Steck Susan E, Guinter Mark, Zheng Jiali, Thomson Cynthia A
Department of Epidemiology and Biostatistics and Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC; and
Department of Epidemiology and Biostatistics and Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC; and.
Adv Nutr. 2015 Nov 13;6(6):763-73. doi: 10.3945/an.115.009746. Print 2015 Nov.
Colorectal cancer (CRC) is the third most common cancer in both men and women in the United States. Various a priori dietary patterns that take into account diet complexity have been associated with CRC risk. This systematic review augments the evidence for an association between CRC risk and the Mediterranean Diet Score (MDS) and the Healthy Eating Index (HEI), and provides new evidence for a novel Dietary Inflammatory Index (DII). Human studies published in English after 31 December 2008 were reviewed. Five case-control studies and 7 prospective cohort studies conducted in the United States and Europe were identified. Five of the studies examined the MDS, 4 examined the HEI, and 4 examined the DII. Comparing highest to lowest score groups, higher MDSs were associated with an 8-54% lower CRC risk, and higher HEI scores were associated with a 20-56% lower CRC risk. More proinflammatory diet scores were associated with a 12-65% higher CRC risk compared with more anti-inflammatory diets in studies that used the DII. The results reported by sex suggested similar associations for men and women. This review builds upon the evidence supporting the association between higher overall diet quality and lower risk of CRC. Increasing scores of MDS and HEI and anti-inflammatory DII scores are characterized by high intake of plant-based foods and low intake of animal products. Future studies in more diverse populations and with consistent scoring calculations are recommended.
结直肠癌（CRC）是美国男性和女性中第三大常见癌症。各种考虑到饮食复杂性的先验饮食模式都与结直肠癌风险相关。本系统综述增强了关于结直肠癌风险与地中海饮食评分（MDS）和健康饮食指数（HEI）之间关联的证据，并为一种新的饮食炎症指数（DII）提供了新证据。对2008年12月31日之后发表的英文人体研究进行了综述。确定了在美国和欧洲进行的5项病例对照研究和7项前瞻性队列研究。其中5项研究考察了MDS，4项考察了HEI，4项考察了DII。将得分最高组与最低组进行比较，较高的MDS与结直肠癌风险降低8 - 54%相关，较高的HEI得分与结直肠癌风险降低20 - 56%相关。在使用DII的研究中，与更多抗炎饮食相比，更多促炎饮食评分与结直肠癌风险高12 - 65%相关。按性别报告的结果表明男性和女性的关联相似。本综述基于支持更高总体饮食质量与更低结直肠癌风险之间关联的证据。MDS和HEI得分以及抗炎DII得分的增加特点是植物性食物摄入量高而动物性产品摄入量低。建议在更多样化的人群中进行进一步研究，并采用一致的评分计算方法。
