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dc.contributor.authorPrentice, Ross L.
dc.contributor.authorCaan, Bette J.
dc.contributor.authorChlebowski, Rowan T.
dc.contributor.authorPatterson, Ruth E.
dc.contributor.authorKuller, Lewis H.
dc.contributor.authorOckene, Judith K.
dc.contributor.authorMargolis, Karen L.
dc.contributor.authorLimacher, Marian C.
dc.contributor.authorManson, JoAnn E.
dc.contributor.authorParker, Linda M.
dc.contributor.authorPaskett, Electra
dc.contributor.authorPhillips, Lawrence
dc.contributor.authorRobbins, John A.
dc.contributor.authorRossouw, Jacques E.
dc.contributor.authorSarto, Gloria E.
dc.contributor.authorShikany, James M.
dc.contributor.authorStefanick, Marcia L.
dc.contributor.authorThomson, Cynthia A.
dc.contributor.authorVan Horn, Linda
dc.contributor.authorVitolins, Mara Z.
dc.contributor.authorWactawski-Wende, Jean
dc.contributor.authorWallace, Robert B.
dc.contributor.authorWassertheil-Smoller, Sylvia
dc.contributor.authorWhitlock, Evelyn
dc.contributor.authorYano, Katsuhiko
dc.contributor.authorAdams-Campbell, Lucile L.
dc.contributor.authorAnderson, Garnet L.
dc.contributor.authorAssaf, Annlouise R.
dc.contributor.authorBeresford, Shirley A. A.
dc.contributor.authorBlack, Henry R.
dc.contributor.authorBrunner, Robert L.
dc.contributor.authorBrzyski, Robert G.
dc.contributor.authorFord, Leslie
dc.contributor.authorGass, Margery
dc.contributor.authorHays, Jennifer
dc.contributor.authorHeber, David
dc.contributor.authorHeiss, Gerardo
dc.contributor.authorHendrix, Susan L.
dc.contributor.authorHsia, Judith
dc.contributor.authorHubbell, F. Allan
dc.contributor.authorJackson, Rebecca D.
dc.contributor.authorJohnson, Karen C.
dc.contributor.authorKotchen, Jane Morley
dc.contributor.authorLaCroix, Andrea Z.
dc.contributor.authorLane, Dorothy S.
dc.contributor.authorLanger, Robert D.
dc.contributor.authorLasser, Norman L.
dc.contributor.authorHenderson, Maureen M.
dc.date2022-08-11T08:11:05.000
dc.date.accessioned2022-08-23T17:32:12Z
dc.date.available2022-08-23T17:32:12Z
dc.date.issued2006-02-08
dc.date.submitted2008-03-04
dc.identifier.citationJAMA. 2006 Feb 8;295(6):629-42. <a href="http://dx.doi.org/10.1001/jama.295.6.629">Link to article on publisher's site</a>
dc.identifier.issn1538-3598 (Electronic)
dc.identifier.doi10.1001/jama.295.6.629
dc.identifier.pmid16467232
dc.identifier.urihttp://hdl.handle.net/20.500.14038/50903
dc.description.abstractCONTEXT: The hypothesis that a low-fat dietary pattern can reduce breast cancer risk has existed for decades but has never been tested in a controlled intervention trial. OBJECTIVE: To assess the effects of undertaking a low-fat dietary pattern on breast cancer incidence. DESIGN AND SETTING: A randomized, controlled, primary prevention trial conducted at 40 US clinical centers from 1993 to 2005. PARTICIPANTS: A total of 48,835 postmenopausal women, aged 50 to 79 years, without prior breast cancer, including 18.6% of minority race/ethnicity, were enrolled. INTERVENTIONS: Women were randomly assigned to the dietary modification intervention group (40% [n = 19,541]) or the comparison group (60% [n = 29,294]). The intervention was designed to promote dietary change with the goals of reducing intake of total fat to 20% of energy and increasing consumption of vegetables and fruit to at least 5 servings daily and grains to at least 6 servings daily. Comparison group participants were not asked to make dietary changes. MAIN OUTCOME MEASURE: Invasive breast cancer incidence. RESULTS: Dietary fat intake was significantly lower in the dietary modification intervention group compared with the comparison group. The difference between groups in change from baseline for percentage of energy from fat varied from 10.7% at year 1 to 8.1% at year 6. Vegetable and fruit consumption was higher in the intervention group by at least 1 serving per day and a smaller, more transient difference was found for grain consumption. The number of women who developed invasive breast cancer (annualized incidence rate) over the 8.1-year average follow-up period was 655 (0.42%) in the intervention group and 1072 (0.45%) in the comparison group (hazard ratio, 0.91; 95% confidence interval, 0.83-1.01 for the comparison between the 2 groups). Secondary analyses suggest a lower hazard ratio among adherent women, provide greater evidence of risk reduction among women having a high-fat diet at baseline, and suggest a dietary effect that varies by hormone receptor characteristics of the tumor. CONCLUSIONS: Among postmenopausal women, a low-fat dietary pattern did not result in a statistically significant reduction in invasive breast cancer risk over an 8.1-year average follow-up period. However, the nonsignificant trends observed suggesting reduced risk associated with a low-fat dietary pattern indicate that longer, planned, nonintervention follow-up may yield a more definitive comparison. CLINICAL TRIALS REGISTRATION: ClinicalTrials.gov Identifier: NCT00000611.