Turner Nancy D, Lloyd Shannon K
1 Nutrition & Food Science Department, Texas A&M University, TX 77843-2253, USA.
2 Department of Veterinary Pathobiology, Texas A&M University, TX 77843-2253, USA.
Exp Biol Med (Maywood). 2017 Apr;242(8):813-839. doi: 10.1177/1535370217693117. Epub 2017 Jan 1.
A role for red and processed meat in the development of colorectal cancer has been proposed based largely on evidence from observational studies in humans, especially in those populations consuming a westernized diet. Determination of causation specifically by red or processed meat is contingent upon identification of plausible mechanisms that lead to colorectal cancer. We conducted a systematic review of the available evidence to determine the availability of plausible mechanistic data linking red and processed meat consumption to colorectal cancer risk. Forty studies using animal models or cell cultures met specified inclusion criteria, most of which were designed to examine the role of heme iron or heterocyclic amines in relation to colon carcinogenesis. Most studies used levels of meat or meat components well in excess of those found in human diets. Although many of the experiments used semi-purified diets designed to mimic the nutrient loads in current westernized diets, most did not include potential biologically active protective compounds present in whole foods. Because of these limitations in the existing literature, there is currently insufficient evidence to confirm a mechanistic link between the intake of red meat as part of a healthy dietary pattern and colorectal cancer risk. Impact statement Current recommendations to reduce colon cancer include the reduction or elimination of red or processed meats. These recommendations are based on data from epidemiological studies conducted among cultures where meat consumption is elevated and consumption of fruits, vegetables, and whole grains are reduced. This review evaluated experimental data exploring the putative mechanisms whereby red or processed meats may contribute to colon cancer. Most studies used levels of meat or meat-derived compounds that were in excess of those in human diets, even in cultures where meat intake is elevated. Experiments where protective dietary compounds were used to mitigate the extreme levels of meat and meat-derived compounds showed protection against colon cancer, with some essentially negating the impact of meat in the diet. It is essential that better-designed studies be conducted that use relevant concentrations of meat or meat-derived compounds in complex diets representative of the foods consumed by humans.
红肉和加工肉类在结直肠癌发生发展中的作用,很大程度上是基于对人类的观察性研究证据提出的,尤其是在那些食用西式饮食的人群中。要明确红肉或加工肉类与结直肠癌之间的因果关系,取决于能否找到导致结直肠癌的合理机制。我们对现有证据进行了系统综述,以确定是否存在将红肉和加工肉类消费与结直肠癌风险联系起来的合理机制数据。40项使用动物模型或细胞培养的研究符合特定纳入标准,其中大多数旨在研究血红素铁或杂环胺在结肠癌发生中的作用。大多数研究使用的肉类或肉类成分水平远远超过人类饮食中的水平。尽管许多实验使用了旨在模拟当前西式饮食中营养负荷的半纯化饮食,但大多数实验并未纳入全食物中存在的潜在生物活性保护化合物。由于现有文献存在这些局限性,目前尚无足够证据证实将红肉作为健康饮食模式的一部分摄入与结直肠癌风险之间存在机制联系。影响声明 当前关于降低结肠癌风险的建议包括减少或消除红肉或加工肉类。这些建议基于在肉类消费增加、水果、蔬菜和全谷物消费减少人群中开展的流行病学研究数据。本综述评估了探索红肉或加工肉类可能导致结肠癌的假定机制的实验数据。即使在肉类摄入量较高的人群中,大多数研究使用的肉类或肉类衍生化合物水平也超过了人类饮食中的水平。使用保护性膳食化合物来减轻肉类和肉类衍生化合物极端水平的实验显示对结肠癌有保护作用,有些实验基本消除了饮食中肉类的影响。必须开展设计更好的研究,在代表人类食用食物的复杂饮食中使用相关浓度的肉类或肉类衍生化合物。