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Dietary and Physical Activity Interventions for Colorectal Cancer Survivors: A Randomized Controlled Trial. Sci Rep 2018; 8:5731. [PMID: 29636539 PMCID: PMC5893594 DOI: 10.1038/s41598-018-24042-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 03/26/2018] [Indexed: 11/25/2022] Open
Abstract
There has been evidence on the protective effects of diets high in fiber and low in red and processed meat (RPM), and physical activity (PA) against colorectal cancer (CRC) development, but that against CRC recurrence has been limited. This study evaluated the efficacy of a behavioral program comprising dietary and PA interventions in improving Chinese CRC survivors’ lifestyle. A 2 × 2 factorial randomized controlled trial of 223 CRC patients (82 females, mean age 65), randomly assigned to receive dietary, PA or both interventions, or usual care for 12 months, and assessed every 6 months for 24 months. Primary outcomes included two dietary and two PA targets. Secondary outcomes included changes in dietary consumptions and PA levels. Dietary interventions significantly increased the odds of achieving the targets of consuming less RPM at all time-points (OR 3.22–4.57, all p < 0.01) and refined grain (RG) at months 6 (OR 3.13, p = 0.002) and 24 (OR 2.19, p = 0.039), and reduced RPM (2.49–3.48 servings/week, all p < 0.01) and RG (0.31–0.5 servings/day, all p < 0.01) consumptions. Patients receiving PA interventions potentially spent more time on moderate-to-vigorous PA. This study demonstrated the efficacy of a behavioral program in improving dietary habits of Chinese CRC survivors.
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102
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Yu D, Zheng W, Cai H, Xiang YB, Li H, Gao YT, Shu XO. Long-term Diet Quality and Risk of Type 2 Diabetes Among Urban Chinese Adults. Diabetes Care 2018; 41:723-730. [PMID: 29269510 PMCID: PMC5860845 DOI: 10.2337/dc17-1626] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 11/25/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Little evidence exists regarding long-term diet quality and the risk of type 2 diabetes among Asian populations, who have undergone a nutrition transition and a diabetes epidemic. RESEARCH DESIGN AND METHODS A total of 117,919 Chinese men and women, 40-74 years old, free of diabetes, cardiovascular disease, and cancer at baseline, were followed from 1996 to 2015. Diet quality was assessed by a healthy diet score (HDS) based on eight commonly consumed food groups previously suggested to be related to diabetes. Long-term diet quality and its changes were assessed by repeated surveys using food-frequency questionnaires. RESULTS We identified 6,111 incident diabetes cases during a mean follow-up of 11.5 years. Higher HDS was associated with lower diabetes risk (hazard ratio [HR] 0.85 [95% CI 0.78-0.92] in the highest vs. lowest quintile, Pcontinuous <0.0001) after adjustment for potential confounders including BMI. Maintaining a high HDS during follow-up was associated with 26% lower risk compared with a consistently low HDS (HR 0.74 [95% CI 0.63-0.85]). The inverse association between HDS and diabetes was observed regardless of participants' age, sex, smoking and exercise habits, obesity status, and metabolic disease status but was more prominent among those who participated in leisure-time exercise (Pinteraction = 0.004). When considered jointly, a sustained high HDS plus exercise was associated with a 45% reduced risk of diabetes (HR 0.55 [95% CI 0.45-0.67]). CONCLUSIONS A high-quality diet, especially maintained over the long term and in conjunction with leisure-time exercise, is associated with lower risk of type 2 diabetes among urban Chinese adults.
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Affiliation(s)
- Danxia Yu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, TN
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, TN
| | - Hui Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, TN
| | - Yong-Bing Xiang
- State Key Laboratory of Oncogene and Related Genes and Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China
| | - Honglan Li
- State Key Laboratory of Oncogene and Related Genes and Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China
| | - Yu-Tang Gao
- State Key Laboratory of Oncogene and Related Genes and Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, TN
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103
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Wu L, Zheng W, Xiang YB, Gao YT, Li HL, Cai H, Shu XO. Physical Activity and Pancreatic Cancer Risk among Urban Chinese: Results from Two Prospective Cohort Studies. Cancer Epidemiol Biomarkers Prev 2018; 27:479-487. [PMID: 29475964 PMCID: PMC5971116 DOI: 10.1158/1055-9965.epi-17-0895] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 01/04/2018] [Accepted: 01/29/2018] [Indexed: 12/27/2022] Open
Abstract
Background: Associations between physical activity and pancreatic cancer risk are unclear.Methods: In two prospective cohort studies, the Shanghai Women's Health Study and Shanghai Men's Health Study, physical activity and other information were collected at the baseline interview of 72,451 women and 60,037 men. Participants were followed up through annual linkage with a cancer registry in combination with in-person interviews taking place every 2 to 4 years.Results: We identified 225 female and 159 male cases during a median follow up of 16.1 and 10.3 years, respectively. Adult exercise participation was significantly associated with a decreased pancreatic cancer risk in men [hazard ratio (HR), 95% confidence interval (CI): 0.71 (0.50-1.00)]. Meeting the recommended minimum exercise threshold to achieve health benefits of 150 min/week of moderate-intensity or 75 min/week of vigorous-intensity exercise was associated with further decreased pancreatic cancer risk [HR (95% CI): 0.59 (0.40-0.87)]. We also observed an inverse association between adolescent physical activity and pancreatic cancer risk in men [HR (95% CI): 0.54 (0.33-0.90)]. Exercise throughout one's lifetime was associated with a 68% decrease in pancreatic cancer risk [HR (95% CI): 0.32 (0.16-0.66)]. No significant association was found in women. Adult non-exercise daily activity and occupational activity were not associated with pancreatic cancer risk in either men or women.Conclusions: Adult exercise and adolescent physical activity were significantly associated with a decreased pancreatic cancer risk in men but not in women.Impact: These findings underscore the importance of investigating the possible modification by sex on the exercise and pancreatic cancer risk association. Cancer Epidemiol Biomarkers Prev; 27(4); 479-87. ©2018 AACR.
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Affiliation(s)
- Lang Wu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Yong-Bing Xiang
- State Key Laboratory of Oncogene and Related Genes & Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yu-Tang Gao
- State Key Laboratory of Oncogene and Related Genes & Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hong-Lan Li
- State Key Laboratory of Oncogene and Related Genes & Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hui Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee.
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Gosadi IM, Alatar AA, Otayf MM, AlJahani DM, Ghabbani HM, AlRajban WA, Alrsheed AM, Al-Nasser KA. Development of a Saudi Food Frequency Questionnaire and testing its reliability and validity. Saudi Med J 2018; 38:636-641. [PMID: 28578444 PMCID: PMC5541188 DOI: 10.15537/smj.2017.6.20055] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To create a food frequency questionnaire specifically designed to capture the dietary habits of Saudis and test its validity and reliability. Methods: This investigation is a longitudinal, test-retest study conducted in King Saud University, Riyadh, Kingdom of Saudi Arabia between December 2015 and March 2016. A list of 140 food items was included in the questionnaire where a closed-ended and open-ended approach was used. Regarding past year food frequency consumption and 24 hours dietary recall, body weight and height were collected. Internal consistency, test-retest reliability, completeness of the food list, and criterion validity were assessed. Results: One-hundred and thirty eight participants were interviewed to complete the 24 hours dietary recall and the constructed questionnaire. Approximately 85% of the food items reported in the dietary recall were covered in the food frequency questionnaire. The association of body mass index with meats (regression coefficients: 2.28) and dairy products consumption frequency was statistically significant (regression coefficients: 2.31). A high overall reproducibility rate of the questionnaire was detected (Pearsons' correlation coefficient: 0.78 p less than 0.001). Conclusion: The developed questionnaire has a high reliability and reasonable validity, and suitable for use in nutritional epidemiological investigations in Saudi Arabia.
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Affiliation(s)
- Ibrahim M Gosadi
- Prince Sattam Chair for Epidemiology and Public Health Research, Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail.
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Joint Effects of PON1 Polymorphisms and Vegetable Intake on Ischemic Stroke: A Family-Based Case Control Study. Int J Mol Sci 2017; 18:ijms18122652. [PMID: 29215590 PMCID: PMC5751254 DOI: 10.3390/ijms18122652] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 11/04/2017] [Indexed: 12/18/2022] Open
Abstract
Paraoxonase 1 gene (PON1) polymorphisms and dietary vegetable and fruit intake are both established determinants of ischemic stroke (IS). However, little is known about whether these factors jointly influence the risk of IS. We analyzed the main effects of PON1, as well as the interactions between PON1 and dietary vegetable or fruit intake with the risk of total IS and its subtypes in a family-based case-control study conducted among 2158 Chinese participants (1007 IS cases and 1151 IS-free controls) from 918 families. Conditional logistic regression models, with each family as a stratum, were used to examine the association between rs662 and IS. Gene-diet interactions were tested by including a cross-product term of dietary vegetable or fruit intake by rs662_G allele count in the models. Each copy of the PON1 rs662_G allele was associated with 28% higher risk of total IS (p = 0.008) and 32% higher risk of large artery atherosclerosis subtype (LAA) (p = 0.01). We observed an interaction between rs662 and vegetable intake for both total IS (p = 0.006) and LAA (p = 0.02) after adjustment for covariates. Individuals who carry the rs662_A allele may benefit to a greater extent from intake of vegetables and thus be more effectively protected from ischemic stroke, whereas carriers of the G allele may still remain at greater risk for ischemic stroke due to their genetic backgrounds even when they consume a high level of vegetables. More studies are needed to replicate our findings among other populations.
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106
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Sanjeevi N, Freeland-Graves J, George GC. Relative Validity and Reliability of a 1-Week, Semiquantitative Food Frequency Questionnaire for Women Participating in the Supplemental Nutrition Assistance Program. J Acad Nutr Diet 2017; 117:1972-1982.e2. [DOI: 10.1016/j.jand.2017.05.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Accepted: 05/12/2017] [Indexed: 11/16/2022]
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Shu X, Cai H, Xiang YB, Li H, Lipworth L, Miller NL, Zheng W, Shu XO, Hsi RS. Nephrolithiasis Among Middle Aged and Elderly Urban Chinese: A Report from Prospective Cohort Studies in Shanghai. J Endourol 2017; 31:1327-1334. [PMID: 29048227 DOI: 10.1089/end.2017.0467] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Kidney stone risk factors are understudied among Asians. Our study objective was to investigate associations of obesity and other chronic diseases with incident kidney stones among the urban Chinese. PATIENTS AND METHODS Included in this study are two prospective cohorts: the Shanghai Women's Health Study (N = 69,166) and Shanghai Men's Health Study (N = 58,054). Incident kidney stones were determined by self-report in 2004 and 2008. Cox regression models were used to evaluate the associations of study variables with stone risk with adjustment of demographics, medical history, and dietary intakes. RESULTS There were 2653 incident stones over 1,007,958 person-years of follow-up. Overall incidence rates (per 1000 person-years, 95% confidence interval [CI]) were 2.10 (1.99, 2.21) among women and 3.80 (3.59, 4.02) among men. Higher body mass index (BMI) was associated with risk (BMI ≥25 vs 18.5-24.9 kg/m2, women: hazard ratio [HR] = 1.14 [95% CI 1.01, 1.28]; men: HR = 1.17 [1.03, 1.32]). High waist-hip ratio (≥0.80 and ≥0.90 for women and men, respectively) was associated with risk (HR 1.13, 95% CI 1.01, 1.27 for women; HR 1.19, 95% CI 1.05, 1.35 for men). Coronary heart disease or stroke history was associated with risk in women only (HR 1.31, 95% CI 1.10, 1.56). Hypertension history was associated with risk in men only (HR 1.27, 95% CI 1.11, 1.45). No significant association with diabetes mellitus was observed. CONCLUSIONS Among the Chinese, kidney stone incidence in men is almost twice that of women. Obesity is a shared risk factor. Hypertension history is associated with risk in men, whereas history of coronary heart disease or stroke is associated with risk in women.
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Affiliation(s)
- Xiang Shu
- 1 Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center , Nashville, Tennessee
| | - Hui Cai
- 1 Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center , Nashville, Tennessee
| | - Yong-Bing Xiang
- 2 SKLORG & Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine , Shanghai, China
| | - Honglan Li
- 2 SKLORG & Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine , Shanghai, China
| | - Loren Lipworth
- 1 Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center , Nashville, Tennessee
| | - Nicole L Miller
- 3 Department of Urologic Surgery, Vanderbilt University Medical Center , Nashville, Tennessee
| | - Wei Zheng
- 1 Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center , Nashville, Tennessee
| | - Xiao-Ou Shu
- 1 Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center , Nashville, Tennessee
| | - Ryan S Hsi
- 3 Department of Urologic Surgery, Vanderbilt University Medical Center , Nashville, Tennessee
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108
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Yang JJ, Yu D, Takata Y, Smith-Warner SA, Blot W, White E, Robien K, Park Y, Xiang YB, Sinha R, Lazovich D, Stampfer M, Tumino R, Aune D, Overvad K, Liao L, Zhang X, Gao YT, Johansson M, Willett W, Zheng W, Shu XO. Dietary Fat Intake and Lung Cancer Risk: A Pooled Analysis. J Clin Oncol 2017; 35:3055-3064. [PMID: 28742456 PMCID: PMC5590804 DOI: 10.1200/jco.2017.73.3329] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Purpose Dietary fat may play a role in lung carcinogenesis. Findings from epidemiologic studies, however, remain inconsistent. In this pooled analysis of 10 prospective cohort studies from the United States, Europe, and Asia, we evaluated the associations of total and specific types of dietary fat with lung cancer risk. Methods Cox regression was used to estimate hazard ratios (HRs) and 95% CIs in each cohort. Study-specific risk estimates were pooled by random- or fixed-effects meta-analysis. The first 2 years of follow-up were excluded to address potential influence of preclinical dietary changes. Results Among 1,445,850 participants, 18,822 incident cases were identified (mean follow-up, 9.4 years). High intakes of total and saturated fat were associated with an increased risk of lung cancer (for highest v lowest quintile: HR, 1.07 and 1.14, respectively; 95% CI, 1.00 to 1.15 and 1.07 to 1.22, respectively; P for trend for both < .001). The positive association of saturated fat was more evident among current smokers (HR, 1.23; 95% CI, 1.13 to 1.35; P for trend < .001) than former/never smokers ( P for interaction = .004), and for squamous cell and small cell carcinoma (HR, 1.61 and 1.40, respectively; 95% CI, 1.38 to 1.88 and 1.17 to 1.67, respectively; P for trend for both < .001) than other histologic types ( P for heterogeneity < .001). In contrast, a high intake of polyunsaturated fat was associated with a decreased risk of lung cancer (HR, 0.92; 95% CI, 0.87 to 0.98 for highest v lowest quintile; P for trend = .02). A 5% energy substitution of saturated fat with polyunsaturated fat was associated with a 16% to 17% lower risk of small cell and squamous cell carcinoma. No associations were found for monounsaturated fat. Conclusion Findings from this large, international cohort consortium suggest that modifying dietary fat intake (ie, replacing saturated fat with polyunsaturated fat) may reduce lung cancer risk, particularly among smokers and for squamous cell and small cell carcinoma.
