Shahar Suzana, Shafurah Siti, Hasan Shaari Nur Suraiya Abu, Rajikan Roslee, Rajab Nor Fadilah, Golkhalkhali Babak, Zainuddin Zulkifli Md
Department of Nutrition and Dietetics, Faculty of Allied Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Asian Pac J Cancer Prev. 2011;12(3):605-11.
There is a paucity of information on risk factors of prostate cancer, especially those related to dietary and lifestyle among Asian populations.
This study aimed to determine the relationship between dietary intake (macronutrients, fruits, vegetables and lycopene), lifetime physical activity and oxidative DNA damage with prostate cancer.
A case control study was carried out among 105 subjects (case n=35, control n=70), matched for age and ethnicity. Data on sociodemographic, medical, dietary intake, consumption of lycopene rich food and lifetime physical activity were obtained through an interview based questionnaire. Anthropometric measurements including weight, height and waist hip circumferences were also carried out on subjects. A total of 3 mL fasting venous blood was drawn to assess lymphocyte oxidative DNA damage using the alkaline comet assay.
Cases had a significantly higher intake of fat (27.7 ± 5.5%) as compared to controls (25.1 ± 5.9%) (p < 0.05). Mean intakes of fruits and vegetables (3.11 ± 1.01 servings/d)(p < 0.05), fruits (1.23 ± 0.59 servings/d) (p<0.05) and vegetables (1.97 ± 0.94 servings/d) were higher in controls than cases (2.53 ± 1.01, 0.91 ∓ 0.69, 1.62 ± 0.82 servings/d). A total of 71% of cases did not met the recommendation of a minimum of three servings of fruits and vegetables daily, as compared to 34% of controls (p < 0.05) (adjusted OR 6.52 (95% CI 2.3-17.8)) (p < 0.05). Estimated lycopene intake among cases (2,339 ∓ 1,312 mcg/d) were lower than controls (3881 ∓ 3120 mcg/d) (p< 0.01). Estimated lycopene intake of less than 2,498 mcg/day (50th percentile) increased risk of prostate cancer by double [Adjusted OR 2.5 (95%CI 0.99-6.31)]. Intake of tomatoes, watermelon, guava, pomelo, papaya, mango, oranges, dragon fruit, carrot, tomato sauce and barbeque sauce were higher in controls compared to cases. Intake of tomato sauce of more than 2.24 g/d (25th percentile), papaya more than 22.7 g/d (50th percentile) and oranges more than 19.1g/h (50th percentile) reduced prostate cancer risk by 7.4 (Adjusted OR 7.4 (95% CI 1.17-46.8)), 2.7 (adjusted OR 2.75 (95% CI 1.03-7.39)) and 2.6 times (adjusted OR = 2.6 (95% CI=1.01-6.67)), respectively (p < 0.05 for all parameters). No oxidative damage was observed among subjects. Past history of not engaging with any physical activities at the age of 45 to 54 years old increased risk of prostate cancer by approximately three folds (Adjusted OR 2.9(95% CI = 0.8-10.8)) (p < 0.05). In conclusion, low fat diet, high intake of fruits, vegetables and lycopene rich foods and being physical active at middle age were found to be protective. Thus, it is essential for Malaysian men to consume adequate fruits and vegetables, reduce fat intake and engage in physical activity in order to reduce prostate cancer risk.
关于前列腺癌风险因素的信息匮乏，尤其是亚洲人群中与饮食和生活方式相关的因素。
本研究旨在确定饮食摄入（宏量营养素、水果、蔬菜和番茄红素）、终生身体活动以及氧化DNA损伤与前列腺癌之间的关系。
对105名受试者（病例组n = 35，对照组n = 70）进行了一项病例对照研究，根据年龄和种族进行匹配。通过基于访谈的问卷获取社会人口统计学、医学、饮食摄入、富含番茄红素食物的消费情况以及终生身体活动的数据。还对受试者进行了人体测量，包括体重、身高和腰臀围。抽取3毫升空腹静脉血，使用碱性彗星试验评估淋巴细胞氧化DNA损伤。
病例组的脂肪摄入量（27.7±5.5%）显著高于对照组（25.1±5.9%）（p<0.05）。对照组的水果和蔬菜平均摄入量（3.11±1.01份/天）（p<0.05）、水果（1.23±0.59份/天）（p<0.05）和蔬菜（1.97±0.94份/天）均高于病例组（2.53±1.01、0.91±0.69、1.62±0.82份/天）。共有71%的病例未达到每日至少三份水果和蔬菜的建议摄入量，而对照组为34%（p<0.05）（调整后的OR为6.52（95%CI 2.3 - 17.8））（p<0.05）。病例组的估计番茄红素摄入量（2339±1312微克/天）低于对照组（3881±3120微克/天）（p<0.01）。估计番茄红素摄入量低于每天2498微克（第50百分位数）会使前列腺癌风险增加一倍[调整后的OR为2.5（95%CI 0.99 - 6.31）]。对照组的番茄、西瓜、番石榴、柚子、木瓜、芒果、橙子、火龙果、胡萝卜、番茄酱和烧烤酱的摄入量高于病例组。番茄酱摄入量超过2.24克/天（第25百分位数）、木瓜超过22.7克/天（第50百分位数）和橙子超过19.1克/小时（第5百分位数）分别使前列腺癌风险降低7.4倍（调整后的OR为7.4（95%CI 1.17 - 46.8））、2.7倍（调整后的OR为2.75（95%CI 1.03 - 7.39））和2.6倍（调整后的OR = 2.6（95%CI = 1.01 - 6.67））（所有参数p<0.05）。在受试者中未观察到氧化损伤。45至54岁时无任何身体活动的既往史使前列腺癌风险增加约三倍（调整后的OR为2.9（95%CI = 0.8 - 10.8））（p<0.05）。总之，发现低脂饮食、高摄入水果、蔬菜和富含番茄红素的食物以及中年时积极进行身体活动具有保护作用。因此，马来西亚男性为降低前列腺癌风险，摄入足够的水果和蔬菜、减少脂肪摄入并进行身体活动至关重要。
