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Brian C.-H. Chiu, MS; James R. Cerhan, MD, PhD; Aaron R. Folsom, MD; Thomas A. Sellers, PhD; Lawrence H. Kushi, ScD; Robert B. Wallace, MD; Wei Zheng, MD, PhD; John D. Potter, MD, PhD

JAMA. 1996;275(17):1315-1321.

Abstract
Objective.
—To test whether high dietary intakes of fat, protein, and milk are associated with the development of non-Hodgkin lymphoma in older women.

Design.
—Prospective cohort study with a 7-year follow-up period.

Setting.
—General community.

Participants.
—Sample of 35156 Iowa women aged 55 to 69 years with no prior history of cancer who returned the 1986 baseline questionnaire.

Main Outcome Measure.
—Non-Hodgkin lymphoma (104 incident cases).

Main Results.
—After controlling for age, marital status, residence, total energy intake, and transfusion history, the relative risks (RRs) for the highest tertile of intake compared with the lowest were 2.00 (95% confidence interval [CI], 1.21-3.30; P for trend=.01) for animal fat, 1.69 (95% CI, 1.07-2.67; P for trend=.02) for saturated fat, and 1.90 (95% CI, 1.18-3.04; P for trend=.01) for monounsaturated fat, and there was no association with vegetable fat or polyunsaturated fat. Greater intake of animal protein (RR=1.52; 95% CI, 0.94-2.44; P for trend=.08), but not vegetable protein, was associated with elevated risk, and this was mainly explained by greater consumption of red meat (RR=1.98; 95% CI, 1.13-3.47; P for trend=.02) and hamburger in particular (RR=2.35; 95% CI, 1.23-4.48; P for trend=.02). Milk and dairy product consumption were not associated with elevated risk. There was also a decreased risk of non-Hodgkin lymphoma with greater consumption of fruits (RR=0.64; 95% CI, 0.40-1.05; P for trend=.07).

Conclusions.
—A high-meat diet and a high intake of fat from animal sources is associated with an increased risk of non-Hodgkin lymphoma in older women.

(JAMA. 1996;275:1315-1321)

Author Affiliations
From the Department of Preventive Medicine and Environmental Health, College of Medicine, University of Iowa, Iowa City (Mr Chiu and Drs Cerhan and Wallace); the Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis (Drs Folsom, Sellers, Kushi, and Zheng); and the Fred Hutchinson Cancer Research Center, Seattle, Wash (Dr Potter).

Footnotes
Corresponding author: James R. Cerhan, MD, PhD, Department of Preventive Medicine and Environmental Health, University of Iowa College of Medicine, 2830 Steindler Bldg, Iowa City, IA 52242-1008.

Reprints: Aaron R. Folsom, MD, Division of Epidemiology, University of Minnesota School of Public Health, 1300 S Second St, Suite 300, Minneapolis, MN 55454-1015.

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