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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Article info
Publication history
Published online: September 29, 2018
Accepted:
September 28,
2018
Received in revised form:
September 7,
2018
Received:
June 18,
2018
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
