Cao Yin, Strate Lisa L, Keeley Brieze R, Tam Idy, Wu Kana, Giovannucci Edward L, Chan Andrew T
Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Gut. 2018 Mar;67(3):466-472. doi: 10.1136/gutjnl-2016-313082. Epub 2017 Jan 9.
Diverticulitis is a common disease with a substantial clinical and economic burden. Besides dietary fibre, the role of other foods in the prevention of diverticulitis is underexplored.
We prospectively examined the association between consumption of meat (total red meat, red unprocessed meat, red processed meat, poultry and fish) with risk of incident diverticulitis among 46 461 men enrolled in the Health Professionals Follow-Up Study (1986-2012). Cox proportional hazards models were used to compute relative risks (RRs) and 95% CIs.
During 651 970 person-years of follow-up, we documented 764 cases of incident diverticulitis. Compared with men in the lowest quintile (Q1) of total red meat consumption, men in the highest quintile (Q5) had a multivariable RR of 1.58 (95% CI 1.19 to 2.11; p for trend=0.01). The increase in risk was non-linear, plateauing after six servings per week (p for non-linearity=0.002). The association was stronger for unprocessed red meat (RR for Q5 vs Q1: 1.51; 95% CI 1.12 to 2.03; p for trend=0.03) than for processed red meat (RR for Q5 vs Q1: 1.03; 95% CI 0.78 to 1.35; p for trend=0.26). Higher consumption of poultry or fish was not associated with risk of diverticulitis. However, the substitution of poultry or fish for one serving of unprocessed red meat per day was associated with a decrease in risk of diverticulitis (multivariable RR 0.80; 95% CI 0.63 to 0.99).
Red meat intake, particularly unprocessed red meat, was associated with an increased risk of diverticulitis. The findings provide practical dietary guidance for patients at risk of diverticulitis.
憩室炎是一种常见疾病，会带来巨大的临床和经济负担。除膳食纤维外，其他食物在预防憩室炎方面的作用尚未得到充分研究。
我们前瞻性地研究了参与健康专业人员随访研究（1986 - 2012年）的46461名男性中，肉类（总红肉、未加工红肉、加工红肉、家禽和鱼类）的摄入量与憩室炎发病风险之间的关联。采用Cox比例风险模型计算相对风险（RRs）和95%置信区间（CIs）。
在651970人年的随访期间，我们记录了764例憩室炎发病病例。与总红肉摄入量处于最低五分位数（Q1）的男性相比，最高五分位数（Q5）的男性多变量RR为1.58（95% CI 1.19至2.11；趋势p值 = 0.01）。风险增加呈非线性，每周食用六份后趋于平稳（非线性p值 = 0.002）。未加工红肉的关联比加工红肉更强（Q5与Q1相比的RR：1.51；95% CI 1.12至2.03；趋势p值 = 0.03），而加工红肉的关联为（Q5与Q1相比的RR：1.03；95% CI 0.78至1.35；趋势p值 = 0.26）。较高的家禽或鱼类摄入量与憩室炎风险无关。然而，每天用一份家禽或鱼类替代一份未加工红肉与憩室炎风险降低相关（多变量RR 0.80；95% CI 0.63至0.99）。
红肉摄入量，尤其是未加工红肉，与憩室炎风险增加相关。这些发现为有憩室炎风险的患者提供了实用的饮食指导。
