Department of Genetics and Biotechnology, College of Life Science, Kyung Hee University, Yongin, South Korea.
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Am J Gastroenterol. 2023 Nov 1;118(11):2061-2070. doi: 10.14309/ajg.0000000000002448. Epub 2023 Aug 7.
We examined multiple dietary patterns in relation to total digestive system cancer (DSC) incidence and death.
A total of 213,038 health professionals from the Health Professionals Follow-up Study (1986-2016), the Nurses' Health Study (1986-2018), and the Nurses' Health Study II (1991-2017) with no cancer diagnosis at baseline were analyzed. DSC incidence and death were estimated using time-varying Cox proportional hazards regression models.
During up to 32 years of follow-up, 5,724 DSC cases accrued. Adherence to 8 healthy diet patterns was associated with a 7%-13% lower risk of DSC, particularly for digestive tract cancers. An inverse association with gastrointestinal tract cancer was also shown for all pattern scores except Alternate Mediterranean Diet and the healthful Plant-based Diet Index, with hazard ratios between 0.84 and 0.89. Inverse associations were shown for the reversed empirical dietary index for hyperinsulinemia (hazard ratio for 90th vs 10th percentile 0.64, 95% confidence interval [CI] 0.47-0.87) and the empirical dietary index associated with lower inflammation (rEDIP) (0.53, 95% CI 0.39-0.72) for stomach cancer, and for the rEDIP (0.58, 95% CI 0.37-0.92) for small intestine cancer. Among accessory cancers, the Alternate Healthy Eating Index-2010, alternate Mediterranean diet, and diabetes risk reduction diet were associated with a 43%-51% lower risk of liver cancer. The reversed empirical dietary index for hyperinsulinemia, rEDIP, and the Alternate Healthy Eating Index-2010 were inversely associated with the risk of fatal DSC.
Adherence to healthy diets was associated with a lower risk of incident and fatal DSC, although the magnitude of the association varied slightly among the patterns.
我们研究了多种饮食模式与全消化系统癌症（DSC）发病率和死亡率的关系。
本研究共纳入了 213038 名来自健康专业人员随访研究（1986-2016 年）、护士健康研究（1986-2018 年）和护士健康研究 II（1991-2017 年）的健康专业人员，这些人员在基线时均无癌症诊断。通过时间变化的 Cox 比例风险回归模型来估计 DSC 的发病率和死亡率。
在长达 32 年的随访期间，共发生了 5724 例 DSC 病例。坚持 8 种健康饮食模式与 DSC 风险降低 7%-13%相关，特别是对消化道癌症。除了交替地中海饮食和健康植物性饮食指数外，所有模式评分与胃肠道癌症呈负相关，危险比在 0.84 到 0.89 之间。对于胃和小肠癌症，与高胰岛素血症的反向经验性饮食指数（第 90 百分位与第 10 百分位的危险比为 0.64，95%置信区间 [CI] 0.47-0.87）和与炎症降低相关的经验性饮食指数（rEDIP，0.53，95%CI 0.39-0.72）呈负相关，对于小肠道癌，rEDIP （0.58，95%CI 0.37-0.92）也呈负相关。在辅助癌症中，替代健康饮食指数-2010、交替地中海饮食和降低糖尿病风险饮食与肝癌风险降低 43%-51%相关。高胰岛素血症的反向经验性饮食指数、rEDIP 和替代健康饮食指数-2010 与致命 DSC 风险呈负相关。
坚持健康饮食与较低的 DSC 发病率和死亡率相关，尽管各种模式之间的关联程度略有不同。
