I-prostate Cancer: Abstract
Umhlaza weProstate (PCa) uhlala ungoyena nobangela uphambili wokusweleka kwamadoda ase-US kwaye ukuxhaphaka kuyaqhubeka nokunyuka kwihlabathi liphela ngakumbi kumazwe apho amadoda atya "indlela yaseNtshona" yokutya. Izifundo ze-Epidemiologic, i-preclinical kunye neklinikhi zibonisa indima enokuthi ithathelwe ukutya kwiziganeko kunye nokuqhubela phambili kwe-PCa. 'Lo mboniso omncinci unikezela umboniso weencwadi ezipapashwe kutshanje malunga nezondlo, izinto zokutya, iipatheni zokutya kunye neziganeko ze-PCa kunye nokuqhubela phambili. I-carbohydrates ephantsi, iprotheni ye-soy, i-omega-3 (w-3) i-fat, i-teas eluhlaza, utamatisi kunye nemveliso ye-tomato kunye ne-zyflamend ibonise isithembiso ekunciphiseni umngcipheko we-PCa okanye ukuqhubela phambili. Ukutya okunamafutha aphezulu kunye nesimo esiphezulu se-?-carotene kunokunyusa umngcipheko. Ubudlelwane bobume bunokuba khona phakathi kwe-folate, i-vitamin C, i-vitamin D kunye ne-calcium enengozi ye-PCa. Nangona ukufunyaniswa okungahambelaniyo kunye nokungagqibekanga, amandla okuba nendima yokutya ekuthinteleni kunye nokunyangwa kwe-PCa kuyathembisa. Ukudibaniswa kwazo zonke izinto ezinenzuzo yokunciphisa ingozi ye-PCa kwindlela yokutya enempilo ingaba yingcebiso engcono yokutya. Lo mzekelo uquka iziqhamo ezityebileyo kunye nemifuno, ukunciphisa i-carbohydrates ecocekileyo, i-fat and saturated fats, kunye nokunciphisa inyama ephekiweyo. Ulingo olongezelelweyo oluyilwe ngononophelo olulindelekileyo lufanelekile.
Amagama abalulekileyo: Ukutya, umdlavuza weprostate, i-nutrients, iphethini yesondlo, Indlela yokuphila, Ukukhusela, unyango, Isondlo, ukungenelela kokutya, Ukuphonononga
Contents
Intshayelelo: I-Cancer Cancer
Umhlaza wesifo seprotate (PCa) ngumdla wesibini oqhelekileyo emadodeni, kunye neepesenti ezimalunga nezigidi ezithe zafunyanwa emhlabeni jikelele ngonyaka [1], malunga neemeko eziphakamileyo ezintandathu eziseNtshona kunamazwe angewona aseNtshona. Ukutya, indlela yokuphila, indawo yokusingqongileyo kunye nemfuza yezinto ezifuywayo ixhaswa ukuba ithathe indima kule ngxabano. Olu hlalutyo lubhekisela kubungqina bwakutshanje benxaxheba ebalulekileyo yezinto zokutya kwi-PCa kwaye iquka uvavanyo lwe-epidemiologic kunye novavanyo lwekliniki ubungqina befuthe leprotheni, i-fat, i-carbohydrate, i-fibre, ii-phytochemicals, ezinye izinto zokutya, ukutya okupheleleyo kunye neendlela zokutya kwi-PCa iziganeko, uphuhliso kunye / okanye ukuqhubela phambili. Iingxelo ezivela kwiimeta-uhlalutyo okanye izilingo ezenzelwe i-randomized trials kunye nezifundo ezizayo zigxininiswe kulo mbononongo. Kufuneka kuqatshelwe ukuba uphando lwezidlo zokutya okanye ukutya okunomsoco kunye nomhlaza kaninzi luphantsi kwemiqathango eyahlukeneyo kwaye ngoko ke kunzima ukuchazwa kweziphumo. Ngokomzekelo, xa isifundo senzelwe ukuhlolisisa umphumo wenani lokudla, ukuguqulwa kwamanqatha okungenakwenzeka kuya kutshintshela i-protein kunye / okanye i-carbohydrate, kwaye ingatshintsha ukutyiwa kwezinye izondlo. Ngenxa yoko, kunzima ukuchaza ukuba isiphumo sokutshintsha kwiinqwelo zizodwa. Ukongezelela, impembelelo yamacronutrients inokubandakanya iinkalo zobini obuninzi kunye nohlobo lwe-macronutrients ezidliwe. Zomibini iinkalo zinokuchaphazela ukuqaliswa komhlaza kunye / okanye uphuhliso ngokuzimeleyo, kodwa abahlala behlukana kwiinkalo zophando. Nangona esi sihloko sisandul 'ukuhlaziywa [2], sinikezelwe ngokubanzi uncwadi olutsha ngesihloko, ukuhlaziywa okuhlaziyiweyo kunikwe apha kunye netafile yesishwankathelo kunikezelwa ngokukhawuleza (Itafile 1).
Izondlo zeCarbohydrates Ngenxa ye-hypothesis yokuba i-insulin yinto yokukhula kwe-PCa, kuye kwacatshangelwa ukuba ukunciphisa i-carbohydrates kwaye ngoko ukunciphisa i-serum insulin kunokunciphisa ukukhula kwe-PCa [3]. Enyanisweni, kwiimodeli zezilwanyana, mhlawumbi i-no-carbohydrate ketogenic diet (NCKD) [4,5] okanye i-low-carbohydrate diet (20% kcal njenge-carbohydrate) inemiphumo emihle ekunciphiseni ukukhula kwe-prostate tumor [6,7]. Kwizifundo zabantu, uphononongo olunye lufumene ukuba ukuthathwa okuphezulu kwe-carbohydrates esulungekileyo kuhambelana nomngcipheko owongeziweyo we-PCa [7]. Ukongeza kwisixa se-carbohydrates, uhlobo lwe-carbohydrates lunokuthi lube nefuthe kwi-PCa kodwa uphando aluzange lugqibe. Amandla okunciphisa umngcipheko we-PCa kunye nokuqhubela phambili ngokuchaphazela i-carbohydrate metabolism iphandwa nge-Metformin. I-Metformin yanciphisa ukwanda kweeseli ze-PCa kunye nokulibaziseka kokuqhubela phambili kwi-vitro kunye ne-vivo, ngokulandelanayo [8-10] kunye nokunciphisa ingozi yesiganeko kunye nokufa kwabantu [11-13]. Izilingo ezimbini zeklinikhi zengalo enye nazo zibonise umphumo omuhle we-metformin ekuchaphazela iimpawu ze-PCa yokwanda kunye nokuqhubela phambili [14,15]. Nangona kunjalo, ezinye izifundo ze-retrospective cohort azizange zixhase umphumo we-metformin ngokuphindaphindiweyo okanye ingozi yesiganeko se-PCa [16-22]. Nangona kunokwenzeka ukunciphisa i-carbohydrates epheleleyo okanye elula ekuzuzeni ulawulo lwe-PCa, ubungqina buyanqongophala kwizilingo ezilawulwa ngokungahleliwe (RCT). Izilingo ezimbini ezingabonakaliyo ziqhubeka nokuvavanya impembelelo yokutya okuphantsi kwe-carbohydrate (malunga ne-5% kcal) kwixesha eliphindwe kabini le-PSA phakathi kwezigulane ze-PCa emva kwe-radical prostatectomy (NCT01763944) kunye nempendulo ye-glycemic phakathi kwezigulane eziqala unyango lwe-androgen deprivation (ADT). NCT00932672 ). Iziphumo ezivela kwezi zilingo ziya kukhanyisa umphumo we-carbohydrate intake kumanqaku okuqhubela phambili kwe-PCa kunye nendima yokunciphisa i-carbohydrate yokunciphisa imiphumo emibi ye-ADT.
protein
Inqanaba elifanelekileyo leprotein ekudleni impilo epheleleyo okanye iprotrate impilo ayicacanga. Nangona udumo lwezidlo ezincinane ze-carbohydrates eziphezulu kwiiprotheyini, uphando lwabantu lwakutshanje luchaza ukuba ukunyuka kweprotheni ephantsi kwahlanganiswa nomngcipheko omncinci womhlaza kunye nokufa kwabantu bonke phakathi kwe-65 nabancinci. Phakathi kwamadoda amakhulu kunama-65, i-protein ye-protein ephantsi yayinomngcipheko ophezulu womhlaza kunye nokufa kwabantu bonke [23]. Kwiimodeli zezilwanyana umlinganiselo phakathi kweprotheni kunye ne-carbohydrate ifuthe kwimpilo ye-cardiometabolic, ukuguga nokuphila ixesha elide [24]. Inendima yeprotheni yokutya kunye neprotheni kumlinganiselo we-carbohydrate kwiPCa yophuhliso kunye nokuqhubela phambili kudinga ukufundisisa.
