{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T23:11:59Z","timestamp":1782515519963,"version":"3.54.5"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"12","funder":[{"DOI":"10.13039\/100000066","name":"National Institute of Environmental Health Sciences","doi-asserted-by":"publisher","award":["R01-ES024749"],"award-info":[{"award-number":["R01-ES024749"]}],"id":[{"id":"10.13039\/100000066","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Uterine leiomyomata (UL) are associated with severe reproductive morbidity and are the primary indication for hysterectomy in the United States. A recent prospective cohort study of Black women reported positive associations between intakes of marine-sourced \u03c9-3 fatty acids and UL risk. We examined whether intakes of dietary fat were associated with UL incidence in a 5-year prospective study of premenopausal Black women living in Detroit who underwent serial ultrasound. At baseline (2010\u20132012) and 20, 40, and 60 months of follow-up, participants underwent transvaginal ultrasound. Among 1,171 UL-free women at baseline, incident UL were detected in 277 women. Cox regression was used to estimate hazard ratios and 95% confidence intervals for the association of dietary fat and UL incidence. Intakes of total fat and saturated, monounsaturated, polyunsaturated, and trans-fat were not appreciably associated with UL incidence. Intake of the marine \u03c9-3 polyunsaturated fatty acid, docosahexaenoic acid, was associated with 49% higher UL incidence (quartile 4 vs. 1: hazard ratio\u00a0=\u00a01.49, 95% confidence interval: 1.04, 2.14; P for trend\u00a0=\u00a00.01). Intakes of total marine \u03c9-3 polyunsaturated fatty acids were similarly associated with elevated UL incidence (hazard ratio =\u00a01.35, 95% confidence interval: 0.94, 1.93; P for trend\u00a0=\u00a00.03). It remains unclear whether the fatty acids or persistent environmental pollutants drive the association.<\/jats:p>","DOI":"10.1093\/aje\/kwaa097","type":"journal-article","created":{"date-parts":[[2020,6,4]],"date-time":"2020-06-04T19:11:54Z","timestamp":1591297914000},"page":"1538-1546","source":"Crossref","is-referenced-by-count":25,"title":["Dietary Fat Intake and Risk of Uterine Leiomyomata: A Prospective Ultrasound Study"],"prefix":"10.1093","volume":"189","author":[{"given":"Theodore M","family":"Brasky","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Traci N","family":"Bethea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelia K","family":"Wesselink","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ganesa R","family":"Wegienka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna D","family":"Baird","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren A","family":"Wise","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,6,17]]},"reference":[{"issue":"1","key":"2021020319053594100_ref1","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1097\/GRF.0000000000000164","article-title":"Epidemiology of uterine fibroids: from menarche to menopause","volume":"59","author":"Wise","year":"2016","journal-title":"Clin Obstet Gynecol"},{"issue":"5","key":"2021020319053594100_ref2","first-page":"764","article-title":"Complications in pregnancy, labor, and delivery with uterine leiomyomas: a population-based study","volume":"95","author":"Coronado","year":"2000","journal-title":"Obstet Gynecol"},{"issue":"7","key":"2021020319053594100_ref3","first-page":"483","article-title":"Uterine leiomyomas. Racial differences in severity, symptoms and age at diagnosis","volume":"41","author":"Kjerulff","year":"1996","journal-title":"J Reprod Med"},{"issue":"1","key":"2021020319053594100_ref4","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1067\/mob.2003.99","article-title":"High cumulative incidence of uterine leiomyoma in Black and White women: ultrasound evidence","volume":"188","author":"Baird","year":"2003","journal-title":"Am J Obstet Gynecol"},{"issue":"3","key":"2021020319053594100_ref5","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1016\/j.jclinepi.2003.09.004","article-title":"Uterine leiomyomata (fibroids): are bleeding symptoms more likely to be reported after diagnosis?","volume":"57","author":"Wegienka","year":"2004","journal-title":"J Clin Epidemiol"},{"issue":"6","key":"2021020319053594100_ref6","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1016\/S0029-7844(97)00534-6","article-title":"Variation in the incidence of uterine leiomyoma among premenopausal women by age and race","volume":"90","author":"Marshall","year":"1997","journal-title":"Obstet Gynecol"},{"issue":"3","key":"2021020319053594100_ref7","doi-asserted-by":"crossref","first-page":"211.e1","DOI":"10.1016\/j.ajog.2011.12.002","article-title":"The estimated annual cost of uterine leiomyomata in the United States","volume":"206","author":"Cardozo","year":"2012","journal-title":"Am J Obstet Gynecol"},{"issue":"4","key":"2021020319053594100_ref8","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1016\/j.ajog.2006.02.020","article-title":"Health