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Mahjoub M, Ben-Tahar R, Omari A, Arabi M, Boukich O, Slamini M, Smiri Y. Hg, Cd, and Pb in fish of the Moulouya River, Morocco, and human health risk. FOOD ADDITIVES & CONTAMINANTS. PART B, SURVEILLANCE 2024; 17:241-250. [PMID: 39146973 DOI: 10.1080/19393210.2024.2367476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 06/10/2024] [Indexed: 08/17/2024]
Abstract
Concentrations of toxic metals (Hg, Pb, and Cd) were determined in the muscles of Lepomis macrochirus, Barbus callensis, and Barbus nasus caught from the Moulouya River of Morocco by graphite furnace (for Pb and Cd) and cold vapour (for Hg) atomic absorption spectrometry, after acid digestion. Although the concentration of metals in some species was relatively high, no health risk has been identified in comparison to the maximum limits as set by the European Commission. The order of increasing concentrations was Cd < Hg < Pb. Calculated Target Hazard Quotients and Hazard Indices were below 1, indicating that the intake of metals via consumption of the muscles of both fish species does not represent a hazard to human health.
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Affiliation(s)
- Mohammed Mahjoub
- Department of Biology, Laboratory of the Agricultural Production Improvement, Biotechnology and Environment, Faculty of Sciences, Mohamed First University, Oujda, Morocco
| | - Rihab Ben-Tahar
- Department of Biology, Laboratory of the Agricultural Production Improvement, Biotechnology and Environment, Faculty of Sciences, Mohamed First University, Oujda, Morocco
| | - Abdelouadoud Omari
- Department of Biology, Laboratory of the Agricultural Production Improvement, Biotechnology and Environment, Faculty of Sciences, Mohamed First University, Oujda, Morocco
| | - Mourad Arabi
- Department of Biology, Laboratory of the Agricultural Production Improvement, Biotechnology and Environment, Faculty of Sciences, Mohamed First University, Oujda, Morocco
| | - Oualid Boukich
- Department of Biology, Laboratory of the Agricultural Production Improvement, Biotechnology and Environment, Faculty of Sciences, Mohamed First University, Oujda, Morocco
| | - Maryam Slamini
- Department of Biology, Laboratory of the Agricultural Production Improvement, Biotechnology and Environment, Faculty of Sciences, Mohamed First University, Oujda, Morocco
| | - Youssef Smiri
- Department of Biology, Laboratory of the Agricultural Production Improvement, Biotechnology and Environment, Faculty of Sciences, Mohamed First University, Oujda, Morocco
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Wang C, Ding K, Xie X, Zhou J, Liu P, Wang S, Fang T, Xu G, Tang C, Hong H. Soy Product Consumption and the Risk of Cancer: A Systematic Review and Meta-Analysis of Observational Studies. Nutrients 2024; 16:986. [PMID: 38613019 PMCID: PMC11013307 DOI: 10.3390/nu16070986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 03/24/2024] [Accepted: 03/24/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND The association between soy product consumption and cancer risk varies among studies. Therefore, this comprehensive meta-analysis of observational studies examines the association between soy product consumption and total cancer risk. METHODS This study was conducted following the PRISMA guidelines. Up to October 2023, all eligible published studies were searched through PubMed and Web of Science databases. RESULTS A total of 52 studies on soy product consumption were included in this meta-analysis (17 cohort studies and 35 case-control studies). High consumption of total soy products (RR: 0.69; 95% CI: 0.60, 0.80), tofu (RR: 0.78; 95% CI: 0.70, 0.86), and soymilk (RR: 0.75; 95% CI: 0.60, 0.93) were associated with reduced total cancer risk. No association was found between high consumption of fermented soy products (RR: 1.18; 95% CI: 0.95, 1.47), non-fermented soy products (RR: 0.95; 95% CI: 0.77, 1.18), soy paste (RR: 1.00; 95% CI: 0.88, 1.14), miso soup (RR: 0.99; 95% CI: 0.87, 1.12), or natto (RR: 0.96; 95% CI: 0.82, 1.11) and cancer risk. A 54 g per day increment of total soy products reduced cancer risk by 11%, a 61 g per day increment of tofu reduced cancer risk by 12%, and a 23 g per day increment of soymilk reduced cancer risk by 28%, while none of the other soy products were associated with cancer risk. CONCLUSION Our findings suggest that high total soy product consumption, especially soymilk and tofu, is associated with lower cancer risk. More prospective cohort studies are still needed to confirm the causal relationship between soy product consumption and cancer risk.
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Affiliation(s)
- Chenting Wang
- School of Public Health, Health Science Center, Ningbo University, Ningbo 315211, China; (C.W.); (X.X.); (J.Z.); (P.L.); (S.W.); (T.F.)
| | - Keqing Ding
- Ningbo Center for Disease Control and Prevention, Ningbo 315010, China;
| | - Xuanzhen Xie
- School of Public Health, Health Science Center, Ningbo University, Ningbo 315211, China; (C.W.); (X.X.); (J.Z.); (P.L.); (S.W.); (T.F.)
| | - Jinyue Zhou
- School of Public Health, Health Science Center, Ningbo University, Ningbo 315211, China; (C.W.); (X.X.); (J.Z.); (P.L.); (S.W.); (T.F.)
| | - Pengju Liu
- School of Public Health, Health Science Center, Ningbo University, Ningbo 315211, China; (C.W.); (X.X.); (J.Z.); (P.L.); (S.W.); (T.F.)
| | - Shuang Wang
- School of Public Health, Health Science Center, Ningbo University, Ningbo 315211, China; (C.W.); (X.X.); (J.Z.); (P.L.); (S.W.); (T.F.)
| | - Ting Fang
- School of Public Health, Health Science Center, Ningbo University, Ningbo 315211, China; (C.W.); (X.X.); (J.Z.); (P.L.); (S.W.); (T.F.)
| | - Guozhang Xu
- School of Public Health, Health Science Center, Ningbo University, Ningbo 315211, China; (C.W.); (X.X.); (J.Z.); (P.L.); (S.W.); (T.F.)
| | - Chunlan Tang
- School of Public Health, Health Science Center, Ningbo University, Ningbo 315211, China; (C.W.); (X.X.); (J.Z.); (P.L.); (S.W.); (T.F.)
| | - Hang Hong
- School of Public Health, Health Science Center, Ningbo University, Ningbo 315211, China; (C.W.); (X.X.); (J.Z.); (P.L.); (S.W.); (T.F.)
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Otsuka K, Nishiyama H, Kuriki D, Kawada N, Ochiya T. Connecting the dots in the associations between diet, obesity, cancer, and microRNAs. Semin Cancer Biol 2023; 93:52-69. [PMID: 37156343 DOI: 10.1016/j.semcancer.2023.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/27/2023] [Accepted: 05/01/2023] [Indexed: 05/10/2023]
Abstract
The prevalence of obesity has reached pandemic levels worldwide, leading to a lower quality of life and higher health costs. Obesity is a major risk factor for noncommunicable diseases, including cancer, although obesity is one of the major preventable causes of cancer. Lifestyle factors, such as dietary quality and patterns, are also closely related to the onset and development of obesity and cancer. However, the mechanisms underlying the complex association between diet, obesity, and cancer remain unclear. In the past few decades, microRNAs (miRNAs), a class of small non-coding RNAs, have been demonstrated to play critical roles in biological processes such as cell differentiation, proliferation, and metabolism, highlighting their importance in disease development and suppression and as therapeutic targets. miRNA expression levels can be modulated by diet and are involved in cancer and obesity-related diseases. Circulating miRNAs can also mediate cell-to-cell communications. These multiple aspects of miRNAs present challenges in understanding and integrating their mechanism of action. Here, we introduce a general consideration of the associations between diet, obesity, and cancer and review the current knowledge of the molecular functions of miRNA in each context. A comprehensive understanding of the interplay between diet, obesity, and cancer could be valuable for the development of effective preventive and therapeutic strategies in future.
