Chan June M, Gann Peter H, Giovannucci Edward L
Department of Epidemiology and Biostatistics, 1600 Divisadero St, Box 1695, San Francisco, CA 94143-1695, USA.
J Clin Oncol. 2005 Nov 10;23(32):8152-60. doi: 10.1200/JCO.2005.03.1492.
Increasing evidence supports the important role of nutrition in cancer prevention, including prevention of prostate cancer. In this review, we summarize data for some of the most consistently observed dietary associations for prostate cancer incidence, briefly consider possible postdiagnostic effects of nutrition on prostate cancer progression/survival, discuss new but limited data on diet-gene interactions, and comment on current areas of controversy for future research focus. Potential protective dietary elements include tomatoes/lycopene, other carotenoids, cruciferous vegetables, vitamin E, selenium, fish/marine omega-3 fatty acids, soy, isoflavones and polyphenols; whereas milk, dairy, calcium, zinc at high doses, saturated fat, grilled meats, and heterocyclic amines may increase risk. It is important to note that randomized clinical trial data exist only for vitamin E, calcium, beta-carotene, and selenium (all of which suggest inverse or no association). Several genes, such as MnSOD, XRCC1, and GST, may modify the association of specific nutrients and foods with prostate cancer risk; and further research is warranted to confirm these initial observed relationships. Until further clinical trial data are available on specific supplements and prostate cancer prevention, it would be prudent to emphasize a diet consisting of a wide variety of plant-based foods and fish; this is similar to what is recommended (and what is more well established) for the primary prevention of heart disease.
越来越多的证据支持营养在癌症预防中发挥的重要作用,包括预防前列腺癌。在本综述中,我们总结了一些最常观察到的与前列腺癌发病率相关的饮食关联数据,简要考虑营养对前列腺癌进展/生存的可能诊断后影响,讨论饮食与基因相互作用的新的但有限的数据,并对当前有争议的领域进行评论以供未来研究重点关注。潜在的保护性饮食元素包括番茄/番茄红素、其他类胡萝卜素、十字花科蔬菜、维生素E、硒、鱼类/海洋ω-3脂肪酸、大豆、异黄酮和多酚;而牛奶、乳制品、钙、高剂量锌、饱和脂肪、烤肉和杂环胺可能会增加风险。需要注意的是,仅存在关于维生素E、钙、β-胡萝卜素和硒的随机临床试验数据(所有这些都表明呈负相关或无关联)。几个基因,如锰超氧化物歧化酶(MnSOD)、X射线修复交叉互补蛋白1(XRCC1)和谷胱甘肽S-转移酶(GST),可能会改变特定营养素和食物与前列腺癌风险之间的关联;需要进一步研究以证实这些初步观察到的关系。在获得关于特定补充剂与前列腺癌预防的更多临床试验数据之前,谨慎的做法是强调由多种植物性食物和鱼类组成的饮食;这与预防心脏病的一级预防建议(且更已确立的建议)相似。