2011年中国恶性肿瘤发病与死亡分析

  目的  了解腌制食品摄入联合吸烟、饮酒与食管癌发病的关系,为食管癌防治策略的制定提供理论依据。  方法  采用以医院为基础的病例对照研究方法,对2010 年1月 — 2015年12月在福建医科大学附属漳州市医院经病理组织确诊的645例原发性食管癌新发病例作为病例组及按病例组同性别、年龄（± 5 岁）匹配的同期在该院就诊的646例非肿瘤患者作为对照组进行问卷调查。  结果  在调整了性别、年龄、文化程度、婚姻状况、人均月收入等混杂因素后,多因素条件logistic回归分析结果显示,腌制食品是食管癌发病的危险因素,腌制食品摄入频率与食管癌发病风险存在剂量–反应关系（χ²_趋势 = 21.030,P < 0.001）;腌制食品摄入5～7次/周且吸烟者食管癌发病风险为腌制食品摄入< 1次/周且不吸烟者的2.517倍（OR = 2.517,95 % CI = 1.412～4.485）;腌制食品摄入5～7次/周且饮酒者食管癌发病风险为腌制食品摄入< 1次/周且不饮酒者的3.683倍（OR = 3.683,95 % CI = 2.101～6.456）;腌制食品摄入3～7次/周且吸烟和饮酒者食管癌发病风险为腌制食品摄入 ≤ 2次/周且不吸烟和不饮酒者的4.455倍（OR = 4.455,95 % CI = 2.502～7.931）。  结论  腌制食品的摄入是食管癌发病的危险因素,腌制食品摄入联合吸烟和饮酒会明显增加食管癌发病的风险。     

Dietary habits, food consumption, and nutrient intake during adolescence.

Adolescents and young adults adopt eating patterns which may well form the basis of their dietary habits for much of their lives. At the same time, this section of the population can come under considerable pressure from the world at large, to conform to the current trends in fashion, language, behavior, or foods. Recent developments in Western dietary practice have tended to leave adolescents vulnerable to low intakes of energy and of some nutrients, as snacking accounts for an increasing proportion of dietary intake. Achieving a balanced diet is more difficult when the most popular and widely available snack foods are high in sugar or in fat. Results from major British studies, together with a review of data from other developed countries, support the need for more effective dietary education for adolescents and for children generally.     

新疆哈萨克族食管癌高发区居民膳食状况及一碳单位代谢相关营养素水平调查

  目的   探讨中国人群进食快对食管癌发病的影响,为食管癌的预防提供科学依据。  方法   检索中国知网数据库、万方数据库、PubMed数据库和Web of Science数据库,并辅以手工检索和文献追溯法收集1980年1月 —2017年2月公开发表的有关进食快与食管癌关系的相关文献;应用Stata 11.0软件对纳入的文献进行meta分析。  结果   最终纳入26篇文献（中文文献22篇,英文文献4篇）,均为病例对照研究,累计病例组8 418例,对照组11 710例;Meta分析结果显示,中国人群进食快者食管癌的发病风险为非进食快者的2.518倍（OR = 2.518,95 % CI = 2.024～3.131）;亚组分析结果显示,在不同地区、不同对照来源、不同发表年份、不同文献来源中进食快者食管癌发病风险均高于非进食快者（均P < 0.01）;敏感性分析和发表偏倚检验结果显示,本次meta分析纳入的文献不存在发表偏倚,结果较为稳定。  结论   进食快会增加中国人群中食管癌的发病风险。     

Correlations of dietary intake and blood nutrient levels with esophageal cancer mortality in China

Using dietary, blood nutrient, and esophageal cancer mortality data from 65 Chinese counties, we examined several correlations to help provide clues to the influence of diet and nutrition on the geographic variation of esophageal cancer in China. Esophageal cancer mortality was significantly inversely related to reported fruit consumption and to plasma ascorbic acid concentration. The age-adjusted mortality rates were more than three times higher for counties in the lowest compared with the highest quartile of fruit intake or plasma vitamin C. Positive correlations with intake of moldy vegetables were observed but not with tobacco and alcohol consumption. There were suggestive inverse associations with blood selenium and riboflavin but little effect of fat-soluble vitamins. Limitations of ecological data preclude causal inferences, but the relationships provide leads to dietary factors that may contribute to the exceptionally high rates of esophageal cancer in several areas of China.     

