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Chamkasem A, Toniti W. Sequence to structure approach of estrogen receptor alpha and ligand interactions. Asian Pac J Cancer Prev 2016; 16:2161-6. [PMID: 25824732 DOI: 10.7314/apjcp.2015.16.6.2161] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Estrogen receptors (ERs) are steroid receptors located in the cytoplasm and on the nuclear membrane. The sequence similarities of human ERα, mouse ERα, rat ERα, dog ERα, and cat ERα are above 90%, but structures of ERα may different among species. Estrogen can be agonist and antagonist depending on its target organs. This hormone play roles in several diseases including breast cancer. There are variety of the relative binding affinity (RBA) of ER and estrogen species in comparison to 17β-estradiol (E2), which is a natural ligand of both ERα and ERβ. The RBA of the estrogen species are as following: diethyl stilbestrol (DES)>hexestrol>dienestrol>17β-estradiol (E2)>17-estradiol>moxestrol>estriol (E3)>4-OH estradiol>estrone-3-sulfate. Estrogen mimetic drugs, selective estrogen receptor modulators (SERMs), have been used as hormonal therapy for ER positive breast cancer and postmenopausal osteoporosis. In the postgenomic era, in silico models have become effective tools for modern drug discovery. These provide three dimensional structures of many transmembrane receptors and enzymes, which are important targets of de novo drug development. The estimated inhibition constants (Ki) from computational model have been used as a screening procedure before in vitro and in vivo studies.
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Affiliation(s)
- Aekkapot Chamkasem
- Faculty of Veterinary Science, Mahidol University, Salaya, Nakhon-Pathom, Thailand E-mail :
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Cervantes-Paz B, Victoria-Campos CI, Ornelas-Paz JDJ. Absorption of Carotenoids and Mechanisms Involved in Their Health-Related Properties. Subcell Biochem 2016; 79:415-454. [PMID: 27485232 DOI: 10.1007/978-3-319-39126-7_16] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Carotenoids participate in the normal metabolism and function of the human body. They are involved in the prevention of several diseases, especially those related to the inflammation syndrome. Their main mechanisms of action are associated to their potent antioxidant activity and capacity to regulate the expression of specific genes and proteins. Recent findings suggest that carotenoid metabolites may explain several processes where the participation of their parent carotenoids was unclear. The health benefits of carotenoids strongly depend on their absorption and transformation during gastrointestinal digestion. The estimation of the 'bioaccessibility' of carotenoids through in vitro models have made possible the evaluation of the effect of a large number of factors on key stages of carotenoid digestion and intestinal absorption. The bioaccessibility of these compounds allows us to have a clear idea of their potential bioavailability, a term that implicitly involves the biological activity of these compounds.
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Affiliation(s)
- Braulio Cervantes-Paz
- Centro de Investigación en Alimentación y Desarrollo A. C.-Unidad Cuauhtémoc, Av. Río Conchos S/N, Parque Industrial, C.P. 31570, Cd. Cuauhtémoc, Chihuahua, Mexico
| | - Claudia I Victoria-Campos
- Centro de Investigación en Alimentación y Desarrollo A. C.-Unidad Cuauhtémoc, Av. Río Conchos S/N, Parque Industrial, C.P. 31570, Cd. Cuauhtémoc, Chihuahua, Mexico
| | - José de Jesús Ornelas-Paz
- Centro de Investigación en Alimentación y Desarrollo A. C.-Unidad Cuauhtémoc, Av. Río Conchos S/N, Parque Industrial, C.P. 31570, Cd. Cuauhtémoc, Chihuahua, Mexico.
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Moran NE, Cichon MJ, Riedl KM, Grainger EM, Schwartz SJ, Novotny JA, Erdman JW, Clinton SK. Compartmental and noncompartmental modeling of ¹³C-lycopene absorption, isomerization, and distribution kinetics in healthy adults. Am J Clin Nutr 2015; 102:1436-49. [PMID: 26561629 PMCID: PMC4658456 DOI: 10.3945/ajcn.114.103143] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 09/28/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Lycopene, which is a red carotenoid in tomatoes, has been hypothesized to mediate disease-preventive effects associated with tomato consumption. Lycopene is consumed primarily as the all-trans geometric isomer in foods, whereas human plasma and tissues show greater proportions of cis isomers. OBJECTIVE With the use of compartmental modeling and stable isotope technology, we determined whether endogenous all-trans-to-cis-lycopene isomerization or isomeric-bioavailability differences underlie the greater proportion of lycopene cis isomers in human tissues than in tomato foods. DESIGN Healthy men (n = 4) and women (n = 4) consumed (13)C-lycopene (10.2 mg; 82% all-trans and 18% cis), and plasma was collected over 28 d. Unlabeled and (13)C-labeled total lycopene and lycopene-isomer plasma concentrations, which were measured with the use of high-performance liquid chromatography-mass spectrometry, were fit to a 7-compartment model. RESULTS Subjects absorbed a mean ± SEM of 23% ± 6% of the lycopene. The proportion of plasma cis-(13)C-lycopene isomers increased over time, and all-trans had a shorter half-life than that of cis isomers (5.3 ± 0.3 and 8.8 ± 0.6 d, respectively; P < 0.001) and an earlier time to reach maximal plasma concentration than that of cis isomers (28 ± 7 and 48 ± 9 h, respectively). A compartmental model that allowed for interindividual differences in cis- and all-trans-lycopene bioavailability and endogenous trans-to-cis-lycopene isomerization was predictive of plasma (13)C and unlabeled cis- and all-trans-lycopene concentrations. Although the bioavailability of cis (24.5% ± 6%) and all-trans (23.2% ± 8%) isomers did not differ, endogenous isomerization (0.97 ± 0.25 μmol/d in the fast-turnover tissue lycopene pool) drove tissue and plasma isomeric profiles. CONCLUSION (13)C-Lycopene combined with physiologic compartmental modeling provides a strategy for following complex in vivo metabolic processes in humans and reveals that postabsorptive trans-to-cis-lycopene isomerization, and not the differential bioavailability of isomers, drives tissue and plasma enrichment of cis-lycopene. This trial was registered at clinicaltrials.gov as NCT01692340.
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Affiliation(s)
- Nancy E Moran
- The Ohio State University Comprehensive Cancer Center
| | | | - Kenneth M Riedl
- The Ohio State University Comprehensive Cancer Center, Departments of Food Science and Technology
| | | | - Steven J Schwartz
- The Ohio State University Comprehensive Cancer Center, Departments of Food Science and Technology
| | | | - John W Erdman
- Department of Food Science and Human Nutrition and Division of Nutritional Sciences, The University of Illinois, Urbana, IL
| | - Steven K Clinton
- The Ohio State University Comprehensive Cancer Center, Internal Medicine-Division of Medical Oncology, and The James Cancer Hospital, The Ohio State University, Columbus, OH;
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104
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Key TJ, Appleby PN, Travis RC, Albanes D, Alberg AJ, Barricarte A, Black A, Boeing H, Bueno-de-Mesquita HB, Chan JM, Chen C, Cook MB, Donovan JL, Galan P, Gilbert R, Giles GG, Giovannucci E, Goodman GE, Goodman PJ, Gunter MJ, Hamdy FC, Heliövaara M, Helzlsouer KJ, Henderson BE, Hercberg S, Hoffman-Bolton J, Hoover RN, Johansson M, Khaw KT, King IB, Knekt P, Kolonel LN, Le Marchand L, Männistö S, Martin RM, Meyer HE, Mondul AM, Moy KA, Neal DE, Neuhouser ML, Palli D, Platz EA, Pouchieu C, Rissanen H, Schenk JM, Severi G, Stampfer MJ, Tjønneland A, Touvier M, Trichopoulou A, Weinstein SJ, Ziegler RG, Zhou CK, Allen NE. Carotenoids, retinol, tocopherols, and prostate cancer risk: pooled analysis of 15 studies. Am J Clin Nutr 2015; 102:1142-57. [PMID: 26447150 PMCID: PMC4625592 DOI: 10.3945/ajcn.115.114306] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 09/01/2015] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Individual studies have suggested that circulating carotenoids, retinol, or tocopherols may be associated with prostate cancer risk, but the studies have not been large enough to provide precise estimates of associations, particularly by stage and grade of disease. OBJECTIVE The objective of this study was to conduct a pooled analysis of the associations of the concentrations of 7 carotenoids, retinol, α-tocopherol, and γ-tocopherol with risk of prostate cancer and to describe whether any associations differ by stage or grade of the disease or other factors. DESIGN Principal investigators of prospective studies provided individual participant data for prostate cancer cases and controls. Risk by study-specific fifths of each biomarker was estimated by using multivariable-adjusted conditional logistic regression in matched case-control sets. RESULTS Data were available for up to 11,239 cases (including 1654 advanced stage and 1741 aggressive) and 18,541 controls from 15 studies. Lycopene was not associated with overall risk of prostate cancer, but there was statistically significant heterogeneity by stage of disease, and the OR for aggressive disease for the highest compared with the lowest fifth of lycopene was 0.65 (95% CI: 0.46, 0.91; P-trend = 0.032). No other carotenoid was significantly associated with overall risk of prostate cancer or with risk of advanced-stage or aggressive disease. For retinol, the OR for the highest compared with the lowest fifth was 1.13 (95% CI: 1.04, 1.22; P-trend = 0.015). For α-tocopherol, the OR for the highest compared with the lowest fifth was 0.86 (95% CI: 0.78, 0.94; P-trend < 0.001), with significant heterogeneity by stage of disease; the OR for aggressive prostate cancer was 0.74 (95% CI: 0.59, 0.92; P-trend = 0.001). γ-Tocopherol was not associated with risk. CONCLUSIONS Overall prostate cancer risk was positively associated with retinol and inversely associated with α-tocopherol, and risk of aggressive prostate cancer was inversely associated with lycopene and α-tocopherol. Whether these associations reflect causal relations is unclear.