Iiprotheni ezisezilwanyana
Ukufunda i-protein intake, njengazo zonke iinkalo zesayensi yesondlo, zinokuba nzima. Ngokomzekelo, inyama yezilwanyana, eyimithombo yeeprotheyini kwizidlo zaseNtshona, ayilwanga nje kuphela ngeeprotheyini, kodwa kunye neoli, i-cholesterol, izityela kunye nezinye izondlo. Isixa salezi zondlo kubandakanya i-fatty acids iyakwazi ukuhluka kwenye inyama yezilwanyana ukuya kwelinye. Uphando olwangaphambili lwabantu lubonise ukuba ukusetyenziswa kweenkukhu ezingenakunqanda, ezincinci kwi-cholesterol kunye namafutha amaninzi kunamafutha amaninzi obomvu, ayengahambelani nokuphindaphinda okanye ukuqhubela phambili kwe-PCa [25]. Nangona kunjalo, ukusetyenziswa kweenkukhu ezibhakabhile kwakunxulumene nePCa ephakamileyo [26,27], ngelixa inyama ebomvu ephekwe yayixhomekeke kwiingozi eziphezulu ze-PCa [26,27]. Ngaloo ndlela, indlela ukutya okulungiselelwe ngayo kunokuguqula impembelelo yayo kwi-PCa mngcipheko kunye nenkqubela phambili. Ngokubanzi, ukusetyenziswa kweentlanzi kungabandakanywa nokufa kwe-PCa, kodwa intlanzi ephezulu ephekweyo inokubangela i-PCa carcinogenesis [28]. Ngaloo ndlela, kunokucetyiswa ukuba udle intlanzi rhoqo kodwa ukushisa okufunekayo kufuneka kugcinwe ngokulinganayo.
Iproteinyini esekelwe ngobisi
Omnye umthombo weprotheni oqhelekileyo yimveliso yobisi, njengobisi, ushizi kunye ne-yogurt. Iziphumo zangaphambili zibonise ukuba ubisi bunyuke ingozi enkulu ye-PCa kodwa kungekhona ngeCafa enobudlova okanye ebulalayo [29,30]. Ukongezelela, ubisi obupheleleyo kunye nokusetyenziswa kobisi oluphantsi kokunxiliswa kwamabhanki kuye kwaxelwa ukuba kukhuthazwe okanye kulibazise ukuqhubela phambili kwe-PCa [29,31]. KwiiNgcali zezeMpilo zilandelelana iqela kunye namadoda akwa-21,660, ukufunyanwa kokusetyenziswa kweebisi kufumaneke ukudibaniswa ne-PCa incidence [32]. Ngokukodwa, ubisi obuphantsi okanye ubisi oluphantsi luye lwaba yi-PCa ephantsi, kodwa ubisi obuninzi bwandisa ingozi ye-PCa engozi. Nangona iinqununu (imveliso) zeemveliso zobisi eziqhuba le mibutho aziwa, iindawo eziphakamileyo zeoli kunye ne-calcium ezinokuthi zibandakanyeke. Uphando lwesigxina samadoda akwa-1798 lubonise ukuba iprotheni yobisi ihlanganiswe ngokufanelekileyo kunye ne-serum IGF-1 [33] amanqanaba angakhuthaza ukuqaliswa okanye ukuqhubela phambili kwe-PCa. Ngaloo ndlela, uphando olongezelelweyo lufunekayo ukucacisa ubudlelwane phakathi kokudla kweebisi kunye ne-PCa. Kukho idatha enganeleyo ukubonelela ngeengcebiso ezinxulumene ngqo neprojekthi yobisi okanye yobisi kunye ne-PCa mngcipheko okanye ukuqhubela phambili.
Iiprotheni ezisisityalo
I-Soy kunye neemveliso ezisekelwe kwi-soy zizityebi kwiprotheni kunye ne-phytoestrogens enokuthi iququzelele ukuthintela i-PCa, kodwa indima yayo kwi-PCa ayicacanga. Kuphononongo kwiigundane, ukuthathwa kweemveliso zesoya kudibene nokuncipha kwe-hepatic aromatase, i-5? Ulingo olutshanje lwamadoda angama-1 anesifo esinobungozi obuphezulu emva kokuba i-prostatectomy enkulu ifumene ukuba i-soy protein supplementation iminyaka emibini ayinayo impembelelo kumngcipheko wokuphindaphinda kwe-PCa [34]. Nangona izifundo ze-epidemiological and pre-clinical studies [177] zixhasa indima enokubakho ye-soy / isoflavones ye-soy kwi-PCa yokunciphisa umngcipheko okanye ukuqhubela phambili, uhlalutyo lwe-meta aluzange lufumane impembelelo ebalulekileyo ye-soy intake kumanqanaba e-PSA, i-globulin ye-hormone-binding, i-hormone yesondo, testosterone, i-testosterone yamahhala, i-estradiol okanye i-dihydrotestosterone [35]. Enye i-RCT kwizigulane ngaphambi kwe-prostatectomy nayo ayizange ifumane nayiphi na impembelelo ye-soy isoflavone yongezelela ukuya kwiiveki ezintandathu kwi-PSA, i-serum iyonke ye-testosterone, i-testosterone yamahhala, i-estrogen iyonke, i-estradiol okanye i-cholesterol epheleleyo [36,37]. Kuba uninzi lwee-RCTs ezenziweyo bezincinci kwaye zinexesha elifutshane, uviwo olongezelelweyo luyafuneka.
Izifundo ezininzi ziye zaqhubeka zihlola i-isoflavone ephambili kwi-soy, i-genistein, kunye nefuthe layo kwi-PCa. I-potentialiste ye-genistein ukuvimbela i-PCa cell detachment, ukuhlasela kunye ne-metastasis ibikwa [40]. I-Genistein inokuguqula ukuhlaziywa kweglucose kunye ne-glucose transporter (GLUT) ibinzana kwi-PCa cells [41], okanye usebenzise umphumo wayo wokulwa nesifo se-tumor ngokulawulwa kwe-microRNAs [42]. Izifundo usebenzisa iisilini zeesisu kunye neentlobo zezilwanyana zibonisa ukuba i-genistein iyakwazi ukukhuphisana kunye nokuvimbela i-estrogens engapheliyo ekumkhonkeleni kwi-estrogen receptor, oko kukuvimbela ukwanda kwamaseli, ukukhula kunye nokunciphisa ukwahlukana kwaye, ngokukodwa, i-genistein inokuvimbela isithinteli se-cell, ukuveliswa kweprotease, ukuhlasela kweeseli kwaye thintela i-metastasis [36,40,43]. Nangona kunjalo, akukho plasma okanye amanqanaba okugaya ama-urine ahlanganiswe nomngcipheko we-PCa xa uphando lwezolawulo (44,45]. Kwisigaba se-2-RCT elawulwa yi-placebo kunye namadoda e-47, ukuxhaswa kwe-30 mg genistein kwiiveki ezintathu ukuya kweyesithandathu kunciphise kakhulu amanqaku anxulumene ne-androgen ye-PCa progression [46]. Ukongeza, i-genistein inokuba luncedo ekuphuculeni i-cabazitaxel chemotherapy kwi-PCa ye-metastatic castration-resistant [37]. Ucwaningo lwezonyango lufanelekile ukuba luhlolisise indima ye-soy kunye ne-soy isoflavones ye-PCa yokuthintela okanye unyango. Isiphakamiso esicacileyo malunga nokufunyanwa kweprotein kwi-PCa yokuthintela okanye unyango alufumanekanga okwamanje.
