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

  • María del Pilar del Pozo
    Affiliations
    Department of Preventive Medicine, Public Health and Microbiology, Universidad Autónoma de Madrid (UAM), C/ Arzobispo Morcillo 4, 28029, Madrid, Spain
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  • Adela Castelló
    Affiliations
    Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Av. Monforte de Lemos 5, 28029, Madrid, Spain

    Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Av. Monforte de Lemos 5, 28029, Madrid, Spain

    Faculty of Medicine, University of Alcalá, Campus Científico-Tecnológico, Crta. de Madrid-Barcelona, Km. 33,600, 28871, Alcalá de Henares, Madrid, Spain
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  • Carmen Vidal
    Affiliations
    Cancer Prevention and Control Program, Catalan Institute of Oncology-IDIBELL, Av. Gran Vía s/n km 2,7, 08907, L’Hospitalet de Llobregat, Barcelona, Spain
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  • Dolores Salas-Trejo
    Affiliations
    General Directorate Public Health, and FISABIO, Av. de Catalunya 21, 46020, Valencia, Spain
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  • Carmen Sánchez-Contador
    Affiliations
    Balearic Islands Breast Cancer Screening Program, Health Promotion for Women and Childhood, General Directorate Public Health and Participation, Regional Authority of Health and Consumer Affairs, C/Jesús, 40 Pabellón II, 07010, Palma, Balearic Islands, Spain
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  • Carmen Pedraz-Pingarrón
    Affiliations
    Castile-Leon Breast Cancer Screening Program, General Directorate Public Health SACYL, Av. Sierra de Atapuerca s/n, 09002, Burgos, Spain
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  • Pilar Moreo
    Affiliations
    Aragon Breast Cancer Screening Program, Health Service of Aragon, Av. Cesar Augusto 11, 50004, Zaragoza, Spain
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  • Carmen Santamariña
    Affiliations
    Galicia Breast Cancer Screening Program, Regional Authority of Health, Galicia Regional Government, C/ Duran Loriga 3, 15003, Corunna, Spain
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  • María Ederra
    Affiliations
    Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Av. Monforte de Lemos 5, 28029, Madrid, Spain

    Early Detection Section, Public and Labor Health Institute of Navarra, C/ Leyre, 15, 31003, Pamplona, Spain

    Healthcare Research Institute of Navarre (IdiSNA), C/ de Irunlarrea 3, 31008, Pamplona, Spain
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  • Rafael Llobet
    Affiliations
    Institute of Computer Technology, Universitat Politècnica de València, Camino de Vera s/n, 46022, Valencia, Spain
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  • Jesús Vioque
    Affiliations
    Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Av. Monforte de Lemos 5, 28029, Madrid, Spain

    Nutritional Epidemiology Unit, University Miguel Hernandez, ISABIAL-FISABIO, Ctra. Nacional 332 s/n, 03550, Sant Joan D'alacant, Alicante, Spain
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  • Beatriz Pérez-Gómez
    Affiliations
    Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Av. Monforte de Lemos 5, 28029, Madrid, Spain

    Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Av. Monforte de Lemos 5, 28029, Madrid, Spain
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  • Author Footnotes
    1 Co-last authors.
    Marina Pollán
    Footnotes
    1 Co-last authors.
    Affiliations
    Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Av. Monforte de Lemos 5, 28029, Madrid, Spain

    Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Av. Monforte de Lemos 5, 28029, Madrid, Spain
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  • Author Footnotes
    1 Co-last authors.
    Virginia Lope
    Correspondence
    Corresponding author at: Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029 Madrid, Spain.
    Footnotes
    1 Co-last authors.
    Affiliations
    Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Av. Monforte de Lemos 5, 28029, Madrid, Spain

    Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Av. Monforte de Lemos 5, 28029, Madrid, Spain
    Search for articles by this author
  • Author Footnotes
    1 Co-last authors.
Published:September 29, 2018DOI:https://doi.org/10.1016/j.maturitas.2018.09.006

      Highlights

      • Caloric intake above predicted levels seems to increase mammographic density.
      • For every 20% increase in relative energy intake, mammographic density increased by 5%.
      • Caloric restriction does not appear to affect breast density.

      Abstract

      Objectives

      Mammographic density (MD) is a strong risk factor for breast cancer. The present study evaluates the association between relative caloric intake and MD in Spanish women.

      Study design

      We conducted a cross-sectional study in which 3517 women were recruited from seven breast cancer screening centers. MD was measured by an experienced radiologist using craniocaudal mammography and Boyd’s semi-quantitative scale. Information was collected through an epidemiological survey. Predicted calories were calculated using linear regression models, including the basal metabolic rate and physical activity as explanatory variables. Overeating and caloric restriction were defined taking into account the 99% confidence interval of the predicted value. Odds ratios (OR) and 95% confidence intervals (95%CI) were estimated using center-specific mixed ordinal logistic regression models, adjusted for age, menopausal status, body mass index, parity, tobacco use, family history of breast cancer, previous biopsies, age at menarche and adherence to a Western diet.

      Main outcome measure

      Mammographic density.

      Results

      Those women with an excessive caloric intake (>40% above predicted) presented higher MD (OR = 1.41, 95%CI = 0.97–2.03; p = 0.070). For every 20% increase in relative caloric consumption the probability of having higher MD increased by 5% (OR = 1.05, 95%CI = 0.98–1.14; p = 0.178), not observing differences between the categories of explanatory variables. Caloric restriction was not associated with MD in our study.

      Conclusions

      This is the first study exploring the association between MD and the effect of caloric deficit or excessive caloric consumption according to the energy requirements of each woman. Although caloric restriction does not seem to affect breast density, a caloric intake above predicted levels seems to increase this phenotype.

      Abbreviations:

      BMI (body mass index), BMR (basal metabolic rate), DDM-Spain (Determinants of Mammographic Density in Spain), MD (mammographic density), OR (odds ratio), 95%CI (95% confidence interval)

      Keywords

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