Aim: This cross-sectional study aimed to evaluate the associations between low and high-fat dairy food (DF) intake and breast density (BD). Materials and Methods: A total of 775 premenopausal and 771 postmenopausal women recruited during screening mammography completed a food frequency questionnaire. Adjusted linear regression models were used to assess the associations. Results: As frequency quartiles of high-fat DF consumption increased, the adjusted mean of absolute BD increased from 31.5 to 36.1 cm 2 for all women (p trend =0.0034) and from 42.4 to 50.1 cm 2 for premenopausal women (p trend =0.0047). Conversely, as frequency quartiles of low-fat DF consumption increased, the adjusted mean of absolute BD decreased from 34.7 to 29.6 cm 2 for all women (p trend =0.001) and from 49.7 to 40.7 cm 2 for premenopausal women (p trend =0.0012). Conclusion: A higher intake of high-fat and low-fat DF is respectively associated with higher and lower BD, particularly in premenopausal women. Mammographic breast density (BD) is a well-known determinant of breast cancer, but also a mediator for other risk factors (1). This role as an intermediate marker may allow identifying new breast cancer risk factors and interventions to reduce BD and thus reduce breast cancer risk (2). The use of BD as a biomarker of breast cancer risk is relevant because of the ease in obtaining the measure, the acceptability of mammography in the population, and the reduction in the time required to complete studies (as compared to evaluating the effect of an intervention on disease onset) (3). A few studies have investigated the role of diet in relation to mammographic density. Specifically, ten studies (4-13) have examined the association between dairy food (DF) consumption and BD, but no consensus has yet been reached. Of the ten studies reviewed, seven are crosssectional studies (4-10), two are case-control studies nested in cohorts (11, 12), and one is a prospective cohort study (13). Only five out of the ten studies found significant associations between DF intake and BD (4-7, 10), two of them favouring a positive association between DF consumption and BD (7, 10), while the other three reported a reverse association (4-6). The inconsistency between study results may be explained by the fat content in dairy products. Up to now, only two studies (5, 10) have considered the dairy fat content, and both suggested an inverse trend between low-fat dairy products consumption and BD in premenopausal women. However, only one study specifically examined the association of high-fat DF consumption with BD and reported insignificant results (5). BD is an important factor in breast cancer risk, which can be altered by women's diet behaviours. If such an association exists for DF, then simple changes in eating habits could help reduce the risk of developing breast cancer by reducing a woman's BD. We took advantage of a cross-sectional study comprising 1546 women without breast cancer for which complete diet information was available to evaluate the influence of...
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