RELATION OF MEAT, FAT, AND FIBER INTAKE TO THE RISK OF COLON CANCER IN A PROSPECTIVE-STUDY AMONG WOMEN
RELATION OF MEAT, FAT, AND FIBER INTAKE TO THE RISK OF COLON CANCER IN A PROSPECTIVE-STUDY AMONG WOMEN
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DOI：
10.1056/nejm199012133232404
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发表时间：
1990-12-13
影响因子：
158.5
通讯作者：
SPEIZER, FE
中科院分区：
文献类型：
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作者：
WILLETT, WC;STAMPFER, MJ;SPEIZER, FE
背景资料：各国的结肠癌发病率与红肉和动物脂肪的人均消费量密切相关，在较小程度上与纤维的消费量呈负相关。研究方法：我们对88,751名年龄在34 - 59岁之间的女性进行了一项前瞻性研究，这些女性没有癌症、炎症性肠病或家族性息肉病史，并在1980年完成了饮食调查问卷。到1986年，在512，488人年的随访中，记录了150例结肠癌事件。结果如下：调整总能量摄入后，动物脂肪与结肠癌风险呈正相关（趋势P = 0.01）;最高与最低五分位数相比的相对风险为1.89（95%置信区间，1.13至3.15）。没有发现与植物脂肪有关。每天吃牛肉、猪肉或羊肉作为主菜的女性患结肠癌的相对风险为2.49（95%置信区间为1.24~5.03），与那些报告每月食用少于一次的女性相比。加工肉类和肝脏也与风险增加显著相关，而鱼和去皮鸡肉与风险降低有关。红肉摄入量与鸡肉和鱼类摄入量的比例与结肠癌发病率的增加特别密切相关（趋势P = 0.0005）;与最低五分之一的女性相比，最高五分之一女性的相对风险为2.49（95%置信区间，1.50至4.13）。从水果中摄入低纤维似乎有助于结肠癌的风险，但这种关系在统计学上并不独立于肉类摄入。结论：这些前瞻性数据为高动物脂肪摄入量增加结肠癌风险的假设提供了证据，并支持以鱼类和鸡肉替代高脂肪肉类的现有建议。
Background: The rates of colon cancer in various countries are strongly correlated with the per capita consumption of red meat and animal fat and, to lesser degree, inversely associated with the consumption of fiber. Methods: We conducted a prospective study among 88,751 women 34 to 59 years old and without a history of cancer, inflammatory bowel disease, or familial polyposis who completed a dietary questionnaire in 1980. By 1986, during 512,488 person-years of follow-up, 150 incident cases of colon cancer had been documented. Results: After adjustment for total energy intake, animal fat was positively associated with the risk of colon cancer (P for trend = 0.01); the relative risk for the highest as compared with the lowest quintile was 1.89 (95 percent confidence interval, 1.13 to 3.15). No association was found for vegetable fat. The relative risk of colon cancer in women who ate beef, pork, or lamb as a main dish every day was 2.49 (95 percent confidence interval, 1.24 to 5.03), as compared with those reporting consumption less than once a month. Processed meats and liver were also significantly associated with increased risk, whereas fish and chicken without skin were related to decreased risk. The ratio of the intake of red meat to the intake of chicken and fish was particularly strongly associated with an increased incidence of colon cancer (P for trend = 0.0005); the relative risk for women in the highest quintile of this ratio as compared with those in the lowest quintile was 2.49 (95 percent confidence interval, 1.50 to 4.13). A low intake of fiber from fruits appeared to contribute to the risk of colon cancer, but this relation was not statistically independent of meat intake. Conclusions: These prospective data provide evidence for the hypothesis that a high intake of animal fat increases the risk of colon cancer, and they support existing recommendations to substitute fish and chicken for meats high in fat.