Seasonal variation in food intake, physical activity, and body weight in a predominantly overweight population

OBJECTIVE: To describe seasonal variation in food intake, physical activity, and body weight in a predominantly overweight population. DESIGN: A longitudinal observational study. SETTING: Most of the study participants were recruited from a health maintenance organization (HMO) in central Massachusetts, USA. Additional individuals of Hispanic descent were recruited from outside of the HMO population to increase the ethnic diversity of this sample. SUBJECTS: Data from 593 participants, aged 20-70, were used for this investigation. Each participant was followed quarterly (five sampling points: baseline and four consecutive quarters) for 1-year period. Body weight measurements and three 24-h dietary and physical activity recalls were obtained on randomly selected days (including 2 weekdays and 1 weekend day) per quarter. Sinusoidal regression models were used to estimate peak-to-trough amplitude and phase of the peaks. RESULTS: Daily caloric intake was higher by 86 kcal/day during the fall compared to the spring. Percentage of calories from carbohydrate, fat and saturated fat showed slight seasonal variation, with a peak in the spring for carbohydrate and in the fall for total fat and saturated fat intake. The lowest physical activity level was observed in the winter and the highest in the spring. Body weight varied by about 1/2 kg throughout the year, with a peak in the winter (P<0.001 winter versus summer). Greater seasonal variation was observed in subjects who were male, middle aged, nonwhite, and less educated. CONCLUSIONS: Although there is seasonal variation in diet, physical activity and body weight, the magnitude of the change is generally small in this population. SPONSORSHIP: US National Heart, Lung and Blood Institute.     

Inter- and intra-individual variation of food and nutrient consumption in a rural Japanese population

OBJECTIVES: To determine the relative contribution of intra- and inter-individual variation in the consumption of foods and nutrients. DESIGN: Cross-sectional study. SETTING: Two rural towns in the Miyagi Prefecture, a northeastern part of Japan. SUBJECTS: Fifty-nine men and sixty women. METHODS: Four 3-d food records were collected in four seasons within a year. The total variance in the consumption of 15 nutrient variables and 16 food groups was partitioned by analysis of variance into its inter- and intra-individual components, separately for men and women. RESULTS: The ratio of the intra- to inter-individual variance was larger than unity in 87% (13/15) of the nutrients in men and 100% (15/15) in women. The ratio was largest for retinol (52.9 in men and infinity in women) and smallest for carbohydrates (0.8 in men and 1.5 in women). The ratio was larger than unity in 88% (14/16) of the food groups in men and 94% (15/16) in women, which was smallest for cereals (0.6 in men and 0.9 in women). CONCLUSIONS: The results were consistent with previous western studies in that intra-individual variation was generally larger than inter-individual variation for the consumption of both foods and nutrients. SPONSORSHIP: This study was supported in part by Grants-in-Aid for Scientific Research from the Ministry of Education, Science, Sports and Culture (09470106) and by Health Sciences Research Grants for Research on Health Services (H10-25) from the Ministry of Health and Welfare in Japan.     

