红肉及加工肉制品与结直肠癌风险关系的研究进展

近年来我国结直肠癌的发病率和死亡率逐年上升。据研究,结直肠癌发生率的升高可能与红肉及加工肉制品消费的增长具有一定相关性,但该关联性一直存在争议。为此,本文分析了现阶段研究红肉及加工肉制品与结直肠癌相关性的方法及其局限性,并综述了与红肉及加工肉制品相关的潜在结直肠癌致病因素,为确定结直肠癌及其他癌症与红肉及加工肉制品之间的关系提供了新的思路。     

Red meat,diseases, and healthy alternatives: A critical review

Meat is an important food for human nutrition, by especially providing high-quality protein and also some essential micronutrients, in front iron, zinc, and vitamin B₁₂. However, a high intake of red and processed meat is associated with an increased risk for diseases, especially type 2 diabetes and colorectal cancer, as several epidemiological studies and meta-analyses have shown. This review summarizes meta-analyses of publications studying the association between red and processed meat intake and type 2 diabetes, cardiovascular diseases, colorectal and other cancers, and all-cause mortality. Various potential mechanisms involved in the increased disease risk are discussed. Furthermore, the beneficial effects of healthy alternatives for meat, like fish, nuts, vegetables and fruits, pulses and legumes, whole grains, and dairy products are reviewed by including selected papers and recent meta-analyses.     

The role of red and processed meat in colorectal cancer development: a perspective

This paper is based on a workshop held in Oslo, Norway in November 2013, in which experts discussed how to reach consensus on the healthiness of red and processed meat. Recent nutritional recommendations include reducing intake of red and processed meat to reduce cancer risk, in particular colorectal cancer (CRC). Epidemiological and mechanistic data on associations between red and processed meat intake and CRC are inconsistent and underlying mechanisms are unclear. There is a need for further studies on differences between white and red meat, between processed and whole red meat and between different types of processed meats, as potential health risks may not be the same for all products. Better biomarkers of meat intake and of cancer occurrence and updated food composition databases are required for future studies. Modifying meat composition via animal feeding and breeding, improving meat processing by alternative methods such as adding phytochemicals and improving our diets in general are strategies that need to be followed up.     

How meaty? Detection and quantification of adulterants,foreign proteins and food additives in meat products

The worldwide consumption of meat is increasing, especially in developing countries. Many studies have correlated a diet characterised by high intake of processed red meats with a risk of colorectal cancer, stroke, coronary heart diseases and diabetes. Moreover, the quality and safety of meat products may be compromised by several admitted and not admitted procedures (i.e. addition of food additives and/or foreign proteins). For these reasons, the topic ‘meat products’ quality and safety’ has gained much in importance during last few years. In this review, the recent advances in the field of analytical methods for the evaluation of meat adulteration due to the addition of foreign proteins and food additives are reported, compared and critically evaluated. Moreover, the most representative monitoring practices, developed worldwide, related to meats adulteration are described and discussed.     

加工肉制品中多环芳烃的研究现状

多环芳烃在环境中广泛存在。对于非职业性接触多环芳烃的工人和非吸烟者来说,通过饮食接触是多环芳烃的主要暴露方式。自2015年国际癌症研究机构(IARC)将红肉及其加工肉制品划分为致癌物后,降低加工肉制品中有毒有害物质(如多环芳烃)生成显得尤为重要。本文根据加工肉制品中多环芳烃研究现状,对其“三致”机理、生成机制、加工肉制品中暴露情况及其控制措施进行概述。     

The World Cancer Research Fund report 2007: A challenge for the meat processing industry

