Center for Nutrition, Healthy Lifestyle and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, CA, USA.
Department of Preventive Medicine, School of Medicine, Loma Linda University, Loma Linda, CA, USA.
Am J Clin Nutr. 2022 Aug 4;116(2):314-324. doi: 10.1093/ajcn/nqac093.
Prostate cancer is the most common noncutaneous cancer in American males. Causal links between dairy, or dietary calcium, and this cancer are considered suggestive but limited.
To evaluate these associations in a large North American cohort, including many with no (or very low) dairy intake and much calcium from nondairy sources.
A prospective cohort study of 28,737 Seventh-day Adventist men in the United States and Canada, of whom 6389 were of black ethnicity. Diet was measured by FFQ, and 275 male participants also provided repeated 24-h dietary recalls as a calibration substudy. Incident cancers were mainly found by matching with cancer registries. Analyses used multivariable proportional hazards regressions and regression calibration for some analyses.
In total, 1254 (190 advanced) incident prostate cancer cases were found during an average 7.8 y of follow-up. Men at the 90th percentile of dairy intake (430 g/d) compared with the 10th percentile (20.2 g/d) had higher prostate cancer risk (HR: 1.27; 95% CI: 1.12, 1.43). Similar findings, comparing the same g/d intakes, were demonstrated for advanced prostate cancers (HR: 1.38; 95% CI: 1.02, 1.88), for nonadvanced cases (HR: 1.27; 95% CI: 1.11, 1.45), in black participants (HR: 1.24; 95% CI: 0.98, 1.58), and when excluding vegan participants (HR: 1.22; 95% CI: 1.03, 1.43). Calibrated dairy (g/d) regressions (all participants and all prostate cancers), adjusting for dietary measurement error, found a HR of 1.75 (95% CI: 1.32, 2.32). Comparing 90th percentile intake to zero intakes (uncalibrated), the HR was 1.62 (95% CI: 1.26, 2.05). There was no evidence of an effect of higher (905 mg/d) compared with lower (349 mg/d) intakes of nondairy calcium (HR: 1.16; 95% CI: 0.94, 1.44).
Men with higher intake of dairy foods, but not nondairy calcium, had a higher risk of prostate cancer compared with men having lower intakes. Associations were nonlinear, suggesting greatest increases in risk at relatively low doses.
前列腺癌是美国男性中最常见的非皮肤癌。乳制品或饮食钙与这种癌症之间的因果关系被认为是提示性的，但证据有限。
在美国和加拿大的一个大型北美队列中评估这些关联，其中许多人没有（或很少有）乳制品摄入，而钙的主要来源是非乳制品。
这是一项对美国和加拿大 28737 名第七天 Adventist 男性进行的前瞻性队列研究，其中 6389 名是黑人。饮食通过 FFQ 进行测量，275 名男性参与者还提供了重复的 24 小时饮食记录作为校准子研究。通过与癌症登记处匹配发现了新发癌症。分析使用多变量比例风险回归和回归校准进行了一些分析。
在平均 7.8 年的随访期间，共发现 1254 例（190 例晚期）前列腺癌病例。与第 10 百分位（20.2 g/d）相比，第 90 百分位（430 g/d）的乳制品摄入量较高的男性患前列腺癌的风险更高（HR：1.27；95%CI：1.12，1.43）。对于晚期前列腺癌（HR：1.38；95%CI：1.02，1.88）、非晚期病例（HR：1.27；95%CI：1.11，1.45）、黑人参与者（HR：1.24；95%CI：0.98，1.58）和排除素食参与者（HR：1.22；95%CI：1.03，1.43），同样发现了相似的结果，这些结果比较了相同的 g/d 摄入量。对所有参与者和所有前列腺癌进行校准乳制品（g/d）回归（所有参与者和所有前列腺癌），调整了饮食测量误差，发现 HR 为 1.75（95%CI：1.32，2.32）。与零摄入量相比（未校准），比较第 90 百分位摄入量和零摄入量，HR 为 1.62（95%CI：1.26，2.05）。与较低的非乳制品钙摄入量（349 mg/d）相比，较高的（905 mg/d）非乳制品钙摄入量并没有增加前列腺癌的风险（HR：1.16；95%CI：0.94，1.44）。
与低摄入量的男性相比，摄入更多乳制品（而非非乳制品钙）的男性患前列腺癌的风险更高。这些关联是非线性的，表明在相对低剂量时风险增加最大。
