Zusammenfassung
Etliche Aspekte der Ernährung und Lebensgewohnheiten könnten für die Entwicklung unterschiedlicher
Krebsarten in westlichen Ländern verantwortlich sein. Vor allem die Unterschiede zwischen
den Brustkrebsraten zwischen den einzelnen Ländern, den Änderungen der Krebsinzidenz
unter Emigranten und den raschen Wandel dieser Inzidenz in den verschiedenen Ländern
deuten darauf hin. Der Anstieg der Mammakarzinominzidenz in den modernen Industrieländern
wird sehr häufig mit veränderten Umweltbedingungen in Zusammenhang gebracht. Mit zunehmender
Aufklä rung in der Bevölkerung und steigendem Gesundheitsbewusstsein werden verschiedenste
Faktoren gesucht, die maßgeblich zur Entstehung von Brustkrebs beitragen oder diesen
selbst auslösen. Durch Ausschaltung dieser vermeintlich krebserregenden Umweltfaktoren
oder aber gezielten Ersatz von Defiziten würde letztlich ein präventiver Ansatz verfügbar
sein. Der karzinogene Effekt von Ernährung und Lebensgewohnheiten könnte indirekt
durch Zellstimulierungen (Alkohol, Hormonersatztherapie), Hemmung von DNA-Reparaturmechanismen
(Mangel an Vitaminen), Beeinflussung des Östrogenmetabolismus (Phytoestrogene) oder
als produktiver Faktor des Wachstums von Tumoren (Körpermassenindex) zurückzuführen
sein. Einige „Substanzen” sind direkte Karzinogene, wie z. B. aromatische Kohlenwasserstoffe
in Tabak oder polyzyklische aromatische Kohlenwasserstoffe im gebratenen Fleisch.
Individuelle Wirkungsunterschiede von Nahrungsstoffen auf das Brustepithel könnte
durch genetische Polymorphismen bedingt sein. In dieser Übersicht konzentrieren wir
uns auf gegenwärtige Daten bezü glich der Wirkung von Ernährung und Lebensgewohnheiten
auf das Risiko der Entstehung von Brustkrebs. Gesunde Lebensgewohnheiten, welche u.
a. aus einer „gesunden” Ernährung, physischer Aktivität und Verzicht auf Stimulanzien
besteht, wird von Beginn der Kindheit über das ganze Leben empfohlen.
Abstract
Aspects of nutrition and lifestyle may be largely responsible for the development
of common cancers in Western countries, as indicated by the large differences in breast
cancer rates between countries, the striking changes in these rates among migrating
populations, and the rapid changes over time within countries. The better informed
and increasingly health-conscious population of the present day are intensively seeking
to identify and eliminate these putative carcinogenic risk factors and to exploit
the preventive effects that have been attributed to certain dietary components. Nutrition
and ‘lifestyle’ may exert its carcinogenic effects indirectly by cell stimulations
(alcohol, hormon replacement therapy), inhibition of DNA-repair mechanisms (lack of
vitamines), effecting estrogen metabolism (phytoestrogenes), or as promotors to enhance
growth of tumors (body mass index). Some ‘substances’ may act as a carcinogenic itself,
e. g. aromatic hydrocarbons in tobacco or increased polycyclic aromatic hydrocarbons
in well done meat. Individual differences in the effects of nutritional factors on
mammary epithelia could be caused by genetic polymorphisms. In this critical review,
we focus on current data regarding the effect of nutrition and lifestyle, on the risk
of developing breast cancer. A health lifestyle, consisting of „healthy diet”, physical
activity, renunciation of stimulants, is recommended from childhood throughout life.
Schlüsselwörter
Brustkrebs - Ernährung - Lebensgewohnheiten - Prävention - Risikofaktoren
Key words
Breast cancer - nutrition - lifestyle - prevention - risk factors
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Prof. Dr. med. Bernd Gerber
I. Frauenklinik, Klinikum Innenstadt · Ludwig-Maximilians-Universität München
Maistraße 11
80337 München
Phone: +49/89/51 60-45 13
Fax: +49/89/51 60-46 62
Email: bernd.gerber@fk-i.med.uni-muenchen.de