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Affiliation(s)
- Jae Jeong Yang
- Jae Jeong Yang, Danxia Yu, Yumie Takata, William Blot, Wei Zheng, and Xiao-Ou Shu, Vanderbilt University Medical Center, Nashville, TN; Yumie Takata, Oregon State University, Corvallis, OR; Stephanie A. Smith-Warner, Meir Stampfer, and Walter Willett, Harvard T.H. Chan School of Public Health, Boston, MA; Emily White, Fred Hutchinson Cancer Research Center, Seattle, WA; Kim Robien, George Washington University, Washington, DC; Yikyung Park, Washington University School of Medicine, St Louis, MO; Yong-Bing Xiang and Yu-Tang Gao, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; Rashmi Sinha and Linda Liao, National Cancer Institute, Bethesda, MD; DeAnn Lazovich, University of Minnesota, Minneapolis, MN; Rosario Tumino, “Civic – M.P. Arezzo” Hospital, ASP Ragusa, Italy; Dagfinn Aune, Imperial College, London, United Kingdom; Kim Overvad, Aarhus University, Aarhus, Denmark; Xuehong Zhang, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA; Mattias Johansson, International Agency for Research on Cancer, Lyons, France
| | - Danxia Yu
- Jae Jeong Yang, Danxia Yu, Yumie Takata, William Blot, Wei Zheng, and Xiao-Ou Shu, Vanderbilt University Medical Center, Nashville, TN; Yumie Takata, Oregon State University, Corvallis, OR; Stephanie A. Smith-Warner, Meir Stampfer, and Walter Willett, Harvard T.H. Chan School of Public Health, Boston, MA; Emily White, Fred Hutchinson Cancer Research Center, Seattle, WA; Kim Robien, George Washington University, Washington, DC; Yikyung Park, Washington University School of Medicine, St Louis, MO; Yong-Bing Xiang and Yu-Tang Gao, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; Rashmi Sinha and Linda Liao, National Cancer Institute, Bethesda, MD; DeAnn Lazovich, University of Minnesota, Minneapolis, MN; Rosario Tumino, “Civic – M.P. Arezzo” Hospital, ASP Ragusa, Italy; Dagfinn Aune, Imperial College, London, United Kingdom; Kim Overvad, Aarhus University, Aarhus, Denmark; Xuehong Zhang, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA; Mattias Johansson, International Agency for Research on Cancer, Lyons, France
| | - Yumie Takata
- Jae Jeong Yang, Danxia Yu, Yumie Takata, William Blot, Wei Zheng, and Xiao-Ou Shu, Vanderbilt University Medical Center, Nashville, TN; Yumie Takata, Oregon State University, Corvallis, OR; Stephanie A. Smith-Warner, Meir Stampfer, and Walter Willett, Harvard T.H. Chan School of Public Health, Boston, MA; Emily White, Fred Hutchinson Cancer Research Center, Seattle, WA; Kim Robien, George Washington University, Washington, DC; Yikyung Park, Washington University School of Medicine, St Louis, MO; Yong-Bing Xiang and Yu-Tang Gao, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; Rashmi Sinha and Linda Liao, National Cancer Institute, Bethesda, MD; DeAnn Lazovich, University of Minnesota, Minneapolis, MN; Rosario Tumino, “Civic – M.P. Arezzo” Hospital, ASP Ragusa, Italy; Dagfinn Aune, Imperial College, London, United Kingdom; Kim Overvad, Aarhus University, Aarhus, Denmark; Xuehong Zhang, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA; Mattias Johansson, International Agency for Research on Cancer, Lyons, France
| | - Stephanie A. Smith-Warner
- Jae Jeong Yang, Danxia Yu, Yumie Takata, William Blot, Wei Zheng, and Xiao-Ou Shu, Vanderbilt University Medical Center, Nashville, TN; Yumie Takata, Oregon State University, Corvallis, OR; Stephanie A. Smith-Warner, Meir Stampfer, and Walter Willett, Harvard T.H. Chan School of Public Health, Boston, MA; Emily White, Fred Hutchinson Cancer Research Center, Seattle, WA; Kim Robien, George Washington University, Washington, DC; Yikyung Park, Washington University School of Medicine, St Louis, MO; Yong-Bing Xiang and Yu-Tang Gao, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; Rashmi Sinha and Linda Liao, National Cancer Institute, Bethesda, MD; DeAnn Lazovich, University of Minnesota, Minneapolis, MN; Rosario Tumino, “Civic – M.P. Arezzo” Hospital, ASP Ragusa, Italy; Dagfinn Aune, Imperial College, London, United Kingdom; Kim Overvad, Aarhus University, Aarhus, Denmark; Xuehong Zhang, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA; Mattias Johansson, International Agency for Research on Cancer, Lyons, France
| | - William Blot
- Jae Jeong Yang, Danxia Yu, Yumie Takata, William Blot, Wei Zheng, and Xiao-Ou Shu, Vanderbilt University Medical Center, Nashville, TN; Yumie Takata, Oregon State University, Corvallis, OR; Stephanie A. Smith-Warner, Meir Stampfer, and Walter Willett, Harvard T.H. Chan School of Public Health, Boston, MA; Emily White, Fred Hutchinson Cancer Research Center, Seattle, WA; Kim Robien, George Washington University, Washington, DC; Yikyung Park, Washington University School of Medicine, St Louis, MO; Yong-Bing Xiang and Yu-Tang Gao, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; Rashmi Sinha and Linda Liao, National Cancer Institute, Bethesda, MD; DeAnn Lazovich, University of Minnesota, Minneapolis, MN; Rosario Tumino, “Civic – M.P. Arezzo” Hospital, ASP Ragusa, Italy; Dagfinn Aune, Imperial College, London, United Kingdom; Kim Overvad, Aarhus University, Aarhus, Denmark; Xuehong Zhang, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA; Mattias Johansson, International Agency for Research on Cancer, Lyons, France
| | - Emily White
- Jae Jeong Yang, Danxia Yu, Yumie Takata, William Blot, Wei Zheng, and Xiao-Ou Shu, Vanderbilt University Medical Center, Nashville, TN; Yumie Takata, Oregon State University, Corvallis, OR; Stephanie A. Smith-Warner, Meir Stampfer, and Walter Willett, Harvard T.H. Chan School of Public Health, Boston, MA; Emily White, Fred Hutchinson Cancer Research Center, Seattle, WA; Kim Robien, George Washington University, Washington, DC; Yikyung Park, Washington University School of Medicine, St Louis, MO; Yong-Bing Xiang and Yu-Tang Gao, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; Rashmi Sinha and Linda Liao, National Cancer Institute, Bethesda, MD; DeAnn Lazovich, University of Minnesota, Minneapolis, MN; Rosario Tumino, “Civic – M.P. Arezzo” Hospital, ASP Ragusa, Italy; Dagfinn Aune, Imperial College, London, United Kingdom; Kim Overvad, Aarhus University, Aarhus, Denmark; Xuehong Zhang, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA; Mattias Johansson, International Agency for Research on Cancer, Lyons, France
| | - Kim Robien
- Jae Jeong Yang, Danxia Yu, Yumie Takata, William Blot, Wei Zheng, and Xiao-Ou Shu, Vanderbilt University Medical Center, Nashville, TN; Yumie Takata, Oregon State University, Corvallis, OR; Stephanie A. Smith-Warner, Meir Stampfer, and Walter Willett, Harvard T.H. Chan School of Public Health, Boston, MA; Emily White, Fred Hutchinson Cancer Research Center, Seattle, WA; Kim Robien, George Washington University, Washington, DC; Yikyung Park, Washington University School of Medicine, St Louis, MO; Yong-Bing Xiang and Yu-Tang Gao, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; Rashmi Sinha and Linda Liao, National Cancer Institute, Bethesda, MD; DeAnn Lazovich, University of Minnesota, Minneapolis, MN; Rosario Tumino, “Civic – M.P. Arezzo” Hospital, ASP Ragusa, Italy; Dagfinn Aune, Imperial College, London, United Kingdom; Kim Overvad, Aarhus University, Aarhus, Denmark; Xuehong Zhang, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA; Mattias Johansson, International Agency for Research on Cancer, Lyons, France
| | - Yikyung Park
- Jae Jeong Yang, Danxia Yu, Yumie Takata, William Blot, Wei Zheng, and Xiao-Ou Shu, Vanderbilt University Medical Center, Nashville, TN; Yumie Takata, Oregon State University, Corvallis, OR; Stephanie A. Smith-Warner, Meir Stampfer, and Walter Willett, Harvard T.H. Chan School of Public Health, Boston, MA; Emily White, Fred Hutchinson Cancer Research Center, Seattle, WA; Kim Robien, George Washington University, Washington, DC; Yikyung Park, Washington University School of Medicine, St Louis, MO; Yong-Bing Xiang and Yu-Tang Gao, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; Rashmi Sinha and Linda Liao, National Cancer Institute, Bethesda, MD; DeAnn Lazovich, University of Minnesota, Minneapolis, MN; Rosario Tumino, “Civic – M.P. Arezzo” Hospital, ASP Ragusa, Italy; Dagfinn Aune, Imperial College, London, United Kingdom; Kim Overvad, Aarhus University, Aarhus, Denmark; Xuehong Zhang, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA; Mattias Johansson, International Agency for Research on Cancer, Lyons, France
| | - Yong-Bing Xiang
- Jae Jeong Yang, Danxia Yu, Yumie Takata, William Blot, Wei Zheng, and Xiao-Ou Shu, Vanderbilt University Medical Center, Nashville, TN; Yumie Takata, Oregon State University, Corvallis, OR; Stephanie A. Smith-Warner, Meir Stampfer, and Walter Willett, Harvard T.H. Chan School of Public Health, Boston, MA; Emily White, Fred Hutchinson Cancer Research Center, Seattle, WA; Kim Robien, George Washington University, Washington, DC; Yikyung Park, Washington University School of Medicine, St Louis, MO; Yong-Bing Xiang and Yu-Tang Gao, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; Rashmi Sinha and Linda Liao, National Cancer Institute, Bethesda, MD; DeAnn Lazovich, University of Minnesota, Minneapolis, MN; Rosario Tumino, “Civic – M.P. Arezzo” Hospital, ASP Ragusa, Italy; Dagfinn Aune, Imperial College, London, United Kingdom; Kim Overvad, Aarhus University, Aarhus, Denmark; Xuehong Zhang, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA; Mattias Johansson, International Agency for Research on Cancer, Lyons, France
| | - Rashmi Sinha
- Jae Jeong Yang, Danxia Yu, Yumie Takata, William Blot, Wei Zheng, and Xiao-Ou Shu, Vanderbilt University Medical Center, Nashville, TN; Yumie Takata, Oregon State University, Corvallis, OR; Stephanie A. Smith-Warner, Meir Stampfer, and Walter Willett, Harvard T.H. Chan School of Public Health, Boston, MA; Emily White, Fred Hutchinson Cancer Research Center, Seattle, WA; Kim Robien, George Washington University, Washington, DC; Yikyung Park, Washington University School of Medicine, St Louis, MO; Yong-Bing Xiang and Yu-Tang Gao, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; Rashmi Sinha and Linda Liao, National Cancer Institute, Bethesda, MD; DeAnn Lazovich, University of Minnesota, Minneapolis, MN; Rosario Tumino, “Civic – M.P. Arezzo” Hospital, ASP Ragusa, Italy; Dagfinn Aune, Imperial College, London, United Kingdom; Kim Overvad, Aarhus University, Aarhus, Denmark; Xuehong Zhang, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA; Mattias Johansson, International Agency for Research on Cancer, Lyons, France
| | - DeAnn Lazovich
- Jae Jeong Yang, Danxia Yu, Yumie Takata, William Blot, Wei Zheng, and Xiao-Ou Shu, Vanderbilt University Medical Center, Nashville, TN; Yumie Takata, Oregon State University, Corvallis, OR; Stephanie A. Smith-Warner, Meir Stampfer, and Walter Willett, Harvard T.H. Chan School of Public Health, Boston, MA; Emily White, Fred Hutchinson Cancer Research Center, Seattle, WA; Kim Robien, George Washington University, Washington, DC; Yikyung Park, Washington University School of Medicine, St Louis, MO; Yong-Bing Xiang and Yu-Tang Gao, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; Rashmi Sinha and Linda Liao, National Cancer Institute, Bethesda, MD; DeAnn Lazovich, University of Minnesota, Minneapolis, MN; Rosario Tumino, “Civic – M.P. Arezzo” Hospital, ASP Ragusa, Italy; Dagfinn Aune, Imperial College, London, United Kingdom; Kim Overvad, Aarhus University, Aarhus, Denmark; Xuehong Zhang, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA; Mattias Johansson, International Agency for Research on Cancer, Lyons, France
| | - Meir Stampfer
- Jae Jeong Yang, Danxia Yu, Yumie Takata, William Blot, Wei Zheng, and Xiao-Ou Shu, Vanderbilt University Medical Center, Nashville, TN; Yumie Takata, Oregon State University, Corvallis, OR; Stephanie A. Smith-Warner, Meir Stampfer, and Walter Willett, Harvard T.H. Chan School of Public Health, Boston, MA; Emily White, Fred Hutchinson Cancer Research Center, Seattle, WA; Kim Robien, George Washington University, Washington, DC; Yikyung Park, Washington University School of Medicine, St Louis, MO; Yong-Bing Xiang and Yu-Tang Gao, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; Rashmi Sinha and Linda Liao, National Cancer Institute, Bethesda, MD; DeAnn Lazovich, University of Minnesota, Minneapolis, MN; Rosario Tumino, “Civic – M.P. Arezzo” Hospital, ASP Ragusa, Italy; Dagfinn Aune, Imperial College, London, United Kingdom; Kim Overvad, Aarhus University, Aarhus, Denmark; Xuehong Zhang, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA; Mattias Johansson, International Agency for Research on Cancer, Lyons, France
| | - Rosario Tumino
- Jae Jeong Yang, Danxia Yu, Yumie Takata, William Blot, Wei Zheng, and Xiao-Ou Shu, Vanderbilt University Medical Center, Nashville, TN; Yumie Takata, Oregon State University, Corvallis, OR; Stephanie A. Smith-Warner, Meir Stampfer, and Walter Willett, Harvard T.H. Chan School of Public Health, Boston, MA; Emily White, Fred Hutchinson Cancer Research Center, Seattle, WA; Kim Robien, George Washington University, Washington, DC; Yikyung Park, Washington University School of Medicine, St Louis, MO; Yong-Bing Xiang and Yu-Tang Gao, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; Rashmi Sinha and Linda Liao, National Cancer Institute, Bethesda, MD; DeAnn Lazovich, University of Minnesota, Minneapolis, MN; Rosario Tumino, “Civic – M.P. Arezzo” Hospital, ASP Ragusa, Italy; Dagfinn Aune, Imperial College, London, United Kingdom; Kim Overvad, Aarhus University, Aarhus, Denmark; Xuehong Zhang, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA; Mattias Johansson, International Agency for Research on Cancer, Lyons, France
| | - Dagfinn Aune
- Jae Jeong Yang, Danxia Yu, Yumie Takata, William Blot, Wei Zheng, and Xiao-Ou Shu, Vanderbilt University Medical Center, Nashville, TN; Yumie Takata, Oregon State University, Corvallis, OR; Stephanie A. Smith-Warner, Meir Stampfer, and Walter Willett, Harvard T.H. Chan School of Public Health, Boston, MA; Emily White, Fred Hutchinson Cancer Research Center, Seattle, WA; Kim Robien, George Washington University, Washington, DC; Yikyung Park, Washington University School of Medicine, St Louis, MO; Yong-Bing Xiang and Yu-Tang Gao, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; Rashmi Sinha and Linda Liao, National Cancer Institute, Bethesda, MD; DeAnn Lazovich, University of Minnesota, Minneapolis, MN; Rosario Tumino, “Civic – M.P. Arezzo” Hospital, ASP Ragusa, Italy; Dagfinn Aune, Imperial College, London, United Kingdom; Kim Overvad, Aarhus University, Aarhus, Denmark; Xuehong Zhang, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA; Mattias Johansson, International Agency for Research on Cancer, Lyons, France
| | - Kim Overvad
- Jae Jeong Yang, Danxia Yu, Yumie Takata, William Blot, Wei Zheng, and Xiao-Ou Shu, Vanderbilt University Medical Center, Nashville, TN; Yumie Takata, Oregon State University, Corvallis, OR; Stephanie A. Smith-Warner, Meir Stampfer, and Walter Willett, Harvard T.H. Chan School of Public Health, Boston, MA; Emily White, Fred Hutchinson Cancer Research Center, Seattle, WA; Kim Robien, George Washington University, Washington, DC; Yikyung Park, Washington University School of Medicine, St Louis, MO; Yong-Bing Xiang and Yu-Tang Gao, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; Rashmi Sinha and Linda Liao, National Cancer Institute, Bethesda, MD; DeAnn Lazovich, University of Minnesota, Minneapolis, MN; Rosario Tumino, “Civic – M.P. Arezzo” Hospital, ASP Ragusa, Italy; Dagfinn Aune, Imperial College, London, United Kingdom; Kim Overvad, Aarhus University, Aarhus, Denmark; Xuehong Zhang, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA; Mattias Johansson, International Agency for Research on Cancer, Lyons, France
| | - Linda Liao
- Jae Jeong Yang, Danxia Yu, Yumie Takata, William Blot, Wei Zheng, and Xiao-Ou Shu, Vanderbilt University Medical Center, Nashville, TN; Yumie Takata, Oregon State University, Corvallis, OR; Stephanie A. Smith-Warner, Meir Stampfer, and Walter Willett, Harvard T.H. Chan School of Public Health, Boston, MA; Emily White, Fred Hutchinson Cancer Research Center, Seattle, WA; Kim Robien, George Washington University, Washington, DC; Yikyung Park, Washington University School of Medicine, St Louis, MO; Yong-Bing Xiang and Yu-Tang Gao, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; Rashmi Sinha and Linda Liao, National Cancer Institute, Bethesda, MD; DeAnn Lazovich, University of Minnesota, Minneapolis, MN; Rosario Tumino, “Civic – M.P. Arezzo” Hospital, ASP Ragusa, Italy; Dagfinn Aune, Imperial College, London, United Kingdom; Kim Overvad, Aarhus University, Aarhus, Denmark; Xuehong Zhang, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA; Mattias Johansson, International Agency for Research on Cancer, Lyons, France
| | - Xuehong Zhang
- Jae Jeong Yang, Danxia Yu, Yumie Takata, William Blot, Wei Zheng, and Xiao-Ou Shu, Vanderbilt University Medical Center, Nashville, TN; Yumie Takata, Oregon State University, Corvallis, OR; Stephanie A. Smith-Warner, Meir Stampfer, and Walter Willett, Harvard T.H. Chan School of Public Health, Boston, MA; Emily White, Fred Hutchinson Cancer Research Center, Seattle, WA; Kim Robien, George Washington University, Washington, DC; Yikyung Park, Washington University School of Medicine, St Louis, MO; Yong-Bing Xiang and Yu-Tang Gao, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; Rashmi Sinha and Linda Liao, National Cancer Institute, Bethesda, MD; DeAnn Lazovich, University of Minnesota, Minneapolis, MN; Rosario Tumino, “Civic – M.P. Arezzo” Hospital, ASP Ragusa, Italy; Dagfinn Aune, Imperial College, London, United Kingdom; Kim Overvad, Aarhus University, Aarhus, Denmark; Xuehong Zhang, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA; Mattias Johansson, International Agency for Research on Cancer, Lyons, France
| | - Yu-Tang Gao
