Low-Fat Dietary Pattern and Risk of Invasive Breast Cancer: The Women's Health Initiative Randomized Controlled Dietary Modification Trial
CONTEXT The hypothesis that a low-fat dietary pattern can reduce breast cancer risk has existed for decades but has never been tested in a controlled intervention trial. OBJECTIVE To assess the effects of undertaking a low-fat dietary pattern on breast cancer incidence. DESIGN AND SETTING A randomiz...
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| Veröffentlicht in: | JAMA : the journal of the American Medical Association 2006-02, Vol.295 (6), p.629-642 |
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| creator | Prentice, Ross L Caan, Bette Chlebowski, Rowan T Patterson, Ruth Kuller, Lewis H Ockene, Judith K Margolis, Karen L Limacher, Marian C Manson, JoAnn E Parker, Linda M Paskett, Electra Phillips, Lawrence Robbins, John Rossouw, Jacques E Sarto, Gloria E Shikany, James M Stefanick, Marcia L Thomson, Cynthia A Van Horn, Linda Vitolins, Mara Z Wactawski-Wende, Jean Wallace, Robert B Wassertheil-Smoller, Sylvia Whitlock, Evelyn Yano, Katsuhiko Adams-Campbell, Lucile Anderson, Garnet L Assaf, Annlouise R Beresford, Shirley A. A Black, Henry R Brunner, Robert L Brzyski, Robert G Ford, Leslie Gass, Margery Hays, Jennifer Heber, David Heiss, Gerardo Hendrix, Susan L Hsia, Judith Hubbell, F. Allan Jackson, Rebecca D Johnson, Karen C Kotchen, Jane Morley LaCroix, Andrea Z Lane, Dorothy S Langer, Robert D Lasser, Norman L Henderson, Maureen M |
| description | CONTEXT The hypothesis that a low-fat dietary pattern can reduce breast cancer risk has existed for decades but has never been tested in a controlled intervention trial. OBJECTIVE To assess the effects of undertaking a low-fat dietary pattern on breast cancer incidence. DESIGN AND SETTING A randomized, controlled, primary prevention trial conducted at 40 US clinical centers from 1993 to 2005. PARTICIPANTS A total of 48 835 postmenopausal women, aged 50 to 79 years, without prior breast cancer, including 18.6% of minority race/ethnicity, were enrolled. INTERVENTIONS Women were randomly assigned to the dietary modification intervention group (40% [n = 19 541]) or the comparison group (60% [n = 29 294]). The intervention was designed to promote dietary change with the goals of reducing intake of total fat to 20% of energy and increasing consumption of vegetables and fruit to at least 5 servings daily and grains to at least 6 servings daily. Comparison group participants were not asked to make dietary changes. MAIN OUTCOME MEASURE Invasive breast cancer incidence. RESULTS Dietary fat intake was significantly lower in the dietary modification intervention group compared with the comparison group. The difference between groups in change from baseline for percentage of energy from fat varied from 10.7% at year 1 to 8.1% at year 6. Vegetable and fruit consumption was higher in the intervention group by at least 1 serving per day and a smaller, more transient difference was found for grain consumption. The number of women who developed invasive breast cancer (annualized incidence rate) over the 8.1-year average follow-up period was 655 (0.42%) in the intervention group and 1072 (0.45%) in the comparison group (hazard ratio, 0.91; 95% confidence interval, 0.83-1.01 for the comparison between the 2 groups). Secondary analyses suggest a lower hazard ratio among adherent women, provide greater evidence of risk reduction among women having a high-fat diet at baseline, and suggest a dietary effect that varies by hormone receptor characteristics of the tumor. CONCLUSIONS Among postmenopausal women, a low-fat dietary pattern did not result in a statistically significant reduction in invasive breast cancer risk over an 8.1-year average follow-up period. However, the nonsignificant trends observed suggesting reduced risk associated with a low-fat dietary pattern indicate that longer, planned, nonintervention follow-up may yield a more definitive comparison. CLINICAL TRIALS R |
