Table 2.

Adolescent and early adulthood inflammatory dietary patterna and breast cancer, NHS II, 1989–2011

Quintile of intake
12345Ptrendb
Adolescent inflammatory pattern
 Premenopausal cases
  No. of cases162154180189185
  Person-years131,603133112132,213131,417129,387
  Age-adjusted RR1.000.94 (0.75–1.17)1.11 (0.89–1.38)1.21 (0.97–1.51)1.23 (0.97–1.56)0.02
  Adjusted for adolescent characteristicsc1.000.95 (0.76–1.18)1.11 (0.90–1.39)1.25 (1.00–1.56)1.30 (1.02–1.65)0.007
  Adjusted for adolescent and adult characteristicsd1.000.96 (0.77–1.20)1.14 (0.92–1.42)1.30 (1.04–1.62)1.35 (1.06–1.73)0.002
 Postmenopausal cases
  No. of cases1041089210482
  Person-years42,40941,84842,31443,04144,510
  Age-adjusted RR1.001.03 (0.79–1.35)0.89 (0.67–1.18)0.99 (0.74–1.32)0.78 (0.56–1.08)0.15
  Adjusted for adolescent characteristicsc1.001.03 (0.78–1.35)0.89 (0.67–1.19)0.99 (0.74–1.33)0.82 (0.59–1.14)0.25
  Adjusted for adolescent and adult characteristicsd1.001.03 (0.78–1.36)0.90 (0.67–1.21)1.01 (0.75–1.35)0.84 (0.60–1.17)0.33
 All cases
  No. of cases280297295318287
  Person-years182,457183,842183,627183,743183,080
  Age-adjusted RR1.001.04 (0.88–1.23)1.05 (0.89–1.24)1.13 (0.96–1.34)1.02 (0.85–1.23)0.62
  Adjusted for adolescent characteristicsc1.001.05 (0.89–1.23)1.06 (0.90–1.25)1.16 (0.98–1.37)1.08 (0.89–1.29)0.28
  Adjusted for adolescent and adult characteristicsd1.001.05 (0.89–1.24)1.07 (0.90–1.27)1.18 (1.00–1.40)1.11 (0.92–1.34)0.16
Early adulthood inflammatory pattern
 Premenopausal cases
  No. of cases168163175155161
  Person-years128,118127,650128,066123,731115,401
  Age-adjusted RR1.001.02 (0.82–1.27)1.14 (0.92–1.41)1.06 (0.85–1.32)1.24 (0.99–1.55)0.06
  Adjusted for adolescent characteristicsc1.001.02 (0.82–1.27)1.13 (0.91–1.40)1.04 (0.84–1.30)1.26 (1.00–1.57)0.06
  Adjusted for adolescent and adult characteristicsd1.001.05 (0.85–1.31)1.19 (0.96–1.48)1.12 (0.89–1.40)1.41 (1.11–1.78)0.006
 Postmenopausal cases
  No. of cases124109928756
  Person-years49,73543,10239,88137,05233,510
  Age-adjusted RR1.001.07 (0.82–1.38)0.98 (0.75–1.29)0.98 (0.74–1.30)0.74 (0.54–1.03)0.09
  Adjusted for adolescent characteristicsc1.001.06 (0.82–1.38)0.98 (0.74–1.28)0.97 (0.73–1.28)0.75 (0.54–1.04)0.10
  Adjusted for adolescent and adult characteristicsd1.001.05 (0.81–1.37)0.98 (0.74–1.29)0.99 (0.74–1.32)0.76 (0.54–1.06)0.14
 All cases
  No. of cases313290295267234
  Person-years187,213179,486176,507168,808156,452
  Age-adjusted RR1.001.03 (0.88–1.21)1.09 (0.93–1.28)1.05 (0.89–1.24)1.04 (0.87–1.24)0.62
  Adjusted for adolescent characteristicsc1.001.02 (0.87–1.20)1.08 (0.92–1.27)1.04 (0.88–1.22)1.04 (0.88–1.24)0.60
  Adjusted for adolescent and adult characteristicsd1.001.04 (0.88–1.22)1.11 (0.94–1.30)1.08 (0.91–1.28)1.11 (0.93–1.33)0.22
Average of adolescent and early adult inflammatory pattern
