Skip to main content
Log in

Dietary fiber, vitamins A, C, and E, and risk of breast cancer: a cohort study

  • Research Paper
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Risk of breast cancer was examined in relation to intake of dietary fiber and vitamins A, C, and E, and food groups which are sources of these dietary constituents, in a cohort of 56,837 women enrolled in the Canadian National Breast Screening Study. Between 1982 and 1987, 519 incident, histologically confirmed cases of breast cancer were identified among women who previously had completed self-administered dietary questionnaires. Their nutrient and food intake was compared with that of 1,182 women who had not developed breast cancer during the follow-up period. Women at the uppermost quintile level of dietary fiber intake had a 30 percent reduction in risk of breast cancer relative to that for women at the lowest quintile level (adjusted odds ratio = 0.68,95 percent confidence interval = 0.46–1.00), and the reduction in risk persisted after adjustment (separately) for total vitamin A, β-carotene, vitamin C, and α-tocopherol. Inverse associations of similar magnitude were observed in association with consumption of pasta, cereals (the trend for which was statistically significant), and vegetables rich in vitamins A and C. Smaller, statistically nonsignificant reductions in risk were observed with increasing intake of dietary retinol, β-carotene, and vitamin C, but the magnitude of these associations was reduced after adjustment for other dietary factors. Vitamin E intake was not associated with altered risk of breast cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Harris JR, Lippman ME, Veronesi U, Willett W. Breast cancer. N Engl J Med 1992; 327: 319–28.

    Google Scholar 

  2. Rose DI. Dietary fiber and breast cancer. Nutr Cancer 1990; 13: 1–8.

    Google Scholar 

  3. Ziegler RG. Vegetables, fruits, and carotenoids and the risk of cancer. Am J Clin Nutr 1991; 53 (suppl): 251–9.

    Google Scholar 

  4. Block G. Epidemiologic evidence regarding vitamin C and cancer. Am J Clin Nutr 1991; 54 (suppl); 1310–4.

    Google Scholar 

  5. Knekt P, Aromass A, Maatela J, et al. Vitamin E and eancer prevention. Am J Clin Nutr 1991; 53 (suppl); 283–6.

    Google Scholar 

  6. Graham S, Hellman R, Marshall J, et al. Nutritional epidemiology of postmenopausal breast cancer in western New York. Am J Epidemiol 1991; 134: 552–66.

    Google Scholar 

  7. Hunter DJ, Stampfer MJ, Coldirz GA, et al. A prospective study of consumption of vitamins A, C, and E and breast cancer risk (Abstract). Am J Epidemiol 1991; 134: 715.

    Google Scholar 

  8. Howe GR, Friedenreich CM, Jain M, Miller AB, A cohort study of fat intake and risk of breast cancer. JNCI 1991; 83: 336–40.

    Google Scholar 

  9. Miller AB, Howe GR, Wall C. The national study of breast cancer screening: Protocol for a randomized control trial of screening for breast cancer in women. Clin Invest Med 1991; 4: 227–58.

    Google Scholar 

  10. Morgan RW, Jain M, Miller AB, et al. Comparison of dietary methods in epidemiologic studies. Am J Epidemiol 1978; 107: 488–98.

    Google Scholar 

  11. US Department of Agriculture. Composition of Foods: Raw, Processed, Prepared. Washington, DC: USDA, Agriculture Research Service, 1968; Agriculture Handbook No. 8, Expansion (March 1972).

    Google Scholar 

  12. McCance RA, Widdowson EM. The composition of foods. In: Paul AA, Southgate DAT, eds. The Composition of Foods. London; HM Stationery Office, 1978.

    Google Scholar 

  13. Paul AA, Southgate DAT. McCance & Widdowson's ‘The composition of foods’: Dietary fiber in egg, meat and fish dishes. J Hum Nutrit 1979; 33: 335–6.

    Google Scholar 

  14. Wiles SA, Nettleton PA, Black AE, Paul AA. The nutrient composition of some cooked dishes eaten in Britain. A supplementary food composition table. J Hum Nutr 1980; 34: 189–223.

    Google Scholar 

  15. Southgate DAT. Determination of carbohydrates in foods. II. Unavailable carbohydrates. J Sci Food Agric 1969; 20: 331–5.

    Google Scholar 

  16. US Department of Agriculture. Food Yields: Summarized by Different Stages of Preparation. Washington, DC: USDA Agriculture Research Service, 1956; Agr. Handbook No. 102.

    Google Scholar 

  17. Jain MG, Howe GR, Johnson KC, Miller AB. Evaluation of a diet history questionaire for epidemiologic studies. Am J Epidemiol 1980; 111: 212–19.

    Google Scholar 

  18. Jain MG, Harrison L, Howe GR, Miller AB. Evaluation of a self-administered dietary questionnaire for use in a cohort study. Am J Clin Nutr 1982; 36: 931–5.

    Google Scholar 

  19. Howe GR, Harrison L, Jain M. A short diet history for assessing dietary exposure to N-nitrosamines in epidemiologic studies. Am J Epidemiol 1986; 124: 595–602.

