Abstract
Objective: To assess the relation between whole and refined grain intake and risk of incident postmenopausal breast cancer. Findings from case–control studies of whole and refined grain intake and risk of postmenopausal breast cancer have been inconclusive. Methods: The Iowa Women's Health Study is a prospective cohort study of women initially 55–69 years old that relates diet and other lifestyle factors to cancer risk. After exclusions a total of 29,119 menopausal women who answered a 1986 baseline and a 1989 follow-up questionnaire were followed for 9 years for incident breast cancer. Results: Compared to women who at baseline rarely ate whole grain foods, women who habitually ate whole grain had a healthier lifestyle, including a higher likelihood of prior screening mammography. The multivariate-adjusted risk of incident breast cancer was 20% higher in women in the highest quintile of whole grain intake, compared to women in the lowest quintile of whole grain intake (95% confidence interval 0.95–1.5; p-value for trend = 0.03). No increase in breast cancer risk was found in women who had not undergone screening mammography before 1989; the apparent increase in risk was therefore likely due to increased use of screening mammography. Refined grain intake was not associated with breast cancer risk. Conclusion: Consistent with inverse but not statistically significant associations between whole grain intake and breast cancer in case–control studies, both whole and refined grain intakes are unrelated to risk of postmenopausal breast cancer in these Iowa women.
Similar content being viewed by others
References
Slavin JL (1994) Epidemiological evidence for the impact of whole grains on health. Crit Rev Food Sci Nutr 34: 427-443.
Slavin J, Jacobs D, Marquart L (1997) Whole grain consumption and chronic disease: protective mechanisms. Nutr Cancer 27: 14-21.
Pedersen B, Knudsen KEB, Eggum BO (1989) Nutritive value of cereal products with emphasis on the effect of milling. World Rev Nutr Diet 60: 1-91.
Jacobs DR, Meyer KA, Kushi LH, Folsom AR (1999) Is whole grain intake associated with reduced total and cause-specific death rates in older women? The Iowa Women's Health Study. Am J Publ Health 89: 322-329.
Jacobs DR, Meyer HE, Solvoll K (2001) Reduced mortality among whole grain bread eaters in men and women in the Norwegian County Study. Eur J Clin Nutr 55: 137-143.
Jacobs DR, Marquart L, Slavin J, Kushi LH (1998) Whole-grain intake and cancer: an expanded review and meta-analysis. Nutr Cancer 30: 85-96.
Chatenoud L, Tavani A, La Vecchia C, et al. (1998) Whole grain food intake and cancer risk. Int J Cancer 77: 24-28.
Challier B, Perarnau J-M, Viel J-F (1998) Garlic, onion and cereal fibre as protective factors for breast cancer: a French case-control study. Eur J Epidemiol 14: 737-747.
Caygill CPJ, Charlett A, Hill MJ (1998) Relationship between the intake of high-fibre foods and energy and the risk of cancer of the large bowel and breast. Eur J Cancer Prev 7(Suppl. 2): S11-S17.
Van't Veer P, Kolb CM, Verhof P, et al. (1990) Dietary fiber, beta-carotene, and breast cancer: results from a case-control study. Int J Cancer 45: 825-828.
Levi F, Francheschi S, Negri E, La Vecchia C (1993) Dietary factors and the risk of endometrial cancer. Cancer 71: 3575-3581.
Phillips RL (1975) Role of lifestyle and dietary habits in risk of cancer among Seventh-Day Adventists. Cancer Res 35: 3513-3522.
De Stefani E, Correa P, Ronco A, Mendilaharsu M, Guidobono M, Deneo-Pellegrini H (1997) Dietary fiber and risk of breast cancer: a case-control study in Uruguay. Nutr Cancer 28: 14-19.
Witte JS, Ursin G, Siemiatycki J, Thompson WD, Paganini-Hill A, Haile RW (1997) Diet and premenopausal bilateral breast cancer: a case-control study. Breast Cancer Res Treat 42: 243-251.
Howe GR, Hirohata T, Hislop TG, et al. (1990) Dietary factors and risk of breast cancer: combined analysis of 12 case-control studies. J Natl Cancer Inst 82: 561-569.
Gerber M (1998) Fibre and breast cancer. Eur J Cancer Prev 7(Suppl. 2): S63-S67.
Mazur W, Adlercreutz H (1998) Natural and anthropogenic environmental oestrogens: the scientific basis for risk assessment. Naturally occurring oestrogens in food. Pure Appl Chem 70: 1759-1776.
Adlercreutz H, Fostis T, Bannwart C, et al. (1986) Determination of urinary lignans and phytoestrogen metabolites, potential antiestrogens and anticarcinogens, in urine of women on various habitual diets. J Steroid Biochem Mol Biol 25: 791-797.