 Premenopausal cases
  No. of cases151162167166176
  Person-years121,899124,191124,665126,767125,443
  Age-adjusted RR1.001.08 (0.86–1.35)1.12 (0.90–1.41)1.14 (0.90–1.43)1.29 (1.02–1.64)0.04
  Adjusted for adolescent characteristicsb1.001.10 (0.88–1.37)1.14 (0.91–1.43)1.16 (0.92–1.45)1.35 (1.06–1.71)0.02
  Adjusted for adolescent and adult characteristicsc1.001.12 (0.89–1.40)1.19 (0.95–1.49)1.23 (0.97–1.55)1.49 (1.16–1.90)0.002
 Postmenopausal cases
  No. of cases931151107773
  Person-years43,07041,07941,19338,75339,186
  Age-adjusted RR1.001.28 (0.97–1.69)1.26 (0.95–1.68)0.95 (0.69–1.30)0.94 (0.67–1.31)0.37
  Adjusted for adolescent characteristicsc1.001.29 (0.97–1.70)1.27 (0.96–1.69)0.95 (0.69–1.31)0.98 (0.70–1.36)0.49
  Adjusted for adolescent and adult characteristicsd1.001.29 (0.97–1.71)1.30 (0.97–1.73)0.95 (0.69–1.31)1.01 (0.71–1.43)0.62
 All cases
  No. of cases263295301270270
  Person-years172,972173,937174,412173,870173,275
  Age-adjusted RR1.001.14 (0.96–1.35)1.18 (0.99–1.39)1.09 (0.91–1.29)1.13 (0.94–1.36)0.30
  Adjusted for adolescent characteristicsc1.001.15 (0.97–1.36)1.19 (1.01–1.41)1.10 (0.92–1.31)1.18 (0.98–1.42)0.16
  Adjusted for adolescent and adult characteristicsd1.001.15 (0.97–1.36)1.22 (1.03–1.44)1.13 (0.94–1.35)1.25 (1.03–1.52)0.04
  • aThe inflammatory pattern is characterized by higher intake of sugar-sweetened and diet soft drinks, refined grains, red and processed meat, margarine, corn, other vegetables, and fish and lower intake of green leafy vegetables, yellow vegetables, cruciferous vegetables, and coffee.

  • bTrend based on median values of each quintile.

  • cAdjusted for age (continuous), total calories in adolescence (continuous), height at age 18 (continuous), age at menarche (<11, 11, 12, 13, 14, 15+), BMI at age 18 (continuous), physical activity in adolescence (<21, 21–35, 36–53, 54–80, 81+ metabolic equivalent tasks/week), and family history of breast cancer (yes, no).

  • dAdjusted for the variables above plus age at first birth (<25, 25–30, 31+ years), parity (nulliparous, 0, 1, 2, 3, 4+), oral contraceptive use (never use, past use <5 years, past use 5+ years, current use <5 years, current use 5–9 years, current use 10+ years), physical activity in adulthood (<3, 3–8, 9–17, 18–26, 27–41, 42+ metabolic equivalent tasks/week), alcohol consumption (non-drinker, <7.5, 7.5–15, 15–29, 30+ grams/day), weight change since age 18 (continuous), and history of benign breast disease (yes, no). In the analyses including postmenopausal women, we additionally adjusted for hormone replacement therapy use (premenopausal, postmenopausal never users, postmenopausal past users, postmenopausal current users) and menopausal status/age at menopause (premenopausal, unknown menopause, <45, 45–46, 47–48, 49–50, 51–52, 53+ years).