Table 3.
Energy-adjusted micronutrient intake during adolescence and relative risk (95% confidence interval) of proliferative benign breast disease in NHSII.a
| Exposures | Quintile of energy-adjusted micronutrient intake | P trend |
||||
|---|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | 5 | ||
| Retinol activity equivalents (RAE) | ||||||
| Median intake (mcg/day) | 710 | 913 | 1100 | 1370 | 2179 | |
| No. of combined BBD casesb | 133 | 155 | 164 | 124 | 106 | |
| Multivariate RR (95% CI) | 1.00 (ref) | 1.19 (0.94, 1.50) | 1.27 (1.01, 1.60) | 0.98 (0.76, 1.25) | 0.83 (0.64, 1.07) | 0.01 |
| Additional adjustment for fiber, nuts, and vitamin D | 1.00 (ref) | 1.24 (0.98, 1.58) | 1.37 (1.08, 1.75) | 1.09 (0.84, 1.43) | 0.99 (0.73, 1.34) | 0.32 |
| No. of incident BBD casesc | 31 | 33 | 31 | 25 | 22 | |
| Multivariate RR (95% CI) | 1.00 (ref) | 1.06 (0.65, 1.75) | 1.01 (0.61, 1.68) | 0.77 (0.45, 1.32) | 0.73 (0.42, 1.28) | 0.14 |
| Additional adjustment for fiber, nuts, and vitamin D | 1.00 (ref) | 1.11 (0.67, 1.86) | 1.11 (0.65, 1.89) | 0.88 (0.49, 1.58) | 0.93 (0.48, 1.81) | 0.63 |
| RAE from food only | ||||||
| Median intake (mcg/day) | 699 | 884 | 1041 | 1236 | 1638 | |
| No. of combined BBD casesb | 135 | 142 | 155 | 130 | 120 | |
| Multivariate RR (95% CI) | 1.00 (ref) | 1.08 (0.85, 1.37) | 1.20 (0.95, 1.51) | 1.02 (0.80, 1.30) | 0.94 (0.73, 1.20) | 0.37 |
| Additional adjustment for fiber, nuts, and vitamin D | 1.00 (ref) | 1.15 (0.90, 1.46) | 1.31 (1.03, 1.67) | 1.17 (0.90, 1.51) | 1.12 (0.86, 1.47) | 0.60 |
| No. of incident BBD casesc | 29 | 34 | 31 | 26 | 22 | |
| Multivariate RR (95% CI) | 1.00 (ref) | 1.16 (0.70, 1.91) | 1.11 (0.66, 1.85) | 0.88 (0.51, 1.51) | 0.70 (0.39, 1.24) | 0.10 |
| Additional adjustment for fiber, nuts, and vitamin D | 1.00 (ref) | 1.24 (0.74, 2.07) | 1.26 (0.74, 2.15) | 1.06 (0.60, 1.87) | 0.88 (0.47, 1.63) | 0.46 |
| Vitamin E | ||||||
| Median intake (mg/day) | 9.8 | 11.3 | 12.4 | 13.6 | 15.7 | |
| No. of combined BBD casesb | 147 | 160 | 140 | 112 | 123 | |
| Multivariate RR (95% CI) | 1.00 (ref) | 1.14 (0.91, 1.43) | 1.00 (0.79, 1.27) | 0.82 (0.64, 1.05) | 0.90 (0.70, 1.15) | 0.08 |
| Additional adjustment for fiber, nuts, and vitamin D | 1.00 (ref) | 1.16 (0.93, 1.46) | 1.04 (0.82, 1.32) | 0.86 (0.67, 1.11) | 0.97 (0.76, 1.25) | 0.30 |
| No. of incident BBD casesc | 36 | 28 | 29 | 19 | 30 | |
| Multivariate RR (95% CI) | 1.00 (ref) | 0.80 (0.49, 1.32) | 0.86 (0.52, 1.43) | 0.54 (0.31, 0.95) | 0.87 (0.52, 1.43) | 0.37 |
| Additional adjustment for fiber, nuts, and vitamin D | 1.00 (ref) | 0.83 (0.50, 1.38) | 0.94 (0.56, 1.56) | 0.61 (0.34, 1.08) | 1.02 (0.60, 1.72) | 0.83 |
| Vitamin E from food only | ||||||
| Median intake (mg/day) | 9.8 | 11.3 | 12.3 | 13.4 | 15.3 | |
| No. of combined BBD casesb | 145 | 159 | 145 | 110 | 123 | |
| Multivariate RR (95% CI) | 1.00 (ref) | 1.15 (0.91, 1.44) | 1.05 (0.83, 1.33) | 0.81 (0.63, 1.04) | 0.87 (0.68, 1.12) | 0.04 |
| Additional adjustment for fiber, nuts, and vitaminD | 1.00 (ref) | 1.16 (0.92, 1.46) | 1.08 (0.85, 1.37) | 0.84 (0.65, 1.09) | 0.92 (0.71, 1.18) | 0.13 |
| No. of incident BBD casesc | 36 | 32 | 28 | 19 | 27 | |
| Multivariate RR (95% CI) | 1.00 (ref) | 0.91 (0.56, 1.47) | 0.78 (0.47, 1.29) | 0.55 (0.31, 0.96) | 0.77 (0.46, 1.28) | 0.13 |
| Additional adjustment for fiber, nuts, and vitamin D | 1.00 (ref) | 0.94 (0.58, 1.53) | 0.84 (0.50, 1.40) | 0.60 (0.33, 1.07) | 0.84 (0.49, 1.43) | 0.28 |
| α-Carotene | ||||||
| Median intake (mcg/day) | 310 | 598 | 856 | 1283 | 2295 | |
| No. of combined BBD casesb | 139 | 146 | 129 | 142 | 126 | |
| Multivariate RR (95% CI) | 1.00 (ref) | 1.02 (0.81, 1.29) | 0.92 (0.72, 1.17) | 1.00 (0.79, 1.26) | 0.90 (0.71, 1.15) | 0.39 |
| Additional adjustment for fiber, nuts, and vitamin D | 1.00 (ref) | 1.07 (0.84, 1.35) | 1.01 (0.78, 1.29) | 1.13 (0.87, 1.45) | 1.08 (0.82, 1.43) | 0.56 |
| No. of incident BBD casesc | 32 | 30 | 25 | 30 | 25 | |
| Multivariate RR (95% CI) | 1.00 (ref) | 0.96 (0.58, 1.58) | 0.76 (0.44, 1.30) | 0.94 (0.56, 1.56) | 0.78 (0.46, 1.33) | 0.42 |
| Additional adjustment for fiber, nuts, and vitamin D | 1.00 (ref) | 1.03 (0.62, 1.73) | 0.90 (0.51, 1.57) | 1.14 (0.66, 1.96) | 1.02 (0.55, 1.88) | 0.85 |
| β-Carotene | ||||||
| Median intake (mcg/day) | 1599 | 2509 | 3319 | 4411 | 6713 | |
| No. of combined BBD casesb | 146 | 123 | 147 | 144 | 122 | |
| Multivariate RR (95% CI) | 1.00 (ref) | 0.85 (0.67, 1.08) | 1.01 (0.80, 1.27) | 0.98 (0.78, 1.24) | 0.85 (0.66, 1.08) | 0.35 |
| Additional adjustment for fiber, nuts, and vitamin D | 1.00 (ref) | 0.90 (0.70, 1.15) | 1.13 (0.88, 1.44) | 1.16 (0.89, 1.51) | 1.09 (0.81, 1.47) | 0.33 |
| No. of incident BBD casesc | 30 | 27 | 38 | 25 | 22 | |
| Multivariate RR (95% CI) | 1.00 (ref) | 0.91 (0.54, 1.54) | 1.27 (0.78, 2.07) | 0.82 (0.48, 1.42) | 0.72 (0.41, 1.26) | 0.17 |
| Additional adjustment for fiber, nuts, and vitamin D | 1.00 (ref) | 1.01 (0.59, 1.72) | 1.52 (0.90, 2.57) | 1.07 (0.58, 1.95) | 0.97 (0.49, 1.93) | 0.85 |
| β-Cryptoxanthin | ||||||
| Median intake (mcg/day) | 57 | 103 | 154 | 212 | 304 | |
| No. of combined BBD casesb | 135 | 119 | 159 | 127 | 142 | |
| Multivariate RR (95% CI) | 1.00 (ref) | 0.88 (0.69, 1.13) | 1.19 (0.95, 1.51) | 0.93 (0.73, 1.19) | 1.06 (0.83, 1.34) | 0.57 |
