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植物性饮食和生酮饮食作为应对癌症的不同路径：综述

泰然健康网
2024-12-12 07:17

SCI

13 July 2022

Plant-Based and Ketogenic Diets As Diverging Paths to Address Cancer: A Review

(JAMA Oncol, IF: 33.006)

Shah Urvi A,Iyengar Neil M,Plant-Based and Ketogenic Diets As Diverging Paths to Address Cancer: A Review.[J] .JAMA Oncol, 2022, undefined: undefined.

Importance 重要性

As the incidence of cancer and metabolic disorders, such as obesity, concurrently rise, there has been increasing awareness of the pervasive effect of nutrition. The whole foods plant-based diet (WFPBD) and ketogenic diet (KD) have gained popularity in oncology, and this topic is increasingly permeating clinical dialogue.

随着癌症和代谢紊乱(如肥胖)的发病率同时上升，人们越来越意识到营养的普遍影响。全食物植物性饮食(WFPBD)和生酮饮食(KD)在肿瘤学领域越来越受欢迎，并日益渗透到临床对话中。

Observations 观察

Dietary intake is associated with multiple pathways involved in carcinogenesis and tumor progression. Consumption of a plant-enriched diet is associated with reduced cancer incidence and is recommended by dietary guidelines for cancer prevention. Despite a starkly different nutrient composition, a WFPBD and KD can be associated with weight loss, decreased inflammation, and decreased insulin levels. In addition, a WFPBD is associated with increased fiber, phytochemicals, and butyrate levels and decreased insulin-like growth factor 1 levels, whereas a KD exerts potential anticancer effects by increasing β hydroxybutyrate levels. A KD may be of interest in select, less common settings, such as tumors treated with phosphatidylinositol 3-kinase inhibitors, which induce hyperinsulinemia and hyperglycemia. Completed interventional trials have focused on increasing fruit and vegetable intake or reducing fat intake but have not specifically tested WFPBD or KD for cancer prevention or treatment. Currently available data support plant-based diets as opposed to KD as part of a lifestyle associated with reduced cancer risk. In the postdiagnosis setting, there are currently no rigorously tested approaches that support the recommendation of any diet to treat cancer.

饮食摄入与多种途径有关，涉及癌变和肿瘤进展。食用富含植物的饮食与降低癌症发病率有关，这是预防癌症的膳食指南所推荐的。尽管营养成分截然不同，但WFPBD和KD可与体重减轻、炎症减轻和胰岛素水平下降有关。此外，WFPBD与纤维、植物化学物质和丁酸水平的增加以及胰岛素样生长因子1水平的降低有关，而KD通过增加β羟基丁酸水平发挥潜在的抗癌作用。KD可能对某些不太常见的情况有兴趣，比如用磷脂酰肌醇3激酶抑制剂治疗的肿瘤，可诱导高胰岛素血症和高血糖。已完成的干预临床试验中注重在增加水果和蔬菜摄入或减少脂肪摄入，但没有专门测试WFPBD或KD的癌症预防或治疗。目前可用的数据支持以植物为基础的饮食作为生活方式的一部分与降低癌症风险有关，而不是KD。在诊断后的设置中，目前还没有严格的测试方法支持任何治疗癌症的饮食建议。

Conclusions and Relevance 结论与相关性

The results of this review suggest that the collective evidence supports plant-enriched diets vs KD for the reduction of cancer risk and the improvement of metabolic disorders in survivors. Additional prospective randomized clinical trials are needed to encourage use of dietary modification across the cancer continuum. Rigorous trial designs that adapt classical oncologic end points may identify populations that are likely to benefit from starkly contrasting diets. Current data support prioritization of plant-based diets, and future data could further personalize dietary recommendations in cancer populations.

这一综述的结果表明，集体证据支持植物丰富的饮食与KD相比，在减少癌症风险和改善幸存者的代谢紊乱。需要额外的前瞻性随机临床试验来鼓励在癌症连续体中使用饮食改变。采用经典肿瘤学终点的严格试验设计可能会确定哪些人群可能从截然不同的饮食中受益。目前的数据支持植物性饮食的优先排序，未来的数据可以进一步个性化癌症人群的饮食建议。

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