Austin Gregory L, Adair Linda S, Galanko Joseph A, Martin Christopher F, Satia Jessie A, Sandler Robert S
Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina 27599, USA.
J Nutr. 2007 Apr;137(4):999-1004. doi: 10.1093/jn/137.4.999.
Recent evidence suggests overall dietary patterns, rather than specific dietary components, may be a better predictor of colorectal adenomas or cancers. Using cluster analysis, we aimed to assess the association between dietary patterns and colorectal adenomas and whether adjusting for total energy consumption prior to creating clusters affects this relation. Data from a case-control study of 725 individuals undergoing a colonoscopy were utilized. Cases (n = 203) had > or =1 adenoma on colonoscopy, and controls (n = 522) were those who had no adenomas. Dietary data were obtained from an FFQ. Daily intake for 18 different food groups was calculated. The values were transformed into Z-scores. Participants were first clustered without energy adjustment, then again based on their consumption per 1000 kcal (4187 kJ). There was no association between dietary patterns and colorectal adenomas without energy adjustment prior to creating dietary clusters, as clusters formed as a by-product of energy consumption. After adjusting for energy consumption, 3 distinct clusters emerged: 1) high fruit-low meat cluster; 2) high vegetable-moderate meat cluster; and 3) high meat cluster. After adjusting for potential confounders, the high vegetable-moderate meat cluster (odds ratio [OR] 2.17: [95% CI] 1.20-3.90) and high meat cluster (OR 1.70: [95% CI] 1.04-2.80) were at significantly increased odds of having had an adenoma compared with the high fruit-low meat cluster. A high-fruit, low-meat diet appears to be protective against colorectal adenomas compared with a dietary pattern of increased vegetable and meat consumption.
近期证据表明,总体饮食模式而非特定饮食成分可能是结直肠腺瘤或癌症更好的预测指标。我们采用聚类分析来评估饮食模式与结直肠腺瘤之间的关联,以及在创建聚类之前对总能量消耗进行调整是否会影响这种关系。我们利用了一项对725名接受结肠镜检查的个体进行的病例对照研究的数据。病例组(n = 203)在结肠镜检查中有≥1个腺瘤,对照组(n = 522)为无腺瘤者。饮食数据通过食物频率问卷获得。计算了18种不同食物组的每日摄入量。这些值被转换为Z分数。参与者首先在不进行能量调整的情况下进行聚类,然后再根据每1000千卡(4187千焦)的消耗量进行聚类。在创建饮食聚类之前不进行能量调整时,饮食模式与结直肠腺瘤之间没有关联,因为聚类是能量消耗的副产品。在调整能量消耗后,出现了3个不同的聚类:1)高水果 - 低肉类聚类;2)高蔬菜 - 中等肉类聚类;3)高肉类聚类。在调整潜在混杂因素后,与高水果 - 低肉类聚类相比,高蔬菜 - 中等肉类聚类(优势比[OR] 2.17:[95%置信区间] 1.20 - 3.90)和高肉类聚类(OR 1.70:[95%置信区间] 1.04 - 2.80)患腺瘤的几率显著增加。与增加蔬菜和肉类消费的饮食模式相比,高水果、低肉类饮食似乎对结直肠腺瘤具有保护作用。