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Affiliation(s)
- Kurataka Otsuka
- Tokyo NODAI Research Institure, Tokyo University of Agriculture, 1-1-1 Sakuragaoka, Setagaya, Tokyo 156-8502, Japan; R&D Division, Kewpie Corporation, 2-5-7, Sengawa-cho, Chofu-shi, Tokyo 182-0002, Japan; Division of Molecular and Cellular Medicine, Institute of Medical Science, Tokyo Medical University, 6-7-1, Nishishinjyuku, Shinjuku-ku, Tokyo 160-0023, Japan; Division of Molecular and Cellular Medicine, National Cancer Center Research Institute, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
| | - Hiroshi Nishiyama
- R&D Division, Kewpie Corporation, 2-5-7, Sengawa-cho, Chofu-shi, Tokyo 182-0002, Japan
| | - Daisuke Kuriki
- R&D Division, Kewpie Corporation, 2-5-7, Sengawa-cho, Chofu-shi, Tokyo 182-0002, Japan
| | - Naoki Kawada
- R&D Division, Kewpie Corporation, 2-5-7, Sengawa-cho, Chofu-shi, Tokyo 182-0002, Japan
| | - Takahiro Ochiya
- Division of Molecular and Cellular Medicine, Institute of Medical Science, Tokyo Medical University, 6-7-1, Nishishinjyuku, Shinjuku-ku, Tokyo 160-0023, Japan
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Wajszczyk B, Charzewska J, Godlewski D, Zemła B, Nowakowska E, Kozaczka M, Chilimoniuk M, Pathak DR. Consumption of Dairy Products and the Risk of Developing Breast Cancer in Polish Women. Nutrients 2021; 13:nu13124420. [PMID: 34959971 PMCID: PMC8703752 DOI: 10.3390/nu13124420] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/01/2021] [Accepted: 12/08/2021] [Indexed: 02/06/2023] Open
Abstract
Lack of consistency in the relationship between dairy products consumption and breast cancer (BC) risk motivated us to evaluate this association in a case-control study of BC among Polish women. The study includes 1699 women 26–79 years of age, 823 BC cases identified in Cancer Registries and 876 randomly selected controls from the national population registry. Using a validated, semiquantitative food frequency questionnaire (FFQ), the consumption of dairy products was collected for a time period of 10–15 years prior to BC diagnosis. We used logistic regression, adjusting for potential confounders, to assess the relationship between total dairy consumption as well as individual dairy groups of milk, cottage cheese and hard cheese and BC risk for premenopausal and postmenopausal women. For total consumption, a significant decrease in BC risk was observed with increased consumption of one serving/week, OR trend = 0.98, 2% decrease in risk, for premenopausal women only. For milk, a significant decrease in BC risk was observed for an increase in consumption of one glass/week, OR trend = 0.95, 5% decrease, in both strata of menopause. In contrast, for hard cheese, a significant increase in the risk of 10% was observed only in premenopausal women, OR trend = 1.10. Cottage cheese consumption significantly reduced BC risk by 20%, OR trend = 0.80, for an increase in one serving/week for postmenopausal women only. Our results show that individual dairy products have a statistically significant but bi-directional relationship with BC risk, which differs for premenopausal and postmenopausal women.
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Affiliation(s)
- Bożena Wajszczyk
- Department of Nutrition and Nutritional Value of Food, National Institute of Public Health NIH-National Research Institute, 00-791 Warszawa, Poland
- Correspondence: (B.W.); (J.C.); (D.R.P.)
| | - Jadwiga Charzewska
- Department of Nutrition and Nutritional Value of Food, National Institute of Public Health NIH-National Research Institute, 00-791 Warszawa, Poland
- Correspondence: (B.W.); (J.C.); (D.R.P.)
| | - Dariusz Godlewski
- Center of Cancer Prevention and Epidemiology OPEN, 61-863 Poznań, Poland;
| | | | | | - Maciej Kozaczka
- II Clinic of Radiology and Chemiotherapy, National Institute of Oncology, 44-102 Gliwice, Poland;
| | | | - Dorothy R. Pathak
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI 48824, USA
- Correspondence: (B.W.); (J.C.); (D.R.P.)
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He Y, Tao Q, Zhou F, Si Y, Fu R, Xu B, Xu J, Li X, Chen B. The relationship between dairy products intake and breast cancer incidence: a meta-analysis of observational studies. BMC Cancer 2021; 21:1109. [PMID: 34654387 PMCID: PMC8520314 DOI: 10.1186/s12885-021-08854-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 10/08/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The effect of dairy products intake on breast cancer (BC) is highly controversial. This study aims to investigate the relationship between dairy intake and BC incidence. METHODS A search was carried out in PubMed, EBSCO, Web of Science, and Cochrane Library databases before January 2021. The primary objective was the risk of BC and intake of dairy products were exposure variables. RESULTS The meta-analysis comprised 36 articles with 1,019,232 participants. Total dairy products have a protective effect on female population (hazard ratio (HR) =0.95, 95% confidence interval (CI) =0.91-0.99, p = 0.019), especially for estrogen receptor-positive (ER+) (HR = 0.79, p = 0.002) and progesterone receptor-positive (PR+) BC (HR = 0.75, p = 0.027). For ER+/PR+ BC, there is a trend of protection, but it has not reached statistical significance (HR = 0.92, p = 0.075). Fermented dairy products can reduce BC risk in postmenopausal population (HR = 0.96, 95%CI = 0.93-0.99, p = 0.021), but have no protective effect on premenopausal population (HR = 0.98, 95%CI = 0.94-1.03, p = 0.52). Non-fermented dairy products have no significant effect on BC occurrence (p > 0.05). High-fat dairy products are harmful to women, without statistical difference (HR = 1.06, 95%CI = 1.00-1.13, p = 0.066). On the contrary, low-fat dairy products can protect the premenopausal population (HR = 0.94, 95%CI = 0.89-1.00, p = 0.048). CONCLUSION The intake of dairy products can overall reduce BC risk in the female population, but different dairy products have varying effects on different BC subtypes and menopausal status.
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Affiliation(s)
- Yujing He
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Zhejiang, Hangzhou, China
| | - Qinghua Tao
- Emergency Medical Center, Ningbo Yinzhou No. 2 Hospital, Ningbo, Zhejiang, China
| | - Feifei Zhou
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Zhejiang, Hangzhou, China
| | - Yuexiu Si
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Zhejiang, Hangzhou, China
| | - Rongrong Fu
- The First Clinical Medical College, Zhejiang Chinese Medical University, Zhejiang, Hangzhou, China
| | - Binbin Xu
- Department of Nutrition, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, China
| | - Jiaxuan Xu
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Zhejiang, Hangzhou, China
| | - Xiangyuan Li
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Zhejiang, Hangzhou, China
| | - Bangsheng Chen
- Emergency Medical Center, Ningbo Yinzhou No. 2 Hospital, Ningbo, Zhejiang, China.
