Biomarker-calibrated energy and protein consumption and increased cancer risk among postmenopausal women

Ross L. Prentice, Pamela A. Shaw, Sheila A. Bingham, Shirley A.A. Beresford, Bette Caan, Marian L. Neuhouser, Ruth E. Patterson, Marcia L. Stefanick, Suzanne Satterfield, Cynthia A. Thomson, Linda Snetselaar, Asha Thomas, Lesley F. Tinker

Research output: Contribution to journalArticle

68 Scopus citations

Abstract

The authors previously reported equations, derived from the Nutrient Biomarker Study within the Women's Health Initiative, that produce calibrated estimates of energy, protein, and percentage of energy from protein consumption from corresponding food frequency questionnaire estimates and data on other factors, such as body mass index, age, and ethnicity. Here, these equations were applied to yield calibrated consumption estimates for 21,711 women enrolled in the Women's Health Initiative dietary modification trial comparison group and 59,105 women enrolled in the observational study. These estimates were related prospectively to total and site-specific invasive cancer incidence (1993-2005). In combined cohort analyses that do not control for body mass, uncalibrated energy was not associated with total cancer incidence or site-specific cancer incidence for most sites, whereas biomarker-calibrated energy was positively associated with total cancer (hazard ratio=1.18, 95% confidence interval: 1.10, 1.27, for 20% consumption increase), as well as with breast, colon, endometrial, and kidney cancer (respective hazard ratios of 1.24, 1.35, 1.83, and 1.47). Calibrated protein was weakly associated, and calibrated percentage of energy from protein was inversely associated, with total cancer. Calibrated energy and body mass index associations were highly interdependent. Implications for the interpretation of nutritional epidemiology studies are described.

Original languageEnglish (US)
Pages (from-to)977-989
Number of pages13
JournalAmerican journal of epidemiology
Volume169
Issue number8
DOIs
StatePublished - Apr 2009

Keywords

  • Bias (epidemiology)
  • Biological markers
  • Diet
  • Energy intake
  • Epidemiologic methods
  • Neoplasms
  • Nutrition assessment
  • Proteins

ASJC Scopus subject areas

  • Epidemiology

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    Prentice, R. L., Shaw, P. A., Bingham, S. A., Beresford, S. A. A., Caan, B., Neuhouser, M. L., Patterson, R. E., Stefanick, M. L., Satterfield, S., Thomson, C. A., Snetselaar, L., Thomas, A., & Tinker, L. F. (2009). Biomarker-calibrated energy and protein consumption and increased cancer risk among postmenopausal women. American journal of epidemiology, 169(8), 977-989. https://doi.org/10.1093/aje/kwp008