Wednesday, December 17, 2008

Lifestyle Prevention of Cancer: Anorexia and Teenage Pregnancy

Caloric Restriction and Incidence of Breast Cancer

Karin B. Michels, ScD, MSc, MPH; Anders Ekbom, MD, PhD
JAMA. 2004;291:1226-1230.

Context Restricting caloric intake is one of the most effective ways to extend lifespan and to reduce spontaneous tumor occurrence in experimental animals, but whether similar associations hold in humans has not been appropriately studied.
Objective To determine whether caloric restriction in early life reduces the risk of invasive breast cancer.
Design, Setting, and Participants Retrospective cohort study using data from the Swedish Inpatient Registry, the Swedish Cancer Registry, the Swedish Death Registry, and the Swedish Fertility Registry. Participants were 7303 Swedish women hospitalized for anorexia nervosa prior to age 40 years between 1965 and 1998. Women were excluded (n = 31) if they were diagnosed with cancer prior to their first discharge from hospitalization for anorexia nervosa.
Main Outcome Measure Incidence of invasive breast cancer.
Results Compared with the Swedish general population, women hospitalized for anorexia nervosa prior to age 40 years had a 53% (95% confidence interval [CI], 3%-81%) lower incidence of breast cancer; nulliparous women with anorexia nervosa had a 23% (95% CI, 79% higher to 75% lower) lower incidence, and parous women with anorexia nervosa had a 76% (95% CI, 13%-97%) lower incidence.
Conlusions Severe caloric restriction in humans may confer protection from invasive breast cancer. Low caloric intake prior to first birth followed by a subsequent pregnancy appears to be associated with an even more pronounced reduction in risk

BrooklynDodger(s) comment: Forgive this comment for snarkyness. The Dodger(s) twitch when authorities advocate decreasing disease risk, in this case breast cancer, through "healthy" individual life choices. The other side of that coin is blaming the victim for not making those choices. This framework is rife in the mainstream cancer prevention literature (for example, Cancer Facts from the ACS]: do what your mother told you, eat your vegatables, exercise, don't smoke [the Dodger(s) agree with this, although cancer risks from cigarettes are overestimated, the subject of another post], drink or eat fried food.

The observation of this report is that anorexia, to the point of hospitalization, is associated with up to a 75% reduced risk of breast cancer. The Dodger(s) remember, but couldn't retrieve, a report with a similar result for anorexia combined with teenage pregnancy.

So, to prevent breast cancer, promote anorexia [and maybe other risk behavior] among your daughters.

Contradicting this advice, the Dodger(s) note(s) that persons in the lowest decile of BMI suffer increased mortality from all causes compared to persons who are classified as "overweight" by BMI.

Remember, this ain't the NAS, it's only blogging.

No comments: