Zusammenfassung
Deutliche internationale Unterschiede in der Krebsinzidenz haben zu der Hypothese geführt, dass die Ernährung ein wichtiger Risikofaktor für die Kanzerogenese ist und bis zu 30 % der Tumorentstehung erklären könnte. Im vorliegenden Artikel wird ein Überblick über die epidemiologische Evidenz der Primärprävention maligner Tumoren durch die Ernährung gegeben. Der Artikel orientiert sich dabei an entsprechenden nationalen und internationalen Evaluationen und geht auf aktuelle Studienergebnisse ein. Zu den Ernährungsfaktoren, für die überzeugende Evidenz existiert, dass sie das Risiko bestimmter Krebserkrankungen erhöhen, zählen Übergewicht und Adipositas, hoher Alkoholkonsum, Aflatoxine und bestimmte Formen gesalzenen bzw. fermentierten Fisches. Die in den letzten Jahren aus Observations- und Interventionsstudien gewonnenen Erkenntnisse zur Bedeutung des Obst- und Gemüseverzehrs in der Krebsprävention sind hingegen, mit wenigen Ausnahmen, ernüchternd. In der Reduktion des Verzehrs von rotem und verarbeitetem Fleisch und der Erhöhung der Ballaststoffaufnahme steckt ein hohes primärpräventives Potential für die Reduktion des Dickdarmkrebsrisikos und anderer maligner gastrointestinaler Tumoren, allerdings sind auch hier weitergehende Studien zur Sicherung der wissenschaftlichen Evidenz erforderlich. Zusammenfassend liegt innerhalb der Ernährungsfaktoren zum gegenwärtigen Zeitpunkt für Präventionsmaßnahmen, die sich auf die Senkung der Prävalenz von Übergewicht und Adipositas sowie die Reduktion des Alkoholkonsums konzentrieren, die stärkste wissenschaftliche Evidenz vor zur Reduktion der Krebsinzidenz in Deutschland.
Abstract
Substantial differences in cancer incidence rates between countries have supported the hypothesis that nutrition is an important risk factor for cancer occurrence and may explain up to 30 % of cancer risk. Based on national and international evaluations and results of recently published studies this article provides an overview about the epidemiological evidence of the role of nutrition in the primary prevention of malignant tumors. Convincing evidence to increase cancer risk exists for overweight and obesity, and a high consumption of alcoholic beverages, aflatoxins, and some forms of salting and fermenting fish. In contrast, results from observational and intervention studies published during the past years do not support the hypothesis that high intake of fruits and vegetables may substantially decrease cancer risk. Reduction of the consumption of red and processed meat and increase in intake of dietary fiber may reduce the incidence of colorectal cancer and other malignant tumors of the gastrointestinal tract; however, further studies are needed to verify the evidence of this hypothesis. In conclusion, among nutritional factors the strongest evidence for a reduction of cancer incidence in Germany exists for preventive measures that aim to decrease the prevalence of overweight and obesity and reduce the consumption of alcohol.
Schlüsselwörter
Ernährung - Primärprävention - maligne Tumoren - Krebs - Epidemiologie
Key words
diet - nutrition - cancer - primary prevention - epidemiology
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Dr. med. Tobias Pischon, MPH
Abteilung Epidemiologie, Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke
Arthur-Scheunert-Allee 114 - 116
14558 Nuthetal
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