Low-Fat Dietary Pattern and Breast Cancer Mortality in the Women’s Health Initiative Randomized Controlled Trial
Author
Chlebowski, Rowan T.Aragaki, Aaron K.
Anderson, Garnet L.
Thomson, Cynthia A.
Manson, JoAnn E.
Simon, Michael S.
Howard, Barbara V.
Rohan, Thomas E.
Snetselar, Linda
Lane, Dorothy
Barrington, Wendy
Vitolins, Mara Z.
Womack, Catherine
Qi, Lihong
Hou, Lifang
Thomas, Fridtjof
Prentice, Ross L.
Affiliation
Univ Arizona, Canc CtrIssue Date
2017-09
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AMER SOC CLINICAL ONCOLOGYCitation
Low-Fat Dietary Pattern and Breast Cancer Mortality in the Women’s Health Initiative Randomized Controlled Trial 2017, 35 (25):2919 Journal of Clinical OncologyJournal
Journal of Clinical OncologyRights
Copyright © 2017 American Society of Clinical Oncology. All rights reserved.Collection Information
This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.Abstract
Purpose Earlier Women's Health Initiative Dietary Modification trial findings suggested that a low-fat eating pattern may reduce breast cancers with greater mortality. Therefore, as a primary outcome-related analysis from a randomized prevention trial, we examined the long-term influence of this intervention on deaths as a result of and after breast cancer during 8.5 years (median) of dietary intervention and cumulatively for all breast cancers diagnosed during 16.1 years (median) of follow-up. Patients and Methods The trial randomly assigned 48,835 postmenopausal women with normal mammograms and without prior breast cancer from 1993 to 1998 at 40 US clinical centers to a dietary intervention with goals of a reduction of fat intake to 20% of energy and an increased intake of fruits, vegetables, and grains (40%; n = 19,541) or to a usual diet comparison (60%; n = 29,294). Results In the dietary group, fat intake and body weight decreased (all P < .001). During the 8.5-year dietary intervention, with 1,764 incident breast cancers, fewer deaths occurred as a result of breast cancer in the dietary group, which was not statistically significant (27 deaths [0.016% per year] v 61 deaths [0.024% per year]; hazard ratio [HR], 0.67; 95% CI, 0.43 to 1.06; P = .08). During the same period, deaths after breast cancer (n = 134) were significantly reduced (40 deaths [0.025% per year] v 94 deaths [0.038% per year]; HR, 0.65; 95% CI, 0.45 to 0.94; P = .02) by the dietary intervention. During the 16.1-year follow-up, with 3,030 incident breast cancers, deaths after breast cancer also were significantly reduced (234 deaths [0.085% per year] v 443 deaths [0.11% per year]; HR, 0.82; 95% CI, 0.70 to 0.96; P = .01) in the dietary group. Conclusion Compared with a usual diet comparison group, a low-fat dietary pattern led to a lower incidence of deaths after breast cancer. (C) 2017 by American Society of Clinical OncologyNote
6 month embargo; Published online: June 27, 2017.ISSN
0732-183X1527-7755
PubMed ID
28654363Version
Final published versionSponsors
National Heart, Lung, and Blood Institute [N01WH22110, 24152, 32100-2, 32105-6, 32108-9, 32111-13, 32115, 32118-32119, 32122, 42107-26, 42129-32, 44221]; American Institute for Cancer Research Grant [30210-01]; National Cancer Institute Grant [UM1CA173642]Additional Links
http://ascopubs.org/doi/10.1200/JCO.2016.72.0326ae974a485f413a2113503eed53cd6c53
10.1200/JCO.2016.72.0326
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