Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, P.R. China.
AMITA Health Saint Joseph Hospital Chicago, Chicago, IL 60657, USA.
Nutr Res. 2022 Apr;100:70-92. doi: 10.1016/j.nutres.2022.01.004. Epub 2022 Feb 3.
The association between dietary carbohydrate intake and breast cancer (BC) remains controversial. This meta-analysis aimed to elucidate the association between dietary carbohydrate intake (dietary fiber, whole grain, sugar, and unidentified carbohydrate) and BC risk in a cohort study. We hypothesized that dietary carbohydrate intake is associated with an increased risk of BC. PubMed, Cochrane Library, Web of Science, Embase, and Chinese databases were searched for relevant articles through March 2021. Pooled relative risks (RRs) were calculated using random-effects model. The results showed the pooled RRs for dietary carbohydrate intake and BC incidence, mortality, and recurrence were 0.98 (95% confidence interval [CI], 0.95-1.00), 0.96 (95% CI, 0.89-1.03), and 0.96 (95% CI, 0.83-1.11), respectively. In subgroup analysis, a negative association was found between dietary fiber and BC incidence and mortality. Pooled RRs were 0.94 (95% CI, 0.91-0.98) and 0.88 (95% CI, 0.78-1.00). Dose-response analysis showed that every 10-g/d increments in dietary fiber intake was associated with a significant 3% reduction in BC incidence, and every 10-g/d increase in dietary fiber intake, BC incidence in premenopausal women was significantly reduced by 14%. In addition, the marginal relation for whole grain, which may decrease BC incidence (RR = 0.95; 95% CI, 0.86-1.05), but increase BC mortality (RR = 1.02; 95% CI, 0.92-1.14). A marginal positive relation was also observed between sugar and BC incidence (RR = 1.04; 95% CI, 0.94-1.14). This meta-analysis of cohort studies suggested that dietary carbohydrate intake is associated with a lower risk of BC incidence, mortality, and recurrence.
碳水化合物摄入与乳腺癌（BC）之间的关联仍存在争议。本荟萃分析旨在阐明队列研究中膳食碳水化合物摄入（膳食纤维、全谷物、糖和未识别的碳水化合物）与 BC 风险之间的关系。我们假设膳食碳水化合物的摄入与 BC 风险的增加有关。通过 2021 年 3 月的 PubMed、Cochrane 图书馆、Web of Science、Embase 和中国数据库检索相关文章。使用随机效应模型计算汇总相对风险（RR）。结果表明，膳食碳水化合物摄入与 BC 发病率、死亡率和复发率的汇总 RR 分别为 0.98（95%置信区间 [CI]，0.95-1.00）、0.96（95% CI，0.89-1.03）和 0.96（95% CI，0.83-1.11）。在亚组分析中，膳食纤维与 BC 发病率和死亡率呈负相关。汇总 RR 分别为 0.94（95% CI，0.91-0.98）和 0.88（95% CI，0.78-1.00）。剂量反应分析表明，膳食纤维摄入量每增加 10g/d，BC 发病率降低 3%，膳食纤维摄入量每增加 10g/d，绝经前女性 BC 发病率降低 14%。此外，全谷物的边缘关系可能会降低 BC 发病率（RR=0.95；95%CI，0.86-1.05），但会增加 BC 死亡率（RR=1.02；95%CI，0.92-1.14）。还观察到糖与 BC 发病率之间存在边际正相关（RR=1.04；95%CI，0.94-1.14）。这些队列研究的荟萃分析表明，膳食碳水化合物的摄入与 BC 的发病率、死亡率和复发率较低有关。