Thompson LU, Robb P, Serraino M, Cheung F (1991) Mammalian lignan production from various foods. Nutr Cancer 16: 43-52.
Brezezinski A, Debi A (1999) Phytoestrogens: The “natural” selective estrogen receptor modulators? Eur J Obstet Gynecol 85: 47-51.
Pietinen P, Stumpf K, Männistö S, Kataja V, Adlercreutz H (2001) Serum enterolactone and risk of breast cancer: a case-control study in castern Finland. Cancer Epidemiol Biomarkers Prev 10: 339-344.
den Tonkelaar I, Keinan-Boker L, van't Veer P, et al. (2001) Urinary phytoestrogens and breast cancer risk in a Western population. Cancer Epidemiol Biomarkers Prev 10: 223-228.
Kasum CM, Nicodemus K, Harnack LJ, Jacobs DR, Folsom AR (2001) Whole grain intake and incident endometrial cancer. The Iowa Women's Health Study. Nutr Ca 39: 180-186
Willett WC, Sampson L, Browne ML, et al. (1988) The use of a self-administered questionnairc to assess diet four years in the past. Am J Epidemiol 127: 188-199.
Jacobs DR, Jr, Meyer KA, Kushi LH, Folsom AR (1998) Whole grain intake may reduce risk of coronary heart disease death in postmenopausal women: the Iowa Women's Health Study. Am J Clin Nutr 68: 248-257.
Munger RG, Folsom AR, Kushi LH, Kaye SA, Sellers TA (1992) Dietary assessment of older Iowan women with a food frequency questionnaire: nutrient intake reproducibility and comparison with 24-hour dictary recall interviews. Am J Epidemiol 136: 192-200.
Kushi LH, Kaye SA, Folsom AR, Soler JT, Prineas RJ (1988) Accuracy and reliability of self-measurements of body girths. Am J Epidemiol 128: 740-748.
Willett WC, Hunter DJ, Stampfer MJ, et al. (1992) Dietary fat and fiber in relation to risk of breast cancer. JAMA 268: 2037-2044.
Rohan TE, Howe GR, Friedenreich CM, Jain M, Miller AB (1993) Dietary fiber, vitamins A, C, and E, and risk of breast cancer: a cohort study. Cancer Causes Control 4: 29-37.
Freudenheim JL, Marshall JR, Vena JE, et al. (1996) Premenopausal breast cancer risk and intake of vegetables, fruits, and related nutrients. J Natl Cancer Inst 88: 340-348.
Potischman N, Swanson CA, Coates RJ, et al. (1999) Intake of food groups and associated micronutrients in relation to risk of early-stage breast cancer. Int J Cancer 82: 315-321.
Pryor M, Slattery ML, Robison LM, Egger M (1989) Adolescent diet and breast cancer in Utah. Cancer Res 49: 2161-2167.
Franceschi S, Favero A, Decarli A, et al. (1996) Intake of macronutrients and risk of breast cancer. Lancet 347: 1351-1356.
Favero A, Parpinel M, Franceschi S (1998) Diet and risk of breast cancer: major findings from an Italian case-control study. Biomed Pharmacother 52: 109-115.
Franceschi S, La Vecchia C, Russo A, Negri E, Favero A, Decarli A (1997) Low-risk diet for breast cancer in Italy. Cancer Epidemiol Biomarkers Prev 6: 875-879.
Franceschi S, Favero A, La Vecchia C, et al. (1995) Influence of food groups and food diversity on breast cancer risk in Italy. Int J Cancer 63: 785-789.
Yuan JM, Wang QS, Ross RK, Henderson BE, Yu MC (1995) Diet and breast cancer in Shanghai and Tianjin, China. Br J Cancer 71: 1353-1358.
Koo LC, Mang OWK, Ho JH-C (1997) An ecological study of trends in cancer incidence and dietary changes in Hong Kong. Nutr Cancer 28: 289-301.
Hebert JR, Rosen A (1996) Nutritional, socioeconomic, and reproductive factors in relation to female breast cancer mortality: findings from a cross-national study. Cancer Detect Prev 20: 234-244.
Caygill CPJ, Hill MJ, Charlett A (1999) Meat-cereal ratio and colorectal and breast cancer. Eur J Cancer Prev 8: 461-463.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Nicodemus, K.K., Jacobs, D.R. & Folsom, A.R. Whole and refined grain intake and risk of incident postmenopausal breast cancer (United States). Cancer Causes Control 12, 917–925 (2001). https://doi.org/10.1023/A:1013746719385
Issue Date:
DOI: https://doi.org/10.1023/A:1013746719385