- Jae Jeong Yang, Danxia Yu, Yumie Takata, William Blot, Wei Zheng, and Xiao-Ou Shu, Vanderbilt University Medical Center, Nashville, TN; Yumie Takata, Oregon State University, Corvallis, OR; Stephanie A. Smith-Warner, Meir Stampfer, and Walter Willett, Harvard T.H. Chan School of Public Health, Boston, MA; Emily White, Fred Hutchinson Cancer Research Center, Seattle, WA; Kim Robien, George Washington University, Washington, DC; Yikyung Park, Washington University School of Medicine, St Louis, MO; Yong-Bing Xiang and Yu-Tang Gao, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; Rashmi Sinha and Linda Liao, National Cancer Institute, Bethesda, MD; DeAnn Lazovich, University of Minnesota, Minneapolis, MN; Rosario Tumino, “Civic – M.P. Arezzo” Hospital, ASP Ragusa, Italy; Dagfinn Aune, Imperial College, London, United Kingdom; Kim Overvad, Aarhus University, Aarhus, Denmark; Xuehong Zhang, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA; Mattias Johansson, International Agency for Research on Cancer, Lyons, France
| | - Mattias Johansson
- Jae Jeong Yang, Danxia Yu, Yumie Takata, William Blot, Wei Zheng, and Xiao-Ou Shu, Vanderbilt University Medical Center, Nashville, TN; Yumie Takata, Oregon State University, Corvallis, OR; Stephanie A. Smith-Warner, Meir Stampfer, and Walter Willett, Harvard T.H. Chan School of Public Health, Boston, MA; Emily White, Fred Hutchinson Cancer Research Center, Seattle, WA; Kim Robien, George Washington University, Washington, DC; Yikyung Park, Washington University School of Medicine, St Louis, MO; Yong-Bing Xiang and Yu-Tang Gao, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; Rashmi Sinha and Linda Liao, National Cancer Institute, Bethesda, MD; DeAnn Lazovich, University of Minnesota, Minneapolis, MN; Rosario Tumino, “Civic – M.P. Arezzo” Hospital, ASP Ragusa, Italy; Dagfinn Aune, Imperial College, London, United Kingdom; Kim Overvad, Aarhus University, Aarhus, Denmark; Xuehong Zhang, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA; Mattias Johansson, International Agency for Research on Cancer, Lyons, France
| | - Walter Willett
- Jae Jeong Yang, Danxia Yu, Yumie Takata, William Blot, Wei Zheng, and Xiao-Ou Shu, Vanderbilt University Medical Center, Nashville, TN; Yumie Takata, Oregon State University, Corvallis, OR; Stephanie A. Smith-Warner, Meir Stampfer, and Walter Willett, Harvard T.H. Chan School of Public Health, Boston, MA; Emily White, Fred Hutchinson Cancer Research Center, Seattle, WA; Kim Robien, George Washington University, Washington, DC; Yikyung Park, Washington University School of Medicine, St Louis, MO; Yong-Bing Xiang and Yu-Tang Gao, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; Rashmi Sinha and Linda Liao, National Cancer Institute, Bethesda, MD; DeAnn Lazovich, University of Minnesota, Minneapolis, MN; Rosario Tumino, “Civic – M.P. Arezzo” Hospital, ASP Ragusa, Italy; Dagfinn Aune, Imperial College, London, United Kingdom; Kim Overvad, Aarhus University, Aarhus, Denmark; Xuehong Zhang, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA; Mattias Johansson, International Agency for Research on Cancer, Lyons, France
| | - Wei Zheng
- Jae Jeong Yang, Danxia Yu, Yumie Takata, William Blot, Wei Zheng, and Xiao-Ou Shu, Vanderbilt University Medical Center, Nashville, TN; Yumie Takata, Oregon State University, Corvallis, OR; Stephanie A. Smith-Warner, Meir Stampfer, and Walter Willett, Harvard T.H. Chan School of Public Health, Boston, MA; Emily White, Fred Hutchinson Cancer Research Center, Seattle, WA; Kim Robien, George Washington University, Washington, DC; Yikyung Park, Washington University School of Medicine, St Louis, MO; Yong-Bing Xiang and Yu-Tang Gao, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; Rashmi Sinha and Linda Liao, National Cancer Institute, Bethesda, MD; DeAnn Lazovich, University of Minnesota, Minneapolis, MN; Rosario Tumino, “Civic – M.P. Arezzo” Hospital, ASP Ragusa, Italy; Dagfinn Aune, Imperial College, London, United Kingdom; Kim Overvad, Aarhus University, Aarhus, Denmark; Xuehong Zhang, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA; Mattias Johansson, International Agency for Research on Cancer, Lyons, France
| | - Xiao-Ou Shu
- Jae Jeong Yang, Danxia Yu, Yumie Takata, William Blot, Wei Zheng, and Xiao-Ou Shu, Vanderbilt University Medical Center, Nashville, TN; Yumie Takata, Oregon State University, Corvallis, OR; Stephanie A. Smith-Warner, Meir Stampfer, and Walter Willett, Harvard T.H. Chan School of Public Health, Boston, MA; Emily White, Fred Hutchinson Cancer Research Center, Seattle, WA; Kim Robien, George Washington University, Washington, DC; Yikyung Park, Washington University School of Medicine, St Louis, MO; Yong-Bing Xiang and Yu-Tang Gao, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; Rashmi Sinha and Linda Liao, National Cancer Institute, Bethesda, MD; DeAnn Lazovich, University of Minnesota, Minneapolis, MN; Rosario Tumino, “Civic – M.P. Arezzo” Hospital, ASP Ragusa, Italy; Dagfinn Aune, Imperial College, London, United Kingdom; Kim Overvad, Aarhus University, Aarhus, Denmark; Xuehong Zhang, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA; Mattias Johansson, International Agency for Research on Cancer, Lyons, France
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109
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Yu D, Takata Y, Smith-Warner SA, Blot W, Sawada N, White E, Freedman N, Robien K, Giovannucci E, Zhang X, Park Y, Gao YT, Chlebowski RT, Langhammer A, Yang G, Severi G, Manjer J, Khaw KT, Weiderpass E, Liao LM, Caporaso N, Krokstad S, Hveem K, Sinha R, Ziegler R, Tsugane S, Xiang YB, Johansson M, Zheng W, Shu XO. Prediagnostic Calcium Intake and Lung Cancer Survival: A Pooled Analysis of 12 Cohort Studies. Cancer Epidemiol Biomarkers Prev 2017; 26:1060-1070. [PMID: 28264875 PMCID: PMC5500413 DOI: 10.1158/1055-9965.epi-16-0863] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 01/09/2017] [Accepted: 02/24/2017] [Indexed: 01/12/2023] Open
Abstract
Background: Lung cancer is the leading cause of cancer death. Little is known about whether prediagnostic nutritional factors may affect survival. We examined the associations of prediagnostic calcium intake from foods and/or supplements with lung cancer survival.Methods: The present analysis included 23,882 incident, primary lung cancer patients from 12 prospective cohort studies. Dietary calcium intake was assessed using food-frequency questionnaires at baseline in each cohort and standardized to caloric intake of 2,000 kcal/d for women and 2,500 kcal/d for men. Stratified, multivariable-adjusted Cox regression was applied to compute hazard ratios (HR) and 95% confidence intervals (CI).Results: The 5-year survival rates were 56%, 21%, and 5.7% for localized, regional, and distant stage lung cancer, respectively. Low prediagnostic dietary calcium intake (<500-600 mg/d, less than half of the recommendation) was associated with a small increase in risk of death compared with recommended calcium intakes (800-1,200 mg/d); HR (95% CI) was 1.07 (1.01-1.13) after adjusting for age, stage, histology, grade, smoking status, pack-years, and other potential prognostic factors. The association between low calcium intake and higher lung cancer mortality was evident primarily among localized/regional stage patients, with HR (95% CI) of 1.15 (1.04-1.27). No association was found for supplemental calcium with survival in the multivariable-adjusted model.Conclusions: This large pooled analysis is the first, to our knowledge, to indicate that low prediagnostic dietary calcium intake may be associated with poorer survival among early-stage lung cancer patients.Impact: This multinational prospective study linked low calcium intake to lung cancer prognosis. Cancer Epidemiol Biomarkers Prev; 26(7); 1060-70. ©2017 AACR.
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Affiliation(s)
- Danxia Yu
- Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Yumie Takata
- Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, Tennessee
- College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon
| | - Stephanie A Smith-Warner
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - William Blot
- Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Norie Sawada
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Emily White
- Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Neal Freedman
- Division of Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Kim Robien
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia
| | - Edward Giovannucci
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Xuehong Zhang
- Dana Farber Cancer Institute, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Yikyung Park
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Yu-Tang Gao
- Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Rowan T Chlebowski
- Los Angeles Biomedical Research Institute at the Harbor-UCLA Medical Center, Torrance, California
| | - Arnulf Langhammer
- HUNT Research Centre, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Gong Yang
- Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Gianluca Severi
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
- Gustave Roussy, Villejuif, France
- Human Genetics Foundation, Torino, Italy
- Cancer Council Victoria and University of Melbourne, Australia
| | - Jonas Manjer
- Department of Surgery, Lund University, University Hospital Malmö, Malmö, Sweden
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge School of Clinical Medicine, United Kingdom
| | - Elisabete Weiderpass
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
- Department of Community Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
| | - Linda M Liao
- Division of Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Neil Caporaso
- Division of Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Steinar Krokstad
- HUNT Research Centre, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kristian Hveem
- HUNT Research Centre, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Rashmi Sinha
- Division of Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Regina Ziegler
- Division of Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Yong-Bing Xiang
- Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Mattias Johansson
- Genetic Epidemiology Group, International Agency for Research on Cancer, Lyons, France
| | - Wei Zheng
- Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Xiao-Ou Shu
- Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, Tennessee.
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Liu Y, Wang Y, Hu F, Sun H, Zhang Z, Wang X, Luo X, Zhu L, Huang R, Li Y, Li G, Li X, Lin S, Wang F, Liu Y, Rong J, Yuan H, Zhao Y. Multiple gene-specific DNA methylation in blood leukocytes and colorectal cancer risk: a case-control study in China. Oncotarget 2017; 8:61239-61252. [PMID: 28977860 PMCID: PMC5617420 DOI: 10.18632/oncotarget.18054] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 04/07/2017] [Indexed: 12/17/2022] Open
Abstract
The relationship between gene-specific DNA methylation in peripheral blood leukocytes and colorectal cancer (CRC) susceptibility is unclear. In this case-control study, the methylation status of a panel of 10 CRC-related genes in 428 CRC cases and 428 cancer-free controls were detected with methylation-sensitive high-resolution melting analysis. We calculated a weighted methylation risk score (MRS) that comprehensively combined the methylation status of the panel of 10 genes and found that the MRS_10 was significantly associated with CRC risk. Compared with MRS-Low group, MRS-High group and MRS-Medium group exhibited a 6.51-fold (95% CI, 3.77-11.27) and 3.85-fold (95% CI, 2.72-5.45) increased risk of CRC, respectively. Moreover, the CRC risk increased with increasing MRS_10 (Ptrend < 0.0001). Stratified analyses demonstrated that the significant association retained in both men and women, younger and older, and normal weight or underweight and overweight or obese subjects. The area under the receiver operating characteristic curves for the MRS_10 model was 69.04% (95% CI, 65.57-72.66%) and the combined EF and MRS_10 model yielded an AUC of 79.12% (95% CI, 76.22-82.15%). Together, the panel of 10 gene-specific DNA methylation in leukocytes was strongly associated with the risk of CRC and might be a useful marker of susceptibility for CRC.
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Affiliation(s)
- Yupeng Liu
- Department of Epidemiology, Public Health College, Harbin Medical University, Harbin 150081, Heilongjiang Province, The People's Republic of China
| | - Yibaina Wang
- Department of Epidemiology, Public Health College, Harbin Medical University, Harbin 150081, Heilongjiang Province, The People's Republic of China
| | - Fulan Hu
- Department of Epidemiology, Public Health College, Harbin Medical University, Harbin 150081, Heilongjiang Province, The People's Republic of China
| | - Hongru Sun
- Department of Epidemiology, Public Health College, Harbin Medical University, Harbin 150081, Heilongjiang Province, The People's Republic of China
| | - Zuoming Zhang
- Department of Epidemiology, Public Health College, Harbin Medical University, Harbin 150081, Heilongjiang Province, The People's Republic of China
| | - Xuan Wang
- Department of Epidemiology, Public Health College, Harbin Medical University, Harbin 150081, Heilongjiang Province, The People's Republic of China
| | - Xiang Luo
- Department of Epidemiology, Public Health College, Harbin Medical University, Harbin 150081, Heilongjiang Province, The People's Republic of China
| | - Lin Zhu
- Department of Epidemiology, Public Health College, Harbin Medical University, Harbin 150081, Heilongjiang Province, The People's Republic of China
| | - Rong Huang
- Department of Epidemiology, Public Health College, Harbin Medical University, Harbin 150081, Heilongjiang Province, The People's Republic of China
| | - Yan Li
- Department of Epidemiology, Public Health College, Harbin Medical University, Harbin 150081, Heilongjiang Province, The People's Republic of China
| | - Guangxiao Li
- Department of Epidemiology, Public Health College, Harbin Medical University, Harbin 150081, Heilongjiang Province, The People's Republic of China
| | - Xia Li
- Department of Epidemiology, Public Health College, Harbin Medical University, Harbin 150081, Heilongjiang Province, The People's Republic of China
| | - Shangqun Lin
- Department of Epidemiology, Public Health College, Harbin Medical University, Harbin 150081, Heilongjiang Province, The People's Republic of China
| | - Fan Wang
- Department of Epidemiology, Public Health College, Harbin Medical University, Harbin 150081, Heilongjiang Province, The People's Republic of China
| | - Yanhong Liu
- Department of Clinical Laboratory, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, Heilongjiang Province, The People's Republic of China
| | - Jiesheng Rong
- Department of Orthopedics Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, Heilongjiang Province, The People's Republic of China
| | - Huiping Yuan
- Key Laboratory of Ophthalmology, Department of Ophthalmology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, Heilongjiang Province, The People's Republic of China
| | - Yashuang Zhao
- Department of Epidemiology, Public Health College, Harbin Medical University, Harbin 150081, Heilongjiang Province, The People's Republic of China
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111
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Yuan C, Spiegelman D, Rimm EB, Rosner BA, Stampfer MJ, Barnett JB, Chavarro JE, Subar AF, Sampson LK, Willett WC. Validity of a Dietary Questionnaire Assessed by Comparison With Multiple Weighed Dietary Records or 24-Hour Recalls. Am J Epidemiol 2017; 185:570-584. [PMID: 28338828 DOI: 10.1093/aje/kww104] [Citation(s) in RCA: 318] [Impact Index Per Article: 45.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Accepted: 04/12/2016] [Indexed: 11/12/2022] Open
Abstract
The authors evaluated the validity of a 152-item semiquantitative food frequency questionnaire (SFFQ) by comparing it with two 7-day dietary records (7DDRs) or up to 4 automated self-administered 24-hour recalls (ASA24s) over a 1-year period in the women's Lifestyle Validation Study (2010-2012), conducted among subgroups of the Nurses' Health Studies. Intakes of energy and 44 nutrients were assessed using the 3 methods among 632 US women. Compared with the 7DDRs, SFFQ responses tended to underestimate sodium intake but overestimate intakes of energy, macronutrients, and several nutrients in fruits and vegetables, such as carotenoids. Spearman correlation coefficients between energy-adjusted intakes from 7DDRs and the SFFQ completed at the end of the data-collection period ranged from 0.36 for lauric acid to 0.77 for alcohol (mean r = 0.53). Correlations of the end-period SFFQ were weaker when ASA24s were used as the comparison method (mean r = 0.43). After adjustment for within-person variation in the comparison method, the correlations of the final SFFQ were similar with 7DDRs (mean r = 0.63) and ASA24s (mean r = 0.62). These data indicate that this SFFQ provided reasonably valid estimates for intakes of a wide variety of dietary variables and that use of multiple 24-hour recalls or 7DDRs as a comparison method provided similar conclusions if day-to-day variation was taken into account.
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Shrestha A, Koju RP, Beresford SAA, Chan KCG, Connell FA, Karmacharya BM, Shrestha P, Fitzpatrick AL. Reproducibility and relative validity of food group intake in a food frequency questionnaire developed for Nepalese diet. Int J Food Sci Nutr 2017; 68:605-612. [PMID: 28092991 DOI: 10.1080/09637486.2016.1268099] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
We developed a food frequency questionnaire (FFQ) designed to measure the dietary practices of adult Nepalese. The present study examined the validity and reproducibility of the FFQ. To evaluate the reproducibility of the FFQ, 116 subjects completed two 115-item FFQ across a four-month interval. Six 24-h dietary recalls were collected (1 each month) to assess the validity of the FFQ. Seven major food groups and 23 subgroups were clustered from the FFQ based on macronutrient composition. Spearman correlation coefficients evaluating reproducibility for all food groups were greater than 0.5, with the exceptions of oil. The correlations varied from 0.41 (oil) to 0.81 (vegetables). All crude spearman coefficients for validity were greater than 0.5 except for dairy products, pizzas/pastas and sausage/burgers. The FFQ was found to be reliable and valid for ranking the intake of food groups for Nepalese dietary intake.
