Prolonged nightly fasting and breast cancer prognosis

Catherine R. Marinac, Sandahl H. Nelson, Caitlin I. Breen, Sheri J. Hartman, Loki Natarajan, John P. Pierce, Shirley W. Flatt, Dorothy D. Sears, Ruth E. Patterson

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

IMPORTANCE Rodent studies demonstrate that prolonged fasting during the sleep phase positively influences carcinogenesis and metabolic processes that are putatively associated with risk and prognosis of breast cancer. To our knowledge, no studies in humans have examined nightly fasting duration and cancer outcomes. OBJECTIVE To investigate whether duration of nightly fasting predicted recurrence and mortality among women with early-stage breast cancer and, if so, whether it was associated with risk factors for poor outcomes, including glucoregulation (hemoglobin A1c), chronic inflammation (C-reactive protein), obesity, and sleep. DESIGN, SETTING, AND PARTICIPANTS Datawere collected from 2413women with breast cancer but without diabetes mellitus who were aged 27 to 70 years at diagnosis and participated in the prospectiveWomen's Healthy Eating and Living study between March 1, 1995, and May 3, 2007. Data analysis was conducted from May 18 to October 5, 2015. EXPOSURES Nightly fasting duration was estimated from 24-hour dietary recalls collected at baseline, year 1, and year 4. MAIN OUTCOMES AND MEASURES Clinical outcomeswere invasive breast cancer recurrence and new primary breast tumors during a mean of 7.3 years of study follow-up as well as death from breast cancer or any cause during a mean of 11.4 years of surveillance. Baseline sleep duration was self-reported, and archived blood samples were used to assess concentrations of hemoglobin A and C-reactive protein. RESULTS The cohort of 2413 women (mean [SD] age, 52.4 [8.9] years) reported a mean (SD) fasting duration of 12.5 (1.7) hours per night. In repeated-measures Cox proportional hazards regression models, fasting less than 13 hours per night (lower 2 tertiles of nightly fasting distribution) was associated with an increase in the risk of breast cancer recurrence compared with fasting 13 or more hours per night (hazard ratio, 1.36; 95%CI, 1.05-1.76). Nightly fasting less than 13 hours was not associated with a statistically significant higher risk of breast cancer mortality (hazard ratio, 1.21; 95%CI, 0.91-1.60) or a statistically significant higher risk of all-cause mortality (hazard ratio, 1.22; 95%CI, 0.95-1.56). In multivariable linear regression models, each 2-hour increase in the nightly fasting duration was associated with significantly lower hemoglobin A1c levels (β = -0.37; 95%CI, -0.72 to -0.01) and a longer duration of nighttime sleep (β = 0.20; 95%CI, 0.14-0.26). CONCLUSIONS AND RELEVANCE Prolonging the length of the nightly fasting intervalmay be a simple, nonpharmacologic strategy for reducing the risk of breast cancer recurrence. Improvements in glucoregulation and sleep may be mechanisms linking nightly fasting with breast cancer prognosis.

Original languageEnglish (US)
Pages (from-to)1049-1055
Number of pages7
JournalJAMA Oncology
Volume2
Issue number8
DOIs
StatePublished - Aug 2016
Externally publishedYes

Fingerprint

Fasting
Breast Neoplasms
Sleep
Recurrence
C-Reactive Protein
Mortality
Linear Models
Hemoglobins
Hemoglobin C
Hemoglobin A
Proportional Hazards Models
Rodentia
Diabetes Mellitus
Carcinogenesis
Obesity
Inflammation

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Marinac, C. R., Nelson, S. H., Breen, C. I., Hartman, S. J., Natarajan, L., Pierce, J. P., ... Patterson, R. E. (2016). Prolonged nightly fasting and breast cancer prognosis. JAMA Oncology, 2(8), 1049-1055. https://doi.org/10.1001/jamaoncol.2016.0164

Prolonged nightly fasting and breast cancer prognosis. / Marinac, Catherine R.; Nelson, Sandahl H.; Breen, Caitlin I.; Hartman, Sheri J.; Natarajan, Loki; Pierce, John P.; Flatt, Shirley W.; Sears, Dorothy D.; Patterson, Ruth E.

In: JAMA Oncology, Vol. 2, No. 8, 08.2016, p. 1049-1055.

