Chen Shuhui, Hua Baojie, Liu Bin, Wang Le, Yuan Qi, Yang Yudan, Sun Xiaohui, Ye Ding, Du Lingbin, Mao Yingying, Li Jiayu
Department of Epidemiology, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China.
Department of Cancer Prevention, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China.
Front Nutr. 2025 Jun 18;12:1607358. doi: 10.3389/fnut.2025.1607358. eCollection 2025.
Cancer is among the world's top causes of death, and diet plays an important role in cancer risk. However, few studies have addressed a comprehensive atlas that details the connections between dietary carbohydrates and cancer risk.
We conducted a large population-based prospective cohort research based on the UK Biobank including 194,388 participants. The Oxford WebQ, a web-based 24-h recall questionnaire, was used to collect dietary information of each study participant. Using the Cox proportional hazards model, we calculated the hazard ratios (HRs) with 95% confidence intervals (CIs) for the associations of energy-adjusted carbohydrates intake and the incidence of overall cancer as well as 21 site-specific cancers.
A total of 19,990 incidences of cancer (excluding non-melanoma skin cancer) were recorded with a median follow-up of 12.8 years. Energy-adjusted fiber was associated with a reduced risk of overall cancer [HR (95% CI): 0.97 (0.96, 0.99); : 0.045] and esophageal [0.79 (0.68, 0.91); 0.024], colorectal [0.92 (0.87, 0.97); 0.025], lung [0.87 (0.81, 0.94); 0.014], and kidney cancer [0.85 (0.76, 0.94); 0.031]. Energy-adjusted free sugars were tied to a higher risk of lung [1.12 (1.05, 1.19); 0.024] and kidney cancer [1.15 (1.05, 1.26); 0.039], while non-free sugars were associated with a reduced risk of overall cancer [0.97 (0.95, 0.99); 0.031], colorectal [0.89 (0.84, 0.94); 0.006] and lung cancer [0.86 (0.79, 0.93); 0.014]. Finally, energy-adjusted sucrose was associated with an elevated risk of both lung cancer [1.10 (1.04, 1.17); 0.024] and non-Hodgkin lymphoma [1.15 (1.07, 1.23); 0.008].
Increased consumption of dietary fiber and non-free sugars is associated with a reduced risk of certain cancers (e.g., overall cancer, esophageal, colorectal, lung, and kidney cancers), potentially due to their anti-inflammatory effects, short-chain fatty acid production, and other protective mechanisms. In contrast, higher intakes of free sugars and sucrose are associated with an elevated risk (e.g., lung, kidney cancer, and non-Hodgkin lymphoma), which may be attributed to inflammation and oxidative stress.
癌症是全球主要死因之一，饮食在癌症风险中起着重要作用。然而，很少有研究构建一个全面的图谱来详细阐述膳食碳水化合物与癌症风险之间的联系。
我们基于英国生物银行开展了一项大规模的基于人群的前瞻性队列研究，纳入了194,388名参与者。采用牛津网络问卷（一种基于网络的24小时回顾性问卷）收集每位研究参与者的饮食信息。使用Cox比例风险模型，我们计算了能量调整后的碳水化合物摄入量与总体癌症以及21种特定部位癌症发病率之间关联的风险比（HRs）及其95%置信区间（CIs）。
共记录了19,990例癌症（不包括非黑色素瘤皮肤癌）发病病例，中位随访时间为12.8年。能量调整后的纤维与总体癌症风险降低相关[HR（95%CI）：0.97（0.96，0.99）；P = 0.045]，以及食管癌[0.79（0.68，0.91）；0.024]、结直肠癌[0.92（0.87，0.97）；0.025]、肺癌[0.87（0.81，0.94）；0.014]和肾癌[0.85（0.76，0.94）；0.031]。能量调整后的游离糖与肺癌[1.12（1.05，1.19）；0.024]和肾癌[1.15（1.05，1.26）；0.039]风险升高相关，而非游离糖与总体癌症风险降低相关[0.97（0.95，0.99）；0.031]、结直肠癌[0.89（0.84，0.94）；0.006]和肺癌[0.86（0.79，0.93）；0.014]。最后，能量调整后的蔗糖与肺癌[1.10（1.04，1.17）；0.024]和非霍奇金淋巴瘤[1.15（1.07，1.23）；0.008]风险升高均相关。
膳食纤维和非游离糖的摄入量增加与某些癌症（如总体癌症、食管癌、结直肠癌、肺癌和肾癌）风险降低相关，这可能归因于它们的抗炎作用、短链脂肪酸生成及其他保护机制。相反，游离糖和蔗糖摄入量较高与风险升高相关（如肺癌、肾癌和非霍奇金淋巴瘤），这可能归因于炎症和氧化应激。
