Re: Dietary Folate Consumption and Breast Cancer Risk
Bibliographic record
Abstract
Alcohol may increase folate requirements, and low folate intake has been associated with a moderately increased risk of breast cancer in women with relatively high alcohol intake in a Canadian cohort study (1), as well as in the Nurses' Health study (2). Other studies, however, showed no consistent association between folate intake and breast cancer risk (3,4). Alcohol drinking is considerably more frequent in Italian women compared with U.S. or northern European women, and a consistent association was found between alcohol drinking and breast cancer risk in Italy (5,6). We decided, therefore, to consider the effect of folate consumption—and its interaction with alcohol—on the risk of breast cancer. From 1991 through 1994, we conducted a case–control study of breast cancer in six Italian areas (four in the north, one in the center, and one in the south). Case subjects were 2569 women (aged 23–74 years; median = 55 years) with incident, histologically confirmed breast cancer. Control subjects were 2588 women (aged 20–74 years; median = 56 years) admitted to hospitals in the same catchment areas for acute, nonneoplastic diseases (22% traumas, 33% other orthopedic, 15% surgical, 18% eye, and 12% other miscellaneous). Information was collected in the hospital by trained interviewers who used a validated food-frequency questionnaire, including questions on 78 foods or groups of foods, various alcoholic beverages, and the subject's fat-intake pattern (6). To compute nutrient intake, Italian food-composition databases were used (7). To control for confounding, multiple logistic regression was used, including terms for age, center, education, parity, menopausal status, and energy intake. Table 1 gives the distribution of case and control subjects according to quintiles of folate intake and the corresponding odds ratios (ORs) in the overall dataset and in strata of menopausal status and alcohol drinking. The overall OR for women in the highest quintile of folate was 0.73. Although no statistically significant interaction was observed across strata of menopause or alcohol drinking, the inverse association was somewhat stronger in premenopausal women (OR = 0.57) and in heavy alcohol drinkers (≥25 g/day; OR = 0.49). The continuous ORs, however, were statistically nonsignificant for the overall dataset and most strata, indicating that the trends were nonlinear. Likewise, there was no indication that the inverse association between folate consumption and breast cancer risk increased across strata of alcohol drinking, a statistically significant protection being apparently restricted to the high alcohol/high folate stratum. In this study, therefore, no consistent linear association emerged between folic acid intake and breast cancer risk, although the ORs tended to be below unity in the highest quintile of intake. Apparent differences between various studies may be related to levels of intake and to different sources of folates, including supplementation, which is, however, uncommon in Italy. Furthermore, there are uncertainties in dietary assessment of micronutrients by interview and in the validity of measurement of specific micronutrients. These cautions notwithstanding, this study confirms that high folate intake may have a favorable effect in women consuming two or more drinks of alcoholic beverages per day, a group that included more than 20% of case subjects with breast cancer in this Italian dataset. Odds ratio (ORs)* of breast cancer and 95% confidence intervals (CIs) according to quintile of dietary folate intake (Italy, 1991–1994) Odds ratio (ORs)* of breast cancer and 95% confidence intervals (CIs) according to quintile of dietary folate intake (Italy, 1991–1994)
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.003 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".