French study incriminates blood lipids in breast cancer risk
Comments
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Hi all,
I just happened across a recent French study that shows a clear correlation between high blood lipids (cholesterol and triglycerides) and the risk of breast cancer. Another reason to take that Lipitor, apparently.
I'm including the article below for those who read/understand French.
Annie
Cancer du sein : les acides gras trans incriminés
Deux équipes de l'Inserm et de l'Institut Gustave Roussy se sont associées pour mener une étude épidémiologique portant sur la cohorte française de femmes adhérentes de la Mutuelle Générale de l'Education Nationale (E3N). Les chercheurs montrent que le risque de cancer du sein est presque doublé chez les femmes ayant des taux sanguins élevés d'acides gras trans. Les acides gras trans incriminés sont ceux d'origine industrielle (produits manufacturés, pains industriels, viennoiserie, gâteaux, chips, pâtes à pizzas)
Par ailleurs, contrairement à ce qui a été montré dans des études asiatiques, ces travaux ne mettent pas en évidence d'effet protecteur des acides gras oméga 3 d'origine marine sur le risque de cancer du sein.
Ces résultats sont publiés dans la revue American Journal of Epidemiology.
La cohorte E3N est la partie française de EPIC, vaste étude européenne coordonnée par le Centre International de Recherche sur le Cancer, portant sur 500 000 européens dans 10 pays.
Les effets défavorables des acides gras trans sur le risque cardiovasculaire sont connus depuis le début des années 1990, mais leur impact sur le risque de cancer du sein restait à définir. Les équipes de chercheurs de l'Inserm et de l'Institut Gustave Roussy ont cherché à évaluer le rôle joué par les différents types d'acides gras sur le développement du cancer du sein en utilisant des prélèvements sanguins recueillis entre 1995 et 1998 parmi 25 000 des 100 000 femmes suivies dans le cadre de l'étude E3N.
Pour tester l'effet de l'alimentation sur la santé, les scientifiques ont mesuré différents biomarqueurs de l'alimentation dans le sang, en particulier ici les taux d'acides gras. Les données des 363 femmes ayant eu un cancer du sein postérieur au prélèvement de sang ont été analysées. Leurs taux sanguins d'acides gras ont été comparés avec ceux de femmes n'ayant pas eu de cancer du sein et choisies comme témoins. Pour chaque cas de cancer du sein, deux témoins ont été sélectionnés soit 702 femmes témoins au total.
Un risque presque doublé
En analysant les acides gras trans et cis, les chercheurs ont trouvé que le risque de cancer du sein augmente avec la teneur en acides gras trans, reflet de la consommation en produits manufacturés. Ces résultats montrent que les femmes ayant des taux élevés d'acide gras trans dans le sérum ont un risque d'avoir un cancer du sein presque doublé par rapport aux femmes ayant le taux le plus bas. « A ce stade, nous ne pouvons que recommander une diminution de la consommation de produits manufacturés, source d'acides gras trans d'origine industrielle. Il conviendrait en particulier de limiter les procédés industriels générant des acides gras trans (huiles végétales partiellement hydrogénées) encore utilisés, ainsi que cela a été entrepris au Danemark depuis quelques années. En matière de réglementation concernant l'étiquetage des produits manufacturés, la quantité d'acides gras trans devrait être clairement indiquée » indiquent les chercheurs.
L'effet protecteur des acides gras oméga-3 pour le cancer du sein n'est pas universel
Par ailleurs, dans ce travail, les auteurs sont en accord avec les résultats des études conduites dans les pays occidentaux concernant l'absence d'association entre les taux sanguins d'acides gras oméga-3, dont la source alimentaire principale est la consommation de poissons, et le risque de cancer du sein. Si un effet protecteur des acides gras oméga-3 sur le risque de cancer du sein a clairement été montré dans les pays asiatiques, où la consommation de poissons est beaucoup plus importante qu'en Occident, cet effet protecteur n'est pas mesurable dans cette puissante étude française probablement en raison d'une consommation trop faible de poissons.
