Lanza Elaine, Hartman Terryl J, Albert Paul S, Shields Rusty, Slattery Martha, Caan Bette, Paskett Electra, Iber Frank, Kikendall James Walter, Lance Peter, Daston Cassandra, Schatzkin Arthur
Nutritional Epidemiology Branch, Division of Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.
J Nutr. 2006 Jul;136(7):1896-903. doi: 10.1093/jn/136.7.1896.
Adequate fruit and vegetable intake was suggested to protect against colorectal cancer and colorectal adenomas; however, several recent prospective studies reported no association. We examined the association between fruits and vegetables and adenomatous polyp recurrence in the Polyp Prevention Trial (PPT). The PPT was a low-fat, high-fiber, high-fruit, and vegetable dietary intervention trial of adenoma recurrence, in which there were no differences in the rate of adenoma recurrence in participants in the intervention and control arms of the trial. In this analysis of the entire PPT trial-based cohort, multiple logistic regression analysis was used to estimate the odds ratio (OR) of advanced and nonadvanced adenoma recurrence within quartiles of baseline and change (baseline minus the mean over 3 y) in fruit and vegetable intake, after adjustment for age, total energyy intake, use of nonsteroidal anti-inflammatory drugs, BMI, and gender. There were no significant associations between nonadvanced adenoma recurrence and overall change in fruit and vegetable consumption; however, those in the highest quartile of change in dry bean intake (greatest increase) compared with those in the lowest had a significantly reduced OR for advanced adenoma recurrence (OR = 0.35; 95% CI, 0.18-0.69; P for trend = 0.001). The median in the highest quartile of change in dry bean intake was 370% higher than the baseline intake. The PPT trial-based cohort provides evidence that dry beans may be inversely associated with advanced adenoma recurrence.
建议摄入足够的水果和蔬菜以预防结直肠癌和结直肠腺瘤;然而,最近的几项前瞻性研究报告称二者并无关联。我们在息肉预防试验(PPT)中研究了水果和蔬菜与腺瘤性息肉复发之间的关联。PPT是一项关于腺瘤复发的低脂、高纤维、高水果和蔬菜的饮食干预试验,试验中干预组和对照组参与者的腺瘤复发率并无差异。在对整个基于PPT试验的队列进行的这项分析中,我们使用多元逻辑回归分析来估计在调整年龄、总能量摄入、非甾体抗炎药的使用、体重指数和性别后,水果和蔬菜摄入量的基线四分位数以及变化量(基线减去3年期间的均值)内进展期和非进展期腺瘤复发的比值比(OR)。非进展期腺瘤复发与水果和蔬菜消费的总体变化之间并无显著关联;然而,与摄入量最低四分位数的人群相比,干豆摄入量变化最高四分位数(增加最多)的人群进展期腺瘤复发的OR显著降低(OR = 0.35;95%可信区间,0.18 - 0.69;趋势P值 = 0.001)。干豆摄入量变化最高四分位数的中位数比基线摄入量高370%。基于PPT试验的队列提供了证据表明干豆可能与进展期腺瘤复发呈负相关。