One of the 10 universal guidelines for healthy nutrition in a report of the World Cancer Research Fund released at the end of 2007 is to "limit intake of red meat and avoid processed meat", as a result of the "convincing evidence" for an association with an increased risk of colorectal cancer development. In the present paper, the scientific evidence for the association between processed meats intake and colorectal cancer development is explored and the most probable hypothesis on the mechanism underlying this relationship formulated. It seems that the present state of knowledge is not well understood but relates to a combination of haem iron, oxidative stress, formation of N-nitroso compounds and related residues in the digestive tract as the causal factors. Although criticisms of the inaccurate definition of processed meats and the insufficient accounting for the large variability in composition of meat products have been expressed, it is clear that the report urges proper action by the meat and nutrition research community and the meat industry. Research items that in our view should be addressed are discussed. They include: (1) evaluating the health risks associated with processed meats intake within the context of the supply of beneficial nutrients and other nutrition associated health risks; (2) definition of the role of nitrites and nitrates in meat processing; (3) investigating the role of red and processed meats on the endogenous formation of N-nitroso compounds in the digestive tract; and (4) developing improved processed meats using new ingredients.     

Oxidation During Digestion of Meat: Interactions with the Diet and Helicobacter pylori Gastritis,and Implications on Human Health

The last decade has seen epidemiological evidence of a positive association between high consumption of red meat and processed meat and the risk of developing a range of chronic diseases, such as colorectal cancer, cardiovascular disease, and type 2 diabetes. Oxidative stress is potentially involved in this association; however, oxidative stress is likely limited if red meat and processed meat are consumed in moderation, and combined with high intake of fruits and vegetables and low intake of refined sugars. In addition, it appears that some subgroups of the population are more prone to developing oxidative stress‐related diseases as a consequence of high red and processed meat consumption. For example, the gastric juice in the inflamed stomach of individuals infected with Helicobacter pylori may be an excellent site for enhanced oxidation following meat consumption. Similarly, patients with inflammatory bowel disease may be at increased risk. Oxidative stress resulting from red or processed meat consumption may mediate the onset and/or progression of a wide range of diseases through various mechanisms, which are discussed in this review.     

The World Cancer Research Fund report 2007: A challenge for the meat processing industry

One of the 10 universal guidelines for healthy nutrition in a report of the World Cancer Research Fund released at the end of 2007 is to “limit intake of red meat and avoid processed meat”, as a result of the “convincing evidence” for an association with an increased risk of colorectal cancer development. In the present paper, the scientific evidence for the association between processed meats intake and colorectal cancer development is explored and the most probable hypothesis on the mechanism underlying this relationship formulated.It seems that the present state of knowledge is not well understood but relates to a combination of haem iron, oxidative stress, formation of N-nitroso compounds and related residues in the digestive tract as the causal factors. Although criticisms of the inaccurate definition of processed meats and the insufficient accounting for the large variability in composition of meat products have been expressed, it is clear that the report urges proper action by the meat and nutrition research community and the meat industry.Research items that in our view should be addressed are discussed. They include: (1) evaluating the health risks associated with processed meats intake within the context of the supply of beneficial nutrients and other nutrition associated health risks; (2) definition of the role of nitrites and nitrates in meat processing; (3) investigating the role of red and processed meats on the endogenous formation of N-nitroso compounds in the digestive tract; and (4) developing improved processed meats using new ingredients.     

Update on the relationship of fish intake with prostate, breast, and colorectal cancers

A systematic review of prospective cohort and case-control studies investigating relationships between the intake of fish and incidence of prostate, breast, or colorectal cancers was conducted. A total of 106 studies fulfilled the requirements stated in the "Search strategy and selection criteria." Among 273 estimates of association reported by these studies, 53 indicated decreased risk while 12 indicated increased risk associated with fish intake. The hypothesis linking fish consumption and low cancer incidence appears to be supported by little epidemiological data. However, there are several factors that may mask potential protective associations with fish intake. The type and the amount of fish eaten, the cooking method, the stage of the cancer and, amongst women, menopausal status may all be important factors that relate to whether fish is protective or not. Future epidemiologic studies with a clearer assessment of these factors are needed to know more about the effects of fish consumption on cancer risk. Therefore, until there are better measures of dietary exposure or biomarkers to correlate self-report, no conclusion can be drawn regarding the recommendation for increasing fish consumption in general to reduce the risk of developing the most common cancers in Western societies.     

