Cancer Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain.
Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain.
Eur J Nutr. 2019 Jun;58(4):1495-1505. doi: 10.1007/s00394-018-1674-5. Epub 2018 Mar 26.
To assess if the associations found between three previously identified dietary patterns with breast, prostate and gastric cancer are also observed for colorectal cancer (CRC).
MCC-Spain is a multicase-control study that collected information of 1629 incident cases of CRC and 3509 population-based controls from 11 Spanish provinces. Western, Prudent and Mediterranean data-driven dietary patterns-derived in another Spanish case-control study-were reconstructed in MCC-Spain. Their association with CRC was assessed using mixed multivariable logistic regression models considering a possible interaction with sex. Risk by tumor site (proximal colon, distal colon, and rectum) was evaluated using multinomial regression models.
While no effect of the Prudent pattern on CRC risk was observed, a high adherence to the Western dietary pattern was associated with increased CRC risk for both males [OR (95% CI): 1.45 (1.11;1.91)] and females [OR (95% CI): 1.50 (1.07;2.09)] but seem to be confined to distal colon [OR (95% CI): 2.02 (1.44;2.84)] and rectal [OR (95% CI): 1.46 (1.05;2.01)] tumors. The protective effect of the Mediterranean dietary pattern against CRC was observed for both sexes [males: OR (95% CI): 0.71 (0.55;0.92); females: OR (95% CI): 0.56 (0.40;0.77)] and for all cancer sites: proximal colon [OR (95% CI): 0.70 (0.51;0.97)], distal colon [OR (95% CI): 0.65 (0.48;0.89)], and rectum (OR (95% CI): 0.60 (0.45;0.81)].
Our results are consistent with most of the associations previously found between these patterns and breast, prostate and gastric cancer risk and indicate that consuming whole fruits, vegetables, legumes, olive oil, nuts, and fish and avoiding red and processed meat, refined grains, sweets, caloric drinks, juices, convenience food, and sauces might reduce CRC risk.
评估之前确定的三种饮食模式与乳腺癌、前列腺癌和胃癌的关联是否也与结直肠癌(CRC)有关。
MCC-Spain 是一项多病例对照研究,在西班牙 11 个省份收集了 1629 例 CRC 新发病例和 3509 例基于人群的对照信息。在 MCC-Spain 中,重建了来自另一项西班牙病例对照研究的西方、谨慎和地中海数据驱动的饮食模式。使用混合多变量逻辑回归模型考虑性别可能的相互作用,评估它们与 CRC 的相关性。使用多项回归模型评估按肿瘤部位(近端结肠、远端结肠和直肠)的风险。
尽管谨慎饮食模式对 CRC 风险没有影响,但高西方饮食模式的依从性与男性 [比值比(95%置信区间):1.45(1.11;1.91)]和女性 [比值比(95%置信区间):1.50(1.07;2.09)]的 CRC 风险增加有关,但似乎仅限于远端结肠 [比值比(95%置信区间):2.02(1.44;2.84)]和直肠 [比值比(95%置信区间):1.46(1.05;2.01)]肿瘤。地中海饮食模式对 CRC 的保护作用在男性和女性中均观察到 [男性:比值比(95%置信区间):0.71(0.55;0.92);女性:比值比(95%置信区间):0.56(0.40;0.77)],并且适用于所有癌症部位:近端结肠 [比值比(95%置信区间):0.70(0.51;0.97)]、远端结肠 [比值比(95%置信区间):0.65(0.48;0.89)]和直肠(比值比(95%置信区间):0.60(0.45;0.81)]。
我们的结果与之前发现的这些模式与乳腺癌、前列腺癌和胃癌风险之间的大多数关联一致,并表明食用全水果、蔬菜、豆类、橄榄油、坚果和鱼类,避免食用红肉和加工肉、精制谷物、甜食、高热量饮料、果汁、方便食品和酱汁可能会降低 CRC 风险。