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

Research output: Contribution to journalArticle


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.


  • Michèle Matta
  • Inge Huybrechts
  • Carine Biessy
  • Corinne Casagrande
  • Sahar Yammine
  • Agnès Fournier
  • Karina Standahl Olsen
  • Marco Lukic
  • Inger Torhild Gram
  • Eva Ardanaz
  • Maria José Sánchez
  • Laure Dossus
  • Renée T. Fortner
  • Bernard Srour
  • Franziska Jannasch
  • Matthias B. Schulze
  • Pilar Amiano
  • Antonio Agudo
  • Sandra Colorado-Yohar
  • J. Ramón Quirós
  • Rosario Tumino
  • Salvatore Panico
  • Giovanna Masala
  • Valeria Pala
  • Carlotta Sacerdote
  • Anne Tjønneland
  • Anja Olsen
  • Christina C. Dahm
  • Maria Wennberg
  • Alicia K. Heath
  • Dagfinn Aune
  • Julie Schmidt
  • Elisabete Weiderpass
  • Veronique Chajes
  • Marc J. Gunter
  • Neil Murphy
External organisations
  • International Agency for Research on Cancer, World Health Organization
  • UiT The Arctic University of Norway, Tromsø
  • Health Research Institute of Navarra (IDISNA)
  • CIBER Epidemiology and Public Health (CIBERESP)
  • Andalusian School Of Public Health (EASP)
  • University of Granada
  • German Cancer Research Centre
  • German Institute of Human Nutrition
  • German Center for Diabetes Research
  • Biodonostia Health Research Institute
  • Bellvitge Biomedical Research Institute
  • Murcia Regional Health Council
  • University of Antioquia
  • Public Health Directorate
  • University of Naples Federico II
  • Institute for Cancer Research, Prevention and Clinical Network (ISPRO)
  • Istituto Nazionale dei Tumori
  • Citta' della Salute e della Scienza Hospital-University of Turin
  • Danish Cancer Society Research Center
  • University of Copenhagen
  • Aarhus University
  • Skåne University Hospital
  • Aarhus University Hospital
  • Umeå University
  • Imperial College London
  • Bjørknes University College
  • Oslo university hospital
  • University of Oxford
  • University of Paris-Sud
  • University of Paris-Saclay
  • NutriAct - Competence Cluster Nutrition Research Berlin-Potsdam
  • L'Hospitalet de Llobregat, Barcelona
  • Provincial Health Authority (ASP) Ragusa
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cancer and Oncology
  • Nutrition and Dietetics
  • Public Health, Global Health, Social Medicine and Epidemiology


  • Breast cancer, Diet, Industrial trans fatty acids, Ruminant trans fatty acids
Original languageEnglish
Article number81
JournalBMC Medicine
Issue number1
Publication statusPublished - 2021
Publication categoryResearch