| doi_str_mv | 10.1001/jama.295.6.629 |
| format | Article |
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A ; Black, Henry R ; Brunner, Robert L ; Brzyski, Robert G ; Ford, Leslie ; Gass, Margery ; Hays, Jennifer ; Heber, David ; Heiss, Gerardo ; Hendrix, Susan L ; Hsia, Judith ; Hubbell, F. Allan ; Jackson, Rebecca D ; Johnson, Karen C ; Kotchen, Jane Morley ; LaCroix, Andrea Z ; Lane, Dorothy S ; Langer, Robert D ; Lasser, Norman L ; Henderson, Maureen M</creator><creatorcontrib>Prentice, Ross L ; Caan, Bette ; Chlebowski, Rowan T ; Patterson, Ruth ; Kuller, Lewis H ; Ockene, Judith K ; Margolis, Karen L ; Limacher, Marian C ; Manson, JoAnn E ; Parker, Linda M ; Paskett, Electra ; Phillips, Lawrence ; Robbins, John ; Rossouw, Jacques E ; Sarto, Gloria E ; Shikany, James M ; Stefanick, Marcia L ; Thomson, Cynthia A ; Van Horn, Linda ; Vitolins, Mara Z ; Wactawski-Wende, Jean ; Wallace, Robert B ; Wassertheil-Smoller, Sylvia ; Whitlock, Evelyn ; Yano, Katsuhiko ; Adams-Campbell, Lucile ; Anderson, Garnet L ; Assaf, Annlouise R ; Beresford, Shirley A. A ; Black, Henry R ; Brunner, Robert L ; Brzyski, Robert G ; Ford, Leslie ; Gass, Margery ; Hays, Jennifer ; Heber, David ; Heiss, Gerardo ; Hendrix, Susan L ; Hsia, Judith ; Hubbell, F. Allan ; Jackson, Rebecca D ; Johnson, Karen C ; Kotchen, Jane Morley ; LaCroix, Andrea Z ; Lane, Dorothy S ; Langer, Robert D ; Lasser, Norman L ; Henderson, Maureen M</creatorcontrib><description>CONTEXT The hypothesis that a low-fat dietary pattern can reduce breast cancer risk has existed for decades but has never been tested in a controlled intervention trial. OBJECTIVE To assess the effects of undertaking a low-fat dietary pattern on breast cancer incidence. DESIGN AND SETTING A randomized, controlled, primary prevention trial conducted at 40 US clinical centers from 1993 to 2005. PARTICIPANTS A total of 48 835 postmenopausal women, aged 50 to 79 years, without prior breast cancer, including 18.6% of minority race/ethnicity, were enrolled. INTERVENTIONS Women were randomly assigned to the dietary modification intervention group (40% [n = 19 541]) or the comparison group (60% [n = 29 294]). The intervention was designed to promote dietary change with the goals of reducing intake of total fat to 20% of energy and increasing consumption of vegetables and fruit to at least 5 servings daily and grains to at least 6 servings daily. Comparison group participants were not asked to make dietary changes. MAIN OUTCOME MEASURE Invasive breast cancer incidence. RESULTS Dietary fat intake was significantly lower in the dietary modification intervention group compared with the comparison group. The difference between groups in change from baseline for percentage of energy from fat varied from 10.7% at year 1 to 8.1% at year 6. Vegetable and fruit consumption was higher in the intervention group by at least 1 serving per day and a smaller, more transient difference was found for grain consumption. The number of women who developed invasive breast cancer (annualized incidence rate) over the 8.1-year average follow-up period was 655 (0.42%) in the intervention group and 1072 (0.45%) in the comparison group (hazard ratio, 0.91; 95% confidence interval, 0.83-1.01 for the comparison between the 2 groups). Secondary analyses suggest a lower hazard ratio among adherent women, provide greater evidence of risk reduction among women having a high-fat diet at baseline, and suggest a dietary effect that varies by hormone receptor characteristics of the tumor. CONCLUSIONS Among postmenopausal women, a low-fat dietary pattern did not result in a statistically significant reduction in invasive breast cancer risk over an 8.1-year average follow-up period. However, the nonsignificant trends observed suggesting reduced risk associated with a low-fat dietary pattern indicate that longer, planned, nonintervention follow-up may yield a more definitive comparison. CLINICAL TRIALS REGISTRATION ClinicalTrials.gov Identifier: NCT00000611</description><identifier>ISSN: 