Anne Hy Chu, Kehuan Lin, Helen Croker, Sarah Kefyalew, Georgios Markozannes, Konstantinos K Tsilidis, Yikyung Park, John Krebs, Matty P Weijenberg, Monica L Baskin, Ellen Copson, Sarah J Lewis, Jacob C Seidell, Rajiv Chowdhury, Lynette Hill, Doris Sm Chan, Dong Hoon Lee, Edward L Giovannucci
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引用次数: 0
Abstract
Background: Although healthy dietary and lifestyle factors have been individually linked to lower colorectal cancer (CRC) risks, recommendations for whole diet-lifestyle patterns remained unestablished because of limited studies and inconsistent pattern definitions.
Objectives: This updated review synthesized literature on dietary-lifestyle patterns and CRC risk/mortality.
Methods: PubMed and Embase were searched through March 31, 2023 for randomized controlled trials and prospective cohort studies examining adulthood dietary patterns combined with modifiable lifestyle factors such as adiposity, smoking, alcohol consumption, physical activity, and/or others. Patterns were categorized by derivation methods: a priori, a posteriori, and a hybrid combining both; and were then descriptively reviewed for 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 predefined grading criteria.
Results: Thirty-three observational studies were reviewed. "Strong-probable" evidence was concluded for higher levels of alignment with the a priori-derived World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) recommendations score and lower CRC risk; and "limited-suggestive" evidence for the American Cancer Society guidelines and Healthy Lifestyle Index with lower CRC risk (mainly because of concerns about risk of bias for confounding). A posteriori-derived patterns lack firm evidence (only 1 study). "Strong-probable" evidence was concluded for higher levels of alignment with the Empirical Lifestyle Index for Hyperinsulinemia hybrid pattern and higher CRC risk. By cancer subsite, only the WCRF/AICR recommendations score showed "strong-probable" evidence with lower colon cancer risk. All exposure-mortality pairs were graded "limited-no conclusion." The evidence for other pattern-outcome associations was graded as "limited-no conclusion."
Conclusions: Adopting a healthy pattern of diet, maintaining a healthy weight, staying physically active, and embracing health-conscious habits, such as avoiding tobacco and moderating alcohol, are collectively associated with a lower CRC risk. Healthy lifestyle habits are key to primary CRC prevention. This study was registered at PROSPERO as CRD42022324327 (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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