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Categorizing the characteristics of human carcinogens: a need for specificity. Arch Toxicol 2021; 95:2883-2889. [PMID: 34148101 DOI: 10.1007/s00204-021-03109-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 06/17/2021] [Indexed: 02/07/2023]
Abstract
The International Agency for Research on Cancer (IARC) has recently proposed employing "ten key characteristics of human carcinogens" (TKCs) to determine the potential of agents for harmful effects. The TKCs seem likely to confuse the unsatisfactory correlation from testing regimes that have ignored the differences evident when cellular changes are compared in short and long-lived species, with their very different stem cell and somatic cell phylogenies. The proposed characteristics are so broad that their use will lead to an increase in the current unacceptably high rate of false positives. It could be an informative experiment to take well-established approved therapeutics with well-known human safety profiles and test them against this new TKC paradigm. Cancers are initiated and driven by heritable and transient changes in gene expression, expand clonally, and progress via additional associated acquired mutations and epigenetic alterations that provide cells with an evolutionary advantage. The genotoxicity testing protocols currently employed and required by regulation, emphasize testing for the mutational potential of the test agent. Two-year, chronic rodent cancer bioassays are intended to test for the entire spectrum of carcinogenic transformation. The use of cytotoxic doses causing increased, sustained cell proliferation that facilitates accumulated genetic damage leads to a high false-positive rate of tumor induction. Current cancer hazard assessment protocols and weight-of-the-evidence analysis of agent-specific cancer risk align poorly with the pathogenesis of human carcinoma and so need modernization and improvement in ways suggested here.
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Umesawa M, Yamagishi K, Iso H. Intake of fish and long-chain n-3 polyunsaturated fatty acids and risk of diseases in a Japanese population: a narrative review. Eur J Clin Nutr 2020; 75:902-920. [PMID: 32939045 DOI: 10.1038/s41430-020-00751-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 08/28/2020] [Accepted: 09/05/2020] [Indexed: 11/09/2022]
Abstract
Since the 1970s, the potential benefit of fish intake in terms of noncommunicable diseases has been one of the most important themes in disease prevention. Epidemiological studies have revealed the extent to which fish consumption affects the incidence of and mortality from diseases. Meta-analyses summarized the effect of fish and long-chain n-3 polyunsaturated fatty acid intake on noncommunicable diseases, especially cardiovascular diseases in Western countries. However, few reviews have spotlighted the effect of fish intake in East-Asian countries that have high population levels of fish intake such as Japan. We narratively reviewed the epidemiological studies concerned with the associations of fish and long-chain n-3 polyunsaturated fatty acid intake with risk of noncommunicable diseases, mainly of cardiovascular disease, among Japanese, whose fish intake has been twice or more than that of most Westerners. Overall, fish or long-chain n-3 polyunsaturated fatty acid intake may be beneficial for prevention of noncommunicable diseases, especially coronary heart disease and heart failure in Japanese as well as in Westerners. However, the beneficial effects of their intakes seemed to be nonlinear and varied according to disease severity and culture. Studies on other noncommunicable disease were also narratively reviewed.
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Affiliation(s)
- Mitsumasa Umesawa
- Dokkyo Medical University School of Medicine, Mibu, Japan.,Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan. .,Ibaraki Western Medical Center, Chikusei, Japan.
| | - Hiroyasu Iso
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan.,Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan
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Wang Q, Liu X, Ren S. Tofu intake is inversely associated with risk of breast cancer: A meta-analysis of observational studies. PLoS One 2020; 15:e0226745. [PMID: 31910211 PMCID: PMC6946133 DOI: 10.1371/journal.pone.0226745] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 12/01/2019] [Indexed: 01/11/2023] Open
Abstract
Observational studies on the association between tofu intake and breast cancer incidence have reported inconsistent results. We reviewed the current evidence and quantitatively assessed this association by conducting a dose-response meta-analysis. The electronic databases PubMed and EMBASE were searched for relevant studies published up to August, 2018. We included epidemiological studies that reported relative risks (RRs) or odds ratios (ORs) with 95% confidence intervals (CIs) for the association between tofu intake and breast cancer risk. A total of 14 studies (2 cohort studies, 12 case-control studies) were included in the meta-analysis. The overall OR of breast cancer for highest vs lowest intake of tofu was 0.78 (95% CI 0.69–0.88), with moderate heterogeneity (P = 0.011, I2 = 49.7%). Dose-response analysis based on 5 case-control studies revealed that each 10 g/d increase in tofu intake was associated with 10% reduction in the risk of breast cancer (95% CI 7%–13%, P = 0.037, I2 = 40.8%). In summary, our findings suggest an inverse dose-response association between tofu intake and risk of breast cancer. However, owing to the limitations of case-control studies, more properly designed prospective studies are warranted to confirm this association.
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Affiliation(s)
- Qianghui Wang
- Department of Urology, No. 906 Hospital of the Chinese People's Liberation Army Joint Logistic Support Force, Ningbo, China
- * E-mail:
| | - Xingming Liu
- Department of Urology, No. 906 Hospital of the Chinese People's Liberation Army Joint Logistic Support Force, Ningbo, China
| | - Shengqiang Ren
- Department of Urology, No. 906 Hospital of the Chinese People's Liberation Army Joint Logistic Support Force, Ningbo, China
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Association between flavonoids, flavonoid subclasses intake and breast cancer risk: a case-control study in China. Eur J Cancer Prev 2019; 29:493-500. [DOI: 10.1097/cej.0000000000000561] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Nindrea RD, Aryandono T, Lazuardi L, Dwiprahasto I. Protective Effect of Omega-3 Fatty Acids in Fish Consumption Against Breast Cancer in Asian Patients: A Meta-Analysis. Asian Pac J Cancer Prev 2019; 20:327-332. [PMID: 30803190 PMCID: PMC6897018 DOI: 10.31557/apjcp.2019.20.2.327] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Objective: This systematic review and meta-analysis was performed to determine the protective effect of omega-3 fatty acids in fish consumption against breast cancer in Asian patients. Methods: The authors conducted a meta-analysis of published research articles on protective effect of omega-3 fatty acids in fish consumption against breast cancer in Asian patients published between January 2000 and July 2018 in online database of PubMed, ProQuest and EBSCO. Pooled odds ratios (OR) were calculated by using fixed and random-effect models. Publication bias was visually evaluated by using funnel plots and statistically assessed in Egger’s and Begg’s tests. Data were processed by Review Manager 5.3 (RevMan 5.3) and Stata version 14.2 (Stata Corporation). Results: This study reviewed 913 articles. There were 11 studies which conducted systematic review then continued by meta-analysis of relevant data with total number of samples were 130,365 patients. The results showed there was protective effect of omega-3 fatty acids in fish consumption against breast cancer in Asian patients (OR = 0.80 [95% CI 0.73-0.87, p <0.00001]). There was not any study with significant publication bias included. Conclusion: This analysis confirmed the protective effect of omega-3 fatty acids in fish consumption against breast cancer in Asian patients.
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Affiliation(s)
- Ricvan Dana Nindrea
- Doctoral Program, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta City, Indonesia.,Department of Public Health, Faculty of Medicine, Universitas Andalas, Padang City, Indonesia.
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11
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Postmenopausal osteoporosis and breast cancer: The biochemical links and beneficial effects of functional foods. Biomed Pharmacother 2018; 107:571-582. [DOI: 10.1016/j.biopha.2018.08.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 08/02/2018] [Accepted: 08/06/2018] [Indexed: 12/24/2022] Open
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12
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Abstract
BACKGROUND We aimed to estimate the association between dietary carrot intake and risk of breast cancer by conducting a meta-analysis of epidemiologic studies. METHODS Relevant studies were identified by searching databases through September 2017. We included studies that reported risk estimates with 95% confidence intervals for the association between dietary carrot intake and breast cancer risk. Random-effects models were used to calculate the summary risk estimates. Publication bias was estimated using Begg's funnel plot and Egger's regression asymmetry test. RESULTS A total of 10 articles met the eligibility criteria and were included in the meta-analysis involving 13,747 cases. The combined odds ratios (ORs) of breast cancer for the highest compared with the lowest dietary carrot intake was 0.79 (95% CI: 0.68, 0.90), and a significant heterogeneity was observed. In the subgroup analyses separated by study design, the inverse associations were more pronounced in the case-control studies than in the cohort studies, while the associations did not significantly differ by geographical region, study quality, exposure assessment. Omission of any single study had little effect on the combined risk estimate. CONCLUSION The overall current literatures suggested that dietary carrot intake was associated with decreased risk of breast cancer.
