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脂肪、纤维、水果、蔬菜与结直肠腺瘤风险

Fat, fiber, fruits, vegetables, and risk of colorectal adenomas.

作者信息

Mathew Aleyamma, Peters Ulrike, Chatterjee Nilanjan, Kulldorff Martin, Sinha Rashmi

机构信息

Division of Cancer Epidemiology & Genetics, National Cancer Institute, Rockville, MD, USA.

出版信息

Int J Cancer. 2004 Jan 10;108(2):287-92. doi: 10.1002/ijc.10984.

Abstract

A case-control study was conducted at the National Naval Medical Center (Maryland, USA) from 1994 to 1996 to investigate the possible association between dietary factors and colorectal adenomas. Cases (n = 239) were subjects diagnosed with adenomas (146 new and 93 recurrent) by sigmoidoscopy or colonoscopy. Those with no evidence of adenomas found by sigmoidoscopy were recruited as controls (n = 228). Dietary variables, assessed by a 100-item food frequency questionnaire, were analyzed by the logistic regression model, which was adjusted for age, gender and total energy intake. Variables of fat intake were further adjusted for red meat intake. An increased risk of 7% [odds ratio (OR): 1.07; 95% confidence interval (95% CI): 0.94-1.22] per 5% energy/day from total fat was observed. Every additional 5% unit of oleic acid intake/day significantly increased the adenoma risk by 115% (OR: 2.15; 95% CI: 1.05-4.39). Red meat fat increased the risk by 20% (OR: 1.20; 95% CI: 0.71-2.04), and white meat fat decreased the risk by 67% (OR: 0.33; 95% CI: 0.19-0.95) for every additional 5% unit of respective intake/day. Risk decreased by 41% (OR: 0.59; 95% CI: 0.41-0.86) for every additional 5% unit of fiber intake/day. Vegetable [OR per 100 g of vegetable intake/day: 0.83, 95% CI: 0.67-1.04] and fruit (OR per 100 g of fruit intake/day: 0.92, 95% CI: 0.82-1.03) intake showed an inverse association, and the results are suggestive of an association with the risk for adenomas. In conclusion, a strong positive association between oleic acid intake and colorectal adenoma risk was observed. This is likely to be an indicator of "unhealthy" food (meat, dairy, margarine, mayonnaise, sweet baked food) consumption in this population. Increased intake of dietary fiber was associated with a moderately decreased risk of adenomas.

摘要

1994年至1996年,美国国立海军医疗中心(马里兰州)开展了一项病例对照研究,以调查饮食因素与结肠直肠腺瘤之间可能存在的关联。病例组(n = 239)为经乙状结肠镜检查或结肠镜检查诊断为腺瘤的受试者(146例新发和93例复发)。乙状结肠镜检查未发现腺瘤证据的受试者被招募为对照组(n = 228)。通过一份包含100个条目的食物频率问卷评估饮食变量,并采用逻辑回归模型进行分析,该模型对年龄、性别和总能量摄入进行了调整。脂肪摄入变量进一步根据红肉摄入量进行了调整。观察到总脂肪每增加5%能量/天,风险增加7%[比值比(OR):

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