Yale School of Public Health, New Haven, CT , USA.
J Natl Cancer Inst. 2013 Sep 4;105(17):1298-305. doi: 10.1093/jnci/djt185. Epub 2013 Aug 15.
Dietary pattern analyses characterizing combinations of food intakes offer conceptual and statistical advantages over food- and nutrient-based analyses of disease risk. However, few studies have examined dietary patterns and pancreatic cancer risk and none focused on the 2005 Dietary Guidelines for Americans. We used the Healthy Eating Index 2005 (HEI-2005) to estimate the association between meeting those dietary guidelines and pancreatic cancer risk.
We calculated the HEI-2005 score for 537 218 men and women in the National Institutes of Health-American Association of Retired Persons Diet and Health Study using responses to food frequency questionnaires returned in 1995 and 1996. We used Cox proportional hazards regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for risk of pancreatic cancer according to HEI-2005 quintiles and explored effect modification by known risk factors. P interaction values were calculated using the Wald test. All statistical tests were two-sided.
We identified 2383 incident, exocrine pancreatic cancer cases (median = 10.5 years follow-up). Comparing participants who met the most dietary guidelines (Q5) with those who met the fewest guidelines (Q1), we observed a reduced risk of pancreatic cancer (HR = 0.85, 95% CI = 0.74 to 0.97). Among men there was an interaction by body mass index (P interaction = .03), with a hazard ratio of 0.72 (95% CI = 0.59 to 0.88) comparing Q5 vs Q1 in overweight/obese men (body mass index ≥ 25 kg/m(2)) but no association among normal weight men.
Our findings support the hypothesis that consuming a high-quality diet, as scored by the HEI-2005, may reduce the risk of pancreatic cancer.
与基于食物和营养素的疾病风险分析相比,描述食物摄入量组合的饮食模式分析具有概念和统计学上的优势。然而,很少有研究检查饮食模式与胰腺癌风险之间的关系,也没有研究专门针对美国 2005 年饮食指南。我们使用 2005 年健康饮食指数(HEI-2005)来估计符合这些饮食指南与胰腺癌风险之间的关联。
我们使用美国国立卫生研究院-美国退休人员协会饮食与健康研究中 1995 年和 1996 年返回的食物频率问卷的回答,计算了 537218 名男性和女性的 HEI-2005 评分。我们使用 Cox 比例风险回归来估计根据 HEI-2005 五分位数的胰腺癌风险的危险比(HR)和 95%置信区间(CI),并探索了已知危险因素的效应修饰。使用 Wald 检验计算 P 交互值。所有统计检验均为双侧。
我们确定了 2383 例散发的外分泌性胰腺癌病例(中位数= 10.5 年随访)。与符合最少饮食指南(Q1)的参与者相比,符合最多饮食指南(Q5)的参与者胰腺癌风险降低(HR = 0.85,95%CI = 0.74 至 0.97)。在男性中,体重指数存在交互作用(P 交互值=.03),与 Q1 相比,超重/肥胖男性(体重指数≥25kg/m2)中 Q5 的危险比为 0.72(95%CI = 0.59 至 0.88),而正常体重男性中没有关联。
我们的研究结果支持这样的假设,即按照 HEI-2005 评分的高质量饮食可能会降低胰腺癌的风险。