Soy, isoflavones, and prostate cancer

Prostate cancer has marked geographic variations between countries. Genetic, epigenetic, and environmental factors co-contribute to the development of the cancer. The association between dietary factors and prostate cancer has been investigated and one explanation for the low incidence of the cancer in Asia might be high consumption of fresh vegetables including soybean and its products. Soybean is a species of legume contain high amount of isoflavones including genistein, daidzein, glycitein, and equol, which have a prophylactic effect on prostate cancer. In this article, epidemiological and laboratory studies on the relationship between soybeans, isoflavones and prostate cancer are reviewed and large scale multiethnic epidemiological studies are recommended.     

Mechanisms Linking Colorectal Cancer to the Consumption of (Processed) Red Meat: A Review

Colorectal cancer (CRC) is the third most commonly diagnosed cancer in the world. The vast majority of CRC cases have been linked to environmental causes rather than to heritable genetic changes. Over the last decades, epidemiological evidence linking the consumption of red and, more convincingly, of processed red meat to CRC has accumulated. In parallel, hypotheses on carcinogenic mechanisms underlying an association between CRC and the intake of red and processed red meat have been proposed and investigated in biological studies. The hypotheses that have received most attention until now include (1) the presence of polycyclic aromatic hydrocarbons and heterocyclic aromatic amines, two groups of compounds recognized as carcinogenic, (2) the enhancing effect of (nitrosyl)heme on the formation of carcinogenic N-nitroso compounds and lipid peroxidation. However, none of these hypotheses completely explains the link between red and processed red meat intake and the CRC risk. Consequently, scientists have proposed additional mechanisms or refined their hypotheses. This review first briefly summarizes the development of CRC followed by an in-depth overview and critical discussion of the different potential carcinogenic mechanisms underlying the increased CRC risk associated with the consumption of red and processed red meat.     

Novel approaches in improving the quality and safety aspects of processed meat products through high pressure processing technology - A review

BackgroundIn recent years, there has been growing consumer demand for the minimally processed and chemical additives free Ready-To-Eat (RTE) healthier meat products. On the other hand processed and RTE meat products have been notified as the primary cause for food borne outbreaks in different countries that commonly associated with emerging pathogens such as Salmonella, Listeria monocytogenes and Escherichia coli species.Scope and approachHigh pressure processing (HPP) has been renewed as a best non-thermal intervention for extending the shelf-life and safety of RTE meat products without altering the sensory and nutritional properties. Meat products are complex medium with different physical and chemical compositions that influence the lethality of the microorganisms during HPP. Using high pressure levels (above 600 MPa) for complete sterility of meat products may not be economically feasible more over it may negatively affect the product quality characteristics. The present review aimed to explore the recent research investigations addressed the multi hurdle approaches to increase the effectiveness of HPP at lower processing levels in order to reduce the processing costs and to improve the safety and quality of processed meat products.Key findings and conclusionsThe combination of natural antimicrobials (plant bioactive compounds and bacteriocins) and antioxidants (plant phenolic compounds) as additional hurdles through different mechanisms (active and intelligent packaging) during HPP can definitely be an effective and innovative intervention in ensuring the complete safety of processed meat products. Moreover, the development of low salt meat products with optimum quality attributes can be highly possible through HPP technology.     

Recent advances in heterocyclic aromatic amines: An update on food safety and hazardous control from food processing to dietary intake