核黄素强化盐预防高发区食管癌效果研究

目的 探讨核黄素强化盐对食管癌高发区居民食管癌的预防效果,为进一步推广其应用提供现场依据.方法 将河北省磁县固义乡21个村所有居民分为干预组和对照组,从2000年开始,干预组服用核黄素强化盐(核黄素100～150mg/kg)；对照组服用未添加核黄素的普通盐.随机抽取干预组和对照组40～69岁组各250人测定其血液中红细胞谷胱甘肽还原酶活性系数(EGRAC),评价核黄素营养状况.通过磁县肿瘤登记处进行随访,监测两组人群食管癌发病情况.结果 核黄素强化盐干预8年后,干预组EGRAC平均值为1.383,低于对照组1.532,且差异有统计学意义(P＜0.01)；干预组2003～2008年共发生食管癌90例,年发病率为131.79/10万,对照组共发生食管癌80例,年发病率为137.30/10万,干预组稍低于对照组,但差异未显示出统计学意义.结论 核黄素强化盐能显著改善人体核黄素营养状况,是经济、简便和有效的营养干预手段.     

Maternal one-carbon nutrient intake and cancer risk in offspring

Dietary intake of one-carbon nutrients, particularly folate, vitamin B(2) (riboflavin), vitamin B(6) , vitamin B(12) , and choline have been linked to the risk of cancers of the colon and breast in both human and animal studies. More recently, experimental and epidemiological data have emerged to suggest that maternal intake of these nutrients during gestation may also have an impact on the risk of cancer in offspring later in life. Given the plasticity of DNA methylation in the developing embryo and the established role of one-carbon metabolism in supporting biological methylation reactions, it is plausible that alterations in maternal one-carbon nutrient availability might induce subtle epigenetic changes in the developing embryo and fetus that persist into later life, altering the risk of tumorigenesis throughout the lifespan. This review summarizes the current literature on maternal one-carbon nutrient intake and offspring cancer risk, with an emphasis on cancers of the colon and breast, and discusses specific epigenetic modifications that may play a role in their pathogenesis.     

高发区食管癌和癌前病变内镜普查方案的效益评估

目的:分析肥城市自愿参加碘染色内镜食管疾病普查和全人群高应答率普查两类资料,为进一步探讨在食管癌高发区开展碘染色内镜普查可滚动持续发展的模式提供基础.方法:自愿参加普查组普查免费、治疗自费,高应答率普查组普查费和治疗费用全免,分析两组人群的食管疾病检出率和成本效益比率.结果:自愿参加普查组总应答率22.10%,高应答率普查组为79.99%;自愿参加普查组食管疾病的栓出率显著高于高应答率普查组,自愿参加普查组的成本效益比率为1.0:5.7,高应答率普查组为1.0:1.43.结论:自愿参加普查组成本效益比率远远高于高应答率普查组,如何筛选需要进行内镜普查的高危险性个体是需要解决的关键问题.     

Contributions of specific foods to absolute intake and between-person variation of nutrient consumption

Contributions of specific foods and supplements to absolute intake and between-person variance in consumption of 19 macronutrients, vitamins, and minerals were examined using dietary records of all foods consumed over 4 weeks by 194 US nurses aged 34 to 59 years. To measure their contribution to absolute nutrient intake, we ranked foods by the percentage of the population's total nutrient intake that they provided. To assess the degree to which differences in consumption of specific foods explain between-person variability in nutrient intake, we re-ranked the 20 foods contributing most to absolute intake of each nutrient as independent variables in stepwise multiple regression analyses predicting total intake of that nutrient. The increase in percentage of the variance in nutrient intake explained by the addition of a food to the progressively larger list of food items (expressed as the cumulative R2) served as the measure of contribution to variation in intake. Some nutrients had only a few major sources and were assessed relatively well by a small number of foods. For preformed vitamin A without supplements, 10 foods accounted for 82% of the absolute intake and 98% of total variance. The corresponding percentages for absolute intake and total variance, respectively, were 66% and 94% for beta-carotene; 77% and 92% for cholesterol; and 71% and 95% for vitamin C without supplements. In contrast, 20 foods accounted for only 54% of the absolute intake and 73% of the variance for total energy intake; 58% and 89%, respectively, for total carbohydrates; and 59% and 84%, respectively, for potassium.(ABSTRACT TRUNCATED AT 250 WORDS)     

