Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands.
Department of Internal Medicine, Admiraal de Ruyter Hospital, Goes, The Netherlands.
Eur J Nutr. 2023 Oct;62(7):2891-2904. doi: 10.1007/s00394-023-03201-0. Epub 2023 Jul 2.
Higher dairy consumption is associated with a lower risk of colorectal cancer (CRC), but no studies thus far have investigated its relation with recurrence in CRC. Few studies have investigated total dairy in relation to mortality in CRC, and yielded inconsistent results.
In this prospective cohort study, people newly diagnosed with stage I-III CRC filled out a food frequency questionnaire at diagnosis (n = 1812) and six months after diagnosis (n = 1672). We examined associations between pre- and post-diagnostic intake of total dairy, low-fat dairy, high-fat dairy, milk, yoghurt, and cheese with recurrence and all-cause mortality using multivariable Cox proportional hazard models and restricted cubic splines (RCS).
A total of 176 recurrences and 301 deaths occurred during a median follow-up of 3.0 and 5.9 years, respectively. Before diagnosis, a higher low-fat dairy intake was associated with a lower risk of recurrence (HR: 0.42, 95% CI 0.26-0.67; P: 0.008) and all-cause mortality (HR: 0.58, 95% CI 0.41-0.81; P < 0.001), whereas a higher high-fat dairy consumption tended to be associated with an increased all-cause mortality risk (HR: 1.41, 95% CI 0.98-2.01; P: 0.030). After diagnosis, only the associations between low- and high-fat dairy in relation to all-cause mortality remained.
This study demonstrated that higher pre- and post-diagnostic intakes of low-fat dairy were associated with a reduced all-cause mortality risk in people with stage I-III CRC, whereas higher intakes of high-fat dairy were associated with an increased all-cause mortality risk. Also, a higher pre-diagnostic low-fat dairy intake was associated with a reduced risk of recurrence.
Clinical Trials.gov identifier: NCT03191110.
较高的乳制品摄入量与结直肠癌（CRC）的风险降低有关，但迄今为止尚无研究探讨其与 CRC 复发的关系。很少有研究调查总乳制品与 CRC 死亡率的关系，且结果不一致。
在这项前瞻性队列研究中，新诊断为 I-III 期 CRC 的患者在诊断时（n=1812）和诊断后 6 个月（n=1672）填写了食物频率问卷。我们使用多变量 Cox 比例风险模型和限制性立方样条（RCS）来检查诊断前和诊断后总乳制品、低脂乳制品、高脂乳制品、牛奶、酸奶和奶酪的摄入量与复发和全因死亡率之间的关系。
中位随访 3.0 年和 5.9 年期间，共发生 176 例复发和 301 例死亡。在诊断前，较高的低脂乳制品摄入量与较低的复发风险（HR：0.42，95%CI 0.26-0.67；P=0.008）和全因死亡率（HR：0.58，95%CI 0.41-0.81；P<0.001）相关，而较高的高脂乳制品摄入与全因死亡率风险增加相关（HR：1.41，95%CI 0.98-2.01；P=0.030）。在诊断后，只有低脂和高脂乳制品与全因死亡率之间的关联仍然存在。
这项研究表明，I-III 期 CRC 患者在诊断前和诊断后较高的低脂乳制品摄入量与全因死亡率降低相关，而较高的高脂乳制品摄入量与全因死亡率升高相关。此外，较高的低脂乳制品摄入与复发风险降低相关。
ClinicalTrials.gov 标识符：NCT03191110。
