Dos Santos Silva Isabel, Mangtani Punam, McCormack Valerie, Bhakta Dee, Sevak Leena, McMichael Anthony J
Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, England.
Int J Cancer. 2002 May 10;99(2):238-44. doi: 10.1002/ijc.10300.
To investigate the role of lifelong vegetarianism on the aetiology of female breast cancer, we conducted a population-based case-control study among South Asian migrant women from the Indian subcontinent resident in England. A total of 240 South Asian breast cancer cases were identified from 2 cancer registries during 1995-1999. For each case, 2 age-matched South Asian controls were randomly selected from the age-sex register of the case practice. Lifelong vegetarians had a slight reduction, although not statistically significant, in the odds of breast cancer relative to lifelong meat-eaters, which persisted after adjustment for socio-demographic and reproductive variables [odds ratio (OR)=0.77; 95% confidence interval (CI)=0.50-1.18]. Analysis by food group revealed no linear trend in the odds of breast cancer with increasing consumption of meat (p=0.10) but the odds were higher for women in the top 75%. In contrast, there were strong inverse trends in the odds of breast cancer with increasing intake of vegetables (p=0.005), pulses (p=0.007) and fibre [non-starch polysaccharides, NSP (p=0.02)], with women in the highest 25% of intake of these foods having about 50% of the odds of those in the lowest ones. Adjustment for intake of vegetables and pulses reverted the odds of breast cancer in lifelong vegetarians relative to lifelong meat-eaters (OR=1.04; 95% CI=0.65-1.68) and attenuated the quartile-specific estimates for meat intake, whereas the inverse trends in the odds of breast cancer with intake of vegetables and pulses remained after adjustment for type of diet or meat intake. These findings suggest that lifelong vegetarianism may be associated with a reduction in the risk of breast cancer through its association with a higher intake of vegetables and pulses. Although it is not possible to exclude the possibility that lifelong meat abstention may also play a role, the findings provide evidence that a diet rich in vegetables and pulses, such as those typically found in South Asian diets, may be protective against this cancer.
为了研究终身素食主义在女性乳腺癌病因学中的作用，我们对居住在英格兰的印度次大陆南亚移民女性进行了一项基于人群的病例对照研究。1995年至1999年期间，从2个癌症登记处共识别出240例南亚乳腺癌病例。对于每例病例，从病例诊所的年龄性别登记册中随机选取2名年龄匹配的南亚对照。与终身食肉者相比，终身素食者患乳腺癌的几率略有降低，尽管无统计学意义，在对社会人口统计学和生殖变量进行调整后这一情况仍然存在[比值比（OR）=0.77；95%置信区间（CI）=0.50 - 1.18]。按食物类别分析显示，随着肉类消费量增加，乳腺癌几率无线性趋势（p = 0.10），但处于前75%的女性几率更高。相比之下，随着蔬菜摄入量（p = 0.005）、豆类摄入量（p = 0.007）和纤维[非淀粉多糖，NSP（p = 0.02）]增加，乳腺癌几率呈强烈的反向趋势，这些食物摄入量处于最高25%的女性患癌几率约为最低者的50%。对蔬菜和豆类摄入量进行调整后，终身素食者相对于终身食肉者患乳腺癌的几率恢复（OR = 1.04；95% CI = 0.65 - 1.68），并减弱了肉类摄入量按四分位数的估计值，而在对饮食类型或肉类摄入量进行调整后，乳腺癌几率随蔬菜和豆类摄入量增加的反向趋势仍然存在。这些发现表明，终身素食主义可能通过与较高的蔬菜和豆类摄入量相关联而与乳腺癌风险降低有关。虽然无法排除终身不食肉也可能起作用的可能性，但这些发现提供了证据，表明富含蔬菜和豆类的饮食，如南亚饮食中常见的饮食，可能对这种癌症具有保护作用。
