Frankel S, Gunnell D J, Peters T J, Maynard M, Davey Smith G
Department of Social Medicine, University of Bristol.
BMJ. 1998 Feb 14;316(7130):499-504. doi: 10.1136/bmj.316.7130.499.
To examine the relation between energy intake in childhood and adult mortality from cancer.
Cohort study.
16 rural and urban centres in England and Scotland.
3834 people who took part in Lord Boyd Orr's Carnegie survey of family diet and health in prewar Britain between 1937 and 1939 who were followed up with the NHS, central register. Standardised methods were used to measure household dietary intake during a one week period.
Cancer mortality.
Significant associations between childhood energy intake and cancer mortality were seen when the confounding effects of social variables were taken into account in proportional hazards models (relative hazard for all cancer mortality 1.15 (95% confidence interval 1.06 to 1.24), P = 0.001, for every MJ increase in adult equivalent daily intake in fully adjusted models). This effect was essentially limited to cancers not related to smoking (relative hazard 1.20; 1.07 to 1.34; P = 0.001), with similar effects seen in men and women.
This positive association between childhood energy intake and later cancer is consistent with animal evidence linking energy restriction with reduced incidence of cancer and the association between height and human cancer, implying that higher levels of energy intake in childhood increase the risk of later development of cancer. This evidence for long term effects of early diet confirm the importance of optimal nutrition in childhood and suggest that the unfavourable trends seen in the incidence of some cancers may have their origins in early life.
研究儿童期能量摄入与成人癌症死亡率之间的关系。
队列研究。
英格兰和苏格兰的16个城乡中心。
1937年至1939年间参与博伊德·奥尔勋爵关于战前英国家庭饮食与健康的卡内基调查的3834人,通过国民保健服务中央登记处进行随访。采用标准化方法测量一周内家庭饮食摄入量。
癌症死亡率。
在比例风险模型中考虑社会变量的混杂效应时,发现儿童期能量摄入与癌症死亡率之间存在显著关联(完全调整模型中,成人等效每日摄入量每增加1兆焦耳,所有癌症死亡率的相对风险为1.15(95%置信区间1.06至1.24),P = 0.001)。这种效应基本上仅限于与吸烟无关的癌症(相对风险1.20;1.07至1.34;P = 0.001),男性和女性的情况相似。
儿童期能量摄入与后期癌症之间的这种正相关与动物实验证据一致,即能量限制与癌症发病率降低有关,以及身高与人类癌症之间的关联,这意味着儿童期较高的能量摄入量会增加后期患癌症的风险。早期饮食长期影响的这一证据证实了儿童期最佳营养的重要性,并表明某些癌症发病率中出现的不利趋势可能源于早期生活。