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Affiliation(s)
- Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health,
| | - Paul N Appleby
- Cancer Epidemiology Unit, Nuffield Department of Population Health
| | - Ruth C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, US National Cancer Institute, Bethesda, MD
| | - Anthony J Alberg
- Department of Epidemiology, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD; Hollings Cancer Center, Medical University of South Carolina, Charleston, SC
| | - Aurelio Barricarte
- Navarre Public Health Institute, Pamplona, Spain, and Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública), Spain
| | - Amanda Black
- Division of Cancer Epidemiology and Genetics, US National Cancer Institute, Bethesda, MD
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - H Bas Bueno-de-Mesquita
- National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands; Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, Netherlands; School of Public Health, Imperial College, London, United Kingdom
| | - June M Chan
- Departments of Epidemiology & Biostatistics and Urology, University of California, San Francisco, San Francisco, CA
| | - Chu Chen
- Public Health Sciences Division, Program in Epidemiology
| | - Michael B Cook
- Division of Cancer Epidemiology and Genetics, US National Cancer Institute, Bethesda, MD
| | - Jenny L Donovan
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Pilar Galan
- Sorbonne Paris Cité Epidemiology and Biostatistics Research Center, Nutritional Epidemiology Research Team (Nutritional Epidemiology Research Team), Inserm U1153, Inra U1125, Cnam, University Paris 13, University Paris 5, University Paris 7, Bobigny, France
| | - Rebecca Gilbert
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Graham G Giles
- Cancer Epidemiology Centre, The Cancer Council Victoria, Melbourne, Australia
| | - Edward Giovannucci
- Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, MA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Gary E Goodman
- Departments of Epidemiology and Environmental Health, University of Washington, Seattle, WA
| | | | - Marc J Gunter
- School of Public Health, Imperial College, London, United Kingdom
| | | | | | | | - Brian E Henderson
- Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Serge Hercberg
- Sorbonne Paris Cité Epidemiology and Biostatistics Research Center, Nutritional Epidemiology Research Team (Nutritional Epidemiology Research Team), Inserm U1153, Inra U1125, Cnam, University Paris 13, University Paris 5, University Paris 7, Bobigny, France
| | - Judy Hoffman-Bolton
- George W Comstock Center for Public Health Research and Prevention, Hagerstown, MD
| | - Robert N Hoover
- Division of Cancer Epidemiology and Genetics, US National Cancer Institute, Bethesda, MD
| | - Mattias Johansson
- International Agency for Research on Cancer, Lyon, France; Department for Biobank Research, Umeå University, Umeå, Sweden
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care and
| | - Irena B King
- Public Health Sciences Core Laboratories, Department of Internal Medicine, University of New Mexico, Albuquerque, NM
| | - Paul Knekt
- National Institute for Health and Welfare, Helsinki, Finland
| | | | | | - Satu Männistö
- National Institute for Health and Welfare, Helsinki, Finland
| | - Richard M Martin
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom; Medical Research Council/University of Bristol Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom; National Institute for Health Research, Bristol Biomedical Research Unit in Nutrition, Bristol, United Kingdom
| | - Haakon E Meyer
- Department of Community Medicine, Faculty of Medicine, University of Oslo and Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Alison M Mondul
- Division of Cancer Epidemiology and Genetics, US National Cancer Institute, Bethesda, MD
| | - Kristin A Moy
- Division of Cancer Epidemiology and Genetics, US National Cancer Institute, Bethesda, MD
| | - David E Neal
- Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | | | - Domenico Palli
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute-ISPO, Florence, Italy
| | - Elizabeth A Platz
- Department of Epidemiology, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Camille Pouchieu
- Cancer Epidemiology Centre, The Cancer Council Victoria, Melbourne, Australia
| | - Harri Rissanen
- National Institute for Health and Welfare, Helsinki, Finland
| | - Jeannette M Schenk
- Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Gianluca Severi
- Cancer Epidemiology Centre, The Cancer Council Victoria, Melbourne, Australia
| | - Meir J Stampfer
- Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, MA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Anne Tjønneland
- Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark
| | - Mathilde Touvier
- Sorbonne Paris Cité Epidemiology and Biostatistics Research Center, Nutritional Epidemiology Research Team (Nutritional Epidemiology Research Team), Inserm U1153, Inra U1125, Cnam, University Paris 13, University Paris 5, University Paris 7, Bobigny, France
| | - Antonia Trichopoulou
- Hellenic Health Foundation and Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece and
| | - Stephanie J Weinstein
- Division of Cancer Epidemiology and Genetics, US National Cancer Institute, Bethesda, MD
| | - Regina G Ziegler
- Division of Cancer Epidemiology and Genetics, US National Cancer Institute, Bethesda, MD
| | - Cindy Ke Zhou
- Division of Cancer Epidemiology and Genetics, US National Cancer Institute, Bethesda, MD
| | - Naomi E Allen
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
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Specific serum carotenoids are inversely associated with breast cancer risk among Chinese women: a case-control study. Br J Nutr 2015; 115:129-37. [PMID: 26482064 DOI: 10.1017/s000711451500416x] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Previous epidemiological studies have revealed the anti-cancer effect of dietary circulating carotenoids. However, the protective role of specific individual circulating carotenoids has not been elucidated. The purpose of this study was to examine whether serum carotenoids, including α-carotene, β-carotene, β-cryptoxanthin, lycopene and lutein/zeaxanthin, could lower the risk for breast cancer among Chinese women. A total of 521 women with breast cancer and age-matched controls (5-year interval) were selected from three teaching hospitals in Guangzhou, China. Concentrations of α-carotene, β-carotene, β-cryptoxanthin, lycopene and lutein/zeaxanthin were measured using HPLC. Unconditional logistic regression models were used to calculate OR and 95% CI using quartiles defined in the control subjects. Significant inverse associations were observed between serum α-carotene, β-carotene, lycopene, lutein/zeaxanthin and the risk for breast cancer. The multivariate OR for the highest quartile of serum concentration compared with the lowest quartile were 0·44 (95% CI 0·30, 0·65) for α-carotene, 0·27 (95% CI 0·18, 0·40) for β-carotene, 0·41 (95% CI 0·28, 0·61) for lycopene and 0·26 (95% CI 0·17, 0·38) for lutein/zeaxanthin. However, no significant association was found between serum β-cryptoxanthin and the risk for breast cancer. Stratified analysis by menopausal status and oestrogen receptor (ER)/progesterone receptor (PR) showed that serum α-carotene, β-carotene, lycopene and lutein/zeaxanthin were inversely associated with breast cancer risk among premenopausal women and among all subtypes of ER or PR status. The results suggest a protective role of α-carotene, β-carotene, lycopene and lutein/zeaxanthin, but not β-cryptoxanthin, in breast cancer risk.
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107
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Food Processing and the Mediterranean Diet. Nutrients 2015; 7:7925-64. [PMID: 26393643 PMCID: PMC4586566 DOI: 10.3390/nu7095371] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 09/03/2015] [Accepted: 09/09/2015] [Indexed: 02/06/2023] Open
Abstract
The benefits of the Mediterranean diet (MD) for protecting against chronic disorders such as cardiovascular disease are usually attributed to high consumption of certain food groups such as vegetables, and low consumption of other food groups such as meat. The influence of food processing techniques such as food preparation and cooking on the nutrient composition and nutritional value of these foods is not generally taken into consideration. In this narrative review, we consider the mechanistic and epidemiological evidence that food processing influences phytochemicals in selected food groups in the MD (olives, olive oil, vegetables and nuts), and that this influences the protective effects of these foods against chronic diseases associated with inflammation. We also examine how the pro-inflammatory properties of meat consumption can be modified by Mediterranean cuisine. We conclude by discussing whether food processing should be given greater consideration, both when recommending a MD to the consumer and when evaluating its health properties.
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108
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Ferrini K, Ghelfi F, Mannucci R, Titta L. Lifestyle, nutrition and breast cancer: facts and presumptions for consideration. Ecancermedicalscience 2015; 9:557. [PMID: 26284121 PMCID: PMC4531134 DOI: 10.3332/ecancer.2015.557] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Indexed: 12/13/2022] Open
Abstract
Breast cancer is the most common cancer in women worldwide, and the high incidence of this cancer coupled with improvements in initial treatments has led to an ever-increasing number of breast cancer survivors. Among the prospective epidemiological studies on diet and breast cancer incidence and recurrence, to date, there is no association that is strong, reproducible and statistically significant, with the exception of alcohol intake, overweight, and weight gain. Nevertheless, many beliefs about food and breast cancer persist in the absence of supporting scientific evidence. After a comprehensive review regarding the role of lifestyle on breast cancer outcomes and a thorough study of the dissemination field including mass media, clinical institutions, and academic figures, we briefly reported the most common presumptions and also facts from the literature regarding lifestyle, nutrition, and breast cancer. The randomised controlled trial is the best study-design that could provide direct evidence of a causal relationship; however, there are methodological difficulties in applying and maintaining a lifestyle intervention for a sufficient period; consequently, there is a lack of this type of study in the literature. Instead, it is possible to obtain indirect evidence from observational prospective studies. In this article, it becomes clear that for now the best advice for women’s health is to follow the World Cancer Research Fund/American Institute of Cancer Research (WCRF/AICR) recommendations on diet, nutrition, physical activity, and weight management for cancer prevention, because they are associated with a lower risk of developing most types of cancer, including breast cancer. Despite current awareness of the role of nutrition in cancer outcomes, there is inadequate translation from research findings into clinical practice. We suggest the establishment of a multidisciplinary research consortium to demonstrate the real power of lifestyle interventions.
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Affiliation(s)
- Krizia Ferrini
- SmartFood Program, European Institute of Oncology, Milan 20141, Italy ; Università degli Studi di Pavia, 27100, Italy
| | - Francesca Ghelfi
- SmartFood Program, European Institute of Oncology, Milan 20141, Italy ; Università degli Studi di Parma, 43121, Italy
| | - Roberta Mannucci
- SmartFood Program, European Institute of Oncology, Milan 20141, Italy
| | - Lucilla Titta
- SmartFood Program, European Institute of Oncology, Milan 20141, Italy
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Wang Y, Gapstur SM, Gaudet MM, Furtado JD, Campos H, McCullough ML. Plasma carotenoids and breast cancer risk in the Cancer Prevention Study II Nutrition Cohort. Cancer Causes Control 2015; 26:1233-44. [DOI: 10.1007/s10552-015-0614-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 06/06/2015] [Indexed: 12/22/2022]
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Anticancer Properties of Phyllanthus emblica (Indian Gooseberry). OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2015; 2015:950890. [PMID: 26180601 PMCID: PMC4477227 DOI: 10.1155/2015/950890] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 12/22/2014] [Accepted: 12/24/2014] [Indexed: 12/18/2022]
Abstract
There is a wealth of information emanating from both in vitro and in vivo studies indicating fruit extract of the Phyllanthus emblica tree, commonly referred to as Indian Gooseberries, has potent anticancer properties. The bioactivity in this extract is thought to be principally mediated by polyphenols, especially tannins and flavonoids. It remains unclear how polyphenols from Phyllanthus emblica can incorporate both cancer-preventative and antitumor properties. The antioxidant function of Phyllanthus emblica can account for some of the anticancer activity, but clearly other mechanisms are equally important. Herein, we provide a brief overview of the evidence supporting anticancer activity of Indian Gooseberry extracts, suggest possible mechanisms for these actions, and provide future directions that might be taken to translate these findings clinically.