Heterocyclic aromatic amines (HAAs) as probable carcinogenic substances are mainly generated in meat products during thermal processing. Numerous studies have contributed to the analysis, formation, and mitigation of HAAs during food processing. However, few articles have comprehensively reviewed food safety aspects from both food processing and dietary intake regarding the formation, mitigation, metabolism, biomarkers for exposure, hazard control, and risk assessment of HAAs, and related food safety researches. Several factors may influence the generation of HAAs, including processing temperature, processing time, and chemical composition of the meat. Nonetheless, these mutagenic compounds are attenuated to different levels by the addition of natural or synthetic flavorings and antioxidant‐rich marinades, as well as pretreatments using technique such as microwave heating. After dietary intake, different types of HAAs are metabolized in humans by several enzymes, including cytochrome P450s, peroxidases, N‐acetyltransferases, sulfotransferases, uridine diphosphate‐glucuronosyltransferases, and glutathione S‐transferases. Their primary metabolites are further conjugated with DNA or ultimately excreted in urine and feces. The 2‐amino‐1‐methyl‐6‐phenylimidazo[4,5‐b]pyridine in hair as well as DNA, hemoglobin, and serum albumin adducts has been considered as biomarkers for exposure assessment. Dietary intake information obtained from questionnaires and the results of epidemiological investigations have shown a positive relationship between the intakes of red meat and processed meat and high risk of cancer incidence. As several cancers have been reported to be associated with HAAs, HAAs should be both effectively reduced during food processing and controlled from dietary intake to facilitate human health.     

Relevance of protein fermentation to gut health

It is generally accepted that carbohydrate fermentation results in beneficial effects for the host because of the generation of short chain fatty acids, whereas protein fermentation is considered detrimental for the host's health. Protein fermentation mainly occurs in the distal colon, when carbohydrates get depleted and results in the production of potentially toxic metabolites such as ammonia, amines, phenols and sulfides. However, the effectivity of these metabolites has been established mainly in in vitro studies. In addition, some important bowel diseases such as colorectal cancer (CRC) and ulcerative colitis appear most often in the distal colon, which is the primary site of protein fermentation. Finally, epidemiological studies revealed that diets rich in meat are associated with the prevalence of CRC, as is the case in Western society. Importantly, meat intake not only increases fermentation of proteins but also induces increased intake of fat, heme and heterocyclic amines, which may also play a role in the development of CRC. Despite these indications, the relationship between gut health and protein fermentation has not been thoroughly investigated. In this review, the existing evidence about the potential toxicity of protein fermentation from in vitro animal and human studies will be summarized.     

Effect of Dietary Red Meat on Colorectal Cancer Risk—A Review

Heme iron overload has been implicated as the main cause of the increased risk of cancer due to the consumption of red meat. However, fish and shellfish, teas, and spices contain up to five times more iron than red meat. There is insufficient evidence that iron intake in dietary red meat is the primary causal factor for colorectal cancer. In addition, harmful substances produced during the preparation of red meat, including heterocyclic amines (HCAs), polycyclic aromatic hydrocarbons (PAHs), N‐nitroso compounds, and acrylamide, are extrinsic factors that increase carcinogenicity. HCAs are produced during the cooking of red meat, poultry meat, and fish. PAHs may also be produced during the cooking of diverse food groups, such as dairy products, fruits, vegetables, and cereals. The average daily intake of red meat among Korean individuals is 62 g; the amount of PAHs entering the body via red meat is less than the average amount of PAHs the body is exposed to in the air. Therefore, it is difficult to conclude that dietary red meat is the main cause of colorectal cancer. Rather, there may be an intricate influence of multiple factors, including fruit and vegetable intake, alcohol consumption, smoking, overweight, obesity, and stress.     

Meat and cancer

An increasing literature associates high intake of meat, especially red meat and processed meat with an increased risk of cancers, especially colorectal cancer. There is evidence that this risk may not be a function of meat per se, but may reflect high-fat intake, and/or carcinogens generated through various cooking and processing methods. The cancer risk may be modulated by certain genotypes. Cancers associated with high meat consumption may be reduced by the addition of anticarcinogens in the diet, especially at the same time as meat preparation or meat consumption, or modification of food preparation methods. Meat contains potential anticarcinogens, including omega-3 polyunsaturated fatty acids, and conjugated linoleic acid (CLA). Red meat, in particular, is an important source of micronutrients with anticancer properties, including selenium, vitamin B6 and B12, and vitamin D. Adjusting the balance between meat and other dietary components may be critical to protecting against potential cancer risks.     