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Gucalp A, Zhou XK, Cook ED, Garber JE, Crew KD, Nangia JR, Bhardwaj P, Giri DD, Elemento O, Verma A, Wang H, Lee JJ, Vornik LA, Mays C, Weber D, Sepeda V, O'Kane H, Krasne M, Williams S, Morris PG, Heckman-Stoddard BM, Dunn BK, Hudis CA, Brown PH, Dannenberg AJ. A Randomized Multicenter Phase II Study of Docosahexaenoic Acid in Patients with a History of Breast Cancer, Premalignant Lesions, or Benign Breast Disease. Cancer Prev Res (Phila) 2018; 11:203-214. [PMID: 29453232 PMCID: PMC6290902 DOI: 10.1158/1940-6207.capr-17-0354] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 01/02/2018] [Accepted: 02/02/2018] [Indexed: 12/12/2022]
Abstract
Obesity, a cause of subclinical inflammation, is a risk factor for the development of postmenopausal breast cancer and is associated with poorer cancer outcomes. Docosahexaenoic acid (DHA), an omega-3 fatty acid, possesses anti-inflammatory properties. We hypothesized that treatment with DHA would reduce the expression of proinflammatory genes and aromatase, the rate-limiting enzyme for estrogen biosynthesis, in benign breast tissue of overweight/obese women. A randomized, placebo-controlled, double-blind phase II study of DHA given for 12 weeks to overweight/obese women with a history of stage I-III breast cancer, DCIS/LCIS, Paget's disease, or proliferative benign breast disease was carried out. In this placebo controlled trial, the primary objective was to determine whether DHA (1,000 mg by mouth twice daily) reduced breast tissue levels of TNFα. Secondary objectives included evaluation of the effect of DHA on breast tissue levels of COX-2, IL1β, aromatase, white adipose tissue inflammation, and gene expression by RNA-seq. Red blood cell fatty acid levels were measured to assess compliance. From July 2013 to November 2015, 64 participants were randomized and treated on trial (32 women per arm). Increased levels of omega-3 fatty acids in red blood cells were detected following treatment with DHA (P < 0.001) but not placebo. Treatment with DHA did not alter levels of TNFα (P = 0.71), or other biomarkers including the transcriptome in breast samples. Treatment with DHA was overall well-tolerated. Although compliance was confirmed, we did not observe changes in the levels of prespecified biomarkers in the breast after treatment with DHA when compared with placebo. Cancer Prev Res; 11(4); 203-14. ©2018 AACRSee related editorial by Fabian and Kimler, p. 187.
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Affiliation(s)
- Ayca Gucalp
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
- Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Xi K Zhou
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York
| | - Elise D Cook
- Department of Clinical Cancer Prevention, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Judy E Garber
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Katherine D Crew
- Departments of Medicine/Epidemiology, New York-Presbyterian/Columbia University Medical Center, New York, New York
| | - Julie R Nangia
- Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Priya Bhardwaj
- Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Dilip D Giri
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Olivier Elemento
- Departments of Physiology and Biophysics/Computational Biomedicine, Weill Cornell Medical College, New York, New York
| | - Akanksha Verma
- Departments of Physiology and Biophysics/Computational Biomedicine, Weill Cornell Medical College, New York, New York
| | - Hanhan Wang
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York
| | - J Jack Lee
- Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Lana A Vornik
- Department of Clinical Cancer Prevention, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Carrie Mays
- Department of Clinical Cancer Prevention, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Diane Weber
- Department of Clinical Cancer Prevention, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Valerie Sepeda
- Department of Clinical Cancer Prevention, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Holly O'Kane
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Margaret Krasne
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Samantha Williams
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Patrick G Morris
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | - Barbara K Dunn
- Division of Cancer Prevention, National Cancer Institute, Bethesda, Maryland
| | - Clifford A Hudis
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
- American Society of Clinical Oncology, Alexandria, Virginia
| | - Powel H Brown
- Department of Clinical Cancer Prevention, University of Texas MD Anderson Cancer Center, Houston, Texas
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14
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Zheng T, Ni Y, Li J, Chow BKC, Panagiotou G. Designing Dietary Recommendations Using System Level Interactomics Analysis and Network-Based Inference. Front Physiol 2017; 8:753. [PMID: 29033850 PMCID: PMC5625024 DOI: 10.3389/fphys.2017.00753] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 09/19/2017] [Indexed: 12/14/2022] Open
Abstract
Background: A range of computational methods that rely on the analysis of genome-wide expression datasets have been developed and successfully used for drug repositioning. The success of these methods is based on the hypothesis that introducing a factor (in this case, a drug molecule) that could reverse the disease gene expression signature will lead to a therapeutic effect. However, it has also been shown that globally reversing the disease expression signature is not a prerequisite for drug activity. On the other hand, the basic idea of significant anti-correlation in expression profiles could have great value for establishing diet-disease associations and could provide new insights into the role of dietary interventions in disease. Methods: We performed an integrated analysis of publicly available gene expression profiles for foods, diseases and drugs, by calculating pairwise similarity scores for diet and disease gene expression signatures and characterizing their topological features in protein-protein interaction networks. Results: We identified 485 diet-disease pairs where diet could positively influence disease development and 472 pairs where specific diets should be avoided in a disease state. Multiple evidence suggests that orange, whey and coconut fat could be beneficial for psoriasis, lung adenocarcinoma and macular degeneration, respectively. On the other hand, fructose-rich diet should be restricted in patients with chronic intermittent hypoxia and ovarian cancer. Since humans normally do not consume foods in isolation, we also applied different algorithms to predict synergism; as a result, 58 food pairs were predicted. Interestingly, the diets identified as anti-correlated with diseases showed a topological proximity to the disease proteins similar to that of the corresponding drugs. Conclusions: In conclusion, we provide a computational framework for establishing diet-disease associations and additional information on the role of diet in disease development. Due to the complexity of analyzing the food composition and eating patterns of individuals our in silico analysis, using large-scale gene expression datasets and network-based topological features, may serve as a proof-of-concept in nutritional systems biology for identifying diet-disease relationships and subsequently designing dietary recommendations.
