经常吃有机食品可以减少癌症风险

　　有机食品通常指不使用农药和化肥的天然食品。虽然有机食品与普通食品相比，农药残留的可能性较小，但是有机食品与癌症风险之间的关系尚不明确。

　　2018年10月22日，《美国医学会杂志》内科学分册在线发表法国巴黎第十三大学、圣安德烈医院、阿维森纳医院、马赛大学的研究报告，前瞻调查了大样本法国成人的有机食品与癌症风险之间的相关性。

　　该法国成年志愿者人群前瞻队列研究收集了6万8946位参与者（女性占78.0%，平均入组年龄为44.2±14.5岁）16种有机食品摄入频次（从不、偶尔、经常）和饮食摄入量数据，并且计算有机食品评分（范围：0～32分），随访日期为2009年5月10日至2016年11月30日。通过多因素比例风险回归模型，对可能的癌症风险因素进行校正，推算有机食品评分（四分位）相关癌症风险。

　　结果，随访期间发生癌症1340例，依次为乳腺癌459例、前列腺癌180例、皮肤癌135例、结直肠癌99例、非霍奇金淋巴瘤47例、其他淋巴瘤15例。

　　摄入有机食品评分最高四分之一者与最低四分之一者相比：

  • 所有类型癌症风险减少25%（风险比：0.75，95%置信区间：0.63～0.88，P<0.001）

  • 所有乳腺癌的风险减少23%（风险比：0.77，95%置信区间：0.58～1.01，P=0.10）

  • 绝经前乳腺癌风险减少11%（风险比：0.89，95%置信区间：0.59～1.35，P=0.76）

  • 绝经后乳腺癌风险减少34%（风险比：0.66，95%置信区间：0.45～0.96，P=0.03）

　　因此，该研究结果表明，经常摄入有机食品与癌症风险减少相关，尤其绝经后乳腺癌。虽然需要对研究结果进一步确认，但是促进普通人群摄入有机食品可能成为一种大有希望的癌症预防策略。

　　对此，哈佛大学陈曾熙公共卫生学院、哈佛大学医学院布列根妇女医院发表特邀评论：预防癌症的有机食品——值得投资吗？

JAMA Intern Med. 2018 Oct 22. [Epub ahead of print]

Association of Frequency of Organic Food Consumption With Cancer Risk: Findings From the NutriNet-Santé Prospective Cohort Study.

Julia Baudry; Karen E. Assmann; Mathilde Touvier; Benjamin Allès; Louise Seconda; Paule Latino-Martel; Khaled Ezzedine; Pilar Galan; Serge Hercberg; Denis Lairon; Emmanuelle Kesse-Guyot.

Université Paris 13, Bobigny, France; Hopital St André, Bordeaux, France; Hopital Avicenne, Bobigny, France; Aix Marseille Université, Marseille, France.

QUESTION: What is the association between an organic food-based diet (ie, a diet less likely to contain pesticide residues) and cancer risk?

FINDINGS: In a population-based cohort study of 68946 French adults, a significant reduction in the risk of cancer was observed among high consumers of organic food.

MEANING: A higher frequency of organic food consumption was associated with a reduced risk of cancer; if the findings are confirmed, promoting organic food consumption in the general population could be a promising preventive strategy against cancer.

IMPORTANCE: Although organic foods are less likely to contain pesticide residues than conventional foods, few studies have examined the association of organic food consumption with cancer risk.

OBJECTIVE: To prospectively investigate the association between organic food consumption and the risk of cancer in a large cohort of French adults.

DESIGN, SETTING, AND PARTICIPANTS: In this population-based prospective cohort study among French adult volunteers, data were included from participants with available information on organic food consumption frequency and dietary intake. For 16 products, participants reported their consumption frequency of labeled organic foods (never, occasionally, or most of the time). An organic food score was then computed (range, 0-32 points). The follow-up dates were May 10, 2009, to November 30, 2016.

MAIN OUTCOMES AND MEASURES: This study estimated the risk of cancer in association with the organic food score (modeled as quartiles) using Cox proportional hazards regression models adjusted for potential cancer risk factors.

RESULTS: Among 68946 participants (78.0% female; mean [SD] age at baseline, 44.2 [14.5] years), 1340 first incident cancer cases were identified during follow-up, with the most prevalent being 459 breast cancers, 180 prostate cancers, 135 skin cancers, 99 colorectal cancers, 47 non-Hodgkin lymphomas, and 15 other lymphomas. High organic food scores were inversely associated with the overall risk of cancer (hazard ratio for quartile 4 vs quartile 1, 0.75; 95% CI, 0.63-0.88; P for trend=.001; absolute risk reduction, 0.6%; hazard ratio for a 5-point increase, 0.92; 95% CI, 0.88-0.96).

CONCLUSIONS AND RELEVANCE: A higher frequency of organic food consumption was associated with a reduced risk of cancer. Although the study findings need to be confirmed, promoting organic food consumption in the general population could be a promising preventive strategy against cancer.

DOI: 10.1001/jamainternmed.2018.4357

JAMA Intern Med. 2018 Oct 22. [Epub ahead of print]

Organic Foods for Cancer Prevention—Worth the Investment?

Elena C. Hemler; Jorge E. Chavarro; Frank B. Hu.

Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts

DOI: 10.1001/jamainternmed.2018.4363

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