Comminuted meat products—consumption,composition, and approaches to healthier formulations

Comminuted meat products are significant contributors to consumer fat and salt intakes, which are currently above World Health Organization recommended levels. Reducing fat and salt in comminuted meat products may therefore have a significant positive effect on public health in countries with a high consumption of these meats. As an example, the processed meat intake and the fat and salt levels of various comminuted meat products in Ireland and the UK are presented. The review focuses on substitution of fat and salt (including nitrite) with ingredients that yield products with acceptable organoleptic properties and have proven human health benefits.     

Vegetarian,vegan diets and multiple health outcomes: A systematic review with meta-analysis of observational studies

Background: Beneficial effects of vegetarian and vegan diets on health outcomes have been supposed in previous studies. Objectives: Aim of this study was to clarify the association between vegetarian, vegan diets, risk factors for chronic diseases, risk of all-cause mortality, incidence, and mortality from cardio-cerebrovascular diseases, total cancer and specific type of cancer (colorectal, breast, prostate and lung), through meta-analysis. Methods: A comprehensive search of Medline, EMBASE, Scopus, The Cochrane Library, and Google Scholar was conducted. Results: Eighty-six cross-sectional and 10 cohort prospective studies were included. The overall analysis among cross-sectional studies reported significant reduced levels of body mass index, total cholesterol, LDL-cholesterol, and glucose levels in vegetarians and vegans versus omnivores. With regard to prospective cohort studies, the analysis showed a significant reduced risk of incidence and/or mortality from ischemic heart disease (RR 0.75; 95% CI, 0.68 to 0.82) and incidence of total cancer (RR 0.92; 95% CI 0.87 to 0.98) but not of total cardiovascular and cerebrovascular diseases, all-cause mortality and mortality from cancer. No significant association was evidenced when specific types of cancer were analyzed. The analysis conducted among vegans reported significant association with the risk of incidence from total cancer (RR 0.85; 95% CI, 0.75 to 0.95), despite obtained only in a limited number of studies. Conclusions: This comprehensive meta-analysis reports a significant protective effect of a vegetarian diet versus the incidence and/or mortality from ischemic heart disease (?25%) and incidence from total cancer (?8%). Vegan diet conferred a significant reduced risk (?15%) of incidence from total cancer.     

Literature compilation of volatile N-nitrosamines in processed meat and poultry products - an update

ABSTRACT

A compilation of volatile N-nitrosamine levels in processed (e.g., cured, canned, smoked) meat and poultry products is presented. Over 1800 samples of processed meat products including bacon, ham, salami, sausage, and various other processed meat and poultry products have been examined for the presence of eight volatile N-nitrosamines. The database compiled from the literature is based on 25 references published for the period of 1985 to 2018 from 14 countries. N-nitrosodimethylamine (NDMA), N-nitrosopiperidine (NPIP), and N-nitrosopyrrolidine (NPYR), are the most frequently identified volatile N-nitrosamines occurring in processed meat and poultry products. N-nitrosodiethylamine (NDEA), and N-nitrosodibutylamine (NDBA) are also frequently observed to a lesser extent. The processed meat and poultry products with the highest levels of volatile N-nitrosamines were pork (fried, fat only eaten), poultry (fried), poultry (spiced, grilled), and bacon (fried).     

加工肉制品中杂环胺的研究进展

存在于加工肉制品中的杂环胺主要包括氨基咪唑氮和氨基咔啉两大类,两类杂环胺大多数都具有致癌、致突变作用,特别是2- 氨基-3- 甲基IQ 咪唑并[4,5-f]喹啉(IQ),已被国际癌症研究中心归类为“对人类高可疑致癌物(2A 级)”。长期研究表明,随着加工温度的升高和加工时间的延长,杂环胺含量显著上升;原料肉的种类会对产品中杂环胺含量产生影响;此外肉汁和肉汤中的杂环胺含量也是评估其每日摄取量的重要因素之一。本文对杂环胺的结构、分类、生物毒性、提取检测方法等进行综述,重点述评影响其形成的因素,以增进公众对杂环胺的认识。