0098-7484</identifier><identifier>EISSN: 1538-3598</identifier><identifier>DOI: 10.1001/jama.295.6.629</identifier><identifier>PMID: 16467232</identifier><identifier>CODEN: JAMAAP</identifier><language>eng</language><publisher>Chicago, IL: American Medical Association</publisher><subject>Aged ; Biological and medical sciences ; Biomarkers - blood ; Body Weight ; Breast cancer ; Breast Neoplasms - epidemiology ; Breast Neoplasms - prevention & control ; Cholesterol, LDL - blood ; Clinical trials ; Diet ; Diet Records ; Diet, Fat-Restricted ; Diseases of the digestive system ; Female ; Follow-Up Studies ; General aspects ; Gonadal Steroid Hormones - blood ; Gynecology. Andrology. Obstetrics ; Humans ; Incidence ; Mammary gland diseases ; Medical sciences ; Middle Aged ; Postmenopause ; Primary Prevention ; Proportional Hazards Models ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Risk ; Sex Hormone-Binding Globulin - analysis ; Tumors</subject><ispartof>JAMA : the journal of the American Medical Association, 2006-02, Vol.295 (6), p.629-642</ispartof><rights>2006 INIST-CNRS</rights><rights>Copyright American Medical Association Feb 8, 2006</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://jamanetwork.com/journals/jama/articlepdf/10.1001/jama.295.6.629$$EPDF$$P50$$Gama$$H</linktopdf><linktohtml>$$Uhttps://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.295.6.629$$EHTML$$P50$$Gama$$H</linktohtml><link.rule.ids>64,314,776,780,3327,27901,27902,76232,76235</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17474120$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16467232$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Prentice, Ross L</creatorcontrib><creatorcontrib>Caan, Bette</creatorcontrib><creatorcontrib>Chlebowski, Rowan T</creatorcontrib><creatorcontrib>Patterson, Ruth</creatorcontrib><creatorcontrib>Kuller, Lewis H</creatorcontrib><creatorcontrib>Ockene, Judith K</creatorcontrib><creatorcontrib>Margolis, Karen L</creatorcontrib><creatorcontrib>Limacher, Marian C</creatorcontrib><creatorcontrib>Manson, JoAnn E</creatorcontrib><creatorcontrib>Parker, Linda M</creatorcontrib><creatorcontrib>Paskett, Electra</creatorcontrib><creatorcontrib>Phillips, Lawrence</creatorcontrib><creatorcontrib>Robbins, John</creatorcontrib><creatorcontrib>Rossouw, Jacques E</creatorcontrib><creatorcontrib>Sarto, Gloria E</creatorcontrib><creatorcontrib>Shikany, James M</creatorcontrib><creatorcontrib>Stefanick, Marcia L</creatorcontrib><creatorcontrib>Thomson, Cynthia A</creatorcontrib><creatorcontrib>Van Horn, Linda</creatorcontrib><creatorcontrib>Vitolins, Mara Z</creatorcontrib><creatorcontrib>Wactawski-Wende, Jean</creatorcontrib><creatorcontrib>Wallace, Robert B</creatorcontrib><creatorcontrib>Wassertheil-Smoller, Sylvia</creatorcontrib><creatorcontrib>Whitlock, Evelyn</creatorcontrib><creatorcontrib>Yano, Katsuhiko</creatorcontrib><creatorcontrib>Adams-Campbell, Lucile</creatorcontrib><creatorcontrib>Anderson, Garnet L</creatorcontrib><creatorcontrib>Assaf, Annlouise R</creatorcontrib><creatorcontrib>Beresford, Shirley A. A</creatorcontrib><creatorcontrib>Black, Henry R</creatorcontrib><creatorcontrib>Brunner, Robert L</creatorcontrib><creatorcontrib>Brzyski, Robert G</creatorcontrib><creatorcontrib>Ford, Leslie</creatorcontrib><creatorcontrib>Gass, Margery</creatorcontrib><creatorcontrib>Hays, Jennifer</creatorcontrib><creatorcontrib>Heber, David</creatorcontrib><creatorcontrib>Heiss, Gerardo</creatorcontrib><creatorcontrib>Hendrix, Susan L</creatorcontrib><creatorcontrib>Hsia, Judith</creatorcontrib><creatorcontrib>Hubbell, F. Allan</creatorcontrib><creatorcontrib>Jackson, Rebecca D</creatorcontrib><creatorcontrib>Johnson, Karen C</creatorcontrib><creatorcontrib>Kotchen, Jane Morley</creatorcontrib><creatorcontrib>LaCroix, Andrea Z</creatorcontrib><creatorcontrib>Lane, Dorothy S</creatorcontrib><creatorcontrib>Langer, Robert D</creatorcontrib><creatorcontrib>Lasser, Norman L</creatorcontrib><creatorcontrib>Henderson, Maureen M</creatorcontrib><title>Low-Fat