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Soy Food Consumption, Exercise, and Body Mass Index and Osteoporotic Fracture Risk Among Breast Cancer Survivors: The Shanghai Breast Cancer Survival Study
Breast cancer survivors have a high incidence of osteoporosis-related fractures; the associated factors are understudied. We investigated incidence of bone fracture and its associations with soy food consumption, exercise, and body mass index among breast cancer survivors. This prospective study inc...
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| Published in: | JNCI cancer spectrum 2019-06, Vol.3 (2), p.pkz017-pkz017 |
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| creator | Zheng, Neil Hsieh, Evelyn Cai, Hui Shi, Liang Gu, Kai Zheng, Ying Bao, Ping-Ping Shu, Xiao-Ou |
| description | Breast cancer survivors have a high incidence of osteoporosis-related fractures; the associated factors are understudied. We investigated incidence of bone fracture and its associations with soy food consumption, exercise, and body mass index among breast cancer survivors.
This prospective study included 4139 stage 0-III breast cancer patients and 1987 pre-/perimenopausal and 2152 postmenopausal patients. Fractures were assessed at 18 months and at 3, 5, and 10 years after cancer diagnosis. Osteoporotic fractures were defined as fractures caused by falls from standing height and at sites associated with osteoporosis. Exercise and soy isoflavone intake were assessed at 6 and 18 months postdiagnosis. Weight and height were measured at baseline. Lifetable and Cox regression analyses were employed. All statistical tests were two sided.
The 10-year incidence for osteoporotic fractures was 2.9% and 4.4% for pre-/perimenopausal and postmenopausal patients, respectively. High soy isoflavone intake was associated with reduced risk among pre-/perimenopausal patients (hazard ratio [HR] = 0.22, 95% confidence interval [CI] = 0.09 to 0.53, for soy isoflavone mg/d ≥56.06 vs |
| doi_str_mv | 10.1093/jncics/pkz017 |
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This prospective study included 4139 stage 0-III breast cancer patients and 1987 pre-/perimenopausal and 2152 postmenopausal patients. Fractures were assessed at 18 months and at 3, 5, and 10 years after cancer diagnosis. Osteoporotic fractures were defined as fractures caused by falls from standing height and at sites associated with osteoporosis. Exercise and soy isoflavone intake were assessed at 6 and 18 months postdiagnosis. Weight and height were measured at baseline. Lifetable and Cox regression analyses were employed. All statistical tests were two sided.
The 10-year incidence for osteoporotic fractures was 2.9% and 4.4% for pre-/perimenopausal and postmenopausal patients, respectively. High soy isoflavone intake was associated with reduced risk among pre-/perimenopausal patients (hazard ratio [HR] = 0.22, 95% confidence interval [CI] = 0.09 to 0.53, for soy isoflavone mg/d ≥56.06 vs <31.31;
< .001) but not among postmenopausal patients (
< .01). Overweight (vs normal weight) was a risk factor for pre-/perimenopausal patients (HR = 1.81, 95% CI = 1.04 to 3.14) but not for postmenopausal patients (HR = 0.67, 95% CI = 0.43 to 1.03;
= .01). Exercise was inversely associated with osteoporotic fractures in postmenopausal patients (HR = 0.56, 95% CI = 0.33 to 0.97, for metabolic equivalents hours ≥12.6 vs <4.5) following a dose-response pattern (
= .035), an association not modified by menopausal status.
Our findings, especially the novel association of soy food intake with osteoporotic fractures in breast cancer survivors, if confirmed, can help guide future strategies for fracture risk reduction in this vulnerable population.</description><identifier>ISSN: 2515-5091</identifier><identifier>EISSN: 2515-5091</identifier><identifier>DOI: 10.1093/jncics/pkz017</identifier><identifier>PMID: 31157323</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Angiogenesis inhibitors ; Body mass index ; Breast cancer ; Cancer diagnosis ; Cancer patients ; Cancer research ; Cancer survivors ; Exercise ; Food consumption ; Fractures (Injuries) ; Health aspects ; Isoflavones ; Measurement ; Medical research ; Menopause ; Novels ; Obesity ; Osteoporosis ; Physiological aspects ; Postmenopausal women ; Risk factors</subject><ispartof>JNCI cancer spectrum, 2019-06, Vol.3 (2), p.pkz017-pkz017</ispartof><rights>COPYRIGHT 2019 Oxford University Press</rights><rights>The Author(s) 2019. Published by Oxford University Press. 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c426t-9dcfc5ecf8ac434f6421f1ef52b90a9f23b51d7dce03cb7816761b3fed92ad363</citedby><cites>FETCH-LOGICAL-c426t-9dcfc5ecf8ac434f6421f1ef52b90a9f23b51d7dce03cb7816761b3fed92ad363</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6527440/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6527440/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31157323$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zheng, Neil</creatorcontrib><creatorcontrib>Hsieh, Evelyn</creatorcontrib><creatorcontrib>Cai, Hui</creatorcontrib><creatorcontrib>Shi, Liang</creatorcontrib><creatorcontrib>Gu, Kai</creatorcontrib><creatorcontrib>Zheng, Ying</creatorcontrib><creatorcontrib>Bao, Ping-Ping</creatorcontrib><creatorcontrib>Shu, Xiao-Ou</creatorcontrib><title>Soy Food Consumption, Exercise, and Body Mass Index and Osteoporotic Fracture Risk Among Breast Cancer Survivors: The Shanghai Breast Cancer Survival Study</title><title>JNCI cancer spectrum</title><addtitle>JNCI Cancer Spectr</addtitle><description>Breast cancer survivors have a high incidence of osteoporosis-related fractures; the associated factors are understudied. We investigated incidence of bone fracture and its associations with soy food consumption, exercise, and body mass index among breast cancer survivors.
