Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, China.
Nursing College of Henan University of Chinese Medicine, Zhengzhou, Henan, China.
Nutr J. 2020 Jun 3;19(1):52. doi: 10.1186/s12937-020-00556-6.
Several epidemiological studies have investigated the association between whole grains intake and digestive tract cancer risk; however, the results are still controversial. The purpose of this meta-analysis was to assess the association.
Studies published before March 2020 were searched in database and other sources. The risk ratio (RR) with the 95% confidence interval (CI) were pooled using fix or random-effects models.
This meta-analysis included 34 articles reporting 35 studies, 18 studies of colorectal cancer, 11 studies of gastric cancer and 6 studies of esophagus cancer, involving 2,663,278 participants and 28,921 cases. Comparing the highest-intake participants with the lowest-intake participants for whole grains, we found that the intake of whole grains were inversely related to colorectal cancer (RR = 0.89, 95% CI: 0.84-0.93, P < 0.001), gastric cancer (RR = 0.64, 95% CI: 0.53-0.79, P < 0.001), esophagus cancer (RR = 0.54, 95% CI: 0.44-0.67, P < 0.001), respectively. However, subgroup analysis of colorectal cancer found no significant association in the case-control studies and studies of sample size < 500, and subgroup analysis of gastric cancer found no significant association in the cohort studies and studies of American population. No study significantly affected the findings in the sensitivity analysis. No publication bias was found in the studies for colorectal cancer and esophagus cancer except in the studies for gastric cancer.
This meta-analysis provides further evidence that whole grains intake was associated with a reduced risk of digestive tract cancer. Our result supports the dietary guidelines that increase whole grains intake to reduce the risk of digestive tract cancer.
有几项流行病学研究调查了全谷物摄入量与消化道癌症风险之间的关系，但结果仍存在争议。本荟萃分析的目的是评估这种关联。
在数据库和其他来源中搜索了 2020 年 3 月之前发表的研究。使用固定或随机效应模型汇总风险比（RR）和 95%置信区间（CI）。
本荟萃分析纳入了 34 篇报告 35 项研究的文章，其中 18 项研究结直肠癌，11 项研究胃癌，6 项研究食管癌，共涉及 2663278 名参与者和 28921 例病例。将全谷物摄入量最高和最低的参与者进行比较，我们发现全谷物的摄入量与结直肠癌（RR=0.89，95%CI：0.84-0.93，P<0.001）、胃癌（RR=0.64，95%CI：0.53-0.79，P<0.001）和食管癌（RR=0.54，95%CI：0.44-0.67，P<0.001）呈负相关。然而，结直肠癌的亚组分析发现病例对照研究和样本量<500 的研究中无显著相关性，胃癌的亚组分析发现队列研究和美国人群研究中无显著相关性。敏感性分析未发现任何研究对结果有显著影响。除了胃癌研究外，结直肠癌和食管癌研究均未发现发表偏倚。
本荟萃分析进一步证明了全谷物摄入量与消化道癌症风险降低之间存在关联。我们的结果支持增加全谷物摄入量以降低消化道癌症风险的饮食指南。
