A comparison of two dietary instruments for evaluating the fat-breast cancer relationship

Laurence S. Freedman; Nancy Potischman; Victor Kipnis; Douglas Midthune; Arthur Schatzkin; Frances E. Thompson; Richard P. Troiano; Ross Prentice; Ruth Patterson; Raymond Carroll; Amy F. Subar

doi:10.1093/ije/dyl085

A comparison of two dietary instruments for evaluating the fat-breast cancer relationship

Laurence S. Freedman, Nancy Potischman, Victor Kipnis, Douglas Midthune, Arthur Schatzkin, Frances E. Thompson, Richard P. Troiano, Ross Prentice, Ruth Patterson, Raymond Carroll, Amy F. Subar

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Abstract

Background: Previous research suggests food diaries may be more efficient than food frequency questionnaires (FFQ) in detecting a dietary fat-breast cancer relationship. We assessed this further using 4 day food records (FRs) and FFQs in a large sample. Methods: Participants were from the non-intervention group of the dietary modification component of the Women's Health Initiative Clinical Trial: 603 breast cancer cases and 1206 controls matched on age, clinic, and length of follow-up. Relative risks (RRs) were estimated using unconditional logistic regression, adjusted for confounders and for the selection into the trial of women with an FFQ report exceeding 32% calories from fat. Direct comparison of the statistical power of the two instruments used the standardized log RR. An alternative analysis after removing subjects with missing covariate data was also conducted. Results: The RR estimate for breast cancer in the top quintile of total fat intake, adjusted for confounders and total energy, was 1.82 (P for trend 0.02) for the FR but 0.67 for the FFQ (P for trend 0.24). Following adjustment for selection, estimates were 2.09 (P for trend 0.008) for the FR (alternative: 2.54, P for trend 0.006) and 1.71 (P for trend 0.18) for the FFQ (alternative: 1.24, P for trend 0.41). Similar results were seen for fat subtypes, particularly unsaturated fats. Comparisons showed higher statistical power for the FR than the FFQ (e.g. total fat, P = 0.08: alternative P = 0.01). Conclusions: Alternative instruments, such as FRs, may be preferable to FFQs for evaluating diet-disease relationships in cohort studies. The results support a positive association between dietary fat and breast cancer.

Original language	English
Pages (from-to)	1011-1021
Number of pages	11
Journal	International Journal of Epidemiology
Volume	35
Issue number	4
DOIs	https://doi.org/10.1093/ije/dyl085
State	Published - Aug 2006
Externally published	Yes

Bibliographical note

Funding Information:
We thank Joe Barker and Lisa Kahle from Information Management Systems, Inc. for invaluable assistance in running the first set of statistical and dietary sources analyses and LieLing Wu, Eric N. Meier, Alan R. Kristal, and Marian L. Neuhouser for help with compiling datasets. R.C.’s research was supported by a grant from the National Cancer Institute (CA-57030) and by the Texas A & M Center for Environmental and Rural Health via a grant from the National Institute of Environmental Health Sciences (P30-ES09106). R.P.’s research was supported by NCI programme grant CA53996. The WHI programme is funded by the National Heart, Lung and Blood Institute, US Department of Health and Human Services.

Keywords

Breast cancer
Dietary fat
Food frequency questionnaire
Multiple-day food record

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1093/ije/dyl085

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title = "A comparison of two dietary instruments for evaluating the fat-breast cancer relationship",

abstract = "Background: Previous research suggests food diaries may be more efficient than food frequency questionnaires (FFQ) in detecting a dietary fat-breast cancer relationship. We assessed this further using 4 day food records (FRs) and FFQs in a large sample. Methods: Participants were from the non-intervention group of the dietary modification component of the Women's Health Initiative Clinical Trial: 603 breast cancer cases and 1206 controls matched on age, clinic, and length of follow-up. Relative risks (RRs) were estimated using unconditional logistic regression, adjusted for confounders and for the selection into the trial of women with an FFQ report exceeding 32% calories from fat. Direct comparison of the statistical power of the two instruments used the standardized log RR. An alternative analysis after removing subjects with missing covariate data was also conducted. Results: The RR estimate for breast cancer in the top quintile of total fat intake, adjusted for confounders and total energy, was 1.82 (P for trend 0.02) for the FR but 0.67 for the FFQ (P for trend 0.24). Following adjustment for selection, estimates were 2.09 (P for trend 0.008) for the FR (alternative: 2.54, P for trend 0.006) and 1.71 (P for trend 0.18) for the FFQ (alternative: 1.24, P for trend 0.41). Similar results were seen for fat subtypes, particularly unsaturated fats. Comparisons showed higher statistical power for the FR than the FFQ (e.g. total fat, P = 0.08: alternative P = 0.01). Conclusions: Alternative instruments, such as FRs, may be preferable to FFQs for evaluating diet-disease relationships in cohort studies. The results support a positive association between dietary fat and breast cancer.",

keywords = "Breast cancer, Dietary fat, Food frequency questionnaire, Multiple-day food record",

author = "Freedman, {Laurence S.} and Nancy Potischman and Victor Kipnis and Douglas Midthune and Arthur Schatzkin and Thompson, {Frances E.} and Troiano, {Richard P.} and Ross Prentice and Ruth Patterson and Raymond Carroll and Subar, {Amy F.}",