This prospective study included 4139 stage 0-III breast cancer patients and 1987 pre-/perimenopausal and 2152 postmenopausal patients. Fractures were assessed at 18 months and at 3, 5, and 10 years after cancer diagnosis. Osteoporotic fractures were defined as fractures caused by falls from standing height and at sites associated with osteoporosis. Exercise and soy isoflavone intake were assessed at 6 and 18 months postdiagnosis. Weight and height were measured at baseline. Lifetable and Cox regression analyses were employed. All statistical tests were two sided.
The 10-year incidence for osteoporotic fractures was 2.9% and 4.4% for pre-/perimenopausal and postmenopausal patients, respectively. High soy isoflavone intake was associated with reduced risk among pre-/perimenopausal patients (hazard ratio [HR] = 0.22, 95% confidence interval [CI] = 0.09 to 0.53, for soy isoflavone mg/d ≥56.06 vs <31.31;
< .001) but not among postmenopausal patients (
< .01). Overweight (vs normal weight) was a risk factor for pre-/perimenopausal patients (HR = 1.81, 95% CI = 1.04 to 3.14) but not for postmenopausal patients (HR = 0.67, 95% CI = 0.43 to 1.03;
= .01). Exercise was inversely associated with osteoporotic fractures in postmenopausal patients (HR = 0.56, 95% CI = 0.33 to 0.97, for metabolic equivalents hours ≥12.6 vs <4.5) following a dose-response pattern (
= .035), an association not modified by menopausal status.
Our findings, especially the novel association of soy food intake with osteoporotic fractures in breast cancer survivors, if confirmed, can help guide future strategies for fracture risk reduction in this vulnerable population.</description><subject>Angiogenesis inhibitors</subject><subject>Body mass index</subject><subject>Breast cancer</subject><subject>Cancer diagnosis</subject><subject>Cancer patients</subject><subject>Cancer research</subject><subject>Cancer survivors</subject><subject>Exercise</subject><subject>Food consumption</subject><subject>Fractures (Injuries)</subject><subject>Health aspects</subject><subject>Isoflavones</subject><subject>Measurement</subject><subject>Medical research</subject><subject>Menopause</subject><subject>Novels</subject><subject>Obesity</subject><subject>Osteoporosis</subject><subject>Physiological aspects</subject><subject>Postmenopausal women</subject><subject>Risk factors</subject><issn>2515-5091</issn><issn>2515-5091</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNptks1O3DAURiPUChBl2W3lZRcE_BMn4y4qDSOmRQIhdejacuzrGUNip3YyYniVvmxDQxFIlRe2ro-P7pW_LPtI8CnBgp3dee10OuvuHzGp9rJDygnPORbk3avzQXac0h3GmAghuCj3swNGCK8YZYfZ71XYoWUIBi2CT0Pb9S74E3TxAFG7BCdIeYPOg9mha5USuvQGHv7WblIPoQsx9E6jZVS6HyKgHy7do3kb_BqdR1CpRwvlNUS0GuLWbUNMX9DtBtBqo_x6o9x_KdWgVT-Y3YfsvVVNguPn_Sj7uby4XXzPr26-XS7mV7kuaNnnwmirOWg7U7pghS0LSiwBy2ktsBKWspoTUxkNmOm6mpGyKknNLBhBlWElO8q-Tt5uqFsYOd9H1cguulbFnQzKybc33m3kOmxlyWlVFHgUfH4WxPBrgNTL1iUNTaM8hCFJSllRzPCs4CN6OqFr1YB03obRqMdloHU6eLBurM9Lwikb9U_N5dMDHUNKEexLXwTLpxDIKQRyCsHIf3o9zAv978vZH8DZstQ</recordid><startdate>20190601</startdate><enddate>20190601</enddate><creator>Zheng, Neil</creator><creator>Hsieh, Evelyn</creator><creator>Cai, Hui</creator><creator>Shi, Liang</creator><creator>Gu, Kai</creator><creator>Zheng, Ying</creator><creator>Bao, Ping-Ping</creator><creator>Shu, Xiao-Ou</creator><general>Oxford University Press</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20190601</creationdate><title>Soy Food Consumption, Exercise, and Body Mass Index and Osteoporotic Fracture Risk Among Breast Cancer Survivors: The Shanghai Breast Cancer Survival Study</title><author>Zheng, Neil ; Hsieh, Evelyn ; Cai, Hui ; Shi, Liang ; Gu, Kai ; Zheng, Ying ; Bao, Ping-Ping ; Shu, Xiao-Ou</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c426t-9dcfc5ecf8ac434f6421f1ef52b90a9f23b51d7dce03cb7816761b3fed92ad363</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Angiogenesis inhibitors</topic><topic>Body mass index</topic><topic>Breast cancer</topic><topic>Cancer diagnosis</topic><topic>Cancer patients</topic><topic>Cancer research</topic><topic>Cancer survivors</topic><topic>Exercise</topic><topic>Food