Research output: Contribution to journalArticle

Marinac, CR, Nelson, SH, Breen, CI, Hartman, SJ, Natarajan, L, Pierce, JP, Flatt, SW, Sears, DD & Patterson, RE 2016, 'Prolonged nightly fasting and breast cancer prognosis', JAMA Oncology, vol. 2, no. 8, pp. 1049-1055. https://doi.org/10.1001/jamaoncol.2016.0164
Marinac CR, Nelson SH, Breen CI, Hartman SJ, Natarajan L, Pierce JP et al. Prolonged nightly fasting and breast cancer prognosis. JAMA Oncology. 2016 Aug;2(8):1049-1055. https://doi.org/10.1001/jamaoncol.2016.0164
Marinac, Catherine R. ; Nelson, Sandahl H. ; Breen, Caitlin I. ; Hartman, Sheri J. ; Natarajan, Loki ; Pierce, John P. ; Flatt, Shirley W. ; Sears, Dorothy D. ; Patterson, Ruth E. / Prolonged nightly fasting and breast cancer prognosis. In: JAMA Oncology. 2016 ; Vol. 2, No. 8. pp. 1049-1055.
@article{fdef1e02f1cd40bc9d2880cfebb25f12,
title = "Prolonged nightly fasting and breast cancer prognosis",
abstract = "IMPORTANCE Rodent studies demonstrate that prolonged fasting during the sleep phase positively influences carcinogenesis and metabolic processes that are putatively associated with risk and prognosis of breast cancer. To our knowledge, no studies in humans have examined nightly fasting duration and cancer outcomes. OBJECTIVE To investigate whether duration of nightly fasting predicted recurrence and mortality among women with early-stage breast cancer and, if so, whether it was associated with risk factors for poor outcomes, including glucoregulation (hemoglobin A1c), chronic inflammation (C-reactive protein), obesity, and sleep. DESIGN, SETTING, AND PARTICIPANTS Datawere collected from 2413women with breast cancer but without diabetes mellitus who were aged 27 to 70 years at diagnosis and participated in the prospectiveWomen's Healthy Eating and Living study between March 1, 1995, and May 3, 2007. Data analysis was conducted from May 18 to October 5, 2015. EXPOSURES Nightly fasting duration was estimated from 24-hour dietary recalls collected at baseline, year 1, and year 4. MAIN OUTCOMES AND MEASURES Clinical outcomeswere invasive breast cancer recurrence and new primary breast tumors during a mean of 7.3 years of study follow-up as well as death from breast cancer or any cause during a mean of 11.4 years of surveillance. Baseline sleep duration was self-reported, and archived blood samples were used to assess concentrations of hemoglobin A and C-reactive protein. RESULTS The cohort of 2413 women (mean [SD] age, 52.4 [8.9] years) reported a mean (SD) fasting duration of 12.5 (1.7) hours per night. In repeated-measures Cox proportional hazards regression models, fasting less than 13 hours per night (lower 2 tertiles of nightly fasting distribution) was associated with an increase in the risk of breast cancer recurrence compared with fasting 13 or more hours per night (hazard ratio, 1.36; 95{\%}CI, 1.05-1.76). Nightly fasting less than 13 hours was not associated with a statistically significant higher risk of breast cancer mortality (hazard ratio, 1.21; 95{\%}CI, 0.91-1.60) or a statistically significant higher risk of all-cause mortality (hazard ratio, 1.22; 95{\%}CI, 0.95-1.56). In multivariable linear regression models, each 2-hour increase in the nightly fasting duration was associated with significantly lower hemoglobin A1c levels (β = -0.37; 95{\%}CI, -0.72 to -0.01) and a longer duration of nighttime sleep (β = 0.20; 95{\%}CI, 0.14-0.26). CONCLUSIONS AND RELEVANCE Prolonging the length of the nightly fasting intervalmay be a simple, nonpharmacologic strategy for reducing the risk of breast cancer recurrence. Improvements in glucoregulation and sleep may be mechanisms linking nightly fasting with breast cancer prognosis.",
author = "Marinac, {Catherine R.} and Nelson, {Sandahl H.} and Breen, {Caitlin I.} and Hartman, {Sheri J.} and Loki Natarajan and Pierce, {John P.} and Flatt, {Shirley W.} and Sears, {Dorothy D.} and Patterson, {Ruth E.}",
year = "2016",
month = "8",
doi = "10.1001/jamaoncol.2016.0164",
language = "English (US)",
volume = "2",
pages = "1049--1055",
journal = "JAMA oncology",
issn = "2374-2437",
publisher = "American Medical Association",
number = "8",

}

TY - JOUR

T1 - Prolonged nightly fasting and breast cancer prognosis

AU - Marinac, Catherine R.

AU - Nelson, Sandahl H.

AU - Breen, Caitlin I.

AU - Hartman, Sheri J.

AU - Natarajan, Loki

AU - Pierce, John P.

AU - Flatt, Shirley W.

AU - Sears, Dorothy D.

AU - Patterson, Ruth E.