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Affiliation(s)
- Tingting Zheng
- Systems Biology and Bioinformatics Group, Faculty of Sciences, School of Biological Sciences, The University of HongKong, Hong Kong, Hong Kong
| | - Yueqiong Ni
- Systems Biology and Bioinformatics Group, Faculty of Sciences, School of Biological Sciences, The University of HongKong, Hong Kong, Hong Kong
| | - Jun Li
- Systems Biology and Bioinformatics Group, Faculty of Sciences, School of Biological Sciences, The University of HongKong, Hong Kong, Hong Kong
| | - Billy K C Chow
- Faculty of Science, School of Biological Sciences, The University of Hong Kong, Hong Kong, Hong Kong
| | - Gianni Panagiotou
- Systems Biology and Bioinformatics Group, Faculty of Sciences, School of Biological Sciences, The University of HongKong, Hong Kong, Hong Kong.,Department of Systems Biology and Bioinformatics, Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany
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15
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Magaki M, Ishii H, Yamasaki A, Kitai Y, Kametani S, Nakai R, Dabid A, Tsuda H, Ohnishi T. A high-fat diet increases the incidence of mammary cancer inc-Ha- ras proto-oncogene transgenic rats. J Toxicol Pathol 2016; 30:145-152. [PMID: 28458452 PMCID: PMC5406593 DOI: 10.1293/tox.2016-0052] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 11/07/2016] [Indexed: 02/06/2023] Open
Abstract
Mammary cancer is the most common type of cancer and the fifth most common cause of cancer-related deaths among Japanese women. The recent sharp increase in the number of women diagnosed with mammary cancer per year is thought to be associated with increased fat intake resulting from changes in the dietary habits of contemporary Japanese citizens. In this study, human c-Ha-ras proto-oncogene transgenic (Hras128) rats, which are highly susceptible to mammary carcinogens, were fed high- or low-fat diets to examine the relationship between fat consumption and the development of mammary cancer. Female 7-week-old Hras128 rats and wild-type littermates were administered benzo[a]pyrene. A week later, the animals were randomly assigned to high-fat or low-fat diet groups (45% or 10% of calories from fat, respectively). After 12 weeks, the rats were sacrificed and autopsied, and mammary tumors were excised and processed for microscopic observation. Mammary tumors were found in 11 of the 12 animals in the high-fat diet group and in 5 of the 12 animals in the low-fat diet group, and the numbers of mammary gland tumors per animal in these groups were 1.7 and 0.7, respectively. Notably, the observed differences in incidence and multiplicity of mammary tumors between the two groups were statistically significant. These results suggest a positive relationship between the incidence of breast cancer and high fat intake.
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Affiliation(s)
- Mie Magaki
- Department of Nutrition Management, Faculty of Health Science, Hyogo University, 2301 Shinzaike, Hiraoka-cho, Kakogawa, Hyogo 675-0195, Japan
| | - Hiroko Ishii
- Department of Nutrition Management, Faculty of Health Science, Hyogo University, 2301 Shinzaike, Hiraoka-cho, Kakogawa, Hyogo 675-0195, Japan
| | - Aya Yamasaki
- Department of Nutrition Management, Faculty of Health Science, Hyogo University, 2301 Shinzaike, Hiraoka-cho, Kakogawa, Hyogo 675-0195, Japan
| | - Yurika Kitai
- Laboratory of Molecular Nutrition and Food Chemistry, Graduate School of Agriculture, Kagawa University and The United Graduate School of Agricultural Science, Ehime University, 3-5-7 Tarumi, Matsuyama, Ehime 790-8566, Japan
| | - Saeda Kametani
- Department of Nutrition Management, Faculty of Health Science, Hyogo University, 2301 Shinzaike, Hiraoka-cho, Kakogawa, Hyogo 675-0195, Japan
| | - Reiko Nakai
- Department of Nutrition Management, Faculty of Health Science, Hyogo University, 2301 Shinzaike, Hiraoka-cho, Kakogawa, Hyogo 675-0195, Japan
| | - Alexander Dabid
- Nanotoxicology Project Lab, Nagoya City University, 3-1 Tanabedohri, Mizuho-ku, Nagoya 467-8603, Japan
| | - Hiroyuki Tsuda
- Nanotoxicology Project Lab, Nagoya City University, 3-1 Tanabedohri, Mizuho-ku, Nagoya 467-8603, Japan
| | - Takamasa Ohnishi
- Department of Nutrition Management, Faculty of Health Science, Hyogo University, 2301 Shinzaike, Hiraoka-cho, Kakogawa, Hyogo 675-0195, Japan
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16
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The Role of Docosahexaenoic Acid (DHA) in the Control of Obesity and Metabolic Derangements in Breast Cancer. Int J Mol Sci 2016; 17:505. [PMID: 27058527 PMCID: PMC4848961 DOI: 10.3390/ijms17040505] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 03/24/2016] [Accepted: 03/31/2016] [Indexed: 12/15/2022] Open
Abstract
Obesity represents a major under-recognized preventable risk factor for cancer development and recurrence, including breast cancer (BC). Healthy diet and correct lifestyle play crucial role for the treatment of obesity and for the prevention of BC. Obesity is significantly prevalent in western countries and it contributes to almost 50% of BC in older women. Mechanisms underlying obesity, such as inflammation and insulin resistance, are also involved in BC development. Fatty acids are among the most extensively studied dietary factors, whose changes appear to be closely related with BC risk. Alterations of specific ω-3 polyunsaturated fatty acids (PUFAs), particularly low basal docosahexaenoic acid (DHA) levels, appear to be important in increasing cancer risk and its relapse, influencing its progression and prognosis and affecting the response to treatments. On the other hand, DHA supplementation increases the response to anticancer therapies and reduces the undesired side effects of anticancer therapies. Experimental and clinical evidence shows that higher fish consumption or intake of DHA reduces BC cell growth and its relapse risk. Controversy exists on the potential anticancer effects of marine ω-3 PUFAs and especially DHA, and larger clinical trials appear mandatory to clarify these aspects. The present review article is aimed at exploring the capacity of DHA in controlling obesity-related inflammation and in reducing insulin resistance in BC development, progression, and response to therapies.
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17
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Kakutani Y, Kamiya S, Omi N. Association between the frequency of meals combining "Shushoku, Shusai, and Hukusai" (Staple food, main dish, and side dish) and intake of nutrients and food groups among Japanese young adults aged 18-24 years: a cross-sectional study. J Nutr Sci Vitaminol (Tokyo) 2016; 61:55-63. [PMID: 25994140 DOI: 10.3177/jnsv.61.55] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
"Shushoku," "Shusai," and "Hukusai" are staple food, main dish, and side dish, respectively. The recommended meal in Japan is a combination of "Shushoku," "Shusai," and "Hukusai"; however, it remains unclear whether there is an association between the frequency of these meals and intake of nutrients and food groups. This cross-sectional study examined the association between the frequency of meals combining "Shushoku, Shusai, and Hukusai" and intake of nutrients and food groups among 664 Japanese young adults aged 18-24 y. The dietary habits of the subjects during the preceding month were assessed using a validated brief-type self-administered diet history questionnaire. The frequency of meals combining "Shushoku, Shusai, and Hukusai" was self-reported according to four categories: "less than 1 d or 1 d/wk," "2 or 3 d/wk," "4 or 5 d/wk," and "every day." In both women and men, there was an association between the higher frequency of these meals and higher intake of the following food groups: pulses, green and yellow vegetables, other vegetables, mushrooms, seaweeds, fish and shellfish, and eggs. Moreover, there was an association with higher intake of protein, polyunsaturated fat, n-6 and n-3 polyunsaturated fat, total dietary fiber, soluble and insoluble dietary fiber, β-carotene, α-tocopherol, vitamin K, thiamin, riboflavin, folate, pantothenic acid, vitamin C, potassium, calcium, magnesium, iron, and copper, and lower intake of carbohydrate in both women and men. Our findings support the hypothesis that the meals combining "Shushoku, Shusai, and Hukusai" may be associated with intake of many food groups and nutrients among Japanese young adults.
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Affiliation(s)
- Yuya Kakutani
- Graduate School of Comprehensive Human Science, University of Tsukuba
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18
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Gucalp A, Iyengar NM, Hudis CA, Dannenberg AJ. Targeting obesity-related adipose tissue dysfunction to prevent cancer development and progression. Semin Oncol 2015; 43:154-160. [PMID: 26970134 DOI: 10.1053/j.seminoncol.2015.09.012] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The incidence of obesity, a leading modifiable risk factor for common solid tumors, is increasing. Effective interventions are needed to minimize the public health implications of obesity. Although the mechanisms linking increased adiposity to malignancy are incompletely understood, growing evidence points to complex interactions among multiple systemic and tissue-specific pathways including inflamed white adipose tissue. The metabolic and inflammatory consequences of white adipose tissue dysfunction collectively provide a plausible explanation for the link between overweight/obesity and carcinogenesis. Gaining a better understanding of these underlying molecular pathways and developing risk assessment tools that identify at-risk populations will be critical in implementing effective and novel cancer prevention and management strategies.
