Taborelli Martina, Polesel Jerry, Parpinel Maria, Stocco Carmen, Birri Silvia, Serraino Diego, Zucchetto Antonella
Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, Aviano (PN), Italy.
Unit of Hygiene and Epidemiology, Department of Biological and Medical Sciences, Udine University, Udine, Italy.
Mol Nutr Food Res. 2017 Apr;61(4). doi: 10.1002/mnfr.201600816. Epub 2016 Dec 5.
Since the evidence on the role of diet on prostate cancer (PCa) prognosis is still controversial, we evaluated the long-term effects of fruit and vegetables consumption on survival after PCa.
A retrospective cohort study included 777 men with PCa diagnosed between 1995 and 2002 in north-eastern Italy and followed up to 2013. A validated food frequency questionnaire assessed the usual diet in the 2 years before PCa diagnosis, including detailed fruit and vegetables consumption. Adjusted hazard ratios (HRs) of death with 95% confidence intervals (CIs) were estimated using Fine-Gray models. PCa patients with a consumption of both fruit and vegetables above the median showed a higher 15-year overall survival probability than those with lower intakes (71% versus 58%, p = 0.04; HR = 0.66, 95% CI: 0.47-0.93). Consumption of foods rich in fiber (HR = 0.59, 95% CI: 0.41-0.86) and proanthocyanidins (HR = 0.58, 95% CI: 0.40-0.82) were inversely associated with overall mortality. Interestingly, proanthocyanidins (HR = 0.52; 95% CI: 0.27-0.98) and flavonols (HR = 0.40; 95% CI: 0.19-0.84) were inversely associated also with PCa-specific mortality.
High consumption of fruit and vegetables offers an advantage in survival among the rising number of men living after a PCa diagnosis, possibly through the epigenetic effect of some nutrients.
由于饮食对前列腺癌(PCa)预后作用的证据仍存在争议,我们评估了食用水果和蔬菜对PCa患者生存的长期影响。
一项回顾性队列研究纳入了1995年至2002年在意大利东北部诊断为PCa并随访至2013年的777名男性。一份经过验证的食物频率问卷评估了PCa诊断前2年的日常饮食,包括水果和蔬菜的详细摄入量。使用Fine-Gray模型估计调整后的死亡风险比(HRs)及95%置信区间(CIs)。水果和蔬菜摄入量均高于中位数的PCa患者15年总生存概率高于摄入量较低者(71%对58%,p = 0.04;HR = 0.66,95% CI:0.47 - 0.93)。富含纤维食物(HR = 0.59,95% CI:0.41 - 0.86)和原花青素食物(HR = 0.58,95% CI:0.40 - 0.82)的摄入与总死亡率呈负相关。有趣的是,原花青素(HR = 0.52;95% CI:0.27 - 0.98)和黄酮醇(HR = 0.40;95% CI:0.19 - 0.84)也与PCa特异性死亡率呈负相关。
大量食用水果和蔬菜可能通过某些营养素的表观遗传效应,为越来越多的PCa诊断后存活男性提供生存优势。