其他
如何吃可能远离癌症?BMJ这11000字专业指导请收藏
这是《肠道产业》第 330 篇文章
关键信息:
●肥胖和饮酒增加了多种癌症的风险;这是造成全球范围癌症负担的最重要的营养因素。
●对于结直肠癌,加工肉会增加其患病风险,红肉可能会增加其患病风险;膳食纤维、乳制品和钙可能降低患病风险。
●含有致变物的食物可能导致癌症;某些种类的咸鱼会诱发鼻咽癌,含有黄曲霉毒素的食物会诱发肝癌。
●水果蔬菜与癌症风险之间尚未有明确的联系,尽管研究表明极低的摄入量可能会增加呼吸道、消化道相关癌症和其他癌症的风险。
营养与癌症
BOX 1 水果和蔬菜是癌症风险的重要决定性因素吗?
早期的病例对照研究表明,摄入更多的水果蔬菜与许多类型的癌症的较低风险相关11。但随后的不受回忆和筛选偏差影响的前瞻性试验产生的结果则要弱得多。2018 年世界癌症研究基金会报道,水果和蔬菜均不被认为与任何癌症的风险有令人信服的可能的联系8。但是也存在水果蔬菜对某些癌症具有保护作用的暗示性证据,而且有研究表明水果蔬菜摄入量低时,癌症的患病风险可能增加,这可能是因为一些水果蔬菜中的特定成分具有保护功能。
素食者既不吃肉也不吃鱼,相较于非素食者往往摄入更多的水果蔬菜。素食者(包括纯素食者和素食者)所有癌症部位的风险加起来可能比非素食主义者略低,但是在个别癌症中的结果并不明确12。
BOX 2 维生素和矿物质能降低癌症风险吗?
缺乏维生素和基本矿物质会造成身体不适,这可能包括增加对一些癌症的易感性,但是要明确这些影响是很困难的。高剂量的维生素或矿物质补充剂在营养良好的人群中并不能够降低癌症风险,可能反而增加风险13。尽管对于健康的其他方面很重要,如叶酸的补充对于备孕的女性很重要,但维生素和矿物质补充剂不应该被用于癌症干预。
消化道相关癌症
非消化道癌症
专家组的评估
不确定性仍然存在
BOX 3 为什么个子更高的人癌症风险较高?
大部分癌症的风险都会随身高增加。WCRF 的一项系统性综述表明,每长高 5cm 癌症风险的增加从前列腺癌的 4%到恶性黑色素瘤的 12%不等83。其中机制尚不明确,但是更高的人拥有更多具有癌症风险的干细胞,或是像胰岛素样生长因子-1 这样同时影响身高和癌症风险的因素84。营养不良造成生长受限,而在儿童时期和青少年时期,给予充足的营养,比如能量和蛋白质的充分摄入,可能导致相对较高的身高和整体较高的癌症风险83。但是,尚不清楚更好地了解这一通路能否带来降低癌症风险的方法。
膳食作为预防癌症的因素有多重要?
未来方向
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