Nikhil K Khankari1, Patrick T Bradshaw2, Susan E Steck3, Ka He4, Andrew F Olshan5, Jing Shen6, Jiyoung Ahn7, Yu Chen7, Habibul Ahsan8, Mary Beth Terry9, Susan L Teitelbaum10, Alfred I Neugut11, Regina M Santella6, Marilie D Gammon5. 1. Department of Epidemiology, University of North Carolina, Chapel Hill. Electronic address: khankari@email.unc.edu. 2. Department of Nutrition, University of North Carolina, Chapel Hill. 3. Department of Epidemiology and Biostatistics, University of South Carolina, Columbia. 4. Department of Epidemiology and Biostatistics, Indiana University, Bloomington, IN. 5. Department of Epidemiology, University of North Carolina, Chapel Hill. 6. Department of Environmental Health, Columbia University, New York, NY. 7. Department of Population Health, New York University, New York; Department of Environmental Medicine, New York University, New York. 8. Department of Health Studies and Comprehensive Cancer Center, University of Chicago, Chicago, IL. 9. Department of Epidemiology, Columbia University, New York, NY. 10. Department of Preventive Medicine, Mount Sinai School of Medicine, New York, NY. 11. Department of Epidemiology, Columbia University, New York, NY; Department of Medicine, Columbia University, New York, NY.
Abstract
PURPOSE: Experimental studies demonstrate that ω-3 polyunsaturated fatty acids (PUFAs) inhibit inflammatory eicosanoids generated by ω-6 PUFAs. Epidemiologic studies on dietary ω-3 PUFA intake show consistent inverse associations with breast cancer incidence among Asian populations, where ω-3, relative to ω-6, intake is high. In contrast, associations are inconsistent among Western populations, where intake of ω-3, relative to ω-6, is low. We hypothesized that examining interactions between ω-3 and ω-6 would help elucidate the PUFA-breast cancer association in the United States. METHODS: In a Long Island, New York, population-based study of 1463 breast cancer cases and 1500 controls, we estimated multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) using unconditional logistic regression to examine interactions between ω-3 and ω-6 intake. RESULTS: We observed a super-additive interaction (relative excess risk due to interaction = 0.41; 95% confidence interval = 0.06-0.76) between ω-3 and ω-6 intake in association with breast cancer incidence, although the CIs for the joint exposure of low ω-3/high ω-6 compared to high ω-3/low ω-6 intake were wide (odds ratio = 1.20; 95% confidence interval = 0.85-1.69). CONCLUSIONS: Breast cancer risk reduction may be possible for U.S. women with dietary consumption of higher ω-3, which has anti-inflammatory properties, in concert with lower ω-6, which induces inflammation. Replication from future U.S.-based investigations is needed.
PURPOSE: Experimental studies demonstrate that ω-3 polyunsaturated fatty acids (PUFAs) inhibit inflammatory eicosanoids generated by ω-6 PUFAs. Epidemiologic studies on dietary ω-3 PUFA intake show consistent inverse associations with breast cancer incidence among Asian populations, where ω-3, relative to ω-6, intake is high. In contrast, associations are inconsistent among Western populations, where intake of ω-3, relative to ω-6, is low. We hypothesized that examining interactions between ω-3 and ω-6 would help elucidate the PUFA-breast cancer association in the United States. METHODS: In a Long Island, New York, population-based study of 1463 breast cancer cases and 1500 controls, we estimated multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) using unconditional logistic regression to examine interactions between ω-3 and ω-6 intake. RESULTS: We observed a super-additive interaction (relative excess risk due to interaction = 0.41; 95% confidence interval = 0.06-0.76) between ω-3 and ω-6 intake in association with breast cancer incidence, although the CIs for the joint exposure of low ω-3/high ω-6 compared to high ω-3/low ω-6 intake were wide (odds ratio = 1.20; 95% confidence interval = 0.85-1.69). CONCLUSIONS:Breast cancer risk reduction may be possible for U.S. women with dietary consumption of higher ω-3, which has anti-inflammatory properties, in concert with lower ω-6, which induces inflammation. Replication from future U.S.-based investigations is needed.
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