日本传统饮食评分与乳腺癌发病死亡
日本传统饮食（又称日本料理）被认为是日本人健康长寿的重要因素之一。乳腺癌是全世界女性最常见的癌症。不过，日本传统饮食与乳腺癌的相关性尚不明确。
2021年1月29日，英国《自然》旗下《欧洲临床营养杂志》在线发表日本三重津市大学、同志社女子大学、名古屋学芸大学、爱知厚生连足助医院、金城学院大学、滨松医科大学、名古屋第二红十字医院的研究报告，探讨了日本传统饮食评分与乳腺癌发病和死亡的长期相关性。
该生态学纵向研究首先从联合国粮食及农业组织数据库获取按国家划分的食品供应数据，从世界卫生组织全球疾病负担数据库获取按国家划分的乳腺癌发病率和死亡率数据。
随后，根据大米、小麦、鱼类、大豆、蔬菜、蛋类、海藻、肉类、奶类等9类食物和地中海饮食比例，按国家或地区计算传统日本饮食评分，总评分范围为-9分～9分，评分越高表明越符合日本传统饮食。
最后，对人口≥100万的139个国家分析日本传统饮食评分与财政年度的相互作用对乳腺癌发病率和死亡率的长期相关性，采用4种线性混合效应模型对不同的相关因素进行校正后进行纵向分析。
结果，对于日本传统饮食评分较高的大多数国家，1990～2017年乳腺癌发病率和死亡率分布较低。
采用线性混合效应模型对社会经济和生活方式影响因素进行校正后的纵向分析表明，日本传统饮食评分与财政年度之间的相互作用：
与乳腺癌发病率成反比（-0.453±0.138，P<0.01）
与乳腺癌死亡率成反比（-0.455±0.135，P<0.001）
因此，该纵向分析表明，近年来日本传统饮食与较低的乳腺癌发病率和死亡率存在显著相关性。
Eur J Clin Nutr. 2021 Jan 29. Online ahead of print.
A longitudinal association between the traditional Japanese diet score and incidence and mortality of breast cancer—an ecological study.
Abe C, Imai T, Sezaki A, Miyamoto K, Kawase F, Shirai Y, Sanada M, Inden A, Kato T, Shimokata H.
Tsu City College, Tsu, Mie, Japan; Doshisha Women's College of Liberal Arts, Kyoto, Japan; Nagoya University of Arts and Sciences, Nisshin, Aichi, Japan; Nagoya University of Arts and Sciences, Nagoya, Aichi, Japan; Asuke Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Toyota, Aichi, Japan; Kinjo Gakuin University, Nagoya, Aichi, Japan; Hamamatsu University Hospital, Shizuoka, Japan; Japanese Red Cross Nagoya Daini Hospital, Nagoya, Aichi, Japan.
BACKGROUND: The traditional Japanese diet is considered one of the important factors of health and longevity in Japanese people. Breast cancer is the most common cancer among women in the world. However, the association between the traditional Japanese diet and breast cancer is unclear. The purpose of this study was to investigate the longitudinal association between the traditional Japanese diet score (TJDS) with the incidence and mortality of breast cancer in an ecological study.
METHODS: Food supply and breast cancer incidence and mortality by country were obtained from an international database. TJDS by country was calculated from nine food groups and the total score ranged from -9 to 9, with higher scores indicating greater adherence to a traditional Japanese diet. Longitudinal associations of interaction between TJDS and fiscal year on breast cancer incidence and mortality were investigated in 139 countries with populations of 1 million or greater. The longitudinal analysis was evaluated using four linear mixed-effect models with different adjustment covariables.
RESULTS: Many countries with high scores on TJDS had lower distributions of breast cancer incidence and mortality in 1990-2017. Longitudinal analysis using a linear mixed-effect model controlled for socio-economic and lifestyle covariables showed that the interaction between TJDS and fiscal year was significantly associated with incidence of breast cancer (-0.453±0.138, p<0.01) and mortality of breast cancer (-0.455±0.135, p<0.001).
CONCLUSIONS: This longitudinal analysis suggested that a traditional Japanese diet has been associated with lower breast cancer incidence and mortality worldwide in recent years.
PMID: 33514870
DOI: 10.1038/s41430-020-00847-5