Jenab Mazda, Ferrari Pietro, Slimani Nadia, Norat Teresa, Casagrande Corinne, Overad Kim, Olsen Anja, Stripp Connie, Tjønneland Anne, Boutron-Ruault Marie-Christine, Clavel-Chapelon Françoise, Kesse Emmanuelle, Nieters Alexandra, Bergmann Manuela, Boeing Heiner, Naska Androniki, Trichopoulou Antonia, Palli Domenico, Krogh Vittorio, Celentano Egidio, Tumino Rosario, Sacerdote Carlotta, Bueno-de-Mesquita Hendrik B, Ocké Marga C, Peeters Petra H M, Engeset Dagrun, Quirós José R, González Carlos A, Martínez Carmen, Chirlaque Maria D, Ardanaz Eva, Dorronsoro Miren, Wallström Peter, Palmqvist Richard, Van Guelpen Bethany, Bingham Sheila, San Joaquin Miguel A, Saracci Rodolfo, Kaaks Rudolf, Riboli Elio
Nutrition and Hormones Group, IARC-WHO, 150 cours Albert-Thomas, 69372 Lyon Cedex 08, France.
Cancer Epidemiol Biomarkers Prev. 2004 Oct;13(10):1595-603.
A link between unsaturated fatty acids or phytonutrients and reduced risk of colorectal cancer has been suggested. However, the effects of higher intake of dietary sources of these nutrients, such as the nuts and seeds food group, are less clear. The objective of this study was to determine the effects of nut and seed intake on colorectal cancer risk within the European Prospective Investigation into Cancer and Nutrition study, a large prospective cohort study involving 10 European countries. Total nut and seed intake was determined from country-specific dietary questionnaires. The data set included 478,040 subjects (141,988 men, 336,052 women) with a total of 855 (327 men, 528 women) colon and 474 (215 men, 259 women) rectal cancer cases. A multivariate Cox proportional hazards model, stratified by center and controlled for fruit intake, dietary fiber, energy, height, weight, sex, age, physical activity, and smoking, was used. The data show no association between higher intake of nuts and seeds and risk of colorectal, colon, and rectal cancers in men and women combined, but a significant inverse association was observed in subgroup analyses for colon cancer in women at the highest (>6.2 g/d) versus the lowest (nonconsumers; hazard ratio, 0.69; 95% confidence interval, 0.50-0.95) category of intake and for the linear effect of log-transformed intake (hazard ratio, 0.89; 95% confidence interval, 0.80-0.98), with no associations in men. It is not evident from this data why there may be a stronger association in women or why it may be limited to the colon, suggesting that much further research is necessary.
不饱和脂肪酸或植物营养素与降低结直肠癌风险之间的联系已被提出。然而，这些营养素的更高饮食摄入量（如坚果和种子食物组）的影响尚不清楚。本研究的目的是在欧洲癌症与营养前瞻性调查（一项涉及10个欧洲国家的大型前瞻性队列研究）中确定坚果和种子摄入量对结直肠癌风险的影响。通过特定国家的饮食问卷确定坚果和种子的总摄入量。数据集包括478,040名受试者（141,988名男性，336,052名女性），共有855例（327名男性，528名女性）结肠癌和474例（215名男性，259名女性）直肠癌病例。使用了多变量Cox比例风险模型，按中心分层并控制水果摄入量、膳食纤维、能量、身高、体重、性别、年龄、身体活动和吸烟情况。数据显示，坚果和种子的较高摄入量与男性和女性联合的结直肠癌、结肠癌和直肠癌风险之间没有关联，但在摄入量最高（>6.2克/天）与最低（非消费者；风险比，0.69；95%置信区间，0.50 - 0.95）类别的女性结肠癌亚组分析以及对数转换摄入量的线性效应（风险比，0.89；95%置信区间，0.80 - 0.98）中观察到显著的负相关，在男性中无关联。从这些数据中尚不清楚为什么女性可能存在更强的关联，或者为什么可能仅限于结肠癌，这表明有必要进行更多的研究。