PY - 2016/8

Y1 - 2016/8

N2 - IMPORTANCE Rodent studies demonstrate that prolonged fasting during the sleep phase positively influences carcinogenesis and metabolic processes that are putatively associated with risk and prognosis of breast cancer. To our knowledge, no studies in humans have examined nightly fasting duration and cancer outcomes. OBJECTIVE To investigate whether duration of nightly fasting predicted recurrence and mortality among women with early-stage breast cancer and, if so, whether it was associated with risk factors for poor outcomes, including glucoregulation (hemoglobin A1c), chronic inflammation (C-reactive protein), obesity, and sleep. DESIGN, SETTING, AND PARTICIPANTS Datawere collected from 2413women with breast cancer but without diabetes mellitus who were aged 27 to 70 years at diagnosis and participated in the prospectiveWomen's Healthy Eating and Living study between March 1, 1995, and May 3, 2007. Data analysis was conducted from May 18 to October 5, 2015. EXPOSURES Nightly fasting duration was estimated from 24-hour dietary recalls collected at baseline, year 1, and year 4. MAIN OUTCOMES AND MEASURES Clinical outcomeswere invasive breast cancer recurrence and new primary breast tumors during a mean of 7.3 years of study follow-up as well as death from breast cancer or any cause during a mean of 11.4 years of surveillance. Baseline sleep duration was self-reported, and archived blood samples were used to assess concentrations of hemoglobin A and C-reactive protein. RESULTS The cohort of 2413 women (mean [SD] age, 52.4 [8.9] years) reported a mean (SD) fasting duration of 12.5 (1.7) hours per night. In repeated-measures Cox proportional hazards regression models, fasting less than 13 hours per night (lower 2 tertiles of nightly fasting distribution) was associated with an increase in the risk of breast cancer recurrence compared with fasting 13 or more hours per night (hazard ratio, 1.36; 95%CI, 1.05-1.76). Nightly fasting less than 13 hours was not associated with a statistically significant higher risk of breast cancer mortality (hazard ratio, 1.21; 95%CI, 0.91-1.60) or a statistically significant higher risk of all-cause mortality (hazard ratio, 1.22; 95%CI, 0.95-1.56). In multivariable linear regression models, each 2-hour increase in the nightly fasting duration was associated with significantly lower hemoglobin A1c levels (β = -0.37; 95%CI, -0.72 to -0.01) and a longer duration of nighttime sleep (β = 0.20; 95%CI, 0.14-0.26). CONCLUSIONS AND RELEVANCE Prolonging the length of the nightly fasting intervalmay be a simple, nonpharmacologic strategy for reducing the risk of breast cancer recurrence. Improvements in glucoregulation and sleep may be mechanisms linking nightly fasting with breast cancer prognosis.

AB - IMPORTANCE Rodent studies demonstrate that prolonged fasting during the sleep phase positively influences carcinogenesis and metabolic processes that are putatively associated with risk and prognosis of breast cancer. To our knowledge, no studies in humans have examined nightly fasting duration and cancer outcomes. OBJECTIVE To investigate whether duration of nightly fasting predicted recurrence and mortality among women with early-stage breast cancer and, if so, whether it was associated with risk factors for poor outcomes, including glucoregulation (hemoglobin A1c), chronic inflammation (C-reactive protein), obesity, and sleep. DESIGN, SETTING, AND PARTICIPANTS Datawere collected from 2413women with breast cancer but without diabetes mellitus who were aged 27 to 70 years at diagnosis and participated in the prospectiveWomen's Healthy Eating and Living study between March 1, 1995, and May 3, 2007. Data analysis was conducted from May 18 to October 5, 2015. EXPOSURES Nightly fasting duration was estimated from 24-hour dietary recalls collected at baseline, year 1, and year 4. MAIN OUTCOMES AND MEASURES Clinical outcomeswere invasive breast cancer recurrence and new primary breast tumors during a mean of 7.3 years of study follow-up as well as death from breast cancer or any cause during a mean of 11.4 years of surveillance. Baseline sleep duration was self-reported, and archived blood samples were used to assess concentrations of hemoglobin A and C-reactive protein. RESULTS The cohort of 2413 women (mean [SD] age, 52.4 [8.9] years) reported a mean (SD) fasting duration of 12.5 (1.7) hours per night. In repeated-measures Cox proportional hazards regression models, fasting less than 13 hours per night (lower 2 tertiles of nightly fasting distribution) was associated with an increase in the risk of breast cancer recurrence compared with fasting 13 or more hours per night (hazard ratio, 1.36; 95%CI, 1.05-1.76). Nightly fasting less than 13 hours was not associated with a statistically significant higher risk of breast cancer mortality (hazard ratio, 1.21; 95%CI, 0.91-1.60) or a statistically significant higher risk of all-cause mortality (hazard ratio, 1.22; 95%CI, 0.95-1.56). In multivariable linear regression models, each 2-hour increase in the nightly fasting duration was associated with significantly lower hemoglobin A1c levels (β = -0.37; 95%CI, -0.72 to -0.01) and a longer duration of nighttime sleep (β = 0.20; 95%CI, 0.14-0.26). CONCLUSIONS AND RELEVANCE Prolonging the length of the nightly fasting intervalmay be a simple, nonpharmacologic strategy for reducing the risk of breast cancer recurrence. Improvements in glucoregulation and sleep may be mechanisms linking nightly fasting with breast cancer prognosis.

UR - http://www.scopus.com/inward/record.url?scp=85015678054&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85015678054&partnerID=8YFLogxK

U2 - 10.1001/jamaoncol.2016.0164

DO - 10.1001/jamaoncol.2016.0164

M3 - Article

C2 - 27032109

AN - SCOPUS:85015678054

VL - 2

SP - 1049

EP - 1055

JO - JAMA oncology

JF - JAMA oncology

SN - 2374-2437

IS - 8

ER -