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Affiliation(s)
- Archana Shrestha
- a Department of Epidemiology , University of Washington , Seattle , WA , USA
| | - Rajendra Prasad Koju
- b Department of Cardiology , Dhulikhel Hospital Kathmandu University Teaching Hospital , Dhulikhel , Nepal.,c Department of Global Health , University of Washington , Seattle , WA , USA
| | | | | | - Frederik A Connell
- e Department of Health Services , University of Washingonton , Seattle , WA , USA
| | - Biraj Man Karmacharya
- f Department of Epidemiology and Global Health , University of Washington , Seattle , WA , USA.,g Department of Community Medicine , Dhulikhel Hospital Kathmandu University Teaching Hospital , Dhulikhel , Nepal.,h Department of Community Programs , Dhulikhel Hospital Kathmandu University Teaching Hospital , Dhulikhel , Nepal
| | - Pramita Shrestha
- h Department of Community Programs , Dhulikhel Hospital Kathmandu University Teaching Hospital , Dhulikhel , Nepal
| | - Annette L Fitzpatrick
- i Department of Family Medicine, Epidemiology, and Global Health , University of Washington , Seattle , WA , USA
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113
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Zhao LG, Shu XO, Li HL, Zhang W, Gao J, Sun JW, Zheng W, Xiang YB. Dietary antioxidant vitamins intake and mortality: A report from two cohort studies of Chinese adults in Shanghai. J Epidemiol 2016; 27:89-97. [PMID: 28142039 PMCID: PMC5363781 DOI: 10.1016/j.je.2016.10.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 04/09/2016] [Indexed: 12/27/2022] Open
Abstract
Background Few studies have evaluated dietary antioxidant vitamins intake in relation to risk of mortality in Asia. Methods We examined the associations between total carotene, vitamin C, and vitamin E from diet and risk of mortality from all causes, cancer, and cardiovascular disease in 134,358 participants (59,739 men and 74,619 women) from the Shanghai Men's Health Study and Shanghai Women's Health Study, two prospective cohort studies of middle-aged and elderly Chinese adults in urban Shanghai. Participants were followed up for a median period of 8.3 and 14.2 years for men and women, respectively. Hazard ratios (HRs) and 95% confidence interval (CIs) were estimated using Cox proportional hazards regression models. Results During the 495,332 and 1,029,198 person-years of follow-up for men and women, respectively, there were 10,079 deaths (4170 men and 5909 women). For men, compared with the lowest quintiles, the multivariable-adjusted risk reductions in the highest categories were 17% (HR 0.83; 95% CI, 0.76–0.92) for dietary total carotene and 17% (HR 0.83; 95% CI, 0.75–0.91) for dietary vitamin C. Associations were weaker in women than in men, though they were still statistically significant (highest versus lowest quintiles of dietary total carotene, HR 0.87; 95% CI, 0.80–0.95; dietary vitamin C: HR 0.83; 95% CI, 0.77–0.91). Significant inverse associations were observed between dietary total carotene, vitamin C, and risk of cardiovascular disease mortality but not cancer mortality. Conclusion This study suggests that total carotene and vitamin C intake from diet were inversely associated with deaths from all causes and cardiovascular disease in middle-aged or elderly people in China. Dietary vitamin C and carotene were inversely associated with total deaths in China. These associations were more pronounced for cardiovascular disease mortality. Dietary antioxidant vitamins might not be associated with cancer mortality risk.
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Affiliation(s)
- Long-Gang Zhao
- School of Public Health, Fudan University, Shanghai, China; SKLORG & Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Hong-Lan Li
- SKLORG & Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wei Zhang
- SKLORG & Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jing Gao
- SKLORG & Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jiang-Wei Sun
- SKLORG & Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Yong-Bing Xiang
- SKLORG & Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
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Monteiro LS, Rodrigues PRM, Veiga GVD, Marchioni DML, Pereira RA. Diet quality among adolescents has deteriorated: a panel study in Niterói, Rio de Janeiro State, Brazil, 2003-2008. CAD SAUDE PUBLICA 2016; 32:e00124715. [PMID: 28001207 DOI: 10.1590/0102-311x00124715] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 03/02/2016] [Indexed: 11/22/2022] Open
Abstract
This study aimed to analyze changes in the diet quality of adolescents from public schools in Niterói, Rio de Janeiro State, Brazil, over a five-year period. Data on the food consumption of adolescents (12-19 years) were obtained by means of two sets of 3-day food records in two school-based, cross-sectional studies conducted in 2003 and 2008. The Brazilian Revised Healthy Eating Index (BHEI-R) was used to estimate dietary quality. From 2003 to 2008 there was an overall decrease in the scores attributed to "total vegetables", "dark green and orange vegetables", and "meat, eggs, and legumes", but there was an increase in the score for "milk and dairy" (4.0 vs. 5.2; p < 0.01). Among female adolescents, the BHEI-R decreased (64.1 vs. 62.4; p = 0.04), as did the scores attributed to "total vegetables", "dark green and orange vegetables", "meat, eggs, and legumes", and "solid fat, alcohol, and added sugar". In contrast, among males, only the "whole grains" score decreased (0.2 vs. 0.1; p = 0.04). From 2003 to 2008, the diet quality of female public school students declined in Niterói.
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115
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Ma X, Yang Y, Li HL, Zheng W, Gao J, Zhang W, Yang G, Shu XO, Xiang YB. Dietary trace element intake and liver cancer risk: Results from two population-based cohorts in China. Int J Cancer 2016; 140:1050-1059. [PMID: 27859272 DOI: 10.1002/ijc.30522] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 10/21/2016] [Accepted: 11/02/2016] [Indexed: 01/07/2023]
Abstract
Dietary factors have been hypothesized to affect the risk of liver cancer via various mechanisms, but the influence has been not well studied and the evidence is conflicting. We investigated associations of dietary trace element intake, assessed through a validated food frequency questionnaire, with risk of liver cancer in two prospective cohort studies of 132,765 women (1997-2013) and men (2002-2013) in Shanghai, China. The associations were first evaluated in cohort studies and further assessed in a case-control study nested within these cohorts adjusting for hepatitis B virus infection. For cohort analyses, Cox proportional hazard models were used to estimate hazard ratios and 95% confidence intervals. For nested case-control analyses, conditional logistic regression was used to calculate odds ratios and 95% confidence intervals. After a median follow-up time of 15.2 years for the Shanghai Women's Health Study and 9.3 years for the Shanghai Men's Health Study, 192 women and 344 men developed liver cancer. Dietary intake of manganese was inversely associated with liver cancer risk (highest vs. lowest quintile, HR = 0.51, 95% CI: 0.35-0.73; ptrend = 0.001). Further adjustment for hepatitis B virus infection in the nested case-control study yielded a similar result (highest vs. lowest quintile, OR = 0.38, 95% CI: 0.21-0.69; ptrend < 0.001). No significant association was found between dietary intake of selenium, iron, zinc, copper and liver cancer risk. The results suggest that higher intake of manganese may be associated with a lower risk of liver cancer in China.
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Affiliation(s)
- Xiao Ma
- School of Public Health, Fudan University, Shanghai, China.,SKLORG & Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yang Yang
- SKLORG & Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hong-Lan Li
- SKLORG & Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN
| | - Jing Gao
- SKLORG & Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wei Zhang
- SKLORG & Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Gong Yang
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN
| | - Yong-Bing Xiang
- SKLORG & Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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116
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Yu D, Zhang X, Shu XO, Cai H, Li H, Ding D, Hong Z, Xiang YB, Gao YT, Zheng W, Yang G. Dietary glycemic index, glycemic load, and refined carbohydrates are associated with risk of stroke: a prospective cohort study in urban Chinese women. Am J Clin Nutr 2016; 104:1345-1351. [PMID: 27733400 PMCID: PMC5081713 DOI: 10.3945/ajcn.115.129379] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 08/15/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Epidemiologic evidence on dietary carbohydrates and stroke risk remains controversial. Very few prospective cohort studies have been conducted in Asian populations, who usually consume a high-carbohydrate diet and have a high burden of stroke. OBJECTIVE We examined dietary glycemic index (GI), glycemic load (GL), and intakes of refined and total carbohydrates in relation to risks of total, ischemic, and hemorrhagic stroke and stroke mortality. DESIGN This study included 64,328 Chinese women, aged 40-70 y, with no history of cardiovascular disease, diabetes, or cancer. A validated, interviewer-administered food-frequency questionnaire was used to assess usual dietary intakes at baseline and during follow-up. Incident stroke cases and deaths were identified via follow-up interviews and death registries and were confirmed by review of medical records and death certificates. RESULTS During mean follow-ups of 10 y for stroke incidence and 12 y for stroke mortality, we ascertained 2991 stroke cases (2750 ischemic and 241 hemorrhagic) and 609 stroke deaths. After potential confounders were controlled for, we observed significant positive associations of dietary GI and GL with total stroke risk; multivariable-adjusted HRs (95% CIs) for high compared with low levels (90th compared with 10th percentile) were 1.19 (1.04, 1.36) for GI and 1.27 (1.04, 1.54) for GL (both P-linearity < 0.05 and P-overall significance < 0.05). Similar linear associations were found for ischemic stroke, but the associations with hemorrhagic stroke appeared to be J-shaped. Similar trends of positive associations with stroke risks were suggested for refined carbohydrates but not for total carbohydrates. No significant associations were found for stroke mortality after multivariable adjustment. CONCLUSION Our results suggest that high dietary GI and GL, primarily due to high intakes of refined grains, are associated with increased risks of total, ischemic, and hemorrhagic stroke in middle-aged and older urban Chinese women.
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Affiliation(s)
- Danxia Yu
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Xianglan Zhang
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN.,Tennessee Department of Health, Nashville, TN
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Hui Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Honglan Li
- Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China; and
| | - Ding Ding
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhen Hong
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yong-Bing Xiang
- Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China; and
| | - Yu-Tang Gao
- Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China; and
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Gong Yang
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN;
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Wang T, Cai H, Sasazuki S, Tsugane S, Zheng W, Cho ER, Jee SH, Michel A, Pawlita M, Xiang YB, Gao YT, Shu XO, You WC, Epplein M. Fruit and vegetable consumption, Helicobacter pylori antibodies, and gastric cancer risk: A pooled analysis of prospective studies in China, Japan, and Korea. Int J Cancer 2016; 140:591-599. [PMID: 27759938 DOI: 10.1002/ijc.30477] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 08/31/2016] [Accepted: 10/06/2016] [Indexed: 12/14/2022]
Abstract
Epidemiological findings on the association between fruit and vegetable consumption and gastric cancer risk remain inconsistent. The present analysis included 810 prospectively ascertained non-cardia gastric cancer cases and 1,160 matched controls from the Helicobacter pylori Biomarker Cohort Consortium, which collected blood samples, demographic, lifestyle, and dietary data at baseline. Conditional logistic regression adjusting for total energy intake, smoking, and H. pylori status, was applied to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for gastric cancer risk across cohort- and sex-specific quartiles of fruit and vegetable intake. Increasing fruit intake was associated with decreasing risk of non-cardia gastric cancer (OR = 0.71, 95% CI: 0.52-0.95, p trend = 0.02). Compared to low-fruit consumers infected with CagA-positive H. pylori, high-fruit consumers without evidence of H. pylori antibodies had the lowest odds for gastric cancer incidence (OR = 0.12, 95% CI: 0.06-0.25), whereby the inverse association with high-fruit consumption was attenuated among individuals infected with CagA-positive H. pylori (OR = 0.82, 95% CI: 0.66-1.03). To note, the small number of H. pylori negative individuals does influence this finding. We observed a weaker, nondose-response suggestion of an inverse association of vegetable intake with non-cardia gastric cancer risk. High fruit intake may play a role in decreasing risk of non-cardia gastric cancer in Asia.
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Affiliation(s)
- Tianyi Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, Peking University Health Science Center, Beijing, China.,Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center and Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN
| | - Hui Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center and Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN
| | - Shizuka Sasazuki
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center and Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN
| | - Eo Rin Cho
- Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea
| | - Sun Ha Jee
- Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea
| | - Angelika Michel
- Division of Molecular Diagnostics of Oncogenic Infections, Research Program in Infection, Inflammation, and Cancer, German Cancer Research Center (DFKZ), Heidelberg, Germany
| | - Michael Pawlita
- Division of Molecular Diagnostics of Oncogenic Infections, Research Program in Infection, Inflammation, and Cancer, German Cancer Research Center (DFKZ), Heidelberg, Germany
| | - Yong-Bing Xiang
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China
| | - Yu-Tang Gao
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center and Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN
| | - Wei-Cheng You
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, Peking University Health Science Center, Beijing, China
| | - Meira Epplein
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center and Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN
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118
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Dairy and plant based food intakes are associated with altered faecal microbiota in 2 to 3 year old Australian children. Sci Rep 2016; 6:32385. [PMID: 27694811 PMCID: PMC5046176 DOI: 10.1038/srep32385] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 08/08/2016] [Indexed: 02/06/2023] Open
Abstract
The first 1000 days (conception to 24 months) is when gut microbiota composition and eating patterns are established, and a critical period influencing lifelong health. The aim of this study is to examine the associations between food intakes and microbiota composition at the end of this period. Diet was quantified for 37 well-nourished Australian children aged between 2 to 3 years by using a food frequency questionnaire and 24 hr recalls. Both dairy and plant-based (fruit, vegetables, soy, pulses and nuts) food intakes were associated with distinct microbiota profiles. Dairy intake was positively associated with the Firmicutes:Bacteroidetes ratio, and in particular Erysipelatoclostridium spp., but negatively associated with species richness and diversity. Vegetable intake was positively associated with the relative abundance of the Lachnospira genus, while soy, pulse and nut intake was positively associated with the relative abundance of bacteria related to Bacteroides xylanisolvens. Fruit intake, especially apples and pears, were negatively associated with the relative abundance of bacteria related to Ruminococcus gnavus. In this cohort of young children dairy and plant based food intakes were found to be associated with altered microbiota composition. Further exploration is needed to elucidate the effect of these dietary and microbial differences on host phenotype.
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119
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Zhang P, Wu H, Zhou X, Lu Y, Yuan Z, Moore JB, Maddock JE. The Association between Family and Parental Factors and Obesity among Children in Nanchang, China. Front Public Health 2016; 4:162. [PMID: 27570761 PMCID: PMC4981590 DOI: 10.3389/fpubh.2016.00162] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 07/22/2016] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND With rapid economic development in China, traditional patterns of health behaviors are changing, concurrent with a rise in childhood obesity. While the home environment and parenting behaviors are modifiable factors that could be targeted for intervention, little is known about their relationship with children's health behaviors. Therefore, the purpose of this study was to investigate the relationship between obesity and home and parenting factors in Chinese children. METHODS A cross-sectional survey was conducted in Nanchang, China in 2013 with caregivers (N = 470) of a child between the ages of 2 and 10 years. Regression analyses were conducted to determine risk factors for childhood obesity. RESULTS Obesity prevalence (21.7%) did not differ by demographic variables. Eight physical activity, nutrition, and sedentary variables had significant relationships to obesity status. Logistic regression analysis revealed three significant predictors of obesity: the number of days the family eats meals together (odds ratio = 0.84, 95% CI 0.73-0.96) and parental home computer use time (odds ratio = 0.83, 95% CI 0.72-0.96) were related to lower levels of obesity, while parental television time (odds ratio = 1.25 95% CI 1.07-1.47) was related to higher levels of obesity. CONCLUSION The prevalence of obesity among children is high in Nanchang. Family and environmental risk factors are significantly related to obesity.
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Affiliation(s)
- Peng Zhang
- School of Public Health, Nanchang University , Nanchang, Jiangxi , China
| | - Hongjiao Wu
- School of Public Health, Nanchang University , Nanchang, Jiangxi , China
| | - Xiaojun Zhou
- School of Public Health, Nanchang University , Nanchang, Jiangxi , China
| | - Yuanan Lu
- School of Public Health, Nanchang University, Nanchang, Jiangxi, China; Office of Public Health Studies, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Zhaokang Yuan
- School of Public Health, Nanchang University , Nanchang, Jiangxi , China
| | - Justin B Moore
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina , Columbia, SC , USA
| | - Jay E Maddock
- School of Public Health, Nanchang University, Nanchang, Jiangxi, China; Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, USA
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Kadawathagedara M, Tong ACH, Heude B, Forhan A, Charles MA, Sirot V, Botton J. Dietary acrylamide intake during pregnancy and anthropometry at birth in the French EDEN mother-child cohort study. ENVIRONMENTAL RESEARCH 2016; 149:189-196. [PMID: 27208470 DOI: 10.1016/j.envres.2016.05.019] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 05/05/2016] [Accepted: 05/13/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND AND AIM Acrylamide is a contaminant formed in a wide variety of carbohydrate-containing foods during frying or baking at high temperatures. Recent studies have suggested reduced foetal growth after exposure to high levels of acrylamide during pregnancy. OBJECTIVE To study the relationship between maternal dietary acrylamide intake during pregnancy and their offspring's anthropometry at birth. DESIGN In our population of 1471 mother-child pairs from two French cities, Nancy and Poitiers, dietary acrylamide intake during pregnancy was assessed by combining maternal food frequency questionnaires with data on food contamination at the national level, provided by the second "French Total Diet Study". Newborns weighing less than the 10th percentile, according to a customised definition, were defined as small for gestational age (SGA). Linear and logistic regression models were used to study continuous and binary outcomes respectively, adjusting for the study centre, maternal age at delivery, height, education, parity, smoking during pregnancy, the newborn's gestational age at birth and sex. RESULTS The median and interquartile range of dietary acrylamide intake were 19.2μg/day (IQR, 11.8;30.3). Each 10μg/day increase in acrylamide intake was associated with an odds-ratio for SGA of 1.11 (95% Confidence Interval: 1.03,1.21), birth length change of -0.05cm (95% CI: -0.11,0.00) and birth weight change of -9.8g (95% CI: -21.3,1.7). CONCLUSIONS Our results, consistent with both experimental and epidemiological studies, add to the evidence of an effect of acrylamide exposure on the risk of SGA and suggest an effect on foetal growth, for both weight and length.