amafutha
Iziphumo zophando zokuvavanya ukusetyenziswa kwamafutha kunye nomngcipheko we-PCa okanye ukuqhubela phambili kuyaphikisana. Bobabini ukuthathwa okupheleleyo okupheleleyo [47] kwamafutha okutya kunye ne-fatty fatty acid composition inokuzimela ngokuzimeleyo kwi-PCa ukuqaliswa kunye / okanye ukuqhubela phambili. Nangona uphando lwezilwanyana lubonisa ngokuphindaphindiweyo ukuba ukunciphisa ukutya okutyayo kunciphisa ukukhula kwe-tumor [48-50] kunye nokutya okunamafutha aphezulu, ngakumbi i-fat fat and corn oil yandisa i-PCa progression [51], idatha yomntu ayihambelani kangako. Izifundo zokulawula iimeko kunye nezifundo zeqela ziye zabonisa ukuba akukho nxulumano phakathi kokusetyenziswa kwamafutha apheleleyo kunye nomngcipheko we-PCa [52-55] okanye umbutho ochaseneyo phakathi kokutya kwamafutha kunye nokusinda kwe-PCa, ngakumbi phakathi kwamadoda ane-PCa yendawo [47]. Ukongezelela, uphando olunqamlekileyo lubonise ukuba i-fat intake echazwe njengepesenti ye-calorie eyonke ithathwa ngokufanelekileyo idibene namanqanaba e-PSA kumadoda e-13,594 ngaphandle kwe-PCa [56]. Ukunikezelwa kwezi datha eziphikisanayo, kunokwenzeka ukuba uhlobo lwe-fatty acid [56] kunokuba inani elipheleleyo lingadlala indima ebalulekileyo ekuphuhlisweni kwe-PCa kunye nokuqhubela phambili. Uphononongo lufumene i-plasma egcwele i-fatty acids ukuba idibaniswe ngokuqinisekileyo ne-PCa ingozi kwiqela elilindelekileyo le-14,514 yamadoda e-Melbourne Collaborative Cohort Study [57]. Ukongezelela, olunye uphando lufumene ukuba ukutya okunamafutha amaninzi asekelwe kwizityalo kwakudibene nokunciphisa ingozi ye-PCa [58]. Ezi zifundo zixhasa isikhokelo sangoku sokutya sokutya amanqatha amancinci asekelwe kwizilwanyana kunye namafutha amaninzi asekwe kwisityalo.
Idatha emalunga ne-omega-6 (w-6) kunye ne-omega-3 (w-3) i-polyunsaturated fatty acid (PUFA) yokusetyenziswa kunye nomngcipheko we-PCa nayo iyaphikisana. Ngelixa kukho idatha yokuxhasa ikhonkco phakathi kokunyuka kwe-w-6 PUFA yokungenisa (ikakhulu ithathwe kwioyile yombona) kunye nomngcipheko wePCA ngokubanzi [57,59], ayisiyiyo yonke idatha exhasa unxibelelwano olunjalo [60]. Ngapha koko, ukutyeba okuninzi okunamafutha kwe-polyunsaturated kwakudityaniswa nesezantsi konke ukubangela ukusweleka phakathi kwamadoda ane-PCa engeyiyo eyomeleleyo kwizifundo zokulandelela iingcali kwezempilo [58]. Inkqubo ebekiweyo edibanisa i-w-6 PUFAs kunye ne-PCa umngcipheko kukuguqulwa kwe-arachidonic acid (w-6 PUFA) kwii-eicosanoids (prostaglandin E-2, hydroxyeicosatetraenoic acid kunye ne-epoxyeicosatrienoic acid) ekhokelela kukudumba kunye nokukhula kweselula [61]. Kwelinye icala, i-w-3 PUFAs, ezifumaneka ikakhulu emanzini abandayo anentlanzi enamafutha, zinokucothisa ukukhula kwe-PCa ngeendlela ezininzi [61-63]. Kuhlolisiso lwamadoda angama-48 anomngcipheko ophantsi we-PCa phantsi koqwalaselo olusebenzayo, ukuphinda i-biopsy kwiinyanga ezintandathu kubonise ukuba izicubu zeprostate w-3 fatty acids, ngakumbi i-eicosapentaenoic acid (EPA), inokukhusela ekuqhubekeni kwe-PCa [64]. Izifundo ze-in vitro kunye nezilwanyana zibonisa ukuba i-w-3 PUFAs yenza i-anti-inflammatory, pro-apoptotic, antiproliferative kunye ne-anti-angiogenic pathways [65,66]. Ngapha koko, isifundo sempuku ngokuthelekisa iintlobo ezahlukeneyo zamafutha kufumanise ukuba kuphela kukutya kweoyile yeentlanzi (oko kukuthi, ukutya okusekwe kwi-omega-3) kunciphise ukukhula kwe-PCa xa kuthelekiswa namanye amafutha okutya [67]. Ngokubhekisele kwidatha yabantu, inqanaba lesibini lokwenza uvavanyo olungenamkhethe lubonisa ukuba ukutya okunamafutha asezantsi kunye no-w-3 ukongezwa kweeveki ezine ukuya kwezintandathu ngaphambi kwe-radical prostatectomy kunciphise ukwanda kwe-PCa kunye nokuqhubela phambili komjikelo weseli (CCP) [62,68]. Ukutya okunamafutha asezantsi okutya okuneentlanzi kukhokelele ekunciphiseni i-15 (S) - i-hydroxyeicosatetraenoic acid level kunye nokwehlisa amanqaku e-CCP malunga nokutya kwaseNtshona [69]. Izibonelelo ezinokubakho ze-omega-3 fatty acids kwiintlanzi zixhaswe loncwadi lwezifo olubonisa ukuba i-w-3 fatty acid intake yayihambelana nomngcipheko we-PCa umngcipheko [70,71]. Ngaphandle kwesithembiso se-omega-3 fatty acids, ayizizo zonke izifundo ezivumayo. Ukuxhasa i-2 g ye-alpha-linolenic acid (ALA) ngosuku ngeenyanga ezingama-40 kumadoda angama-1,622 ane-PSA <4 ng / ml ayitshintshanga i-PSA [72]. Nangona kunjalo, olunye uphononongo lufumanise ukuba i-serum ephezulu yegazi n-3 PUFA kunye ne-docosapentaenoic acid (DPA) yayihambelana nomngcipheko opheleleyo we-PCa ngelixa i-serum ephezulu ye-EPA kunye ne-docosahexaenoic acid (DHA) inokuthi inxulunyaniswe nomngcipheko we-PCa ophezulu [73] . Uphando olongezelelweyo luyafuneka ukuqonda ngcono indima ye-omega-3 PUFAs kukhuseleko lwe-PCa okanye unyango.
