Full fat sour cream for fish 0 0. That is, we added the residuals of the regression of the intake of dairy foods and calcium on total energy intake, to the predicted intake at mean level of energy intake.
Abstract Background Although some observational studies have associated higher calcium intake and especially higher vitamin D intake and hydroxyvitamin D levels with lower breast cancer risk, no randomized trial has evaluated these relationships.
Mammograms and breast exams were serially conducted. Invasive breast cancer was a secondary outcome. Baseline serum hydroxyvitamin D levels were assessed in a nested case—control study of case patients and control subjects.
A Cox proportional hazards model was used to estimate the risk of breast cancer associated with random assignment to calcium with vitamin D 3.
Associations between hydroxyvitamin D serum levels and total vitamin D intake, body mass index BMIrecreational physical activity, and breast cancer risks were evaluated using logistic regression models.
Statistical tests were two-sided.
In the nested case—control study, no effect of supplement group assignment on breast cancer risk was seen. Conclusions Calcium and vitamin D supplementation did not reduce invasive breast cancer incidence in postmenopausal women. In addition, hydroxyvitamin D levels were not associated with subsequent breast cancer risk.
These findings do not support a relationship between total vitamin D intake and hydroxyvitamin D levels with breast cancer risk. Study design Randomized double-blind placebo-controlled clinical trial of calcium and vitamin D supplementation vs placebo among postmenopausal women and a nested case—control study of associations between baseline serum hydroxyvitamin D levels, breast cancer risk factors, and risk of breast cancer.
Contribution Incidence of invasive breast cancer was similar in the two randomized groups after a mean of 7 years. Baseline serum hydroxyvitamin D levels were correlated with supplement use and were higher among women who did more recreational physical activity and had a lower body mass index BMIbut they were not associated with breast cancer risk after adjustment for BMI and physical activity.
Implications Vitamin D and calcium supplementation has no detectable effect on the risk of postmenopausal invasive breast cancer.
Limitations Additional use of calcium and vitamin D supplements was allowed during the study. The duration of calcium and vitamin D supplementation was short compared with how long it takes to develop breast cancer.
From the Editors Breast cancer is the most common cancer among women in the United States and is the focus of risk reduction efforts 1. Some preclinical 23 and observational 4 studies have reported associations between higher calcium intake and higher vitamin D intake 5—7 and reduced breast cancer risk in postmenopausal women, but the results have not been consistent 8— Against this background, the Women's Health Initiative WHI designed a trial to test the hypothesis that calcium plus vitamin D supplementation would reduce risk of hip fracture as primary endpoint and of colorectal and breast cancer as designated secondary endpoints among postmenopausal women.
The hip fracture and colorectal cancer results have been previously reported 12 Here, we report the breast cancer findings. Details of eligibility criteria and recruitment have been previously described 12 Postmenopausal women aged 50—79 years with life expectancy of more than 3 years, no prior breast cancer, and no other cancer within 10 years were eligible.
Women with history of hypercalcemia, kidney stones, and corticosteroid or calcitriol use were excluded. Personal use of calcium and vitamin D during the study was allowed: Using a permuted block algorithm, eligible women were randomly assigned in a double-blind fashion to active supplement or an identical-appearing placebo both provided by GlaxoSmith Kline stratified by clinical center and age.
Active tablets contained mg of elemental calcium as calcium carbonate combined with IU of vitamin D 3.The median caffeine levels for the reference category were 0 mg/day in five studies [24,] and up to 50 mg/day in another four studies [6,9,28,34]; three studies have higher median caffeine levels for the reference category due to broad categorization [25,27,35].
The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation will be followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of .
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