Greater survival after breast cancer in physically active women with high vegetable-fruit intake regardless of obesity
Greater survival after breast cancer in physically active women with high vegetable-fruit intake regardless of obesity
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DOI：
10.1200/jco.2006.08.6819
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发表时间：
2007-06-10
影响因子：
45.3
通讯作者：
Rock, Cheryl L.
中科院分区：
文献类型：
--
作者：
Pierce, John P.;Stefanick, Marcia L.;Rock, Cheryl L.
目的 单变量分析将体力活动、饮食和肥胖与乳腺癌后的生存相关。本报告调查了这些变量之间的相互作用。 患者和方法 对 1,490 名在 1991 年至 2000 年间诊断并接受早期乳腺癌治疗的女性进行了一项前瞻性研究。平均诊断后 2 年入组。截至 2005 年 12 月，只有 7 名女性失访。 结果 在单变量分析中，死亡率降低与较高的蔬菜水果摄入量、增加的体力活动以及既不低体重也不肥胖的体重指数呈弱相关。在多变量 Cox 模型中，只有每天摄入 5 份或更多蔬菜水果，并累积 540+ 分钟/周代谢当量任务（相当于每周 6 天步行 30 分钟）的组合，才与显着的生存优势相关（风险比，0.56；95% CI，0.31 至 0.98）。在肥胖和非肥胖女性中观察到与这些健康生活方式行为相关的风险降低了约 50%，尽管通过健康饮食模式进行身体活动的肥胖女性较少（16% vs 30%）。在坚持这种健康生活方式的人中，肥胖对生存没有明显影响。对于患有激素受体阳性癌症的女性来说，这种效果更为明显。 结论 少数乳腺癌幸存者遵循健康的生活方式，包括推荐摄入的蔬菜水果和适度的体力活动。观察到的强烈保护作用表明需要进一步研究饮食和身体活动的综合影响对乳腺癌生存的影响。
Purpose Single-variable analyses have associated physical activity, diet, and obesity with survival after breast cancer. This report investigates interactions among these variables.Patients and Methods A prospective study was performed of 1,490 women diagnosed and treated for early-stage breast cancer between 1991 and 2000. Enrollment was an average of 2 years postdiagnosis. Only seven women were lost to follow-up through December 2005.Results In univariate analysis, reduced mortality was weakly associated with higher vegetable-fruit consumption, increased physical activity, and a body mass index that was neither low weight nor obese. In a multivariate Cox model, only the combination of consuming five or more daily servings of vegetables-fruits, and accumulating 540+ metabolic equivalent tasks-min/wk (equivalent to walking 30 minutes 6 d/wk), was associated with a significant survival advantage (hazard ratio, 0.56; 95% CI, 0.31 to 0.98). The approximate 50% reduction in risk associated with these healthy lifestyle behaviors was observed in both obese and nonobese women, although fewer obese women were physically active with a healthy dietary pattern (16% v 30%). Among those who adhered to this healthy lifestyle, there was no apparent effect of obesity on survival. The effect was stronger in women who had hormone receptor-positive cancers.Conclusion A minority of breast cancer survivors follow a healthy lifestyle that includes both recommended intakes of vegetables-fruits and moderate levels of physical activity. The strong protective effect observed suggests a need for additional investigation of the effect of the combined influence of diet and physical activity on breast cancer survival.