Dietary intake of trans fatty acids and breast cancer risk in 9 European countries

Research output: Contribution to journalJournal articleResearchpeer-review


  • Michele Matta
  • Inge Huybrechts
  • Carine Biessy
  • Corinne Casagrande
  • Sahar Yammine
  • Agnes Fournier
  • Karina Standahl Olsen
  • Marco Lukic
  • Inger Torhild Gram
  • Eva Ardanaz
  • Maria-Jose Sanchez
  • Laure Dossus
  • Renee T. Fortner
  • Bernard Srour
  • Franziska Jannasch
  • Matthias B. Schulze
  • Pilar Amiano
  • Antonio Agudo
  • Sandra Colorado-Yohar
  • J. Ramon Quiros
  • Rosario Tumino
  • Salvatore Panico
  • Giovanna Masala
  • Valeria Pala
  • Carlotta Sacerdote
  • Anja Olsen
  • Christina C. Dahm
  • Ann H. Rosendahl
  • Signe Borgquist
  • Maria Wennberg
  • Alicia K. Heath
  • Dagfinn Aune
  • Julie Schmidt
  • Elisabete Weiderpass
  • Veronique Chajes
  • Marc J. Gunter
  • Neil Murphy

Background Trans fatty acids (TFAs) have been hypothesised to influence breast cancer risk. However, relatively few prospective studies have examined this relationship, and well-powered analyses according to hormone receptor-defined molecular subtypes, menopausal status, and body size have rarely been conducted. Methods In the European Prospective Investigation into Cancer and Nutrition (EPIC), we investigated the associations between dietary intakes of TFAs (industrial trans fatty acids [ITFAs] and ruminant trans fatty acids [RTFAs]) and breast cancer risk among 318,607 women. Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models, adjusted for other breast cancer risk factors. Results After a median follow-up of 8.1 years, 13,241 breast cancer cases occurred. In the multivariable-adjusted model, higher total ITFA intake was associated with elevated breast cancer risk (HR for highest vs lowest quintile, 1.14, 95% CI 1.06-1.23; P trend = 0.001). A similar positive association was found between intake of elaidic acid, the predominant ITFA, and breast cancer risk (HR for highest vs lowest quintile, 1.14, 95% CI 1.06-1.23; P trend = 0.001). Intake of total RTFAs was also associated with higher breast cancer risk (HR for highest vs lowest quintile, 1.09, 95% CI 1.01-1.17; P trend = 0.015). For individual RTFAs, we found positive associations with breast cancer risk for dietary intakes of two strongly correlated fatty acids (Spearman correlation r = 0.77), conjugated linoleic acid (HR for highest vs lowest quintile, 1.11, 95% CI 1.03-1.20; P trend = 0.001) and palmitelaidic acid (HR for highest vs lowest quintile, 1.08, 95% CI 1.01-1.16; P trend = 0.028). Similar associations were found for total ITFAs and RTFAs with breast cancer risk according to menopausal status, body mass index, and breast cancer subtypes. Conclusions These results support the hypothesis that higher dietary intakes of ITFAs, in particular elaidic acid, are associated with elevated breast cancer risk. Due to the high correlation between conjugated linoleic acid and palmitelaidic acid, we were unable to disentangle the positive associations found for these fatty acids with breast cancer risk. Further mechanistic studies are needed to identify biological pathways that may underlie these associations.

Original languageEnglish
Article number81
JournalBMC Medicine
Issue number1
Number of pages11
Publication statusPublished - 2021

    Research areas

  • Industrial trans fatty acids, Ruminant trans fatty acids, Breast cancer, Diet

ID: 260089849