Institute of Nutrition and Health, Qingdao University, Qingdao 266071, China.
Department of Food Science and Nutrition, Zhejiang University, Hangzhou 310058, China.
Nutrients. 2019 Aug 2;11(8):1791. doi: 10.3390/nu11081791.
The results of epidemiological studies on the relationship between fruit and vegetable intake and lung cancer risk were inconsistent among participants with different smoking status. The purpose of this study was to investigate these relationships in participants with different smoking status with prospective cohort studies. A systematic literature retrieval was conducted using PubMed and Scopus databases up to June 2019. The summary relative risks (RRs) and the corresponding 95% confidence intervals (CIs) were calculated by random-effects model. The nonlinear dose-response analysis was carried out with restricted cubic spline regression model. Publication bias was estimated using Begg's test. Nine independent prospective studies were included for data synthesis. Dietary consumption of fruit was negatively correlated with lung cancer risk among current smokers and former smokers, and the summery RRs were 0.86 (95% CI: 0.78, 0.94) and 0.91 (95% CI: 0.84, 0.99), respectively. Consumption of vegetable was significantly associated with reduced risk of lung cancer for current smokers (summary RR = 87%; 95% CI: 0.78, 0.94), but not for former smokers and never for smokers. Dose-response analysis suggested that risk of lung cancer was reduced by 5% (95% CI: 0.93, 0.97) in current smokers, and reduced by 4% (95% CI: 0.93, 0.98) in former smokers with an increase of 100 grams of fruit intake per day, respectively. Besides, dose-response analysis indicated a 3% reduction in lung cancer risk in current smokers for 100 gram per day increase of vegetable intake (95% CI: 0.96, 1.00). The findings of this study provide strong evidence that higher fruit consumption is negatively associated with the risk of lung cancer among current smokers and former smokers, while vegetable intake is significantly correlated with reducing the risk of lung cancer in current smokers. These findings might have considerable public health significance for the prevention of lung cancer through dietary interventions.
这项研究的目的是通过前瞻性队列研究来调查不同吸烟状态下的参与者中这些关系。系统地检索了截至 2019 年 6 月的 PubMed 和 Scopus 数据库中的文献。使用随机效应模型计算了汇总相对风险（RR）及其相应的 95%置信区间（CI）。使用限制性立方样条回归模型进行非线性剂量反应分析。使用贝叶斯检验估计发表偏倚。共有 9 项独立的前瞻性研究纳入数据综合分析。水果的饮食消耗与当前吸烟者和前吸烟者的肺癌风险呈负相关，汇总 RR 分别为 0.86（95%CI：0.78，0.94）和 0.91（95%CI：0.84，0.99）。蔬菜的摄入量与当前吸烟者的肺癌风险降低显著相关（汇总 RR = 87%；95%CI：0.78，0.94），但与前吸烟者和从不吸烟者无关。剂量反应分析表明，当前吸烟者每天增加 100 克水果摄入量，肺癌风险降低 5%（95%CI：0.93，0.97），前吸烟者降低 4%（95%CI：0.93，0.98）。此外，每天增加 100 克蔬菜摄入量可使当前吸烟者的肺癌风险降低 3%（95%CI：0.96，1.00）。这项研究的结果提供了强有力的证据，表明较高的水果摄入量与当前吸烟者和前吸烟者的肺癌风险呈负相关，而蔬菜摄入量与降低当前吸烟者的肺癌风险显著相关。这些发现对于通过饮食干预预防肺癌可能具有重要的公共卫生意义。
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