Geographical variation in nutrient intake between urban and rural areas of Jiangsu province,China and development of a semi-quantitative food frequency questionnaire for middle-aged inhabitants

The intake of food and nutrients differs between urban and rural areas in China. To develop a practical semi-quantitative food frequency questionnaire to cover both the urban and rural areas, we conducted diet surveys and compared food and nutrient intake between the two areas. We recruited 198 urban and 214 rural healthy inhabitants aged 35-55 years, and performed diet surveys, using a 3-day weighed dietary record approach. The intake of 29 nutrients was calculated according to actual consumption of foods, with Standard Food Composition Tables for China and Japan. Then, contribution analysis and multiple regression analysis were employed to select food items covering up to a 90% contribution and a 0.90 R2 of coefficient of determination, respectively. Consumption of energy and carbohydrates was greater in the rural area, but mean protein intake was higher in the urban case. Values for total fat were greater for rural than for urban males, with animal fat as the major contributor. We finally selected 117 and 76 food items for the urban and rural semi-quantitative food frequency questionnaires, respectively, covering 18 and 27 nutrients constituting up to 90% of the nutrient intake. Further validity and reproducibility tests are now needed to assess their appropriateness for usage.     

Patterns of food and nutrient intake in a suburb of Dublin with chronically high unemployment

The diet-history (7 typical recent days) method was used to determine patterns of food and nutrient intake in 50 families, randomly selected from the electoral register of a socially disadvantaged Dublin suburb. Some 66% of income was from unearned social security or other payments. Financial assistance was sought from money lenders by 11 of the 50 families. There was little evidence to suggest that nutrient intakes among males or among children were inadequate. Women, because of a low energy intake and a below average intake of meat, had low intakes of iron (8.1 ±2.3 mg/d). Women also had low intakes of fibre and vitamin C (14 ± 5 and 45 ± 18 mg/d, respectively). These low intakes of fibre and vitamin C among women relative to the RDAs were characterized by low intakes of fruits, vegetables, cereals and pulses. Single mothers (n –10) had the lowest intakes of iron, vitamin C or fibre although their incomes and food expenditures were average. The children of single-parent families had identical intakes of nutrients to all other children. The estimated cost of the average energy intake of adolescent children (e.g. boys 11–18 years, IRE15-10/week) well exceeded their social security payments.     

大豆食品摄入与乳腺癌发病关系的Meta分析

目的探讨大豆食品摄入与乳腺癌发病的关系。方法检索1991年到2011年4月公开发表的关于大豆食品摄入与乳腺癌关系的流行病学研究进行Meta分析,结果报告合并比值比(OR)及95%可信区间(95%CI)。结果 28个研究纳入Meta分析,其中有23个病例对照研究,5个队列研究。总体分析,大豆食品摄入对乳腺癌具有保护作用(合并OR=0.86,95%CI 0.78～0.94),但按设计类型分层后,只有病例对照研究的结果显示大豆食品对乳腺癌具有保护作用(合并OR=0.86,95%CI 0.77～0.95)。在不同国家和地区人群中开展的研究结果显示,在亚洲地区人群中,合并OR=0.76(95%CI 0.67～0.87),而欧美地区人群的研究合并OR=1.01(95%CI 0.93～1.09)。对在亚洲地区人群中开展的病例对照研究和队列研究分别进行合并分析,结果显示大豆食品摄入对乳腺癌均具有保护作用,合并OR分别为0.76(95%CI 0.65～0.89)和0.81(95%CI 0.70～0.92)。但在欧美地区人群中开展的两类研究均未发现大豆食品摄入对乳腺癌有保护作用。根据绝经前后的亚组分析结果显示,仅在绝经后女性中大豆食品摄入对乳腺癌起保护作用。结论根据亚洲地区人群中开展的研究,尤其是病例对照研究结果的合并分析,提示大豆食品摄入对亚洲地区女性乳腺癌具有保护作用。     

Diversity and change of food consumption and nutrient intake among the Gidra in Lowland Papua

Food consumption and nutrient intake of the Gidra in lowland Papua, who number 1,850 and inhabit 13 villages, were analyzed by compilation of five two‐week (or twelve‐day) records, in a single village in 1971 and in four different villages (including the above village) in 1981.

