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Vitamin D intake and lung cancer risk in the Women's Health Initiative.

ABSTRACT: Prior research suggests that vitamin D protects against lung cancer only among certain subgroups.We investigated whether vitamin D intake was associated with lung cancer and explored whether vitamin A intake modified the association.Prospective cohort data from 128,779 postmenopausal women, including 1771 incident lung cancers in the Women's Health Initiative (Clinical Trials and Observational Study) 1993-2010, were analyzed. Twelve percent of women received active intervention (1 g Ca + 400 IU vitamin D3/d) in the Calcium/Vitamin D Trial. Baseline total intake included both dietary intake (from food-frequency questionnaires) and supplement intake (from bottle labels). HRs were estimated by Cox proportional hazard models.No significant association was observed overall. Among never smokers, a total vitamin D intake ?400 IU/d was significantly associated with lower risks of lung cancer (HR: 0.37; 95% CI: 0.18, 0.77 for ?800 compared with <100 IU/d; P-trend = 0.01). No significant effect modification of total vitamin A intake on the association between total vitamin D intake and lung cancer was found. However, the Calcium/Vitamin D Trial active intervention was significantly associated with a lower lung cancer risk only among women with a vitamin A intake <1000 ?g/d retinol activity equivalents (HR: 0.69; 95% CI: 0.50, 0.96; P-interaction = 0.09).Vitamin D intake was associated with a lower lung cancer risk in never-smoking, postmenopausal women. Lower vitamin A intake may be important for a beneficial association of 1 g Ca + 400 IU vitamin D3 supplementation with lung cancer. This trial was registered at clinicaltrials.gov as NCT00000611.

SUBMITTER: Cheng TY

PROVIDER: S-EPMC3778856 | biostudies-literature | 2013 Oct

REPOSITORIES: biostudies-literature

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Vitamin D intake and lung cancer risk in the Women's Health Initiative.

Cheng Ting-Yuan David TY Lacroix Andrea Z AZ Beresford Shirley A A SA Goodman Gary E GE Thornquist Mark D MD Zheng Yingye Y Chlebowski Rowan T RT Ho Gloria Y F GY Neuhouser Marian L ML

The American journal of clinical nutrition 20130821 4

<h4>Background</h4>Prior research suggests that vitamin D protects against lung cancer only among certain subgroups.<h4>Objectives</h4>We investigated whether vitamin D intake was associated with lung cancer and explored whether vitamin A intake modified the association.<h4>Design</h4>Prospective cohort data from 128,779 postmenopausal women, including 1771 incident lung cancers in the Women's Health Initiative (Clinical Trials and Observational Study) 1993-2010, were analyzed. Twelve percent of ...[more]

PMID: 23966428

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Project description:BackgroundNutrient-related anemia among postmenopausal women is preventable; recent data on prevalence are limited.ObjectiveTo investigate the association between nutrient intakes and anemia prevalence, in relation to both incidence and persistence, in a longitudinal sample of postmenopausal women. We hypothesized that anemia prevalence, incidence, and persistence would be greater among women reporting lower intake of vitamin B-12, folate, and iron.DesignProspective cohort analysis.Participants/settingThe observational cohort of the Women's Health Initiative, including 93,676 postmenopausal women, aged 50 to 79 years, who were recruited across the United States at 40 clinical study sites. Women were enrolled between 1993 and 1998; data collection for these analyses continued through 2000.Main outcome measuresAnemia was defined as a blood hemoglobin concentration of <12.0 g/dL (120.0 g/L). Persistent anemia was defined as anemia present at each measurement time point. Diet was assessed by food frequency questionnaire for iron, folate, B-12, red meat, and cold breakfast cereal; inadequacies were based on dietary reference intakes for women older than age 50 years.Statistical analysisDescriptive statistics (mean ± standard deviation) were used to characterize the population demographics, anemia rates, and diet. Unconditional logistic regression was used to investigate associations between diet and incident and persistent anemia. Associations are presented as odds ratio and 95% confidence intervals.ResultsAnemia was identified in 3,979 (5.5%) of the cohort. Inadequate intakes of multiple anemia-associated nutrients were less frequent in non-Hispanic whites (7.4%) than other race/ethnic groups (inadequacies demonstrated in 14.6% to 16.3% of the sample). Age, body mass index, and smoking were associated with anemia. Women with anemia reported lower intakes of energy, protein, folate, vitamin B-12, iron, vitamin C, and red meat. Multiple (more than a single nutrient) dietary deficiencies were associated with a 21% greater risk of persistent anemia (odds ratio 1.21, 95% confidence interval 1.05 to 1.41) and three deficiencies resulted in a 44% increase in risk for persistent anemia (odds ratio 1.44, 95% confidence interval 1.20 to 1.73).ConclusionsInadequate nutrient intake, a modifiable condition, is associated with greater risk for anemia in postmenopausal women participating in the Observational Study of the Women's Health Initiative. Efforts to identify and update incidence estimates for anemia-associated nutrient deficiencies in aging women should be undertaken.

Dataset Information

Vitamin D intake and lung cancer risk in the Women's Health Initiative.

Publications

Vitamin D intake and lung cancer risk in the Women's Health Initiative.

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