众所周知，人生不同时期的营养因素可能影响乳腺癌风险，而良性乳腺疾病也是公认的乳腺癌风险因素之一。
2019年6月20日，施普林格·自然《乳腺癌研究与治疗》在线发表美国哈佛大学医学院、布莱根医院和波士顿妇女医院、达纳法伯癌症研究院、哈佛大学陈曾熙公共卫生学院、圣路易斯华盛顿大学医学院西特曼癌症中心、澳大利亚墨尔本大学皇家妇女医院的研究报告，调查了从出生至14岁的童年营养以及随后良性乳腺疾病的发生情况。
该前瞻定群研究于1996～2001、2003、2005、2007、2010、2013、2014年对全美国50个州护士健康研究II期（NHSII）参与者的9031位9～15岁女儿进行问卷调查（包括身高、体重）。1996年，由母亲报告女儿出生第一年的婴儿喂养方法。从1996年开始，由女儿完成每年食物频率调查问卷。2005年，18岁以上的女儿开始报告是否曾被诊断为经活检证实的良性乳腺疾病。通过多因素逻辑回归模型分析，推算儿童营养与良性乳腺疾病的相关性，并且根据母亲乳腺疾病和儿童身高体重因素进行校正。
结果，所有女儿发生活检确诊良性乳腺疾病173例，虽然与婴儿期营养因素无关，但是与某些青春期饮食因素相关。
同时包括不同年龄段最重要饮食和身高体重因素的多因素逻辑回归模型分析表明：
10岁前动物脂肪摄入量最多与最低四分之一相比：良性乳腺疾病风险高127%（比值比：2.27，P=0.016）
14岁后坚果花生摄入量最多与最低四分之一相比：良性乳腺疾病风险低 40%（比值比：0.60，P=0.033）
注：动物脂肪（对能量进行校正后，不包括乳制品）、坚果花生（包括小袋坚果和花生酱三明治）
因此，该研究结果表明，10岁前动物脂肪（不包括乳制品）摄入量较多、14岁以下坚果花生摄入量较少，与良性乳腺疾病风险增加独立相关。这些饮食因素可能与良性乳腺疾病风险相关，无论儿童期生长（妊娠期体重增加、儿童期体重指数和身高、青春期身高增长速度）、青年期身高和体重指数、家族史等其他影响因素如何。
Breast Cancer Res Treat. 2019 Jun 20.
Dietary intake from birth through adolescence in relation to risk of benign breast disease in young women.
Catherine S. Berkey, Rulla M. Tamimi, Walter C. Willett, Bernard Rosner, Martha Hickey, Adetunji T. Toriola, A. Lindsay Frazier, Graham A. Colditz.
Brigham & Women's Hospital and Harvard Medical School, Boston, USA; Harvard T.H. Chan School of Public Health, Boston, USA; The University of Melbourne and the Royal Women's Hospital, Melbourne, Australia; Washington University School of Medicine, Alvin J. Siteman Cancer Center, St. Louis, USA; Dana-Farber Cancer Institute, Boston, USA.
PURPOSE: Nutritional factors during different periods in life impact breast cancer risk. Because benign breast disease (BBD) is a well-established risk factor for breast cancer, we investigated childhood nutrition from birth through age 14 year and subsequent BBD.
METHODS: A prospective cohort study of 9031 females, 9-15 year at baseline, completed questionnaires (including heights, weights) annually from 1996 to 2001, in 2003, 2005, 2007, 2010, 2013 and 2014. In 1996, mothers reported infant feeding practices during their daughters first year of life. Beginning in 1996, participants completed annual food frequency questionnaires. In 2005, participants (18 year +) began reporting whether they had ever been diagnosed with biopsy-confirmed BBD (N = 173 cases). Multivariable logistic regression models estimated associations between childhood nutrition and BBD, adjusted for maternal breast disease and childhood body size factors.
RESULTS: Although no infant nutrition factors were associated with biopsy-confirmed BBD, certain adolescent dietary factors were. A multivariable model simultaneously included the most important diet and body size factors from different age periods: higher BBD risk was associated with greater age 10 year consumption of animal (non-dairy, energy-adjusted) fat (OR 2.27, p < .02, top vs. bottom quartiles) and with lower 14 year consumption of nuts/peanut butter (OR 0.60, p = .033, top vs. bottom quartiles).
CONCLUSION: Greater intake of animal (non-dairy) fat at 10 year and lower intake of nuts/peanut butter at 14 year were independently associated with higher BBD risk. These dietary factors appeared to operate on BBD risk independent of childhood growth (gestational weight gain, childhood BMI and height, adolescent height growth velocity), young adult height and BMI, and family history.
KEYWORDS: Infant nutrition Childhood diet Adolescent diet Alcohol Pre-malignant Benign breast disease
DOI: 10.1007/s10549-019-05323-8
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