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High-fibre diet 'can cut cancer risk'
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Wed February 14, 2007
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Best Offer
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***Description:
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A high-fibre diet can halve the risk of breast cancer in pre-menopausal women, reported four newspapers on 24 January 2007. The reports were based on a large prospective cohort study, however, further research is needed to confirm the study's findings.
Four newspapers (1-4) reported that a high-fibre diet can halve the risk of breast cancer in pre-menopausal women but that no protective effect was found in older, post-menopausal women. Two newspapers (1, 2) reported that the strongest protective effect came from cereal fibre.
The reports were based on a large prospective cohort study (5) (UK Women's Cohort Study) involving 35,792 women, aged between 35 and 69 years. Participants were recruited between 1995 and 1998, and were followed up over seven years. The study found that pre-menopausal women with a fibre-rich diet (over 30 grams per day) halved their likelihood of developing breast cancer. Fibre intake from cereals was associated with the largest reduction in breast cancer. No protective effect of fibre on breast cancer was found for post-menopausal women.
The reports were broadly accurate of the main findings, although one newspaper (3) inaccurately reported the number of pre-menopausal women who developed breast cancer. Whilst the findings of the study appear to provide reasonable evidence of an association between high-fibre intake and reduced rates of pre-menopausal breast cancer, more rigorous research would be required to determine a definite protective effect.
Evaluation of the evidence base for a high-fibre diet for protection against breast cancer in pre-menopausal women.
Where does the evidence come from?
The research was conducted by Professor Cade and colleagues from the Centre for Epidemiology and Biostatistics, University of Leeds. The UK Women's Cohort Study was funded by the World Cancer Research Fund. The Nutritional Epidemiological Group has received some funding for research and consultancy from the Kelloggs Company.
What were the authors' objectives?
To examine the relationship between dietary fibre intake and breast cancer.
What was the nature of the evidence?
The evidence comes from a large prospective cohort study involving 35,792 women living in the UK, aged 35 to 69 years at study entry, who were followed-up over seven years for incidence of invasive breast cancer.
What were the factors of interest?
Women were selected from approximately 500,000 respondents to a postal questionnaire sent out by the World Cancer Research Fund that included questions about diet. All women aged 35 to 69 years, who described themselves as vegetarian or non-red meat eaters were invited to participate. A comparison group was selected from the remaining eligible women; for every vegetarian the next listed non-vegetarian within a 10 year age-range was also invited to participate. Dietary intake was assessed via postal questionnaire with a validated 217-item food frequency questionnaire; baseline data were collected between 1995 and 1998.
All participants were flagged for deaths and cancer registrations on the Office of National Statistics National Health Service central register. All malignant breast cancers registered after participants returned their questionnaire were included as new incidents. The effect of fibre intake was examined separately for pre- and post-menopausal women. Associations were estimated after adjusting for age and total energy intake and also multiple potential confounding variables; age, body mass index, physical activity, smoking status, oral contraceptive and hormone replacement therapy use, number of children, alcohol consumption and total energy intake at baseline. Of the study participants, 17,781 were defined as post-menopausal and 15,951 were defined as pre-menopausal.
What were the findings?
Of the 33,732 participants included in the analysis, 350 post-menopausal women and 257 pre-menopausal women developed invasive breast cancer.
A greater proportion of energy intake in pre-menopausal women who developed breast cancer came from protein. These women also demonstrated lower intakes of total carbohydrate, sugar, dietary fibre and vitamin C.
After adjustment for potential confounding variables, a high-fibre diet (over 30 grams per day) was associated with a statistically significant 52% reduction in the development of breast cancer in pre-menopausal women compared with a diet of less than 20g per day.
Fibre intake from cereals was also associated with a statistically significant trend for a reduction in the incidence of breast cancer in pre-menopausal women. Fibre intake from fruit was associated with a non-statistically significant reduction in the incidence of breast cancer in pre-menopausal women. Vegetable fibre did not reduce the incidence of breast cancer in this group.
No statistically significant associations were found between the development of breast cancer and total fibre intake, or fibre intake from cereals, fruit or vegetables in post-menopausal women.
What were the authors' conclusions?
Total fibre intake is protective against breast cancer in pre-menopausal women. The specific food sources which had a protective effect were cereals and possibly fruit.
How reliable are the conclusions?
The authors' conclusions appear to be supported by the findings of this large cohort study. The study included three broad dietary groups: vegetarians, fish eaters (not meat), and meat eaters. However, dietary habits appear to have been assessed at only one time point and changes in dietary habits would not have been accounted for. In addition, the questionnaire was self-administered, increasing the possibility of bias. Many high-fibre foods, such as cereals, are also rich in vitamins, zinc and other antioxidants, so it may not have been the fibre that produced the protective effect. Further research would be needed to determine whether the association represents a true protective effect.
MHS
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Keywords:
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High-fibre diet 'can cut cancer risk'
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Registered: December 2006