Anne H Y Chu, Kehuan Lin, Helen Croker, Sarah Kefyalew, Nerea Becerra-Tomás, Laure Dossus, Esther M González-Gil, Nahid Ahmadi, Yikyung Park, John Krebs, Matty P Weijenberg, Monica L Baskin, Ellen Copson, Sarah J Lewis, Jacob C Seidell, Rajiv Chowdhury, Lynette Hill, Doris S M Chan, Dong Hoon Lee, Edward L Giovannucci
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引用次数: 0
Abstract
Background: The 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Third Expert Report, including studies up to 2015, determined 'limited-no conclusion' evidence on dietary patterns and colorectal cancer (CRC) risk due to insufficient data and varying pattern definitions.
Objective: This updated review synthesized literature on dietary patterns and CRC risk/mortality.
Methods: PubMed and Embase were searched through 31 March 2023 for randomized controlled trials (RCTs) and prospective cohort studies on adulthood dietary patterns. Patterns were categorized by derivation method: a priori, a posteriori, or hybrid; and were then descriptively reviewed in relation to the primary outcomes: CRC risk or mortality. The Global Cancer Update Programme Expert Committee and Expert Panel independently graded the evidence on the likelihood of causality using pre-defined criteria.
Results: Thirty-two dietary scores from 53 observational studies and three RCTs were reviewed. 'Limited-suggestive' evidence was concluded for higher alignment with a priori-derived patterns: Mediterranean, healthful plant-based index, Healthy Eating Index (HEI)/alternate HEI (AHEI), and Dietary Approaches to Stop Hypertension (DASH) in relation to lower CRC risk. Common features across these diets included high plant-based food intake and limited red/processed meat. Hybrid-derived patterns: the Empirical Dietary Pattern for Hyperinsulinemia (EDIH) and Empirical Dietary Inflammatory Pattern (EDIP) showed 'strong-probable' evidence for increased CRC risk. Evidence for a priori-derived low-fat dietary interventions and a posteriori-derived patterns was graded as 'limited-no conclusion'. By cancer subsite, higher alignment with Mediterranean diet showed 'limited-suggestive' evidence for lower rectal cancer risk, and with HEI/AHEI and DASH showed 'limited-suggestive' evidence for lower colon and rectal cancer risks. EDIH and EDIP showed 'strong-probable' evidence for increased colon cancer risks. All exposure-mortality pairs and other pattern-outcome associations were graded as 'limited-no conclusion'.
Conclusions: This review highlights the role of dietary patterns in CRC risk/mortality, providing insights for future research and public health strategies. This review was registered at PROSPERO as CRD42022324327 (Link: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022324327).
期刊介绍：
American Journal of Clinical Nutrition is recognized as the most highly rated peer-reviewed, primary research journal in nutrition and dietetics.It focuses on publishing the latest research on various topics in nutrition, including but not limited to obesity, vitamins and minerals, nutrition and disease, and energy metabolism.
Purpose:
The purpose of AJCN is to:
Publish original research studies relevant to human and clinical nutrition.
Consider well-controlled clinical studies describing scientific mechanisms, efficacy, and safety of dietary interventions in the context of disease prevention or health benefits.
Encourage public health and epidemiologic studies relevant to human nutrition.
Promote innovative investigations of nutritional questions employing epigenetic, genomic, proteomic, and metabolomic approaches.
Include solicited editorials, book reviews, solicited or unsolicited review articles, invited controversy position papers, and letters to the Editor related to prior AJCN articles.
Peer Review Process:
All submitted material with scientific content undergoes peer review by the Editors or their designees before acceptance for publication.
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