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Affiliation(s)
- M Kadawathagedara
- INSERM, Unit 1153, Research Center in Epidemiology and Biostatistics Paris Sorbonne Cité, Team: Early Origin of the Child's Health and Development, Paris Descartes 5 University, 16, Avenue Paul Vaillant-Couturier, 94807 Villejuif Cedex, France.
| | - A Chan Hon Tong
- ANSES (French agency for Food, Environmental, and Occupational Health and Safety), 14 rue Pierre et Marie Curie, F-94701 Maisons-Alfort, France
| | - B Heude
- INSERM, Unit 1153, Research Center in Epidemiology and Biostatistics Paris Sorbonne Cité, Team: Early Origin of the Child's Health and Development, Paris Descartes 5 University, 16, Avenue Paul Vaillant-Couturier, 94807 Villejuif Cedex, France
| | - A Forhan
- INSERM, Unit 1153, Research Center in Epidemiology and Biostatistics Paris Sorbonne Cité, Team: Early Origin of the Child's Health and Development, Paris Descartes 5 University, 16, Avenue Paul Vaillant-Couturier, 94807 Villejuif Cedex, France
| | - M-A Charles
- INSERM, Unit 1153, Research Center in Epidemiology and Biostatistics Paris Sorbonne Cité, Team: Early Origin of the Child's Health and Development, Paris Descartes 5 University, 16, Avenue Paul Vaillant-Couturier, 94807 Villejuif Cedex, France
| | - V Sirot
- ANSES (French agency for Food, Environmental, and Occupational Health and Safety), 14 rue Pierre et Marie Curie, F-94701 Maisons-Alfort, France
| | - J Botton
- INSERM, Unit 1153, Research Center in Epidemiology and Biostatistics Paris Sorbonne Cité, Team: Early Origin of the Child's Health and Development, Paris Descartes 5 University, 16, Avenue Paul Vaillant-Couturier, 94807 Villejuif Cedex, France; Faculty of Pharmacy, University Paris Sud, Châtenay-Malabry, France
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121
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Validity and Reproducibility of a Dietary Questionnaire for Consumption Frequencies of Foods during Pregnancy in the Born in Guangzhou Cohort Study (BIGCS). Nutrients 2016; 8:nu8080454. [PMID: 27483304 PMCID: PMC4997369 DOI: 10.3390/nu8080454] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 07/18/2016] [Accepted: 07/22/2016] [Indexed: 01/15/2023] Open
Abstract
This study aimed to examine the reproducibility and validity of a new food frequency questionnaire (FFQ) used in a birth cohort study to estimate the usual consumption frequencies of foods during pregnancy. The reference measure was the average of three inconsecutive 24 h diet recalls (24 HR) administrated between two FFQs, and the reproducibility was measured by repeating the first FFQ (FFQ1) approximately eight weeks later (FFQ2). A total of 210 pregnant women from the Born in Guangzhou Cohort Study (BIGCS) with full data were included in the analysis. The Spearman's correlation coefficients of FFQ1 and FFQ2 ranged from 0.33 to 0.71. The intraclass correlation coefficients of the two FFQs ranged from 0.22 to 0.71. The Spearman's correlation coefficients of the 24 HR and FFQ2 ranged from 0.23 to 0.62. Cross-classification analysis showed 65.1% of participants were classified into same and contiguous quintiles, while only 3.2% were misclassified into the distant quintiles. Bland-Altman methods showed good agreement for most food groups across the range of frequencies between FFQ1 and FFQ2. Our findings indicated that the reproducibility and validity of the FFQ used in BIGCS for assessing the usual consumption frequencies of foods during pregnancy were acceptable.
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Ndanuko RN, Tapsell LC, Charlton KE, Neale EP, O'Donnell KM, Batterham MJ. Relationship between sodium and potassium intake and blood pressure in a sample of overweight adults. Nutrition 2016; 33:285-290. [PMID: 27712964 DOI: 10.1016/j.nut.2016.07.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 07/05/2016] [Accepted: 07/09/2016] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The aim of this study was to examine the relationship between sodium and potassium intakes and blood pressure (BP) in a clinical sample. METHODS Secondary analysis of baseline data from 328 participants (mean age: 43.6 ± 8 y, mean body mass index [BMI]: 32.4 ± 4.2 kg/m2, mean systolic BP [SBP]/diastolic BP [DBP]: 124.9 ± 14.5/73.3 ± 9.9 mm Hg) of the 12-mo HealthTrack randomized controlled weight loss trial was conducted. Resting BP and 24-h urine sodium and potassium were measured. Dietary intake was evaluated with 4-d food records and self-reported diet histories. RESULTS Urinary sodium was positively correlated (Spearman's rho) with SBP (r = 0.176; P = 0.001) and DBP (r = 0.150; P = 0.003). The ratio of sodium to potassium was positively correlated with SBP (r = 0.1; P = 0.035). Urinary sodium (F [4,323] = 20.381; P < 0.0005; adjusted R2 = 0.231) and sodium-to-potassium ratio (F[4,323] = 25.008; P < 0.0005; adjusted R2 = 0.227) significantly predicted SBP after controlling for age, sex, BMI, and hypertension medication use. Dietary sodium and potassium significantly predicted urinary sodium (B = 0.33, t = 4.032, P < 0.01) and potassium (B = 0.67, t = 8.537, P < 0.01) excretion, respectively, after adjustment for energy and BMI. Median dietary sodium intake was 3197 mg/d and median dietary potassium intake was 2886 mg/d. Cereal-based products and dishes were the major contributors (22%) to total sodium intake. CONCLUSIONS In the present study, a high dietary sodium intake and high sodium-to-potassium ratio predicted high SBP. This suggests a need to focus dietary advice on reduction of sources of sodium and increasing sources of potassium in weight loss interventions to improve BP control.
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Affiliation(s)
- Rhoda N Ndanuko
- School of Medicine, University of Wollongong, Northfields Avenue, Wollongong, NSW, Australia.
| | - Linda C Tapsell
- School of Medicine, University of Wollongong, Northfields Avenue, Wollongong, NSW, Australia
| | - Karen E Charlton
- School of Medicine, University of Wollongong, Northfields Avenue, Wollongong, NSW, Australia
| | - Elizabeth P Neale
- School of Medicine, University of Wollongong, Northfields Avenue, Wollongong, NSW, Australia
| | - Katrina M O'Donnell
- School of Medicine, University of Wollongong, Northfields Avenue, Wollongong, NSW, Australia
| | - Marijka J Batterham
- Statistical Consulting Service, School of Mathematics and Applied Statistics, University of Wollongong, Wollongong, NSW, Australia
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Abbasalizad Farhangi M, Mohseni F, Farajnia S, Jafarabadi MA. Major components of metabolic syndrome and nutritional intakes in different genotype of UCP2 -866G/A gene polymorphisms in patients with NAFLD. J Transl Med 2016; 14:177. [PMID: 27301474 PMCID: PMC4908770 DOI: 10.1186/s12967-016-0936-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 06/02/2016] [Indexed: 01/09/2023] Open
Abstract
Background It has been suggested that dietary modifications in combination with genetic predisposition play an important role in the pathogenesis of NAFLD. In the current study we aimed to investigate the major components of metabolic syndrome in patients with non-alcoholic fatty liver disease (NAFLD) and nutritional intakes according to different genotype of uncoupling protein-2 (UCP2) −866G/A gene polymorphism in these patients. Methods In this study 151 participants including 75 patients with NAFLD and 76 healthy individuals were enrolled. Dietary intakes were assessed using a semi-quantitative food-frequency questionnaire. Physical activity was obtained by metabolic equivalent questionnaire. Anthropometric assessments were conducted by a trained researcher and body mass index and waist to hip ratio were calculated. Body composition was measured by bioelectrical impedance analysis and biochemical assays including fasting serum glucose, liver enzymes and lipid profiles were measured. Polymorphisms of −866G/A UCP2 gene was determined using polymerase chain reaction-restriction fragment length polymorphism method. Results Serum triglyceride concentrations in 53.3 % of NAFLD patients compared with 35.5 % of control group was more than 150 mg/dl (P = 0.034). A significantly higher prevalence of low serum high density lipoprotein cholesterol concentrations was also observed in female NAFLD patients (P < 0.001). Dietary intakes in NAFLD group were not significantly different compared with control group (P > 0.05). However, according to genotypes patients with AG genotype had significantly higher protein consumption compared with control group (P < 0.05). Significantly higher consumption of dietary iron and copper in NAFLD patients with AG genotype was only observed among patients with NAFLD. However, the comparison of macro and micronutrient intakes in control group sound for stronger differences for AA genotype although these differences did not achieve significant threshold. Conclusions A high prevalence of metabolic abnormalities was reported among NAFLD patients. Additionally, among NAFLD group, patients with AG genotype significantly consumed more protein, iron and copper in their usual diet.
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Affiliation(s)
- Mahdieh Abbasalizad Farhangi
- Nutrition Research Center, Department of Community Nutrition, School of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Fatemeh Mohseni
- Drug Applied Research Center (DARC), Tabriz University of Medical Sciences, Tabriz, Iran
| | - Safar Farajnia
- Drug Applied Research Center (DARC), Tabriz University of Medical Sciences, Tabriz, Iran
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Wu SH, Shu XO, Milne G, Xiang YB, Zhang X, Cai Q, Fazio S, Linton MF, Chen H, Purdue M, Rothman N, Gao YT, Zheng W, Yang G. Uric acid correlates to oxidation and inflammation in opposite directions in women. Biomarkers 2016; 20:225-31. [PMID: 26301880 PMCID: PMC4989504 DOI: 10.3109/1354750x.2015.1068852] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To evaluate the association of uric acid (UA) levels with a panel of markers of oxidative stress and inflammation. METHODS Plasma UA levels, along with a panel of oxidative stress and inflammatory markers, were measured in 755 Chinese women. RESULTS Plasma UA levels were inversely associated with urinary levels of the oxidative stress marker F2-isoprostanes and positively correlated to levels of inflammatory markers, such as C-reactive protein and some proinflammatory cytokines (tumor necrosis factor-α and interleukin-6) in blood as well as prostaglandin E2 metabolites in urine. CONCLUSIONS Plasma UA levels correlate to oxidation and inflammation biomarkers in opposite directions in women.
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Affiliation(s)
- Sheng Hui Wu
- a Department of Medicine, Division of Epidemiology , Vanderbilt University Medical Center , Nashville , TN , USA
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Wentzel-Viljoen E, Laubscher R, Kruger A. Using different approaches to assess the reproducibility of a culturally sensitive quantified food frequency questionnaire. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2016. [DOI: 10.1080/16070658.2011.11734366] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Dietary selenium intake and mortality in two population-based cohort studies of 133 957 Chinese men and women. Public Health Nutr 2016; 19:2991-2998. [PMID: 27197889 DOI: 10.1017/s1368980016001130] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To investigate the potential influence of dietary Se intake on mortality among Chinese populations. DESIGN We prospectively evaluated all-cause, CVD and cancer mortality risks associated with dietary Se intake in participants of the Shanghai Women's Health Study (SWHS) and the Shanghai Men's Health study (SMHS). Dietary Se intake was assessed by validated FFQ during in-person interviews. Cox proportional hazards models were used to calculate hazard ratios (HR) and 95 % CI. SETTING Urban city in China. SUBJECTS Chinese adults (n 133 957). RESULTS During an average follow-up of 13·90 years in the SWHS and 8·37 years in the SMHS, 5749 women and 4217 men died. The mean estimated dietary Se intake was 45·48 μg/d for women and 51·34 μg/d for men, respectively. Dietary Se intake was inversely associated with all-cause mortality and CVD mortality in both women and men, with respective HR for the highest compared with the lowest quintile being 0·79 (95 % CI 0·71, 0·88; P trend<0·0001) and 0·80 (95 % CI 0·66, 0·98; P trend=0·0268) for women, and 0·79 (95 % CI 0·70, 0·89; P trend=0·0001) and 0·66 (95 % CI 0·54, 0·82; P trend=0·0002) for men. No significant associations were observed for cancer mortality in both women and men. Results were similar in subgroup and sensitivity analyses. CONCLUSIONS Dietary Se intake was inversely associated with all-cause and cardiovascular mortality in both sexes, but not cancer mortality.
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Guo X, Cai Q, Bao P, Wu J, Wen W, Ye F, Zheng W, Zheng Y, Shu XO. Long-term soy consumption and tumor tissue MicroRNA and gene expression in triple-negative breast cancer. Cancer 2016; 122:2544-51. [PMID: 27183356 DOI: 10.1002/cncr.29981] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 02/08/2016] [Accepted: 02/16/2016] [Indexed: 11/06/2022]
Abstract
BACKGROUND Soy food intake may have protective effects against the risk for breast cancer, including estrogen receptor (ER)-negative breast cancer. However, the underlying molecular mechanisms remain unclear. METHODS To evaluate the association of soy intake with the expression of microRNAs (miRNAs) and genes in the tumor tissue of patients with triple-negative breast cancer (TNBC; ie, breast cancer lacking expression of ER, progesterone receptor, and human epidermal growth factor receptor 2), the expression of 800 miRNAs and 302 genes were measured with NanoString nCounter assays in formalin-fixed, paraffin-embedded tumor tissue from 272 TNBC patients. Soy intake during the 1-year period before the cancer diagnosis was assessed with a validated food-frequency questionnaire. The association of soy intake with the expression of miRNAs and genes was evaluated via linear regression analysis with adjustments for patient age and TNM stage. RESULTS A total of 14 miRNAs and 24 genes were significantly associated with soy food intake (P < .05): Thirteen of the 14 miRNAs (92.9%) and 9 of the 24 genes (37.5%), including tumor suppressors miR-29a-3p and IGF1R, showed overexpression for those women with high soy intake, whereas the remaining miRNAs and genes, including oncogenes KRAS and FGFR4, showed underexpression. Furthermore, cell growth-related genes showed a predominantly underexpression pattern according to a comparison of tumor samples from women with high soy food intake and samples from women with lower soy food intake. CONCLUSIONS This study suggests that long-term prediagnosis soy intake may lead to increased expression of tumor suppressors and decreased expression of oncogenes, especially cell growth-related genes, in breast tumor tissues. Cancer 2016;122:2544-51. © 2016 American Cancer Society.
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Affiliation(s)
- Xingyi Guo
- Division of Epidemiology, Department of Medicine and Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Vanderbilt University, Nashville, Tennessee
| | - Qiuyin Cai
- Division of Epidemiology, Department of Medicine and Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Vanderbilt University, Nashville, Tennessee
| | - Pingping Bao
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People's Republic of China
| | - Jie Wu
- Division of Epidemiology, Department of Medicine and Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Vanderbilt University, Nashville, Tennessee
| | - Wanqing Wen
- Division of Epidemiology, Department of Medicine and Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Vanderbilt University, Nashville, Tennessee
| | - Fei Ye
- Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine and Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Vanderbilt University, Nashville, Tennessee
| | - Ying Zheng
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People's Republic of China
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine and Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Vanderbilt University, Nashville, Tennessee
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Baglia ML, Zheng W, Li H, Yang G, Gao J, Gao YT, Shu XO. The association of soy food consumption with the risk of subtype of breast cancers defined by hormone receptor and HER2 status. Int J Cancer 2016; 139:742-8. [PMID: 27038352 DOI: 10.1002/ijc.30117] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 03/18/2016] [Indexed: 01/15/2023]
Abstract
Soy food intake has previously been associated with reduced breast cancer risk. Epidemiological evidence for subgroups of breast cancer, particularly by menopausal and hormone receptor status, is less consistent. To evaluate the role of hormone receptor and menopausal status on the association between soy food intake and breast cancer risk, we measured usual soy food intake in adolescence and adulthood via food frequency questionnaire in 70,578 Chinese women, aged 40-70 years, recruited to the Shanghai Women's Health Study (1996-2000). After a median follow-up of 13.2 years (range: 0.01-15.0), 1,034 incident breast cancer cases were identified. Using Cox models, we found that adult soy intake was inversely associated with breast cancer risk [hazard ratio (HR) for fifth versus first quintile soy protein intake = 0.78; 95% confidence interval (CI):0.63-0.97]. The association was predominantly seen in premenopausal women (HR = 0.46; 95% CI:0.29-0.74). Analyses further stratified by hormone receptor status showed that adult soy intake was associated with significantly decreased risk of estrogen receptor (ER)+/progesterone receptor (PR)+ breast cancer in postmenopausal women (HR = 0.72; 95% CI:0.53-0.96) and decreased risk of ER-/PR- breast cancer in premenopausal women (HR = 0.46; 95% CI:0.22-0.97). The soy association did not vary by human epidermal growth factor-2 (HER2) status. Furthermore, we found that high soy intake during adulthood and adolescence was associated with reduced premenopausal breast cancer risk (HR = 0.53; 95% CI: 0.32-0.88; comparing third vs. first tertile) while high adulthood soy intake was associated with postmenopausal breast cancer only when adolescent intake was low (HR = 0.63; 95% CI: 0.43-0.91). Our study suggests that hormonal status, menopausal status and time window of exposure are important factors influencing the soy-breast cancer association.