care resource use for uterine fibroid tumors in the United States","volume":"195","author":"Flynn","year":"2006","journal-title":"Am J Obstet Gynecol"},{"issue":"14","key":"2021020319053594100_ref9","doi-asserted-by":"crossref","first-page":"1344","DOI":"10.1056\/NEJMra1209993","article-title":"Uterine fibroids","volume":"369","author":"Bulun","year":"2013","journal-title":"N Engl J Med"},{"issue":"49","key":"2021020319053594100_ref10","first-page":"1","article-title":"Trends in intake of energy and macronutrients in adults from 1999-2000 through 2007-2008","author":"Wright","year":"2010","journal-title":"NCHS Data Brief"},{"issue":"3","key":"2021020319053594100_ref11","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1017\/S1368980099000348","article-title":"Differences in fat-related dietary patterns between Black, Hispanic and White women: results from the Women's Health Trial Feasibility Study in Minority Populations","volume":"2","author":"Kristal","year":"1999","journal-title":"Public Health Nutr"},{"key":"2021020319053594100_ref12","doi-asserted-by":"crossref","DOI":"10.3402\/fnr.v58.23287","article-title":"Seafood consumption among pregnant and non-pregnant women of childbearing age in the United States, NHANES 1999\u20132006","volume":"58","author":"Razzaghi","year":"2014","journal-title":"Food Nutr Res"},{"issue":"5","key":"2021020319053594100_ref13","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.3945\/ajcn.113.073635","article-title":"A prospective study of dietary fat and risk of uterine leiomyomata","volume":"99","author":"Wise","year":"2014","journal-title":"Am J Clin Nutr"},{"issue":"11","key":"2021020319053594100_ref14","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1089\/jwh.2015.5277","article-title":"A prospective, ultrasound-based study to evaluate risk factors for uterine fibroid incidence and growth: Methods and results of recruitment","volume":"24","author":"Baird","year":"2015","journal-title":"J Womens Health (Larchmt)"},{"issue":"7","key":"2021020319053594100_ref15","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.7863\/ultra.33.7.1217","article-title":"Intraobserver variability in fibroid size measurements: estimated effects on assessing fibroid growth","volume":"33","author":"Moshesh","year":"2014","journal-title":"J Ultrasound Med"},{"issue":"1","key":"2021020319053594100_ref16","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1097\/00001648-199001000-00013","article-title":"A reduced dietary questionnaire: development and validation","volume":"1","author":"Block","year":"1990","journal-title":"Epidemiology"},{"issue":"1","key":"2021020319053594100_ref17","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1079\/PHN2005763","article-title":"Validity and reliability of the Block98 food-frequency questionnaire in a sample of Canadian women","volume":"9","author":"Boucher","year":"2006","journal-title":"Public Health Nutr"},{"issue":"8","key":"2021020319053594100_ref18","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1093\/aje\/kwi279","article-title":"Validation of a food frequency questionnaire by direct measurement of habitual ad libitum food intake","volume":"162","author":"Paul","year":"2005","journal-title":"Am J Epidemiol"},{"key":"2021020319053594100_ref19","author":"US Department of Agriculture"},{"issue":"4 suppl","key":"2021020319053594100_ref20","doi-asserted-by":"crossref","first-page":"1220S","DOI":"10.1093\/ajcn\/65.4.1220S","article-title":"Adjustment for total energy intake in epidemiologic studies","volume":"65","author":"Willett","year":"1997","journal-title":"Am J Clin Nutr"},{"issue":"3","key":"2021020319053594100_ref21","first-page":"395","article-title":"Diet and uterine myomas","volume":"94","author":"Chiaffarino","year":"1999","journal-title":"Obstet Gynecol"},{"issue":"4","key":"2021020319053594100_ref22","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1016\/j.envres.2011.01.006","article-title":"Uterine leiomyomata in a cohort of Great Lakes sport fish consumers","volume":"111","author":"Lambertino","year":"2011","journal-title":"Environ Res"},{"issue":"5","key":"2021020319053594100_ref23","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1158\/1055-9965.EPI-10-1349","article-title":"Prioritization of diet and cancer manuscripts: a brief primer","volume":"20","author":"Kristal","year":"2011","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"issue":"1","key":"2021020319053594100_ref24","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1097\/EDE.0b013e3181fe1fbe","article-title":"Childhood abuse and fibroids","volume":"22","author":"Baird","year":"2011","journal-title":"Epidemiology"},{"issue":"1","key":"2021020319053594100_ref25","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1097\/EDE.0b013e3181ffb172","article-title":"Abuse in childhood and risk of uterine leiomyoma: the role of emotional support in biologic