Dans les pays industrialisés, le cancer du sein est le cancer plus fréquent chez la femme. Selon les auteurs, parmi les facteurs de risque pouvant faire l'objet d'une prévention, l'alimentation présente un fort potentiel puisqu'une modification adéquate des habitudes alimentaires permettrait de diminuer le risque de cancer du sein, sous réserve que les nutriments en cause soient clairement identifiés. Parmi ces nutriments, le rôle des lipides alimentaires pourrait être extrêmement important.
Une étude des taux d'acides gras trans dans des populations aux pratiques alimentaires encore plus diverses est donc essentielle pour confirmer les résultats de cette analyse. Une telle étude devrait être prochainement entreprise au sein de la population européenne de l'étude EPIC.
L'ETUDE E3N
E3N, Etude Epidémiologique auprès de femmes de la MGEN (Mutuelle Générale de l'Education Nationale) menée par le docteur Françoise Clavel-Chapelon (Inserm-Institut Gustave Roussy), est une enquête de cohorte prospective portant sur environ 100 000 femmes volontaires françaises nées entre 1925 et 1950 et suivies depuis 1990.
Les informations concernant d'une part leur mode de vie (alimentation, prise de traitements hormonaux ...) et d'autre part l'évolution de leur état de santé, sont recueillies par auto-questionnaires tous les 2 ans depuis 1990. Elles sont complétées par des données biologiques, obtenues sur 25 000 volontaires, à partir d'un prélèvement sanguin stocké à des fins de dosages ultérieurs (études cas-témoins dans la cohorte). E3N est la partie française de EPIC, vaste étude européenne coordonnée par le Centre International de Recherches sur le Cancer portant sur 500 000 européens dans 10 pays. Deux localisations cancéreuses sont étudiées en priorité du fait de leur forte incidence : le sein et le côlon-rectum.
Source
Serum trans-monounsaturated fatty acids are associated with an increased risk of breast cancer in the E3N-EPIC Study.
V. Chajès; A. C.M. Thiébaut; M. Rotival; E. Gauthier ; V. Maillard; M.C. Boutron-Ruault; V. Joulin; G. M. Lenoir ; F. Clavel-Chapelon.
1 Centre National de la Recherche Scientifique, FRE 2939, Institut Gustave Roussy, Villejuif, France.
2 Institut National de la Santé et de la Recherche Médicale, ERI-20, EA4045, and Institut Gustave Roussy, Villejuif, France.
Am. J. Epidemiol. 2008 (DOI: 10.1093/aje/kwn069)
Contacts chercheurs
Véronique Chajès
Unité de recherche CNRS -IGR-Université Paris Sud FRE 2939 "Stabilité génétique et oncogenèse"
e-mail: chajes@igr.fr
Françoise Clavel-Chapelon
Responsable de l'Etude E3N
Directrice de Recherche Inserm, Equipe ERI 20, Institut Gustave Roussy.
e-mail: clavel@igr.fr -
Dang it, Annie, I can't read French. First, I tried to use Babel Fish to do a translation. Then I realized the original paper was published in the American Journal of Epidemiology, in English! It's on-line in our library (Advance Access published on April 4, 2008; doi:10.1093/aje/kwn069). Here's the abstract of the original paper that's discussed in the release you've posted:
"The authors assessed the association between serum phospholipid fatty acids as biomarkers of fatty acid intake and breast cancer risk among women in the E3N Study (1989-2002), the French component of the European Prospective Investigation into Cancer and Nutrition. During an average of 7 years of follow-up, 363 cases of incident invasive breast cancer were documented among 19,934 women who, at baseline (1995-1998), had completed a diet history questionnaire and provided serum samples. Controls were randomly matched to cases by age, menopausal status at blood collection, fasting status at blood collection, date, and collection center. Serum phospholipid fatty acid composition was assessed by gas chromatography. Adjusted odds ratios for risk of breast cancer with increasing levels of fatty acids were calculated using conditional logistic regression. An increased risk of breast cancer was associated with increasing levels of the trans-monounsaturated fatty acids palmitoleic acid and elaidic acid (highest quintile vs. lowest: odds ratio = 1.75, 95% confidence interval: 1.08, 2.83; p-trend = 0.018). cis-Monounsaturated fatty acids were unrelated to breast cancer risk. A high serum level of trans-monounsaturated fatty acids, presumably reflecting a high intake of industrially processed foods, is probably one factor contributing to increased risk of invasive breast cancer in women."