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16467232&dopt=Abstract ">Link to article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1001/jama.295.6.629
dc.subjectAged
dc.subjectBiological Markers
dc.subjectBody Weight
dc.subjectBreast Neoplasms
dc.subjectCholesterol, LDL
dc.subjectDiet Records
dc.subject*Diet, Fat-Restricted
dc.subjectFemale
dc.subjectFollow-Up Studies
dc.subjectGonadal Steroid Hormones
dc.subjectHumans
dc.subjectIncidence
dc.subjectMiddle Aged
dc.subjectPostmenopause
dc.subjectPrimary Prevention
dc.subjectProportional Hazards Models
dc.subjectRisk
dc.subjectSex Hormone-Binding Globulin
dc.subjectLife Sciences
dc.subjectMedicine and Health Sciences
dc.subjectWomen's Studies
dc.titleLow-fat dietary pattern and risk of invasive breast cancer: the Women's Health Initiative Randomized Controlled Dietary Modification Trial
dc.typeJournal Article
dc.source.journaltitleJAMA : the journal of the American Medical Association
dc.source.volume295
dc.source.issue6
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/wfc_pp/431
dc.identifier.contextkey447487
html.description.abstract<p>CONTEXT: The hypothesis that a low-fat dietary pattern can reduce breast cancer risk has existed for decades but has never been tested in a controlled intervention trial.</p> <p>OBJECTIVE: To assess the effects of undertaking a low-fat dietary pattern on breast cancer incidence.</p> <p>DESIGN AND SETTING: A randomized, controlled, primary prevention trial conducted at 40 US clinical centers from 1993 to 2005.</p> <p>PARTICIPANTS: A total of 48,835 postmenopausal women, aged 50 to 79 years, without prior breast cancer, including 18.6% of minority race/ethnicity, were enrolled.</p> <p>INTERVENTIONS: Women were randomly assigned to the dietary modification intervention group (40% [n = 19,541]) or the comparison group (60% [n = 29,294]). The intervention was designed to promote dietary change with the goals of reducing intake of total fat to 20% of energy and increasing consumption of vegetables and fruit to at least 5 servings daily and grains to at least 6 servings daily. Comparison group participants were not asked to make dietary changes.</p> <p>MAIN OUTCOME MEASURE: Invasive breast cancer incidence.</p> <p>RESULTS: Dietary fat intake was significantly lower in the dietary modification intervention group compared with the comparison group. The difference between groups in change from baseline for percentage of energy from fat varied from 10.7% at year 1 to 8.1% at year 6. Vegetable and fruit consumption was higher in the intervention group by at least 1 serving per day and a smaller, more transient difference was found for grain consumption. The number of women who developed invasive breast cancer (annualized incidence rate) over the 8.1-year average follow-up period was 655 (0.42%) in the intervention group and 1072 (0.45%) in the comparison group (hazard ratio, 0.91; 95% confidence interval, 0.83-1.01 for the comparison between the 2 groups). Secondary analyses suggest a lower hazard ratio among adherent women, provide greater evidence of risk reduction among women having a high-fat diet at baseline, and suggest a dietary effect that varies by hormone receptor characteristics of the tumor.</p> <p>CONCLUSIONS: Among postmenopausal women, a low-fat dietary pattern did not result in a statistically significant reduction in invasive breast cancer risk over an 8.1-year average follow-up period. However, the nonsignificant trends observed suggesting reduced risk associated with a low-fat dietary pattern indicate that longer, planned, nonintervention follow-up may yield a more definitive comparison.</p> <p>CLINICAL TRIALS REGISTRATION: ClinicalTrials.gov Identifier: NCT00000611.</p>
dc.identifier.submissionpathwfc_pp/431
dc.contributor.departmentDepartment of Medicine, Division of Preventive and Behavioral Medicine
dc.source.pages629-42


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