Frequency of Consuming Breakfast Meals and After-Dinner Snacks Is not Associated with Postmenopausal Breast Cancer Risk: Women's Health Initiative Observational Study

Valeria Elahy; Cynthia Thomson; Marian L Neuhouser; Luohua Jiang; Sunmin Lee; Kathy Pan; Mara Vitolins; Rowan Chlebowski; Dorothy Lane; Andrew O Odegaard

doi:10.1016/j.tjnut.2023.02.003

Frequency of Consuming Breakfast Meals and After-Dinner Snacks Is not Associated with Postmenopausal Breast Cancer Risk: Women's Health Initiative Observational Study

J Nutr. 2023 Apr;153(4):1089-1100. doi: 10.1016/j.tjnut.2023.02.003. Epub 2023 Feb 8.

Authors

Affiliations

¹ Department of Epidemiology and Biostatistics, University of California, Irvine, CA, USA.
² Department of Health Promotion Sciences, University of Arizona, Tucson, AZ, USA.
³ Cancer Prevention Program, Fred Hutchinson Cancer Center, Seattle, WA, USA.
⁴ Department of Medicine, School of Medicine, University of California, Irvine, CA, USA.
⁵ Department of Hematology/Oncology, Kaiser Permanente Southern California, Downey, CA, USA.
⁶ Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
⁷ Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA.
⁸ Department of Family, Population and Preventive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA.
⁹ Department of Epidemiology and Biostatistics, University of California, Irvine, CA, USA. Electronic address: [email protected].

Abstract

Background: There has been little investigation into how the timing of meals and eating occasions associates with postmenopausal breast cancer risk.

Objective: We examined the association between the frequency of consuming breakfast meals and after-dinner snacks with the risk for postmenopausal breast cancer.

Methods: A prospective analysis of 74,825 postmenopausal women aged 49 to 81 y from the Women's Health Initiative Observational Study cohort. Breakfast and after-dinner snack intake were assessed at year 1 examination. Risk for invasive and in situ breast cancer diagnosed before 28 February 2020 was modeled with multivariable Cox proportional hazards regression models according to breakfast and after-dinner snack consumption frequencies. The models were adjusted for age, self-identified race/ethnicity, education, income, physical activity, smoking, alcohol intake, diet quality score (Healthy Eating Index 2015), energy intake, diabetic status, hormone therapy, and BMI.

Results: During the follow-up period, 5313 participants were diagnosed with invasive breast cancer and 1197 participants with in situ breast cancer. Compared with participants who did not eat breakfast, those with daily breakfast consumption was not associated with invasive breast cancer (HR: 1.04; 95% CI: 0.9, 1.19) nor in situ (HR: 1.25; 95% CI: 0.91, 1.74) breast cancer. There were monotonic higher point estimates of in situ breast cancer for each higher category of breakfast intake from 0 to 7 times per week (P-trend = 0.04, Wald test). Compared with consumption of daily after-dinner snacks, avoidance of after-dinner snacks was not associated with invasive breast cancer (HR: 0.97; 95% CI: 0.87, 1.08) nor in situ (HR: 1.12; 95% CI: 0.89, 1.42) breast cancer.

Conclusions: There was no association between intake frequency of breakfast meals or after-dinner snack habits and with risk of breast cancer in postmenopausal women.

Keywords: after-dinner snack; breakfast; breast cancer; cancer; circadian rhythm; meal timing.

Publication types

Observational Study
Research Support, N.I.H., Extramural

MeSH terms

Breakfast*
Breast Neoplasms* / epidemiology
Energy Intake
Feeding Behavior
Female
Humans
Meals
Postmenopause
Snacks
Women's Health