Dietary Pattern and Risk of Invasive Breast Cancer: The Women's Health Initiative Randomized Controlled Dietary Modification Trial</title><title>JAMA : the journal of the American Medical Association</title><addtitle>JAMA</addtitle><description>CONTEXT The hypothesis that a low-fat dietary pattern can reduce breast cancer risk has existed for decades but has never been tested in a controlled intervention trial. OBJECTIVE To assess the effects of undertaking a low-fat dietary pattern on breast cancer incidence. DESIGN AND SETTING A randomized, controlled, primary prevention trial conducted at 40 US clinical centers from 1993 to 2005. PARTICIPANTS A total of 48 835 postmenopausal women, aged 50 to 79 years, without prior breast cancer, including 18.6% of minority race/ethnicity, were enrolled. INTERVENTIONS Women were randomly assigned to the dietary modification intervention group (40% [n = 19 541]) or the comparison group (60% [n = 29 294]). The intervention was designed to promote dietary change with the goals of reducing intake of total fat to 20% of energy and increasing consumption of vegetables and fruit to at least 5 servings daily and grains to at least 6 servings daily. Comparison group participants were not asked to make dietary changes. MAIN OUTCOME MEASURE Invasive breast cancer incidence. RESULTS Dietary fat intake was significantly lower in the dietary modification intervention group compared with the comparison group. The difference between groups in change from baseline for percentage of energy from fat varied from 10.7% at year 1 to 8.1% at year 6. Vegetable and fruit consumption was higher in the intervention group by at least 1 serving per day and a smaller, more transient difference was found for grain consumption. The number of women who developed invasive breast cancer (annualized incidence rate) over the 8.1-year average follow-up period was 655 (0.42%) in the intervention group and 1072 (0.45%) in the comparison group (hazard ratio, 0.91; 95% confidence interval, 0.83-1.01 for the comparison between the 2 groups). Secondary analyses suggest a lower hazard ratio among adherent women, provide greater evidence of risk reduction among women having a high-fat diet at baseline, and suggest a dietary effect that varies by hormone receptor characteristics of the tumor. CONCLUSIONS Among postmenopausal women, a low-fat dietary pattern did not result in a statistically significant reduction in invasive breast cancer risk over an 8.1-year average follow-up period. However, the nonsignificant trends observed suggesting reduced risk associated with a low-fat dietary pattern indicate that longer, planned, nonintervention follow-up may yield a more definitive comparison. CLINICAL TRIALS REGISTRATION ClinicalTrials.gov Identifier: NCT00000611</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Biomarkers - blood</subject><subject>Body Weight</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - epidemiology</subject><subject>Breast Neoplasms - prevention & control</subject><subject>Cholesterol, LDL - blood</subject><subject>Clinical trials</subject><subject>Diet</subject><subject>Diet Records</subject><subject>Diet, Fat-Restricted</subject><subject>Diseases of the digestive system</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>General aspects</subject><subject>Gonadal Steroid Hormones - blood</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Incidence</subject><subject>Mammary gland diseases</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Postmenopause</subject><subject>Primary Prevention</subject><subject>Proportional Hazards Models</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. 