| Additional adjustment for fiber, nuts, and vitamin D | 1.00 (ref) | 0.92 (0.72, 1.19) | 1.29 (1.01, 1.63) | 1.04 (0.81, 1.34) | 1.22 (0.94, 1.57) | 0.09 |
| No. of incident BBD casesc | 31 | 16 | 35 | 31 | 29 | |
| Multivariate RR (95% CI) | 1.00 (ref) | 0.53 (0.29, 0.97) | 1.13 (0.69, 1.84) | 0.98 (0.59, 1.64) | 0.88 (0.53, 1.48) | 0.74 |
| Additional adjustment for fiber, nuts, and vitamin D | 1.00 (ref) | 0.58 (0.31, 1.07) | 1.32 (0.79, 2.18) | 1.19 (0.70, 2.02) | 1.12 (0.64, 1.95) | 0.26 |
| Lycopene | ||||||
| Median intake (mcg/day) | 3374 | 4770 | 5975 | 8359 | 12803 | |
| No. of combined BBD casesb | 135 | 138 | 149 | 141 | 119 | |
| Multivariate RR (95% CI) | 1.00 (ref) | 1.08 (0.85, 1.38) | 1.16 (0.91, 1.47) | 1.09 (0.86, 1.38) | 0.95 (0.74, 1.22) | 0.46 |
| Additional adjustment for fiber, nuts, and vitamin D | 1.00 (ref) | 1.09 (0.86, 1.39) | 1.18 (0.93, 1.50) | 1.12 (0.88, 1.43) | 0.99 (0.77, 1.29) | 0.71 |
| No. of incident BBD casesc | 29 | 32 | 29 | 24 | 28 | |
| Multivariate RR (95% CI) | 1.00 (ref) | 1.10 (0.66, 1.83) | 1.01 (0.60, 1.71) | 0.82 (0.47, 1.43) | 1.00 (0.59, 1.70) | 0.74 |
| Additional adjustment for fiber, nuts, and vitamin D | 1.00 (ref) | 1.11 (0.67, 1.86) | 1.06 (0.62, 1.81) | 0.88 (0.50, 1.53) | 1.11 (0.64, 1.93) | 0.93 |
| Lutein & zeaxanthin | ||||||
| Median intake (mcg/day) | 938 | 1473 | 1997 | 2658 | 4144 | |
| No. of combined BBD casesb | 140 | 139 | 132 | 145 | 126 | |
| Multivariate RR (95% CI) | 1.00 (ref) | 0.99 (0.78, 1.25) | 0.95 (0.75, 1.21) | 1.02 (0.81, 1.30) | 0.90 (0.71, 1.15) | 0.46 |
| Additional adjustment for fiber, nuts, and vitamin D | 1.00 (ref) | 1.05 (0.82, 1.34) | 1.05 (0.81, 1.36) | 1.19 (0.92, 1.54) | 1.12 (0.84, 1.49) | 0.37 |
| No. of incident BBD casesc | 28 | 29 | 30 | 31 | 24 | |
| Multivariate RR (95% CI) | 1.00 (ref) | 1.04 (0.62, 1.76) | 1.07 (0.64, 1.80) | 1.08 (0.64, 1.82) | 0.79 (0.45, 1.38) | 0.37 |
| Additional adjustment for fiber, nuts, and vitamin D | 1.00 (ref) | 1.19 (0.69, 2.04) | 1.31 (0.75, 2.29) | 1.42 (0.80, 2.53) | 1.13 (0.59, 2.17) | 0.77 |
a
The multivariate models were adjusted for the same variables as in the combined and incident BBD analyses in Table 2. Age-adjusted results were similar. Models of total micronutrient intake (including supplements) not adjusted for multivitamin intake. Variables represent total intake unless otherwise stated.
b
682 cases of proliferative BBD (with or without atypia) were diagnosed during the follow-up period 1991–2001.
c
142 cases of proliferative BBD (with or without atypia) were diagnosed during the follow-up period 1998–2001.