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Affiliation(s)
- Michelle L Baglia
- Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN
| | - Honglan Li
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai, People's Republic of China
| | - Gong Yang
- Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN
| | - Jing Gao
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai, People's Republic of China
| | - Yu-Tang Gao
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai, People's Republic of China
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN
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Nechuta SJ, Shu XO, Yang G, Cai H, Gao YT, Li HL, Xiang YB, Zheng W. Adolescent exercise in association with mortality from all causes, cardiovascular disease, and cancer among middle-aged and older Chinese women. Cancer Epidemiol Biomarkers Prev 2016; 24:1270-6. [PMID: 26231350 DOI: 10.1158/1055-9965.epi-15-0253] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Little is known regarding the role of early-life exercise, a potentially modifiable factor, in long-term adult morbidity and mortality. We utilized the Shanghai Women's Health Study (SWHS) to investigate adolescent exercise in association with cancer, cardiovascular disease (CVD), and all-cause mortality among middle-aged and older women. METHODS The SWHS is a prospective cohort of 74,941 Chinese women ages 40 to 70 years recruited from 1996 to 2000. In-person interviews at enrollment assessed adolescent and adult exercise history, medical and reproductive history, and other lifestyle and socioeconomic (SES) factors. Mortality follow-up occurs via annual linkage to the Shanghai Vital Statistics Registry. Adjusted hazard ratios (HR) and 95% confidence intervals (CI) were derived from Cox regression models. RESULTS Adjusting for birth year and other adolescent factors, adolescent exercise was associated with reduced risk of cancer, CVD, and total mortality [HRs (95% CI), 0.83 (0.72-0.95), 0.83 (0.70-0.98), and 0.78 (0.71-0.85), respectively for ≤1.33 hours (h)/week, and 0.83 (0.74-0.93), 0.62 (0.53-0.72), and 0.71 (0.66-0.77), respectively for >1.33 h/week (reference = none)]. Results were attenuated after adjustment for adult SES and lifestyle factors. Participation in sports teams was inversely associated with cancer mortality [HR (95% CI), 0.86 (0.76-0.97)]. Joint adolescent and adult exercise was associated with reduced risk of all-cause, CVD, and cancer mortality [HRs (95% CIs), 0.80 (0.72-0.89), 0.83 (0.69-1.00), and 0.87 (0.74-1.01), respectively], adjusting for adult/adolescent factors, and adolescence exercise only was inversely associated with cancer mortality [HR (95% CI), 0.84 (0.71-0.98)]. CONCLUSIONS Adolescent exercise participation, independent of adult exercise, was associated with reduced risk of cancer, CVD, and all-cause mortality. IMPACT Results support promotion of exercise in adolescence to reduce mortality in later life.
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Affiliation(s)
- Sarah J Nechuta
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Nashville, Tennessee. Vanderbilt-Ingram Cancer Center, Vanderbilt School of Medicine, Nashville, Tennessee.
| | - Xiao Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Nashville, Tennessee. Vanderbilt-Ingram Cancer Center, Vanderbilt School of Medicine, Nashville, Tennessee
| | - Gong Yang
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Nashville, Tennessee. Vanderbilt-Ingram Cancer Center, Vanderbilt School of Medicine, Nashville, Tennessee
| | - Hui Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Nashville, Tennessee. Vanderbilt-Ingram Cancer Center, Vanderbilt School of Medicine, Nashville, Tennessee
| | - Yu-Tang Gao
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China
| | - Hong-Lan Li
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China
| | - Yong-Bing Xiang
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Nashville, Tennessee. Vanderbilt-Ingram Cancer Center, Vanderbilt School of Medicine, Nashville, Tennessee
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Abstract
We evaluated the reproducibility and validity of an FFQ used in a Chinese community-based nutrition and health survey. A total of ninety-nine males and 104 females aged 31-80 years completed four three consecutive 24-h dietary recalls (24-HDR, served as a reference method, one three consecutive 24-HDR for each season) and two FFQ (FFQ1 and FFQ2) over a 1-year interval. The reproducibility of the FFQ was estimated with correlation coefficients, misclassification and weighted κ statistic. The validity was evaluated by comparing the data obtained from FFQ2 with the mean 24-HDR (m24-HDR). Compared with the m24-HDR, the FFQ tended to underestimate intake of most nutrients and food groups. For all nutrients and food groups, the Spearman's and intra-class correlation coefficients between FFQ1 and FFQ2 ranged from 0·66 to 0·88 and from 0·65 to 0·87, respectively. Most correlation coefficients decreased after adjusting for energy. More than 90% of the subjects were classified into the same or adjacent categories by both FFQ. For all nutrients and food groups, the crude, energy-adjusted and de-attenuated Spearman's correlation coefficients between FFQ2 and the m24-HDR ranged from 0·21 to 0·69, 0·19 to 0·58 and 0·25 to 0·71, respectively. More than 70% of the subjects were classified into the same and adjacent categories by both instruments. Both weighted κ statistic and the Bland-Altman plots showed reasonably acceptable agreement between the FFQ2 and the m24-HDR. The FFQ developed for adults in the Nanjing area can be used to reliably and validly measure usual intake of major nutrients and food groups.
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Abstract
Isoflavones have been suggested to have protective effects on certain cancers. However, the association of soya foods or dietary isoflavones with the risk of myelodysplastic syndromes (MDS) has not been examined. Thus, the aim of this hospital-based case-control study undertaken in China in 2012-2013 was to investigate the association between dietary isoflavone intake and MDS risk. The analysis included 208 cases aged 19-85 years with MDS and 208 controls individually matched to the cases by sex, birth quinquennium and residential locality. Information on habitual food intakes, including nine items of soya foods, was sought from in-person interviews using a validated 107-item FFQ. Dietary intakes of daidzein, genistein, glycitein and total isoflavones were estimated using the 2008 US Department of Agriculture Isoflavone Database. OR were calculated from conditional logistic regression after adjustment for potential confounding by demographics, lifestyle and dietary factors. The mean daily intake of total isoflavones was 19·0 mg in cases and 23·0 mg in controls. Dietary intake of isoflavones was inversely associated with the risk of MDS. The adjusted OR in the highest tertile compared with the lowest tertile of intake were 0·43 (95 % CI 0·21, 0·85) for daidzein, 0·36 (95 % CI 0·18, 0·74) for genistein, 0·49 (95 % CI 0·25, 0·97) for glycitein and 0·40 (95 % CI 0·20, 0·81) for total isoflavones. The findings suggest that higher dietary intake of isoflavones is associated with a reduced risk of MDS in a Chinese population.
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Alcohol consumption and risk of myelodysplastic syndromes: a case–control study. Cancer Causes Control 2015; 27:209-16. [DOI: 10.1007/s10552-015-0698-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 11/14/2015] [Indexed: 10/22/2022]
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Dodington DW, Fritz PC, Sullivan PJ, Ward WE. Higher Intakes of Fruits and Vegetables, β-Carotene, Vitamin C, α-Tocopherol, EPA, and DHA Are Positively Associated with Periodontal Healing after Nonsurgical Periodontal Therapy in Nonsmokers but Not in Smokers. J Nutr 2015; 145:2512-9. [PMID: 26423734 DOI: 10.3945/jn.115.211524] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 09/08/2015] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Periodontitis is a chronic inflammatory disease and a significant risk factor for tooth loss. Although a link between diet and periodontal health exists, the relation between diet and healing after periodontal therapy has yet to be investigated. OBJECTIVE The objective was to determine whether higher intakes of fruits and vegetables or nutrients with antioxidant or anti-inflammatory activity are associated with greater healing, measured as reduced probing depth (PD), after scaling and root planing (SRP), a cost-effective treatment to manage periodontal disease and prevent tooth loss. METHODS Patients (63 nonsmokers, 23 smokers) with chronic generalized periodontitis who were undergoing SRP participated. Healing was evaluated based on PD, assessed at baseline and 8-16 wk after SRP. Intakes of fruits, vegetables, β-carotene, vitamin C, α-tocopherol, α-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) were estimated using the Block 2005 food frequency questionnaire and a supplement questionnaire. Serum 25-hydroxyvitamin D concentrations were also measured. PD (% sites >3 mm) was modeled in multiple linear regression and analysis of covariance by tertile of intake and adjusted for age, sex, body mass index (BMI), baseline PD, examiner, gingival bleeding, and study duration. RESULTS In nonsmokers, PD was associated with fruit and vegetable, β-carotene, vitamin C, α-tocopherol, EPA, and DHA intakes (P < 0.05). PD was not significantly associated with ALA intake or serum 25-hydroxyvitamin D concentration. Significant associations that included supplements (β-carotene, vitamin C, α-tocopherol) were attenuated or lost, depending on the statistical model used. There were no significant associations within the group of smokers. CONCLUSIONS Dietary intakes of fruits and vegetables, β-carotene, vitamin C, α-tocopherol, EPA, and DHA are associated with reduced PD after SRP in nonsmokers, but not smokers, with chronic generalized periodontitis. These findings may lead to the development of dietary strategies to optimize healing after periodontal procedures. This trial was registered at clinicaltrials.gov as NCT02291835.
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Affiliation(s)
- David W Dodington
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada; and
| | - Peter C Fritz
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada; and Reconstructive Periodontics and Implant Surgery Clinic, Fonthill, Ontario, Canada
| | - Philip J Sullivan
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada; and
| | - Wendy E Ward
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada; and
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Schwingshackl L, Hoffmann G, Kalle-Uhlmann T, Arregui M, Buijsse B, Boeing H. Fruit and Vegetable Consumption and Changes in Anthropometric Variables in Adult Populations: A Systematic Review and Meta-Analysis of Prospective Cohort Studies. PLoS One 2015; 10:e0140846. [PMID: 26474158 PMCID: PMC4608571 DOI: 10.1371/journal.pone.0140846] [Citation(s) in RCA: 135] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 10/01/2015] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Randomized controlled trials provide conflicting results on the effects of increased fruit and vegetable consumption on changes in body weight. We aimed to perform a systematic review and meta-analysis of prospective cohort studies on fruit and vegetable consumption in relation to changes in anthropometric measures. METHODS PubMed and EMBASE were searched up to July 2015 for prospective studies reporting on habitual fruit and/or vegetable consumption in relation to changes in body weight or waist circumference or to risk of weight gain/overweight/obesity in adults. Random-effects meta-analysis was applied to pool results across studies. FINDINGS Seventeen cohort studies (from 20 reports) including 563,277 participants met our inclusion criteria. Higher intake of fruits was inversely associated with weight change (decrease) (beta-coefficient per 100-g increment, -13.68 g/year; 95% CI, -22.97 to -4.40). No significant changes could be observed for combined fruit and vegetable consumption or vegetable consumption. Increased intake of fruits was inversely associated with changes (decrease) in waist circumference (beta: -0.04 cm/year; 95% CI, -0.05 to -0.02). Comparing the highest combined fruit & vegetable, fruit, and vegetable intake categories were associated with a 9%, 17%, and 17% reduced risk of adiposity (odds ratio [OR]: 0.91, 95% CI, 0.84 to 0.99), (OR: 0.83, 95% CI, 0.71 to 0.99), and (OR: 0.83, 95% CI, 0.70 to 0.99), respectively. CONCLUSION This meta-analysis showed several inverse associations between fruit and vegetable intake and prospective improvements in anthropometric parameters, and risk of adiposity. The present meta-analysis seems to be limited by low study quality. Nevertheless, when combined with evolutionary nutrition and epidemiological modeling studies, these findings have public health relevance and support all initiatives to increase fruit and vegetable intake.
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Affiliation(s)
- Lukas Schwingshackl
- German Institute of Human Nutrition, Arthur-Scheunert-Allee 114–116, 14558 Nuthetal, Germany
- Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Althanstraße 14 (UZAII), A-1090 Vienna, Austria
| | - Georg Hoffmann
- Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Althanstraße 14 (UZAII), A-1090 Vienna, Austria
| | - Tamara Kalle-Uhlmann
- German Institute of Human Nutrition, Arthur-Scheunert-Allee 114–116, 14558 Nuthetal, Germany
| | - Maria Arregui
- German Institute of Human Nutrition, Arthur-Scheunert-Allee 114–116, 14558 Nuthetal, Germany
| | - Brian Buijsse
- German Institute of Human Nutrition, Arthur-Scheunert-Allee 114–116, 14558 Nuthetal, Germany
| | - Heiner Boeing
- German Institute of Human Nutrition, Arthur-Scheunert-Allee 114–116, 14558 Nuthetal, Germany
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Polymorphisms of 5,10-methylenetetrahydrofolate reductase and thymidylate synthase, dietary folate intake, and the risk of leukemia in adults. Tumour Biol 2015; 37:3265-75. [PMID: 26438060 DOI: 10.1007/s13277-015-4168-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 09/27/2015] [Indexed: 01/12/2023] Open
Abstract
The 5,10-methylenetetrahydrofolate reductase (MTHFR) and thymidylate synthase (TS) are critical enzymes in folate metabolism. Previous studies have reported conflicting results on the associations between MTHFR/TS polymorphisms and adult leukemia risk, which may due to the lack of information on folate intake. We investigated the risks of adult leukemia with genetic polymorphisms of folate metabolic enzymes (MTHFR C677T, A1298C, and TS) and evaluated if the associations varied by dietary folate intake from a multicenter case-control study conducted in Chinese. This study comprised 442 incident adult leukemia cases and 442 outpatient controls, individually matched to cases by gender, birth quinquennium, and study site. Genotypes were determined by a polymerase chain reaction (PCR) or PCR-based restriction fragment length polymorphism assay. Dietary folate intake was assessed by face-to-face interviews using a validated food-frequency questionnaire. The MTHFR 677TT genotype conferred a significant higher risk of leukemia in males than in females and exhibited an increased risk of acute myeloid leukemia (AML) but a decreased risk of acute lymphoblastic leukemia (ALL). The MTHFR 1298AC genotype appeared to decrease the risks of leukemia in both genders, in AML and ALL. Stratified analysis by dietary folate intake showed the increased risks of leukemia with the MTHFR 677TT and TS 2R3R/2R2R genotypes were only significant in individuals with low folate intake. A significant interaction between TS polymorphism and dietary folate intake was observed (P = 0.03). This study suggests that dietary folate intake and gender may modify the associations between MTHFR/TS polymorphisms and adult leukemia risk.
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Associations between antioxidant vitamins and the risk of invasive cervical cancer in Chinese women: A case-control study. Sci Rep 2015; 5:13607. [PMID: 26337940 PMCID: PMC4559762 DOI: 10.1038/srep13607] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 07/17/2015] [Indexed: 11/13/2022] Open
Abstract
Previous studies on the associations between dietary antioxidant vitamins and the risk of cervical cancer remain inconsistent, and little evidence is available for serum antioxidant vitamins, which provide more accurate measurements of these nutrients. We conducted a case-control study of 458 incident cases with invasive cervical cancer and 742 controls to assess the effects of diet or serum antioxidant vitamins. Higher serum antioxidant vitamins were associated with a lower risk of cervical cancer after adjusting for potential confounders. The odds ratios (ORs) for the highest (vs. lowest) quartile were 0.66 (95% confidence interval [CI] = 0.46–0.93; P = 0.024) for α-carotene, 0.63 (95% CI = 0.45–0.90; P = 0.006) for β-carotene, 0.53 (95% CI = 0.37–0.74; P < 0.001) for vitamin E, and 0.48 (95% CI = 0.33–0.69; P < 0.001) for vitamin C. Dietary intakes of vitamins E and C were inversely associated with the risk of cervical cancer. Risk of cervical cancer from serum antioxidant vitamins was more evident in passive smokers than non-passive smokers. These findings indicated that antioxidant vitamins (mainly α-carotene, β-carotene, and vitamins E and C) might be beneficial in reducing the risk of invasive cervical cancer in Chinese women, especially in passive smokers.
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Yu D, Shu XO, Li H, Yang G, Cai Q, Xiang YB, Ji BT, Franke AA, Gao YT, Zheng W, Zhang X. Dietary isoflavones, urinary isoflavonoids, and risk of ischemic stroke in women. Am J Clin Nutr 2015; 102:680-6. [PMID: 26245809 PMCID: PMC4548177 DOI: 10.3945/ajcn.115.111591] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 07/13/2015] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Hormone therapy has been shown to increase risk of ischemic stroke in women. Plant-derived estrogens, particularly soy isoflavones, are known to have some estrogenic effects and have been marketed as natural alternatives to hormone therapy. Concerns have been raised about whether high isoflavone exposure may be related to ischemic stroke risk as well. OBJECTIVE We examined the dietary intake of isoflavones and the urinary excretion of isoflavonoids in relation to risk of ischemic stroke in women. DESIGN A prospective cohort study was conducted in 66,832 Chinese women (aged 40-70 y) who had no cardiovascular disease or cancer at baseline. Usual dietary intakes were assessed via in-person interviews with the use of a validated food-frequency questionnaire. Incident strokes were ascertained during follow-up home visits and confirmed by medical records. We also conducted a nested case-control study in postmenopausal women who had never used hormone therapy, including 1422 incident ischemic stroke cases and 1422 controls individually matched by age, date and time of urine sample collection, time since last meal, and use of antibiotics. Urinary isoflavonoids were measured with the use of high-performance liquid chromatography coupled with mass spectrometry. RESULTS During a mean follow-up of 10 y, 3110 incident ischemic strokes were verified. Dietary isoflavone intake was associated with increased risk of ischemic stroke; multivariable-adjusted HRs from lowest to highest quintiles were 1.00, 1.05, 1.10, 1.11, and 1.24, respectively (95% CI: 1.08, 1.42; P-trend = 0.002). In the case-control study, a similar positive association was observed for dietary isoflavones, but no significant associations were shown for the urinary isoflavonoid concentration [OR: 1.01 (95% CI: 0.77, 1.32) for comparison of extreme quintiles]. CONCLUSIONS A habitually high intake of soy isoflavones may be associated with a modest but significant increase in risk of ischemic stroke in women. However, no association was shown for the urinary excretion of isoflavonoids.
