Raadpleeg ook preventielijst niet-toxische middelen en behandelingen opgesteld door arts-bioloog drs. Engelbert Valstar

24 oktober 2022: JAMA Intern Med. 2015;175(5):767-776.

Uit een groot Amerikaans bevolkingsonderzoek, The Adventist Health Study 2 (AHS-2) , blijkt dat mensen die hoofdzakelijk een vegetarisch dieet gebruiken minder risico hebben op het krijgen van darmkanker en/of rectumkanker in vergelijking met niet vegetariers. Vooral mensen die geen vlees maar naast groenten en fruit wel vis aten (pesco vegetariërs) hadden het minste risico darmkanker of rectumkanker te krijgen. 

The Adventist Health Study 2 (AHS-2) is een grote, prospectieve, Noord-Amerikaanse cohortstudie met 96354 Zevende-dags Adventisten die tussen 1 januari 2002 en 31 december 2007 zijn gerekruteerd. Van deze deelnemers bleef een analytische steekproef van 77659 over na uitsluitingen.

Dieet werd bij aanvang beoordeeld door een gevalideerde kwantitatieve vragenlijst over voedselfrequentie en gecategoriseerd in 4 vegetarische voedingspatronen (veganistisch, lacto-ovo-vegetarisch, pescovegetarisch en semi-vegetarisch) en een niet-vegetarisch voedingspatroon.
De analyse werd uitgevoerd met behulp van Cox proportionele gevarenregressie, waarbij werd gecontroleerd voor belangrijke demografische en levensstijlverstorende factoren. De analyse werd uitgevoerd tussen 1 juni 2014 en 20 oktober 2014. 

DIEETSTATUS van de deelnemers:
  • 8% is veganistisch (geen rood vlees, vis, gevogelte, zuivel of eieren).
  • 28% is lacto-ovo-vegetarisch (consumeert melk en/of eieren, maar geen rood vlees, vis of gevogelte).
  • 10% is pesco-vegetarisch (eet vis, melk en eieren, maar geen rood vlees of gevogelte).
  • 6% is semi-vegetarisch (eet minder dan één keer per week rood vlees, gevogelte en vis).
  • 48% is niet-vegetarisch (eet meer dan eens per week rood vlees, gevogelte, vis, melk en eieren).

Resultaten zoals vertaald uit het abstract, maar in het volledige studieverslag staat alles tot in detail vermeld met bijbehorende grafieken:

Tijdens een gemiddelde follow-up van 7,3 jaar werden 380 gevallen van darmkanker en 110 gevallen van rectumkanker gedocumenteerd. De aangepaste hazard ratio's (HR's) bij alle vegetariërs samen versus niet-vegetariërs waren 0,78 (95% BI, 0,64-0,95) voor alle darmkankers, 0,81 (95% BI, 0,65-1,00) voor darmkanker en 0,71 (95% BI, 0,47-1,06) voor rectumkanker.
De aangepaste HR voor darmkanker bij veganisten was 0,84 (95% BI, 0,59-1,19); bij lacto-ovo-vegetariërs 0,82 (95% BI 0,65-1,02); bij pescovegetariërs 0,57 (95% BI 0,40-0,82); en bij semi-vegetariërs, 0,92 (95% BI, 0,62-1,37) vergeleken met niet-vegetariërs.
Effectschattingen waren vergelijkbaar voor mannen en vrouwen en voor zwarte en niet-zwarte personen.

Conclusies en relevantie:

Vegetarische diëten zijn geassocieerd met een algehele lagere incidentie van darmkankers. Vooral pescovegetariërs hebben een veel lager risico in vergelijking met niet-vegetariërs.

Het volledige studierapport is gratis in te zien of te downloaden. Klik op de titel van het abstract voor het studieverslag:

Vegetarian Dietary Patterns and the Risk of Colorectal Cancers

Michael J. Orlich, MD, PhD1,2; Pramil N. Singh, DrPH1; Joan Sabaté, MD, DrPH1,2; et alJing Fan, MS1; Lars Sveen1; Hannelore Bennett, MS1; Synnove F. Knutsen, MD, PhD1,2; W. Lawrence Beeson, DrPH1; Karen Jaceldo-Siegl, DrPH, MS1,2; Terry L. Butler, DrPH1; R. Patti Herring, PhD1; Gary E. Fraser, PhD, MD1,2
Author Affiliations Article Information
JAMA Intern Med. 2015;175(5):767-776. doi:10.1001/jamainternmed.2015.59
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Abstract

Importance  Colorectal cancers are a leading cause of cancer mortality, and their primary prevention by diet is highly desirable. The relationship of vegetarian dietary patterns to colorectal cancer risk is not well established.

Objective  To evaluate the association between vegetarian dietary patterns and incident colorectal cancers.

Design, Setting, and Participants  The Adventist Health Study 2 (AHS-2) is a large, prospective, North American cohort trial including 96 354 Seventh-Day Adventist men and women recruited between January 1, 2002, and December 31, 2007. Follow-up varied by state and was indicated by the cancer registry linkage dates. Of these participants, an analytic sample of 77 659 remained after exclusions. Analysis was conducted using Cox proportional hazards regression, controlling for important demographic and lifestyle confounders. The analysis was conducted between June 1, 2014, and October 20, 2014.

Exposures  Diet was assessed at baseline by a validated quantitative food frequency questionnaire and categorized into 4 vegetarian dietary patterns (vegan, lacto-ovo vegetarian, pescovegetarian, and semivegetarian) and a nonvegetarian dietary pattern.

