Slattery M L, Boucher K M, Caan B J, Potter J D, Ma K N
Department of Oncological Sciences, University of Utah Medical Center, Salt Lake City 84108, USA.
Am J Epidemiol. 1998 Jul 1;148(1):4-16. doi: 10.1093/aje/148.1.4-a.
Colon cancer has been associated with several nutrients and foods. The authors used data from a population-based study conducted in Northern California, Utah, and Minnesota to examine associations between dietary eating patterns and risk of developing colon cancer. Through factor analysis, detailed dietary intake data obtained from 1,993 cases (diagnosed in 1991-1994) and 2,410 controls were grouped into factors that were evaluated for relations with lifestyle characteristics and colon cancer risk. Several dietary patterns emerged. The dietary patterns with the most variation were labeled "Western," "prudent," "high fat/sugar dairy," "substituters," and "drinkers." The "Western" dietary pattern was associated with a higher body mass index and a greater intake of total energy and dietary cholesterol. The "prudent" pattern was associated with higher levels of vigorous leisure time physical activity, smaller body size, and higher intakes of dietary fiber and folate. Persons who had high scores on the "drinker" pattern were also more likely to smoke cigarettes. The "Western" dietary pattern was associated with an increased risk of colon cancer in both men and women. The association was strongest among people diagnosed prior to age 67 years (for men, odds ratio (OR)=1.96, 95% confidence interval (CI) 1.22-3.15; for women, OR=2.02, 95% CI 1.21-3.36) and among men with distal tumors (OR=2.25, 95% CI 1.47-3.46). The "prudent" diet was protective, with the strongest associations being observed among people diagnosed prior to age 67 years (men: OR=0.63, 95% CI 0.43-0.92; women: OR=0.58, 95% CI 0.38-0.87); associations with this dietary pattern were also strong among persons with proximal tumors (men: OR=0.55, 95% CI 0.38-0.80; women: OR=0.64, 95% CI 0.45-0.92). Although "substituters" (people who substituted low fat dairy products for high fat dairy products, margarine for butter, poultry for red meat, and whole grains for refined grains) were at reduced risk of colon cancer, the reduction in risk was not statistically significant. These data support the hypothesis that overall dietary intake pattern is associated with colon cancer, and that the dietary pattern associated with the greatest increase in risk is the one which typifies a Western-style diet.
结肠癌与多种营养素和食物有关。作者利用在北加利福尼亚、犹他州和明尼苏达州开展的一项基于人群的研究数据，来检验饮食模式与患结肠癌风险之间的关联。通过因子分析，从1993例病例（于1991 - 1994年确诊）和2410名对照者那里获取的详细饮食摄入数据被归为多个因子，这些因子被评估与生活方式特征和结肠癌风险的关系。出现了几种饮食模式。变化最大的饮食模式被标记为“西方型”、“谨慎型”、“高脂肪/高糖乳制品型”、“替代型”和“饮酒型”。“西方型”饮食模式与较高的体重指数、更高的总能量摄入量和膳食胆固醇摄入量相关。“谨慎型”模式与较高水平的剧烈休闲时间体力活动、较小的体型以及较高的膳食纤维和叶酸摄入量相关。在“饮酒型”模式得分高的人也更有可能吸烟。“西方型”饮食模式与男性和女性患结肠癌风险增加相关。这种关联在67岁之前被诊断出的人群中最为强烈（男性，优势比（OR）=1.96，95%置信区间（CI）1.22 - 3.15；女性，OR = 2.02，95% CI 1.21 - 3.36）以及在患有远端肿瘤的男性中（OR = 2.25，95% CI 1.47 - 3.46）。“谨慎型”饮食具有保护作用，在67岁之前被诊断出的人群中观察到的关联最为强烈（男性：OR = 0.63，95% CI 0.43 - 0.92；女性：OR = 0.58，95% CI 0.38 - 0.87）；在患有近端肿瘤的人群中与这种饮食模式的关联也很强（男性：OR = 0.55，95% CI 0.38 - 0.80；女性：OR = 0.64，95% CI 0.45 - 0.92）。尽管“替代型”人群（用低脂乳制品替代高脂乳制品、用人造黄油替代黄油、用家禽替代红肉、用全谷物替代精制谷物的人）患结肠癌的风险降低，但风险降低在统计学上并不显著。这些数据支持这样的假设，即总体饮食摄入模式与结肠癌相关，并且与风险增加最大相关的饮食模式是典型的西式饮食模式。
