title: Nutrient pathways and breast cancer risk: the Long Island Breast Cancer Study Project.
abstract: The relative importance of biochemical pathways has not been previously examined when considering the influence of diet on breast cancer risk. To address this issue, we used interview data from a population-based sample of 1463 breast cancer cases and 1500 controls. Dietary intake was assessed shortly after diagnosis using a 101-item food frequency questionnaire. Age- and energy-adjusted odds ratios (ORs) for individual micro- and macronutrients were estimated with logistic regression. Hierarchical modeling was used to account for biologically plausible nutrient pathways (1-carbon metabolism, oxidative stress, glycemic control, and phytoestrogens). Effect estimates from hierarchical modeling were more precise and plausible compared to those from multivariable models. The strongest relationship observed was for the glycemic control pathway, but confidence intervals (CI) were wide [OR (95% CI): 0.86 (0.62, 1.21)]. Little or no effect was observed for the 1-carbon metabolism, oxidative stress, and phytoestrogen pathways. Associations were similar when stratified by supplement use. Our approach that emphasizes biochemical pathways, rather than individual nutrients, revealed that breast cancer risk may be more strongly associated with glycemic control factors than those from other pathways considered. Our study emphasizes the importance of accounting for multiple nutrient pathways when examining associations between dietary intake and breast cancer.
authors.affiliation: Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA. patrickb@unc.edu
authors.forename: Patrick T
authors.initials: PT
authors.lastname: Bradshaw
authors.forename: Nikhil K
authors.initials: NK
authors.lastname: Khankari
authors.forename: Susan L
authors.initials: SL
authors.lastname: Teitelbaum
authors.forename: Xinran
authors.initials: X
authors.lastname: Xu
authors.forename: Brian N
authors.initials: BN
authors.lastname: Fink
authors.forename: Susan E
authors.initials: SE
authors.lastname: Steck
authors.forename: Mia M
authors.initials: MM
authors.lastname: Gaudet
authors.forename: Geoffrey C
authors.initials: GC
authors.lastname: Kabat
authors.forename: Mary S
authors.initials: MS
authors.lastname: Wolff
authors.forename: Alfred I
authors.initials: AI
authors.lastname: Neugut
authors.forename: Jia
authors.initials: J
authors.lastname: Chen
authors.forename: Marilie D
authors.initials: MD
authors.lastname: Gammon
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000502:physiology; D001943:Breast Neoplasms; D004032:Diet; D004040:Dietary Carbohydrates / Q000009:adverse effects; D019587:Dietary Supplements; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage; D006801:Humans; D016015:Logistic Models; D018977:Micronutrients; D008875:Middle Aged; D009518:New York; D016017:Odds Ratio; D018384:Oxidative Stress; D048789:Phytoestrogens; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D001786:Blood Glucose; D004040:Dietary Carbohydrates; D018977:Micronutrients; D048789:Phytoestrogens; D005492:Folic Acid