Epidemiological and clinical studies of nutrition.

Epidemiological and clinical studies of nutrition.
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DOI:
10.1053/j.seminoncol.2010.05.011
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发表时间:
2010-06
影响因子:
4
通讯作者:
Schatzkin A
Schatzkin A
中科院分区:
医学3区
文献类型:
--
作者:
Gibson TM;Ferrucci LM;Tangrea JA;Schatzkin A

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在这篇综述中,我们简要总结了过去二十年来营养流行病学和癌症方面的一些关键进展,重点介绍了研究设计和饮食评估方法的优点和局限性。我们介绍了来自大型队列研究和随机临床试验(RCT)的关于膳食脂肪、肉类、纤维、抗氧化营养素和钙与癌症发生关系的证据,并参考了2007年世界癌症研究基金会/美国癌症研究所总结报告的结论。出现的一个突出主题是随机对照试验和观察性研究的结果缺乏一致性。这些差异有多个潜在原因,包括研究人群、暴露剂量和时间、对干预的坚持、随访时间和主要终点的差异。因此,随机对照试验的无效发现并不一定表明被测试的饮食因素对癌症风险缺乏影响,因为如果在正确的时间和正确的剂量给予这些营养素中的一些可能具有化学预防作用。这种饮食的潜在好处很可能来自于食物成分的组合,而不是单一成分的单独作用。未来的努力需要认识到饮食暴露的综合性,并试图在更大的食物和饮食背景下研究营养物质。
In this review, we briefly summarize some of the key developments in nutritional epidemiology and cancer over the past two decades with a focus on the strengths and limitations of study designs and dietary assessment methods. We present the evidence on dietary fat, meat, fiber, antioxidant nutrients, and calcium in relation to carcinogenesis from large cohort studies and randomized clinical trials (RCTs) and refer to the conclusions of the 2007 World Cancer Research Fund/American Institute for Cancer Research summary report. One prominent theme that emerged is the lack of concordance of results from RCTs and observational studies. There are multiple potential reasons for these discrepancies, including differences in study population, dose and timing of the exposure, adherence to an intervention, length of follow-up, and the primary endpoint. Therefore, null findings of RCTs do not necessarily indicate a lack of effect for the tested dietary factors on cancer risk, as some of these nutrients may have chemopreventive effects if given at the right time and in the right dose. It is likely that potential benefits from the diet are due to a combination of food constituents rather than single components acting in isolation. Future efforts need to recognize the integrative nature of dietary exposures and attempt to study nutrients in the larger context of the foods and diets in which they are consumed.
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