Diet, body weight, and colorectal cancer: A summary of the epidemiologic evidence
Diet, body weight, and colorectal cancer: A summary of the epidemiologic evidence
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DOI：
10.1089/154099903321576574
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发表时间：
2003-03-01
期刊：
影响因子：
--
通讯作者：
Giovannucci, E
中科院分区：
文献类型：
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作者：
Giovannucci, E
结直肠癌是美国癌症死亡的第二大原因，每年的新病例数量在男性和女性中大致相等。几种营养因素可能对患这种癌症的风险有重大影响。缺乏运动和过度肥胖，尤其是集中分布的人群，明显会增加患结肠癌的风险。高胰岛素血症可能是一个重要的潜在危险因素。肥胖和缺乏运动会诱发胰岛素抵抗状态，与此同时，某些刺激胰岛素分泌的饮食模式，包括大量摄入红肉和加工肉类、饱和脂肪和反式脂肪，以及高度加工的碳水化合物和糖，可能会增加患结肠癌的风险。有证据表明，红肉中的某些成分可能会单独增加患结肠直肠癌的风险，而一些微量营养素可能是重要的保护剂。目前，叶酸和钙的作用最为明显。叶酸对饮酒者尤其重要，因为酒精似乎会增加患病风险，尤其是当叶酸摄入量较低时。这种相互作用可能与酒精的抗叶酸特性有关。与早期的研究相反，最近的流行病学研究普遍不支持膳食纤维或水果和蔬菜的强烈影响，尽管这些对健康有其他好处，应该鼓励食用。大多数结肠癌，以及许多其他疾病，可以通过改变生活方式摄入这些营养因素来预防，除了其他因素，比如吸烟。
Colorectal cancer is the second leading cause of cancer death in the United States, and the number of new cases annually is approximately equal for men and women. Several nutritional factors are likely to have a major influence on risk of this cancer. Physical inactivity and excessive adiposity, especially if centrally distributed, clearly increase the risk of colon cancer. Hyperinsulinemia may be an important underlying risk factor. In conjunction with obesity and physical inactivity, which induce a state of insulin resistance, certain dietary patterns that stimulate insulin secretion, including high intakes of red and processed meats, saturated and trans-fats, and highly processed carbohydrates and sugars, may increase the risk of colon cancer. There is evidence suggesting that some component of red meat may independently increase the risk of colorectal cancer, and some micronutrients may be important as protective agents. Currently, the evidence is strongest for folate and calcium. Folate may be especially important in alcohol drinkers because alcohol appears to increase the risk, particularly when folate intake is low. This interaction may be related to the antifolate properties of alcohol. In contrast to earlier studies, more recent epidemiologic studies have generally not supported a strong influence of dietary fiber or fruits and vegetables, although these have other health benefits, and their consumption should be encouraged. The majority of colon cancers, as well as many other conditions, may be prevented by lifestyle alterations in the intake of these nutritional factors, in addition to other factors, such as smoking.