Cholesterol
Uninzi lwezifundo zangaphambi klinikhi lubonise ukuba ukuqoqwa kwe-cholesterol kunceda ekuqhubekeni kwe-PCa [74-76]. Kwacetyiswa ukuba i-cholesterol ephezulu e-Lin et al. I-BMC Medicine (2015) I-13: I-3 Page 5 ye-15 ukusasazeka ingaba ngumngcipheko wezondo eziqinileyo, ngokukodwa ngokugqitywa kwe-cholesterol synthesis, indlela yokuvusela [77] kunye ne-intratumoral steroidogenesis [78]. Ngokutsho kwiphando lwakutshanje kunye namadoda e-2,408 ahlelwe ukuba yi-biopsy, i-cholesterol ye-serum yayixhomekeke ngokuzimeleyo ngokuchazwa kweengozi ye-PCa [79]. Ukuhambelana neziphumo ze-cholesterol, ukusetyenziswa kwe-cholesterol ye-drug-statical prostatectomy (RP) ye-cholesterol esezantsi ixhomekeke kakhulu kunomngcipheko we-biochemical repurrence kwizigulane ze-1,146 ezinkulu ze-prostatectomy [80]. Olunye uphando luye lwabonisa ukuba i-statins inganciphisa ingozi ye-PCa ngokunciphisa ukuqhubela phambili [81]. Nangona i-mechanism ayinakusungulwa, uphando olutshanje luye lwabonisa ukuba i-cholesterol ye-high-density level (i-HDL) ye-cholesterol inxulumene nomngcipheko ophezulu we-PCa kwaye, ngoko ke, i-HDL ephezulu yayikhusela [81-84]. Ezi ziphumo zixhasa inkcazo yokuba ukungenelela kwintliziyo-enempilo eyenza ukunciphisa i-cholesterol inokufumana inzuzo yempilo ye-prostate nayo.
Iivithamini kunye neMinerali
Apha siza kuphonononga idatha yamva nje kwiivithamini A, B complex, C, D, E, kunye ne-K kunye ne-selenium. Kwizilingo ezimbini ezinkulu zeklinikhi: i-Carotene kunye ne-Retinol Efficacy Trial (CARET; i-PCa yayiyisiphumo sesibini) kunye ne-National Institutes of Health-American Association of Retired Persons (NIH-AARP) Ukutya kunye neMpilo ekulindeleke ukuba ifundwe, i-multivitamin supplementation yayiyiyo. ezinxulumene nomngcipheko ophezulu wokuphuhlisa i-PCa enobudlova, ngokukodwa phakathi kwabo bathatha i-supplement ye-carotene yomntu ngamnye [85,86]. Ngokufanayo, amanqanaba aphezulu e-serum ?-carotene adibene nomngcipheko ophezulu we-PCa phakathi kwe-997 amadoda aseFinland kwi-Kuopio Ischemic Heart Disease Risk Factor cohort [87]. Nangona kunjalo, i-?-carotene isongezelelo asifumanekanga ukuba sichaphazele umngcipheko we-PCa ebulalayo ngexesha lonyango [88], okanye kwi-Danish yabafundi abalindelekileyo be-26,856 [89]. I-retinol ejikelezayo nayo ayizange idibaniswe nomngcipheko we-PCa kwimeko enkulu yokufunda yokulawula [90]. Ngaloo ndlela, umbutho phakathi kwe-vitamin A kunye ne-PCa awukacaci.
Ubungqina be-preclinical bubonisa ukuba ukuchithwa kwe-folate kunokucothisa ukukhula kwe-tumor, ngelixa ukuxhaswa akunampembelelo ekukhuleni okanye ekuqhubeni phambili, kodwa kunokukhokelela ngokuthe ngqo kwiinguqu ze-epigenetic ngokunyuka kwe-DNA methylation [91]. Uhlalutyo lwe-meta ezimbini lubonise ukuba amanqanaba e-folate ajikelezayo ahambelana ngokufanelekileyo nomngcipheko okhulayo we-PCa [92,93], ngelixa i-folate yokutya okanye i-supplementary folate ayinayo impembelelo kwi-PCa ingozi [94] kwisifundo sokubambisana kunye namadoda e-58,279 eNetherlands [ 95] kunye nesifundo solawulo lwetyala e-Itali naseSwitzerland [96]. Ngapha koko, olunye uphononongo lweqela lamadoda atyhubela i-radical prostatectomy kwiindawo ezininzi zoLawulo lwama-Veterans kulo lonke elase-US libonise ukuba amanqanaba aphezulu e-serum folate anxulunyaniswa ne-PSA ephantsi kwaye, ke ngoko, umngcipheko ophantsi wokungaphumeleli kwe-biochemical [97]. Olunye uphando olusebenzisa idatha esuka kwi-2007 ukuya kwi-2010 yezeMpilo yeSizwe kunye isondlo Uphando lweMviwo lubonise ukuba imeko ephezulu ingakhusela amanqanaba ePSA aphezulu phakathi kwamadoda akwa-3,293, iminyaka eyi-40 ubudala nangaphezulu, ngaphandle kwe-PCa [98] efunyanisiweyo. Kwacetyiswa ukuba i-folate ingadlala indima ebini kwi-prostate carcinogenesis kwaye, ngoko ke, ubudlelwane obunzima phakathi kwe-folate ne-PCa kulindeleke uphando olongezelelweyo [99].
Nangona inendima ye-vitamin C (i-ascorbic acid) inokuthi i-antioxidant kwi-antiticancer therapy, izilingo zokuvavanya ukutya okanye ukuxhaswa kwe-vitamin C zimbalwa. I-RCT ayibonakali niphumo ye-vitamin C kwi-PCa mngcipheko [89]. Ukongezelela koko, i-vitamin C kwizikolo eziphezulu ziyakwenza okungakumbi njenge-pro oxidant kune-antioxidant, inzima ukuyila nophando.
Uhlobo oluphambili olusebenzayo lwe-vitamin D, i-1,25 i-dihydroxyvitamin D3 (i-calcitriol) inceda ekubunjweni kwamathambo afanelekileyo, ibangela ukuhlukana kwamanye amaseli omzimba, kwaye inqanda iindlela ze-pro-tumor, ezifana nokunyuka kunye ne-angiogenesis, kwaye kucetyiswa ukuba kuzuze ingozi ye-PCa. [100]; nangona kunjalo, izinto ezifunyanisiweyo ziyaqhubeka zingagqibeki. Uphononongo olutshanje lufumene ukuba ukwanda kwe-serum i-vitamin D amanqanaba adibene nokunciphisa ingozi ye-PCa [101,102]. Ukongezelela, ukongeza i-vitamin D kunokunciphisa ukuqhubela phambili kwe-PCa okanye kubangele i-apoptosis kwiiseli ze-PCa [103-105]. Ezinye izifundo, nangona kunjalo, zichaze ukuba akukho mpembelelo ye-vitamin D eyongezelelweyo kwi-PSA [106] okanye akukho mpembelelo yesimo se-vitamin D kwi-PCa ingozi [107,108]. Olunye uphando luchaze ngokuchasanayo ukuba imeko ephantsi ye-vitamin D idibaniswe nengozi ephantsi ye-PCa kumadoda amadala [109], okanye i-serum ephezulu ye-vitamin D idibaniswe nomngcipheko we-PCa ophezulu [110,111]. Uphononongo luze lucebise ukuba ubudlelwane obubunjiweyo bunokuba khona phakathi kwesimo se-vitamin D kunye ne-PCa kunye noluhlu olufanelekileyo lokujikeleza i-vitamin D yokukhusela i-PCa lunokuba luncinci [112]. Oku kuhambelana neziphumo zezinye izondlo ezinokuthi ukuthathwa okukhulu kweso sondlo esilungileyo kusenokungasoloko kubhetele.
