Moazzen Sara, van der Sloot Kimberley W J, Bock Geertruida H de, Alizadeh Behrooz Z
Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Crit Rev Food Sci Nutr. 2021;61(16):2773-2782. doi: 10.1080/10408398.2020.1786353. Epub 2020 Jul 2.
The quality of existing evidence about the impact of diet quality on colorectal cancer (CRC) risk has only rarely been assessed. In the current review, we searched PubMed, EMBASE, Web of Science, Cochrane, and the resulting references (up to January 2020) for studies that evaluated the role of high diet quality by extreme dietary index categorization and the risk of CRC. Two researchers independently performed the study selection, data extraction, and quality assessment. We then applied a random-effects meta-analysis to estimate the pooled odds ratios (ORs) and 95% confidence intervals (CIs) for CRC at the extremes of each dietary index, and we assessed the quality of the pooled results using the Grading of Recommendations Assessment, Development and Evaluation approach. A high diet quality was significantly associated with reduced CRC risk when patients had a low Diet Inflammatory Index score (OR, 0.66; 95%CI, 0.56-0.78), a high Mediterranean Diet Score (OR, 0.84; 95%CI, 0.78-0.90), high Dietary Approaches to Stop Hypertension adherence (OR, 0.83; 95%CI, 0.78-0.89), and a high Healthy Eating Index score (OR, 0.72; 95%CI, 0.64-0.80). The pooled results for all dietary indices were rated as being of low quality due to concerns over inconsistency or imprecision. We conclude that, despite a high diet quality appearing to have a preventive role in CRC, the evidence is currently of insufficient quality to develop dietary recommendations.
关于饮食质量对结直肠癌（CRC）风险影响的现有证据质量很少得到评估。在当前的综述中，我们检索了PubMed、EMBASE、Web of Science、Cochrane以及所得参考文献（截至2020年1月），以查找通过极端饮食指数分类评估高饮食质量作用及CRC风险的研究。两名研究人员独立进行研究筛选、数据提取和质量评估。然后，我们应用随机效应荟萃分析来估计每个饮食指数极端情况下CRC的合并优势比（OR）和95%置信区间（CI），并使用推荐分级评估、制定和评价方法评估合并结果的质量。当患者的饮食炎症指数得分较低（OR，0.66；95%CI，0.56 - 0.78）、地中海饮食得分较高（OR，0.84；95%CI，0.78 - 0.90）、高血压饮食预防法依从性较高（OR，0.83；95%CI，0.78 - 0.89）以及健康饮食指数得分较高（OR，0.72；95%CI，0.64 - 0.80）时，高饮食质量与CRC风险降低显著相关。由于担心不一致性或不精确性，所有饮食指数的合并结果被评为低质量。我们得出结论，尽管高饮食质量似乎对CRC有预防作用，但目前证据质量不足以制定饮食建议。
