Wang Sabrina E, Hodge Allison, Dashti S Ghazaleh, Dixon-Suen Suzanne C, Castaño-Rodríguez Natalia, Thomas Robert, Giles Graham, Boussioutas Alex, Kendall Bradley, English Dallas R
Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.
Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia.
Br J Nutr. 2023 Apr 14;129(7):1232-1241. doi: 10.1017/S0007114522002112. Epub 2022 Jul 15.
Barrett's oesophagus (BE) is the precursor of oesophageal adenocarcinoma, which has become the most common type of oesophageal cancer in many Western populations. Existing evidence on diet and risk of BE predominantly comes from case-control studies, which are subject to recall bias in measurement of diet. We aimed to investigate the potential effect of diet, including macronutrients, carotenoids, food groups, specific food items, beverages and dietary scores, on risk of BE in over 20 000 participants of the Melbourne Collaborative Cohort Study. Diet at baseline (1990-1994) was measured using a food frequency questionnaire. The outcome was BE diagnosed between baseline and follow-up (2007-2010). Logistic regression models were used to estimate OR and 95 % CI for diet in relation to risk of BE. Intakes of leafy vegetables and fruit were inversely associated with risk of BE (highest . lowest quartile: OR = 0·59; CI: 0·38, 0·94; -trend = 0·02 and OR = 0·58; CI: 0·37, 0·93; -trend = 0·02 respectively), as were dietary fibre and carotenoids. Stronger associations were observed for food than the nutrients found in them. Positive associations were observed for discretionary food (OR = 1·54; CI: 0·97, 2·44; -trend = 0·04) and total fat intake (OR per 10 g/d = 1·11; CI: 1·00, 1·23), the association for fat was less robust in sensitivity analyses. No association was observed for meat, protein, dairy products or diet scores. Diet is a potential modifiable risk factor for BE. Public health and clinical guidelines that incorporate dietary recommendations could contribute to reduction in risk of BE and, thereby, oesophageal adenocarcinoma.
巴雷特食管（BE）是食管腺癌的癌前病变，在许多西方人群中，食管腺癌已成为最常见的食管癌类型。关于饮食与BE风险的现有证据主要来自病例对照研究，这类研究在饮食测量方面存在回忆偏倚。我们旨在调查饮食（包括常量营养素、类胡萝卜素、食物类别、特定食物、饮料和饮食评分）对墨尔本协作队列研究中20000多名参与者患BE风险的潜在影响。使用食物频率问卷对基线期（1990 - 1994年）的饮食进行测量。结局指标是在基线期和随访期（2007 - 2010年）之间诊断出的BE。采用逻辑回归模型估计饮食与BE风险相关的比值比（OR）和95%可信区间（CI）。绿叶蔬菜和水果的摄入量与BE风险呈负相关（最高四分位数.最低四分位数：OR = 0·59；CI：0·38，0·94；P趋势 = 0·02；以及OR = 0·58；CI：0·37，0·93；P趋势 = 0·02），膳食纤维和类胡萝卜素的情况也是如此。食物的关联性比其中所含营养素的关联性更强。对于自由支配食物（OR = 1·54；CI：0·97，2·44；P趋势 = 0·04）和总脂肪摄入量（每10 g/d的OR = 1·11；CI：1·00，1·23）观察到正相关，在敏感性分析中脂肪的关联性较弱。未观察到肉类、蛋白质、乳制品或饮食评分与BE风险有关联。饮食是BE潜在的可改变风险因素。纳入饮食建议的公共卫生和临床指南可能有助于降低BE风险，从而降低食管腺癌的风险。