Uphononongo olutshanje lubonise ukuba umbutho phakathi kwe-vitamin D ne-PCa yahlanjululwa yiproteinyini ebopha i-vitamin D [113] enokuthi ichaze okokufunyaniswa kwangaphambili. Ukuqhubela phambili, uhlalutyo lweemeta oluphenya umbutho phakathi kweVitamin D receptor (VDR) polymorphisms (BsmI neFokI) kunye ne-PCa mngcipheko wachaza akukho buhlobo kunye ne-PCa mngcipheko [114]. Ngaloo ndlela, indima ye vithamini D e-PCa ihlala ingacacile.
Kulingo olukhulu lwe-randomized kunye ne-14,641 yamagqirha angamadoda ase-US ?iminyaka eyi-50 ubudala, abathathi-nxaxheba bafumana i-400 IU ye-vitamin E yonke imihla malunga ne-10.3 (13.8) iminyaka. I-Vitamin E yokuncedisa yayingenayo imiphumo esheshayo okanye yexesha elide kumngcipheko wee-cancer ezipheleleyo okanye i-PCa [115]. Nangona kunjalo, i-dose ephakathi ye-vitamin E yongezelela (i-50 mg okanye malunga ne-75 IU) ibangele umngcipheko we-PCa ophantsi phakathi kwe-29,133 yaseFinnish ababhemayo [116]. Izifundo ezininzi zangaphambi kweklinikhi zibonisa ukuba ivithamin E iyacotha ukukhula kwethumba, ngokuyinxenye ngenxa yokuthintela ukuhlanganiswa kweDNA kunye nokunyanzelwa kwendlela yeapoptotic [117]. Ngelishwa, izifundo zabantu ziye zaba ngaphantsi kwenkxaso. Izifundo ezimbini zokujonga (i-Cancer Prevention Study II Nutrition Cohort kunye ne-NIH-AARP Diet kunye neSifundo sezeMpilo) zombini zibonise ukuba akukho nxulumano phakathi kwe-vitamin E yokuncedisa kunye ne-PCa ingozi [118,119]. Nangona kunjalo, i-serum ephezulu?-tocopherol kodwa kungekhona i-?-tocopherol inqanaba lidibene nomngcipheko we-PCa [120,121] kwaye umbutho unokuguqulwa ngokuhlukahluka kofuzo kwi-vitamin E ehlobene ne-122]. Ngokuphambene noko, uvavanyo olulindelekileyo, i-Selenium kunye ne-Vitamin E ye-Cancer Prevention Trial (SELECT), ibonise ukuxhaswa kwe-vitamin E yandisa kakhulu ingozi ye-PCa [123] kunye nokuba i-plasma ephezulu? PCa ingozi [124]. Oku kufunyaniswayo kuhambelana nesifundo se-case-cohort samatyala e-1,739 kunye nolawulo lwe-3,117 olubonisa i-vitamin E yandisa ingozi ye-PCa phakathi kwabo banesimo esiphantsi se-selenium kodwa kungekhona abo banesimo esiphezulu se-selenium [125]. Ngaloo ndlela, uphando olongezelelweyo lufunekayo ukuhlola umbutho phakathi kwe-vitamin E kunye ne-PCa kunye nomphumo wedosi kunye nokusebenzisana nezinye izondlo kufuneka ziqwalaselwe.
I-Vitamin K iye yacatshangelwa ukuba incede ukukhusela i-PCa ngokunciphisa i-calcium ye-bioavailable. Uphononongo lwangaphambili lubonisa indibaniselwano yevithamini C kunye ne-K inomsebenzi onamandla we-antitumor kwi-vitro kwaye isebenze njenge-chemo- kunye ne-radiosensitizers kwi-vivo [126]. Ukuza kuthi ga ngoku, izifundo ezimbalwa ziye zaphanda oku, nangona uphando oluthile lusebenzisa i-European Prospective Investigation kwiCancer kunye neZondlo (EPIC) -i-Heidelberg cohort ifumene ubudlelwane obuphambeneyo phakathi kwe-vitamin K (njenge-menaquinones) kunye ne-PCa iziganeko [127]. Kuncinci ukuya kwizifundo zangaphambi kweklinikhi eziye zenziwa ukuvavanya indima ye-calcium kunye ne-PCa. I-Retrospective and meta-analyses iphakamisa ukunyuka okanye ukunciphisa ingozi ye-PCa kunye nokunyuka kwe-calcium, ngelixa abanye bacebisa ukuba akukho mbutho [128,129]. Olunye uphando lubonisa umbutho owenziwe ngu-U, apho amanqanaba e-calcium aphantsi kakhulu okanye ukuxhaswa kokubili kuhambelana ne-PCa [130].
I-Selenium, ngakolunye uhlangothi, iye yacatshangelwa ukukhusela i-PCa. Nangona izifundo ze-in vitro zicebise ukuba i-selenium inhibited angiogenesis kunye nokusabalalisa ngelixa ibangela i-apoptosis [131], iziphumo ezivela kwi-SELECT zibonise ukuba akukho nzuzo ye-selenium yodwa okanye idibene ne-vitamin E ye-PCa chemoprevention [123]. Ukuqhubela phambili, ukuxhaswa kwe-selenium akuzange kuzuze amadoda anesimo esiphantsi se-selenium kodwa kwandisa umngcipheko we-PCa ephezulu phakathi kwamadoda anesimo esiphezulu se-selenium kwiqela elikhethiweyo elikhethiweyo lamatyala e-1,739 kunye ne-high-grade (Gleason 7�10) PCa kunye nolawulo lwe-3,117 [ 125]. Uphononongo oluza kubakho kwi-Netherlands Cohort Study, olubandakanya amadoda e-58,279, i-55- ukuya kwi-69-iminyaka ubudala, nayo yabonisa ukuba i-toenail selenium yayinxulumene nomngcipheko oncitshisiweyo we-PCa ephezulu [132]. Uphando olongezelelweyo luyafuneka ukucacisa indima ye-selenium kunye ne-PCa.
Iiphytochemicals
Kanye kunye namavithamini kunye namaminerali [2], izityalo ziqulethe iiprotochemicals ezineempembelelo ezichasene nomhlaza. Ngokuqhelekanga ingabonwa njengeemfuno eziyimfuneko, iiprotochemicals zinezixhobo zokulwa ne-antioxidant kunye ne-anti-inflammatory properties.
I-Silibinin yi-polyphenolic flavonoid efumaneka kwimbewu ye-milk thistle. Kuye kwaboniswa kwi-vitro kunye ne-vivo ukuvimbela ukukhula kwe-PCa ngokujolisa i-epidermal growth factor receptor (EGFR), i-IGF-1 receptor (IGF-1R), kunye neendlela ze-nuclear-kappa B (NF-kB) [133,134]. Uphononongo olutshanje lubonise ukuba i-silibinin ingaba luncedo kwi-PCa yokukhusela ngokuvimbela i-TGF? Inkcazo ye-2 kunye ne-cancerassociated fibroblast (CAF)-efana ne-biomarkers kwiiseli ze-prostate stromal [135]. Ke, i-silibinin ngumgqatswa othembisayo njenge-agent ye-PCa chemopreventive elindele uphando olongezelelweyo.
