Park Yikyung, Leitzmann Michael F, Subar Amy F, Hollenbeck Albert, Schatzkin Arthur
Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Blvd., Bethesda, MD 20852, USA.
Arch Intern Med. 2009 Feb 23;169(4):391-401. doi: 10.1001/archinternmed.2008.578.
Dairy food and calcium intakes have been hypothesized to play roles that differ among individual cancer sites, but the evidence has been limited and inconsistent. Moreover, their effect on cancer in total is unclear.
Dairy food and calcium intakes in relation to total cancer as well as cancer at individual sites were examined in the National Institutes of Health (NIH)-AARP (formerly known as the American Association of Retired Persons) Diet and Health Study. Intakes of dairy food and calcium from foods and supplements were assessed with a food frequency questionnaire. Incident cancer cases were identified through linkage with state cancer registries. A Cox proportional hazard model was used to estimate relative risks and 2-sided 95% confidence intervals (CIs).
During an average of 7 years of follow-up, we identified 36 965 and 16 605 cancer cases in men and women, respectively. Calcium intake was not related to total cancer in men but was nonlinearly associated with total cancer in women: the risk decreased up to approximately 1300 mg/d, above which no further risk reduction was observed. In both men and women, dairy food and calcium intakes were inversely associated with cancers of the digestive system (multivariate relative risk for the highest quintile of total calcium vs the lowest, 0.84; 95% CI, 0.77-0.92 in men, and 0.77; 95% CI, 0.69-0.91 in women). Decreased risk was particularly pronounced with colorectal cancer. Supplemental calcium intake was also inversely associated with colorectal cancer risk.
Our study suggests that calcium intake is associated with a lower risk of total cancer and cancers of the digestive system, especially colorectal cancer.
有假设认为,乳制品摄入和钙摄入量在不同癌症部位所起的作用有所不同,但相关证据有限且不一致。此外,它们对总体癌症的影响尚不清楚。
在美国国立卫生研究院(NIH)-美国退休人员协会(AARP,前身为美国退休人员协会)饮食与健康研究中,研究了乳制品摄入和钙摄入量与总体癌症以及各个部位癌症的关系。通过食物频率问卷评估食物和补充剂中乳制品和钙的摄入量。通过与州癌症登记处的数据链接确定新发癌症病例。使用Cox比例风险模型估计相对风险和双侧95%置信区间(CI)。
在平均7年的随访期间,我们分别在男性和女性中确定了36965例和16605例癌症病例。男性的钙摄入量与总体癌症无关,但与女性的总体癌症呈非线性相关:风险在每日约1300毫克时下降,超过该剂量则未观察到进一步的风险降低。在男性和女性中,乳制品摄入和钙摄入量均与消化系统癌症呈负相关(总钙摄入量最高五分位数与最低五分位数相比的多变量相对风险,男性为0.84;95%CI,0.77-0.92,女性为0.77;95%CI,0.69-0.91)。结直肠癌的风险降低尤为明显。补充钙摄入也与结直肠癌风险呈负相关。
我们的研究表明,钙摄入与总体癌症和消化系统癌症风险较低有关,尤其是结直肠癌。