Red and processed meat, nitrite, and heme iron intakes and postmenopausal breast cancer risk in the NIH-AARP Diet and Health Study.
Previous studies have shown inconsistent associations between red and processed meat intake and breast cancer risk. N-nitroso compounds and heme iron have been hypothesized as contributing factors. We followed 193,742 postmenopausal women in the NIH-AARP Diet and Health Study and identified 9,305 incident breast cancers (1995-2006). Dietary intake was assessed using a food frequency questionnaire at baseline. We adjusted daily intakes of meat, nitrite and heme iron for energy intake using the nutrient density method. We estimated multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) by quintiles of dietary exposures for all breast cancer, by stage (in-situ, localized, regional/distant) and by estrogen/progesterone receptor (ER/PR) status using Cox proportional hazards regression. Total red meat intake was positively associated with risk of regional/distant cancer (p-trend = 0.02). The risk was 25% higher in the highest vs. lowest intake quintile (95% CI = 1.03-1.52). Higher processed red meat intake (Q5 vs. Q1) was associated with 27% higher risk of localized breast cancer (95% CI = 1.01-1.27, p-trend = 0.03) and a 19% higher risk of regional/distant cancer (95% CI = 0.98-1.44, p-trend = 0.10). In addition, higher nitrite intake from processed red meat was positively associated with localized cancer (HR for Q5 vs. Q1 = 1.23, 95% CI = 1.09-1.39, p-trend < 0.0001). Heme iron intake was positively associated with breast cancer risk overall and all cancer stages (p-trend = 0.02-0.05). No heterogeneity was observed in risk associations by hormone receptor status. Our findings suggest that high consumption of red meat and processed meat may increase risk of postmenopausal breast cancer. Added nitrite and heme iron may partly contribute to these observed associations.
Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD.|Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD.
Maki
M
Inoue-Choi
Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD.
Rashmi
R
Sinha
Hormonal and Reproductive Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD.
Gretchen L
GL
Gierach
Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD.
Mary H
MH
Ward
D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D015331:Cohort Studies; D004032:Diet / Q000009:adverse effects; D004034:Diet Surveys; D005260:Female; D006418:Heme / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D019266:Iron, Dietary / Q000009:adverse effects*; D008461:Meat Products / Q000009:adverse effects*; D008875:Middle Aged; D009573:Nitrites / Q000009:adverse effects*; D016017:Odds Ratio; D017698:Postmenopause; D016016:Proportional Hazards Models; D000069466:Red Meat / Q000009:adverse effects*; D012307:Risk Factors
D019266:Iron, Dietary; D009573:Nitrites; D006418:Heme
breast cancer; heme iron; nitrite; processed meat; red meat