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111
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Eliassen AH, Liao X, Rosner B, Tamimi RM, Tworoger SS, Hankinson SE. Plasma carotenoids and risk of breast cancer over 20 y of follow-up. Am J Clin Nutr 2015; 101:1197-205. [PMID: 25877493 PMCID: PMC4441811 DOI: 10.3945/ajcn.114.105080] [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: 12/08/2014] [Accepted: 03/13/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Increasing evidence suggests that carotenoids, which are micronutrients in fruit and vegetables, reduce breast cancer risk. Whether carotenoids are important early or late in carcinogenesis is unclear, and limited analyses have been conducted by breast tumor subtypes. OBJECTIVES We sought to examine issues of the timing of carotenoid exposure as well as associations by breast tumor subtypes. DESIGN We conducted a nested case-control study of plasma carotenoids measured by using reverse-phase high-performance liquid chromatography and breast cancer risk in the Nurses' Health Study. In 1989-1990, 32,826 women donated blood samples; in 2000-2002, 18,743 of these women contributed a second blood sample. Between the first blood collection and June 2010, 2188 breast cancer cases were diagnosed (579 cases were diagnosed after the second collection) and matched with control subjects. RRs and 95% CIs were calculated by using conditional logistic regression adjusted for several breast cancer risk factors. RESULTS Higher concentrations of α-carotene, β-carotene, lycopene, and total carotenoids were associated with 18-28% statistically significantly lower risks of breast cancer (e.g., β-carotene top compared with bottom quintile RR: 0.72; 95% CI: 0.59, 0.88; P-trend < 0.001). Associations were apparent for total carotenoids measured ≥10 y before diagnosis (top compared with bottom quintile RR: 0.69; 95% CI: 0.50, 0.95; P-trend = 0.01) as well as those <10 y before diagnosis (RR: 0.79; 95% CI: 0.64, 0.98; P-trend = 0.04, P-interaction = 0.11). Carotenoid concentrations were strongly inversely associated with breast cancer recurrence and death (e.g., β-carotene top compared with bottom quintile RR: 0.32; 95% CI: 0.21, 0.51; P-trend < 0.001) compared with not recurrent and not lethal disease (P-heterogeneity < 0.001). CONCLUSION In this large prospective analysis with 20 y of follow-up, women with high plasma carotenoids were at reduced breast cancer risk particularly for more aggressive and ultimately fatal disease.
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Affiliation(s)
- A Heather Eliassen
- From the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (AHE, XL, BR, RMT, SST, and SEH); the Departments of Epidemiology (AHE, XL, BR, RMT, SST, and SEH) and Biostatistics (XL and BR), Harvard T.H. Chan School of Public Health, Boston, MA; and the Division of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA (SEH).
| | - Xiaomei Liao
- From the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (AHE, XL, BR, RMT, SST, and SEH); the Departments of Epidemiology (AHE, XL, BR, RMT, SST, and SEH) and Biostatistics (XL and BR), Harvard T.H. Chan School of Public Health, Boston, MA; and the Division of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA (SEH)
| | - Bernard Rosner
- From the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (AHE, XL, BR, RMT, SST, and SEH); the Departments of Epidemiology (AHE, XL, BR, RMT, SST, and SEH) and Biostatistics (XL and BR), Harvard T.H. Chan School of Public Health, Boston, MA; and the Division of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA (SEH)
| | - Rulla M Tamimi
- From the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (AHE, XL, BR, RMT, SST, and SEH); the Departments of Epidemiology (AHE, XL, BR, RMT, SST, and SEH) and Biostatistics (XL and BR), Harvard T.H. Chan School of Public Health, Boston, MA; and the Division of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA (SEH)
| | - Shelley S Tworoger
- From the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (AHE, XL, BR, RMT, SST, and SEH); the Departments of Epidemiology (AHE, XL, BR, RMT, SST, and SEH) and Biostatistics (XL and BR), Harvard T.H. Chan School of Public Health, Boston, MA; and the Division of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA (SEH)
| | - Susan E Hankinson
- From the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (AHE, XL, BR, RMT, SST, and SEH); the Departments of Epidemiology (AHE, XL, BR, RMT, SST, and SEH) and Biostatistics (XL and BR), Harvard T.H. Chan School of Public Health, Boston, MA; and the Division of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA (SEH)
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Fruit and vegetable intake assessed by food frequency questionnaire and plasma carotenoids: a validation study in adults. Nutrients 2015; 7:3240-51. [PMID: 25954899 PMCID: PMC4446749 DOI: 10.3390/nu7053240] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 04/22/2015] [Accepted: 04/23/2015] [Indexed: 02/07/2023] Open
Abstract
Dietary validation studies of self-reported fruit and vegetable intake should ideally include measurement of plasma biomarkers of intake. The aim was to conduct a validation study of self-reported fruit and vegetable intakes in adults, using the Australian Eating Survey (AES) food frequency questionnaire (FFQ), against a range of plasma carotenoids. Dietary intakes were assessed using the semi-quantitative 120 item AES FFQ. Fasting plasma carotenoids (α- and β-carotene, lutein/zeaxanthin, lycopene and cryptoxanthin) were assessed using high performance liquid chromatography in a sample of 38 adult volunteers (66% female). Significant positive correlations were found between FFQ and plasma carotenoids for α-carotene, β-carotene and lutein/zeaxanthin (52%, 47%, 26%, p < 0.001, 0.003, 0.041; respectively) and relationships between plasma carotenoids (except lycopene) and weight status metrics (BMI, waist circumference, fat mass) were negative and highly significant. The results of the current study demonstrate that carotenoid intakes as assessed by the AES FFQ are significantly related to plasma concentrations of α-carotene, β-carotene and lutein/zeaxanthin, the carotenoids commonly found in fruit and vegetables. Lower levels of all plasma carotenoids, except lycopene, were found in individuals with higher BMI. We conclude that the AES can be used to measure fruit and vegetable intakes with confidence.
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113
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Sisti JS, Lindström S, Kraft P, Tamimi RM, Rosner BA, Wu T, Willett WC, Eliassen AH. Premenopausal plasma carotenoids, fluorescent oxidation products, and subsequent breast cancer risk in the nurses' health studies. Breast Cancer Res Treat 2015; 151:415-25. [PMID: 25917867 DOI: 10.1007/s10549-015-3391-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 04/15/2015] [Indexed: 10/25/2022]
Abstract
High levels of circulating carotenoids are hypothesized to reduce breast cancer risk, potentially due to their antioxidant properties. However, little is known about the relationship between carotenoid exposure earlier in life and risk. We examined associations of premenopausal plasma carotenoids and markers of oxidative stress and risk of breast cancer among 1179 case-control pairs in the Nurses' Health Study (NHS) and NHSII. Levels of α- and β-carotene, β-cryptoxanthin, lycopene, and lutein/zeaxanthin were quantified by high-performance liquid chromatography. Three fluorescent oxidation products (FlOP_360, FlOP_320, FlOP_400) were measured in a subset of participants by spectrofluoroscopy. Multivariate conditional logistic regression was used to estimate odds ratios and 95 % confidence intervals for breast cancer by quartile, as well as P values for tests of linear trend. We additionally examined whether 45 single-nucleotide polymorphisms (SNPs) in five genes involved in oxidative and antioxidative processes or carotenoid availability were associated with risk. Carotenoid measures were not inversely associated with breast cancer risk. No differences by estrogen receptor status were observed, though some inverse associations were observed among women postmenopausal at diagnosis. Plasma FlOP levels were not positively associated with risk, and suggestive inverse associations with FlOP_320 and FlOP_360 were observed. Several SNPs were associated with carotenoid levels, and a small number were suggestively associated with breast cancer risk. We observed evidence of interactions between some SNPs and carotenoid levels on risk. We did not observe consistent associations between circulating levels of premenopausal carotenoids or FlOP levels and breast cancer risk.
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Affiliation(s)
- Julia S Sisti
- Departments of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA,
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114
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Ho WJ, Simon MS, Yildiz VO, Shikany JM, Kato I, Beebe-Dimmer JL, Cetnar JP, Bock CH. Antioxidant micronutrients and the risk of renal cell carcinoma in the Women's Health Initiative cohort. Cancer 2015; 121:580-8. [PMID: 25302685 PMCID: PMC5078985 DOI: 10.1002/cncr.29091] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 09/04/2014] [Accepted: 09/05/2014] [Indexed: 12/29/2022]
Abstract
BACKGROUND Renal cell carcinoma (RCC) is the eighth leading cancer among women in incidence and commonly is diagnosed at a more advanced stage. Oxidative stress has been considered to play an important role in the pathogenesis of RCC. Various dietary micronutrients have antioxidant properties, including carotenoids and vitamins C and E; thus, diets rich in these nutrients have been evaluated in relation to RCC prevention. The objective of this study was to explore the correlation between antioxidant micronutrients and the risk of RCC. METHODS In total, 96,196 postmenopausal women who enrolled in the Women's Health Initiative (WHI) between 1993 and 1998 and were followed through July 2013 were included in this analysis. Dietary micronutrient intake was estimated from the baseline WHI food frequency questionnaire, and data on supplement use were collected using an interview-based inventory procedure. RCC cases were ascertained from follow-up surveys and were centrally adjudicated. The risks for RCC associated with intake of α-carotene, β-carotene, β-cryptoxanthin, lutein plus zeaxanthin, lycopene, vitamin C, and vitamin E were analyzed using Cox proportional hazards regression adjusted for confounders. RESULTS Two hundred forty women with RCC were identified during follow-up. Lycopene intake was inversely associated with RCC risk (P = .015); compared with the lowest quartile of lycopene intake, the highest quartile of intake was associated with a 39% lower risk of RCC (hazard ratio, 0.61; 95% confidence interval, 0.39-0.97). No other micronutrient was significantly associated with RCC risk. CONCLUSIONS The current results suggest that further investigation into the correlation between lycopene intake and the risk of RCC is warranted.
