سبوس دار و رژیم غذایی مصرف فیبر و پروستات پرخاشگری سرطان در آمریکایی های آفریقایی تبار و آمریکایی های اروپایی
Abstract: Objective. we examined the impact of whole grains, refined grains and total dietary fiber intake as determinants of the racial differential in the clinical aggressiveness of prostate cancer observed between African Americans (AA) and European Americans (EA).Methods. A population-based case-only study in which the case-control design was used to analyze data from the North Carolina-Louisiana Prostate Cancer Project, on 667 AA and 820 EA. Cases were highly aggressive cases of histologically confirmed adenocarcinoma of the prostate and controls were intermediate-aggressive and lowaggressive cases combined. Logistic regression was utilized to examine differences between cases and controls with respect to intake of refined grains, whole grains and dietary fiber, stratifying by race. Polytomous logistic regression was used to evaluate the associations between the clinical grade of prostate cancer as outcome variable, and nutrient intake including race*nutrient interaction terms. Results. There was a non-significant positive association between refined grains and risk of aggressive prostate cancer for AA (OR, 1.52; 95% CI, 0.82-2.82 for the 4th quartile as compared to the first quartile of intake). ORs showed inverse associations between intake of whole grains and prostate cancer aggressiveness. ORs increased in magnitude with higher intake of whole grains for EA (ORs for the 3rd and 4th quartiles versus the 1st were 0.82, and 0.52 respectively). ORs for AA for the 3rd and 4 th quartiles versus the 1st were 0.58 and 0.92. A similar trend as for whole grains was observed with total dietary fiber. Differential intakes of refined grains and whole grains among AA and EA partly explained the within stage higher prostate cancer grades that AA experience compared with EA. Conclusion. A reduction in the American diet of refined grain foods and an increase in the consumption of whole grain foods with a high amount of dietary fiber may reduce the clinical aggressiveness and consequently the mortality from prostate cancer. Descriptors. prostate cancer, refined grains, whole grains, total dietary fiber, African Americans, nutrition, European Americans, clinical aggressiveness, diet.