Austoker J
Department of Public Health and Primary Care, University of Oxford.
BMJ. 1994 Jun 18;308(6944):1610-4. doi: 10.1136/bmj.308.6944.1610.
Accumulating data indicate that modifications in diet may reduce the risk of cancer by as much as one third and possibly by as much as two thirds. On the basis of the existing evidence, however, it is not possible to be certain which cancers are causally related to diet and what proportion of them are due to specific components of the diet. Diet is currently thought to be a major factor in the aetiology of cancers of the large bowel and stomach, and it may also be important in the aetiology of several other cancers. With the exception of strong and consistent evidence of the protective effect of fruit and vegetables, practical dietary interventions that reduce the risk of cancer are difficult to formulate as, in general, the evidence is theoretical or contradictory and too weak to justify specific intervention. Authoritative guidelines on dietary management in primary care are conspicuously absent because of lack of research. The success of an individual based strategy will depend on adequate education, training, and support being made available to the relevant members of primary care teams.
越来越多的数据表明,饮食调整可将癌症风险降低多达三分之一,甚至可能多达三分之二。然而,根据现有证据,尚无法确定哪些癌症与饮食存在因果关系,以及其中有多大比例是由饮食的特定成分所致。目前认为,饮食是导致大肠癌和胃癌的主要因素,在其他几种癌症的病因中可能也很重要。除了有充分且一致的证据表明水果和蔬菜具有预防作用外,由于总体证据多为理论性或相互矛盾,且力度不足,难以据此制定具体的干预措施,因此很难制定出降低癌症风险的实际饮食干预方案。由于缺乏研究,初级保健中关于饮食管理的权威指南明显缺失。基于个体的策略能否成功,将取决于能否为初级保健团队的相关成员提供充分的教育、培训和支持。