Rao G N
National Toxicology Program, National Institute of Environmental Health Sciences, Research Triangle Park, NC 27709, USA.
Prog Clin Biol Res. 1996;394:41-56.
Approximately 20% of all deaths in the United States are due to cancer. Cancers of the hormonal tissues such as breast, uterus, ovary in women and prostate in men account for about 8% and 5% of total mortality and 30% and 11% of cancer mortality in women and men, respectively. Diet is considered to be a major and important environmental factor contributing to cancers of hormonal tissues. Breast, uterus, and ovary cancers in women and prostate cancers in men were positively correlated with high fat consumption, high body weight (body mass), body fat, and obesity. A major mechanism for development of these cancers appears to be mediated through increased levels of hormones, especially estrogens. Adipose tissue is considered to be one of the major sources of extraglandular estrogen, produced by aromatization of androgen precursors. Weight reduction decreases the estrogen levels possibly due to a decrease in body fat, thus decreasing the risk for cancers of the hormonal tissues. Dietary fiber may modify the risk for these cancers by influencing estrogen metabolism, recirculation, and excretion. Vitamin A and its precursors may decrease the risk for prostate cancer. Iodine deficiency may increase the risk for thyroid neoplasms in humans and experimental animals. Tumors of the hormonal tissues are the most common tumors in laboratory rodents, especially rats and mice. Incidences of mammary and anterior pituitary tumors had significant and positive correlation with body weight in rats and mice. Lowering the body weight by either decreased caloric intake or other means (e.g., exercise, increased fiber consumption) markedly lowered the incidences of these tumors in laboratory rodents. Laboratory studies indicated that mammary tumor rates in rats may not depend on the amount of fat consumed per day. The mammary tumor-promoting effect of fat may be due to complex interactions involving energy intake and energy retention (body mass) mediated through paracrine, endocrine, and neurohormonal mechanisms. Dietary protein may influence chemically induced tumors by affecting the metabolism of chemicals through enzyme induction. Thus, environmental factors such as diet are considered to be major and important factors for tumors of the hormonal tissues such as breast, uterus, and ovary in women and prostate in men. Diet and associated body weight are considered to be the major factors for tumors of hormonal tissues such as mammary and pituitary glands in rodents, especially rats. Modification of diet and a decrease in caloric intake may markedly decrease the incidence or delay the development of tumors of hormonal tissues in humans and in experimental animals.
在美国,约20%的死亡是由癌症导致的。女性的激素组织癌症,如乳腺癌、子宫癌、卵巢癌,以及男性的前列腺癌,分别占总死亡率的约8%和5%,占女性和男性癌症死亡率的30%和11%。饮食被认为是导致激素组织癌症的一个主要且重要的环境因素。女性的乳腺癌、子宫癌和卵巢癌以及男性的前列腺癌与高脂肪摄入、高体重(体重指数)、体脂肪和肥胖呈正相关。这些癌症发生发展的一个主要机制似乎是通过激素水平升高介导的,尤其是雌激素。脂肪组织被认为是腺外雌激素的主要来源之一,由雄激素前体的芳香化作用产生。体重减轻可能由于体脂肪减少而降低雌激素水平,从而降低激素组织癌症的风险。膳食纤维可能通过影响雌激素代谢、再循环和排泄来改变这些癌症的风险。维生素A及其前体可能降低前列腺癌的风险。碘缺乏可能增加人类和实验动物患甲状腺肿瘤的风险。激素组织肿瘤是实验啮齿动物,尤其是大鼠和小鼠中最常见的肿瘤。大鼠和小鼠的乳腺和垂体前叶肿瘤发病率与体重呈显著正相关。通过减少热量摄入或其他方式(如运动、增加纤维摄入量)降低体重,可显著降低实验啮齿动物中这些肿瘤的发病率。实验室研究表明,大鼠的乳腺肿瘤发生率可能不取决于每日脂肪摄入量。脂肪的乳腺肿瘤促进作用可能是由于通过旁分泌、内分泌和神经激素机制介导的能量摄入和能量保留(体重)之间的复杂相互作用。膳食蛋白质可能通过酶诱导影响化学物质代谢,从而影响化学诱导的肿瘤。因此,饮食等环境因素被认为是女性乳腺癌、子宫癌和卵巢癌以及男性前列腺癌等激素组织肿瘤的主要且重要因素。饮食和相关体重被认为是啮齿动物,尤其是大鼠的乳腺和垂体等激素组织肿瘤的主要因素。改变饮食和减少热量摄入可能显著降低人类和实验动物激素组织肿瘤的发病率或延缓其发展。