Kathy Pan1, Aaron K Aragaki2, Marian L Neuhouser2, Michael S Simon3,4, Juhua Luo5, Bette Caan6, Linda Snetselaar7, Joanne E Mortimer8, JoAnn E Manson9, Candyce Kroenke6, Dorothy Lane10, Kerryn Reding11, Thomas E Rohan12, Rowan T Chlebowski13. 1. Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA. kathyjpan@gmail.com. 2. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA. 3. Fred Hutchinson Cancer Research Center, Seattle, WA, USA. 4. Barbara Ann Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA. 5. University of Indiana, Bloomington, IN, USA. 6. Kaiser Permanente Northern California Division of Research, Oakland, CA, USA. 7. University of Iowa, Bloomington, IN, USA. 8. City of Hope National Medical Center, Duarte, CA, USA. 9. Brigham and Women's Hospital/Harvard Medical School, Boston, MA, USA. 10. State University of New York at Stony Brook, Stony Brook, NY, USA. 11. Fred Hutchinson Cancer Research Center & University of Washington, School of Nursing, Seattle, WA, USA. 12. Albert Einstein College of Medicine, Bronx, NY, USA. 13. Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA.
Abstract
BACKGROUND: In the Women's Health Initiative (WHI) dietary modification (DM) randomised trial, the low-fat dietary intervention reduced deaths from breast cancer (P = 0.02). Extending these findings, secondary analysis examined dietary intervention influence on breast cancer mortality by metabolic syndrome (MS) components. METHODS: In total, 48,835 postmenopausal women with no prior breast cancer were randomised to a low-fat dietary intervention or comparison groups. Four MS components were determined at entry in 45,833 participants: (1) high waist circumference, (2) high blood pressure, (3) high cholesterol and (4) diabetes history. Forest plots of hazard ratios (HRs) were generated with P-values for interaction between randomisation groups and MS component score. Primary outcome was death from breast cancer by metabolic syndrome score. RESULTS: HRs and 95% confidence intervals (CI) for dietary intervention influence on death from breast cancer were with no MS components (n = 10,639), HR 1.09, 95% CI 0.63-1.87; with 1-2 MS components (n = 30,948), HR 0.80, 95% CI 0.62-1.02; with 3-4 MS components (n = 4,246), HR 0.31, 95% CI 0.14-0.69 (interaction P = 0.01). CONCLUSIONS: While postmenopausal women with 3-4 MS components were at higher risk of death from breast cancer, those randomised to a low-fat dietary intervention more likely had reduction in this risk. REGISTRY: ClinicalTrials.gov (NCT00000611).
BACKGROUND: In the Women's Health Initiative (WHI) dietary modification (DM) randomised trial, the low-fat dietary intervention reduced deaths from breast cancer (P = 0.02). Extending these findings, secondary analysis examined dietary intervention influence on breast cancer mortality by metabolic syndrome (MS) components. METHODS: In total, 48,835 postmenopausal women with no prior breast cancer were randomised to a low-fat dietary intervention or comparison groups. Four MS components were determined at entry in 45,833 participants: (1) high waist circumference, (2) high blood pressure, (3) high cholesterol and (4) diabetes history. Forest plots of hazard ratios (HRs) were generated with P-values for interaction between randomisation groups and MS component score. Primary outcome was death from breast cancer by metabolic syndrome score. RESULTS: HRs and 95% confidence intervals (CI) for dietary intervention influence on death from breast cancer were with no MS components (n = 10,639), HR 1.09, 95% CI 0.63-1.87; with 1-2 MS components (n = 30,948), HR 0.80, 95% CI 0.62-1.02; with 3-4 MS components (n = 4,246), HR 0.31, 95% CI 0.14-0.69 (interaction P = 0.01). CONCLUSIONS: While postmenopausal women with 3-4 MS components were at higher risk of death from breast cancer, those randomised to a low-fat dietary intervention more likely had reduction in this risk. REGISTRY: ClinicalTrials.gov (NCT00000611).
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