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Intermittent fasting in the prevention and treatment of cancer.

文献信息

DOI10.3322/caac.21694
PMID34383300
期刊CA: a cancer journal for clinicians
影响因子232.4
JCR 分区Q1
发表年份2021
被引次数62
关键词热量限制、禁食、肿瘤、肥胖
文献类型Journal Article, Research Support, Non-U.S. Gov't, Review
ISSN0007-9235
页码527-546
期号71(6)
作者Katherine K Clifton, Cynthia X Ma, Luigi Fontana, Lindsay L Peterson

一句话小结

本综述探讨了间歇性禁食(IF)作为慢性热量限制(CR)替代方案在癌症预防和治疗中的潜在作用,尽管在动物实验中取得了一些积极结果,但缺乏高质量的临床试验使其对人类的影响仍不明确。研究表明,IF可能安全并有助于减轻化疗毒性,但在临床试验之外不建议癌症患者实施,未来需要更多研究来评估其在癌症相关代谢中的作用。

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热量限制 · 禁食 · 肿瘤 · 肥胖

摘要

慢性热量限制(CR)在临床前和临床研究中具有强大的抗癌作用,但可能难以维持。作为CR的替代方案,间歇性禁食(IF)在科学界和公众中引起了越来越多的关注,这主要得益于在实验动物模型中取得的令人鼓舞的研究结果。根据国际食品信息理事会基金会的一项调查,IF在过去一年中已成为最受欢迎的饮食方式,癌症患者正在向肿瘤学家咨询其对癌症预防和治疗的益处。然而,正如本综述中所讨论的,关于IF在啮齿动物中的研究结果存在争议,并暗示在某些肿瘤条件下可能产生潜在的不利影响。由于缺乏高质量的随机临床试验,IF对人类癌症发生率和预后的影响仍不明确。初步研究表明,对于某些癌症患者,长期禁食是安全的,并可能减少化疗相关的毒性和肿瘤生长。然而,由于需要更多的试验来阐明禁食对癌症患者的风险和益处,作者目前不推荐正在接受积极癌症治疗的患者在临床试验之外进行IF。IF可以考虑用于希望通过体重管理获得癌症预防益处的成年人,但IF是否影响与癌症相关的代谢和分子通路仍未得到解答。

英文摘要

Chronic caloric restriction (CR) has powerful anticarcinogenic actions in both preclinical and clinical studies but may be difficult to sustain. As an alternative to CR, there has been growing interest in intermittent fasting (IF) in both the scientific and lay community as a result of promising study results, mainly in experimental animal models. According to a survey by the International Food Information Council Foundation, IF has become the most popular diet in the last year, and patients with cancer are seeking advice from oncologists about its beneficial effects for cancer prevention and treatment. However, as discussed in this review, results from IF studies in rodents are controversial and suggest potential detrimental effects in certain oncologic conditions. The effects of IF on human cancer incidence and prognosis remain unknown because of a lack of high-quality randomized clinical trials. Preliminary studies suggest that prolonged fasting in some patients who have cancer is safe and potentially capable of decreasing chemotherapy-related toxicity and tumor growth. However, because additional trials are needed to elucidate the risks and benefits of fasting for patients with cancer, the authors would not currently recommend patients undergoing active cancer treatment partake in IF outside the context of a clinical trial. IF may be considered in adults seeking cancer-prevention benefits through means of weight management, but whether IF itself affects cancer-related metabolic and molecular pathways remains unanswered.

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主要研究问题

  1. 间歇性禁食如何影响不同类型癌症的代谢途径?
  2. 在癌症患者中,间歇性禁食的具体实施方案有哪些推荐?
  3. 现有的关于间歇性禁食对癌症影响的临床试验有哪些关键发现?
  4. 除了间歇性禁食,还有哪些饮食干预可能对癌症预防有效?
  5. 在进行化疗的患者中,间歇性禁食可能带来的潜在风险有哪些?

