禽肉摄入与慢性疾病:系统综述（英文）

目的通过检索相关文献,综合分析评价禽肉摄入与相关慢性疾病的关系。方法通过检索查阅国内(1997²014年)和国外(20022014年)和国外(2002²014年)相关文献,共纳入35篇学术论文,其中有关禽肉与结直肠癌的文献有5篇、前列腺癌6篇、2型糖尿病5篇。参照世界卫生组织(WHO)推荐的证据评价方法和标准,对禽肉(摄入量)与结直肠癌、前列腺癌、2型糖尿病等疾病进行评价。结果综合分析评价禽肉与相关疾病的关系,主要结果如下:1、禽肉摄入与结直肠癌的发病风险无关:证据共包括5篇文献,其中3篇文献(1篇系统综述、1项队列研究及1项病例对照研究)认为禽肉摄入与结直肠癌无关;1项队列研究发现禽肉与结直肠癌呈负相关;1项病例对照研究发现与健康人群相比加工类禽肉与结直肠癌无关,未加工类禽肉与结直肠癌呈负相关。2、禽肉摄入与前列腺癌发病风险无关:证据共包括6篇文献,其中2篇文献(1项病例对照研究和1项队列研究)显示禽肉摄入与前列腺癌的发病无关;2项病例对照研究显示:炸鸡及鸡肉的摄入量与前列腺癌的发病风险呈正相关;2项病例对照研究显示:禽肉与前列腺癌发病风险呈负相关。3、禽肉摄入与2型糖尿病的发病风险无关:证据共包括5篇文献,其中3篇文献(包括1项随机临床对照试验和2项队列研究)显示禽肉摄入与2型糖尿病的发病风险无关;1项队列研究显示:新鲜禽肉的摄入与2型糖尿病发病风险无关,加工类禽肉的摄入可增加2型糖尿病的发病风险;1项队列研究显示:摄入炸鸡可增加2型糖尿病的发生风险。4、禽肉摄入与心血管疾病、乳腺癌、胰腺癌、食道癌、血压、肥胖及贫血等疾病的相关研究也有报道,但未做综合分析评价。结论目前研究结果提示:禽肉摄入与结直肠癌、前列腺癌、2型糖尿病的发病风险无关。     

钙摄入与心血管疾病

钙是人体必需的矿物质元素。一直以来,文献报道钙摄入有利于降低血压,保护心血管;而近年来,不少文献报道钙摄入可能增加心血管疾病发生风险,补钙安全性受到了质疑。本文针对钙摄入引起心血管疾病发生相关文章进行综述,为进一步研究钙摄入与心血管疾病之间关系以及合理补钙提供理论依据。     

钠盐摄入与脑卒中发生风险关系的Meta分析

目的 探讨钠盐摄入与脑卒中发生风险的关系。方法 对关于钠盐摄入与脑卒中发生风险的前瞻性队列研究进行Meta分析。结果 共纳入10篇文献,与低钠盐摄入组相比,高钠盐摄入组发生脑卒中的风险显著增高15%(RR:1.15,95%CI:1.01～1.31),差异具有统计学意义(P = 0.04)。敏感性分析显示总体研究结果比较稳定,单个研究不会对总体结果产生显著影响。结论 钠盐摄入与脑卒中发病风险呈正相关,适当减少钠盐的摄入有利于预防脑卒中的发生。     

144名初中学生血压与尿钠、钾排出量的关系

本文通过收集三个全夜尿,对父母为高血压的子女其血压水平与盐摄入之间的关系进行了研究。使用逐步回归分析,结果显示,这些学生的血压(收缩压和舒张压)与尿钠/钾排泄量显著相关,提示这些学生的血压与钠、钾电解质摄入有一定联系。     

