de Lorgeril M, Salen P, Martin J L, Monjaud I, Boucher P, Mamelle N
Laboratoire de Physiologie and GIP-Exercice, Centre Hospitalo-Universitaire de Saint-Etienne and School of Medicine, France.
Arch Intern Med. 1998 Jun 8;158(11):1181-7. doi: 10.1001/archinte.158.11.1181.
The Mediterranean dietary pattern is thought to reduce the risk of cancer in addition to being cardioprotective. However, no trial has been conducted so far to prove this belief.
We compared overall survival and newly diagnosed cancer rate among 605 patients with coronary heart disease randomized in the Lyon Diet Heart Study and following either a cardioprotective Mediterranean-type diet or a control diet close to the step 1 American Heart Association prudent diet.
During a follow-up of 4 years, there were a total of 38 deaths (24 in controls vs 14 in the experimental group), including 25 cardiac deaths (19 vs 6) and 7 cancer deaths (4 vs 3), and 24 cancers (17 vs 7). Exclusion of early cancer diagnoses (within the first 24 months after entry into the trial) left a total of 14 cancers (12 vs 2). After adjustment for age, sex, smoking, leukocyte count, cholesterol level, and aspirin use, the reduction of risk in experimental subjects compared with control subjects was 56% (P=.03) for total deaths, 61% (P=.05) for cancers, and 56% (P=.01) for the combination of deaths and cancers. The intakes of fruits, vegetables, and cereals were significantly higher in experimental subjects, providing larger amounts of fiber and vitamin C (P<.05). The intakes of cholesterol and saturated and polyunsaturated fats were lower and those of oleic acid and omega-3 fatty acids were higher (P<.001) in experimental subjects. Plasma levels of vitamins C and E (P<.05) and omega-3 fatty acids (P<.001), measured 2 months after randomization, were higher and those of omega-6 fatty acids were lower (P<.001) in experimental subjects.
This randomized trial suggests that patients following a cardioprotective Mediterranean diet have a prolonged survival and may also be protected against cancer. Further studies are warranted to confirm the data and to explore the role of the different lipids and fatty acids in this protection.
地中海饮食模式除了具有心脏保护作用外，还被认为可降低癌症风险。然而，迄今为止尚未进行试验来证实这一观点。
我们比较了里昂饮食心脏研究中随机分配的605例冠心病患者的总生存率和新诊断癌症率，这些患者分别遵循心脏保护型地中海式饮食或接近美国心脏协会第一步谨慎饮食的对照饮食。
在4年的随访期间，共有38例死亡（对照组24例，试验组14例），包括25例心脏死亡（19例对6例）和7例癌症死亡（4例对3例），以及24例癌症（17例对7例）。排除早期癌症诊断（入组试验后的前24个月内）后，共有14例癌症（12例对2例）。在对年龄、性别、吸烟、白细胞计数、胆固醇水平和阿司匹林使用情况进行调整后，试验组受试者与对照组相比，总死亡风险降低56%（P = 0.03），癌症风险降低61%（P = 0.05），死亡和癌症综合风险降低56%（P = 0.01）。试验组受试者的水果、蔬菜和谷物摄入量显著更高，提供了更多的纤维和维生素C（P < 0.05）。试验组受试者的胆固醇、饱和脂肪和多不饱和脂肪摄入量较低，油酸和ω-3脂肪酸摄入量较高（P < 0.001）。随机分组2个月后测量的试验组受试者血浆维生素C和E水平（P < 0.05）以及ω-3脂肪酸水平（P < 0.001）较高，而ω-6脂肪酸水平较低（P < 0.001）。
这项随机试验表明，遵循心脏保护型地中海饮食的患者生存期延长，可能也受到了癌症保护。有必要进行进一步研究以证实这些数据，并探索不同脂质和脂肪酸在这种保护中的作用。