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Affiliation(s)
- Won Jin Ho
- Department of Medicine, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Michael S. Simon
- Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, Michigan
| | - Vedat O. Yildiz
- Center for Biostatistics, Ohio State University, Columbus, Ohio
| | - James M. Shikany
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Ikuko Kato
- Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, Michigan
| | | | - Jeremy P. Cetnar
- Carbone Cancer Center, University of Wisconsin, Madison, Wisconsin
| | - Cathryn H. Bock
- Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, Michigan
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115
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Zubair N, Kooperberg C, Liu J, Di C, Peters U, Neuhouser ML. Genetic variation predicts serum lycopene concentrations in a multiethnic population of postmenopausal women. J Nutr 2015; 145:187-92. [PMID: 25644336 PMCID: PMC4304022 DOI: 10.3945/jn.114.202150] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The consumption and blood concentrations of lycopene are both positively and inversely associated with the risk of several chronic diseases. The inconsistences in lycopene disease association studies may stem from a lack of knowledge about the genetic variation in the synthesis, metabolism, and deposition of transport and binding proteins, which potentially influence serum lycopene concentrations. OBJECTIVE We examined the association between variation across the genome and serum concentrations of lycopene in a multiethnic population. METHODS Participants included African (n = 914), Hispanic (n = 464), and European (n = 1203) American postmenopausal women from the Women's Health Initiative. We analyzed ∼7 million single nucleotide polymorphisms (SNPs). Linear regression models were used to assess associations between each SNP and serum concentrations (log transformed, continuous) of lycopene; we adjusted for age, body mass index, and population substructure. Models were run separately by ethnicity, and results were combined in a transethnic fixed-effects meta-analysis. RESULTS In the meta-analysis, the scavenger receptor class B, member 1 (SCARB1) gene, which encodes for a cholesterol membrane transporter, was significantly associated with lycopene concentrations (rs1672879; P < 2.68 × 10(-9)). Each additional G allele resulted in a 12% decrease in lycopene concentrations for African Americans, 20% decrease for Hispanic Americans, and 9% decrease for European Americans. In addition, 2 regions were significantly associated with serum lycopene concentrations in African Americans: the slit homolog 3 gene (SLIT3), which serves as a molecular guidance cue in cellular migration, and the dehydrogenase/reductase (SDR family) member 2 (DHRS2) gene, which codes for an oxidoreductase that mitigates the breakdown of steroids. CONCLUSIONS We found 3 novel loci associated with serum lycopene concentrations, 2 of which were specific to African Americans. Future functional studies looking at these specific genes may provide insight into the metabolism and underlying function of lycopene in humans, which may further elucidate lycopene's influence on disease risk and health. This trial was registered at clinicaltrials.gov as NCT00000611.
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Affiliation(s)
| | | | - Jingmin Liu
- Women’s Health Initiative Clinical Coordinating Center, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Chongzhi Di
- Biostatistics and Biomathematics Program, and
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116
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Ulbricht C. An Evidence-Based Systematic Review of Lutein by the Natural Standard Research Collaboration. J Diet Suppl 2015; 12:383-480. [PMID: 25616151 DOI: 10.3109/19390211.2014.988577] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
An evidence-based systematic review of lutein by the Natural Standard Research Collaboration consolidates the safety and efficacy data available in the scientific literature using a validated, reproducible grading rationale. This article includes written and statistical analysis of clinical trials, plus a compilation of expert opinion, folkloric precedent, history, pharmacology, kinetics/dynamics, interactions, adverse effects, toxicology, and dosing.
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117
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Su X, Boeke CE, Collins LC, Baer HJ, Willett WC, Schnitt SJ, Connolly JL, Rosner B, Colditz GA, Tamimi RM. Intakes of fat and micronutrients between ages 13 and 18 years and the incidence of proliferative benign breast disease. Cancer Causes Control 2015; 26:79-90. [PMID: 25376828 PMCID: PMC4282970 DOI: 10.1007/s10552-014-0484-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 10/24/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE Dietary exposures during adolescence may exert important effects on breast development and future breast cancer risk. This study evaluated the associations between high school intakes of fat and micronutrients and the incidence of proliferative benign breast disease (BBD), a marker of increased breast cancer risk. METHODS 29,480 women (mean age 43.3 years, range 33.6-52.9) completed a high school food frequency questionnaire in 1998 in the Nurses' Health Study II. Between 1991 and 2001, 682 women (follow-up time: 259,828 person-years) were diagnosed with proliferative BBD whose biopsy slides were reviewed and confirmed by the study pathologists. RESULTS In multivariate Cox proportional hazards models, high school intakes of total fat and types of fat were not associated with proliferative BBD. Women in the highest quintile of total retinol activity equivalents (RAEs), which incorporate retinol, α- and β-carotene, and β-cryptoxanthin intakes, had a 17 % lower risk of proliferative BBD than those in the lowest quintile [multivariate hazard ratio (HR) 95 % CI 0.83 (0.64, 1.07), p trend = 0.01]; however, additional adjustment for high school dietary factors (vitamin D, nuts, and fiber) rendered the association nonsignificant [0.99 (0.73, 1.34), p trend = 0.32]. Results were similar with additional adjustment for adult RAE intake. Intakes of vitamin E and individual carotenoids were not associated with proliferative BBD, although an inverse association cannot be ruled out. CONCLUSIONS In this study, adolescent fat and micronutrient intakes were not associated with risk of proliferative BBD.
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Affiliation(s)
- Xuefen Su
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, PR China
- CUHK Shenzhen Research Institute, Shenzhen, PR China
| | - Caroline E. Boeke
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, 181 Longwood Avenue, 3 Floor, Boston, Massachusetts 02115
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, 677 Huntington Avenue, Boston, MA 02114
| | - Laura C. Collins
- Department of Pathology, Harvard Medical School and Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, Massachusetts 02215
| | - Heather J. Baer
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, 677 Huntington Avenue, Boston, MA 02114
- Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Walter C. Willett
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, 181 Longwood Avenue, 3 Floor, Boston, Massachusetts 02115
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, 677 Huntington Avenue, Boston, MA 02114
- Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts
| | - Stuart J. Schnitt
- Department of Pathology, Harvard Medical School and Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, Massachusetts 02215
| | - James L. Connolly
- Department of Pathology, Harvard Medical School and Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, Massachusetts 02215
| | - Bernard Rosner
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, 181 Longwood Avenue, 3 Floor, Boston, Massachusetts 02115
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, 677 Huntington Avenue, Boston, MA 02114
- Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts
| | - Graham A. Colditz
- Alvin J. Siteman Cancer Center and Department of Surgery, Washington University School of Medicine, 660 S Euclid Ave, St Louis, Missouri 63110
| | - Rulla M. Tamimi
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, 181 Longwood Avenue, 3 Floor, Boston, Massachusetts 02115
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, 677 Huntington Avenue, Boston, MA 02114
- Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
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Ono M, Takeshima M, Nakano S. Mechanism of the Anticancer Effect of Lycopene (Tetraterpenoids). MECHANISM OF THE ANTICANCER EFFECT OF PHYTOCHEMICALS 2015; 37:139-66. [DOI: 10.1016/bs.enz.2015.06.002] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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119
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Min JY, Min KB. Serum lycopene, lutein and zeaxanthin, and the risk of Alzheimer's disease mortality in older adults. Dement Geriatr Cogn Disord 2014; 37:246-56. [PMID: 24247062 DOI: 10.1159/000356486] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/08/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Oxidative stress is implicated in the pathogenesis of Alzheimer's disease (AD). Accumulating evidence shows that antioxidant-rich food reduces the risk of AD by inhibiting oxidative stress. This study investigates whether serum levels of carotenoids were associated with the risk of AD mortality in a nationally representative sample of US adults. METHODS We used data from the Third Nutrition and Health Examination Survey (NHANES III) database and the NHANES III Linked Mortality File. A total of 6,958 participants aged older than 50 years were included in this study. RESULTS We found that high serum levels of lycopene and lutein+zeaxanthin at baseline were associated with a lower risk of AD mortality after adjustment for potential covariates. The reduction in the mortality risk was progressively raised by increasing serum lycopene (HR = 0.26, 95% CI 0.10-0.69) and lutein+zeaxanthin (HR = 0.43, 95% CI 0.22-0.85) levels. In contrast, no associations with AD mortality were observed for other serum carotenoids, including alpha-carotene, beta-carotene, and beta-cryptoxanthin. CONCLUSION High serum levels of lycopene and lutein+zeaxanthin are associated with a lower risk of AD mortality in adults. Our findings suggest that a high intake of lycopene- or lutein+zeaxanthin-rich food may be important for reducing the AD mortality risk.
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Affiliation(s)
- Jin-young Min
- Department of Epidemiology, Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
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120
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Potter JD. Nutritional epidemiology--there's life in the old dog yet! Cancer Epidemiol Biomarkers Prev 2014; 24:323-30. [PMID: 25515549 DOI: 10.1158/1055-9965.epi-14-1327] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Consideration is given to the idea that the nutritional epidemiology of cancer is dead, as some in the media have claimed. The basis for the claim does not lie in science nor has anyone with relevant knowledge made such a statement-although that, too, has been claimed. Evidence is adduced for the importance of past achievements of nutritional epidemiology. Attention is similarly drawn to recent contributions. In particular, I note the state of play of cancer and plant foods, fat and breast cancer, meat and cancer, vegetarians, intervention studies, migrant studies, and westernization of diet and lifestyle. Some next steps and some currently important questions are outlined.
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Affiliation(s)
- John D Potter
- Centre for Public Health Research, Massey University, Wellington, New Zealand. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington.
