Dietary Fat Intake and Risk of Uterine Leiomyomata: A Prospective Ultrasound Study

• Published in: American journal of epidemiology Vol. 189; no. 12; pp. 1538 - 1546
• Main Authors: Brasky, Theodore M, Bethea, Traci N, Wesselink, Amelia K, Wegienka, Ganesa R, Baird, Donna D, Wise, Lauren A
• Format: Journal Article
• Language: English
• Published: United States Oxford University Press 01.12.2020; Oxford Publishing Limited (England)
• Subjects: Adult; Black or African American; Black People - statistics & numerical data; Confidence intervals; Diet; Dietary Fats - adverse effects; Dietary intake; Docosahexaenoic acid; Docosahexaenoic Acids - adverse effects; Fatty acids; Female; Fibroids; Humans; Hysterectomy; Incidence; Leiomyoma - diagnostic imaging; Leiomyoma - epidemiology; Leiomyoma - etiology; Michigan - epidemiology; Morbidity; Oils & fats; Original Contribution; Pollutants; Polyunsaturated fatty acids; Prospective Studies; Statistical analysis; Ultrasonic imaging; Ultrasonography; Ultrasound; Uterine Neoplasms - diagnostic imaging; Uterine Neoplasms - epidemiology; Uterine Neoplasms - etiology; Uterus; Michigan; fat; 3 fatty acids; cohort; diet; uterine leiomyoma; ω-3 fatty acids
• ISSN: 0002-9262; 1476-6256; 1476-6256
• DOI: 10.1093/aje/kwaa097

Abstract Uterine leiomyomata (UL) are associated with severe reproductive morbidity and are the primary indication for hysterectomy in the United States. A recent prospective cohort study of Black women reported positive associations between intakes of marine-sourced ω-3 fatty acids and UL risk. We examined whether intakes of dietary fat were associated with UL incidence in a 5-year prospective study of premenopausal Black women living in Detroit who underwent serial ultrasound. At baseline (2010–2012) and 20, 40, and 60 months of follow-up, participants underwent transvaginal ultrasound. Among 1,171 UL-free women at baseline, incident UL were detected in 277 women. Cox regression was used to estimate hazard ratios and 95% confidence intervals for the association of dietary fat and UL incidence. Intakes of total fat and saturated, monounsaturated, polyunsaturated, and trans-fat were not appreciably associated with UL incidence. Intake of the marine ω-3 polyunsaturated fatty acid, docosahexaenoic acid, was associated with 49% higher UL incidence (quartile 4 vs. 1: hazard ratio = 1.49, 95% confidence interval: 1.04, 2.14; P for trend = 0.01). Intakes of total marine ω-3 polyunsaturated fatty acids were similarly associated with elevated UL incidence (hazard ratio = 1.35, 95% confidence interval: 0.94, 1.93; P for trend = 0.03). It remains unclear whether the fatty acids or persistent environmental pollutants drive the association.