Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Tianjin's Clinical Research Center for Cancer, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300060, China.
Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
J Transl Med. 2023 Sep 27;21(1):669. doi: 10.1186/s12967-023-04522-8.
BACKGROUND: Plant-based dietary patterns may affect colorectal cancer (CRC) related outcomes, while risks differ in the quality of plant foods. We aimed to examine the association of plant-based diet quality with risks of CRC incidence and mortality and whether this association was modified by genetic risk. METHODS: This prospective cohort study included 186,675 participants free of cancer when the last dietary recall was completed. We calculated three plant-based diet indices (PDIs), i.e., the overall plant-based diet index (PDI), the healthful plant-based diet index (hPDI), and the unhealthful plant-based diet index (uPDI) representing adherence to plant-based diets with diverse quality. Genetic risk was characterized using a weighted polygenic risk score (PRS), capturing overall risk variants associated with CRC. Hazard ratios (HR) and 95% confidential intervals (CI) were estimated by the cause-specific Cox proportional hazards model. RESULTS: Over a follow-up of 9.5 years, 2163 cases and 466 deaths from CRC were documented. The HR of CRC incidence was 0.88 (95% CI, 0.81-0.96) and 0.91 (95% CI, 0.84-0.99) per 10-score increase in PDI and hPDI, respectively. Compared to the lowest quartile, PDI, hPDI, and uPDI in the highest quartile were associated with a 13% decrease, a 15% decrease, and a 14% increase in risk of incident CRC, respectively. We found a joint association of genetic risk and PDIs with incident CRC, with the highest hazard observed in those carrying higher PRS and adhering to lower-quality PDIs. The inverse association of PDI and hPDI with CRC mortality was pronounced in males. CONCLUSIONS: Our results suggested that better adherence to overall and healthful plant-based diets was associated with a lower risk of CRC, whereas an unhealthful plant-based diet was associated with a higher CRC risk. Consumption of a higher-quality plant-based diet combined with decreased genetic risk conferred less susceptibility to CRC. Our findings highlighted the importance of food quality when adhering to a plant-based dietary pattern for CRC prevention in the general population.
背景：植物性饮食模式可能会影响结直肠癌（CRC）相关的结果，而植物性食物的质量差异会影响风险。我们旨在研究植物性饮食质量与 CRC 发病和死亡风险的关系，以及这种关系是否受遗传风险的影响。
方法：这项前瞻性队列研究纳入了 186675 名在最后一次饮食回顾完成时无癌症的参与者。我们计算了三种植物性饮食指数（PDI），即整体植物性饮食指数（PDI）、健康植物性饮食指数（hPDI）和不健康植物性饮食指数（uPDI），代表了对不同质量的植物性饮食的依从性。遗传风险用加权多基因风险评分（PRS）来描述，该评分捕捉了与 CRC 相关的整体风险变异。用特定原因的 Cox 比例风险模型估计危险比（HR）和 95%置信区间（CI）。
结果：在 9.5 年的随访期间，记录了 2163 例 CRC 发病和 466 例 CRC 死亡。PDI 和 hPDI 每增加 10 分，CRC 发病的 HR 分别为 0.88（95%CI，0.81-0.96）和 0.91（95%CI，0.84-0.99）。与最低四分位数相比，PDI、hPDI 和 uPDI 最高四分位数与 CRC 发病风险分别降低 13%、15%和 14%相关。我们发现遗传风险和 PDIs 与 CRC 发病之间存在联合关联，携带更高 PRS 和依从低质量 PDIs 的人观察到的危险最高。PDI 和 hPDI 与 CRC 死亡率的反比关系在男性中更为明显。
结论：我们的研究结果表明，更好地遵循整体和健康的植物性饮食与 CRC 风险降低有关，而不健康的植物性饮食与更高的 CRC 风险有关。食用更高质量的植物性饮食与降低遗传风险相结合，可降低 CRC 的易感性。我们的研究结果强调了在一般人群中预防 CRC 时，当遵循植物性饮食模式时，食物质量的重要性。
Int J Behav Nutr Phys Act. 2025-5-27
Int J Epidemiol. 2023-2-8
Zotero 插件
