Dietary Fat, Fiber, and Carbohydrate Intake in Relation to Risk of Endometrial Cancer

Abstract

Background Macronutrients such as fat and fiber have been hypothesized to play a role in the etiology of endometrial cancer. Methods To investigate these associations, the authors analyzed data from the Nurses’ Health Study (NHS). From 1980 to 2006, 669 invasive adenocarcinoma cases were identified over 1.3 million person-years of follow-up. Dietary intake was assessed in 1980 and updated every 2–4 years. Cox proportional hazard models were used to calculate relative risks (RRs), controlling for total energy and other risk factors. Results Overall, the authors found no significant associations between most dietary factors and endometrial cancer risk. Total fat was associated with a borderline significant decreased risk (top vs. bottom quintile RR=0.78; 95% confidence interval [CI]=0.60, 0.99; Ptrend=0.18). Findings for animal fat were similar. No inverse associations between dietary fibers and cancer risk were observed. Cereal fiber was modestly positively associated with risk (top vs. bottom quintile RR=1.38, 95%CI=1.07, 1.79; Ptrend = 0.05). The inverse association with animal fat intake and a positive association with carbohydrate intake were observed among premenopausal but not among postmenopausal women. Conclusions In this large prospective study, no overall association was observed between dietary fat, fiber, or carbohydrates with endometrial cancer risk, although several of the relationships may vary by menopausal status. Impact Dietary fat and fiber intake do not appear to play a major role in endometrial cancer etiology overall. However, further evaluation of these associations, particularly in premenopausal women, is needed.

Dietary Insulin Index and Insulin Load in Relation to Endometrial Cancer Risk in the Nurses' Health Study

“…With the exception of PLCO, which observed significant reduced risk among women who consumed high GL diets (RR=0.63, 95% CI: 0.46, 0.84 for highest vs. lowest quartile) (25), most studies report non-significant elevations in endometrial cancer risk with GL or GI (26). Cohort studies observed elevated risks of 15% to 36% with high GL diets (pooled RR=1.22, 95% CI: 1.09, 1.37 for highest vs. lowest category), including the NHS (RR=1.29, 95% CI: 0.99, 1.67) (41), but not with GI (pooled RR=1.00, 95% CI: 0.87, 1.14) (26). In contrast, case-control studies observed significant increased endometrial cancer risk with GI (pooled OR=1.56, 95% CI: 1.21, 2.02), but the relationship with high GL diets was weaker (pooled OR=1.14, 95% CI: 0.91, 1.44) compared to cohort studies (26).…”

Evidence-Based Guideline of the German Nutrition Society: Fat Intake and Prevention of Selected Nutrition-Related Diseases

“…In the study by Cui et al [280] (LOE IIb), no association was observed between the intake of n-3 fatty acids and risk of endometrial cancer.…”

“…In the updated version of the WCRF report [261] (LOE IIa), MUFA were not covered for this carcinoma. The study by Cui et al [280] (LOE IIb) with data from the Nurses' Health Study , which has already been mentioned in a different context, showed no risk relation.…”

“…In the WCRF's updated version from 2012, SFA were not covered. Therefore, the cohort study named in the updated version [280] was examined for statements regarding SFA. In the study by Cui et al [280] (LOE IIb) with data from the Nurses' Health Study , no association was observed between SFA intake and risk of endometrial cancer.…”

No Effect of Energy Intake Overall on Risk of Endometrial Cancers: a Meta-analysis

“…A total of 16 published articles reporting risk factor of endometrial cancer satisfied the inclusion criteria and were included in our meta-analysis (Levi et al, 1993;Potischman et al, 1993;Shu et al, 1993;Tzonou et al, 1996;Goodman et al, 1997;Jain et al, 2000;McCann et al, 2000;Littman et al, 2001;Petridou et al, 2002;Folsom et al, 2003;Furberg et al, 2003;Xu et al, 2007;Bravi et al, 2009;Yeh et al, 2009;Biel et al, 2011b;Cui et al, 2011). The characteristics of the included studies were shown in Table 1.…”