The nutrient intake of the Gidra varied both over time and among the villages. Difference in food consumption patterns included different proportions of plant staples such as sago flour, garden crops and purchased cereals. The animal protein sources, mainly game and fish, also markedly varied among the villages. These differences in food consumption were related to environmental conditions such as the fauna and flora in the environment of each village and to the degree of modernization as reflected in ability to purchase foods not locally grown.

The causal relationship between ecological (environmental and cultural) conditions and food and nutrition is discussed, and a schematic model for this relationship is presented.     

以人群为基础的食管癌高发区危险因素病例对照家系研究

目的 探讨食管癌高发区食管癌发生的危险因素,为食管癌的综合防治提供理论依据.方法 采用以人群为基础的病例一对照家系研究方法,在河南省食管痛高发区以匹配方式选择病例和对照家系各505户,家庭成员各1171名,进行以家庭为单位的问卷调查,应用单因素和多因素logistic回归模型分析食管癌危险因素.结果 病例组和对照组比较,食用炯熏食物[2.10%(36/1711),0.82%(14/1711);X2=9.82,P=0.00;OR=2.61,95%C/:1.40～4.85],常吃油炸食品[7.17%(66/921),3.91%(35/894);X2=9.13,P=0.00;OR=1.90,95%C/:1.24～2.89],常吃生硬食物[13.36%(123/921),8.95%(80/894);X2=8.87,P=0.03;OR=1.57,95%CI/:1.16～2.11],喜食热烫食物[20.05%(343/1711),15.20%(260/1711);X2=13.87,P=0.00;OR:1.40,95%C/:1.17～1.67],有精神刺激史[6.72%(115/1711),3.10%(53/1711);X2=24.06,P=0.00;OR=2.25,95%CI:1.62～3.14]和有E消化道不适症状[19.40%(332/1711),12.74%(218/1711);X2=28.15,P=0.00;OR=1.65,95%CI:1.37～1.99]等因素,是食管癌发生的危险因素.而进食速度较快则显示是保护因素[20.85%(192/921),25.14%(225/895);X2=4.73,P=0.03;OR=0.78,95%Cl:0.63～0.98].结论 食管癌发生是多因素综合作用所致,要从生活行为方式、环境因素、社会心理因素和生物遗传因素等多方面进行综合防治.     

以人群为基础的食管癌高发区危险因素病例对照家系研究

目的 探讨食管癌高发区食管癌发生的危险因素,为食管癌的综合防治提供理论依据.方法 采用以人群为基础的病例一对照家系研究方法,在河南省食管痛高发区以匹配方式选择病例和对照家系各505户,家庭成员各1171名,进行以家庭为单位的问卷调查,应用单因素和多因素logistic回归模型分析食管癌危险因素.结果 病例组和对照组比较,食用炯熏食物[2.10%(36/1711),0.82%(14/1711);X2=9.82,P=0.00;OR=2.61,95%C/:1.40～4.85],常吃油炸食品[7.17%(66/921),3.91%(35/894);X2=9.13,P=0.00;OR=1.90,95%C/:1.24～2.89],常吃生硬食物[13.36%(123/921),8.95%(80/894);X2=8.87,P=0.03;OR=1.57,95%CI/:1.16～2.11],喜食热烫食物[20.05%(343/1711),15.20%(260/1711);X2=13.87,P=0.00;OR:1.40,95%C/:1.17～1.67],有精神刺激史[6.72%(115/1711),3.10%(53/1711);X2=24.06,P=0.00;OR=2.25,95%CI:1.62～3.14]和有E消化道不适症状[19.40%(332/1711),12.74%(218/1711);X2=28.15,P=0.00;OR=1.65,95%CI:1.37～1.99]等因素,是食管癌发生的危险因素.而进食速度较快则显示是保护因素[20.85%(192/921),25.14%(225/895);X2=4.73,P=0.03;OR=0.78,95%Cl:0.63～0.98].结论 食管癌发生是多因素综合作用所致,要从生活行为方式、环境因素、社会心理因素和生物遗传因素等多方面进行综合防治.     