    Google Scholar 

  20. Howe GR. Total energy intake: implications for epidemiologic analyses (Letter), Am J Epidemiol 1989; 129: 1314–5.

    Google Scholar 

  21. Graham S, Marshall J, Mettlin C, Rzepka T, Nemoto T, Byers T. Diet in the epidemiology of breast cancer. Am J Epidemial 1982; 116: 68–75.

    Google Scholar 

  22. Howe GR, Hirohata T, Hislop TG, et al. Dierary factors and risk of breast cancer: combined analyses of 12 casecontrol studies. JNCI 1990; 82: 561–9.

    Google Scholar 

  23. Katsouyanni K, Willett W, Trichopoulos D, et al. Risk of breast cancer among Greek women in relation to nutrient intake. Cancer 1988; 61: 181–5.

    Google Scholar 

  24. Potischman N, McCulloch CE, Byers T, et al. Breast cancer and dietary and plasma concentrations of carotenoids and vitamin A. Am J Clin Nutr 1990; 52: 909–15.

    Google Scholar 

  25. La Veechia C, Decarli A, Franceschi S, Gentile A, Negri E, Parazzini F. Dietary factors and the risk of breast cancer. Nutr Cancer 1987; 10: 205–14.

    Google Scholar 

  26. Ingram DM, Nottage E, Roberts T. The role of diet in the development of breast cancer: a case-control study of patients with breast cancer, benign epithelial hyperplasia, and fibrocystic disease of the breast. Br J Cancer 1991; 64: 187–91.

    Google Scholar 

  27. Richardson S, Gerber M, Cenée S. The role of fat, animal protein and some vitamin consumption in breast cancer: a case-control study in southern France. Int J Cancer 1991; 64: 1–9.

    Google Scholar 

  28. van't Veer P, Kolb CM, Verhoef P, et al. Dietary fiber, beta-carotene and breast cancer: results from a case-control study. Int J Cancer 1990; 45: 825–8.

    Google Scholar 

  29. Lee HP, Gourley L, Duffy SW, Estève J, Lee J, Day NE. Dietary effects on breast-cancer risk in Singapore. Lancet 1991; 337: 1197–200.

    Google Scholar 

  30. Zaridze D, Lifanova Y, Maximovitch D, Day NE, Duffy SW. Diet, alcohol consumption and reproductive factors in a case-control study of breast cancer in Moscow. Int J Cancer 1991; 48: 493–501.

    Google Scholar 

  31. Willett WC, Polk BF, Underwood BA, et al. Relation of serum vitamins A and E and carotenoids to the risk of cancer. N Engl J Med 1984; 310: 430–4.

    Google Scholar 

  32. Steinmetz KA, Potter JD. Vegetables, fruit, and cancer. II. Mechanisms. Cancer Causes Control 1991; 2: 427–42.

    Google Scholar 

  33. Committee on Diet and Health. Diet and Health. Washington, DC: National Academy Press, 1989: 332–3.

    Google Scholar 

  34. Shultz TD, Howie BJ. In vitro binding of steroid hormones by natural and purified fibers. Nutr Cancer 1986; 8: 141–7.

    Google Scholar 

  35. Adlercreutz H, Fotsis T, Bannwart C, et al. Determination of urinary lignans and phytoestrogen metabolites, potential antiestrogens and anticarcinogens, in urine of women on various habitual diets. J Steroid Biochem 1986; 25: 791–7.

    Google Scholar 

  36. Bernstein L, Yuan R, Ross RK, et al. Serum hormones in pre-menopausal Chinese women in Shanghai and white women in Los Angeles: results from two breast cancer case-control studies. Cancer Causes Control 1990; 1: 51–8.

    Google Scholar 

  37. Cohen LA, Kendall ME, Zang E, Meschter C, Rose DP. Modulation of N-nitrosomethylurea-induced mammary tumour promotion by dietary fiber and fat. JNCI 1991; 83: 496–501.

    Google Scholar 

  38. Zemla B. The role of dietary elements in breast cancer risk among native and migrant populations in Poland. Nutr Cancer 1984; 6: 187–95.

    Google Scholar 

  39. Willett W. Nutritional Epidemiology, New York: Oxford University Press, 1990: 272–91.

    Google Scholar 

  40. Willett WC, Hunter DJ, Stampfer MJ, et al. Dietary fat and fiber in relation to risk of breast cancer. An 8-year follow-up. JAMA 1992; 268: 2037–44.

    Google Scholar 

Download references

Authors

Additional information

Drs Roban, Howe, and Jain are with the NCIC Epidemiology Unit, University of Toronto, Toronto, Canada. The authors are also affihated teith the Department of Preventive Medicine and Biostatistics, University of Toronto, Toronto, Canada (Drs rohan, Howe, Jain, and Miller), and with the Department of Community Health sciences, University of Calgary, Calgary, Canada (Dr Friedenreich). Address correspondence to Dr Roban, NCIC Epidemiology Unit, University of Toronto, McMurricb Buiding, 3rd Floor, 12 Queen's Park Crescent West, Toronto, Ontario, MSS 1A8, Canada.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rohan, T.E., Howe, G.R., Friedenreich, C.M. et al. Dietary fiber, vitamins A, C, and E, and risk of breast cancer: a cohort study. Cancer Causes Control 4, 29–37 (1993). https://doi.org/10.1007/BF00051711

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00051711

Key words

Navigation