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Dietary intake of trans fatty acids and breast cancer risk in 9 European countries

Michèle Matta 1Inge Huybrechts 1Carine Biessy 1Corinne Casagrande 1Sahar Yammine 1Agnès Fournier 2 3Karina Standahl Olsen 4Marco Lukic 4Inger Torhild Gram 4Eva Ardanaz 5 6 7Maria-José Sánchez 7 8 9 10Laure Dossus 1Renée T Fortner 11Bernard Srour 11Franziska Jannasch 12 13 14Matthias B Schulze 12Pilar Amiano 7 15Antonio Agudo 16Sandra Colorado-Yohar 7 17 18J Ramón Quirós 19Rosario Tumino 20Salvatore Panico 21Giovanna Masala 22Valeria Pala 23Carlotta Sacerdote 24Anne Tjønneland 25 26Anja Olsen 25 27Christina C Dahm 27Ann H Rosendahl 28Signe Borgquist 28 29Maria Wennberg 30Alicia K Heath 31Dagfinn Aune 31 32 33Julie Schmidt 34Elisabete Weiderpass 35Veronique Chajes 1Marc J Gunter 1Neil Murphy 36

BMC Med. 2021 Mar 30;19(1):81. doi: 10.1186/s12916-021-01952-3.


Background: Trans fatty acids (TFAs) have been hypothesised to influence breast cancer risk. However, relatively few prospective studies have examined this relationship, and well-powered analyses according to hormone receptor-defined molecular subtypes, menopausal status, and body size have rarely been conducted.

Methods: In the European Prospective Investigation into Cancer and Nutrition (EPIC), we investigated the associations between dietary intakes of TFAs (industrial trans fatty acids [ITFAs] and ruminant trans fatty acids [RTFAs]) and breast cancer risk among 318,607 women. Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models, adjusted for other breast cancer risk factors.

Results: After a median follow-up of 8.1 years, 13,241 breast cancer cases occurred. In the multivariable-adjusted model, higher total ITFA intake was associated with elevated breast cancer risk (HR for highest vs lowest quintile, 1.14, 95% CI 1.06-1.23; P trend = 0.001). A similar positive association was found between intake of elaidic acid, the predominant ITFA, and breast cancer risk (HR for highest vs lowest quintile, 1.14, 95% CI 1.06-1.23; P trend = 0.001). Intake of total RTFAs was also associated with higher breast cancer risk (HR for highest vs lowest quintile, 1.09, 95% CI 1.01-1.17; P trend = 0.015). For individual RTFAs, we found positive associations with breast cancer risk for dietary intakes of two strongly correlated fatty acids (Spearman correlation r = 0.77), conjugated linoleic acid (HR for highest vs lowest quintile, 1.11, 95% CI 1.03-1.20; P trend = 0.001) and palmitelaidic acid (HR for highest vs lowest quintile, 1.08, 95% CI 1.01-1.16; P trend = 0.028). Similar associations were found for total ITFAs and RTFAs with breast cancer risk according to menopausal status, body mass index, and breast cancer subtypes.

Conclusions: These results support the hypothesis that higher dietary intakes of ITFAs, in particular elaidic acid, are associated with elevated breast cancer risk. Due to the high correlation between conjugated linoleic acid and palmitelaidic acid, we were unable to disentangle the positive associations found for these fatty acids with breast cancer risk. Further mechanistic studies are needed to identify biological pathways that may underlie these associations.