note = "Funding Information: We thank Joe Barker and Lisa Kahle from Information Management Systems, Inc. for invaluable assistance in running the first set of statistical and dietary sources analyses and LieLing Wu, Eric N. Meier, Alan R. Kristal, and Marian L. Neuhouser for help with compiling datasets. R.C.{\textquoteright}s research was supported by a grant from the National Cancer Institute (CA-57030) and by the Texas A & M Center for Environmental and Rural Health via a grant from the National Institute of Environmental Health Sciences (P30-ES09106). R.P.{\textquoteright}s research was supported by NCI programme grant CA53996. The WHI programme is funded by the National Heart, Lung and Blood Institute, US Department of Health and Human Services.",

year = "2006",

month = aug,

doi = "10.1093/ije/dyl085",

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T1 - A comparison of two dietary instruments for evaluating the fat-breast cancer relationship

AU - Freedman, Laurence S.

AU - Potischman, Nancy

AU - Kipnis, Victor

AU - Midthune, Douglas

AU - Schatzkin, Arthur

AU - Thompson, Frances E.

AU - Troiano, Richard P.

AU - Prentice, Ross

AU - Patterson, Ruth

AU - Carroll, Raymond

AU - Subar, Amy F.

N1 - Funding Information: We thank Joe Barker and Lisa Kahle from Information Management Systems, Inc. for invaluable assistance in running the first set of statistical and dietary sources analyses and LieLing Wu, Eric N. Meier, Alan R. Kristal, and Marian L. Neuhouser for help with compiling datasets. R.C.’s research was supported by a grant from the National Cancer Institute (CA-57030) and by the Texas A & M Center for Environmental and Rural Health via a grant from the National Institute of Environmental Health Sciences (P30-ES09106). R.P.’s research was supported by NCI programme grant CA53996. The WHI programme is funded by the National Heart, Lung and Blood Institute, US Department of Health and Human Services.

PY - 2006/8

Y1 - 2006/8

N2 - Background: Previous research suggests food diaries may be more efficient than food frequency questionnaires (FFQ) in detecting a dietary fat-breast cancer relationship. We assessed this further using 4 day food records (FRs) and FFQs in a large sample. Methods: Participants were from the non-intervention group of the dietary modification component of the Women's Health Initiative Clinical Trial: 603 breast cancer cases and 1206 controls matched on age, clinic, and length of follow-up. Relative risks (RRs) were estimated using unconditional logistic regression, adjusted for confounders and for the selection into the trial of women with an FFQ report exceeding 32% calories from fat. Direct comparison of the statistical power of the two instruments used the standardized log RR. An alternative analysis after removing subjects with missing covariate data was also conducted. Results: The RR estimate for breast cancer in the top quintile of total fat intake, adjusted for confounders and total energy, was 1.82 (P for trend 0.02) for the FR but 0.67 for the FFQ (P for trend 0.24). Following adjustment for selection, estimates were 2.09 (P for trend 0.008) for the FR (alternative: 2.54, P for trend 0.006) and 1.71 (P for trend 0.18) for the FFQ (alternative: 1.24, P for trend 0.41). Similar results were seen for fat subtypes, particularly unsaturated fats. Comparisons showed higher statistical power for the FR than the FFQ (e.g. total fat, P = 0.08: alternative P = 0.01). Conclusions: Alternative instruments, such as FRs, may be preferable to FFQs for evaluating diet-disease relationships in cohort studies. The results support a positive association between dietary fat and breast cancer.

AB - Background: Previous research suggests food diaries may be more efficient than food frequency questionnaires (FFQ) in detecting a dietary fat-breast cancer relationship. We assessed this further using 4 day food records (FRs) and FFQs in a large sample. Methods: Participants were from the non-intervention group of the dietary modification component of the Women's Health Initiative Clinical Trial: 603 breast cancer cases and 1206 controls matched on age, clinic, and length of follow-up. Relative risks (RRs) were estimated using unconditional logistic regression, adjusted for confounders and for the selection into the trial of women with an FFQ report exceeding 32% calories from fat. Direct comparison of the statistical power of the two instruments used the standardized log RR. An alternative analysis after removing subjects with missing covariate data was also conducted. Results: The RR estimate for breast cancer in the top quintile of total fat intake, adjusted for confounders and total energy, was 1.82 (P for trend 0.02) for the FR but 0.67 for the FFQ (P for trend 0.24). Following adjustment for selection, estimates were 2.09 (P for trend 0.008) for the FR (alternative: 2.54, P for trend 0.006) and 1.71 (P for trend 0.18) for the FFQ (alternative: 1.24, P for trend 0.41). Similar results were seen for fat subtypes, particularly unsaturated fats. Comparisons showed higher statistical power for the FR than the FFQ (e.g. total fat, P = 0.08: alternative P = 0.01). Conclusions: Alternative instruments, such as FRs, may be preferable to FFQs for evaluating diet-disease relationships in cohort studies. The results support a positive association between dietary fat and breast cancer.

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A comparison of two dietary instruments for evaluating the fat-breast cancer relationship

Abstract

Bibliographical note

Keywords

UN SDGs

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