一项针对女性的前瞻性研究中肉类、脂肪和纤维摄入量与结肠癌风险的关系。

Relation of meat, fat, and fiber intake to the risk of colon cancer in a prospective study among women.

作者信息

Willett W C, Stampfer M J, Colditz G A, Rosner B A, Speizer F E

机构信息

Channing Laboratory, Department of Medicine, Harvard Medical School, Boston.

出版信息

N Engl J Med. 1990 Dec 13;323(24):1664-72. doi: 10.1056/NEJM199012133232404.

DOI:10.1056/NEJM199012133232404

PMID:2172820

Abstract

BACKGROUND

The rates of colon cancer in various countries are strongly correlated with the per capita consumption of red meat and animal fat and, to a lesser degree, inversely associated with the consumption of fiber.

METHODS

We conducted a prospective study among 88,751 women 34 to 59 years old and without a history of cancer, inflammatory bowel disease, or familial polyposis who completed a dietary questionnaire in 1980. By 1986, during 512,488 person-years of follow-up, 150 incident cases of colon cancer had been documented.

RESULTS

After adjustment for total energy intake, animal fat was positively associated with the risk of colon cancer (P for trend = 0.01); the relative risk for the highest as compared with the lowest quintile was 1.89 (95 percent confidence interval, 1.13 to 3.15). No association was found for vegetable fat. The relative risk of colon cancer in women who ate beef, pork, or lamb as a main dish every day was 2.49 (95 percent confidence interval, 1.24 to 5.03), as compared with those reporting consumption less than once a month. Processed meats and liver were also significantly associated with increased risk, whereas fish and chicken without skin were related to decreased risk. The ratio of the intake of red meat to the intake of chicken and fish was particularly strongly associated with an increased incidence of colon cancer (P for trend = 0.0005); the relative risk for women in the highest quintile of this ratio as compared with those in the lowest quintile was 2.49 (95 percent confidence interval, 1.50 to 4.13). A low intake of fiber from fruits appeared to contribute to the risk of colon cancer, but this relation was not statistically independent of meat intake.

CONCLUSIONS

These prospective data provide evidence for the hypothesis that a high intake of animal fat increases the risk of colon cancer, and they support existing recommendations to substitute fish and chicken for meats high in fat.

摘要

背景

各国结肠癌发病率与红肉和动物脂肪的人均消费量密切相关，在较小程度上，与纤维消费量呈负相关。

方法

我们对88751名年龄在34至59岁之间、无癌症、炎症性肠病或家族性息肉病病史的女性进行了一项前瞻性研究，这些女性在1980年完成了一份饮食问卷。到1986年，在512488人年的随访期间，记录了150例结肠癌新发病例。

结果

在调整总能量摄入后，动物脂肪与结肠癌风险呈正相关（趋势P值=0.01）；最高五分位数与最低五分位数相比的相对风险为1.89（95%置信区间，1.13至3.15）。未发现蔬菜脂肪与结肠癌有关联。每天以牛肉、猪肉或羊肉为主菜的女性患结肠癌的相对风险为2.49（95%置信区间，1.24至5.03），而每月食用次数少于一次的女性相比。加工肉类和肝脏也与风险增加显著相关，而无皮鱼和鸡肉与风险降低有关。红肉摄入量与鸡肉和鱼摄入量的比值与结肠癌发病率增加尤其密切相关（趋势P值=0.0005）；该比值最高五分位数的女性与最低五分位数的女性相比，相对风险为2.49（95%置信区间，1.50至4.13）。水果纤维摄入量低似乎会增加患结肠癌的风险，但这种关系在统计学上并不独立于肉类摄入量。