"Carbohydrate quality, not quantity, linked to reduced colorectal cancer incidence and mortality in US populations: evidence from a prospective study"

作者全名："Xiao, Yi; Xiang, Ling; Jiang, Yahui; Tang, Yunhao; Gu, Haitao; Wang, Yaxu; Peng, Linglong"

作者地址："[Xiao, Yi; Jiang, Yahui; Tang, Yunhao; Gu, Haitao; Wang, Yaxu; Peng, Linglong] Chongqing Med Univ, Dept Gastrointestinal Surg, Affiliated Hosp 2, 288 Tianwen Ave, Chongqing 400010, Peoples R China; [Xiang, Ling] Chongqing Med Univ, Dept Clin Nutr, Affiliated Hosp 2, 288 Tianwen Ave, Chongqing 400010, Peoples R China"

通信作者："Wang, YX; Peng, LL (通讯作者)，Chongqing Med Univ, Dept Gastrointestinal Surg, Affiliated Hosp 2, 288 Tianwen Ave, Chongqing 400010, Peoples R China.; Xiang, L (通讯作者)，Chongqing Med Univ, Dept Clin Nutr, Affiliated Hosp 2, 288 Tianwen Ave, Chongqing 400010, Peoples R China."

来源：BMC MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001180242100002

JCR分区：Q1

影响因子：7

年份：2024

卷号：22

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Colorectal cancer; Cancer prevention; Epidemiology; Dietary pattern; Carbohydrate quality index; Low-carbohydrate diet

摘要："BackgroundCarbohydrates have been implicated in colorectal cancer (CRC) risk, but the specific impact of carbohydrate quality and quantity on CRC susceptibility in US populations remains unclear.MethodsWe followed 101,694 participants from Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. The carbohydrate quality index (CQI) and low-carbohydrate diet score (LCDs) were used to evaluate the daily carbohydrate quality and quantity separately, where higher scores indicated greater adherence. Cox proportional hazards regression was used to compute HRs and 95% CIs for incident CRC and related death. Subgroup analyses were conducted to identify potential effect modifiers.ResultsDuring follow-up, we documented 1085 incident cases of CRC, of whom 311 died from CRC. Individuals in the highest compared with the lowest quartiles of CQI had a lower CRC incidence (Q4 vs Q1: HR 0.80, 95% CI 0.67-0.96, Ptrend = 0.012) and mortality (Q4 vs Q1: HR 0.61, 95% CI 0.44-0.86, Ptrend = 0.004). The inverse association between CQI and CRC risk was observed for distal colon and rectum but not for proximal colon cancer. Regarding mortality, this association was only significant for rectum cancer. Subgroup analyses indicated this inverse association of CQI with CRC risk was only observed in participants with lower LCDs. No significant associations were found between LCDs and CRC incidence or mortality.ConclusionsOur findings suggest focusing on higher quality, rather than restricting the quantity, of carbohydrate consumption may be an effective approach to reduce the risk of CRC in the US population, particularly for distal colon and rectal cancers."

基金机构："Natural Science Foundation Project of Chongqing, Chongqing Science and Technology Commission [PLCO-1292]"

基金资助正文：We sincerely appreciate the PLCO study group and PLCO participants. This research has been conducted using the PLCO resource (https://cdas.cancer.gov/plco/) under application number PLCO-1292.