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121
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Murador DC, da Cunha DT, de Rosso VV. Effects of cooking techniques on vegetable pigments: A meta-analytic approach to carotenoid and anthocyanin levels. Food Res Int 2014. [DOI: 10.1016/j.foodres.2014.06.015] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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122
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Woodside JV, McGrath AJ, Lyner N, McKinley MC. Carotenoids and health in older people. Maturitas 2014; 80:63-8. [PMID: 25466302 DOI: 10.1016/j.maturitas.2014.10.012] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 10/20/2014] [Accepted: 10/21/2014] [Indexed: 12/14/2022]
Abstract
As the proportion of older people increases, so will chronic disease incidence and the proportion of the population living with disability. Therefore, new approaches to maintain health for as long as possible in this age group are required. Carotenoids are a group of polyphenolic compounds found predominantly in fruit and vegetables that have been proposed to have anti-inflammatory and antioxidant effects. Such properties may impact on the risk diseases which predominate in older people, and also ageing-related physiological changes. Working out the effect of carotenoid intake versus fruit and vegetable intake is difficult, and the strong correlation between individual carotenoid intakes also complicates any attempt to examine individual carotenoid health effects. Similarly, research to determine whether carotenoids consumed as supplements have similar benefits to increased dietary intake through whole foods, is still required. However, reviewing the recent evidence suggests that carotenoid intake and status are relatively consistently associated with reduced CVD risk, although β-carotene supplementation does not reduce CVD risk and increases lung cancer risk. Increased lycopene intake may reduce prostate cancer progression, with a potential role for carotenoids at other cancer sites. Lutein and zeaxanthin have a plausible role in the maintenance of eye health, whilst an association between carotenoid intake and cognitive and physical health appears possible, although research is limited to date. Given this accruing evidence base to support a specific role for certain carotenoids and ageing, current dietary advice to consume a diet rich in fruit and vegetables would appear prudent, and efforts maintained to encourage increased intake.
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Affiliation(s)
| | | | - Natalie Lyner
- Centre for Public Health, Queen's University, Belfast, UK
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Pantavos A, Ruiter R, Feskens EF, de Keyser CE, Hofman A, Stricker BH, Franco OH, Kiefte-de Jong JC. Total dietary antioxidant capacity, individual antioxidant intake and breast cancer risk: The Rotterdam study. Int J Cancer 2014; 136:2178-86. [DOI: 10.1002/ijc.29249] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 08/26/2014] [Accepted: 09/12/2014] [Indexed: 12/31/2022]
Affiliation(s)
| | - Rikje Ruiter
- Department of Epidemiology; Erasmus MC; Rotterdam The Netherlands
- Department of Internal Medicine; Groene Hart Hospital; Gouda The Netherlands
| | - Edith F. Feskens
- Department of Human Nutrition; Wageningen University; Wageningen The Netherlands
| | - Catherine E. de Keyser
- Department of Epidemiology; Erasmus MC; Rotterdam The Netherlands
- Health Care Expectorate; The Hague The Netherlands
| | - Albert Hofman
- Department of Epidemiology; Erasmus MC; Rotterdam The Netherlands
| | - Bruno H. Stricker
- Department of Epidemiology; Erasmus MC; Rotterdam The Netherlands
- Health Care Expectorate; The Hague The Netherlands
- Department of Internal Medicine; Erasmus MC; Rotterdam The Netherlands
| | - Oscar H. Franco
- Department of Epidemiology; Erasmus MC; Rotterdam The Netherlands
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Wang Y, Gapstur SM, Gaudet MM, Peterson JJ, Dwyer JT, McCullough ML. Evidence for an association of dietary flavonoid intake with breast cancer risk by estrogen receptor status is limited. J Nutr 2014; 144:1603-11. [PMID: 25143370 DOI: 10.3945/jn.114.196964] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Results from preclinical studies suggest that flavonoids, which are ubiquitous in plant-based diets, lower breast cancer risk. Epidemiologic studies of flavonoid intake and breast cancer risk, however, are limited, and few investigated associations with the more aggressive estrogen receptor (ER)-negative (ER-) tumors. OBJECTIVE We examined the associations between 7 subclasses of dietary flavonoids and invasive postmenopausal breast cancer risk overall and by ER status in a U.S. prospective cohort. METHODS In 1999-2000, 56,630 postmenopausal women completed detailed self-administered questionnaires, among whom 2116 invasive breast cancers were verified during a mean follow-up period of 8.5 y. Cox proportional hazards regression was used to calculate multivariable-adjusted HRs and 95% CIs. RESULTS Total flavonoid intake was not associated with breast cancer risk. However, there was a modest inverse association between flavone intake and overall breast cancer risk (fifth vs. first quintile HR: 0.88; 95% CI: 0.76, 1.01; P-trend = 0.04) and between flavan-3-ol intake and risk of ER- breast cancer (for an increment of 40 mg/d; HR: 0.81; 95% CI: 0.67, 0.97) but not for ER-positive (ER+) breast cancer risk. CONCLUSION The inverse association of flavan-3-ol intake with ER- but not ER+ breast cancer is consistent with other studies that suggest a beneficial role of plant-based diets in ER- breast cancer risk.
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Affiliation(s)
- Ying Wang
- Epidemiology Research Program, American Cancer Society, Atlanta, GA; and
| | - Susan M Gapstur
- Epidemiology Research Program, American Cancer Society, Atlanta, GA; and
| | - Mia M Gaudet
- Epidemiology Research Program, American Cancer Society, Atlanta, GA; and
| | | | - Johanna T Dwyer
- School of Medicine and Jean Mayer USDA Human Nutrition Center on Aging, Tufts University, Boston, MA
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Aruoma OI, Somanah J, Bourdon E, Rondeau P, Bahorun T. Diabetes as a risk factor to cancer: functional role of fermented papaya preparation as phytonutraceutical adjunct in the treatment of diabetes and cancer. Mutat Res 2014; 768:60-68. [PMID: 24769427 DOI: 10.1016/j.mrfmmm.2014.04.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Revised: 04/09/2014] [Accepted: 04/10/2014] [Indexed: 06/03/2023]
Abstract
Oncologists and diabetologists quote scientific data from epidemiological and in vitro studies to show that high levels of insulin and glucose, in combination with oxidative stress and chronic inflammation, can heighten the risk of developing cancer amongst patients with diabetes. Although the cancers that have been consistently associated with type 2 diabetes include pancreatic, colorectal, breast and liver cancer, the preponderance of the disease risk factors such as obesity, inflammation, hyperglycemia, hyperinsulinaemia (as a result of insulin resistance and oxidative β-cell damage) and the indirect influence of anti-diabetic medications are increasingly being defined. Fermented papaya preparation (FPP) has defined antioxidant and immune-modulating potentials. The ability of FPP influence signaling cascades associated with cell growth and survival presents a rational for chemopreventive adjunct that can be used in combination with traditional redox based therapies that target oxidative stress in the cancer micro environment. It is further suggested that the demonstrated efficacy FPP to control blood glucose, excessive inflammation and modulate free radical-induced oxidative damage which are triggers of liver, bladder, breast and prostate cancers in type 2 diabetics, may favorably mitigate the side effects of ensuing diabetes and cancer therapy. What remains paramount is early cancer detection and early determination of propensity risks for diabetes. The education of patients, proper dietary management and compliance with therapeutic regime directed at cancer and diabetes encapsulate challenges of global magnitude.
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Affiliation(s)
- Okezie I Aruoma
- Department of Pharmaceutical Sciences, School of Pharmacy, American University of Health Sciences, Signal Hill, CA, USA.
| | - Jhoti Somanah
- ANDI Center for Biomedical and Biomaterials Research, University of Mauritius, MSIRI Building, Réduit, Mauritius
| | - Emmanuel Bourdon
- Groupe d'Etude sur l'Inflammation Chronique et l'Obésité (GEICO), Université de La Réunion, Plateforme CYROI, Saint Denis, France
| | - Philippe Rondeau
- Groupe d'Etude sur l'Inflammation Chronique et l'Obésité (GEICO), Université de La Réunion, Plateforme CYROI, Saint Denis, France
| | - Theeshan Bahorun
- ANDI Center for Biomedical and Biomaterials Research, University of Mauritius, MSIRI Building, Réduit, Mauritius.
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Howell A, Anderson AS, Clarke RB, Duffy SW, Evans DG, Garcia-Closas M, Gescher AJ, Key TJ, Saxton JM, Harvie MN. Risk determination and prevention of breast cancer. Breast Cancer Res 2014; 16:446. [PMID: 25467785 PMCID: PMC4303126 DOI: 10.1186/s13058-014-0446-2] [Citation(s) in RCA: 210] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Breast cancer is an increasing public health problem. Substantial advances have been made in the treatment of breast cancer, but the introduction of methods to predict women at elevated risk and prevent the disease has been less successful. Here, we summarize recent data on newer approaches to risk prediction, available approaches to prevention, how new approaches may be made, and the difficult problem of using what we already know to prevent breast cancer in populations. During 2012, the Breast Cancer Campaign facilitated a series of workshops, each covering a specialty area of breast cancer to identify gaps in our knowledge. The risk-and-prevention panel involved in this exercise was asked to expand and update its report and review recent relevant peer-reviewed literature. The enlarged position paper presented here highlights the key gaps in risk-and-prevention research that were identified, together with recommendations for action. The panel estimated from the relevant literature that potentially 50% of breast cancer could be prevented in the subgroup of women at high and moderate risk of breast cancer by using current chemoprevention (tamoxifen, raloxifene, exemestane, and anastrozole) and that, in all women, lifestyle measures, including weight control, exercise, and moderating alcohol intake, could reduce breast cancer risk by about 30%. Risk may be estimated by standard models potentially with the addition of, for example, mammographic density and appropriate single-nucleotide polymorphisms. This review expands on four areas: (a) the prediction of breast cancer risk, (b) the evidence for the effectiveness of preventive therapy and lifestyle approaches to prevention, (c) how understanding the biology of the breast may lead to new targets for prevention, and (d) a summary of published guidelines for preventive approaches and measures required for their implementation. We hope that efforts to fill these and other gaps will lead to considerable advances in our efforts to predict risk and prevent breast cancer over the next 10 years.