核心洞察

1. 研究背景和目的:
随着慢性热量限制(CR)在预防和治疗癌症方面的显著效果被广泛证实,研究者们开始关注间歇性禁食(IF)作为CR的替代方案。CR虽然有效,但在长期维持上存在困难。近年来,IF因其在动物实验中的积极结果而受到科学界和公众的关注,尤其是在癌症患者中,他们希望了解IF在癌症预防和治疗中的潜在益处。

2. 主要方法和发现:
本文回顾了目前关于IF的研究,特别是在动物模型中的表现,发现IF在某些情况下可能对肿瘤有促进作用。这表明IF的效果并非一成不变,且在某些肿瘤条件下可能存在潜在的危害。研究指出,目前缺乏高质量的随机临床试验来验证IF对人类癌症发生率和预后影响的确切程度。初步研究显示,某些癌症患者在进行长时间禁食时可能是安全的,并且可能降低化疗相关的毒性和抑制肿瘤生长。

3. 核心结论:
尽管IF在体重管理和癌症预防中可能具有一定的潜在益处,但鉴于目前的研究不足,作者不建议正在接受癌症治疗的患者在临床试验之外尝试IF。IF在影响癌症相关的代谢和分子途径方面的作用仍未得到明确的答案。

4. 研究意义和影响:
这项研究的重要性在于它强调了IF在癌症预防和治疗中的潜力和局限性。随着IF在公众中的广泛流行,尤其是在癌症患者中,了解其实际效果和安全性至关重要。研究结果为今后有关IF的临床试验提供了依据,帮助制定更为科学和安全的饮食指导,确保癌症患者在追求健康的同时不冒不必要的风险。未来的研究有望揭示IF对癌症的具体影响,从而为癌症患者的饮食管理提供更有力的支持。

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  2. Calorie Restriction for Cancer Prevention and Therapy: Mechanisms, Expectations, and Efficacy. - Chiara Vidoni;Alessandra Ferraresi;Andrea Esposito;Chinmay Maheshwari;Danny N Dhanasekaran;Vincenzo Mollace;Ciro Isidoro - Journal of cancer prevention (2021)
  3. Metabolomics and the Multi-Omics View of Cancer. - David Wishart - Metabolites (2022)
  4. Scientific Evidences of Calorie Restriction and Intermittent Fasting for Neuroprotection in Traumatic Brain Injury Animal Models: A Review of the Literature. - Yang Xu;Zejie Liu;Shuting Xu;Chengxian Li;Manrui Li;Shuqiang Cao;Yuwen Sun;Hao Dai;Yadong Guo;Xiameng Chen;Weibo Liang - Nutrients (2022)
  5. The Bone Marrow Microenvironment in B-Cell Development and Malignancy. - Anastasia M Hughes;Vincent Kuek;Rishi S Kotecha;Laurence C Cheung - Cancers (2022)
  6. Association of Daily Eating Duration and Day-To-Day Variability in the Timing of Eating With Fatal Cancer Risk in Older Men. - Elisa M S Meth;Lieve T van Egmond;Thiago C Moulin;Jonathan Cedernaes;Fredrik Rosqvist;Christian Benedict - Frontiers in nutrition (2022)
  7. Dietary Intakes of Animal and Plant Proteins and Risk of Colorectal Cancer: The EPIC-Italy Cohort. - Sabina Sieri;Claudia Agnoli;Valeria Pala;Sara Grioni;Domenico Palli;Benedetta Bendinelli;Alessandra Macciotta;Fulvio Ricceri;Salvatore Panico;Maria Santucci De Magistris;Rosario Tumino;Luigi Fontana;Vittorio Krogh - Cancers (2022)
  8. Effect of fasting on cancer: A narrative review of scientific evidence. - Sagun Tiwari;Namrata Sapkota;Zhenxiang Han - Cancer science (2022)
  9. Obesity, cancer risk, and time-restricted eating. - Manasi Das;Nicholas J G Webster - Cancer metastasis reviews (2022)
  10. Hypothesis: Mutations and Immunosurveillance in Obesity-Associated Colorectal Cancer. - Darina Lazarova;Michael Bordonaro - Journal of Cancer (2022)

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