Ⅱ型糖尿病相关因素的Meta-分析

目的 进一步探讨Ⅱ型糖尿病与糖尿病家族史、身高体重指数(BMI)。水果的摄入之间的关系。方法 应用Meta-分析中可信区间方差分析法对国内关于Ⅱ型糖尿病发病与糖尿病家族史、身高体重指数及水果摄入关系的流行病学研究文献进行综合定量分析。结果Ⅱ型糖尿病与以上三因素均有关,合并OR分别为2.555(2.165～3.015)、1.337(1.2173～3.37)、0.701(0.630～0.780)。结论 研究认为糖尿病家族史、BMI与Ⅱ型糖尿病发病的关系密切(P<0.05),二者均为Ⅱ型糖尿病发病的危险因素,而水果的摄入为保护性因素(P<0.05)。     

膳食含糖饮料摄入与高尿酸血症风险相关性的meta分析

目的采用meta分析方法系统评价含糖饮料(sugar-sweetened beverages,SSBs)摄入与高尿酸血症(hyperuricemia,HUA)发生风险之间的关系。方法系统检索PubMed、中国知网(CNKI)、万方数据库(Wanfangdata)以及维普数据库(VIP)中截至2021年12月31日公开发表的有关SSBs摄入量与HUA发生风险的观察性研究,严格遵守纳入和排除标准筛选文献并提取有效数据,应用Stata v.16.0软件进行异质性检验、亚组分析、回归分析、敏感性分析、发表偏倚检测和剂量-反应分析。结果共纳入参考文献10篇,其中包括1篇病例对照研究和9篇横断面研究,共纳入研究对象66559例,包括HUA患者12108例。分析结果显示,膳食SSBs摄入是HUA发病的风险因素(OR=1.37,95%CI:1.25~1.49),剂量-反应分析结果显示,SSBs摄入量与HUA发病风险之间呈现非线性正相关。结论膳食SSBs摄入与HUA之间存在相关性,高SSBs摄入可以增加HUA发病风险。     

红肉摄入和类风湿性关节炎发生关联的meta分析

目的 采用meta分析的方法，评估红肉摄入和发生类风湿性关节炎之间的关联。方法 检索中国知网(CNKI)、万方、维普、PubMed和Web of Science中英文数据库，收集建库至2021年12月31日有关红肉摄入与类风湿性关节炎发生关联的队列研究、病例对照研究和横断面研究。采用优势比(odds ratio,OR)及其95%置信区间(95%confidence interval, 95%CI)作为效应指标进行meta分析。结果 初步共检索文献3 374篇，最终纳入12篇文献，其中队列研究5篇，包括暴露组6 000例，非暴露组403 837例；病例对照研究7篇，包括病例组3 762例，对照组6 856例。二分类meta分析结果显示人群红肉摄入与类风湿性关节炎的关联存在高度异质性(I²=90.3%),且在饮食文化上存在层间异质性(P=0.017)。进一步通过高剂量红肉摄入与类风湿性关节炎患病风险的meta分析，发现高剂量红肉摄入可增加类风湿关节炎的风险(OR=1.19,95%CI:1.00～1.42)。剂量-反应meta分析结果显示，红肉摄入剂量与类风湿性关节炎呈...     

黄酮类化合物和类胡萝卜素作为果蔬摄入生物标志物的研究进展

果蔬摄入能有效调节血糖和血脂代谢,降低多种慢性代谢性疾病的发病风险,因此,准确评估果蔬摄入量对研究果蔬摄入与慢性病的关系具有重要意义。黄酮类化合物和类胡萝卜素广泛存在于果蔬中,具有多种生物学功效且与果蔬摄入的相关性较强。我们综述了黄酮类化合物和类胡萝卜素的来源、作用、体内代谢过程以及其作为果蔬摄入的生物标志物的应用,为正确客观评价果蔬摄入量提供参考。     

