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Table 4.

Calcium and vitamin D intake and breast density

First author (ref.), year, study placeYears of data collectionStudy designSample sizeComparison*EstimatesVariables adjusted for
Vachon (62), 2000, United States 1990- Cross-sectional study 1,508 Total vitamin D (IU/d) Mean (95% CL) % breast density Age, BMI, WHR, physical activity, age at menarche, age at first birth and no. births combined, alcohol, smoking, family history of breast cancer, HRT, and oral contraceptive use (premenopausal women only) 
    Premenopausal, ≤188.7 40 (34, 45)  
    Premenopausal, >562.8 42 (35, 48)  
    Postmenopausal, ≤188.7 32 (30, 35)  
    Postmenopausal, >562.8 32 (30, 34)  
Holmes (63), 2001, United States 1986-1990 Cross-sectional study 885 Premenopausal Mean % density across quintiles (P) Age and BMI 
    Dietary vitamin D intake 45, 41, 38, 42, 33 (0.02)  
    Dietary calcium intake 44, 47, 37, 37, 37 (0.01)  
Bérubé (61), 2004, United States 1988-1990 Cross-sectional study 543 Dietary vitamin D (IU/d), 200+ vs <50 OR (95% CL)§: 0.24 (0.11, 0.53) Age, BMI, age at menarche, no. birth/age at first birth, oral contraceptive use, menopausal status, HRT, family history of breast cancer, education, alcohol, caloric intake, and smoking 
    Dietary calcium (mg/d), 1,000+ vs <499 OR (95% CL)§: 0.24 (0.10, 0.57)  
Bérubé (64), 2005, Canada 2001-2002 Cross-sectional study 1,560 Vitamin D (100 IU increase) β (P) Age, BMI, age at menarche, no. birth, age at first birth, duration of oral contraceptive and HRT use, history of breast biopsies, family history of breast cancer, education, alcohol, caloric intake, physical activity, and smoking 
    Premenopausal   
    Food −1.8 (0.008)  
    Supplements −1.0 (0.16)  
    Total −1.4 (0.004)  
    Postmenopausal   
    Food −0.4 (0.40)  
    Supplements 0.4 (0.29)  
    Total 0.1 (0.76)  
    Calcium (100 mg increase)   
    Premenopausal   
    Food −0.7 (0.005)  
    Supplements −0.7 (0.06)  
    Total −0.8 (0.0004)  
    Postmenopausal   
    Food 0.1 (0.72)  
    Supplements 0.2 (0.46)  
    Total 0.1 (0.49)  
Masala (65), 2005, Italy 1993-2000 Longitudinal study 1,668 Dietary calcium (tertiles), T3 vs T1 OR (95% CL): 0.67 (0.47, 0.94) Age, education, BMI, menopausal status, and total caloric intake 
First author (ref.), year, study placeYears of data collectionStudy designSample sizeComparison*EstimatesVariables adjusted for
Vachon (62), 2000, United States 1990- Cross-sectional study 1,508 Total vitamin D (IU/d) Mean (95% CL) % breast density Age, BMI, WHR, physical activity, age at menarche, age at first birth and no. births combined, alcohol, smoking, family history of breast cancer, HRT, and oral contraceptive use (premenopausal women only) 
    Premenopausal, ≤188.7 40 (34, 45)  
    Premenopausal, >562.8 42 (35, 48)  
    Postmenopausal, ≤188.7 32 (30, 35)  
    Postmenopausal, >562.8 32 (30, 34)  
Holmes (63), 2001, United States 1986-1990 Cross-sectional study 885 Premenopausal Mean % density across quintiles (P) Age and BMI 
    Dietary vitamin D intake 45, 41, 38, 42, 33 (0.02)  
    Dietary calcium intake 44, 47, 37, 37, 37 (0.01)  
Bérubé (61), 2004, United States 1988-1990 Cross-sectional study 543 Dietary vitamin D (IU/d), 200+ vs <50 OR (95% CL)§: 0.24 (0.11, 0.53) Age, BMI, age at menarche, no. birth/age at first birth, oral contraceptive use, menopausal status, HRT, family history of breast cancer, education, alcohol, caloric intake, and smoking 
    Dietary calcium (mg/d), 1,000+ vs <499 OR (95% CL)§: 0.24 (0.10, 0.57)  
Bérubé (64), 2005, Canada 2001-2002 Cross-sectional study 1,560 Vitamin D (100 IU increase) β (P) Age, BMI, age at menarche, no. birth, age at first birth, duration of oral contraceptive and HRT use, history of breast biopsies, family history of breast cancer, education, alcohol, caloric intake, physical activity, and smoking 
    Premenopausal   
    Food −1.8 (0.008)  
    Supplements −1.0 (0.16)  
    Total −1.4 (0.004)  
    Postmenopausal   
    Food −0.4 (0.40)  
    Supplements 0.4 (0.29)  
    Total 0.1 (0.76)  
    Calcium (100 mg increase)   
    Premenopausal   
    Food −0.7 (0.005)  
    Supplements −0.7 (0.06)  
    Total −0.8 (0.0004)  
    Postmenopausal   
    Food 0.1 (0.72)  
    Supplements 0.2 (0.46)  
    Total 0.1 (0.49)  
Masala (65), 2005, Italy 1993-2000 Longitudinal study 1,668 Dietary calcium (tertiles), T3 vs T1 OR (95% CL): 0.67 (0.47, 0.94) Age, education, BMI, menopausal status, and total caloric intake 
*

The associations are presented by menopausal status whenever the studies reported them separately or the studies were restricted to either premenopausal or postmenopausal women. Otherwise, the associations for a combination of premenopausal and postmenopausal women are presented.

Assessment was based on mean (95% CL) of % breast density.

The study was published as an abstract. No detailed information on the 95% CL was presented.

§

This study compared women with mammographic density of ≥70% with those with mammographic density of ≤30%.

β, estimated from linear regression analyses, represented absolute mean decrease or increase in breast density (%) for increments of 100 IU vitamin D or 100 mg calcium, respectively.

The study compared women with high mammographic breast density with those with low mammographic breast density.

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