推荐意见12b：推荐增加豆类摄入降低胃癌发生风险（弱推荐，证据级别：低）。 豆类食品主要包括大豆、蚕豆、红豆、绿豆、黄豆和黑豆等，豆类中的主要营养成分包括碳水化合物、蛋白质和脂肪等。 豆制品可分为发酵豆制品（如腐乳、豆豉等）和非发酵豆制品。综合分析截止至2021年全球10项队列研究和21项病例对照数据的结果［34］显示，摄入大豆可以使胃癌风险降低36%，而大量摄入发酵豆制品会使胃癌的风险增加19%（表14）。这表明大豆食品的有益作用可能与是否发酵有关。大豆的这种有益作用可能归因于一些有益化学成分，例如皂苷和异黄酮。而发酵豆制品含有大量的盐分和致癌的亚硝酸盐化合物，可能会抵消其有益成分的抗癌作用，也会损伤胃黏膜和改变胃内细菌环境。因此，建议多吃非发酵豆制品，少吃发酵豆制品。 参考文献（下滑查看）： [1]SungH, FerlayJ, SiegelRL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021, 71(3): 209-249. DOI: 10.3322/caac.21660. [2]ThriftAP, El-SeragHB. Burden of gastric cancer[J]. Clin Gastroenterol Hepatol, 2020, 18(3): 534-542. DOI: 10.1016/j.cgh.2019.07.045. [3]XiaC, DongX, LiH, et al. Cancer statistics in China and united states, 2022: profiles, trends, and determinants[J]. Chin Med J (Engl), 2022, 135(5): 584-590. DOI: 10.1097/CM9.0000000000002108. [4]中华医学会肿瘤学分会, 中华医学会杂志社. 中华医学会胃癌临床诊疗指南(2021版)[J]. 中华医学杂志, 2022, 102(16): 1169-1189. 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