I-Curcumin isetyenziselwa ukongezwa kokutya e-Asia kwaye njengeyeza lezityalo zokuvuvukala [136]. I-in vitro, i-curcumin inqanda iprotheni ye-pro-inflammatory NF-?B ngelixa ibangela i-apoptosis ngokunyuka kwentetho ye-proapoptotic genes [137]. Kwi-vivo, i-curcumin inciphisa ukukhula kwe-PCa kwiigundane ngelixa ivuselela izicubu kwi-chemo- kunye ne-radiotherapies [136]; nangona kunjalo, akukho lulingo lomntu luye lwahlola impembelelo yalo kwi-PCa.
lwerharnate
I-peel neziqhamo zeerharnate kunye nama-walnuts zizityebi kwi-ellagitannins (i-punicalagins). Ezi zixhobo zeprotokemia zenziwe ngokukhawuleza kwi-form esebenzayo i-ellagic acid nge-gutter flora [138]. Uvavanyo olusenyakathole lubonisa ukuba i-ellagitannins inqanda ukukhula kwe-PCa kunye ne-angiogenesis phantsi kweemeko zenzululwazi kwaye zenze i-apoptosis [137,138]. Kwimvavanyo ekulindelekileyo kumadoda anePSA ekhulayo emva kokunyanga okuphambili, ijusi yamarharnate okanye i-POMx, ukukhishwa kweromegranate ekhoyo yentengiso, kwandise ixesha le-PSA eliphindwe kabini malunga nesiseko [139,140], nangona kungekho zilingo zibandakanya iqela le-placebo. Iziphumo zilindeleke kwi-RCT ye-placebo yengingqi usebenzisa i-pomegranate i-extract in amadoda enePSA ekhulayo. Nangona kunjalo, kwisilingo esilawulwa yi-placebo, iipilisi ezimbini ze-POMx imihla ngemihla kwiiveki ezine ngaphambi kokuba i-prostatectomy enamandla ayinayo impembelelo kwi-pathology pathology okanye ingcinezelo yenkomo okanye nayiphina imilinganiselo ye-tumor [141].
Iti eluhlaza
I-tea eluhlaza iqulethe inani le-polyphenols ye-antioxidant kuquka i-catechin, njenge-epigallocatechin gallate (EGCG), i-epigallocatechin (EGC), (?) -epicatechin-3-gallate (ECG) kunye (?) -epicatechin. Izifundo zangaphambili zibonisa ukuba i-EGCG inqanda ukukhula kwe-PCa, ibangela iindlela zangaphakathi kunye ne-extrinsic apoptotic kunye nokunciphisa ukuvuvukala ngokuvimbela i-NFkB [137]. Ngaphezu koko, iipropathi ze-antioxidant ze-EGCG ziyi-25 kumaxesha e-100 anamandla ngaphezu kwevithamini C kunye ne-E [131]. Kulingo olulindelekileyo lwe-preprostatectomy olulindelekileyo, amadoda asebenzisa iti eluhlaza eyenziwe nguLin et al. I-BMC Medicine (2015) 13: 3 Iphepha le-7 le-15 ngaphambi kokuhlinzwa liye landa amanqanaba e-polyphenols yeti eluhlaza kwi-prostate tissue [142]. Kwilingo elincinci lobungqina bomgaqo kunye namadoda angama-60, ukuxhaswa kwansuku zonke kwe-600 mg ye-catechin ye-tea eluhlaza kuncitshiswe iziganeko ze-PCa nge-90% (3% ngokubhekiselele kwi-30% kwiqela le-placebo) [143]. Olunye ulingo oluncinci lubonise ukuba isongezelelo se-EGCG sibangele ukunciphisa okukhulu kwe-PSA, i-hepatocyte factor factor and vascular growth factor in men with PCa [144]. Ezi zifundo zibonisa ukuba i-polyphenols ye-green tea inokunciphisa iziganeko ze-PCa kunye nokunciphisa ukuqhubela phambili kwe-PCa kodwa uphando olongezelelweyo luyafuneka ukuze kuqinisekiswe kwaye kucaciswe indlela yayo [137,143,145].
Resveratrol
Nangona uphando oluninzi lwe-in vitro lubonisa ukuba i-resveratrol inqanda ukukhula kwe-PCa [146-148], i-resveratrol igxininisa ukukhula kwe-tumor kwezinye [137] kodwa kungekhona yonke imodeli yezilwanyana [149], mhlawumbi ngenxa yokufumaneka koxilongo [150,151]. Kuza kubekho, akukho zilingo zonyango eziphanda iziphumo zokuthintela okanye zonyango ze-resveratrol kwi-PCa.
Zyflamend
I-Zyflamend ngumxube ochasayo wokutshabalala weengcambu eziye zaboniswa ukunciphisa intuthuko ye-PCa ngokunciphisa imbonakalo yabamakishi kuquka i-PAKT, i-PSA, i-histone deacetylases kunye ne-receptor ye-androgen kwiimpawu zezilwanyana kunye ne-PCa cell line [152-154]. Nangona i-155] inamandla okulwa nomhlaza [i-156,157], zifundo ezimbalwa kakhulu ezenziwa ngabantu [23]. Kwileta evulekileyo Isigaba sovavanyo lwezilwanyana ze-18 ezine-high-grade prostraepithelial neoplasia, i-Zyflamend yedwa okanye ngokubambisana nezinye izongezo zokutya zenyanga ze-156 zanciphisa ingozi yokuphuhlisa i-PCa [XNUMX]. Kufuneka ii-RCT ezingaphezulu kubantu ukuba ziqinisekise ukusebenza kunye nesicelo sekliniki yolu longezelelo lwezityalo.
Ezinye iziqhamo zokutya kunye nemifuno
Iintyatyambo kunye nemifuno zinemithombo ecebileyo yamavithamini, amaminerali kunye neeprotochemicals. Ucwaningo oluninzi lweengxaki ze-epidemiologic lufumene ubudlelwane obuphambeneyo phakathi kwezityalo ezipheleleyo kunye nemifuno yokudla imifuno [158], kunye ne-cruciferous yokudla imifuno kunye ne-PCa mngcipheko [159,160]. Imifuno ye-Allium, efana negallic, i-leeks, i-chives, kunye ne-shallots, iqulethe iiprotochemicals ezininzi ezicetyiswayo ezicetyiswayo zokuphucula umzimba wokuzivikela, ukuvimbela ukukhula kweeseli, ukulandelelanisa ukubonakaliswa kwezakhi ze-androgen eziphendulayo kunye nokwenza i-apoptosis [161]. Nangona inani leepapasho ezipapashiweyo lilinganiselwe, idatha ye-preclinical and epidemiologic ibonisa ukuba i-allium ingeniso yemifuno ingakhusela i-PCa, ngokukhethekileyo isifo [162]. Umlingo ongenamagama kunye namadoda akwa-199 wafumanisa ukuba umxube wokuxuba wegrarati, itiye eluhlaza, i-broccoli kunye ne-turmeric yanciphisa kakhulu izinga lokunyuka kwe-PSA kumadoda ane-PCa [163].
Iimveliso zeTumato kunye neTumato
Izifundo ezininzi ziye zahlolisisa ubudlelwane phakathi kweetamatati kunye neemveliso zetamatato kunye ne-PCa kodwa iziphumo azihambelani. I-antioxidant lycopene, enezityebi kwiitamatati, iphinde ifundwe ngokukodwa kwiimpembelelo zayo kwi-PCa. I-in vitro, i-lycopene imisa umjikelezo weseli kwiintlobo eziliqela ze-PCa kunye nokunciphisa ukubonakaliswa kwe-IGF-1 ngokunciphisa i-IGF-1 iiprotheni ezibophayo [131]. Nangona ezinye izilwanyana zezilwanyana zithole i-lycopene ngokukhawuleza zinciphisa ukukhula kwe-PCa [164] okanye zinciphisa i-PCa epithelial cells kwisigaba sokuqalisa, ukuphakanyiswa nokuqhubela phambili [165], izifundo ezimbini zifumene iziphumo eziphikisanayo phakathi kokunqongophala kwetamatyi kunye ne-lycopene [166,167]. Ucwaningo lwabantu olufunyenweyo olufumene ukusetyenziswa kwe-lycopene ephakamileyo [i-168,169] okanye ama-serum aphezulu ahlanganiswe nomngcipheko we-PCa ophantsi [170], kodwa abanye abazange [171,172]. Ingxube yeprosystylene yecycopene ngaphantsi kwe-1 ng / mg umyinge wawuhlanganiswe ne-PCa kwi-biopsy yenyanga-ezintandathu (P = 0.003) [173]. Izilingo ezimbini zexesha elifutshane leproprostatectomy ngokusebenzisa i-tomato sauce okanye ukuxhaswa kwe-lycopene kubonisa ukunyuka kwe-lycopene kwi-prostate tissue kunye ne-antioxidant kunye nefuthe le-antiticancer effect [174,175]. Nangona izilingo ezininzi zeklinikhi zanconywa ukuba ubudlelwane obuphambeneyo phakathi kwe-lycopene supplementation, amazinga e-PSA kunye nokunciphisa impawu ezixhatshazwayo [171,176], akukho mvavanyo ephakamileyo elandeleleneyo eye yavavanya indima yemveliso ye-lycopene okanye i-tomato kwi-PCa yokuthintela okanye unyango.
