Division of Graduate Medical Sciences, Boston University School of Medicine, Boston, MA.
Slone Epidemiology Center at Boston University, Boston, MA.
J Nutr. 2022 May 5;152(5):1254-1262. doi: 10.1093/jn/nxab419.
Black Americans have the highest incidence of colorectal cancer (CRC) of any racial/ethnic group in the United States. High intake of red and processed meats has been associated with an increased CRC risk in predominately White populations. However, 3 prior studies in Black populations, who have been reported to have high intakes of red and processed meats, have reported no associations. Data on a possible association between CRC risk and SFAs and MUFAs, the primary types of fat in red and processed meats, are inconclusive.
We prospectively assessed intakes of processed and unprocessed red meat, SFAs, and MUFAs in relation to CRC risk, utilizing data from the Black Women's Health Study (BWHS, 1995-2018).
Dietary data were derived from validated FFQs completed in 1995 and 2001. Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression.
Among 52,695 BWHS participants aged 21-69 y at baseline and followed for ≤22 y, 564 women developed incident CRC. Unprocessed red meat intake was associated with a 33% increased CRC risk per 100 g/d (HR: 1.33; 95% CI: 1.03-1.71). Examination of CRC anatomic sites revealed that unprocessed red meat was associated with 2-times increased rectal cancer risk (HR: 2.22; 95% CI: 1.15-4.26). There was no evidence of an interaction with age (pinteraction = 0.4), but unprocessed red meat intake was only associated with a significant increased risk of late-onset CRC (≥50 y of age, HR: 1.41; 95% CI: 1.05-1.88). Processed red meat and total SFA and MUFA intakes were not associated with CRC risk.
Unprocessed red meat intake was associated with an increased CRC risk in the present study, the first positive evidence that red meat plays a role in the etiology of CRC in Black women. The findings suggest prevention opportunities.
在美国,非裔美国人的结直肠癌(CRC)发病率是所有种族/族群中最高的。大量摄入红色和加工肉类与白人为主的人群 CRC 风险增加有关。然而,此前在非裔人群中进行的 3 项研究报告称,他们摄入大量的红色和加工肉类,但没有发现关联。关于 CRC 风险与饱和脂肪酸(SFAs)和单不饱和脂肪酸(MUFAs)之间可能存在的关联的数据尚无定论,SFAs 和 MUFAs 是红色和加工肉类中的主要脂肪类型。
我们利用黑人女性健康研究(BWHS,1995-2018 年)的数据,前瞻性评估加工和未加工红色肉类、SFAs 和 MUFAs 的摄入量与 CRC 风险之间的关系。
饮食数据来自于 1995 年和 2001 年完成的经过验证的 FFQ。使用 Cox 比例风险回归估计多变量调整后的风险比(HR)和 95%置信区间(CI)。
在基线时年龄为 21-69 岁且随访时间≤22 年的 52695 名 BWHS 参与者中,有 564 名女性发生了 CRC。每增加 100 克/天,未加工的红色肉类摄入量与 CRC 风险增加 33%相关(HR:1.33;95%CI:1.03-1.71)。对 CRC 解剖部位的检查表明,未加工的红色肉类与直肠癌风险增加 2 倍相关(HR:2.22;95%CI:1.15-4.26)。年龄交互作用检验无统计学意义(p 交互=0.4),但未加工的红色肉类摄入量仅与晚期 CRC(≥50 岁,HR:1.41;95%CI:1.05-1.88)的显著增加风险相关。加工红色肉类以及总 SFA 和 MUFA 摄入量与 CRC 风险无关。
在本研究中,未加工的红色肉类摄入量与 CRC 风险增加相关,这是红色肉类在黑人女性 CRC 病因学中起作用的首个阳性证据。这些发现提示了预防的机会。