Main Outcomes and Measures  The relationship between dietary patterns and incident cancers of the colon and rectum; colorectal cancer cases were identified primarily by state cancer registry linkages.

Results  During a mean follow-up of 7.3 years, 380 cases of colon cancer and 110 cases of rectal cancer were documented. The adjusted hazard ratios (HRs) in all vegetarians combined vs nonvegetarians were 0.78 (95% CI, 0.64-0.95) for all colorectal cancers, 0.81 (95% CI, 0.65-1.00) for colon cancer, and 0.71 (95% CI, 0.47-1.06) for rectal cancer. The adjusted HR for colorectal cancer in vegans was 0.84 (95% CI, 0.59-1.19); in lacto-ovo vegetarians, 0.82 (95% CI, 0.65-1.02); in pescovegetarians, 0.57 (95% CI, 0.40-0.82); and in semivegetarians, 0.92 (95% CI, 0.62-1.37) compared with nonvegetarians. Effect estimates were similar for men and women and for black and nonblack individuals.

Conclusions and Relevance  Vegetarian diets are associated with an overall lower incidence of colorectal cancers. Pescovegetarians in particular have a much lower risk compared with nonvegetarians. If such associations are causal, they may be important for primary prevention of colorectal cancers.

Article Information

Accepted for Publication: November 25, 2014.

Corresponding Author: Michael J. Orlich, MD, PhD, School of Public Health, Loma Linda University, 24951 N Circle Dr, NH 2031, Loma Linda, CA 92350 (morlich@llu.edu).

Published Online: March 9, 2015. doi:10.1001/jamainternmed.2015.59.

Author Contributions: Dr Fraser had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Study concept and design: Orlich, Singh, Knutsen, Beeson, Jaceldo-Siegl.

Acquisition, analysis, or interpretation of data: Orlich, Sabaté, Fan, Sveen, Bennett, Knutsen, Beeson, Jaceldo-Siegl, Butler, Herring, Fraser.

Drafting of the manuscript: Orlich.

Critical revision of the manuscript for important intellectual content: Singh, Sabaté, Fan, Sveen, Bennett, Knutsen, Beeson, Jaceldo-Siegl, Butler, Herring, Fraser.

Statistical analysis: Orlich, Singh, Fan.

Obtained funding: Knutsen, Fraser.

Administrative, technical, or material support: Sveen, Bennett, Herring, Fraser.

Study supervision: Sabaté, Knutsen, Fraser.

Conflict of Interest Disclosures: Dr Orlich reports receiving a small honorarium from the Northern California Conference of Seventh-Day Adventists to partially defray travel expenses for a speaking engagement at which he gave an overview and update of Adventist Health Studies research and a small honorarium from the Southern California Conference of Seventh-Day Adventists for a speaking engagement at which he lectured on lifestyle approaches for chronic disease prevention. No other conflicts are reported.

Funding/Support: Project support was obtained from National Cancer Institute (NCI) grant 1U01CA152939 (Dr Fraser) and World Cancer Research Fund (WCRF) grant 2009/93 (Dr Fraser).

Role of the Funder/Sponsor: The funding organizations had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Disclaimer: The views expressed in this article are those of the authors and do not necessarily represent the views of the NCI, WCRF, or the participating cancer registries. The ideas and opinions expressed herein are those of the authors and endorsement by the NCI, WCRF, or their contractors or subcontractors is not intended nor should it be inferred.

Previous Presentation: The findings of this study were presented as a poster at the Society for Epidemiologic Research annual meeting; June 26, 2014; Seattle, Washington.

Additional Contributions: Cancer incidence data were provided by the Alabama State Cancer Registry, Alaska Cancer Registry, Arizona Cancer Registry, Arkansas Cancer Registry, California Cancer Registry, Colorado Cancer Registry, Connecticut Tumor Registry, District of Columbia Cancer Registry, Delaware Cancer Registry, Florida Cancer Data System, Georgia Department of Public Health, Hawaii Tumor Registry, Cancer Registry of Idaho, Illinois State Cancer Registry, Indiana State Cancer Registry, Iowa Cancer Registry, Kansas Cancer Registry, Kentucky Cancer Registry, Louisiana Tumor Registry, Maryland Cancer Registry, Massachusetts Cancer Registry, Michigan Cancer Surveillance System, Minnesota Cancer Surveillance System, Mississippi Cancer Registry, Missouri Cancer Registry and Research Center, Montana Central Tumor Registry, Nebraska Cancer Registry, Nevada Central Cancer Registry, New Hampshire State Cancer Registry, New Jersey State Cancer Registry, New Mexico Tumor Registry, New York State Cancer Registry, North Carolina Central Cancer Registry, North Dakota Statewide Cancer Registry, Cancer Data Registry of Ohio, Oklahoma Central Cancer Registry, Oregon State Cancer Registry, Pennsylvania Cancer Registry, Rhode Island Cancer Registry, South Carolina Cancer Registry, South Dakota Cancer Registry, Tennessee Cancer Registry, Texas Cancer Registry, Utah Cancer Registry (NCI contract HHSN261201300071), Vermont Cancer Registry, Virginia Cancer Registry, Washington State Cancer Registry, West Virginia Cancer Registry, and Wyoming Cancer Surveillance Program.

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darmkanker, rectumkanker, preventie, vegetarisch dieet, pecto vegetarier, vis, groenten, fruit, vlees


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