I guess Kraft Mac-n-Cheese is not supposed to be on my menu for tonight, after all. OTOH, I'm not seeing anything in there about cholesterol or triglycerides--just unsaturated fatty acids that might be coming from processed foods. Or am I missing something? (OK, I didn't read the whole article.)
otter
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Hi Otter,
Great piece of detective work! I wonder if it would be possible to get the entire article in English because the sentence that piqued my interest was the one I bolded above, namely "que le risque de cancer du sein est presque doublé chez les femmes ayant des taux sanguins élevés d'acides gras trans." Translated, this means that breast cancer risk was found to be double that of the control population in women with high blood lipid levels. The article then goes on to say that the source of those high blood fats was a diet rich in commercial foods with large amounts of unhealthy trans fats.
How are things going?
Annie
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Annie,
Since I don't "do" French, I have to resort to on-line translators. The Babel Fish literal translator puts the phrase this way:
"...that the risk of breast cancer is almost doubled among women having raised blood rates of trans fatty acids."
I think the question is the nature of the lipids they were measuring. I no almost zilch about blood lipids or fatty acids or any of that weird chemistry. So, that means I need to send you the paper so you can read it.
Can you get the electronic version of American Journal of Epidemiology through your university library? I searched the journal for the first author's last name (using "American" letters), and I found the paper. I also have access to the paper in pdf format, which of course means I can send it via email. I don't think attachments can be sent via the BCO message system, can they?
TO:
Heather B. Locklear, Great Midwestern University, U.S.A., right?
I am doing well this evening, thanks. I had Kraft Mac-n-Cheese for dinner anyway, plus some healthy veggies, cooked to very soft consistency because of my tender mouth. How are you doing? I can't wait until the day I can enjoy a glass of wine and not have to worry about a sore mouth or indigestion. My dh has kept the wine rack full, but he's the only one partaking.
otter (pm me if you are interested in pursuing this ... I mean the paper, rather than the wine)
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Curious study....and of course, I am an exception.
Perfect lipid profile, ate well...got BC.
My twin sister has high lipids, eats junk and (thankfully) no cancer.
It's a crap shoot.
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Hi all,
Like most language and literature people, I'm pretty much a science and math dud. However, it's my understanding that high trans fat blood levels translate into lots of LDL ("bad" cholesterol) and lowered HDL ("good" cholesterol). In other words, one contributes directly to the other.
The link below leads to a layman's explanation of the already well-established link between trans fats, increased total (and higher "bad") cholesterol, and heart disease. The article I dug up in French and that Otter tracked down in its original English version broadens the discussion of the deleterious effects of high serum levels of trans fats to implicate them in the development of breast cancer as well.
http://heartdisease.about.com/cs/cholesterol/a/Transfat.htm
Otter -- yes, I'd like to read the entire article in English too. I'll PM you my off-BC email address. Thanks for all your hard work!
Love to all,
Annie
PS: They've moved my next chemo up to Monday, and my colleagues are throwing a huge welcome home party for me on Saturday. I don't care -- I'm still having cocktails and some yummy trans fatty hors d'oeuvres.
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Yeah for treats!
I think these all are trends. From what I understand (and I am not excellent at statistics, so I may be wrong), an odds ratio of 1.75 mean that person is 1.75 times more likely to get bc than the average person - but this is the average person WITHOUT known risk factors, which is something like 3%. (For LCIS, the estimated risk is like 7-10 times.) So I think (not sure) that an odds ration of 1.75 would be like 6%, which is much LESS than the average woman's risk of about 8-12% during their lifetime. We also do not know if the risk is additive. Some risk factors are NOT additive. (For example, if you have risk factor A and risk factor B, if they are additive your risk is A+B. If they are not additive, your risk factor may be just A or just B , or some other value.)
On my last lipid panel (It was nonfasting, so it probably doesn't count), I had a 'very desirable' total cholesterol, an 'optimal' LDL, and a horrid HDL (28.) I happened to talk to a guy associated with the Orick study, and he said that wasn't necessarily something to worry about. HDL is the dump truck that carries the bad cholesterol back to the liver. If you don't have too much junk to carry back, then its not so bad. (He's not a physician.) -
Bonjour
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