Dietary Fat Intake and Risk of Uterine Leiomyomata

A Prospective Ultrasound Study

Theodore M. Brasky; Traci N. Bethea; Amelia K. Wesselink; Ganesa R. Wegienka; Donna D. Baird; Lauren A. Wise

Disclosures

Am J Epidemiol. 2020;189(12):1538-1546. 

In This Article

Results

Baseline characteristics of SELF participants, stratified by total dietary fat intake, are shown in Table 1. With the exception of fish intake, participants' baseline characteristics were not appreciably associated with total dietary fat intake. Women who consumed more dietary fat were more likely to consume fish. Household income, body mass index, and reproductive factors including age at menarche, parity, age at first birth, years since last birth, and use of injectable progestin-only contraceptives were similar across categories of dietary fat intake.

Associations of energy-adjusted quartiles of total fat and individual fatty acid intakes with UL incidence are presented in Table 2 (reduced table) and Web Table 2 (full table). Hazard ratios comparing the highest versus lowest quartiles of fat consumption were: 1.08 (95% confidence interval (CI): 0.76, 1.52) for total dietary fat, 0.97 (95% CI: 0.67, 1.38) for SFA, 1.17 (95% CI: 0.83, 1.64) for MUFA, 0.91 (95% CI: 0.64, 1.31) for PUFA, and 0.83 (95% CI: 0.59, 1.18) for trans-fatty acids. Greater intake of each of the 3 marine ω-3 PUFAs was positively associated with UL incidence (quartiles 4 vs. 1: docosahexaenoic acid (PUFA 22:6) hazard ratio (HR) = 1.49, 95% CI: 1.04, 2.14 (P for trend = 0.01); eicosapentaenoic acid (PUFA 20:5) HR = 1.25, 95% CI: 0.87, 1.81 (P for trend = 0.06); docosapentaenoic acid (PUFA 22:5) HR = 1.22, 95% CI: 0.85, 1.75 (P for trend = 0.21)). The hazard ratios for quartiles 2, 3, and 4 versus 1 of total dietary marine ω-3 PUFA were 0.87 (95% CI: 0.59, 1.29), 1.14 (95% CI: 0.79, 1.66), and 1.35 (95% CI: 0.94, 1.93), respectively, and a linear trend was observed (P for trend = 0.03). Additionally, there was a suggestive association with intake of palmitoleic acid (MUFA 16:1) (HR = 1.42, 95% CI: 0.99, 2.04; P for trend = 0.10; Web Table 2). Hazard ratios for intakes of individual SFAs and trans-fatty acids, as well as the remaining MUFAs and PUFAs did not suggest appreciable associations.

Associations of fish intake and UL risk are given in Table 3. Similar to the marine ω-3 PUFAs, hazard ratios for total fish intake were also elevated: hazard ratio = 1.19 (95% CI: 0.93, 1.71), hazard ratio = 1.33 (95% CI: 0.93, 1.91), and hazard ratio = 1.37 (95% CI: 0.94, 2.00) for quartiles 2, 3, and 4 versus 1 (P for trend = 0.14), respectively. Associations were generally similar for fin fish and shellfish.

After excluding women who used progestin-only injectable contraceptives at baseline, findings for marine ω-3 PUFA were stronger (Table 4). For docosahexaenoic acid specifically, the hazard ratio comparing quartile 4 versus 1 was 1.59 (95% CI: 1.10, 2.30; P for trend < 0.01). Findings for palmitoleic acid were unchanged (data not shown).

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