Dietary intake of trans fatty acids and breast cancer risk in 9 European countries
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Industrial trans fatty acidsRuminant trans fatty acidsBreast cancerDiet
Matta, M., Huybrechts, I., Biessy, C. et al. Dietary intake of trans fatty acids and breast cancer risk in 9 European countries. BMC Med 19, 81 (2021). [https://doi.org/10.1186/s12916-021-01952-3]
SponsorshipEuropean Commission European Commission Joint Research Centre; International Agency for Research on Cancer; Danish Cancer Society; Ligue Contre le Cancer (France); Institut Gustave Roussy (France); Mutuelle Generale de l'Education Nationale (France); Institut National de la Sante et de la Recherche Medicale (Inserm); Deutsche Krebshilfe; German Cancer Research Center (DKFZ) (Germany); Federal Ministry of Education & Research (BMBF); Deutsche Krebshilfe; Deutsches Krebsforschungszentrum (Germany); Federal Ministry of Education & Research (BMBF); Hellenic Health Foundation (Greece); Associazione Italiana per la Ricerca sul Cancro (AIRC); Consiglio Nazionale delle Ricerche (CNR); Dutch Ministry of Public Health, Welfare and Sports (VWS); Netherlands Cancer Registry (NKR); LK Research Funds; Dutch Prevention Funds; Netherlands Organization for Scientific Research (NWO); World Cancer Research Fund International (WCRF); Instituto de Salud Carlos III PI13/00061 PI13/01162; Junta de Andalucia; Catalan Institute of Oncology (Spain); Swedish Cancer Society Swedish Research Council; County Council of Skane (Sweden); County Council of Vasterbotten (Sweden); Cancer Research UK 14136 C570/A16491 C8221/A19170; UK Research & Innovation (UKRI) Medical Research Council UK (MRC) 1000143 MR/M012190/1; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht; National Institute for Public Health and the Environment (RIVM)-Bilthoven, the Netherlands; Nordforsk, Nordic Centre of Excellence programme on Food, Nutrition and Health (Norway); Regional Government of Asturias (Spain); Regional Government of Basque Country (Spain); Regional Government of Murcia (Spain); Regional Government of Navarra (Spain); Junta de Andalucia; ERC-2009-AdG 232997
Background Trans fatty acids (TFAs) have been hypothesised to influence breast cancer risk. However, relatively few prospective studies have examined this relationship, and well-powered analyses according to hormone receptor-defined molecular subtypes, menopausal status, and body size have rarely been conducted. Methods In the European Prospective Investigation into Cancer and Nutrition (EPIC), we investigated the associations between dietary intakes of TFAs (industrial trans fatty acids [ITFAs] and ruminant trans fatty acids [RTFAs]) and breast cancer risk among 318,607 women. Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models, adjusted for other breast cancer risk factors. Results After a median follow-up of 8.1 years, 13,241 breast cancer cases occurred. In the multivariable-adjusted model, higher total ITFA intake was associated with elevated breast cancer risk (HR for highest vs lowest quintile, 1.14, 95% CI 1.06-1.23; P trend = 0.001). A similar positive association was found between intake of elaidic acid, the predominant ITFA, and breast cancer risk (HR for highest vs lowest quintile, 1.14, 95% CI 1.06-1.23; P trend = 0.001). Intake of total RTFAs was also associated with higher breast cancer risk (HR for highest vs lowest quintile, 1.09, 95% CI 1.01-1.17; P trend = 0.015). For individual RTFAs, we found positive associations with breast cancer risk for dietary intakes of two strongly correlated fatty acids (Spearman correlation r = 0.77), conjugated linoleic acid (HR for highest vs lowest quintile, 1.11, 95% CI 1.03-1.20; P trend = 0.001) and palmitelaidic acid (HR for highest vs lowest quintile, 1.08, 95% CI 1.01-1.16; P trend = 0.028). Similar associations were found for total ITFAs and RTFAs with breast cancer risk according to menopausal status, body mass index, and breast cancer subtypes. Conclusions These results support the hypothesis that higher dietary intakes of ITFAs, in particular elaidic acid, are associated with elevated breast cancer risk. Due to the high correlation between conjugated linoleic acid and palmitelaidic acid, we were unable to disentangle the positive associations found for these fatty acids with breast cancer risk. Further mechanistic studies are needed to identify biological pathways that may underlie these associations.