Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA.
Neuro Oncol. 2019 Jul 11;21(7):944-952. doi: 10.1093/neuonc/noz013.
Available evidence on diet and glioma risk comes mainly from studies with retrospective collection of dietary data. To minimize possible differential dietary recall between those with and without glioma, we present findings from 3 large prospective studies.
Participants included 692 176 from the UK Million Women Study, 470 780 from the US National Institutes of Health-AARP study, and 99 148 from the US Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Cox regression yielded study-specific adjusted relative risks for glioma in relation to 15 food groups, 14 nutrients, and 3 dietary patterns, which were combined, weighted by inverse variances of the relative risks. Separate analyses by <5 and ≥5 years follow-up assessed potential biases related to changes of diet before glioma diagnosis.
The 1 262 104 participants (mean age, 60.6 y [SD 5.5] at baseline) were followed for 15.4 million person-years (mean 12.2 y/participant), during which 2313 incident gliomas occurred, at mean age 68.2 (SD 6.4). Overall, there was weak evidence for increased glioma risks associated with increasing intakes of total fruit, citrus fruit, and fiber and healthy dietary patterns, but these associations were generally null after excluding the first 5 years of follow-up. There was little evidence for heterogeneity of results by study or by sex.
The largest prospective evidence to date suggests little, if any, association between major food groups, nutrients, or common healthy dietary patterns and glioma incidence. With the statistical power of this study and the comprehensive nature of the investigation here, it seems unlikely we have overlooked major effects of diet on risk of glioma that would be of public health concern.
关于饮食与神经胶质瘤风险的现有证据主要来自于回顾性收集饮食数据的研究。为了最大程度地减少胶质瘤患者与非患者之间可能存在的饮食回忆差异，我们报告了 3 项大型前瞻性研究的结果。
参与者包括英国百万妇女研究中的 692176 人、美国国立卫生研究院-美国退休人员协会研究中的 470780 人和美国前列腺癌、肺癌、结直肠癌和卵巢癌筛查试验中的 99148 人。Cox 回归分析得出了与 15 种食物组、14 种营养素和 3 种饮食模式相关的胶质瘤特定调整相对风险，这些相对风险通过相对风险的倒数方差进行加权和组合。对随访时间<5 年和≥5 年的患者分别进行分析，以评估与胶质瘤诊断前饮食变化相关的潜在偏倚。
1262104 名参与者（平均年龄为 60.6 岁[标准差 5.5]，基线）随访了 1540 万人年（平均随访时间为 12.2 年/参与者），在此期间有 2313 例新发生的胶质瘤，平均发病年龄为 68.2 岁（标准差 6.4）。总体而言，摄入更多的总水果、柑橘类水果和膳食纤维以及更健康的饮食模式与胶质瘤风险增加呈弱相关，但在排除随访的前 5 年后，这些关联基本消失。研究间或性别间的结果没有明显的异质性。
迄今为止最大的前瞻性证据表明，主要食物组、营养素或常见的健康饮食模式与胶质瘤的发病率之间几乎没有关联。基于这项研究的统计学效力和调查的全面性，我们不太可能忽略了饮食对胶质瘤风险的重大影响，而这些影响可能会引起公众健康关注。
