Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Discovery I Building, Columbia, SC, 29208, USA.
Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.
Eur J Nutr. 2020 Apr;59(3):965-977. doi: 10.1007/s00394-019-01956-z. Epub 2019 Apr 6.
Dietary factors may influence colorectal cancer (CRC) survival through effects on inflammation. We examined the association between post-CRC diagnosis inflammatory potential of diet and all-cause and cancer-specific mortality in the Women's Health Initiative.
The study included 463 postmenopausal women who developed CRC during follow-up and completed a food frequency questionnaire (FFQ), on average 1.7 years after diagnosis. Women were followed from CRC diagnosis until death, censoring, or the end of follow-up in October 2014. Energy-adjusted dietary inflammatory index (E-DII) scores were calculated from the FFQ and dietary supplement inventory. Cox proportional hazards models were fitted to estimate multivariable-adjusted HRs and 95% confidence intervals (CIs) for all-cause, total cancer, and CRC-specific mortality with the most pro-inflammatory E-DII scores (tertile 3) as referent.
After a median 11.6 years of follow-up, 162 deaths occurred, including 77 from CRC. Lowest tertile (i.e., most anti-inflammatory) E-DII scores from diet plus supplements were associated with significantly lower all-cause mortality (HR = 0.49; 95% CI 0.31-0.79) compared to the most pro-inflammatory E-DII tertile. Modest associations with total cancer mortality or CRC-specific mortality were observed, though 95% CIs included 1.
Consuming a dietary pattern and supplements with more anti-inflammatory potential after CRC diagnosis may improve overall survival among postmenopausal women.
饮食因素可能通过影响炎症来影响结直肠癌(CRC)的生存。我们研究了 CRC 诊断后饮食的炎症潜力与全因和癌症特异性死亡率之间的关联,该研究来自妇女健康倡议。
该研究包括 463 名在随访期间发生 CRC 的绝经后妇女,她们在诊断后平均 1.7 年完成了食物频率问卷(FFQ)。从 CRC 诊断到死亡、删失或 2014 年 10 月随访结束,对女性进行随访。从 FFQ 和膳食补充剂清单中计算出能量调整后的饮食炎症指数(E-DII)评分。使用 Cox 比例风险模型估计多变量调整后的 HR 和 95%置信区间(CI),以最具促炎作用的 E-DII 评分(三分位数 3)为参照,用于全因、总癌症和 CRC 特异性死亡率。
中位随访 11.6 年后,发生了 162 例死亡,包括 77 例 CRC 死亡。与最促炎的 E-DII 三分位数相比,饮食加补充剂的最低三分位数(即最抗炎)E-DII 评分与全因死亡率显著降低相关(HR=0.49;95%CI 0.31-0.79)。观察到总癌症死亡率或 CRC 特异性死亡率的适度关联,但 95%CI 包括 1。
CRC 诊断后摄入具有更多抗炎潜力的饮食模式和补充剂可能会改善绝经后妇女的总体生存。