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Affiliation(s)
- Ayca Gucalp
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
| | - Neil M Iyengar
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Clifford A Hudis
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Medicine, Weill Cornell Medical College, New York, NY, USA
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19
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Gao CM, Ding JH, Li SP, Liu YT, Tang JH, Tajima K. Intake of freshwater fish and associated fatty acids and risk of breast cancer. Asian Pac J Cancer Prev 2015; 15:7879-84. [PMID: 25292081 DOI: 10.7314/apjcp.2014.15.18.7879] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
To investigate the association between intake of freshwater fish and their fatty acids and the risk of breast cancer in Chinese women, we conducted a case-control study with 669 cases and 682 population-based controls in Jiangsu Province of China. A structured questionnaire was used to elicit detailed information. Unconditional logistic regression analysis was performed to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Total freshwater fish intake was linked to decrease in the adjusted OR for breast cancer, but without dose-dependence. Analyses by freshwater fish species showed that consumption of black carp and silver carp was inversely related to breast cancer risk, with adjusted-ORs for the highest intake category of black carp (≥500g/month) of 0.54 (95%CI=0.33-0.92; P trend<0.002) and for silver carp (≥1000g/month) of 0.19 (95%CI=0.11-0.33; P trend<0.001). In contrast, consumption of crucian carp was positively related to breast cancer risk, with an adjusted OR for the highest intake category (≥1000g/month) of 6.09 (95%CI=3.04-12.2; P trend<0.001). Moderate intakes of SFA, PUFA, n3-PUFA and n6-PUFA from freshwater fish may decrease the risk of breast cancer among premenopausal women. The findings of this study suggest that intake of freshwater fish and their fatty acids may modify risk of breast cancer, and that different species of freshwater fish could have a different actions on breast cancer risk. Future epidemiologic studies are needed to know the effects of freshwater fish intake on breast cancer risk and the cause of these effects.
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Affiliation(s)
- Chang-Ming Gao
- Division of Epidemiology, Jiangsu Province Institute of Cancer Research, Nanjing, Jiangsu Province, China E-mail :
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20
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Egg consumption and breast cancer risk: a meta-analysis. Breast Cancer 2014; 21:251-61. [DOI: 10.1007/s12282-014-0519-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 01/23/2014] [Indexed: 10/25/2022]
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21
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Wada K, Nagata C, Tamakoshi A, Matsuo K, Oze I, Wakai K, Tsuji I, Sugawara Y, Mizoue T, Tanaka K, Iwasaki M, Inoue M, Tsugane S, Sasazuki S. Body mass index and breast cancer risk in Japan: a pooled analysis of eight population-based cohort studies. Ann Oncol 2014; 25:519-24. [DOI: 10.1093/annonc/mdt542] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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22
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Diorio C, Dumas I. Relations of omega-3 and omega-6 intake with mammographic breast density. Cancer Causes Control 2014; 25:339-51. [PMID: 24402865 DOI: 10.1007/s10552-013-0335-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Accepted: 12/26/2013] [Indexed: 11/30/2022]
Abstract
PURPOSE Omega-3 (n-3) and n-6 fatty acids (FA) intake could influence the occurrence of certain diseases such as breast cancer but little is known about their relation to mammographic density (MD). The purpose of this study is to examine the association of the intake of n-3 FA and n-6 FA with MD among 777 premenopausal and 783 postmenopausal women. METHODS In this cross-sectional study, FA intake was assessed with a self-administered food-frequency questionnaire and MD was measured using a computer-assisted method. Multivariate analyses were performed by using generalized linear models to evaluate the associations of quartiles of FA intake with MD. RESULTS For increasing quartiles of total long-chain n-3 FA intake (< 0.11, 0.11-0.20, 0.21-0.32, and ≥ 0.33 g/day), adjusted mean MD was 29, 29, 27, and 25 %, respectively (P trend = 0.005). This association remained significant among postmenopausal (P trend = 0.006) but not among premenopausal (P trend = 0.21) women. No significant association was found between n-6 FA intake and MD. However, for increasing quartiles of the n-6 FA/long-chain n-3 FA ratio intake (< 31.75, 31.75-52.28, 52.29-94.28, and ≥ 94.29), adjusted mean MD was 26, 27, 29, and 29 %, respectively (P trend = 0.008). CONCLUSIONS Higher intake of long-chain n-3 FA was associated with lower MD, suggesting that increased long-chain n-3 FA intake could be a strategy for breast cancer prevention.
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Affiliation(s)
- Caroline Diorio
- Axe oncologie, Centre de recherche du CHU de Québec, 1050 Chemin Sainte-Foy, Quebec City, QC, G1S 4L8, Canada,
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23
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Fritz H, Seely D, Flower G, Skidmore B, Fernandes R, Vadeboncoeur S, Kennedy D, Cooley K, Wong R, Sagar S, Sabri E, Fergusson D. Soy, red clover, and isoflavones and breast cancer: a systematic review. PLoS One 2013; 8:e81968. [PMID: 24312387 PMCID: PMC3842968 DOI: 10.1371/journal.pone.0081968] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Accepted: 10/18/2013] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Soy and red clover isoflavones are controversial due to purported estrogenic activity and possible effects on breast cancer. We conducted a systematic review of soy and red clover for efficacy in improving menopausal symptoms in women with breast cancer, and for potential impact on risk of breast cancer incidence or recurrence. METHODS We searched MEDLINE, Embase, the Cochrane Library, and AMED from inception to March 2013 for human interventional or observational data pertaining to the safety and efficacy of soy and red clover isoflavones in patients with or at risk of breast cancer. RESULTS Of 4179 records, we included a total of 131 articles: 40 RCTs, 11 uncontrolled trials, and 80 observational studies. Five RCTs reported on the efficacy of soy for hot flashes, showing no significant reductions in hot flashes compared to placebo. There is lack of evidence showing harm from use of soy with respect to risk of breast cancer or recurrence, based on long term observational data. Soy intake consistent with that of a traditional Japanese diet (2-3 servings daily, containing 25-50mg isoflavones) may be protective against breast cancer and recurrence. Human trials show that soy does not increase circulating estradiol or affect estrogen-responsive target tissues. Prospective data of soy use in women taking tamoxifen does not indicate increased risk of recurrence. Evidence on red clover is limited, however existing studies suggest that it may not possess breast cancer-promoting effects. CONCLUSION Soy consumption may be associated with reduced risk of breast cancer incidence, recurrence, and mortality. Soy does not have estrogenic effects in humans. Soy intake consistent with a traditional Japanese diet appears safe for breast cancer survivors. While there is no clear evidence of harm, better evidence confirming safety is required before use of high dose (≥ 100 mg) isoflavones can be recommended for breast cancer patients.
