© 2003 by Oxford University Press
Journal of the National Cancer Institute, Vol. 95, No. 2, 132-141,
January 15, 2003
© 2003 Oxford University Press
ARTICLE |
Diet and Sex Hormones in Girls: Findings From a Randomized Controlled Clinical Trial
Affiliations of authors: J. F. Dorgan, Fox Chase Cancer Center, Philadelphia, PA; S. A. Hunsberger (Division of Cancer Treatment and Diagnosis), S. F. Greenhut (Office of Cancer Genomics), B. H. Patterson (Division of Cancer Prevention), A. Schatzkin (Division of Cancer Epidemiology and Genetics), P. R. Taylor (Center for Cancer Research), National Cancer Institute, Bethesda, MD; R. P. McMahon, Maryland Psychiatric Research Center, University of Maryland, Baltimore; P. O. Kwiterovich, Jr., Johns Hopkins University Hospital, Baltimore, MD; R. M. Lauer, L. G. Snetselaar, University of Iowa, Iowa City; L. Van Horn, Northwestern University Medical School, Chicago, IL; N. L. Lasser, University of Medicine and Dentistry of New Jersey, Newark; V. J. Stevens, Kaiser Permanente Center for Health Research, Portland, OR; L. A. Friedman, B. A. Barton, Maryland Medical Research Institute, Baltimore; J. A. Yanovski, Unit on Growth and Obesity, National Institute of Child Health and Human Development, Bethesda; D. W. Chandler, Esoterix Endocrinology, Inc., Calabasas Hills, CA; F. A. Franklin, Children’s Hospital of Alabama, Birmingham; D. W. Buckman, Information Management Services, Inc., Silver Spring, MD.
Correspondence to: Joanne F. Dorgan, M.P.H., Ph.D., Fox Chase Cancer Center, 7701 Burholme Ave., Philadelphia, PA 19111 (e-mail: jf_dorgan{at}fccc.edu).
Background: Results of several studies have suggested that diet during adolescence may influence the risk of breast cancer in adulthood. We evaluated whether an intervention to lower fat intake among adolescent girls altered their serum concentrations of sex hormones that, in adults, are related to breast cancer development. Methods: We conducted an ancillary hormone study among 286 of the 301 girls who participated between 1988 and 1997 in the Dietary Intervention Study in Children, in which healthy, prepubertal, 8- to 10-year-olds with elevated low-density lipoprotein cholesterol were randomly assigned to usual care or to a behavioral intervention that promoted a low-fat diet. Median time on the intervention was 7 years. Blood samples collected before randomization and at the year 1, year 3, year 5, and last visits were assayed to determine the girls’ serum levels of sex hormones. All P values are two-sided. Results: At the year 5 visit, girls in the intervention group had 29.8% (95% confidence interval [CI] = 5.4% to 47.9%; P = .02) lower estradiol, 30.2% (95% CI = 7.0% to 47.7%; P = .02) lower non-sex hormone binding globulin-bound estradiol, 20.7% (95% CI = 4.7% to 34.0%; P = .02) lower estrone, and 28.7% (95% CI = 5.1% to 46.5%; P = .02) lower estrone sulfate levels during the follicular phase of the menstrual cycle and 27.2% (95% CI = 5.7% to 53.1%; P = .01) higher testosterone levels during the luteal phase of the menstrual cycle than did girls in the usual care group. At the last visit, the luteal phase progesterone level was 52.9% (95% CI = 20.0% to 72.3%) lower for girls in the intervention group than for girls in the usual care group (P = .007). Conclusion: Modest reductions in fat intake during puberty are associated with changes in sex hormone concentrations that are consistent with alterations in the function of the hypothalamic–pituitary–ovarian axis. Whether these changes influence breast cancer risk is currently unknown.
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