腌制鱼摄入与鼻咽癌发病风险的剂量反应Meta分析

目的探讨腌制鱼摄入与鼻咽癌发病风险之间的关系。方法检索PubMed、Medline、Embase、中国期刊全文数据库、万方数据等数据库,检索时限至2021年1月,收集腌制鱼摄入与鼻咽癌发病相关的研究,采用纽卡斯尔-渥太华量表标准进行文献质量评价,应用Stata 15.0统计软件进行meta分析。结果共纳入33项病例对照试验,合计39 951例参与者。meta分析结果显示:腌制鱼摄入的最高频次组比最低频次组与鼻咽癌发病风险的关联有统计学意义(OR=1.92,95%CI:1.60～2.30)。剂量反应meta分析结果提示腌制鱼摄入频次与鼻咽癌发病风险存在非线性剂量反应关系(P0.001)。与不吃腌制鱼的人群相比,每月增加进食一次腌制鱼类食物,则鼻咽癌发病风险增加9.7%。结论食用腌制鱼会增加鼻咽癌发病风险,且随着进食频率的增加,发病风险逐渐升高。     

儿童饮水摄入率的研究进展

当前水污染形势严峻,要评价水中某种化合物对儿童造成的健康风险,需要对饮用水中化合物的暴露量进行计算,饮水摄入率是饮用水暴露健康风险评价中最主要的暴露参数。该文在总结国内外儿童饮水摄入率研究的基础上,提出了我国今后在儿童饮水摄入率发展方向的建议。     

Vegetable and fruit consumption and risks of colon and rectal cancer in a prospective cohort study: The Netherlands Cohort Study on Diet and Cancer

The relation between vegetable and fruit consumption and colorectal cancer risk was comprehensively assessed in the Netherlands Cohort Study on Diet and Cancer using a validated 150-item food frequency questionnaire. After 6.3 years of follow-up (1986-1992), over 1,000 incident cases of colorectal cancer were registered. Using case-cohort analysis, the authors calculated rate ratios and 95% confidence intervals adjusted for age, alcohol intake, and family history of colorectal cancer. For colon cancer, no statistically significant associations with total vegetable intake or total fruit intake were found. However, among women, an inverse association was observed with vegetables and fruits combined (for the highest quintile vs. the lowest, the rate ratio was 0.66 (95% confidence interval: 0.44, 1.01)). Brassica vegetables and cooked leafy vegetables showed inverse associations for both men and women. Among women and, to a lesser extent, among men, inverse associations were stronger for distal colonic tumors than for proximal colonic tumors. For rectal cancer, no statistically significant associations were found for vegetable consumption or fruit consumption or for specific groups of vegetables and fruits; only Brassica vegetables showed a positive association in women. As in other cohort studies, the observed inverse relation between vegetable and fruit consumption and occurrence of colorectal cancer was less strong than relations reported in case-control studies.     

Fruit and vegetable consumption and risk of coronary heart disease: a meta-analysis of cohort studies

The consumption of fruit and vegetables is associated with a reduced rate of coronary heart disease (CHD) in observational cohorts. The purpose of this study was to assess the strength of this association in a meta-analysis. Cohort studies were selected if they reported relative risks (RRs) and 95% CI for coronary heart disease or mortality and if they presented a quantitative assessment of fruit and vegetable intake. The pooled RRs were calculated for each additional portion of fruit and/or vegetables consumed per day, and the linearity of the associations were examined. Nine studies were eligible for inclusion in the meta-analysis that consisted of 91,379 men, 129,701 women, and 5,007 CHD events. The risk of CHD was decreased by 4% [RR (95% CI): 0.96 (0.93-0.99), P = 0.0027] for each additional portion per day of fruit and vegetable intake and by 7% [0.93 (0.89-0.96), P < 0.0001] for fruit intake. The association between vegetable intake and CHD risk was heterogeneous (P = 0.0043), more marked for cardiovascular mortality [0.74 (0.75-0.84), P < 0.0001] than for fatal and nonfatal myocardial infarction [0.95 (0.92-0.99), P = 0.0058]. Visual inspection of the funnel plot suggested a publication bias, although not statistically significant. Therefore, the reported RRs are probably overestimated. This meta-analysis of cohort studies shows that fruit and vegetable consumption is inversely associated with the risk of CHD. The causal mechanism of this association, however, remains to be demonstrated.     