Kofu
Ikhofi iqukethe i-caffeine kunye neendlela ezininzi ezingaziwayo ze-phenolic ezingaba yi-antioxidants. Ucwaningo lwe-epidemiological lubonisa ukuba ulwalamano oluphambeneyo phakathi kwekhofi kunye ne-PCa mngcipheko, ikakhulukazi kwizifo eziphambili okanye ezibulalayo, kwaye iziphumo zizimeleyo kwi-caffeine content [177,178]. Nangona izifundo ezininzi ze-epidemiological [179-182] azifumani nhlobo ubudlelwane phakathi kokusetyenziswa kwekhofi kunye ne-PCa mngcipheko, ukuhlalutya kwe-meta-uphando olutshanje lwabafundi abaye bafikelela ekugqibeleni ukuba ukusetyenziswa kwekhofi kunokunciphisa ingozi ye-PCa [183]. Izindlela ezingenakwenzekayo kunye neendlela (ezibandakanyekayo) azibandakanyi kodwa zingabandakanya i-antioxidant, i-anti-inflammatory effects, i-glucose kunye ne-insulin metabolism, kunye nefuthe kwi-IGF-I kunye ne-hormone yesondo.
Iipatheni zeZidlo
Nangona zininzi izondlo okanye izinto zokutya ziye zahlolwa ngenxa yefuthe okanye ukuhlanganisana neengozi zePC okanye ukuqhubela phambili, iziphumo ziye zazingagqibekanga. Isizathu esingaba singavumelaniyo kukuba igalelo lesondlo esisodwa okanye into yokutya ingaba yincinci kakhulu ukuba ingafunyanwa. Ukongezelela, izondlo ezisekho ngokwezinto eziqhelekileyo ekudleni zihlala zidibene kunye kwaye zinokusebenzisana kunye kwaye, ngoko, zichaphazela impembelelo kwi-PCa. Ngaloo ndlela, uhlalutyo lwendlela yokutya oluthile lufumene i Lin et al. I-BMC Medicine (2015) 13: 3 Page 8 yenzuzo ye-15 kodwa uphando luye lwacutha kwaye iziphumo ezikhoyo azizange zihambelane. Kwinqanaba lamadoda e-293,464, umgangatho ophezulu wokutya, njengoko uboniswe nguManqaku we-Healthy Eating Index (HEI), wahlanganiswa nomngcipheko ophantsi weengozi ye-PCa engozini [70]. Ukutya kweMedithera, ephakamileyo kwimifuno, ioli yeoli, ii-carbohydrates eziyinkimbinkimbi, inyama ezinomzimba kunye nama-antioxidants, ihlala ikhuthazwa kwizigulane zokukhusela Isifo senhliziyo kunye nokukhuluphala [184], kwaye ingabonisa isithembiso kwi-PCa thintelo [185]. Intlanzi kunye ne-omega-3 e-fatty usetyenziso lwe-acid kwiMeditera yayiphathelene kakhulu ne-PCa engozi. Ukongezelela, ukunyamekela kokutya kweMedithera emva kokuxilongwa kwe-PCa engekho-metastatic kwakuxhomekeke ekufeni kwabantu abaphantsi [186]. Nangona, i-Western pattern kunye nokutya okuphakamileyo kwezilwanyana ezibomvu, iindiza ezicwangcisiweyo, iintlanzi ezibikiweyo, iifips, ubisi obuninzi beoli kunye nesonka esimhlophe, zidibene nomngcipheko ophezulu we-PCa [187].
Ngapha koko, amazwe aseAsia asebenzisa kakhulu i-omega-3 PUFAs, i-soy kunye ne-phytochemicals esekwe kwiti eluhlaza, aneziganeko eziphantsi ze-PCa ngokuchasene namazwe atya "indlela yaseNtshona" yokutya [188]. Nangona kunjalo, akuzona zonke izifundo [189-191] ezixhasa umbutho phakathi kwendlela ethile yokutya kunye nomngcipheko we-PCa. Kungenzeka ukuba indlela esetyenzisiweyo ekuchongeni iipatheni zokutya ayinakuthatha zonke izinto zokutya ezinxulumene ne-PCa ingozi. Kungenjalo, ipateni nganye yokutya inokuqulatha zombini izinto eziluncedo neziyingozi ezikhokelela kumanyano olungelulo. Uphando olongezelelweyo luyafuneka ukuqhubeka nokukhangela iipatheni zokutya ezidibanisa uninzi lwezondlo ezinoncedo / izinto zokutya ze-PCa kunye nokunciphisa uninzi lwezondlo ezingalunganga / izinto zokutya.
Isikhokelo Esizayo Kwiimvavanyo Zoklinikhi
Ngokusekelwe kwisihlwele se-epidemiologic, izilingo zengqungquthela kunye neekliniki ezichazwe kule ngongoma, ukungenelela kokutya ukukhusela kunye nokunyangwa kwe-PCa kubambe isithembiso esikhulu. Ukongezelela, izinto ezininzi zokutya kunye namavithamini / izongezelo zingabandakanywa ne-PCa mngcipheko kunye / okanye ukuqhubeka kwezifo. Izilingo ezinokuthi zenzeke ngokungafaniyo ziboniswa ngokucacileyo ukuba zichonge izondlo ezithile okanye iindlela zokudibanisa zokukhusela kunye nokonyango kwe-PCa.
Kungekudala, ukukhangela okusebenzayo (AS) kuye kwavela njengendlela efanelekileyo kumadoda ane-PCa ephantsi yomngcipheko. Amadoda akwi-AS akhuthazwa ukuba abambelele kwisondlo kunye nokuguqulwa kwendlela yokuphila [192], okwenza le nxalenye ibe yinto ekujoliswe kuyo kungenelelo lokutya kunye nomgangatho wezilingo zobomi [193]. Abasindileyo be-PCa abasebenza ngakumbi kwaye baxela "indlela enempilo" yokutya (oko kukuthi, ukutya okunamafutha aphantsi, okucokisekileyo okuncinci kwe-carbohydrates okutyebileyo kwiziqhamo kunye nemifuno) banomgangatho ongcono wobomi ngokuchasene nabalingane babo abangasebenziyo, abangenampilo [194]. Ngaloo ndlela, iimvavanyo ezingaphezulu kwe-random zigunyazisiweyo ukugqiba imiphumo yexesha elide lokungenelela kokutya kulo luntu. Ngokukodwa, imibuzo ephambili yokujongana nezilingo ezizayo zezi: 1) Ngaba ungenelelo lokutya lulibazisa imfuno yonyango kumadoda kwi-AS; I-2) Ngaba ukungenelela kokutya kukuthintela ukuphindaphinda kwamadoda emva kokunyanga; 3) Ngaba ukungenelela kokutya kunokulibazisa ukuqhubela phambili phakathi kwamadoda anesifo esiphindaphindiweyo kwaye, ngoko, ukulibazisa imfuno yonyango lwe-hormonal; I-4) Ngaba ukungenelela kokutya kunganciphisa imiphumo yecala ye-PCa zonyango kubandakanywa unyango lwe-hormonal kunye nonyango olutsha olujoliswe kuyo; kunye ne-5) Ngaba kukho nayiphi na indima yokungenelela kokutya yedwa okanye kudibaniswa nonyango olujoliswe kumadoda kunyango lwe-hormonal ukukhusela ukuxhatshazwa kwe-castrate okanye emva kokuvela kwesifo sokumelana ne-castrate? Ngenxa yokuba ubungqina obuninzi bubonisa ukuba ukungahambi kakuhle kwe-metabolic kwandisa umngcipheko we-PCa, ukungenelela kwindlela yokuphila ephucula iphrofayili ye-metabolic yindlela yokuwina yokukhusela i-PCa kunye nonyango [195,196].