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Affiliation(s)
- Anthony Howell
- Genesis Breast Cancer Prevention Centre, University Hospital of South Manchester, Southmoor Road, Wythenshawe, M29 9LT Manchester, UK
- The Christie, NHS Foundation Trust, Wilmslow Road, Manchester, M20 2QJ UK
- Breakthrough Breast Cancer Research Unit, Institute of Cancer Sciences, University of Manchester, Wilmslow Road, Manchester, M20 2QJ UK
| | - Annie S Anderson
- Centre for Public Health Nutrition Research, Division of Cancer Research, Level 7, University of Dundee, Ninewells Hospital & Medical School, Mailbox 7, George Pirie Way, Dundee, DD1 9SY UK
| | - Robert B Clarke
- Breakthrough Breast Cancer Research Unit, Institute of Cancer Sciences, University of Manchester, Wilmslow Road, Manchester, M20 2QJ UK
| | - Stephen W Duffy
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ UK
| | - D Gareth Evans
- Genesis Breast Cancer Prevention Centre, University Hospital of South Manchester, Southmoor Road, Wythenshawe, M29 9LT Manchester, UK
- The Christie, NHS Foundation Trust, Wilmslow Road, Manchester, M20 2QJ UK
- Manchester Centre for Genomic Medicine, The University of Manchester, Manchester Academic Health Science Centre, Central Manchester Foundation Trust, St. Mary’s Hospital, Oxford Road, Manchester, M13 9WL UK
| | - Montserat Garcia-Closas
- Division of Genetics and Epidemiology, Institute of Cancer Research, Cotswold Road, Sutton, SM2 5NG London, UK
| | - Andy J Gescher
- Department of Cancer Studies and Molecular Medicine, University of Leicester, University Road, Leicester, LE2 7LX UK
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF UK
| | - John M Saxton
- School of Health Sciences, Faculty of Medicine and Health Sciences, University of East Anglia, University Drive, Norwich, NR4 7TJ UK
| | - Michelle N Harvie
- Genesis Breast Cancer Prevention Centre, University Hospital of South Manchester, Southmoor Road, Wythenshawe, M29 9LT Manchester, UK
- The Christie, NHS Foundation Trust, Wilmslow Road, Manchester, M20 2QJ UK
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Rahmioglu N, Fassbender A, Vitonis AF, Tworoger SS, Hummelshoj L, D'Hooghe TM, Adamson GD, Giudice LC, Becker CM, Zondervan KT, Missmer SA. World Endometriosis Research Foundation Endometriosis Phenome and Biobanking Harmonization Project: III. Fluid biospecimen collection, processing, and storage in endometriosis research. Fertil Steril 2014; 102:1233-43. [PMID: 25256929 PMCID: PMC4230639 DOI: 10.1016/j.fertnstert.2014.07.1208] [Citation(s) in RCA: 113] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 07/09/2014] [Accepted: 07/09/2014] [Indexed: 12/12/2022]
Abstract
Objective To harmonize standard operating procedures (SOPs) and standardize the recording of associated data for collection, processing, and storage of fluid biospecimens relevant to endometriosis. Design An international collaboration involving 34 clinical/academic centers and 3 industry collaborators from 16 countries on 5 continents. Setting In 2013, 2 workshops were conducted, followed by global consultation, bringing together 54 leaders in endometriosis research and sample processing worldwide. Patient(s) None. Intervention(s) Consensus SOPs were based on: [1] systematic comparison of SOPs from 18 global centers collecting fluid samples from women with and without endometriosis on a medium/large scale (publication on >100 cases), [2] literature evidence where available, or consultation with laboratory experts otherwise, and [3] several global consultation rounds. Main Outcome Measure(s) Standard recommended and minimum required SOPs for biofluid collection, processing, and storage in endometriosis research. Result(s) We developed recommended standard and minimum required SOPs for the collection, processing, and storage of plasma, serum, saliva, urine, endometrial/peritoneal fluid, and menstrual effluent, and a biospecimen data-collection form necessary for interpretation of sample-derived results. Conclusion(s) The Endometriosis Phenome and Biobanking Harmonisation Project SOPs allow endometriosis research centers to decrease variability in biofluid sample results, facilitating between-center comparisons and collaborations. The procedures are also relevant to research into other female conditions involving biofluid samples subject to cyclic reproductive influences. The consensus SOPs are based on the best available evidence; areas with limited evidence are identified as requiring further pilot studies. The SOPs will be reviewed based on investigator feedback, and through systematic tri-annual follow-up. Updated versions will be made available at: endometriosisfoundation.org/ephect.
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Affiliation(s)
- Nilufer Rahmioglu
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
| | - Amelie Fassbender
- Organ Systems, Department of Development and Regeneration, Katholieke Universiteit Leuven, Leuven, Belgium; Department of Obstetrics and Gynaecology, Leuven University Fertility Centre, University Hospital Leuven, Leuven, Belgium
| | - Allison F Vitonis
- Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Boston Center for Endometriosis, Boston Children's Hospital and Brigham & Women's Hospital, Boston, Massachusetts
| | - Shelley S Tworoger
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
| | - Lone Hummelshoj
- World Endometriosis Research Foundation (WERF), London, United Kingdom
| | - Thomas M D'Hooghe
- Organ Systems, Department of Development and Regeneration, Katholieke Universiteit Leuven, Leuven, Belgium; Department of Obstetrics and Gynaecology, Leuven University Fertility Centre, University Hospital Leuven, Leuven, Belgium
| | - G David Adamson
- World Endometriosis Research Foundation (WERF), London, United Kingdom; Palo Alto Medical Foundation Fertility Physicians of Northern California, Palo Alto, California
| | - Linda C Giudice
- World Endometriosis Research Foundation (WERF), London, United Kingdom; University of California San Francisco, San Francisco, California
| | - Christian M Becker
- Nuffield Department of Obstetrics & Gynaecology, University of Oxford, Oxford, United Kingdom; Endometriosis CaRe Centre Oxford, University of Oxford, Oxford, United Kingdom
| | - Krina T Zondervan
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom; Nuffield Department of Obstetrics & Gynaecology, University of Oxford, Oxford, United Kingdom; Endometriosis CaRe Centre Oxford, University of Oxford, Oxford, United Kingdom.
| | - Stacey A Missmer
- Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Boston Center for Endometriosis, Boston Children's Hospital and Brigham & Women's Hospital, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
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128
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Pouchieu C, Galan P, Ducros V, Latino-Martel P, Hercberg S, Touvier M. Plasma carotenoids and retinol and overall and breast cancer risk: a nested case-control study. Nutr Cancer 2014; 66:980-8. [PMID: 25072980 DOI: 10.1080/01635581.2014.936952] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Experimental studies suggest that carotenoids and retinol may play a role in carcinogenesis, but epidemiological evidence is lacking. We investigated the prospective associations between plasma concentrations of major carotenoids and retinol, and overall and breast cancer risk. A nested case-control study included all first incident cancer cases diagnosed in the SU.VI.MAX cohort between 1994 and 2002 (n = 159 cases, 1 matched control/case). Baseline plasma concentrations of carotenoids and retinol were measured by high-performance liquid chromatography. Conditional logistic regression was used to assess odds ratios for an increase of 0.1 μmol/L [odds ratio (OR)] and 95% confidence intervals (CI). Plasma β-carotene (OR = 0.95, 95% CI = 0.90-0.99, Ptrend = 0.04) and β-cryptoxanthin concentrations (OR = 0.89, 95% CI = 0.81-0.99, Ptrend = 0.03) were inversely associated with overall cancer risk. Plasma β-cryptoxanthin concentration was inversely associated with breast cancer risk (OR = 0.83, 95% CI = 0.71-0.96, Ptrend = 0.02). The OR between plasma lycopene concentration and overall cancer risk was 1.07 (0.99-1.15), Ptrend = 0.06. This association turned significant (Ptrend = 0.01) when excluding cancer cases diagnosed during the first year of follow-up. This prospective study suggests an inverse association between plasma concentrations of β-cryptoxanthin and both overall and breast cancer risk, and an inverse association between β-carotene and overall cancer risk. The direct association between lycopene concentration and cancer risk deserves further investigation.
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Affiliation(s)
- Camille Pouchieu
- a Sorbonne Paris Cité Research Center, Nutritional Epidemiology Research Team, Inserm U557, Inra U1125, Cnam , Paris 13 University , Bobigny , France
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129
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Kaulmann A, Jonville MC, Schneider YJ, Hoffmann L, Bohn T. Carotenoids, polyphenols and micronutrient profiles of Brassica oleraceae and plum varieties and their contribution to measures of total antioxidant capacity. Food Chem 2014; 155:240-50. [DOI: 10.1016/j.foodchem.2014.01.070] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Revised: 12/19/2013] [Accepted: 01/20/2014] [Indexed: 10/25/2022]
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130
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Kardeh S, Ashkani-Esfahani S, Alizadeh AM. Paradoxical action of reactive oxygen species in creation and therapy of cancer. Eur J Pharmacol 2014; 735:150-68. [DOI: 10.1016/j.ejphar.2014.04.023] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2013] [Revised: 04/04/2014] [Accepted: 04/09/2014] [Indexed: 02/07/2023]
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131
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Gonzales JF, Barnard ND, Jenkins DJA, Lanou AJ, Davis B, Saxe G, Levin S. Applying the precautionary principle to nutrition and cancer. J Am Coll Nutr 2014; 33:239-46. [PMID: 24870117 DOI: 10.1080/07315724.2013.866527] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PRIMARY OBJECTIVE Research has identified certain foods and dietary patterns that are associated with reduced cancer risk and improved survival after cancer diagnosis. This research has formed the basis for dietary guidance issued by cancer organizations. Unfortunately, gaps within nutrition research have made it difficult to make recommendations in some areas. This review specifies suggested dietary guidance in which evidence of a dietary influence on cancer risk is substantial, even if not conclusive. Evidence summaries within the review are based on the 2007 report of the World Cancer Research Fund/American Institute for Cancer Research. This review also describes advantages and disadvantages of following the suggested dietary guidance and includes putative mechanisms involved in cancer progression. MAIN OUTCOMES AND RESULTS Suggested dietary guidance where evidence is sufficiently compelling include (1) limiting or avoiding dairy products to reduce the risk of prostate cancer; (2) limiting or avoiding alcohol to reduce the risk of cancers of the mouth, pharynx, larynx, esophagus, colon, rectum, and breast; (3) avoiding red and processed meat to reduce the risk of cancers of the colon and rectum; (4) avoiding grilled, fried, and broiled meats to reduce the risk of cancers of the colon, rectum, breast, prostate, kidney, and pancreas; (5) consumption of soy products during adolescence to reduce the risk of breast cancer in adulthood and to reduce the risk of recurrence and mortality for women previously treated for breast cancer; and (6) emphasizing fruits and vegetables to reduce risk of several common forms of cancer. CONCLUSION By adopting the precautionary principle for nutrition research, this review aims to serve as a useful tool for practitioners and patients.
