Department of Nutrition, Simmons College, 300 The Fenway, Boston, MA 02115, USA.
Am J Epidemiol. 2011 Sep 15;174(6):652-60. doi: 10.1093/aje/kwr148. Epub 2011 Aug 10.
The authors prospectively examined the association between the Dietary Approaches to Stop Hypertension diet score, overall, animal-based, and vegetable-based low-carbohydrate-diet scores, and major plant food groups and the risk of postmenopausal breast cancer in 86,621 women in the Nurses' Health Study. Diet scores were calculated by using data from up to 7 food frequency questionnaires, with follow-up from 1980 to 2006. The authors ascertained 5,522 incident cases of breast cancer, including 3,314 estrogen receptor-positive (ER+) cancers and 826 estrogen receptor-negative (ER-) cancers. After adjustment for potential confounders, the Dietary Approaches to Stop Hypertension diet score was associated with a lower risk of ER- cancer (relative risk comparing extreme quintiles = 0.80, 95% confidence interval: 0.64, 1.01; P trend = 0.02). However, this was largely explained by higher intakes of fruits and vegetables. The authors also observed an inverse association between risk of ER- cancer and the vegetable-based, low-carbohydrate-diet score (corresponding relative risk = 0.81, 95% confidence interval: 0.65, 1.01; P trend = 0.03). High total fruit and low-protein vegetable intakes were associated with a lower risk of ER- cancer (relative risk comparing extreme quintiles = 0.71, 95% confidence interval: 0.55, 0.90; P trend = 0.005). No association was found between ER+ tumors and fruit and vegetable intakes. A diet high in fruits and vegetables, such as one represented by the Dietary Approaches to Stop Hypertension diet score, was associated with a lower risk of ER- breast cancer. In addition, a diet high in plant protein and fat and moderate in carbohydrate content was associated with a lower risk of ER- cancer.
作者前瞻性地研究了饮食方法预防高血压饮食评分、整体、基于动物和基于蔬菜的低碳水化合物饮食评分以及主要植物食物组与绝经后乳腺癌风险之间的关系，该研究共纳入了 86621 名护士健康研究中的女性。饮食评分是通过使用多达 7 份食物频率问卷的数据计算得出的，随访时间从 1980 年到 2006 年。作者确定了 5522 例乳腺癌病例，包括 3314 例雌激素受体阳性（ER+）癌症和 826 例雌激素受体阴性（ER-）癌症。在调整了潜在混杂因素后，饮食方法预防高血压饮食评分与 ER-癌症风险降低相关（极端五分位组比较的相对风险 = 0.80，95%置信区间：0.64，1.01；P 趋势=0.02）。然而，这主要是由于水果和蔬菜摄入量较高所致。作者还观察到 ER-癌症风险与基于蔬菜的低碳水化合物饮食评分呈负相关（相应的相对风险=0.81，95%置信区间：0.65，1.01；P 趋势=0.03）。高总水果和低蛋白质蔬菜摄入量与 ER-癌症风险降低相关（极端五分位组比较的相对风险=0.71，95%置信区间：0.55，0.90；P 趋势=0.005）。ER+肿瘤与水果和蔬菜摄入量之间没有关联。高水果和蔬菜饮食，如饮食方法预防高血压饮食评分所代表的饮食，与 ER-乳腺癌风险降低相关。此外，高植物蛋白和脂肪、中碳水化合物含量的饮食与 ER-癌症风险降低相关。
