Britten Oliver, Tosi Sabrina
Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Turner St, London, E1 2AD, UK.
Leukaemia and Chromosome Laboratory, College of Health, Medicine and Life Sciences, Brunel University London, Kingston Lane, Uxbridge, UB8 3PH, UK.
Genes Nutr. 2024 Aug 3;19(1):15. doi: 10.1186/s12263-024-00750-9.
Cancer universally represents one of the largest public health concerns, substantially contributing to global disease burden and mortality. The multifaceted interplay of environmental and genetic factors in the disease aetiology and progression has required comprehensive research to elucidate modifiable elements which can reduce the risk of incidence and improve prognosis. Among these factors, diet and nutrition have emerged as the most fundamental with a significant potential for influence and effect. Nutrition is not only an essential part of human survival, but also a vital determinant of overall health. Certain dietary requirements are necessary to support normal physiology. This includes individualised levels of macronutrients (proteins, carbohydrates and fats) and specific micronutrients (vitamins and minerals). Extensive research has demonstrated that diet plays a role in cancer pathogenesis at the genetic, epigenetic and cellular level. Therefore, its potential as a modifiable determinant of cancer pathogenesis for the purpose of prevention and improving management of disease must be further explored and implemented. The ability to influence cancer incidence and outcomes through dietary changes is underutilised in clinical practice and insufficiently recognised among the general public, healthcare professionals and policy-makers. Dietary changes offer the opportunity for autonomy and control over individuals health outcomes. Research has revealed that particular dietary components, as well as cultural behaviours and epidemiological patterns may act as causative or protective factors in cancer development. This review aims to comprehensively synthesise this research to further explore how to best utilise this knowledge within the community and clinical environment for more effective cancer prevention and therapeutic strategies. The identified key areas for improvement include the development of more specific, widely accepted guidelines, promoting increased involvement of dieticians within cancer multidisciplinary teams, enhancing nutritional education for healthcare professionals and exploring the potential implementation of personalised nutrition tools. A greater understanding of the complex interactions between diet and cancer will facilitate informed clinical interventions and public health policies to reduce global cancer burden and improve care for cancer patients and survivors.
癌症一直是最大的公共卫生问题之一，对全球疾病负担和死亡率有重大影响。疾病病因和进展中环境与遗传因素的多方面相互作用需要进行全面研究，以阐明可改变的因素，从而降低发病率风险并改善预后。在这些因素中，饮食和营养已成为最基本的因素，具有显著的影响潜力。营养不仅是人类生存的重要组成部分，也是整体健康的关键决定因素。支持正常生理功能需要特定的饮食要求。这包括个性化的常量营养素（蛋白质、碳水化合物和脂肪）水平以及特定的微量营养素（维生素和矿物质）。广泛的研究表明，饮食在癌症发病机制的遗传、表观遗传和细胞水平上发挥作用。因此，必须进一步探索并实施其作为癌症发病机制可改变决定因素以预防疾病和改善疾病管理的潜力。通过饮食改变影响癌症发病率和结局的能力在临床实践中未得到充分利用，在普通公众、医疗保健专业人员和政策制定者中也未得到充分认识。饮食改变为个人健康结局提供了自主和控制的机会。研究表明，特定的饮食成分以及文化行为和流行病学模式可能在癌症发展中充当致病或保护因素。本综述旨在全面综合这项研究，以进一步探索如何在社区和临床环境中最佳利用这些知识，制定更有效的癌症预防和治疗策略。确定的关键改进领域包括制定更具体、被广泛接受的指南，促进营养师更多地参与癌症多学科团队，加强对医疗保健专业人员的营养教育，以及探索个性化营养工具的潜在应用。对饮食与癌症之间复杂相互作用的更深入理解将有助于制定明智的临床干预措施和公共卫生政策，以减轻全球癌症负担，改善对癌症患者和幸存者的护理。