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Diet therapy and various other treatments (general aspects)</topic><topic>Risk</topic><topic>Sex Hormone-Binding Globulin - analysis</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Prentice, Ross L</creatorcontrib><creatorcontrib>Caan, Bette</creatorcontrib><creatorcontrib>Chlebowski, Rowan T</creatorcontrib><creatorcontrib>Patterson, Ruth</creatorcontrib><creatorcontrib>Kuller, Lewis H</creatorcontrib><creatorcontrib>Ockene, Judith K</creatorcontrib><creatorcontrib>Margolis, Karen L</creatorcontrib><creatorcontrib>Limacher, Marian C</creatorcontrib><creatorcontrib>Manson, JoAnn E</creatorcontrib><creatorcontrib>Parker, Linda M</creatorcontrib><creatorcontrib>Paskett, Electra</creatorcontrib><creatorcontrib>Phillips, Lawrence</creatorcontrib><creatorcontrib>Robbins, John</creatorcontrib><creatorcontrib>Rossouw, Jacques E</creatorcontrib><creatorcontrib>Sarto, Gloria E</creatorcontrib><creatorcontrib>Shikany, James M</creatorcontrib><creatorcontrib>Stefanick, Marcia L</creatorcontrib><creatorcontrib>Thomson, Cynthia A</creatorcontrib><creatorcontrib>Van Horn, Linda</creatorcontrib><creatorcontrib>Vitolins, Mara Z</creatorcontrib><creatorcontrib>Wactawski-Wende, Jean</creatorcontrib><creatorcontrib>Wallace, Robert B</creatorcontrib><creatorcontrib>Wassertheil-Smoller, Sylvia</creatorcontrib><creatorcontrib>Whitlock, Evelyn</creatorcontrib><creatorcontrib>Yano, Katsuhiko</creatorcontrib><creatorcontrib>Adams-Campbell, Lucile</creatorcontrib><creatorcontrib>Anderson, Garnet L</creatorcontrib><creatorcontrib>Assaf, Annlouise R</creatorcontrib><creatorcontrib>Beresford, Shirley A. A</creatorcontrib><creatorcontrib>Black, Henry R</creatorcontrib><creatorcontrib>Brunner, Robert L</creatorcontrib><creatorcontrib>Brzyski, Robert G</creatorcontrib><creatorcontrib>Ford, Leslie</creatorcontrib><creatorcontrib>Gass, Margery</creatorcontrib><creatorcontrib>Hays, Jennifer</creatorcontrib><creatorcontrib>Heber, David</creatorcontrib><creatorcontrib>Heiss, Gerardo</creatorcontrib><creatorcontrib>Hendrix, Susan L</creatorcontrib><creatorcontrib>Hsia, Judith</creatorcontrib><creatorcontrib>Hubbell, F. Allan</creatorcontrib><creatorcontrib>Jackson, Rebecca D</creatorcontrib><creatorcontrib>Johnson, Karen C</creatorcontrib><creatorcontrib>Kotchen, Jane Morley</creatorcontrib><creatorcontrib>LaCroix, Andrea Z</creatorcontrib><creatorcontrib>Lane, Dorothy S</creatorcontrib><creatorcontrib>Langer, Robert D</creatorcontrib><creatorcontrib>Lasser, Norman L</creatorcontrib><creatorcontrib>Henderson, Maureen M</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Physical Education Index</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>MEDLINE - Academic</collection><jtitle>JAMA : the journal of the American Medical Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Prentice, Ross L</au><au>Caan, Bette</au><au>Chlebowski, Rowan T</au><au>Patterson, Ruth</au><au>Kuller, Lewis H</au><au>Ockene, Judith K</au><au>Margolis, Karen L</au><au>Limacher, Marian C</au><au>Manson, JoAnn E</au><au>Parker, Linda M</au><au>Paskett, Electra</au><au>Phillips, Lawrence</au><au>Robbins, John</au><au>Rossouw, Jacques E</au><au>Sarto, Gloria E</au><au>Shikany, James M</au><au>Stefanick, Marcia L</au><au>Thomson, Cynthia A</au><au>Van Horn, Linda</au><au>Vitolins, Mara Z</au><au>Wactawski-Wende, Jean</au><au>Wallace, Robert B</au><au>Wassertheil-Smoller, Sylvia</au><au>Whitlock, Evelyn</au><au>Yano, Katsuhiko</au><au>Adams-Campbell, Lucile</au><au>Anderson, Garnet L</au><au>Assaf, Annlouise R</au><au>Beresford, Shirley A. A</au><au>Black, Henry R</au><au>Brunner, Robert L</au><au>Brzyski, Robert G</au><au>Ford, Leslie</au><au>Gass, Margery</au><au>Hays, Jennifer</au><au>Heber, David</au><au>Heiss, Gerardo</au><au>Hendrix, Susan L</au><au>Hsia, Judith</au><au>Hubbell, F. Allan</au><au>Jackson, Rebecca D</au><au>Johnson, Karen C</au><au>Kotchen, Jane Morley</au><au>LaCroix, Andrea Z</au><au>Lane, Dorothy S</au><au>Langer, Robert D</au><au>Lasser, Norman L</au><au>Henderson, Maureen M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Low-Fat Dietary Pattern and Risk of Invasive Breast Cancer: The Women's Health Initiative Randomized Controlled Dietary Modification Trial</atitle><jtitle>JAMA : the journal of the American Medical