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[盐与癌症]

[Salt and cancer].

作者信息

Strnad Marija

机构信息

Akademija medicinskih znanosti Hrvatske, Zagreb, Hrvatska.

出版信息

Acta Med Croatica. 2010 May;64(2):159-61.

Abstract

Besides cardiovascular disease, a high salt intake causes other adverse health effects, i.e., gastric and some other cancers, obesity (risk factor for many cancer sites), Meniere's disease, worsening of renal disease, triggering an asthma attack, osteoporosis, exacerbation of fluid retention, renal calculi, etc. Diets containing high amounts of food preserved by salting and pickling are associated with an increased risk of cancers of the stomach, nose and throat. Because gastric cancer is still the most common cancer in some countries (especially in Japan), its prevention is one of the most important aspects of cancer control strategy. Observations among Japanese immigrants in the U.S.A. and Brazil based on the geographic differences, the trend in cancer incidence with time, and change in the incidence patterns indicate that gastric cancer is closely associated with dietary factors such as the intake of salt and salted food. The findings of many epidemiological studies suggest that high dietary salt intake is a significant risk factor for gastric cancer and this association was found to be strong in the presence of Helicobacter (H.) pylori infection with atrophic gastritis. A high-salt intake strips the lining of the stomach and may make infection with H. pylori more likely or may exacerbate the infection. Salting, pickling and smoking are traditionally popular ways of preparing food in Japan and some parts of Asia. In addition to salt intake, cigarette smoking and low consumption of fruit and vegetables increase the risk of stomach cancer. However, it is not known whether it is specifically the salt in these foods or a combination of salt and other chemicals that can cause cancer. One study identified a mutagen in nitrite-treated Japanese salted fish, and chemical structure of this mutagen suggests that it is derived from methionine and that salt and nitrite are precursors for its formation. Working under conditions of heat stress greatly increased the workers' salt excretion through perspiration. Workers exposed to heat stress consumed as much as 13-38 g salt daily. As salt strongly enhances and promotes chemical gastric carcinogenesis and H. pylori infection in both humans and animals, there is an association between work, salt intake, and development of stomach cancer. Reducing salt intake, especially during pregnancy, also reduces the risk of developing breast cancer and many other diseases, as well as obesity. The risk of most cancers is reduced by losing weight. The geographical data and analyses currently available suggest that road salt (road salting in winter) may be associated with elevated mortality from cancer of the breast, lung, esophagus, throat, larynx, large intestine, rectum and bladder. There is no available literature on the health impacts of road salt. The cause and effect relationships cannot be established without further studies.

摘要

除心血管疾病外,高盐摄入还会导致其他不良健康影响,即胃癌和其他一些癌症、肥胖(许多癌症部位的风险因素)、梅尼埃病、肾病恶化、引发哮喘发作、骨质疏松、液体潴留加剧、肾结石等。含有大量腌制和腌渍食品的饮食与胃癌、鼻癌和喉癌风险增加有关。由于胃癌在一些国家(尤其是日本)仍是最常见的癌症,其预防是癌症控制策略的最重要方面之一。基于地理差异、癌症发病率随时间的趋势以及发病率模式变化,对美国和巴西的日本移民进行的观察表明,胃癌与饮食因素密切相关,如盐和腌制食品的摄入量。许多流行病学研究结果表明,高盐饮食是胃癌的一个重要风险因素,并且在幽门螺杆菌(H. pylori)感染伴萎缩性胃炎的情况下,这种关联很强。高盐摄入会剥脱胃黏膜,可能使感染幽门螺杆菌的可能性增加或使感染加剧。在日本和亚洲一些地区,腌制、腌渍和烟熏是传统的食物制备方式。除盐摄入外,吸烟以及水果和蔬菜摄入量低会增加患胃癌的风险。然而,尚不清楚是这些食物中的盐本身还是盐与其他化学物质的组合会导致癌症。一项研究在经亚硝酸盐处理的日本咸鱼中鉴定出一种诱变剂,这种诱变剂的化学结构表明它源自蛋氨酸,盐和亚硝酸盐是其形成的前体。在热应激条件下工作会大大增加工人通过排汗的盐排泄量。暴露于热应激的工人每天摄入多达13 - 38克盐。由于盐在人类和动物中都强烈增强并促进化学性胃癌发生和幽门螺杆菌感染,工作、盐摄入与胃癌发展之间存在关联。减少盐摄入,尤其是在孕期,还可降低患乳腺癌和许多其他疾病以及肥胖症的风险。大多数癌症的风险可通过减肥降低。目前可得的地理数据和分析表明,道路用盐(冬季道路撒盐)可能与乳腺癌、肺癌、食管癌、喉癌、大肠癌、直肠癌和膀胱癌的死亡率升高有关。关于道路用盐对健康影响的文献资料尚缺。若无进一步研究,因果关系无法确立。

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