Intake of Fruits,Vegetables, and Soy Foods in Relation to Breast Cancer Risk in Korean Women: A Case-Control Study

We conducted a case-control study to examine the relationship between fruit, vegetable, and soy food intake and breast cancer risk in Korean women. Incident cases (n = 359) were identified through cancer biopsies between March 1999 and August 2003 at two university hospitals in Seoul, Korea. Hospital-based controls (n = 708) were selected from patients in the same hospitals during the same period. Subjects were asked by personal interview to indicate their average fruit, vegetable, and soy food intake for a 12-mo period 3 yr prior to the baseline phase. A food intake–frequency questionnaire (98 items) was given by a trained dietitian. Odds ratio (OR) and 95% confidence intervals (CIs) were calculated by unconditional logistic regression after adjustment for confounding factors and total energy intake. There was no association between the intake of total fruits, vegetables, or soy food and breast cancer risk. Increasing consumption of grapes was linked to a significant protective effect against risk of breast cancer (OR = 0.66; 95% CI = 0.41–0.86; P < 0.01). Among the vegetables, reduced risk was observed with high tomato intake (OR = 0.62; 95% CI = 0.38–0.81; P < 0.01). Among soy foods, high consumption of cooked soybeans, including yellow and black soybeans, had an association with reduced breast cancer (OR = 0.67; 95% CI = 0.45–0.91; P < 0.02). Our data suggest that increased intake of some fruits, vegetables, and soy foods may be associated with breast cancer risk reduction in Korean women.     

Fruits and Vegetables in Relation to Prostate Cancer in Japanese Men: The Japan Public Health Center-Based Prospective Study

Although dietary risk factors may differ between localized and advanced prostate cancer, data on associations between the consumption of fruits and vegetables and risk of localized and advanced cancers are limited. We examined associations between fruit and vegetable consumption and risk of prostate cancer in a Japanese population. During 1995–1998, a validated food frequency questionnaire was administered to 43,475 men aged 45–74 yr. During 321,061 person-years of follow-up until the end of 2004, 339 cases of prostate cancer were identified. Consumption of fruits or total vegetables was not associated with a decreased risk of total prostate cancer, with corresponding multivariate hazard ratios of the highest vs. lowest quartiles of 1.09 (95% CI = 0.77–1.53; trend P = 0.39) for fruits and 1.33 (95% CI = 0.93–1.91; trend P = 0.52) for total vegetables. Also, no association was observed for intake of either fruits or vegetables (total or any subtype) with localized or advanced prostate cancer. This prospective cohort study suggests that consumption of fruits or vegetables may not be associated with the risk of either localized or advanced prostate cancer in Japanese men. However, the possibility of confounding by detection bias on the risk of localized cancer could not be totally ruled out.     

Fruit and vegetables consumption and gastric cancer: a systematic review and meta-analysis of cohort studies

Fruit and vegetable intake is widely recognized as protective for gastric cancer occurrence but prospective research challenged this belief. To evaluate the influence of design options in such results we did a meta-analysis of relevant published cohort studies identified from inception to 2004 in PubMed, EMBASE, and LILACS. Random-effects meta-analysis, stratification, and meta-regression were used to pool effects and to analyze the association with type of outcome event and length of follow-up independent of other study characteristics. An inverse association was observed between fruit intake and gastric cancer incidence (relative risk, RR = 0.82; 95% confidence interval, CI = 0.73-0.93) and stronger for follow-up periods of > or = 10 yr (RR = 0.66; 95% CI = 0.52-0.83) but not when the study outcome was death (RR = 1.08; 95% CI = 0.86-1.35). For vegetables, the RR was 0.88 (95% CI = 0.69-1.13) using all incidence studies and 0.71 (95% CI = 0.53-0.94) when considering only those with the longer follow-up. The association observed between vegetable intake and gastric cancer mortality was 1.05 (95% CI = 0.89-1.25). Other study characteristics assessed added no significant contribution to explain heterogeneity. This meta-analysis showed that design options might play a key role in the observed magnitude or the direction of the association between fruit and vegetable intake and gastric cancer.     