Izigqibo: I-Cancer Cancer
Uphando lwexesha elizayo luyafuneka ukugqiba ukutya okufanelekileyo kwi-PCa yokuthintela okanye unyango. Nangona kunjalo, izinto ezininzi zokutya kunye nezinye iipatheni zokutya zibambe isithembiso ekunciphiseni ingozi ye-PCa okanye ukuqhubela phambili kwaye iyahambelana nezikhokelo zokutya zaseMelika [197]. Ukucebisa izigulane malunga nokutya kwiprayimari kunye nesekondari ye-PCa yokuthintela, abaninzi bakholelwa ukuba "intliziyo ephilileyo ilingana ne-prostate enempilo." Ngaloo ndlela, ukunikezelwa kweziphumo ezingabonakaliyo zangoku, isiluleko esilungileyo sokutya kwi-PCa yokuthintela okanye ukulawula kubonakala kubandakanya: ukwandisa iziqhamo kunye nemifuno, ithathe indawo ecocekileyo. I-carbohydrates eneenkozo ezipheleleyo, ukunciphisa amanqatha apheleleyo kunye ahluthayo, ukunciphisa inyama ephekwe kakhulu kunye nokutya umlinganiselo ophakathi weekhalori okanye ukunciphisa i-carbohydrates ngenjongo ephambili yokufumana kunye nokugcina ubunzima bomzimba obunempilo.
Ukunyanzela umdla Ababhali bavakalisa ukuba abanalo inxaxheba.
Igalelo lababhali i-P-HL kunye ne-SF yenze uphononongo, i-P-HL yabhala umbhalo-ngqangi kunye ne-SF kunye ne-WA ehleliweyo kwaye yanika igalelo elibalulekileyo. Bonke ababhali bafunde kwaye bavuma umbhalo-ngqangi wokugqibela.
Ukubonga Iinkxaso zanikezelwa ngamagranti 1K24CA160653 (Freedland), NIH P50CA92131 (W. Aronson). Le ngqangi isiphumo somsebenzi oxhaswe nezixhobo kunye nokusetyenziswa kwezibonelelo kwiziko loLawulo lwezonyango lwe-Veterans, eNtshona Los Angeles (W. Aronson).
Inkcazelo yoMbhali iSebe lezeMpilo le-1, iCandelo leNefrology, i-Duke University Centre Centre, iBhokisi 3487, iDurham, NC NC27710, eU.SA. ICandelo le-2 ye-Urology, iSebe lezoPhepha, iiMantshi e-Greater Los Angeles, inkqubo yezempilo, eLos Angeles, CA, eU.SA. I-3 Isebe le-Urology, i-UCLA School of Medicine, eLos Angeles, CA, eU.SA. Icandelo le-4 ye-Urology, iSebe leZonyango, i-Durham yezilwanyana zezoLimo, iCandelo le-Urology, iDurham, NC, eU.SA. I-5 Duke Prostate Centre, Amasebe Ophulo-mthetho kunye nePathology, i-Duke University Medical Centre, i-Durham, NC, eU.SA.
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Vala i-Accordion
Umgangatho wobuchule wokuSebenza *
Ulwazi olulapha ku "I-prostate Cancer, Isondlo kunye noNcedo lokutya"Akujoliswanga ukuthatha indawo yobudlelwane obubodwa kunye nomntu oqeqeshiweyo wezempilo okanye ugqirha onelayisensi kwaye akusiyo isiluleko sonyango. Sikhuthaza ukuba wenze izigqibo zezempilo ngokusekelwe kuphando lwakho kunye nentsebenziswano kunye nochwepheshe bezempilo abaqeqeshiweyo.
Ulwazi lweBlog kunye neengxoxo zoMda
Umda wethu wolwazi ilinganiselwe kwiChiropractic, i-musculoskeletal, amayeza omzimba, impilo, igalelo le-etiological ukuphazamiseka kwe-viscerosomatic ngaphakathi kweentetho zeklinikhi, ezinxulumene ne-somatovisceral reflex clinical dynamics, i-subluxation complexes, imiba yezempilo ebuthathaka, kunye / okanye amanqaku amayeza asebenzayo, izihloko kunye neengxoxo.
Sibonelela kwaye sibonise intsebenziswano yeklinikhi neengcaphephe kumacandelo ahlukeneyo. Ingcali nganye ilawulwa ngumsebenzi wabo wobugcisa kunye negunya labo lokufumana iphepha-mvume. Sisebenzisa iiprothokholi ezisebenzayo zempilo kunye nempilo entle ukunyanga nokuxhasa ukhathalelo lokwenzakala okanye ukuphazamiseka kwenkqubo ye-musculoskeletal.
Iividiyo zethu, izithuba, izihloko, imixholo, kunye nokuqonda zibandakanya imiba yezonyango, imiba, kunye nezihloko eziyelelene kwaye zixhase ngokuthe ngqo okanye ngokungathanga ngqo umda wokuziqhelanisa wethu.
I-ofisi yethu izamile ngokufanelekileyo ukubonelela ngeengcaphulo ezixhasayo kwaye ichonge uphando olufanelekileyo lophando okanye izifundo ezixhasa izithuba zethu. Sinikezela ngeekopi zophando ezixhasayo ezifumanekayo kwiibhodi ezilawulayo nakuluntu ngesicelo.
Siyaqonda ukuba sigubungela imicimbi efuna inkcazo eyongezelelweyo yokuba inganceda njani kwisicwangciso esithile sokhathalelo okanye inkqubo yonyango; ke, ukuqhubeka nokuxoxa ngombandela ongentla, nceda ukhululeke ukubuza UDkt Alex Jimenez, DC, okanye qha ga mshelana nathi 915-850-0900.
Silapha ukunceda wena kunye nosapho lwakho.
Iintsikelelo
UDkt Alex Jimenez D.C., I-MSACP, RN*, I-CCST, IFMCP*, I-CIFM*, I-ATN*
email: qeqeshi@elpasofunctionalmedicine.com
Ilayisenisi njengoGqirha weChiropractic (DC) kwi Texas & New Mexico*
Texas DC Ilayisensi # TX5807, New Mexico DC Ilayisensi # I-NM-DC2182
Unikwe Ilayisensi njengoMongikazi oBhalisiweyo (RN*) in Florida
Florida License RN Ilayisensi # I-RN9617241 (Nombolo yolawulo. 3558029)
Ubume obubambeneyo: ILayisensi yeeNkcazo ezininzi: Ugunyaziswe Ukuziqhelanisa I-40 States*
UGqr. Alex Jimenez DC, MSACP, RN* CIFM*, IFMCP*, ATN*, CCST
Ikhadi lam loShishino lweDijithali
