成年期饮食和生活方式模式与乳腺癌风险：全球癌症更新计划（CUP全球）系统文献综述
Adulthood dietary and lifestyle patterns and risk of breast cancer: Global Cancer Update Programme (CUP Global) systematic literature review.
作者信息
Konieczna Jadwiga, Chaplin Alice, Paz-Graniel Indira, Croker Helen, Becerra-Tomás Nerea, Markozannes Georgios, Tsilidis Konstantinos K, Dossus Laure, Gonzalez-Gil Esther M, Park Yikyung, Krebs John, Weijenberg Matty P, Baskin Monica L, Copson Ellen, Lewis Sarah J, Seidell Jacob C, Chowdhury Rajiv, Hill Lynette, Chan Doris Sm, Romaguera Dora
机构信息
Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR), Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), Palma de Mallorca, Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR), Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), Palma de Mallorca, Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
出版信息
Am J Clin Nutr. 2025 Jan;121(1):14-31. doi: 10.1016/j.ajcnut.2024.10.003. Epub 2024 Oct 23.
BACKGROUND
An increasing number of studies in recent years investigate various dietary and lifestyle patterns and associated breast cancer (BC) risk.
OBJECTIVES
This study aimed to comprehensively synthesize and grade the evidence on dietary and lifestyle patterns and BC risk.
METHODS
Databases were systematically searched up to 31 March, 2022, for evidence from randomised controlled trials and prospective cohort studies on adherence to a dietary pattern alone or in combination with lifestyle behaviors and incidence of or mortality from primary BC in adult females. Findings in all, premenopausal, and postmenopausal females were descriptively synthesized instead of meta-analyzed due to patterns heterogeneity. An independent Global Cancer Update Programme Expert Panel graded the strength of the evidence.
RESULTS
A total of 84 publications were included. Results for patterns reflecting both a healthy diet and lifestyle were more consistent than for patterns that included diet only. There was strong-probable evidence that a priori World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) and American Cancer Society (ACS) dietary and lifestyle scores may reduce BC risk in all and postmenopausal females, whereas in premenopausal females, less evidence was found contributing to limited-suggestive grade. There was also a limited-suggestive evidence that adherence to the Healthy Lifestyle Index and other diet and lifestyle scores may reduce BC risk in postmenopausal females; a posteriori Western/Meat/Alcohol dietary patterns may increase BC risk in postmenopausal females; and Prudent/Vegetarian/Mediterranean dietary patterns may reduce BC risk in all females. For the remaining patterns, evidence was graded as limited-no conclusions.
CONCLUSIONS
Advice to adopt combined aspects of a healthy diet and lifestyle according to WCRF/AICR and ACS scores, encouraging a healthy weight, physical activity, alcohol and smoking avoidance, and a healthy diet rich in fruits, vegetables, (whole)grains and cereals and discouraging red and processed meat, can be proposed to females to lower BC risk. This review was registered at PROSPERO as ID CRD42021270129 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021270129) on 28 August, 2021, and further updated on 4 May, 2022, in order to extend the search period.
背景
近年来，越来越多的研究调查了各种饮食和生活方式模式以及相关的乳腺癌（BC）风险。
目的
本研究旨在全面综合并分级关于饮食和生活方式模式与BC风险的证据。
方法
系统检索数据库至2022年3月31日，以获取来自随机对照试验和前瞻性队列研究的证据，这些研究涉及成年女性单独坚持饮食模式或与生活方式行为相结合以及原发性BC的发病率或死亡率。由于模式的异质性，对所有、绝经前和绝经后女性的研究结果进行了描述性综合，而非荟萃分析。一个独立的全球癌症最新进展计划专家小组对证据的强度进行了分级。
结果
共纳入84篇出版物。反映健康饮食和生活方式的模式的结果比仅包括饮食的模式更一致。有强有力的证据表明，世界癌症研究基金会/美国癌症研究所（WCRF/AICR）和美国癌症协会（ACS）的先验饮食和生活方式评分可能会降低所有女性和绝经后女性的BC风险，而在绝经前女性中，证据较少，属于有限提示等级。也有有限提示性证据表明，坚持健康生活方式指数以及其他饮食和生活方式评分可能会降低绝经后女性的BC风险；事后分析的西方/肉类/酒精饮食模式可能会增加绝经后女性的BC风险；谨慎/素食/地中海饮食模式可能会降低所有女性的BC风险。对于其余模式，证据被分级为有限——无结论。
结论
可以向女性建议，根据WCRF/AICR和ACS评分采用健康饮食和生活方式的综合方面，鼓励保持健康体重、进行体育活动、避免饮酒和吸烟，以及食用富含水果、蔬菜、（全）谷物和谷类的健康饮食，同时减少红肉和加工肉类的摄入，以降低BC风险。本综述于2021年8月28日在国际前瞻性系统评价注册库（PROSPERO）注册，编号为CRD42021270129（https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021270129），并于2022年5月4日进一步更新，以延长检索期。
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