Dietary fibre, whole grains, and risk of colorectal cancer: systematic review and dose-response meta-analysis of prospective studies.
Dietary fibre, whole grains, and risk of colorectal cancer: systematic review and dose-response meta-analysis of prospective studies.
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DOI：
10.1136/bmj.d6617
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发表时间：
2011-11-10
期刊：
影响因子：
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通讯作者：
Norat T
中科院分区：
文献类型：
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作者：
Aune D;Chan DS;Lau R;Vieira R;Greenwood DC;Kampman E;Norat T
目的探讨膳食纤维和粗粮摄入量与结直肠癌发病风险的关系。设计前瞻性观察性研究的系统回顾和荟萃分析。数据来源PubMed和其他几个数据库，截至2010年12月，分析中包括的研究参考列表以及已发表的荟萃分析中列出的研究。研究选择膳食纤维或全谷物摄入量与结直肠癌发病率的前瞻性队列和巢式病例对照研究。结果纳入25篇前瞻性研究。每日摄入10克总膳食纤维患结直肠癌的相对风险总结（16项研究）为0.90（95%置信区间0.86至0.94，I2=0%），水果纤维（n=9）为0.93（0.82 ~ 1.05，I2=23%），植物纤维（n=9）为0.98豆类纤维（n=4）为0.62（0.27 ~ 1.42，I2=58%），谷类纤维（n=8）为0.90（0.83 ~ 0.97，I2=0%）。每天增加三份全谷物（n=6）的总体相对风险为0.83（0.78至0.89，I2=18%）。结论高膳食纤维摄入，特别是谷物纤维和全谷物，与结直肠癌风险降低有关。进一步的研究应该报告更详细的结果，包括纤维亚型的结果，并根据其他风险因素进行分层，以排除残留的混杂因素。还需要进一步评估测量误差对风险估计的影响。
Objective To investigate the association between intake of dietary fibre and whole grains and risk of colorectal cancer. Design Systematic review and meta-analysis of prospective observational studies. Data sources PubMed and several other databases up to December 2010 and the reference lists of studies included in the analysis as well as those listed in published meta-analyses. Study selection Prospective cohort and nested case-control studies of dietary fibre or whole grain intake and incidence of colorectal cancer. Results 25 prospective studies were included in the analysis. The summary relative risk of developing colorectal cancer for 10 g daily of total dietary fibre (16 studies) was 0.90 (95% confidence interval 0.86 to 0.94, I2=0%), for fruit fibre (n=9) was 0.93 (0.82 to 1.05, I2=23%), for vegetable fibre (n=9) was 0.98 (0.91 to 1.06, I2=0%), for legume fibre (n=4) was 0.62 (0.27 to 1.42, I2=58%), and for cereal fibre (n=8) was 0.90 (0.83 to 0.97, I2=0%). The summary relative risk for an increment of three servings daily of whole grains (n=6) was 0.83 (0.78 to 0.89, I2=18%). Conclusion A high intake of dietary fibre, in particular cereal fibre and whole grains, was associated with a reduced risk of colorectal cancer. Further studies should report more detailed results, including those for subtypes of fibre and be stratified by other risk factors to rule out residual confounding. Further assessment of the impact of measurement errors on the risk estimates is also warranted.