前瞻性NutriNet-Santé队列中可发酵的低聚糖、二糖、单糖和多元醇（FODMAPs）与癌症风险

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

作者信息

Debras Charlotte, Chazelas Eloi, Srour Bernard, Julia Chantal, Schneider Élodie, Kesse-Guyot Emmanuelle, Agaësse Cédric, Druesne-Pecollo Nathalie, Andreeva Valentina A, Wendeu-Foyet Gaëlle, Galan Pilar, Hercberg Serge, Deschasaux-Tanguy Mélanie, Touvier Mathilde

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;152(4):1059-1069. doi: 10.1093/jn/nxab379. Epub 2023 Feb 18.

DOI:10.1093/jn/nxab379

PMID:36967163

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

可发酵的低聚糖、二糖、单糖和多元醇（FODMAPs）已被证明与胃肠道疾病有关。鉴于它们的促炎潜力以及与肠道微生物群的相互作用，有人推测它们对癌症等其他慢性疾病的病因也有影响。然而，据我们所知，迄今为止尚无流行病学研究对这一假设进行调查。

目的

我们的目的是在一个大型前瞻性队列中研究FODMAP摄入量（总量及按类型）与癌症风险（总体、乳腺癌、前列腺癌和结直肠癌）之间的关联。

方法

本研究基于NutriNet-Santé队列（2009年至2020年）；我们的分析纳入了104,909名基线时无癌症的成年参与者（中位随访时间 = 7.7年，78.7%为女性，基线时平均年龄±标准差为42.1±14.5岁）。基线饮食摄入量通过与详细食物成分表相关联的重复24小时饮食记录获得。FODMAP摄入量（以五分位数表示，Q）与癌症风险之间的关联通过Cox比例风险模型进行评估，并对一系列生活方式、社会人口统计学和人体测量学变量进行了调整。

结果

FODMAP总摄入量与总体癌症风险增加相关（n = 3374例新发病例，与Q1相比，性别特异性Q5的风险比：1.21；95%置信区间：1.02，1.44；P趋势 = 0.04）。特别是，低聚糖与癌症风险相关：总体癌症呈现一种趋势（与Q1相比，Q5的风险比：1.10；95%置信区间：0.97，1.25；P趋势 = 0.04），结直肠癌也是如此（n = 272例，与Q `1相比，Q5的风险比：1.78；95%置信区间：1.13 - 2.79；P趋势 = 0.02）。