Quantity and variety of fruit and vegetable consumption and cancer risk

The recommendation for fruit and vegetable intake includes eating a certain quantity as well as a variety. The evidence for eating a variety is limited. We examined the association with cancer in a prospective cohort study among 730 Dutch men aged 65-84 yr followed for 10 years, resulting in 138 cancer cases. The quantity of fruits and vegetables was assessed using a dietary history and the variety in intake was based on a food frequency questionnaire. Adherence to the recommended amounts of fruit and vegetables was inversely associated with total cancer risk: The adjusted relative risk (RR) was 0.56 [95% confidence interval (CI) = 0.31-1.00]. Eating the recommended daily 200 g of vegetables was not related to cancer incidence, whereas eating the recommended 200 g of fruit was associated with a 38% lower risk. Variety in vegetable intake was inversely associated with total cancer and non-lung epithelial cancer: The RRs (95% CI) for the highest and lowest tertiles were 0.64 (0.43-0.95) and 0.51 (0.27-0.97), respectively. Only after excluding the first two years of follow-up, variety in fruit intake was associated with reduced cancer risk. In conclusion, adherence to the guidelines for fruit and vegetable intake was associated with lower cancer risk. Besides quantity, variety in intake is also of importance.     

Intake of vegetables, legumes, and fruit, and risk for all-cause, cardiovascular, and cancer mortality in a European diabetic population

We examined the associations of intake of vegetables, legumes and fruit with all-cause and cause-specific mortality in a population with prevalent diabetes in Europe. A cohort of 10,449 participants with self-reported diabetes within the European Prospective Investigation into Cancer and Nutrition study was followed for a mean of 9 y. Intakes of vegetables, legumes, and fruit were assessed at baseline between 1992 and 2000 using validated country-specific questionnaires. A total of 1346 deaths occurred. Multivariate relative risks (RR) for all-cause mortality were estimated in Cox regression models and RR for cause-specific mortality were derived in a competing risk model. An increment in intake of total vegetables, legumes, and fruit of 80 g/d was associated with a RR of death from all causes of 0.94 [95% CI 0.90-0.98]. Analyzed separately, vegetables and legumes were associated with a significantly reduced risk, whereas nonsignificant inverse associations for fruit intake were observed. Cardiovascular disease (CVD) mortality and mortality due to non-CVD/non-cancer causes were significantly inversely associated with intake of total vegetables, legumes, and fruit (RR 0.88 [95% CI 0.81-0.95] and 0.90 [0.82-0.99], respectively) but not cancer mortality (1.08 [0.99-1.17]). Intake of vegetables, legumes, and fruit was associated with reduced risks of all-cause and CVD mortality in a diabetic population. The findings support the current state of evidence from general population studies that the protective potential of vegetable and fruit intake is larger for CVD than for cancer and suggest that diabetes patients may benefit from a diet high in vegetables and fruits.     

A prospective study of fruits, vegetables, and risk of endometrial cancer

Case-control studies support a lower risk of endometrial cancer associated with greater vegetable consumption but not fruit consumption. One prospective study suggested an inverse association with fruits and vegetables combined. The authors examined associations for vegetables and fruits separately among women in the American Cancer Society's Cancer Prevention Study II Nutrition Cohort. After exclusions, 41,400 postmenopausal women completed a questionnaire on diet, lifestyle, and medical history at baseline in 1992-1993. Information on diet was updated in 1999; historical dietary information from 1982 was also available. The authors identified 435 eligible cases of endometrial cancer through 2003. In multivariate models, neither fruit consumption (top quintile vs. bottom: rate ratio (RR) = 1.24, 95% confidence interval (CI): 0.90, 1.70; p-trend = 0.30) nor vegetable consumption (RR = 1.21, 95% CI: 0.89, 1.65; p-trend = 0.24) at baseline was associated with risk. Results were similar when diet was cumulatively updated. Only among women who had never used hormone replacement therapy was the risk of endometrial cancer lower in the highest (vs. lowest) tertile of fruit (RR = 0.75, 95% CI: 0.52, 1.07; p-interaction = 0.03, p-trend = 0.11) or vegetable (RR = 0.80, 95% CI: 0.57, 1.13; p-interaction = 0.01, p-trend = 0.29) consumption. This prospective study does not support an association between vegetable or fruit consumption and endometrial cancer.     

