Additional adjustment for animal fatd and fiber, nuts, and vitamin D | 1.00 (ref) | 0.86 (0.49,1.50) | 1.18 (0.67, 2.07) | 0.69 (0.36, 1.32) | 0.94 (0.48, 1.82) | 0.69 |
| Saturated fat | ||||||
| Median intake (% of energy) | 12.9 | 14.6 | 15.9 | 17.2 | 19.2 | |
| No. of combined BBD casesa | 115 | 141 | 132 | 138 | 156 | |
| Multivariate RR (95% CI)b | 1.00 (ref) | 1.18 (0.92, 1.51) | 1.04 (0.81, 1.35) | 1.04 (0.80, 1.35) | 1.13 (0.87, 1.46) | 0.62 |
| Additional adjustment for other types of fatb and fiber, nuts, and vitamin D | 1.00 (ref) | 1.13 (0.86, 1.48) | 0.95 (0.70, 1.28) | 0.91 (0.65, 1.27) | 0.93 (0.64, 1.36) | 0.48 |
| No. of incident BBD casesc | 28 | 27 | 30 | 28 | 29 | |
| Multivariate RR (95% CI)d | 1.00 (ref) | 1.00 (0.58, 1.72) | 1.13 (0.66, 1.93) | 1.04 (0.60, 1.81) | 1.10 (0.62, 1.92) | 0.74 |
| Additional adjustment for other types of fatd and fiber, nuts, and vitamin D | 1.00 (ref) | 0.94 (0.52, 1.68) | 1.03 (0.54, 1.94) | 0.90 (0.44, 1.81) | 0.94 (0.41, 2.15) | 0.87 |
| Monounsaturated fat | ||||||
| Median intake (% of energy) | 12.3 | 13.7 | 14.6 | 15.4 | 16.7 | |
| No. of combined BBD casesa | 129 | 129 | 147 | 127 | 150 | |
| Multivariate RR (95% CI)b | 1.00 (ref) | 0.97 (0.75, 1.23) | 1.12 (0.88, 1.42) | 0.94 (0.73, 1.20) | 1.10 (0.86, 1.39) | 0.55 |
| Additional adjustment for other types of fatb and fiber, nuts, and vitamin D | 1.00 (ref) | 0.95 (0.72, 1.25) | 1.12 (0.83, 1.50) | 0.93 (0.67, 1.29) | 1.09 (0.76, 1.57) | 0.67 |
| No. of incident BBD casesc | 26 | 32 | 31 | 25 | 28 | |
| Multivariate RR (95% CI)d | 1.00 (ref) | 1.24 (0.73, 2.10) | 1.26 (0.74, 2.14) | 1.00 (0.57, 1.74) | 1.13 (0.66, 1.96) | 0.90 |
| Additional adjustment for other types of fatd and fiber, nuts, and vitamin D | 1.00 (ref) | 1.20 (0.67, 2.15) | 1.16 (0.61, 2.23) | 0.88 (0.43, 1.79) | 0.90 (0.41, 1.99) | 0.56 |
| Polyunsaturated fat | ||||||
| Median intake (% of energy) | 5.0 | 5.9 | 6.5 | 7.2 | 8.3 | |
| No. of combined BBD casesa | 152 | 135 | 145 | 134 | 116 | |
| Multivariate RR (95% CI)b | 1.00 (ref) | 0.91 (0.72, 1.15) | 1.01 (0.80, 1.27) | 0.94 (0.74, 1.19) | 0.82 (0.64, 1.05) | 0.16 |
| Additional adjustment for other types of fatb and fiber, nuts, and vitamin D | 1.00 (ref) | 0.90 (0.71, 1.14) | 0.99 (0.78, 1.27) | 0.92 (0.71, 1.20) | 0.81 (0.61, 1.07) | 0.19 |
| No. of incident BBD casesc | 30 | 29 | 32 | 22 | 29 | |
| Multivariate RR (95% CI)d | 1.00 (ref) | 0.98 (0.58, 1.65) | 1.04 (0.63, 1.73) | 0.77 (0.44, 1.35) | 1.04 (0.61, 1.75) | 0.88 |
| Additional adjustment for other types of fatd and fiber, nuts, and vitamin D | 1.00 (ref) | 1.02 (0.60, 1.73) | 1.12 (0.65, 1.92) | 0.87 (0.47, 1.59) | 1.20 (0.66, 2.19) | 0.69 |
| Trans-unsaturated fat | ||||||
| Median intake (% of energy) | 1.5 | 1.9 | 2.3 | 2.7 | 3.3 | |
| No. of combined BBD casesa | 139 | 147 | 130 | 142 | 124 | |
| Multivariate RR (95% CI)b | 1.00 (ref) | 1.15 (0.91, 1.46) | 1.07 (0.84, 1.36) | 1.16 (0.91, 1.48) | 0.98 (0.77, 1.26) | 0.84 |
| Additional adjustment for other types of fatb and fiber, nuts, and vitamin D | 1.00 (ref) | 1.13 (0.89, 1.44) | 1.03 (0.80, 1.33) | 1.11 (0.86, 1.43) | 0.92 (0.70, 1.20) | 0.43 |
| No. of incident BBD casesc | 34 | 27 | 22 | 33 | 26 | |
| Multivariate RR (95% CI)d | 1.00 (ref) | 0.84 (0.50, 1.40) | 0.70 (0.40, 1.23) | 1.11 (0.67, 1.83) | 0.84 (0.49, 1.42) | 0.85 |
| Additional adjustment for other types of fatd and fiber, nuts, and vitamin D | 1.00 (ref) | 0.77 (0.46, 1.30) | 0.61 (0.34, 1.09) | 0.94 (0.55, 1.62) | 0.67 (0.38, 1.21) | 0.37 |
682 cases of proliferative BBD (with or without atypia) were diagnosed during the follow-up period 1991–2001.
The multivariate models are adjusted for age in months, time period (5 periods), total energy intake (quintiles), age at menarche (<12, 12, 13, or ≥ 14 years), menopausal status (premenopausal, postmenopausal, or uncertain), average body size between ages 5 and 10 (somatotype pictogram 1, 1.5–2, 2.5–3, 3.5–4.5, or ≥ 5), family history of breast cancer in mother or sister (yes vs. no), alcohol intake between ages 18 and 22 years (0, <5, 5–14, or ≥ 15 grams/day), multivitamin use between ages 13 and 18 years (yes vs. no), recency and duration of OC use (never, past <4 years, past ≥ 4 years, current <4 years, or current ≥4 years), and parity and age at first birth (nulliparous, 1–2 pregnancies and age at first birth <25 years, 1–2 pregnancies and age at first birth 25–29 years, 1–2 pregnancies and age at first birth ≥ 30 years, ≥ 3 pregnancies and age at first birth <25 years, ≥ 3 pregnancies and age at first birth 25–29 years, or ≥3 pregnancies and age at first birth ≥ 30 years). Age-adjusted results were similar.
142 cases of proliferative BBD (with or without atypia) were diagnosed during the follow-up period 1998–2001.
The multivariate models are adjusted for variables categorized as above, except for time period (2 periods), recency and duration of OC use (never, past <4 years, past ≥ 4 years, or current), and parity and age at first birth (nulliparous, 1–2 pregnancies and age at first birth <25 years, 1–2 pregnancies and age at first birth 25–29 years, 1–2 pregnancies and age at first birth ≥ 30 years, ≥ 3 pregnancies and age at first birth <25 years, ≥ 3 pregnancies and age at first birth ≥ 25 years). Age-adjusted results were similar.