title: Prospective study of dietary fat and risk of uterine leiomyomata.
abstract: BACKGROUND
  Uterine leiomyomata (UL) are the primary indication for hysterectomy and are 2-3 times more common in black than white women. High dietary fat intake has been associated with increased endogenous concentrations of estradiol, a sex steroid hormone that is known to influence UL risk.
  
  
  OBJECTIVE
  We assessed the relation of dietary fat intake (total, subtypes, and selected food sources) with UL incidence.
  
  
  METHODS
  Data were from the Black Women's Health Study, a prospective cohort study. Over an 8-y period (2001-2009), 12,044 premenopausal women were followed for a first diagnosis of UL. Diet was assessed via a food-frequency questionnaire in 2001. Cox regression models were used to compute incidence rate ratios (IRRs) and 95% CIs with adjustment for potential confounders.
  
  
  RESULTS
  During 75,687 person-years of follow-up, there were 2695 incident UL cases diagnosed by ultrasound (n = 2191) or surgery (n = 504). Intakes of total fat and fat subtypes were not appreciably associated with UL risk overall, although statistically significant associations were observed for specific saturated (inverse) and monounsaturated and polyunsaturated (positive) fatty acids. With respect to polyunsaturated fats, the IRR for the highest compared with lowest quintiles of marine fatty acid intake [the sum of omega-3 (n-3) polyunsaturated fatty acids eicosapentanoic acid, docosapentaenoic acid, and docosahexaenoic acid] was 1.18 (95% CI: 1.05, 1.34; P-trend = 0.005). The IRR for the highest compared with lowest categories of dark-meat fish consumption was 1.13 (95% CI: 1.00, 1.28).
  
  
  CONCLUSIONS
  In US black women, the most consistent associations of fat intake with UL were small increases in risk associated with intakes of long-chain omega-3 fatty acids. Future studies are warranted to confirm these findings and elucidate which components of fatty foods, if any, are related to UL risk.
authors.affiliation: Slone Epidemiology Center at Boston University, Boston, MA (LAW, RGR, EAR-N, JRP, and LR), and the Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA (SKK).
authors.forename: Lauren A
authors.initials: LA
authors.lastname: Wise
authors.forename: Rose G
authors.initials: RG
authors.lastname: Radin
authors.forename: Shiriki K
authors.initials: SK
authors.lastname: Kumanyika
authors.forename: Edward A
authors.initials: EA
authors.lastname: Ruiz-Narváez
authors.forename: Julie R
authors.initials: JR
authors.lastname: Palmer
authors.forename: Lynn
authors.initials: L
authors.lastname: Rosenberg
mesh_terms: D001741:Black or African American; D000368:Aged; D000818:Animals; D004032:Diet; D004041:Dietary Fats / Q000008:administration & dosage* / Q000009:adverse effects*; D005229:Fatty Acids, Monounsaturated / Q000008:administration & dosage; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage; D005247:Feeding Behavior; D005260:Female; D005399:Fishes; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D015994:Incidence; D007889:Leiomyoma / Q000175:diagnosis / Q000453:epidemiology*; D008460:Meat; D008875:Middle Aged; D015596:Nutrition Assessment; D017697:Premenopause; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D044465:White People
chemical_list: D004041:Dietary Fats; D005229:Fatty Acids, Monounsaturated; D015525:Fatty Acids, Omega-3