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乳腺癌女性的体脂与不良饮食

Body fat and poor diet in breast cancer women.

作者信息

Amaral P, Miguel R, Mehdad A, Cruz C, Monteiro Grillo I, Camilo M, Ravasco P

机构信息

Unidade de Nutrição e Metabolismo, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Serviço de Radioterpaia of the Hospital Universitario de Santa Maria, Lisboa, Portugal.

出版信息

Nutr Hosp. 2010 May-Jun;25(3):456-61.

Abstract

BACKGROUND

Breast cancer is the most common cancer in women worldwide. Differences in breast cancer incidence suggest a significant role of environmental factors in the aetiology: obesity, central adiposity, excess body fat and some dietary factors have been suggested as risk factors. This pilot study aimed to analyse the pattern of nutritional status, body fat, and the usual dietary intake among women diagnosed with breast cancer, consecutively referred to the Radiotherapy Department of the University Hospital Santa Maria.

PATIENTS AND METHODS

Throughout 2006, 71 consecutive women with breast cancer were included.

EVALUATIONS

weight (kg) & height (m), determined with a SECA(R) floor scale+stadiometer to calculate body mass index (BMI), waist circumference, percentage body fat with bipolar hand-held bio-impedance analysis (BF-306), Food Frequency Questionnaire validated for the Portuguese population to assess the usual dietary intake. Frequency analysis and Mann-Whitney U test were used to evaluate prevalence and associations.

RESULTS

Mean age was 60+/-12 (36-90) years. Invasive ductal carcinoma was the most frequent histology (68%), p<0.05. Most patients were in stage I (30%) or stage IIA (25%) of disease vs IIB (10%), IIIB (4%), IV (4%) or others (21%), p<0.05. Regarding nutritional status, 82% were overweight/obese; 89% of patients had a %body fat mass above the maximum limit of 30% vs only 8 (11%) with %body fat within normal range (p<0.002); 62% pts had a waist circumference>88 cm (prevalence analysis: p<0.04), and 61% of pts had gained weight after diagnosis. Univariate analysis did not show any association between histology, BMI, %body fat and waist circumference; by multivariate analysis there was an association between higher BMI, %body fat & aggressive histologies (p<0.005). Food frequency analysis showed a low intake of vegetables and whole grain cereals rich in complex carbohydrates (sources of fibre and phytochemicals), of fatty fish & nuts, primary sources of n-3 PUFA's and a high intake of saturated fat; more aggressive histologies were correlated with low intake of green leafy vegetables (p=0.05) and n-3 fatty acids food sources (p=0.01).

CONCLUSIONS

Our findings show a vast prevalence & homogeneous pattern of overweight/obesity, excessive body and abdominal fat, as well as weight gain after diagnosis, combined with diets deficient in protective nutrients. Further investigation is warranted as cancer rates in Portugal continue to increase.

摘要

背景

乳腺癌是全球女性中最常见的癌症。乳腺癌发病率的差异表明环境因素在病因学中起着重要作用:肥胖、中心性肥胖、体脂过多以及一些饮食因素被认为是风险因素。这项初步研究旨在分析连续转诊至圣玛丽亚大学医院放疗科的乳腺癌女性患者的营养状况、体脂和日常饮食摄入模式。

患者与方法

2006年全年,纳入了71例连续的乳腺癌女性患者。

评估

使用赛多利斯(SECA)落地秤和身高计测量体重(kg)和身高(m),以计算体重指数(BMI)、腰围,采用双极手持生物电阻抗分析法(BF - 306)测量体脂百分比,使用经过葡萄牙人群验证的食物频率问卷评估日常饮食摄入。采用频率分析和曼 - 惠特尼U检验来评估患病率及相关性。

结果

平均年龄为60±12(36 - 90)岁。浸润性导管癌是最常见的组织学类型(68%),p<0.05。大多数患者处于疾病的I期(30%)或IIA期(25%),而IIB期(10%)、IIIB期(4%)、IV期(4%)或其他期(21%),p<0.05。关于营养状况,82%的患者超重/肥胖;89%的患者体脂百分比高于30%的上限,而只有8例(11%)患者的体脂百分比在正常范围内(p<0.002);62%的患者腰围>88 cm(患病率分析:p<0.04),61%的患者在确诊后体重增加。单因素分析未显示组织学、BMI、体脂百分比和腰围之间存在任何关联;多因素分析显示较高的BMI、体脂百分比与侵袭性组织学类型之间存在关联(p<0.005)。食物频率分析显示,富含复合碳水化合物(纤维和植物化学物质来源)的蔬菜和全谷物摄入量低,富含n - 3多不饱和脂肪酸的脂肪鱼和坚果摄入量低,饱和脂肪摄入量高;侵袭性更强的组织学类型与绿叶蔬菜摄入量低(p = 0.05)和n - 3脂肪酸食物来源摄入量低(p = 0.01)相关。

结论

我们的研究结果表明,超重/肥胖、体脂过多和腹部脂肪过多以及确诊后体重增加的情况普遍存在且模式一致,同时饮食中缺乏保护性营养素。鉴于葡萄牙的癌症发病率持续上升,有必要进行进一步调查。

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