resilience","volume":"22","author":"Boynton-Jarrett","year":"2011","journal-title":"Epidemiology"},{"issue":"4","key":"2021020319053594100_ref26","doi-asserted-by":"crossref","first-page":"272.e1","DOI":"10.1016\/j.ajog.2012.12.034","article-title":"Lifetime abuse victimization and risk of uterine leiomyomata in Black women","volume":"208","author":"Wise","year":"2013","journal-title":"Am J Obstet Gynecol"},{"issue":"3","key":"2021020319053594100_ref27","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1067\/mob.2002.121725","article-title":"Accuracy of magnetic resonance imaging and transvaginal ultrasonography in the diagnosis, mapping, and measurement of uterine myomas","volume":"186","author":"Dueholm","year":"2002","journal-title":"Am J Obstet Gynecol"},{"issue":"2\u20133","key":"2021020319053594100_ref28","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.plefa.2009.05.010","article-title":"Dietary docosahexaenoic and eicosapentaenoic acid: emerging mediators of inflammation","volume":"81","author":"Chapkin","year":"2009","journal-title":"Prostaglandins Leukot Essent Fatty Acids"},{"issue":"5","key":"2021020319053594100_ref29","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1042\/BST20160474","article-title":"Omega-3 fatty acids and inflammatory processes: from molecules to man","volume":"45","author":"Calder","year":"2017","journal-title":"Biochem Soc Trans"},{"issue":"49","key":"2021020319053594100_ref30","doi-asserted-by":"crossref","first-page":"6853","DOI":"10.1038\/sj.onc.1203239","article-title":"Activators and target genes of Rel\/NF-kappaB transcription factors","volume":"18","author":"Pahl","year":"1999","journal-title":"Oncogene"},{"issue":"2","key":"2021020319053594100_ref31","article-title":"Effect of marine-derived n-3 polyunsaturated fatty acids on C-reactive protein, interleukin 6 and tumor necrosis factor alpha: a meta-analysis","volume":"9","author":"Li","year":"2014","journal-title":"PloS One"},{"issue":"2","key":"2021020319053594100_ref32","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1016\/j.atherosclerosis.2008.09.020","article-title":"Anti-inflammatory and cardioprotective effects of n-3 polyunsaturated fatty acids and plant sterols in hyperlipidemic individuals","volume":"204","author":"Micallef","year":"2009","journal-title":"Atherosclerosis"},{"issue":"3","key":"2021020319053594100_ref33","doi-asserted-by":"crossref","first-page":"321","DOI":"10.2143\/AC.64.3.2038016","article-title":"Omega-3 fatty acid supplements improve the cardiovascular risk profile of subjects with metabolic syndrome, including markers of inflammation and auto-immunity","volume":"64","author":"Ebrahimi","year":"2009","journal-title":"Acta Cardiol"},{"issue":"9","key":"2021020319053594100_ref34","first-page":"615","article-title":"Efficacy of omega-3 fatty acid supplementation on serum levels of tumour necrosis factor-alpha, C-reactive protein and interleukin-2 in type 2 diabetes mellitus patients","volume":"53","author":"Malekshahi Moghadam","year":"2012","journal-title":"Singapore Med J"},{"issue":"3","key":"2021020319053594100_ref35","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1093\/humrep\/dem394","article-title":"The association between heavy metals, endometriosis and uterine myomas among premenopausal women: National Health and Nutrition Examination Survey 1999\u20132002","volume":"23","author":"Jackson","year":"2008","journal-title":"Hum Reprod"},{"key":"2021020319053594100_ref36","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.reprotox.2014.06.007","article-title":"Increased urinary cobalt and whole blood concentrations of cadmium and lead in women with uterine leiomyomata: findings from the ENDO Study","volume":"49","author":"Johnstone","year":"2014","journal-title":"Reprod Toxicol"},{"issue":"3","key":"2021020319053594100_ref37","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1038\/jes.2014.31","article-title":"Persistent organic pollutants (POPs) and fibroids: results from the ENDO study","volume":"25","author":"Trabert","year":"2015","journal-title":"J Expo Sci Environ Epidemiol"}],"container-title":["American Journal of Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/aje\/advance-article-pdf\/doi\/10.1093\/aje\/kwaa097\/33731585\/kwaa097.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/aje\/article-pdf\/189\/12\/1538\/36184157\/kwaa097.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/aje\/article-pdf\/189\/12\/1538\/36184157\/kwaa097.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,8]],"date-time":"2021-02-08T09:17:08Z","timestamp":1612775828000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/aje\/article\/189\/12\/1538\/5858261"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,17]]},"references-count":37,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2020,6,17]]},"published-print":{"date-parts":[[2020,12,1]]}},"URL":"https:\/\/doi.org\/10.1093\/aje\/kwaa097","relation":{},"ISSN":["0002-9262","1476-6256"],"issn-type":[{"value":"0002-9262","type":"print"},{"value":"1476-6256","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,12]]},"published":{"date-parts":[[2020,6,17]]}}}