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Affiliation(s)
- Joseph F Gonzales
- a Physicians Committee for Responsible Medicine, Clinical Research , Washington , D.C
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132
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Boeke CE, Tamimi RM, Berkey CS, Colditz GA, Eliassen AH, Malspeis S, Willett WC, Frazier AL. Adolescent carotenoid intake and benign breast disease. Pediatrics 2014; 133:e1292-8. [PMID: 24709924 PMCID: PMC4006443 DOI: 10.1542/peds.2013-3844] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Carotenoids may reduce risk of benign breast disease (BBD), an independent risk factor for breast cancer, through antioxidative or antiproliferative mechanisms. Exposure to carotenoids may be most important during adolescence when breast tissue is still developing. We examined adolescent carotenoid intake in relation to BBD in young women. METHODS In 6593 adolescent girls in the prospective Growing Up Today Study cohort, intakes of α-carotene, β-carotene, β-cryptoxanthin, lutein/zeaxanthin, and lycopene were assessed by using the means from food-frequency questionnaires in 1996, 1997, and 1998. Girls reported biopsy-confirmed BBD on questionnaires in 2005, 2007, and 2010 (n = 122). We conducted logistic regression of energy-adjusted carotenoid intakes in relation to BBD, adjusted for age, family history of breast cancer or BBD, age at menarche, nulliparity, alcohol intake, BMI, and physical activity. RESULTS Mean (SD) age at baseline was 12.0 (1.6) years. β-Carotene intake was inversely associated with BBD; comparing the highest to lowest quartile, the multivariate-adjusted odds ratio was 0.58 (95% confidence interval: 0.34-1.00; P-trend = .03). α-Carotene and lutein/zeaxanthin were also inversely associated with BBD, but the associations were not statistically significant. CONCLUSIONS Adolescent carotenoid intake may be associated with lower BBD risk; these findings warrant further study.
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Affiliation(s)
- Caroline E. Boeke
- Departments of Epidemiology and,Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Rulla M. Tamimi
- Departments of Epidemiology and,Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts;,Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Catherine S. Berkey
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts;,Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Graham A. Colditz
- Alvin J. Siteman Cancer Center, Washington University School of Medicine, St Louis, Missouri; and
| | - A. Heather Eliassen
- Departments of Epidemiology and,Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts;,Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Susan Malspeis
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Walter C. Willett
- Departments of Epidemiology and,Nutrition, Harvard School of Public Health, Boston, Massachusetts;,Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts;,Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - A. Lindsay Frazier
- Division of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
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133
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Colditz GA, Bohlke K. Priorities for the primary prevention of breast cancer. CA Cancer J Clin 2014; 64:186-94. [PMID: 24647877 DOI: 10.3322/caac.21225] [Citation(s) in RCA: 154] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 02/11/2014] [Accepted: 02/13/2014] [Indexed: 01/29/2023] Open
Abstract
Despite recent calls to intensify the search for new risk factors for breast cancer, acting on information that we already have could prevent thousands of cases each year. This article reviews breast cancer primary prevention strategies that are applicable to all women, discusses the underutilization of chemoprevention in high-risk women, highlights the additional advances that could be made by including young women in prevention efforts, and comments on how the molecular heterogeneity of breast cancer affects prevention research and strategies.
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Affiliation(s)
- Graham A Colditz
- Niess-Gain Professor of Surgery, Alvin J. Siteman Cancer Center and Department of Surgery, Washington University School of Medicine and Barnes-Jewish Hospital, St. Louis, MO
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134
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Abstract
Preventing breast cancer is an effective strategy for reducing breast cancer deaths. The purpose of chemoprevention (also termed preventive therapy) is to reduce cancer incidence by use of natural, synthetic, or biological agents. The efficacy of tamoxifen, raloxifene, and exemestane as preventive therapy against estrogen-receptor (ER)-positive breast cancer is well established for women at increased risk for breast cancer. However, because breast cancer is a heterogeneous disease, distinct preventive approaches may be required for effective prevention of each subtype. Current research is, therefore, focused on identifying alternative mechanisms by which biologically active compounds can reduce the risk of all breast cancer subtypes including ER-negative breast cancer. Promising agents are currently being developed for prevention of HER2-positive and triple-negative breast cancer (TNBC) and include inhibitors of the ErbB family receptors, COX-2 inhibitors, metformin, retinoids, statins, poly(ADP-ribose) polymerase inhibitors, and natural compounds. This review focuses on recent progress in research to develop more effective preventive agents, in particular for prevention of ER-negative breast cancer.
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135
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Takeshima M, Ono M, Higuchi T, Chen C, Hara T, Nakano S. Anti-proliferative and apoptosis-inducing activity of lycopene against three subtypes of human breast cancer cell lines. Cancer Sci 2014; 105:252-7. [PMID: 24397737 PMCID: PMC4317951 DOI: 10.1111/cas.12349] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Revised: 12/22/2013] [Accepted: 01/03/2014] [Indexed: 11/28/2022] Open
Abstract
Although lycopene, a major carotenoid component of tomatoes, has been suggested to attenuate the risk of breast cancer, the underlying preventive mechanism remains to be determined. Moreover, it is not known whether there are any differences in lycopene activity among different subtypes of human breast cancer cells. Using ER/PR positive MCF-7, HER2-positive SK-BR-3 and triple-negative MDA-MB-468 cell lines, we investigated the cellular and molecular mechanism of the anticancer activity of lycopene. Lycopene treatment for 168 consecutive hours exhibited a time-dependent and dose-dependent anti-proliferative activity against these cell lines by arresting the cell cycle at the G0/G1 phase at physiologically achievable concentrations found in human plasma. The greatest growth inhibition was observed in MDA-MB-468 where the sub-G0/G1 apoptotic population was significantly increased, with demonstrable cleavage of PARP. Lycopene induced strong and sustained activation of the ERK1/2, with concomitant cyclin D1 suppression and p21 upregulation in these three cell lines. In triple negative cells, lycopene inhibited the phosphorylation of Akt and its downstream molecule mTOR, followed by subsequent upregulation of proapoptotic Bax without affecting anti-apoptotic Bcl-xL. Taken together, these data indicate that the predominant anticancer activity of lycopene in MDA-MB-468 cells suggests a potential role of lycopene for the prevention of triple negative breast cancer.
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Affiliation(s)
- Mikako Takeshima
- Graduate School of Health and Nutritional Sciences, Nakamura Gakuen University, Fukuoka, Japan
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136
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Suarez EC, Schramm-Sapyta NL. Race differences in the relation of vitamins A, C, E, and β-carotene to metabolic and inflammatory biomarkers. Nutr Res 2013; 34:1-10. [PMID: 24418240 DOI: 10.1016/j.nutres.2013.10.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Revised: 10/04/2013] [Accepted: 10/07/2013] [Indexed: 12/14/2022]
Abstract
Using archival data, we conducted a secondary analysis to examine race differences in the relation of serum vitamins A, C, E and β-carotene to insulin resistance (IR), fasting insulin and glucose, high sensitivity C-reactive protein (hs-CRP), and leukocyte count in 176 non-smoking, healthy, white, and African American (AA) adults aged 18 to 65 years (48% women, 33% AA). We hypothesized that micronutrient concentrations would be associated with early risk markers of cardiometabolic diseases in a race-dependent manner. Fasting blood samples were analyzed for micronutrients, insulin, glucose, hs-CRP, and leukocyte count. Insulin resistance was estimated using the homeostatic model assessment. After adjusting for age, body mass index, gender, educational level, use of vitamin supplements, alcohol intake, leisure time physical activity, menopausal status, and total cholesterol, we observed that β-carotene was significantly associated with insulin resistance and fasting insulin in a race-dependent manner. Among AA, lower β-carotene levels were associated with higher estimates of insulin resistance and fasting insulin; whereas, these same associations were not significant for whites. Race also significantly moderated the relation of vitamin C to leukocyte count, with lower vitamin C being associated with higher leukocyte count only in AA but not whites. For all subjects, lower β-carotene was associated with higher hs-CRP. In AA, but not whites, lower levels of β-carotene and vitamin C were significantly associated with early risk markers implicated in cardiometabolic conditions and cancer. Whether or not lower levels of micronutrients contribute uniquely to racial health disparities is a worthwhile aim for future research.
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Affiliation(s)
- Edward C Suarez
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC.
| | - Nicole L Schramm-Sapyta
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
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Zeaxanthin Induces Apoptosis in Human Uveal Melanoma Cells through Bcl-2 Family Proteins and Intrinsic Apoptosis Pathway. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:205082. [PMID: 24223611 PMCID: PMC3810440 DOI: 10.1155/2013/205082] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 09/03/2013] [Indexed: 01/04/2023]
Abstract
The cytotoxic effects of zeaxanthin on two human uveal melanoma cell lines (SP6.5 and C918) and related signaling pathways were studied and compared to effects on normal ocular cells (uveal melanocytes, retinal pigment epithelial cells, and scleral fibroblasts). MTT assay revealed that zeaxanthin reduced the cell viability of melanoma cells in a dose-dependent manner (10, 30, and 100 μM), with IC50
at 40.8 and 28.7 μM in SP6.5 and C918 cell lines, respectively. Zeaxanthin did not affect the viability of normal ocular cells even at the highest levels tested (300 μM), suggesting that zeaxanthin has a selectively cytotoxic effect on melanoma cells. Zeaxanthin induced apoptosis in melanoma cells as indicated by annexin V and ethidium III flow cytometry. Western blot analysis demonstrated that zeaxanthin decreased the expression of antiapoptotic proteins (Bcl-2 and Bcl-xL) and increased the expression of proapoptotic proteins (Bak and Bax) in zeaxanthin-treated melanoma cells. Zeaxanthin increased mitochondrial permeability as determined by JC-1 fluorescein study. Zeaxanthin also increased the level of cytosol cytochrome c and caspase-9 and -3 activities, but not caspase-8, as measured by ELISA assay or colorimetric assay. All of these findings indicate that the intrinsic (mitochondrial) pathway is involved in zeaxanthin-induced apoptosis in uveal melanoma cells.