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Affiliation(s)
- Heidi Fritz
- Department of Research & Clinical Epidemiology, Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada
| | - Dugald Seely
- Department of Research & Clinical Epidemiology, Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada
- Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Ottawa Integrative Cancer Center, Ottawa, Ontario, Canada
| | - Gillian Flower
- Department of Research & Clinical Epidemiology, Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada
| | - Becky Skidmore
- Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Rochelle Fernandes
- Department of Research & Clinical Epidemiology, Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada
- Laboratory Medicine and Pathobiology (LMP), University of Toronto, Toronto, Ontario, Canada
| | - Sarah Vadeboncoeur
- Department of Research & Clinical Epidemiology, Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada
| | - Deborah Kennedy
- Department of Research & Clinical Epidemiology, Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Kieran Cooley
- Department of Research & Clinical Epidemiology, Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Raimond Wong
- Juravinski Cancer Centre and Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Stephen Sagar
- Juravinski Cancer Centre and Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Elham Sabri
- Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Dean Fergusson
- Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
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24
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Rafi I, Chowdhury S, Chan T, Jubber I, Tahir M, de Lusignan S. Improving the management of people with a family history of breast cancer in primary care: before and after study of audit-based education. BMC FAMILY PRACTICE 2013; 14:105. [PMID: 23879178 PMCID: PMC3734209 DOI: 10.1186/1471-2296-14-105] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Accepted: 07/08/2013] [Indexed: 12/16/2022]
Abstract
BACKGROUND In England, guidance from National Institute for Clinical Excellence (NICE) states women with a family history of breast cancer presenting to primary care should be reassured or referred.We reviewed the evidence for interventions that might be applied in primary care and conducted an audit of whether low risk women are correctly advised and flagged. METHODS We conducted a literature review to identify modifiable risk factors. We extracted routinely collected data from the computerised medical record systems of 6 general practices (population approximately 30,000); of the variables identified in the guidance. We implemented a quality improvement (QI) intervention called audit-based education (ABE) comparing participant practices with guidelines and each other before and after; we report odds ratios (OR) of any change in data recording. RESULTS The review revealed evidence for advising on: diet, weight control, physical exercise, and alcohol. The proportion of patients with recordings of family history of: disease, neoplasms, and breast cancer were: 39.3%, 5.1% and 1.3% respectively. There was no significant change in the recording of family history of disease or cancer; OR 1.02 (95% CI 0.98-1.06); and 1.08 (95% CI 0.99-1.17) respectively. Recording of alcohol consumption and smoking both increased significantly; OR 1.36 (95% CI 1.30-1.43); and 1.42 (95% CI 1.27-1.60) respectively. Recording lifestyle advice fell; OR 0.84 (95% CI 0.81-0.88). CONCLUSIONS The study informs about current data recording and willingness to engage in ABE. Recording of risk factors improved after the intervention. Further QI is needed to achieve adherence to current guidance.
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Affiliation(s)
- Imran Rafi
- Division of Population Health Sciences and Education, St George’s, University of London, Cranmer Terrace, London SW17 0RE, UK
- Clinical Innovation and Research Centre (CIRC), Royal College of General Practitioners, 30 Euston Square, London NW1 2FB, UK
| | - Susmita Chowdhury
- PHG Foundation, 2 Worts Causeway, Cambridge, Cambridgeshire CB1 8RN, UK
| | - Tom Chan
- Department of Healthcare Management and Policy, University of Surrey, Guildford, Surrey GU2 7XH, UK
| | - Ibrahim Jubber
- Division of Population Health Sciences and Education, St George’s, University of London, Cranmer Terrace, London SW17 0RE, UK
| | - Mohammad Tahir
- Department of Healthcare Management and Policy, University of Surrey, Guildford, Surrey GU2 7XH, UK
| | - Simon de Lusignan
- Department of Healthcare Management and Policy, University of Surrey, Guildford, Surrey GU2 7XH, UK
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25
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Abstract
The family of polyunsaturated fatty acids (PUFAs), which can be found in most lipid classes, includes n-3 PUFAs essential for mammals and whose deficiency is associated with multiple diseases. Because of their multiple physiological actions, n-3 PUFAs play a crucial role in normal human metabolism as well as maintenance of a healthy status, with clinical effects that are not limited to the cardiovascular system but also include maternal and offspring health, growth and development, immune system disorders, cancer, cognitive function and psychological status. Multiple health organisations and scientific societies recommend increasing food-derived n-3 PUFA intake and also suggest that patients with documented coronary heart disease receive a minimum of 1000 mg/day of eicosapentaenoic acid and docosahexaenoic acid. The preventive and therapeutic effects of n-3 PUFAs appear to be largely dependent on the dosages employed and the characteristics of selected patients. So, in the era of personalised medicine, the time has come to move from generic advice to increase n-3 PUFA intake to a more evidence-based approach characterised by tailored indications to n-3 PUFA dietary or supplement consumption. This approach will require evaluation on a case-to-case basis the potential usefulness of n-3 PUFAs, taking into consideration their 'pleiotropic effects', the optimal dose for any given indication in relation to international guidelines, potential interactions with background therapy, possible side effects, differences in genetics and dietary response to supplementation, and the cost:benefit ratio, which is likely to vary as a function of differences in the range of fish intake in the diet.
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Cheraghi Z, Poorolajal J, Hashem T, Esmailnasab N, Doosti Irani A. Effect of body mass index on breast cancer during premenopausal and postmenopausal periods: a meta-analysis. PLoS One 2012; 7:e51446. [PMID: 23236502 PMCID: PMC3517558 DOI: 10.1371/journal.pone.0051446] [Citation(s) in RCA: 177] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE There is no universal consensus on the relationship between body mass index (BMI) and breast cancer. This meta-analysis was conducted to estimate the overall effect of overweight and obesity on breast cancer risk during pre- and post-menopausal period. DATA SOURCES All major electronic databases were searched until April 2012 including Web of Knowledge, Medline, Scopus, and ScienceDirect. Furthermore, the reference lists and related scientific conference databases were searched. REVIEW METHODS All prospective cohort and case-control studies investigating the association between BMI and breast cancer were retrieved irrespective of publication date and language. Women were assessed irrespective of age, race and marital status. The exposure of interest was BMI. The primary outcome of interest was all kinds of breast cancers confirmed pathologically. Study quality was assessed using the checklist of STROBE. Study selection and data extraction were performed by two authors separately. The effect measure of choice was risk ratio (RR(i)) and rate ratio (RR(a)) for cohort studies and odds ratio (OR) in case-control studies. RESULTS Of 9163 retrieved studies, 50 studies were included in meta-analysis including 15 cohort studies involving 2,104,203 subjects and 3,414,806 person-years and 35 case-control studies involving 71,216 subjects. There was an inverse but non-significant correlation between BMI and breast cancer risk during premenopausal period: OR = 0.93 (95% CI 0.86, 1.02); RR(i) = 0.97 (95% CI 0.82, 1.16); and RR(a) = 0.99 (95% CI 0.94, 1.05), but a direct and significant correlation during postmenopausal period: OR = 1.15 (95% CI 1.07, 1.24); RR(i) = 1.16 (95% CI 1.08, 1.25); and RR(a) = 0.98 (95% CI 0.88, 1.09). CONCLUSION The results of this meta-analysis showed that body mass index has no significant effect on the incidence of breast cancer during premenopausal period. On the other hand, overweight and obesity may have a minimal effect on breast cancer, although significant, but really small and not clinically so important.
