可发酵寡糖、双糖、单糖和多元醇（FODMAPs）与前瞻性 NutriNet-Santé 队列中的癌症风险。

Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols (FODMAPs) and Cancer Risk in the Prospective NutriNet-Santé Cohort.

机构信息

Sorbonne Paris Nord University, INSERM U1153, INRAe U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France.

French Network for Nutrition AND Cancer Research (NACRe network), Jouy-en-Josas, France.

出版信息

J Nutr. 2022 Apr 1;152(4):1059-1069. doi: 10.1093/jn/nxab379.

DOI:10.1093/jn/nxab379

PMID:34718693

Abstract

BACKGROUND

Fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) have been shown to be involved in gastrointestinal disorders. In view of their proinflammatory potential and their interactions with the gut microbiota, their contribution to the etiology of other chronic diseases such as cancer has been postulated. However, to our knowledge, no epidemiologic study has investigated this hypothesis so far.

OBJECTIVES

Our objective was to investigate the associations between FODMAP intake (total and by type) and cancer risk (overall, breast, prostate, and colorectal) in a large prospective cohort.

METHODS

The study was based on the NutriNet-Santé cohort (2009-2020); 104,909 adult participants without cancer at baseline were included in our analyses (median follow-up time = 7.7 y, 78.7% women, mean ± SD age at baseline 42.1 ± 14.5 y). Baseline dietary intakes were obtained from repeated 24-h dietary records linked to a detailed food composition table. Associations between FODMAP intake (expressed in quintiles, Q) and cancer risks were assessed by Cox proportional hazard models adjusted for a large range of lifestyle, sociodemographic, and anthropometric variables.

RESULTS

Total FODMAP intake was associated with increased overall cancer risk (n = 3374 incident cases, HR for sex-specific Q5 compared with Q1: 1.21; 95% CI: 1.02, 1.44; P-trend = 0.04). In particular, oligosaccharides were associated with cancer risk: a trend was observed for overall cancer (HR Q5 compared with Q1: 1.10; 95% CI: 0.97, 1.25; P-trend = 0.04) and colorectal cancer (n = 272, HR Q5 compared with Q1: 1.78; 95% CI: 1.13-2.79; P-trend = 0.02).

CONCLUSIONS

Results from this large population-based study on French adults from the NutriNet-Santé cohort show a significant association between FODMAP intake and the risk of cancer development. Further epidemiologic and experimental studies are needed to confirm these results and provide data on the potential underlying mechanisms.

摘要

背景

可发酵的寡糖、双糖、单糖和多元醇（FODMAPs）已被证明与胃肠道疾病有关。鉴于其促炎潜力及其与肠道微生物群的相互作用，人们推测它们对其他慢性疾病（如癌症）的病因有贡献。然而，据我们所知，到目前为止，没有流行病学研究调查过这一假设。

目的

我们的目的是在一项大型前瞻性队列中研究 FODMAP 摄入（总量和类型）与癌症风险（总体、乳腺癌、前列腺癌和结直肠癌）之间的关系。

方法

本研究基于 NutriNet-Santé 队列（2009-2020 年）；共有 104909 名基线时无癌症的成年参与者纳入我们的分析（中位随访时间为 7.7 年，78.7%为女性，基线时平均年龄为 42.1±14.5 岁）。基线时的饮食摄入量来自于重复的 24 小时饮食记录，这些记录与详细的食物成分表相关联。通过 Cox 比例风险模型评估 FODMAP 摄入量（表示为五分位数，Q）与癌症风险之间的关系，该模型调整了大量生活方式、社会人口学和人体测量学变量。

结果

总 FODMAP 摄入量与总体癌症风险增加相关（共发生 3374 例病例，与 Q1 相比，女性 Q5 的 HR 为 1.21；95%CI：1.02，1.44；P 趋势=0.04）。特别是寡糖与癌症风险相关：总体癌症呈趋势（HR Q5 与 Q1 相比：1.10；95%CI：0.97，1.25；P 趋势=0.04）和结直肠癌（n=272，HR Q5 与 Q1 相比：1.78；95%CI：1.13-2.79；P 趋势=0.02）。