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女性健康倡议(WHI)随机对照试验中的低脂饮食模式与癌症死亡率

Low-Fat Dietary Pattern and Cancer Mortality in the Women's Health Initiative (WHI) Randomized Controlled Trial.

作者信息

Chlebowski Rowan T, Anderson Garnet L, Manson JoAnn E, Prentice Ross L, Aragaki Aaron K, Snetselaar Linda, Beresford Shirley A A, Kuller Lewis H, Johnson Karen, Lane Dorothy, Luo Juhua, Rohan Thomas E, Jiao Li, Barac Ana, Womack Catherine, Coday Mace, Datta Mridul, Thomson Cynthia A

机构信息

Los Angeles Biomedical Research Institute, Torrance, CA.

Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA.

出版信息

JNCI Cancer Spectr. 2019 Jan 7;2(4):pky065. doi: 10.1093/jncics/pky065. eCollection 2018 Oct.

Abstract

BACKGROUND

In the Women's Health Initiative Dietary Modification trial, a low-fat dietary pattern reduced deaths after breast cancer. Mortality from other cancer sites has not been reported.

METHODS

A low-fat dietary pattern influence on deaths from and after site-specific cancers was examined during 8.5 years (median) of dietary intervention and cumulatively during 17.7 years (median) of follow-up. A total 48 835 postmenopausal women, ages 50-79 years, were randomly assigned from 1993 to 1998 at 40 US clinical centers to dietary intervention (40%, n = 19 541 or a usual diet comparison group (60%, n = 29 294). Dietary intervention influence on mortality from protocol-specified cancers (breast, colon and rectum, endometrium and ovary), individually and as a composite, represented the primary analyses.

RESULTS

During the dietary intervention period, a reduction in deaths after breast cancer (HR = 0.65 95% CI = 0.45 to 0.94,  = .02) was the only statistically significant cancer mortality finding. During intervention, the HRs for deaths after the protocol-specified cancer composite were 0.90 (95% CI = 0.73 to 1.10) and 0.95 (95% CI = 0.85 to 1.06) for deaths after all cancers. During 17.7 years of follow-up with 3867 deaths after all cancers, reduction in deaths after breast cancer continued in the dietary intervention group (HR = 0.85, 95% CI = 0.74 to 0.99,  = .03). However, no dietary intervention influence on deaths from or after any other cancer or cancer composite was seen.

CONCLUSIONS

A low-fat dietary pattern reduced deaths after breast cancer. No reduction in mortality from or after any other cancer or cancer composite was seen.

摘要

背景

在妇女健康倡议饮食调整试验中,低脂饮食模式降低了乳腺癌后的死亡风险。其他癌症部位的死亡率尚未见报道。

方法

在8.5年(中位数)的饮食干预期间以及累计17.7年(中位数)的随访期间,研究了低脂饮食模式对特定部位癌症及其后死亡的影响。1993年至1998年期间,在美国40个临床中心,共48835名年龄在50 - 79岁的绝经后妇女被随机分配到饮食干预组(40%,n = 19541)或常规饮食对照组(60%,n = 29294)。饮食干预对方案指定癌症(乳腺癌、结肠直肠癌、子宫内膜癌和卵巢癌)单独及综合的死亡率影响为主要分析内容。

结果

在饮食干预期间,乳腺癌后死亡风险降低(HR = 0.65,95%CI = 0.45至0.94,P = 0.02)是唯一具有统计学意义的癌症死亡率发现。干预期间,方案指定癌症综合后的死亡风险比(HR)对于所有癌症后的死亡为0.90(95%CI = 0.73至1.10)和0.95(95%CI = 0.85至1.06)。在17.7年的随访期间,所有癌症后有3867例死亡,饮食干预组乳腺癌后死亡持续降低(HR = 0.85,95%CI = 0.74至0.99,P = 0.03)。然而,未观察到饮食干预对任何其他癌症或癌症综合后的死亡有影响。

结论

低脂饮食模式降低了乳腺癌后的死亡风险。未观察到任何其他癌症或癌症综合后的死亡率降低。

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