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Affiliation(s)
- Danxia Yu
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN
| | - Honglan Li
- Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Gong Yang
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN
| | - Qiuyin Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN
| | - Yong-Bing Xiang
- Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Bu-Tian Ji
- Division of Cancer Epidemiology and Genetics, National Cancer Institute/NIH, Bethesda, MD; and
| | | | - Yu-Tang Gao
- Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN
| | - Xianglan Zhang
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN;
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Liu X, Wang X, Lin S, Song Q, Lao X, Yu ITS. Reproducibility and Validity of a Food Frequency Questionnaire for Assessing Dietary Consumption via the Dietary Pattern Method in a Chinese Rural Population. PLoS One 2015; 10:e0134627. [PMID: 26230275 PMCID: PMC4521698 DOI: 10.1371/journal.pone.0134627] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 07/11/2015] [Indexed: 11/18/2022] Open
Abstract
Objective This study was conducted to assess the reproducibility and validity of a food frequency questionnaire (FFQ) that was developed to assess the overall dietary consumption via dietary pattern method in a rural population in southwest China. Methods A total of 179 participants aged between 40 and 70 years old were included in this study. Participants administered FFQ at baseline (FFQ1) and one year later (FFQ2) to assess the reproducibility. Six 3-day 24-hour recalls (24HRs) were completed between the administrations of two FFQs to determine the validity. Dietary patterns from three separate dietary sources were derived by using principle component factor analysis. Comparisons between dietary pattern scores were made by using Pearson or intraclass correlation coefficient, cross-classification analysis, weighted kappa (κ) statistic and Bland-Altman analysis. The de-attenuated method was adopted to correct the monthly and seasonally variation and the partial correlation analysis was used correct the influence by total energy intake. Results Two major dietary factors, labeled as prudent pattern and processed food pattern, were identified. The prudent pattern was characterized by higher factor loadings of wheat, rice, fresh vegetables, bean products, nuts, red meat, white meat and fresh eggs; and the processed food pattern was characterized by higher factor loadings of pickled vegetables, preserved vegetables and salted meat. Between Two FFQs, intraclass correlation coefficients were 0.57 for prudent pattern and 0.55 for processed food pattern, partial Pearson correlation coefficients were 0.51 for the prudent pattern and 0.56 for the processed food pattern; weighted κ statistic ranged from 0.45 (for the prudent pattern) to 0.56 (for the processed food pattern). Between FFQs and 24HRs, de-attenuated correlation coefficients ranged from 0.54 to 0.78 for the prudent pattern and from 0.55 to 0.61 for the processed food pattern; partial Pearson correlation coefficients ranged from 0.41 to 0.56 for the prudent pattern and from 0.42 to 0.44 for the processed food pattern; weighted κ statistic ranged from 0.42 to 0.46 for prudent pattern and from 0.43 to 0.60 for processed food pattern. The Bland-Altman plots and limits of agreement indicated that the deviation/divergence was not obvious for both of the patterns between FFQ1 and FFQ2 and between FFQs and 24HRs. Conclusion The study suggests that the FFQ is reasonably reproducible and valid to assess the overall dietary consumption via dietary pattern methods in the Chinese rural population.
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Affiliation(s)
- Xudong Liu
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xiaorong Wang
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
- Hong Kong Occupational and Environmental Health Academy, Hong Kong SAR, China
- * E-mail:
| | - Sihao Lin
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
- Hong Kong Occupational and Environmental Health Academy, Hong Kong SAR, China
| | - Qingkun Song
- Beijing Key Laboratory of Cancer Therapeutic Vaccine, Capital Medical University Cancer Center, Beijing Shijitan Hospital, Beijing, China
| | - Xiangqian Lao
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ignatius Tak-Sun Yu
- Hong Kong Occupational and Environmental Health Academy, Hong Kong SAR, China
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Sun K, Xiang X, Li N, Huang S, Qin X, Wu Y, Tang X, Gao P, Li J, Wu T, Chen D, Hu Y. Gene-Diet Interaction between SIRT6 and Soybean Intake for Different Levels of Pulse Wave Velocity. Int J Mol Sci 2015; 16:14338-52. [PMID: 26114387 PMCID: PMC4519845 DOI: 10.3390/ijms160714338] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 06/19/2015] [Accepted: 06/19/2015] [Indexed: 12/20/2022] Open
Abstract
Soybean is a common food for the Chinese people. We aimed to investigate the risk for brachial ankle pulse wave velocity (baPWV) with inflammatory-related SNPs and soybean. baPWV was measured, and 16 inflammatory-related SNPs located on ADIPOQ, CDH13, SIRT3, SIRT6, CXCL12, CXCR4, NOS1, PON1 and CDKN2B were genotyped in 1749 Chinese participants recruited from various communities. ADIPOQ rs12495941 (GT/TT vs. GG: crude OR = 1.27, p = 0.044) and SIRT6 rs107251 (CT/TT vs. CC: crude OR = 0.74, p = 0.009) were associated with abnormal baPWV (baPWV ≥ 1700 cm/s). After adjustment for conventional environmental risk factors, rs12495941 was associated with abnormal baPWV (GT/TT vs. GG: adjusted OR = 1.43, p = 0.011), but the association between rs107251 and abnormal baPWV was not significant (CT/TT vs. CC: adjusted OR = 0.83, p = 0.173). The interaction between rs107251 and soybean intake for different levels of baPWV was statistically significant (p = 0.017). Compared with a high level of soybean intake, a low level of soybean intake can significantly decrease the risk of abnormal baPWV in individuals of rs107251 CT/TT genotypes (≤100 vs. >100 g/week: adjusted OR = 0.542, p = 0.003). In this study, associations between ADIPOQ rs12495941, SIRT6 rs107251 and baPWV, as well as an interaction between SIRT6 rs107251 and soybean intake for different levels of baPWV were found.
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Affiliation(s)
- Kexin Sun
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China.
| | - Xiao Xiang
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China.
| | - Na Li
- Fangshan District Center for Disease Control and Prevention, Beijing 102401, China.
| | - Shaoping Huang
- Fangshan District Center for Disease Control and Prevention, Beijing 102401, China.
| | - Xueying Qin
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China.
| | - Yiqun Wu
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China.
| | - Xun Tang
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China.
| | - Pei Gao
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China.
| | - Jing Li
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China.
| | - Tao Wu
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China.
| | - Dafang Chen
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China.
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China.
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Liu P, Holman CDJ, Jin J, Zhang M. Diet and risk of adult leukemia: a multicenter case-control study in China. Cancer Causes Control 2015; 26:1141-51. [PMID: 26071869 DOI: 10.1007/s10552-015-0608-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 05/30/2015] [Indexed: 12/20/2022]
Abstract
PURPOSE Epidemiologic studies on diet and leukemia risk have shown inconsistent results. This study examined the associations between dietary factors and the risk of adult leukemia in Chinese populations. METHODS A multicenter case-control study was conducted in southeast and northeast China between 2008 and 2013. It included 442 incident cases with hematologically confirmed leukemia and 442 controls, individually match to cases by gender, birth quinquennium, and study site. Information on diet was sought from face-to-face interviews using a validated and reliable 103-item food frequency questionnaire. Odds ratios (ORs) and confidence intervals (CIs) were estimated by conditional logistic regression. RESULTS Vegetables intake was associated with decreased risk of adult leukemia, with a significant dose-response relationship and adjusted OR of 0.30 (95 % CI 0.18-0.50) for the highest versus the lowest quartiles intake. Compared with non-consumers, the adjusted OR was 0.51 (95 % CI 0.29-0.93) for those who consumed milk at the highest tertile. Intakes of fruits, red meat, poultry, and fish were not associated with the risk. Dietary nutrients, including dietary fiber, carotenoids, vitamins B1, B2, and C, niacin, and folate, were significantly associated with reduced risks. Elevated risk was related to dietary intake animal fat and dietary habits with frequent intakes of fat, deep-fried, and smoked foods ( p for trend <0.05). CONCLUSIONS Our findings suggest that diets rich in vegetables and adequate amount of milk reduce the risk of adult leukemia, whereas diets preferring fat, deep-fried, and smoked foods increase the risk in Chinese populations.
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Affiliation(s)
- Ping Liu
- School of Population Health, The University of Western Australia, M431, 135 Stirling Highway, Crawley, Perth, WA, 6009, Australia
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141
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Zhang H, Qiu X, Zhong C, Zhang K, Xiao M, Yi N, Xiong G, Wang J, Yao J, Hao L, Wei S, Yang N, Yang X. Reproducibility and relative validity of a semi-quantitative food frequency questionnaire for Chinese pregnant women. Nutr J 2015; 14:56. [PMID: 26040544 PMCID: PMC4457005 DOI: 10.1186/s12937-015-0044-x] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 05/27/2015] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Food frequency questionnaire (FFQ) is a reliable tool to estimate dietary intake in large nutritional epidemiological studies, but there is lack of a current and validated FFQ for use in urban Chinese pregnant women. This study aimed to evaluate the reproducibility and validity of a semi-quantitative FFQ designed to estimate dietary intake among urban pregnant women in a cohort study conducted in central China. METHODS In the reproducibility study, a sample of 123 healthy pregnant women completed the first FFQ at 12-13 weeks gestation and the second FFQ 3-4 weeks later. To validate the FFQ, the pregnant women completed three 24-h recalls (24HRs) between the intervals of two FFQs. RESULTS The intraclass correlation coefficients of two administrations of FFQ for foods ranged from 0.23 (nuts) to 0.49 (fruits) and for nutrients from 0.24 (iodine) to 0.58 (selenium) and coefficients were all statistically significant. The unadjusted Pearson correlation coefficients between two methods ranged from 0.28 (beans) to 0.53 (fruits) for foods and from 0.15 (iodine) to 0.59 (protein) for nutrients. Energy-adjusted and de-attenuated correlation coefficients for foods ranged from 0.35 (beans) to 0.56 (fruits) and for nutrients from 0.11 (iodine) to 0.63 (protein), and all correlations being statistically significant except for iodine, sodium and riboflavin. On average, 67.0% (51.2%-80.5%) of women were classified by both methods into the same or adjacent quintiles based on their food intakes, while 68.5% (56.1%-77.2%) of women were classified as such based on nutrient intakes. Extreme misclassifications were very low for both foods (average of 2.0%) and nutrients (average of 2.2%). Bland-Altman Plots also showed reasonably acceptable agreement between two methods. CONCLUSION This FFQ is a reasonably reliable and valid tool for assessing most food and nutrient intakes of urban pregnant women in central China.
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Affiliation(s)
- Hongmin Zhang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Xiang Qiu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Chunrong Zhong
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Kewei Zhang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Mei Xiao
- Hubei Maternal and Child Health Hospital, Wuhan, 430070, Hubei, China
| | - Nianhua Yi
- Hubei Maternal and Child Health Hospital, Wuhan, 430070, Hubei, China
| | - Guoping Xiong
- The Central Hospital of Wuhan, Wuhan, 430014, Hubei, China
| | - Jing Wang
- Jiangan Maternal and Child Health Hospital, Wuhan, 430014, Hubei, China
| | - Jing Yao
- Jiangan Maternal and Child Health Hospital, Wuhan, 430014, Hubei, China
| | - Liping Hao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Sheng Wei
- Department of Epidemiology and Biostatistics, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Nianhong Yang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Xuefeng Yang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China.
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142
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Pre-diagnostic cruciferous vegetables intake and lung cancer survival among Chinese women. Sci Rep 2015; 5:10306. [PMID: 25988580 PMCID: PMC4650798 DOI: 10.1038/srep10306] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 04/08/2015] [Indexed: 12/21/2022] Open
Abstract
No study to date has prospectively evaluated the association between pre-diagnostic cruciferous vegetables intake and lung cancer survival among women. This analysis included 547 incident lung cancer cases identified from the Shanghai Women’s Health Study (SWHS) during the follow-up period of 1997-2011. Dietary intake was assessed for all SWHS participants at enrollment and reassessed 2-3 years later. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) with adjustment for potential confounders. Of the 547 lung cancer patients, 412 patients died during the follow-up. A total of 393 (95.4%) deaths from lung cancer were documented with median survival time of 10.3 months (interquartile range, 3.6-21.1 months). High cruciferous vegetables intake was significantly associated with improved lung cancer-specific survival after adjusting for all nonclinical prognostic factors (n = 547, HR = 0.69; 95%CI = 0.49-0.95; P trend = 0.02) for the highest versus lowest quartile. A slightly stronger association of cruciferous vegetables intake with lung cancer-specific survival was observed in analyses restricted to patients with known clinical prognostic factors (n = 331, HR = 0.63; 95%CI = 0.41-0.97; P trend = 0.03) or never smokers (n = 308, HR = 0.58; 95%CI = 0.37-0.91; P trend = 0.02). In conclusion, pre-diagnostic cruciferous vegetables intake is associated with better survival of lung cancer in Chinese women.
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Luu HN, Blot WJ, Xiang YB, Cai H, Hargreaves MK, Li H, Yang G, Signorello L, Gao YT, Zheng W, Shu XO. Prospective evaluation of the association of nut/peanut consumption with total and cause-specific mortality. JAMA Intern Med 2015; 175:755-66. [PMID: 25730101 PMCID: PMC4474488 DOI: 10.1001/jamainternmed.2014.8347] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
IMPORTANCE High intake of nuts has been linked to a reduced risk of mortality. Previous studies, however, were primarily conducted among people of European descent, particularly those of high socioeconomic status. OBJECTIVE To examine the association of nut consumption with total and cause-specific mortality in Americans of African and European descent who were predominantly of low socioeconomic status (SES) and in Chinese individuals in Shanghai, China. DESIGN, SETTING, AND PARTICIPANTS Three large cohorts were evaluated in the study. One included 71 764 US residents of African and European descent, primarily of low SES, who were participants in the Southern Community Cohort Study (SCCS) in the southeastern United States (March 2002 to September 2009), and the other 2 cohorts included 134 265 participants in the Shanghai Women's Health Study (SWHS) (December 1996 to May 2000) and the Shanghai Men's Health Study (SMHS) (January 2002 to September 2006) in Shanghai, China. Self-reported nut consumption in the SCCS (approximately 50% were peanuts) and peanut-only consumption in the SMHS/SWHS were assessed using validated food frequency questionnaires. MAIN OUTCOMES AND MEASURES Deaths were ascertained through linkage with the National Death Index and Social Security Administration mortality files in the SCCS and annual linkage with the Shanghai Vital Statistics Registry and by biennial home visits in the SWHS/SMHS. Cox proportional hazards regression models were used to calculate hazard ratios (HRs) and 95% CIs. RESULTS With a median follow-up of 5.4 years in the SCCS, 6.5 years in the SMHS, and 12.2 years in the SWHS, 14,440 deaths were identified. More than half of the women in the SCCS were ever smokers compared with only 2.8% in the SWHS. The ever-smoking rate for men was 77.1% in the SCCS and 69.6% in the SMHS. Nut intake was inversely associated with risk of total mortality in all 3 cohorts (all P<.001 for trend), with adjusted HRs associated with the highest vs lowest quintiles of intake being 0.79 (95% CI, 0.73-0.86) and 0.83 (95% CI, 0.77-0.88), respectively, for the US and Shanghai cohorts. This inverse association was predominantly driven by cardiovascular disease mortality (P<.05 for trend in the US cohort; P<.001 for trend in the Shanghai cohorts). When specific types of cardiovascular disease were examined, a significant inverse association was consistently seen for ischemic heart disease in all ethnic groups (HR, 0.62; 95% CI, 0.45-0.85 in blacks; HR, 0.60; 95% CI, 0.39-0.92 in whites; and HR, 0.70; 95% CI, 0.54-0.89 in Asians for the highest vs lowest quintile of nut intake). The associations for ischemic stroke (HR, 0.77; 95% CI, 0.60-1.00 for the highest vs lowest quintile of nut intake) and hemorrhagic stroke (HR, 0.77; 95% CI, 0.60-0.99 for the highest vs lowest quintile of nut intake) were significant only in Asians. The nut-mortality association was similar for men and women and for blacks, whites, and Asians and was not modified by the presence of metabolic conditions at study enrollment. CONCLUSIONS AND RELEVANCE Nut consumption was associated with decreased overall and cardiovascular disease mortality across different ethnic groups and among individuals from low SES groups. Consumption of nuts, particularly peanuts given their general affordability, may be considered a cost-effective measure to improve cardiovascular health.