以人群为基础的食管癌高发区危险因素病例对照家系研究

目的 探讨食管癌高发区食管癌发生的危险因素,为食管癌的综合防治提供理论依据.方法 采用以人群为基础的病例一对照家系研究方法,在河南省食管痛高发区以匹配方式选择病例和对照家系各505户,家庭成员各1171名,进行以家庭为单位的问卷调查,应用单因素和多因素logistic回归模型分析食管癌危险因素.结果 病例组和对照组比较,食用炯熏食物[2.10%(36/1711),0.82%(14/1711);X2=9.82,P=0.00;OR=2.61,95%C/:1.40～4.85],常吃油炸食品[7.17%(66/921),3.91%(35/894);X2=9.13,P=0.00;OR=1.90,95%C/:1.24～2.89],常吃生硬食物[13.36%(123/921),8.95%(80/894);X2=8.87,P=0.03;OR=1.57,95%CI/:1.16～2.11],喜食热烫食物[20.05%(343/1711),15.20%(260/1711);X2=13.87,P=0.00;OR:1.40,95%C/:1.17～1.67],有精神刺激史[6.72%(115/1711),3.10%(53/1711);X2=24.06,P=0.00;OR=2.25,95%CI:1.62～3.14]和有E消化道不适症状[19.40%(332/1711),12.74%(218/1711);X2=28.15,P=0.00;OR=1.65,95%CI:1.37～1.99]等因素,是食管癌发生的危险因素.而进食速度较快则显示是保护因素[20.85%(192/921),25.14%(225/895);X2=4.73,P=0.03;OR=0.78,95%Cl:0.63～0.98].结论 食管癌发生是多因素综合作用所致,要从生活行为方式、环境因素、社会心理因素和生物遗传因素等多方面进行综合防治.     

以人群为基础的食管癌高发区危险因素病例对照家系研究

目的 探讨食管癌高发区食管癌发生的危险因素,为食管癌的综合防治提供理论依据.方法 采用以人群为基础的病例一对照家系研究方法,在河南省食管痛高发区以匹配方式选择病例和对照家系各505户,家庭成员各1171名,进行以家庭为单位的问卷调查,应用单因素和多因素logistic回归模型分析食管癌危险因素.结果 病例组和对照组比较,食用炯熏食物[2.10%(36/1711),0.82%(14/1711);X2=9.82,P=0.00;OR=2.61,95%C/:1.40～4.85],常吃油炸食品[7.17%(66/921),3.91%(35/894);X2=9.13,P=0.00;OR=1.90,95%C/:1.24～2.89],常吃生硬食物[13.36%(123/921),8.95%(80/894);X2=8.87,P=0.03;OR=1.57,95%CI/:1.16～2.11],喜食热烫食物[20.05%(343/1711),15.20%(260/1711);X2=13.87,P=0.00;OR:1.40,95%C/:1.17～1.67],有精神刺激史[6.72%(115/1711),3.10%(53/1711);X2=24.06,P=0.00;OR=2.25,95%CI:1.62～3.14]和有E消化道不适症状[19.40%(332/1711),12.74%(218/1711);X2=28.15,P=0.00;OR=1.65,95%CI:1.37～1.99]等因素,是食管癌发生的危险因素.而进食速度较快则显示是保护因素[20.85%(192/921),25.14%(225/895);X2=4.73,P=0.03;OR=0.78,95%Cl:0.63～0.98].结论 食管癌发生是多因素综合作用所致,要从生活行为方式、环境因素、社会心理因素和生物遗传因素等多方面进行综合防治.