Dietary Energy Density Is Positively Associated with Breast Density among Young Women

Abstract

Background Breast density is an established predictor of breast cancer risk, and there is considerable interest in associations of modifiable lifestyle factors, such as diet, with breast density. Objective To determine if dietary energy density (ED) is associated with percent dense breast volume (%DBV) and absolute dense breast volume (ADBV) in young women. Design A cross-sectional analysis was conducted with women who participated in the Dietary Intervention Study in Children Follow-Up Study (DISC06). %DBV and ADBV were measured by magnetic resonance imaging (MRI). Diet was assessed by three 24-hour recalls. Dietary ED (kcal/g) was calculated using three methods: (1) food only, (2) food and caloric beverages, and (3) food and all beverages. Participants/setting 172 women (25–29 years) who were enrolled in the DISC06 study. Subjects who reported breast augmentation or reduction surgery or were pregnant or lactating within three months before breast density assessment were excluded. Main outcome measures ADBV and %DBV. Statistical analyses performed Multivariable linear mixed effects models were used. Final models were adjusted for race, smoking status, education, parity, duration of sex hormone use, whole body percent fat, childhood BMI z-score, and energy from beverages. Results After adjustment, each 1 kcal/g unit increase in food-only ED was associated with a 25.9% (95% confidence interval = 6.2 to 56.8%) increase in %DBV (p=0.01). Childhood BMI z-score modified the association between food-only ED and %DBV such that a significant positive association was observed only in women who were heavier as children. Food-only ED was not associated with ADBV in all women, but a borderline significant positive association was observed in women who had higher childhood BMI z-scores. Conclusions This is the first report to suggest a potential role for dietary ED in breast density; the effects of long-term exposure to high ED diets on breast cancer risk remain unknown.

Association between Dietary Energy Density and Obesity-Associated Cancer: Results from the Women’s Health Initiative

“…41 Furthermore, novel work from Jones et al using the Dietary Intervention Study in Children cohort demonstrated that each one-unit increase in food-only DED conferred 25.9% higher breast density. 42 Given appreciable evidence that breast density is a risk factor for breast cancer, these data, in combination with our findings, suggest that DED may influence breast cancer risk.…”

Dietary Energy Density and Postmenopausal Breast Cancer Incidence in the Cancer Prevention Study II Nutrition Cohort

“…Other aspects of a high-ED diet pattern may also influence cancer risk. For example, ED was positively associated with measures of breast density among young women independent of weight status (22). This may be very important because women with a high breast density have a 4-6-fold increase in breast cancer risk (23).…”

Overeating, caloric restriction and mammographic density in Spanish women. DDM-Spain study

“…Regarding its association with MD, there are previous studies that have detected a positive association between this phenotype and caloric intake [22][23][24], one of them based on the same participants of our study [22]. With respect to weight gain in adulthood, although previous studies have observed a positive relationship with MD, both in this same sample [6] and in others [7], other studies have described an inverse association [8].…”