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138
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Friedman M. Anticarcinogenic, cardioprotective, and other health benefits of tomato compounds lycopene, α-tomatine, and tomatidine in pure form and in fresh and processed tomatoes. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2013; 61:9534-50. [PMID: 24079774 DOI: 10.1021/jf402654e] [Citation(s) in RCA: 153] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Tomatoes produce the bioactive compounds lycopene and α-tomatine that are reported to have potential health-promoting effects in animals and humans, but our understanding of the roles of these compounds in the diet is incomplete. Our current knowledge gained from the chemistry and analysis of these compounds in fresh and processed tomatoes and from studies on their bioavailability, bioactivity, and mechanisms of action against cancer cells and other beneficial bioactivities including antibiotic, anti-inflammatory, antioxidative, cardiovascular, and immunostimulating effects in cells, animals, and humans is discussed and interpreted here. Areas for future research are also suggested. The collated information and suggested research might contribute to a better understanding of the agronomical, biochemical, chemical, physiological, molecular, and cellular bases of the health-promoting effects and facilitate and guide further studies needed to optimize the use of lycopene and α-tomatine in pure form and in fresh tomatoes and processed tomato products to help prevent or treat human disease.
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Affiliation(s)
- Mendel Friedman
- Western Regional Research Center, Agricultural Research Service, U.S. Department of Agriculture , Albany, California 94710, United States
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139
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Fortner RT, Tworoger SS, Wu T, Eliassen AH. Plasma florescent oxidation products and breast cancer risk: repeated measures in the Nurses' Health Study. Breast Cancer Res Treat 2013; 141:307-16. [PMID: 24046001 DOI: 10.1007/s10549-013-2673-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Accepted: 08/16/2013] [Indexed: 02/02/2023]
Abstract
Reactive oxygen species (ROS), normally generated through biologic processes, may damage DNA, lipids, and proteins. ROS are balanced through enzymatic mechanisms and exogenous antioxidants; imbalance results in oxidative stress. Limited data suggest an association between oxidative stress and breast cancer. We evaluated pre-diagnostic plasma fluorescent oxidation products (FlOP), a global biomarker of oxidative stress, and breast cancer risk in a nested case-control study in the Nurses' Health Study. Participants provided two blood samples (1989-1990 and 2000-2002) (N = 18,743). 377 women developed breast cancer between the second collection and June 1, 2006. Cases were matched to 377 controls. Relative fluorescent intensity at three different excitation/emission wavelengths (FlOP_360, FlOP_320, FlOP_400) were quantified in both samples, providing distant (≥10 years before diagnosis) and proximate (≤6 years before diagnosis) measures of oxidative stress. We observed no association between FlOP and breast cancer risk in proximate or distant samples (e.g., proximate extreme quartiles: FlOP_360, RR 0.8, 95 % CI 0.5-1.3, p trend = 0.49; FlOP_320, RR 1.1, 95 % CI 0.7-1.7, p trend = 0.53; FlOP_400, RR 1.3, 95 % CI 0.8-2.0, p trend = 0.80). In general no association was observed when cross-classifying or averaging proximate and distant exposure (e.g., extreme quartile of averages: FlOP_360, OR 0.9, 95 % CI 0.6-1.4, p trend = 0.82; FlOP_400, OR 0.9, 95 % CI 0.6-1.4, p trend = 0.55), with the exception of a significant trend for average FlOP_320 (extreme quartiles, OR 1.6, 95 % CI 1.0-2.4, p trend = 0.02). We did not observe important associations between FlOP and breast cancer risk in this large prospective study, though our data suggest women with consistently high FlOP_320 may be at increased risk.
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Affiliation(s)
- Renée T Fortner
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Ave., Boston, MA, 02115, USA,
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Moran NE, Erdman JW, Clinton SK. Complex interactions between dietary and genetic factors impact lycopene metabolism and distribution. Arch Biochem Biophys 2013; 539:171-80. [PMID: 23845854 DOI: 10.1016/j.abb.2013.06.017] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 06/21/2013] [Accepted: 06/25/2013] [Indexed: 12/28/2022]
Abstract
Intake of lycopene, a red, tetraterpene carotenoid found in tomatoes is epidemiologically associated with a decreased risk of chronic disease processes, and lycopene has demonstrated bioactivity in numerous in vitro and animal models. However, our understanding of absorption, tissue distribution, and biological impact in humans remains very limited. Lycopene absorption is strongly impacted by dietary composition, especially the amount of fat. Concentrations of circulating lycopene in lipoproteins may be further influenced by a number of variations in genes related to lipid absorption and metabolism. Lycopene is not uniformly distributed among tissues, with adipose, liver, and blood being the major body pools, while the testes, adrenals, and liver have the greatest concentrations compared to other organs. Tissue concentrations of lycopene are likely dictated by expression of and genetic variation in lipoprotein receptors, cholesterol transporters, and carotenoid metabolizing enzymes, thus impacting lycopene accumulation at target sites of action. The novel application of genetic evaluation in concert with lycopene tracers will allow determination of which genes and polymorphisms define individual lycopene metabolic phenotypes, response to dietary variables, and ultimately determine biological and clinical outcomes. A better understanding of the relationship between diet, genetics, and lycopene distribution will provide necessary information to interpret epidemiological findings more accurately and to design effective, personalized clinical nutritional interventions addressing hypotheses regarding health outcomes.
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Affiliation(s)
- Nancy E Moran
- Division of Medical Oncology, Comprehensive Cancer Center, Wexner Medical Center, The Ohio State University, Columbus, OH, United States
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Fung TT, Chiuve SE, Willett WC, Hankinson SE, Hu FB, Holmes MD. Intake of specific fruits and vegetables in relation to risk of estrogen receptor-negative breast cancer among postmenopausal women. Breast Cancer Res Treat 2013; 138:925-30. [PMID: 23532538 DOI: 10.1007/s10549-013-2484-3] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Accepted: 03/12/2013] [Indexed: 11/29/2022]
Abstract
In previous studies of postmenopausal women, overall intake of fruits and vegetables groups has been inversely associated with estrogen receptor-negative (ER-) breast cancer. In this analysis, we prospectively examined the associations of specific fruits and vegetables with risk of ER- postmenopausal breast cancer among 75,929 women aged 38-63 years at baseline and followed for up to 24 years. Dietary data were collected seven times during this period. Cox proportional hazard models were used, adjusting for potential confounders, including a modified Alternate Mediterranean Diet score. We ascertained 792 incident cases of ER- postmenopausal breast cancer. The multivariate relative risk (RR) for every 2 servings/week consumption for total berries was 0.82 (95 % CI = 0.71-0.96, p = 0.01), and the RR for women who consumed at least one serving of blueberries a week was 0.69 (95 % CI = 0.50-0.95, p = 0.02) compared with non-consumers. Also, the RR for consuming at least 2 servings of peaches/nectarines per week was 0.59 (95 % CI = 0.37-0.93, p = 0.02). Risk of ER- breast cancer was not associated with intakes of other specific fruits or vegetables. In conclusion, higher intake of berries and peaches was associated with lower risk of ER- breast cancer among postmenopausal women. These results are considered exploratory and need to be confirmed in further studies.
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Affiliation(s)
- Teresa T Fung
- Department of Nutrition, Simmons College, 300 The Fenway, Boston, MA 02115, USA.
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143
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Hendrickson SJ, Lindström S, Eliassen AH, Rosner BA, Chen C, Barrdahl M, Brinton L, Buring J, Canzian F, Chanock S, Clavel-Chapelon F, Figueroa JD, Gapstur SM, Garcia-Closas M, Gaudet MM, Haiman CA, Hazra A, Henderson B, Hoover R, Hüsing A, Johansson M, Kaaks R, Khaw KT, Kolonel LN, Le Marchand L, Lissowska J, Lund E, McCullough ML, Peplonska B, Riboli E, Sacerdote C, Sánchez MJ, Tjønneland A, Trichopoulos D, van Gils CH, Yeager M, Kraft P, Hunter DJ, Ziegler RG, Willett WC. Plasma carotenoid- and retinol-weighted multi-SNP scores and risk of breast cancer in the National Cancer Institute Breast and Prostate Cancer Cohort Consortium. Cancer Epidemiol Biomarkers Prev 2013; 22:927-36. [PMID: 23515144 DOI: 10.1158/1055-9965.epi-13-0017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Dietary and circulating carotenoids have been inversely associated with breast cancer risk, but observed associations may be due to confounding. Single-nucleotide polymorphisms (SNPs) in β-carotene 15,15'-monooxygenase 1 (BCMO1), a gene encoding the enzyme involved in the first step of synthesizing vitamin A from dietary carotenoids, have been associated with circulating carotenoid concentrations and may serve as unconfounded surrogates for those biomarkers. We determined associations between variants in BCMO1 and breast cancer risk in a large cohort consortium. METHODS We used unconditional logistic regression to test four SNPs in BCMO1 for associations with breast cancer risk in 9,226 cases and 10,420 controls from the National Cancer Institute Breast and Prostate Cancer Cohort Consortium (BPC3). We also tested weighted multi-SNP scores composed of the two SNPs with strong, confirmed associations with circulating carotenoid concentrations. RESULTS Neither the individual SNPs nor the weighted multi-SNP scores were associated with breast cancer risk [OR (95% confidence interval) comparing extreme quintiles of weighted multi-SNP scores = 1.04 (0.94-1.16) for β-carotene, 1.08 (0.98-1.20) for α-carotene, 1.04 (0.94-1.16) for β-cryptoxanthin, 0.95 (0.87-1.05) for lutein/zeaxanthin, and 0.92 (0.83-1.02) for retinol]. Furthermore, no associations were observed when stratifying by estrogen receptor status, but power was limited. CONCLUSIONS Our results do not support an association between SNPs associated with circulating carotenoid concentrations and breast cancer risk. IMPACT Future studies will need additional genetic surrogates and/or sample sizes at least three times larger to contribute evidence of a causal link between carotenoids and breast cancer.
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Affiliation(s)
- Sara J Hendrickson
- Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA
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