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A meta-analysis of the effects of energy intake on risk of digestive cancers.
World J Gastroenterol 2012; 18(48):7362-70WJ

Abstract

AIM

To quantitatively assess the relationship between energy intake and the incidence of digestive cancers in a meta-analysis of cohort studies.

METHODS

We searched MEDLINE, EMBASE, Science Citation Index Expanded, and the bibliographies of retrieved articles. Studies were included if they reported relative risks (RRs) and corresponding 95% CIs of digestive cancers with respect to total energy intake. When RRs were not available in the published article, they were computed from the exposure distributions. Data were extracted independently by two investigators and discrepancies were resolved by discussion with a third investigator. We performed fixed-effects meta-analyses and meta-regressions to compute the summary RR for highest versus lowest category of energy intake and for per unit energy intake and digestive cancer incidence by giving each study-specific RR a weight that was proportional to its precision.

RESULTS

Nineteen studies consisting of 13 independent cohorts met the inclusion criteria. The studies included 995,577 participants and 5620 incident cases of digestive cancer with an average follow-up of 11.1 years. A significant inverse association was observed between energy intake and the incidence of digestive cancers. The RR of digestive cancers for the highest compared to the lowest caloric intake category was 0.90 (95% CI 0.81-0.98, P < 0.05). The RR for an increment of 239 kcal/d energy intake was 0.97 (95% CI 0.95-0.99, P < 0.05) in the fixed model. In subgroup analyses, we noted that energy intake was associated with a reduced risk of colorectal cancer (RR 0.90, 95% CI 0.81-0.99, P < 0.05) and an increased risk of gastric cancer (RR 1.19, 95% CI 1.08-1.31, P < 0.01). There appeared to be no association with esophageal (RR 0.96, 95% CI 0.86-1.07, P > 0.05) or pancreatic (RR 0.79, 95% CI 0.49-1.09, P > 0.05) cancer. Associations were also similar in studies from North America and Europe. The RR was 1.02 (95% CI 0.79-1.25, P > 0.05) when considering the six studies conducted in North America and 0.87 (95% CI 0.77-0.98, P < 0.05) for the five studies from Europe.

CONCLUSION

Our findings suggest that high energy intake may reduce the total digestive cancer incidence and has a preventive effect on colorectal cancer.

Authors+Show Affiliations

Department of Gastroenterology, Huadong Hospital, Fudan University, Shanghai 200040, China.

Pub Type(s)

Journal Article
Meta-Analysis

Language

eng

PubMed ID

23326146

Citation

Yu, Xiao-Feng, et al. "A Meta-analysis of the Effects of Energy Intake On Risk of Digestive Cancers." World Journal of Gastroenterology, vol. 18, no. 48, 2012, pp. 7362-70.
Yu XF, Wang YQ, Zou J, et al. A meta-analysis of the effects of energy intake on risk of digestive cancers. World J Gastroenterol. 2012;18(48):7362-70.
Yu, X. F., Wang, Y. Q., Zou, J., & Dong, J. (2012). A meta-analysis of the effects of energy intake on risk of digestive cancers. World Journal of Gastroenterology, 18(48), pp. 7362-70. doi:10.3748/wjg.v18.i48.7362.
Yu XF, et al. A Meta-analysis of the Effects of Energy Intake On Risk of Digestive Cancers. World J Gastroenterol. 2012 Dec 28;18(48):7362-70. PubMed PMID: 23326146.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A meta-analysis of the effects of energy intake on risk of digestive cancers. AU - Yu,Xiao-Feng, AU - Wang,Yi-Qian, AU - Zou,Jian, AU - Dong,Jie, PY - 2012/09/14/received PY - 2012/10/04/revised PY - 2012/11/11/accepted PY - 2013/1/18/entrez PY - 2013/1/18/pubmed PY - 2014/1/10/medline KW - Cancer prevention KW - Diet KW - Digestive cancer KW - Energy intake SP - 7362 EP - 70 JF - World journal of gastroenterology JO - World J. Gastroenterol. VL - 18 IS - 48 N2 - AIM: To quantitatively assess the relationship between energy intake and the incidence of digestive cancers in a meta-analysis of cohort studies. METHODS: We searched MEDLINE, EMBASE, Science Citation Index Expanded, and the bibliographies of retrieved articles. Studies were included if they reported relative risks (RRs) and corresponding 95% CIs of digestive cancers with respect to total energy intake. When RRs were not available in the published article, they were computed from the exposure distributions. Data were extracted independently by two investigators and discrepancies were resolved by discussion with a third investigator. We performed fixed-effects meta-analyses and meta-regressions to compute the summary RR for highest versus lowest category of energy intake and for per unit energy intake and digestive cancer incidence by giving each study-specific RR a weight that was proportional to its precision. RESULTS: Nineteen studies consisting of 13 independent cohorts met the inclusion criteria. The studies included 995,577 participants and 5620 incident cases of digestive cancer with an average follow-up of 11.1 years. A significant inverse association was observed between energy intake and the incidence of digestive cancers. The RR of digestive cancers for the highest compared to the lowest caloric intake category was 0.90 (95% CI 0.81-0.98, P < 0.05). The RR for an increment of 239 kcal/d energy intake was 0.97 (95% CI 0.95-0.99, P < 0.05) in the fixed model. In subgroup analyses, we noted that energy intake was associated with a reduced risk of colorectal cancer (RR 0.90, 95% CI 0.81-0.99, P < 0.05) and an increased risk of gastric cancer (RR 1.19, 95% CI 1.08-1.31, P < 0.01). There appeared to be no association with esophageal (RR 0.96, 95% CI 0.86-1.07, P > 0.05) or pancreatic (RR 0.79, 95% CI 0.49-1.09, P > 0.05) cancer. Associations were also similar in studies from North America and Europe. The RR was 1.02 (95% CI 0.79-1.25, P > 0.05) when considering the six studies conducted in North America and 0.87 (95% CI 0.77-0.98, P < 0.05) for the five studies from Europe. CONCLUSION: Our findings suggest that high energy intake may reduce the total digestive cancer incidence and has a preventive effect on colorectal cancer. SN - 2219-2840 UR - https://www.unboundmedicine.com/medline/citation/23326146/A_meta_analysis_of_the_effects_of_energy_intake_on_risk_of_digestive_cancers_ L2 - http://www.wjgnet.com/1007-9327/full/v18/i48/7362.htm DB - PRIME DP - Unbound Medicine ER -