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Affiliation(s)
- Hung N Luu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Nashville, Tennessee2Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - William J Blot
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Nashville, Tennessee2Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee3International
| | - Yong-Bing Xiang
- Department of Epidemiology, Shanghai Cancer Institute, Xuhui, Shanghai, China
| | - Hui Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Nashville, Tennessee2Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee
| | | | - Honglan Li
- Department of Epidemiology, Shanghai Cancer Institute, Xuhui, Shanghai, China
| | - Gong Yang
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Nashville, Tennessee2Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Lisa Signorello
- Department of Epidemiology, Harvard School of Public Health, Harvard University, Boston, Massachusetts
| | - Yu-Tang Gao
- Department of Epidemiology, Shanghai Cancer Institute, Xuhui, Shanghai, China
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Nashville, Tennessee2Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Nashville, Tennessee2Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee
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Fruit and vegetable consumption and risk of lung cancer: A dose–response meta-analysis of prospective cohort studies. Lung Cancer 2015; 88:124-30. [DOI: 10.1016/j.lungcan.2015.02.015] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 12/21/2014] [Accepted: 02/18/2015] [Indexed: 11/22/2022]
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Lau KK, Wong YK, Chan YH, Li OY, Lee PYS, Yuen GG, Wong YK, Tong S, Wong D, Chan KH, Cheung RTF, Siu CW, Ho SL, Tse HF. Mediterranean-style diet is associated with reduced blood pressure variability and subsequent stroke risk in patients with coronary artery disease. Am J Hypertens 2015; 28:501-7. [PMID: 25352231 DOI: 10.1093/ajh/hpu195] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND PURPOSE The Mediterranean-style diet is widely advocated for the prevention of cardiovascular diseases (CVD). Meanwhile, blood pressure variability (BPV) is a novel risk factor for CVD. It is unknown whether dietary pattern plays a role in modulating BPV. METHODS We prospectively followed-up 274 consecutive patients with stable coronary artery disease (CAD). The Mediterranean diet score (MDS) was derived for all individuals upon recruitment, blood pressure (BP) was measured during each subsequent clinic visit and the visit-to-visit BPV was calculated. The occurrence of major adverse cardiovascular events (MACEs) and all-cause mortality was monitored. RESULTS After a mean follow-up of 77±12 months, 16.1% of the study population developed MACEs. About 11.3% died from all causes. Patients who developed MACEs or all-cause mortality had a greater systolic BPV compared to those who did not develop an adverse event. Patients who developed a MACE had a lower MDS and further analysis revealed those who developed a stroke had a lower MDS compared with those who did not develop a stroke, but there were no significant differences in MDS between CAD patients with or without subsequent acute coronary syndrome, cardiovascular, or all-cause mortality. After adjusting for confounding variables, a high MDS was an independent predictor for low systolic BPV (B -0.74, 95% confidence interval -1.27 to -0.21, P < 0.01) and was noted to be protective against subsequent development of stroke (hazards ratio 0.48, 95% confidence interval 0.24 to 0.94, P = 0.03). CONCLUSIONS Among patients with CAD, a higher MDS is associated with a lower visit-to-visit BPV and with lower stroke risk.
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Affiliation(s)
- Kui-Kai Lau
- Neurology Division, Department of Medicine, The University of Hong Kong, Hong Kong
| | - Yuen-Kwun Wong
- Neurology Division, Department of Medicine, The University of Hong Kong, Hong Kong
| | - Yap-Hang Chan
- Cardiology Division, Department of Medicine, The University of Hong Kong, Hong Kong
| | - Oi-Yi Li
- Neurology Division, Department of Medicine, The University of Hong Kong, Hong Kong
| | - Philip Yat-Sing Lee
- Neurology Division, Department of Medicine, The University of Hong Kong, Hong Kong
| | - Gabrielle G Yuen
- Neurology Division, Department of Medicine, The University of Hong Kong, Hong Kong
| | - Yee-Kiu Wong
- Neurology Division, Department of Medicine, The University of Hong Kong, Hong Kong
| | - Samuel Tong
- Neurology Division, Department of Medicine, The University of Hong Kong, Hong Kong
| | - Dicken Wong
- Neurology Division, Department of Medicine, The University of Hong Kong, Hong Kong
| | - Koon-Ho Chan
- Neurology Division, Department of Medicine, The University of Hong Kong, Hong Kong
| | | | - Chung-Wah Siu
- Cardiology Division, Department of Medicine, The University of Hong Kong, Hong Kong
| | - Shu-Leong Ho
- Neurology Division, Department of Medicine, The University of Hong Kong, Hong Kong
| | - Hung-Fat Tse
- Cardiology Division, Department of Medicine, The University of Hong Kong, Hong Kong.
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146
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Soy isoflavone intake and bone mineral density in breast cancer survivors. Cancer Causes Control 2015; 26:571-80. [PMID: 25687481 DOI: 10.1007/s10552-015-0534-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Accepted: 02/10/2015] [Indexed: 12/26/2022]
Abstract
PURPOSE Low bone mineral density (BMD) is common among breast cancer survivors due to acute estrogen deprivation. Soy food is a rich source of phytoestrogens, namely isoflavones, known to have both estrogenic and anti-estrogenic effects. The objective of the study was to assess the association between soy consumption and BMD in breast cancer survivors, which has not previously been evaluated. METHODS Forearm BMD was evaluated using dual-energy X-ray absorptiometry at 60 months post-diagnosis for 1,587 participants of the Shanghai Breast Cancer Survival Study. Soy intakes collected at 6, 18, and 36 months post-diagnosis were averaged, and the association with BMD, osteopenia, and osteoporosis was evaluated using linear and logistic regression. RESULTS The mean (standard deviation) intake of isoflavones was 48.1 (28.0) mg/day. Soy intake was inversely associated with BMD and positively associated with osteoporosis. Compared with the lowest quartile, the highest quartile of soy isoflavone intake, ≥ 62.64 mg/day, was associated with a reduction of BMD by 1.95% [95% confidence interval (CI) -3.54, -0.36%] and an increased odds ratio of 1.69 for osteoporosis (95% CI 1.09, 2.61). The inverse association was predominantly seen among women who recently entered menopause (≤ 5 years). CONCLUSION In contrast to observations from general populations, high soy intake (≥ 62.64 mg of soy isoflavone/day) was associated with lower proximal forearm BMD among breast cancer survivors, particularly during the early years of menopause. Our finding needs to be replicated, particularly in studies with more comprehensive bone density evaluation.
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147
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Wu Y, Zhang D, Jiang X, Jiang W. Fruit and vegetable consumption and risk of type 2 diabetes mellitus: a dose-response meta-analysis of prospective cohort studies. Nutr Metab Cardiovasc Dis 2015; 25:140-147. [PMID: 25456152 DOI: 10.1016/j.numecd.2014.10.004] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2014] [Revised: 09/19/2014] [Accepted: 10/06/2014] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND AIMS We conducted a dose-response meta-analysis to summarize the evidence from prospective cohort studies regarding the association of fruit and vegetable consumption with risk of type 2 diabetes mellitus (T2DM). METHODS AND RESULTS Pertinent studies were identified by searching Embase and PubMed through June 2014. Study-specific results were pooled using a random-effect model. The dose-response relationship was assessed by the restricted cubic spline model and the multivariate random-effect meta-regression. We standardized all data using a standard portion size of 106 g. The Relative Risk (95% confidence interval) [RR (95% CI)] of T2DM was 0.99 (0.98-1.00) for every 1 serving/day increment in fruit and vegetable (FV) (P = 0.18), 0.98 (0.95-1.01) for vegetable (P = 0.12), and 0.99 (0.97-1.00) for fruit (P = 0.05). The RR (95%CI) of T2DM was 0.99 (0.97-1.01), 0.98 (0.96-1.01), 0.97 (0.93-1.01), 0.96 (0.92-1.01), 0.96 (0.91-1.01) and 0.96 (0.91-1.01) for 1, 2, 3, 4, 5 and 6 servings/day of FV (P(for non-linearity) = 0.44). The T2DM risk was 0.96 (0.95-0.99), 0.94 (0.90-0.98), 0.94 (0.89-0.98), 0.96 (0.91-1.01), 0.98 (0.92-1.05) and 1.00 (0.93-1.08) for 1, 2, 3, 4, 5 and 6 servings/day of vegetable (P(for non-linearity) < 0.01). The T2DM risk was 0.95 (0.93-0.97), 0.91 (0.89-0.94), 0.88 (0.85-0.92), 0.92 (0.88-0.96) and 0.96 (0.92-1.01) for 0.5, 1, 2, 3 and 4 servings/day of fruit (P(for non-linearity) < 0.01). CONCLUSIONS Two-three servings/day of vegetable and 2 servings/day of fruit conferred a lower risk of T2DM than other levels of vegetable and fruit consumption, respectively.
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Affiliation(s)
- Y Wu
- Department of Epidemiology and Health Statistics, Qingdao University Medical College, Qingdao, PR China
| | - D Zhang
- Department of Epidemiology and Health Statistics, Qingdao University Medical College, Qingdao, PR China.
| | - X Jiang
- Department of Epidemiology and Health Statistics, Qingdao University Medical College, Qingdao, PR China
| | - W Jiang
- Department of Epidemiology and Health Statistics, Qingdao University Medical College, Qingdao, PR China
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148
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Muraki I, Wu H, Imamura F, Laden F, Rimm EB, Hu FB, Willett WC, Sun Q. Rice consumption and risk of cardiovascular disease: results from a pooled analysis of 3 U.S. cohorts. Am J Clin Nutr 2015; 101:164-72. [PMID: 25527760 PMCID: PMC4266886 DOI: 10.3945/ajcn.114.087551] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2014] [Accepted: 10/16/2014] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Health concerns have been raised about rice consumption, which may significantly contribute to arsenic exposure. However, little is known regarding whether habitual rice consumption is associated with cardiovascular disease (CVD) risk. OBJECTIVE We examined prospectively the association of white rice and brown rice consumption with CVD risk. DESIGN We followed a total of 207,556 women and men [73,228 women from the Nurses' Health Study (1984-2010), 92,158 women from the Nurses' Health Study II (1991-2011), and 42,170 men from the Health Professionals Follow-Up Study (1986-2010)] who were free of CVD and cancer at baseline. Validated semiquantitative food-frequency questionnaires were used to assess consumption of white rice, brown rice, and other food items. Fatal and nonfatal CVD (coronary artery disease and stroke) was confirmed by medical records or self-reports. RESULTS During 4,393,130 person-years of follow-up, 12,391 cases of CVD were identified. After adjustment for major CVD risk factors, including demographics, lifestyle, and other dietary intakes, rice consumption was not associated with CVD risk. The multivariable-adjuted HR of developing CVD comparing ≥5 servings/wk with <1 serving/wk was 0.98 (95% CI: 0.84, 1.14) for white rice, 1.01 (0.79, 1.28) for brown rice, and 0.99 (0.90, 1.08) for total rice. To minimize the potential impact of racial difference in rice consumption, we restricted the analyses to whites only and obtained similar results: the HRs of CVD for ≥5 servings/wk compared with <1 serving/wk were 1.04 (95% CI: 0.88, 1.22) for white rice and 1.01 (0.78, 1.31) for brown rice. CONCLUSIONS Greater habitual consumption of white rice or brown rice is not associated with CVD risk. These findings suggest that rice consumption may not pose a significant CVD risk among the U.S. population when consumed at current amounts. More prospective studies are needed to explore these associations in other populations.
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Affiliation(s)
- Isao Muraki
- From the Departments of Nutrition (IM, HW, EBR, FBH, WCW, and QS), Epidemiology (FL, EBR, FBH, and WCW), and Environmental Health (FL), Harvard School of Public Health and Channing Division of Network Medicine (FL, EBR, FBH, WCW, and QS), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, and the Medical Research Council Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom (FI)
| | - Hongyu Wu
- From the Departments of Nutrition (IM, HW, EBR, FBH, WCW, and QS), Epidemiology (FL, EBR, FBH, and WCW), and Environmental Health (FL), Harvard School of Public Health and Channing Division of Network Medicine (FL, EBR, FBH, WCW, and QS), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, and the Medical Research Council Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom (FI)
| | - Fumiaki Imamura
- From the Departments of Nutrition (IM, HW, EBR, FBH, WCW, and QS), Epidemiology (FL, EBR, FBH, and WCW), and Environmental Health (FL), Harvard School of Public Health and Channing Division of Network Medicine (FL, EBR, FBH, WCW, and QS), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, and the Medical Research Council Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom (FI)
| | - Francine Laden
- From the Departments of Nutrition (IM, HW, EBR, FBH, WCW, and QS), Epidemiology (FL, EBR, FBH, and WCW), and Environmental Health (FL), Harvard School of Public Health and Channing Division of Network Medicine (FL, EBR, FBH, WCW, and QS), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, and the Medical Research Council Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom (FI)
| | - Eric B Rimm
- From the Departments of Nutrition (IM, HW, EBR, FBH, WCW, and QS), Epidemiology (FL, EBR, FBH, and WCW), and Environmental Health (FL), Harvard School of Public Health and Channing Division of Network Medicine (FL, EBR, FBH, WCW, and QS), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, and the Medical Research Council Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom (FI)
| | - Frank B Hu
- From the Departments of Nutrition (IM, HW, EBR, FBH, WCW, and QS), Epidemiology (FL, EBR, FBH, and WCW), and Environmental Health (FL), Harvard School of Public Health and Channing Division of Network Medicine (FL, EBR, FBH, WCW, and QS), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, and the Medical Research Council Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom (FI)
| | - Walter C Willett
- From the Departments of Nutrition (IM, HW, EBR, FBH, WCW, and QS), Epidemiology (FL, EBR, FBH, and WCW), and Environmental Health (FL), Harvard School of Public Health and Channing Division of Network Medicine (FL, EBR, FBH, WCW, and QS), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, and the Medical Research Council Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom (FI)
| | - Qi Sun
- From the Departments of Nutrition (IM, HW, EBR, FBH, WCW, and QS), Epidemiology (FL, EBR, FBH, and WCW), and Environmental Health (FL), Harvard School of Public Health and Channing Division of Network Medicine (FL, EBR, FBH, WCW, and QS), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, and the Medical Research Council Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom (FI)
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Xu WH, Xiang YB, Zhang X, Ruan Z, Cai H, Zheng W, Shu XO. Association of dietary glycemic index and glycemic load with endometrial cancer risk among Chinese women. Nutr Cancer 2014; 67:89-97. [PMID: 25495185 DOI: 10.1080/01635581.2015.976319] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
We evaluated the association of dietary glycemic index (GI) and glycemic load (GL) with the risk of endometrial cancer in a population-based, case-control study of 1199 endometrial cancer patients and 1212 age-frequency-matched controls in urban Shanghai, China, where diets are typically high in carbohydrates and have a high GL. Information on dietary habits, physical activity, and other relevant information was collected using a validated questionnaire, and anthropometric measurements were taken. Logistic regression was applied in the analysis. Dietary GI and GL were independently associated with risk for endometrial cancer but carbohydrate intake was unrelated to risk. Multivariable-adjusted odds ratios (ORs) for increasing quartiles of intake were 1.0, 1.3, 1.4, and 2.2 [95% confidence interval (CI): 1.2-4.0] for dietary GL (P(trend) = 0.02) and 1.0, 1.2, 1.4, and 1.4 (95% CI: 1.0-2.0) for dietary GI (P(trend) = 0.02). High intake of staples, especially rice, was positively associated with endometrial cancer. The association with GI was more evident among lean and normal weight women, although the test for interaction was not significant. This study suggests that intake of high GL or GI foods, but not carbohydrates per se, may increase risk for endometrial cancer.
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Affiliation(s)
- Wang Hong Xu
- a Department of Epidemiology, School of Public Health , Fudan University , Shanghai , People's Republic of China
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150
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Yu D, Shu XO, Xiang YB, Li H, Yang G, Gao YT, Zheng W, Zhang X. Higher dietary choline intake is associated with lower risk of nonalcoholic fatty liver in normal-weight Chinese women. J Nutr 2014; 144:2034-40. [PMID: 25320186 PMCID: PMC4230213 DOI: 10.3945/jn.114.197533] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Choline deficiency has been shown to induce liver fat accumulation in both rodent and human studies. However, it is unclear whether dietary choline intake is related to fatty liver in the general population. OBJECTIVE We examined the association between choline intake and nonalcoholic fatty liver. METHODS Participants included 56,195 Chinese women and men, 40-75 y of age, with no or negligible alcohol consumption and with no history of hepatitis, cardiovascular disease, or cancer. All participants reported undergoing liver ultrasonography. Fatty liver was defined by self-report of a physician diagnosis. Habitual dietary intakes were assessed via validated food-frequency questionnaires. RESULTS The average total choline intakes were 289 ± 85 mg/d in women and 318 ± 92 mg/d in men. Major food sources were eggs, soy foods, red meat, fish, and vegetables. A higher choline intake was associated with lower risk of fatty liver; after adjustment for sociodemographic characteristics, lifestyle factors, and other dietary intakes, the ORs (95% CIs) for the highest vs. the lowest quintiles of choline intake were 0.68 (0.59, 0.79) in women and 0.75 (0.60, 0.93) in men (both P-trend < 0.01). The inverse association was attenuated after further adjustment for history of metabolic disease and, in particular, BMI. The corresponding ORs (95% CIs) were 0.88 (0.75, 1.03) in women (P-trend = 0.05) and 0.85 (0.68, 1.06) in men (P-trend = 0.09). Stratified analyses suggested a potential effect modification by obesity status in women; the OR (95% CI) across extreme quintiles was 0.72 (0.57, 0.91) in normal-weight women vs. 1.05 (0.84, 1.31) in overweight or obese women (P-trend = 0.007 vs. 0.99, P-interaction < 0.0001). CONCLUSION Higher dietary choline intake may be associated with lower risk of nonalcoholic fatty liver only in normal-weight Chinese women.
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Affiliation(s)
- Danxia Yu
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN; and
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN; and
| | - Yong-Bing Xiang
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China
| | - Honglan Li
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China
| | - Gong Yang
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN; and
| | - Yu-Tang Gao
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN; and
| | - Xianglan Zhang
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN; and
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