Association of Dietary Intake Ratio of n-3/n-6 Polyunsaturated Fatty Acids with Breast Cancer Risk in Western and Asian Countries: A Meta-Analysis

Document Type: Systematic Review and Meta-analysis

Authors

1 Doctoral Program, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta City, Indonesia.

2 Department of Public Health, Faculty of Medicine, Universitas Andalas, Padang City, Indonesia.

3 Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta City, Indonesia.

4 Department of Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta City, Indonesia.

5 Department of Pharmacology and Therapy, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta City, Indonesia.

Abstract

Objective: This systematic review and meta-analysis were performed to determine association of dietary intake ratio
of n-3/n-6 polyunsaturated fatty acids with breast cancer risk in Western and Asian countries. Methods: The authors
conducted a meta-analysis of published research articles on association of dietary intake ratio of n-3/n-6 polyunsaturated
fatty acids (PUFAs) with breast cancer risk in Western and Asian countries published between January 2000 and February
2019 in online article databases of PubMed, ProQuest and EBSCO. Pooled risk ratios (RR) were calculated using
fixed and random-effect models. Publication bias was visually evaluated by performing funnel plots and statistically
assessed by Egger’s and Begg’s tests. Data were processed by using Stata version 14.2 (Stata Corporation). Results:
This study reviewed 913 articles. There were 13 studies included in systematic review continued by meta-analysis
of relevant data with total number of samples: 275,264 patients. The results showed dietary intake ratio of n-3/n-6
PUFAs with breast cancer risk in Western and Asian countries (RR = 0.99; 95% CI: 0.92-1.07). Dietary intake ratio
of n-3/n-6 PUFAs with breast cancer risk in Western countries reached (RR = 0.98; 95% CI: 0.91-1.06) and there was
any significant publication bias for studies included. Dietary intake ratio of n-3/n-6 PUFAs with breast cancer risk in
Asian countries reached (RR = 1.18; 95% CI: 0.94-1.47) and there was not any significant publication bias for studies
included. Conclusion: This analysis confirmed association of dietary intake ratio of n-3/n-6 PUFAs with breast cancer
risk in Western and Asian countries. Higher dietary intake ratio is associated with lower risk of breast cancer in Asian
countries rather than Western countries. This study suggests increasing dietary intake ratio n-3/n-6 PUFAs will provide
benefit for breast cancer prevention.

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