According to the American Cancer Society, little evidence currently exists that implicates cholesterol itself as causing the increased risk of certain cancers associated with eating foods from animal sources. In contrast to cholesterol, increased risk of cancer has been associated with the intake of saturated fats, with varying evidence in regard to the effect of total fat consumption on the risk of various cancers. However, diets high in fat are often correlated with those high in calories, potentially contributing to obesity and overweight, a risk factor linked to the incidence of multiple cancers such as pancreas, kidney, colon, and esophagus.75,76
A report of the National Cholesterol Education Program (NCEP) indicates that the percentage of total fat in the diet, independent of caloric intake, has not been documented to be related to cancer risk in the general population.77 The Women's Health Initiative Dietary Modification Trial, involving approximately 49,000 subjects, showed that those exposed to dietary intervention including an 8.1% lower fat intake than the control group developed colon cancer at the same rate as the control.78 As with colon cancer, the study showed similar rates of breast cancer risk in women eating a low-fat diet (8.1% decrease from comparison) and in those without diet modification. The Nurses' Health Study also reported no association between total fat intake or specific types of fat and breast cancer risk.79 In contrast, a higher risk of prostate cancer progression is seen in men with a high fat intake, with fat of animal origin correlating to the highest risk of prostate cancer.80,81
Various clinical, experimental, and epidemiologic studies have suggested that colorectal cancer is related to diets high in total fat, protein, calories, alcohol, and meat, and low in calcium and folate. A literature search on dietary fat and breast cancer risk involving published articles from January 1990 through December 2003 found a positive association between increased total and saturated fat intake and the development of breast cancer.82 The review acknowledges that not all epidemiolog-ical studies provided a strong positive association between dietary fat and breast cancer risk, but a moderate association does exist.82,83
Research has shown a correlation between saturated fat intake and cancer risk. A recent prospective cohort study performed by the European Prospective Investigation into Cancer project found no association between breast cancer and saturated fat intake measured by a food-frequency questionnaire, but when using a food diary, a daily intake of 35 g of saturated fat doubles the risk of breast cancer in comparison to women who had a daily intake of 10 g or less.84 A greater intake of saturated fat may increase the risk of esophageal adenocarcinoma and distal stomach cancer.85 In addition, a meta-analysis of the association between dietary fat intake and breast cancer found significant summary relative risks for saturated fat.86
While cholesterol intake is not correlated with cancer risk, intake of both fat and saturated fat has been implicated in the risk of cancer. In general, total fat intake may not be positively correlated with cancer risk, while saturated fat intake may possess a positive correlation with various cancers.
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