Objectives

To examine the long-term effects of an intervention to lower fat intake among adolescent girls on biomarkers that are related to breast cancer risk in adults.

Background

Although animal and ecologic studies have suggested a link between dietary fat and the incidence of breast cancer, previous observational studies have not yielded definitive results. In the Women's Health Initiative dietary trial, breast cancer incidence was not significantly different between the low-fat diet group and the control group. However, findings from previous studies in humans on the association between adolescent diet and breast cancer are inconsistent and self-reports of childhood diets may yield biased results. The DISC06 follow-up study explored the hypothesis that diet during adolescence may play a greater role in breast cancer risk than diet during adulthood by evaluating the longer-term effects of the DISC intervention during childhood and adolescence on subsequent biomarkers that have been associated with breast cancer risk in adults.

Participants

In the original DISC study, 663 children 8-10 years old with elevated LDL-cholesterol were recruited into DISC at six clinical centers between 1988 and 1990. From 2006 to 2008, all female DISC participants, who were now 25 to 29 years old, were invited to participate in the DISC06 Follow-Up Study and 260 (86.4%) of the 301 females originally randomized in DISC participated.

Design

The DISC06 follow-up study enrolled young adult women that had participated in the DISC dietary intervention during childhood and adolescence to examine biomarkers that have been associated with breast cancer risk in adults, including serum levels of estrogens and progesterone, breast density, and bone mineral density.

Each participant attended a single clinic visit between 2006 and 2008. These follow-up data collection visits were timed to occur in the luteal phase of the menstrual cycle, 1-14 days before the anticipated start of next menses. Participants completed questionnaires that covered the following topics: demographic characteristics, medical history, reproductive and menstrual histories, prescription and non-prescription drug use including extensive information on past and current hormone use, health habits including smoking and alcohol use, family history of breast cancer, and leisure physical activity. Data from three nonconsecutive 24-hour dietary recalls collected over 2 weeks were averaged to estimate nutrient intakes. Participants completed menstrual cycle calendars following visits for up to 6 weeks until the start of their next menses. Hormones were measured in serum that was collected in the morning after an overnight fast by venipuncture using standard procedures. Breast density was measured using non-contrast magnetic resonance imaging. Bone density was measured using clinical dual-energy x-ray absorptiometry (DXA) protocols.

Conclusions

Results from the DISC06 follow-up study did not support the hypothesis that consumption of a lower fat diet during adolescence reduces breast cancer risk via effects on subsequent serum estradiol and progesterone levels, breast density or BMD.

Dorgan JF, Liu L, Klifa C, Hylton N, Shepherd JA, Stanczyk FZ, Snetselaar LG, Van Horn L, Stevens VJ, Robson A, Kwiterovich PO Jr, Lasser NL, Himes JH, Pettee Gabriel K, Kriska A, Ruder EH, Fang CY, Barton BA. Adolescent diet and subsequent serum hormones, breast density, and bone mineral density in young women: results of the Dietary Intervention Study in Children follow-up study. Cancer Epidemiol Biomarkers Prev. 2010 Jun;19(6):1545-56. doi: 10.1158/1055-9965.EPI-09-1259. Epub 2010 May 25. PMID: 20501774; PMCID: PMC2883023.

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