Fruit and vegetable intake and risk of cardiovascular disease: the Women's Health Study

BACKGROUND: Prospective data relating fruit and vegetable intake to cardiovascular disease (CVD) risk are sparse, particularly for women. OBJECTIVE: In a large, prospective cohort of women, we examined the hypothesis that higher fruit and vegetable intake reduces CVD risk. DESIGN: In 1993 we assessed fruit and vegetable intake among 39876 female health professionals with no previous history of CVD or cancer by use of a detailed food-frequency questionnaire. We subsequently followed these women for an average of 5 y for incidence of nonfatal myocardial infarction (MI), stroke, percutaneous transluminal coronary angioplasty, coronary artery bypass graft, or death due to CVD. RESULTS: During 195647 person-years of follow-up, we documented 418 incident cases of CVD including 126 MIs. After adjustment for age, randomized treatment status, and smoking, we observed a significant inverse association between fruit and vegetable intake and CVD risk. For increasing quintiles of total fruit and vegetable intake (median servings/d: 2. 6, 4.1, 5.5, 7.1, and 10.2), the corresponding relative risks (RRs) were 1.0 (reference), 0.78, 0.72, 0.68, and 0.68 (95% CI comparing the 2 extreme quintiles: 0.51, 0.92; P: for trend = 0.01). An inverse, though not statistically significant, trend remained after additional adjustment for other known CVD risk factors, with RRs of 1.0, 0.75, 0.83, 0.80, and 0.85 (95% CI for extreme quintiles: 0.61, 1.17). After excluding participants with a self-reported history of diabetes, hypertension, or high cholesterol at baseline, the multivariate-adjusted RR was 0.45 when extreme quintiles were compared (95% CI: 0.22, 0.91; P: for trend = 0.09). Higher fruit and vegetable intake was also associated with a lower risk of MI, with an adjusted RR of 0.62 for extreme quintiles (95% CI: 0.37, 1.04; P: for trend = 0.07). CONCLUSION: These data suggest that higher intake of fruit and vegetables may be protective against CVD and support current dietary guidelines to increase fruit and vegetable intake.     

Diet and bladder cancer: a meta-analysis of six dietary variables

In 1996, more than 300,000 new cases of bladder cancer were diagnosed worldwide. Besides tobacco smoking, occupation, and other factors, diet may play a role in causation of this illness. The authors performed a meta-analytical review of epidemiologic studies linking six dietary factors to bladder cancer. These factors include retinol, beta-carotene, fruits, vegetables, meat, and fat. Increased risks of bladder cancer were associated with diets low in fruit intake (relative risk (RR) = 1.40, 95% confidence interval (CI): 1.08, 1.83), and slightly increased risks were associated with diets low in vegetable intake (RR = 1.16, 95% CI: 1.01, 1.34). Elevated risks were identified for diets high in fat intake (RR = 1.37, 95% CI: 1.16, 1.62) but not for diets high in meat intake (RR = 1.08, 95% CI: 0.82, 1.42). No increased risks were found for diets low in retinol (RR = 1.01, 95% CI: 0.83, 1.23) or beta-carotene (RR = 1.10, 95% CI: 0.93, 1.30) intake. These results suggest that a diet high in fruits and vegetables and low in fat intake may help prevent bladder cancer, but the individual dietary constituents that reduce the risks remain unknown.