Dietary Fat Intake and Risk of Uterine Leiomyomata: A Prospective Ultrasound Study

Am J Epidemiol. 2020 Dec 1;189(12):1538-1546. doi: 10.1093/aje/kwaa097.


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 ω-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 (2010-2012) 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 ω-3 polyunsaturated fatty acid, docosahexaenoic acid, was associated with 49% higher UL incidence (quartile 4 vs. 1: hazard ratio = 1.49, 95% confidence interval: 1.04, 2.14; P for trend = 0.01). Intakes of total marine ω-3 polyunsaturated fatty acids were similarly associated with elevated UL incidence (hazard ratio = 1.35, 95% confidence interval: 0.94, 1.93; P for trend = 0.03). It remains unclear whether the fatty acids or persistent environmental pollutants drive the association.

Keywords: ω-3 fatty acids; cohort; diet; fat; uterine leiomyoma.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Blacks / statistics & numerical data
  • Dietary Fats / adverse effects*
  • Docosahexaenoic Acids / adverse effects
  • Female
  • Humans
  • Incidence
  • Leiomyoma / diagnostic imaging
  • Leiomyoma / epidemiology*
  • Leiomyoma / etiology
  • Michigan / epidemiology
  • Prospective Studies
  • Ultrasonography
  • Uterine Neoplasms / diagnostic imaging
  • Uterine Neoplasms / epidemiology*
  • Uterine Neoplasms / etiology


  • Dietary Fats
  • Docosahexaenoic Acids