consumption</topic><topic>Fractures (Injuries)</topic><topic>Health aspects</topic><topic>Isoflavones</topic><topic>Measurement</topic><topic>Medical research</topic><topic>Menopause</topic><topic>Novels</topic><topic>Obesity</topic><topic>Osteoporosis</topic><topic>Physiological aspects</topic><topic>Postmenopausal women</topic><topic>Risk factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zheng, Neil</creatorcontrib><creatorcontrib>Hsieh, Evelyn</creatorcontrib><creatorcontrib>Cai, Hui</creatorcontrib><creatorcontrib>Shi, Liang</creatorcontrib><creatorcontrib>Gu, Kai</creatorcontrib><creatorcontrib>Zheng, Ying</creatorcontrib><creatorcontrib>Bao, Ping-Ping</creatorcontrib><creatorcontrib>Shu, Xiao-Ou</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>JNCI cancer spectrum</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zheng, Neil</au><au>Hsieh, Evelyn</au><au>Cai, Hui</au><au>Shi, Liang</au><au>Gu, Kai</au><au>Zheng, Ying</au><au>Bao, Ping-Ping</au><au>Shu, Xiao-Ou</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Soy Food Consumption, Exercise, and Body Mass Index and Osteoporotic Fracture Risk Among Breast Cancer Survivors: The Shanghai Breast Cancer Survival Study</atitle><jtitle>JNCI cancer spectrum</jtitle><addtitle>JNCI Cancer Spectr</addtitle><date>2019-06-01</date><risdate>2019</risdate><volume>3</volume><issue>2</issue><spage>pkz017</spage><epage>pkz017</epage><pages>pkz017-pkz017</pages><issn>2515-5091</issn><eissn>2515-5091</eissn><abstract>Breast cancer survivors have a high incidence of osteoporosis-related fractures; the associated factors are understudied. We investigated incidence of bone fracture and its associations with soy food consumption, exercise, and body mass index among breast cancer survivors.
This prospective study included 4139 stage 0-III breast cancer patients and 1987 pre-/perimenopausal and 2152 postmenopausal patients. Fractures were assessed at 18 months and at 3, 5, and 10 years after cancer diagnosis. Osteoporotic fractures were defined as fractures caused by falls from standing height and at sites associated with osteoporosis. Exercise and soy isoflavone intake were assessed at 6 and 18 months postdiagnosis. Weight and height were measured at baseline. Lifetable and Cox regression analyses were employed. All statistical tests were two sided.
The 10-year incidence for osteoporotic fractures was 2.9% and 4.4% for pre-/perimenopausal and postmenopausal patients, respectively. High soy isoflavone intake was associated with reduced risk among pre-/perimenopausal patients (hazard ratio [HR] = 0.22, 95% confidence interval [CI] = 0.09 to 0.53, for soy isoflavone mg/d ≥56.06 vs <31.31;
< .001) but not among postmenopausal patients (
< .01). Overweight (vs normal weight) was a risk factor for pre-/perimenopausal patients (HR = 1.81, 95% CI = 1.04 to 3.14) but not for postmenopausal patients (HR = 0.67, 95% CI = 0.43 to 1.03;
= .01). Exercise was inversely associated with osteoporotic fractures in postmenopausal patients (HR = 0.56, 95% CI = 0.33 to 0.97, for metabolic equivalents hours ≥12.6 vs <4.5) following a dose-response pattern (
= .035), an association not modified by menopausal status.
Our findings, especially the novel association of soy food intake with osteoporotic fractures in breast cancer survivors, if confirmed, can help guide future strategies for fracture risk reduction in this vulnerable population.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>31157323</pmid><doi>10.1093/jncics/pkz017</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Angiogenesis inhibitors Body mass index Breast cancer Cancer diagnosis Cancer patients Cancer research Cancer survivors Exercise Food consumption Fractures (Injuries) Health aspects Isoflavones Measurement Medical research Menopause Novels Obesity Osteoporosis Physiological aspects Postmenopausal women Risk factors |
| title | Soy Food Consumption, Exercise, and Body Mass Index and Osteoporotic Fracture Risk Among Breast Cancer Survivors: The Shanghai Breast Cancer Survival Study |
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