Diet, nutrition, and avoidable cancer.
Diet, nutrition, and avoidable cancer.
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DOI：
10.1289/ehp.95103s8165
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发表时间：
1995-11
影响因子：
10.4
通讯作者：
中科院分区：
文献类型：
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在1981年的一项综述中，多尔和佩托估计，在美国，大约35%的癌症死亡是可以通过改变饮食来避免的，但这一比例可能低至10%，也可能高达70%。从那时起，关于饮食和癌症的流行病学文献有了很大的增长，对致癌机制的理解也有了很大的增长。一般来说，这一扩展的文献没有提供充分改变Doll和Peto估计的理由。对于结肠癌，越来越多的证据表明，一些归因于饮食的国际差异可能是由于体力活动。对于乳腺癌，脂肪摄入本身是各国发病率差异的主要原因这一概念尚未得到前瞻性研究的支持。尽管多项证据表明，热量限制和缓慢的生长速度可能是西方国家以外乳腺癌发病率较低的重要原因，但这可能并不能直接转化为实用的预防手段。与乳腺癌相反，最近的数据支持红肉在结肠癌和前列腺癌的发展中起着致病作用，尽管可能不完全是由于其脂肪含量。早期关于营养和癌症的思考强调了饮食中脂肪和其他成分的不利影响，而过去十年最令人信服的证据表明了水果和蔬菜中保护因素的重要性，这些因素在很大程度上尚未确定。考虑到最近的证据，粗略估计约有32%的癌症可以通过改变饮食来避免;然而，现在看来，通过改变饮食来避免癌症死亡的可能性不超过20%或42%。
In a 1981 review, Doll and Peto estimated that approximately 35% of cancer deaths in the United States were potentially avoidable by the modification of diet but that this percentage might be as low as 10% or as high as 70%. Since that time, the epidemiologic literature on diet and cancer has grown greatly, as has understanding of the mechanisms of carcinogenesis. In general, this expanded literature has not provided reason to alter the Doll and Peto estimate substantially. For colon cancer, evidence has accumulated that some of the international differences that were attributed to diet are probably due to physical activity. For breast cancer, the concept that fat intake per se is the primary reason for differences in rates among countries has not been supported by prospective studies. Although several lines of evidence suggest that caloric restriction and slow growth rates may contribute importantly to the low rates of breast cancer found outside Western countries, this may not translate directly to practical means of prevention. In contrast to breast cancer, more recent data have supported a causative role for red meat in the development of colon and prostate cancers, although perhaps not entirely due to its fat content. Whereas earlier thinking about nutrition and cancer emphasized the adverse effects of fat and other components in the diet, the most compelling evidence of the last decade has indicated the importance of protective factors, largely unidentified, in fruits and vegetables. Considering the more recent evidence, it is roughly estimated that about 32% of cancer may be avoidable by changes in diet; however, it now seems unlikely that less than 20% or more than 42% of cancer deaths would be avoidable by dietary change.