Jeanine M. Genkinger, Anita Koushik*
發表日期2007年12月11日
發表於PLoS Med 4(12): e345 doi:10.1371/journal.pmed.0040345
網址：http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0040345&ct=1
國際的癌症發病率不同和從移民的研究中，表明環境因素如飲食習慣與患癌症的風險相關。攝取的肉類如牛肉，世界各地存在三倍的差異，世界各地的消耗量最高的在發達國家（23公斤/人均），相比欠發達國家的消耗量（ 6公斤/人均）[1] 。基於Richard Doll and Richard Peto在1981年的研究，據估計，大約有35 ％ （範圍10％ - 70％）的癌症可以歸因於飲食，這和吸煙致癌的幅度類似達30％（範圍25％-40％） [2] 。
已經有一百多篇流行病學研究報道肉類消耗和癌症的風險，這包括了世界各國的不同飲食習慣的研究。這些研究從不同方麵對肉類攝入量和癌症的風險的聯係進行了評估，既包括了總體肉類攝入量之間的比較，又有更精細的分類，尤其是攝取紅肉，其中包括牛肉，羊肉，豬肉，小牛肉攝入量之間的比較，還有處理過肉類，包括肉類保存醃製，熏製，或壓製之間的比較。
雖然癌症和肉類攝入量的聯係可部分歸罪於高能量或高脂肪（ "西化" ）的飲食，但我們更感興趣是直接作用的潛在致癌化合物。肉類中含有包括N -亞硝基化合物，雜環胺，或多環芳烴。 動物實驗中發現N -亞硝基化合物和亞硝胺是烈性致癌物質[3]。同樣，雜環胺被列為誘變因素和動物致癌物[4-8] 。科學界公認存在於肉類這些化合物（鹽，硝酸鹽，亞硝酸鹽，血紅素鐵，飽和脂肪，雌二醇）會增加DNA合成和細胞增殖，增加胰島素樣生長因子，影響激素代謝，促進自由基損傷，並產生致癌物質雜環胺[9-16] ，所有這些都可能促進癌症的產生。
腸癌
肉類攝入量和結腸癌的關係被研究得最廣泛。地球人生態研究發現，人均肉類攝入量與結腸癌發病率（>0.85）和死亡率（>0.70）率聯係非常高[17,18] 。同樣在案例和人群研究中發現，大腸癌的風險直接與紅肉和加工肉類攝入量相關。 1997年總結這些研究後，由世界癌症研究基金組織和美國癌症研究組織得出的結論是，攝入的紅肉可能增加患結直腸癌的幾率，而加工肉類可能增加大腸癌的危險[ 19 ] 。據報道，在世界衛生組織的共識會議結腸癌討論小組[20]和關於飲食與癌症的委員會對醫療方麵的食品和營養政策工作組[21] 得出類似的結論。在最近的匯總分析腸癌（其中包括公布到2005年研究）結論表示，紅肉攝取量增加腸癌風險28 ％ -35 ％，加工肉類增加腸癌風險的20% - 49% [22-24]。
其他癌症
此外，還有大量的研究探討了肉類攝入量與胃癌的風險。在最近一次的匯總分析得出結論：加工肉類攝入量增加胃癌的風險[25]。現在有一些研究報道，肉類攝入量與膀胱癌[26,27]、乳腺癌[28,29]、子宮內膜癌[30]、神經膠質瘤[31]、胰髒癌[32-34]、前列腺癌[35]，腎癌[36]風險有關，但需要更多的實驗數據支持。同樣，肉類攝入量和肺癌[37,38]、食道癌[39]、口腔癌[40,41] ，卵巢[42-44] ，子宮頸[45]，與肝癌[41]的風險有待於更多實驗數據支持。這些研究需要進一步考慮能量攝入或身體質量指數兩個指標。
最新的多種癌症研究
在這期plos醫藥雜誌上，Amanda Cross和他的同事，分析了一個很有前瞻性的大型的關於紅色和加工肉類攝入量與人體數種癌症風險聯係的人群研究[46]。這個研究是美國國家衛生研究院（NIH）和美國退休者協會（前身為美國退休人員協會）的飲食習慣和健康研究，它包括了500000美國人，其中超過53000癌症案例。
對於腸癌，紅肉攝入量62.5克/1000千卡增加24％的風險，紅肉攝入量22.6克/1000千卡增加20%的風險。男性和女性沒有區別。這個結論和以前匯總結論相同[22-24]。研究人員還發現，紅肉攝入量增加食道癌、肝癌、肺癌風險20％ - 60％。加工肉製品攝入量增加肺癌16％。紅肉和加工肉類攝入會增加男人胰腺癌的風險。
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