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Saturated, mono- and polyunsaturated fatty acid intake and cancer risk: results from the French prospective cohort NutriNet-Santé

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Abstract

Purpose

Lipid intakes such as saturated (SFA), monounsaturated (MUFA) and polyunsaturated (PUFA) fatty acids have been widely studied regarding cardiovascular health, but their relevance to cancer is unclear. Inconsistent epidemiological results may be explained by varied mechanisms involving PUFAs and redox balance, inflammatory status and cell signalling, along with interactions with other dietary components such as antioxidants, dietary fibre and more generally fruits and vegetable intakes. Therefore, this study aimed to investigate the associations between lipid intakes and cancer risk, and their potential modulation by vitamin C, vitamin E, dietary fibre and fruit and vegetable intakes.

Methods

This prospective study included 44,039 participants aged ≥ 45 years from the NutriNet-Santé cohort (2009–2017). Dietary data were collected using repeated 24 h-dietary records. Multivariable Cox models were performed to characterize associations.

Results

SFA intake was associated with increased overall [n = 1722 cases, HRQ5vsQ1 = 1.44 (1.10–1.87), p-trend = 0.008] and breast [n = 545 cases, HRQ5vsQ1 = 1.98 (1.24–3.17), p-trend = 0.01] cancer risks. n-6 PUFA [HRQ5vsQ1 = 0.56 (0.32–0.97), p-trend = 0.01] and MUFA (HRQ5vsQ1 = 0.41 [0.18-0.0.95), p-trend = 0.009] intakes were associated with a decreased risk of digestive cancers (n = 190 cases). Associations between n-6 PUFA, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) intakes and digestive cancer risk were modulated by dietary fibre, vitamin C and fruit and vegetable intakes.

Conclusion

These findings suggested that SFA intake could increase overall and breast cancer risks while some unsaturated fatty acids could decrease digestive cancer risk. However, in line with mechanistic hypotheses, our results suggest that intakes of fruits and vegetables and their constituents (antioxidants, fibre) may interact with PUFAs to modulate these associations.

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Abbreviations

DHA:

Docosahexaenoic acid

DPA:

Docosapentaenoic acid

EPA:

Eicosapentaenoic acid

PUFAs:

Polyunsaturated fatty acids

MUFAs:

Monounsaturated fatty acids

SFAs:

Saturated fatty acids

HR:

Hazard ratio

CI:

Confidence interval

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Acknowledgements

The authors thank all the volunteers of the NutriNet-Santé cohort. We also thank Frédéric Coffinieres, Thi Hong Van Duong, Younes Esseddik (IT manager), Paul Flanzy, Régis Gatibelza, Jagatjit Mohinder and Maithyly Sivapalan (computer scientists); and Julien Allegre, Nathalie Arnault, Laurent Bourhis, Véronique Gourlet, PhD and Fabien Szabo de Edelenyi, PhD (manager) (data-manager/biostatisticians) for their technical contribution to the NutriNet-Santé study and Nathalie Druesne-Pecollo, PhD (operational coordination).

Funding

The NutriNet-Santé study was supported by the following public institutions: Ministère de la Santé, Institut de Veille Sanitaire (InVS), Institut National de la Prévention et de l’Education pour la Santé (INPES), Région Ile-de-France (CORDDIM), Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Recherche Agronomique (INRA), Conservatoire National des Arts et Métiers (CNAM) and Université Paris 13. Mélanie Deschasaux and Philippine Fassier were funded by a PhD Grant from the Cancéropôle Ile de France/Région Ile de France (public funding). Bernard Srour was funded by the French National Cancer Institute (grant number INCa_8085).

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Authors and Affiliations

  1. Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), U1153 Inserm, U1125, Inra, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), Bobigny, France

    Laury Sellem, Bernard Srour, Emmanuelle Kesse-Guyot, Thibault Fiolet, Céline Lavalette, Manon Egnell, Paule Latino-Martel, Philippine Fassier, Serge Hercberg, Pilar Galan, Mélanie Deschasaux & Mathilde Touvier

  2. INRA UMR1331, TOXALIM (Research Center in Food Toxicology), Université de Toulouse, ENVT, INP, Toulouse, France

    Françoise Guéraud & Fabrice Pierre

Authors
  1. Laury Sellem
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  2. Bernard Srour
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  3. Françoise Guéraud
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  4. Fabrice Pierre
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  11. Serge Hercberg
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  13. Mélanie Deschasaux
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  14. Mathilde Touvier
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Contributions

LS and MT: designed the research; SH, PG, EKG, MT: conducted the research; LS: performed statistical analysis; MT: supervised statistical analysis; LS and MT: wrote the paper; LS, BS, FG, FP, EKG, TF, CL, ME, PLM, PF, SH, PG, MD, and MT: contributed to the data interpretation and revised each draft for important intellectual content. All authors read and approved the final manuscript. MT had primary responsibility for the final content. None of the authors reported a conflict of interest related to the study. The funders had no role in the design, implementation, analysis, or interpretation of the data. This research was performed in the framework of the French network for Nutrition And Cancer Research (NACRe network).

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Correspondence to Bernard Srour.

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Sellem, L., Srour, B., Guéraud, F. et al. Saturated, mono- and polyunsaturated fatty acid intake and cancer risk: results from the French prospective cohort NutriNet-Santé. Eur J Nutr 58, 1515–1527 (2019). https://doi.org/10.1007/s00394-018-1682-5

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