Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1124 W. Carson Street, Building J-3, Torrance, CA 90502, USA.
Breast. 2013 Aug;22 Suppl 2:S30-7. doi: 10.1016/j.breast.2013.07.006.
To provide a current perspective on nutrition and physical activity influence on breast cancer.
A comprehensive literature review was conducted and selective presentation of findings follows. While some observational studies have associated higher dietary fat intake with higher breast cancer incidence, two full-scale randomized, clinical trials of dietary fat intake reduction programs were negative. However, a lifestyle intervention targeting fat intake reduction in the Women's Intervention Nutrition Study (WINS), resulted in weight loss and also reduced breast cancer recurrences in women with early stage disease. Observational studies evaluating specific nutrient intakes and dietary supplements have provided mixed results. Several observational studies find women with early stage breast cancer with lower 25-hydroxyvitamin D levels at higher recurrence risk, a finding requiring cautious interpretation. The lifestyle factor most strongly and consistently associated with both breast cancer incidence and breast cancer recurrence risk is physical activity. A meta-analyses of observational studies supports the concept that moderate recreational physical activity (about 3-4 h walking per week) may reduce breast cancer incidence and that women with early stage breast cancer who increased or maintain their physical activity may have lower recurrence risk as well. Feasibility of achieving increased physical activity and weight loss in women with early-stage breast cancer has been established. Two full-scale randomized clinical trials are evaluating weight loss/maintenance and increased physical activity in relation to recurrence risk in women with early-stage, resected breast cancer.
DISCUSSION/CONCLUSIONS: Dietary intake may influence breast cancer but influence is difficult to separate from influence of body weight. A consistent body of observational study evidence suggests higher physical activity has favorable influence on breast cancer incidence and outcome. While awaiting definitive evidence from ongoing randomized trials, breast cancer patients can reasonably be counseled to avoid weight gain and reduce body weight if overweight or obese and increase or maintain a moderate level of physical activity.
提供营养和身体活动对乳腺癌影响的最新观点。
进行了全面的文献综述，并选择性地介绍了研究结果。虽然一些观察性研究表明较高的饮食脂肪摄入量与较高的乳腺癌发病率相关，但两项全规模随机临床试验的饮食脂肪摄入量减少计划均为阴性。然而，针对妇女营养干预研究（WINS）中的脂肪摄入量减少的生活方式干预导致了体重减轻，并降低了早期疾病妇女的乳腺癌复发率。评估特定营养素摄入量和膳食补充剂的观察性研究提供了混合结果。一些观察性研究发现，25-羟维生素 D 水平较低的早期乳腺癌妇女复发风险较高，这一发现需要谨慎解释。与乳腺癌发病率和乳腺癌复发风险最密切和一致相关的生活方式因素是身体活动。观察性研究的荟萃分析支持这样一种观点，即适度的娱乐性身体活动（每周约 3-4 小时步行）可能降低乳腺癌发病率，并且增加或保持身体活动的早期乳腺癌妇女复发风险也可能降低。在早期乳腺癌妇女中实现身体活动增加和体重减轻的可行性已经得到确立。两项全规模随机临床试验正在评估体重减轻/维持和增加身体活动与早期乳腺癌切除后妇女复发风险的关系。
讨论/结论：饮食摄入可能会影响乳腺癌，但影响很难与体重的影响分开。大量的观察性研究证据表明，较高的身体活动对乳腺癌的发病率和结局有有利影响。在等待正在进行的随机试验的明确证据的同时，乳腺癌患者可以合理地接受咨询，避免体重增加，并减轻超重或肥胖者的体重，增加或保持适度的身体活动水平。
