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編者按：根據(jù)世界公共衛(wèi)生營養(yǎng)協(xié)會(huì)和巴西圣保羅大學(xué)和里約熱內(nèi)盧州立大學(xué)制定并且已被聯(lián)合國糧農(nóng)組織和世界衛(wèi)生組織采納的食品新（葡萄牙語：NOVA）分類法,，精加工食品主要指面包,、餅干、蛋糕,、冰淇淋,、果醬,、蜜餞、罐裝糖水水果,、巧克力,、糖果、谷物棒,、加糖麥片,、薯片、調(diào)味料,、甜食,、奶酪,、含糖水果和乳制飲料,、汽水、可樂,、熱狗,、香腸、漢堡,、方便面,、腌肉、熏肉,、罐裝蔬菜,、罐裝肉類、嬰兒配方奶粉等非常好看美味的食品,，有的甚至過度加工,。這些食品為了改善色香味，往往添加了很多添加劑,。植物油,、人造奶油、黃油,、豬油,、精制糖、精制鹽,、淀粉,、精制面粉、精制大米,、蛋白粉也可以視為精加工,，已經(jīng)不屬于天然食品。 2018年2月14日,，英國醫(yī)學(xué)會(huì)《英國醫(yī)學(xué)雜志》在線發(fā)表法國國家農(nóng)業(yè)研究院,、巴黎第十三大學(xué)（北巴黎大學(xué)）,、阿維森納醫(yī)院、巴西圣保羅大學(xué)的前瞻研究報(bào)告,，對過度加工食品攝入量與癌癥風(fēng)險(xiǎn)之間的相關(guān)性進(jìn)行了評定,。 該法國人群隊(duì)列研究（NutriNet-Santé）于2009～2017年通過互聯(lián)網(wǎng)招募10萬4980位年齡≥18歲（平均年齡42.8歲）無癌癥參與者（2萬2821位男性，占21.7%,；8萬2159位女性,，占78.3%），通過24小時(shí)飲食記錄問卷,，收集飲食攝入量,，該問卷被設(shè)計(jì)用于登記參與者3300項(xiàng)不同食品日常攝入量。根據(jù)NOVA分類法,，對這些食品的加工程度進(jìn)行分類,。通過多因素比例風(fēng)險(xiǎn)模型，對已知風(fēng)險(xiǎn)因素的影響進(jìn)行校正,，對過度加工食物攝入量與所有癌,、乳腺癌，前列腺癌,、結(jié)直腸癌風(fēng)險(xiǎn)之間的相關(guān)性進(jìn)行評定,。 結(jié)果發(fā)現(xiàn)，中位5年隨訪后,，出現(xiàn)原發(fā)癌2228例,，其中乳腺癌739例（絕經(jīng)前264例、絕經(jīng)后475例）,、前列腺癌281例,、結(jié)直腸癌153例。過度加工食品攝入占飲食比例每增加10%,，以下癌癥風(fēng)險(xiǎn)顯著提高：
對若干飲食營養(yǎng)質(zhì)量指標(biāo)（脂肪、鈉,、碳水化合物的攝入量,，西方飲食模式）影響因素進(jìn)行校正后，上述癌癥風(fēng)險(xiǎn)仍然顯著提高,。 因此,，根據(jù)該大樣本前瞻研究結(jié)果，至少對于這10萬多位愿意通過互聯(lián)網(wǎng)填寫24小時(shí)3300項(xiàng)飲食記錄問卷的法國人,，過度加工食品占飲食比例每增加10%,，所有癌和乳腺癌的風(fēng)險(xiǎn)顯著增加超過10%,。有必要開進(jìn)展進(jìn)一步研究，深入了解食品加工各個(gè)相關(guān)因素（營養(yǎng)組合,、食品添加劑,、包裝材料、新形成污染物）對上述風(fēng)險(xiǎn)的相對影響,。 對此,，墨西哥國家公共衛(wèi)生研究所、美國哈佛大學(xué)陳曾熙公共衛(wèi)生學(xué)院發(fā)表同期述評：過度加工食品與癌癥風(fēng)險(xiǎn)的相關(guān)性值得進(jìn)一步仔細(xì)探索,。 BMJ. 2018 Feb 14;360:k322. Consumption of ultra-processed foods and cancer risk: results from NutriNet-Santé prospective cohort. Fiolet T, Srour B, Sellem L, Kesse-Guyot E, Allès B, Méjean C, Deschasaux M, Fassier P, Latino-Martel P, Beslay M, Hercberg S, Lavalette C, Monteiro CA, Julia C, Touvier M. Paris 13 University, Bobigny, France; INRA, UMR 1110 MOISA, Montpellier, France; Avicenne Hospital, AP-HP, Bobigny, France; University of Sao Paulo, Sao Paulo, Brazil. OBJECTIVE: To assess the prospective associations between consumption of ultra-processed food and risk of cancer. DESIGN: Population based cohort study. SETTING AND PARTICIPANTS: 104980 participants aged at least 18 years (median age 42.8 years) from the French NutriNet-Santé cohort (2009-17). Dietary intakes were collected using repeated 24 hour dietary records, designed to register participants' usual consumption for 3300 different food items. These were categorised according to their degree of processing by the NOVA classification. MAIN OUTCOME MEASURES: Associations between ultra-processed food intake and risk of overall, breast, prostate, and colorectal cancer assessed by multivariable Cox proportional hazard models adjusted for known risk factors. RESULTS: Ultra-processed food intake was associated with higher overall cancer risk (n=2228 cases; hazard ratio for a 10% increment in the proportion of ultra-processed food in the diet 1.12 (95% confidence interval 1.06 to 1.18); P for trend<0.001) and breast cancer risk (n=739 cases; hazard ratio 1.11 (1.02 to 1.22); P for trend=0.02). These results remained statistically significant after adjustment for several markers of the nutritional quality of the diet (lipid, sodium, and carbohydrate intakes and/or a Western pattern derived by principal component analysis). CONCLUSIONS: In this large prospective study, a 10% increase in the proportion of ultra-processed foods in the diet was associated with a significant increase of greater than 10% in risks of overall and breast cancer. Further studies are needed to better understand the relative effect of the various dimensions of processing (nutritional composition, food additives, contact materials, and neoformed contaminants) in these associations. STUDY REGISTRATION: Clinicaltrials.gov NCT03335644. PMID: 29444771 DOI: 10.1136/bmj.k322 BMJ. 2018 Feb 14;360:k599. Ultra-processed foods and cancer: The possibility of a link deserves further careful exploration. Monge A, Lajous M. National Institute of Public Health, Mexico City, Mexic; Harvard T.H. Chan School of Public Health, Boston, MA. PMID: 29444772 DOI: 10.1136/bmj.k599
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