Association</jtitle><addtitle>JAMA</addtitle><date>2006-02-08</date><risdate>2006</risdate><volume>295</volume><issue>6</issue><spage>629</spage><epage>642</epage><pages>629-642</pages><issn>0098-7484</issn><eissn>1538-3598</eissn><coden>JAMAAP</coden><abstract>CONTEXT The hypothesis that a low-fat dietary pattern can reduce breast cancer risk has existed for decades but has never been tested in a controlled intervention trial. OBJECTIVE To assess the effects of undertaking a low-fat dietary pattern on breast cancer incidence. DESIGN AND SETTING A randomized, controlled, primary prevention trial conducted at 40 US clinical centers from 1993 to 2005. PARTICIPANTS A total of 48 835 postmenopausal women, aged 50 to 79 years, without prior breast cancer, including 18.6% of minority race/ethnicity, were enrolled. INTERVENTIONS Women were randomly assigned to the dietary modification intervention group (40% [n = 19 541]) or the comparison group (60% [n = 29 294]). The intervention was designed to promote dietary change with the goals of reducing intake of total fat to 20% of energy and increasing consumption of vegetables and fruit to at least 5 servings daily and grains to at least 6 servings daily. Comparison group participants were not asked to make dietary changes. MAIN OUTCOME MEASURE Invasive breast cancer incidence. RESULTS Dietary fat intake was significantly lower in the dietary modification intervention group compared with the comparison group. The difference between groups in change from baseline for percentage of energy from fat varied from 10.7% at year 1 to 8.1% at year 6. Vegetable and fruit consumption was higher in the intervention group by at least 1 serving per day and a smaller, more transient difference was found for grain consumption. The number of women who developed invasive breast cancer (annualized incidence rate) over the 8.1-year average follow-up period was 655 (0.42%) in the intervention group and 1072 (0.45%) in the comparison group (hazard ratio, 0.91; 95% confidence interval, 0.83-1.01 for the comparison between the 2 groups). Secondary analyses suggest a lower hazard ratio among adherent women, provide greater evidence of risk reduction among women having a high-fat diet at baseline, and suggest a dietary effect that varies by hormone receptor characteristics of the tumor. CONCLUSIONS Among postmenopausal women, a low-fat dietary pattern did not result in a statistically significant reduction in invasive breast cancer risk over an 8.1-year average follow-up period. However, the nonsignificant trends observed suggesting reduced risk associated with a low-fat dietary pattern indicate that longer, planned, nonintervention follow-up may yield a more definitive comparison. CLINICAL TRIALS REGISTRATION ClinicalTrials.gov Identifier: NCT00000611</abstract><cop>Chicago, IL</cop><pub>American Medical Association</pub><pmid>16467232</pmid><doi>10.1001/jama.295.6.629</doi><tpages>14</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0098-7484 |
| ispartof | JAMA : the journal of the American Medical Association, 2006-02, Vol.295 (6), p.629-642 |
| issn | 0098-7484 1538-3598 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_67651312 |
| source | MEDLINE; American Medical Association Journals |
| subjects | Aged Biological and medical sciences Biomarkers - blood Body Weight Breast cancer Breast Neoplasms - epidemiology Breast Neoplasms - prevention & control Cholesterol, LDL - blood Clinical trials Diet Diet Records Diet, Fat-Restricted Diseases of the digestive system Female Follow-Up Studies General aspects Gonadal Steroid Hormones - blood Gynecology. Andrology. Obstetrics Humans Incidence Mammary gland diseases Medical sciences Middle Aged Postmenopause Primary Prevention Proportional Hazards Models Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Risk Sex Hormone-Binding Globulin - analysis Tumors |
| title | Low-Fat Dietary Pattern and Risk of Invasive Breast Cancer: The Women's Health Initiative Randomized Controlled Dietary Modification Trial |
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