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Affiliation(s)
- Zahra Cheraghi
- Department of Epidemiology & Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
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Bao PP, Shu XO, Zheng Y, Cai H, Ruan ZX, Gu K, Su Y, Gao YT, Zheng W, Lu W. Fruit, vegetable, and animal food intake and breast cancer risk by hormone receptor status. Nutr Cancer 2012; 64:806-19. [PMID: 22860889 DOI: 10.1080/01635581.2012.707277] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The effects of diet on breast cancer are controversial and whether the effects vary with hormone receptor status has not been well investigated. This study evaluated the associations of dietary factors with risk for breast cancer overall and by the hormone receptor status of tumors among Chinese women. The Shanghai Breast Cancer Study, a large, population-based, case-control study, enrolled 3,443 cases and 3,474 controls in 1996-1998 (phase I) and 2002-2005 (phase II); 2676 cases had estrogen receptor (ER) and progesterone receptor (PR) data. Dietary intake was assessed using a validated, quantitative, food frequency questionnaire. Odds ratios (OR) and 95% confidence intervals (95% CI) were derived from multivariate, polychotomous, unconditional logistic regression models. Total vegetable intake was inversely related to breast cancer risk, with an adjusted OR for the highest quintile of 0.80 (95% CI = 0.67-0.95; P trend = 0.02). Reduced risk was also related to high intake of allium vegetables (P trend = 0.01) and fresh legumes (P trend = 0.0008). High intake of citrus fruits and rosaceae fruits were inversely associated with breast cancer risk (P trend = 0.003 and 0.004, respectively), although no consistent association was seen for total fruit intake. Elevated risk was observed for all types of meat and fish intake (all P trend < 0.05), whereas intakes of eggs and milk were associated with a decreased risk of breast cancer (both P trend <0.05). There was little evidence that associations with dietary intakes varied across the 4 tumor subtypes or between ER+/PR+ and ER-/PR- tumors (P for heterogeneity >0.05). Our results suggest that high intake of total vegetables, certain fruits, milk, and eggs may reduce the risk of breast cancer, whereas high consumption of animal-source foods may increase risk. The dietary associations did not appear to vary by ER/PR status.
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Affiliation(s)
- Ping-Ping Bao
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People's Republic of China
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Sirot V, Dumas C, Desquilbet L, Mariotti F, Legrand P, Catheline D, Leblanc JC, Margaritis I. A restricted cubic spline approach to assess the association between high fat fish intake and red blood cell EPA + DHA content. Nutr Metab Cardiovasc Dis 2012; 22:318-326. [PMID: 20875947 DOI: 10.1016/j.numecd.2010.06.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2010] [Revised: 05/04/2010] [Accepted: 06/14/2010] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND AIMS Fish, especially fatty fish, are the main contributor to eicosapentaenoic (EPA) and docosahexaenoic (DHA) intake. EPA and DHA concentrations in red blood cells (RBC) has been proposed as a cardiovascular risk factor, with <4% and >8% associated with the lowest and greatest protection, respectively. The relationship between high fat fish (HFF) intake and RBC EPA + DHA content has been little investigated on a wide range of fish intake, and may be non-linear. We aimed to study the shape of this relationship among high seafood consumers. METHODS AND RESULTS Seafood consumption records and blood were collected from 384 French heavy seafood consumers and EPA and DHA were measured in RBC. A multivariate linear regression was performed using restricted cubic splines to consider potential non-linear associations. Thirty-six percent of subjects had an RBC EPA + DHA content lower than 4% and only 5% exceeded 8%. HFF consumption was significantly associated with RBC EPA + DHA content (P [overall association] = 0.021) adjusted for sex, tobacco status, study area, socioeconomic status, age, alcohol, other seafood, meat, and meat product intakes. This relationship was non-linear: for intakes higher than 200 g/wk, EPA + DHA content tended to stagnate. Tobacco status and fish contaminants were negatively associated with RBC EPA + DHA content. CONCLUSION Because of the saturation for high intakes, and accounting for the concern with exposure to trace element contaminants, intake not exceeding 200 g should be considered.
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Affiliation(s)
- V Sirot
- AFSSA, French Food Safety Agency, 27 avenue du Général Leclerc, F-94701 Maisons-Alfort, France.
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Sala-Vila A, Calder PC. Update on the relationship of fish intake with prostate, breast, and colorectal cancers. Crit Rev Food Sci Nutr 2012; 51:855-71. [PMID: 21888535 DOI: 10.1080/10408398.2010.483527] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
A systematic review of prospective cohort and case-control studies investigating relationships between the intake of fish and incidence of prostate, breast, or colorectal cancers was conducted. A total of 106 studies fulfilled the requirements stated in the "Search strategy and selection criteria." Among 273 estimates of association reported by these studies, 53 indicated decreased risk while 12 indicated increased risk associated with fish intake. The hypothesis linking fish consumption and low cancer incidence appears to be supported by little epidemiological data. However, there are several factors that may mask potential protective associations with fish intake. The type and the amount of fish eaten, the cooking method, the stage of the cancer and, amongst women, menopausal status may all be important factors that relate to whether fish is protective or not. Future epidemiologic studies with a clearer assessment of these factors are needed to know more about the effects of fish consumption on cancer risk. Therefore, until there are better measures of dietary exposure or biomarkers to correlate self-report, no conclusion can be drawn regarding the recommendation for increasing fish consumption in general to reduce the risk of developing the most common cancers in Western societies.
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Affiliation(s)
- Aleix Sala-Vila
- Institute of Human Nutrition and Developmental Origins of Health and Disease, School of Medicine, University of Southampton , Southampton , SO16 6YD, United Kingdom
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Chajès V, Torres-Mejía G, Biessy C, Ortega-Olvera C, Angeles-Llerenas A, Ferrari P, Lazcano-Ponce E, Romieu I. ω-3 and ω-6 Polyunsaturated fatty acid intakes and the risk of breast cancer in Mexican women: impact of obesity status. Cancer Epidemiol Biomarkers Prev 2011; 21:319-26. [PMID: 22194528 DOI: 10.1158/1055-9965.epi-11-0896] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND ω-3 polyunsaturated fatty acids (PUFA) could play a protective role on the risk of breast cancer; however, little is known about this relation among Mexican women. We evaluated the association between ω-3 and ω-6 PUFA intake and breast cancer risk by obesity status in Mexican women. METHODS A population-based case-control study was conducted in Mexico, including 1,000 incident breast cancer cases and 1,074 controls matched to cases by age, health care system, and region. Women provided information on health and diet by in-person interview. Body mass index (BMI) measures were used to define overall obesity. Obesity status was categorized as normal weight (18.5 < BMI < 25), overweight (25 ≤ BMI < 30), and obese (BMI ≥ 30). A conditional logistic regression model was used to assess the association between PUFA and breast cancer risk. RESULTS Overall, there was no significant association between ω-3 PUFA intake and breast cancer risk (P = 0.31). An increased risk of breast cancer was associated with increasing ω-6 PUFA intake in premenopausal women [OR = 1.92, 95% confidence interval (CI) = 1.13-3.26; P = 0.04]. A decreased risk of breast cancer was significantly associated with increasing ω-3 PUFA intake in obese women (OR = 0.58, 95% CI = 0.39-0.87; P = 0.008) but not in normal weight nor in overweight women (P(heterogeneity) = 0.017). CONCLUSIONS Obesity status may affect the association between ω-3 PUFA intake and breast cancer risk. The underlying mechanisms may be related to decreased inflammation and improved adipokin and estrogen levels induced by ω-3 PUFA in adipose tissue in obese women. IMPACT Increased intake of ω-3 PUFA should be recommended among Mexican women in particular in obese women.
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Affiliation(s)
- Véronique Chajès
- Nutrition and Metabolism, International Agency for Research on Cancer, 150, cours Albert Thomas, 69372 Lyon cedex 08, France
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Abstract
Seafood provides n-3 long-chain PUFA (n-3 LC-PUFA), vitamins and minerals, which are essential to maintain good health. Moreover, seafood is a source of contaminants such as methylmercury, arsenic and persistent organic pollutants that may affect health. The aim of the present study was to determine in what quantities seafood consumption would provide nutritional benefits, while minimising the risks linked to food contaminants. Seafood was grouped into clusters using a hierarchical cluster analysis. Those nutrients and contaminants were selected for which it is known that seafood is a major source. The risk–benefit analysis consisted in using an optimisation model with constraints to calculate optimum seafood cluster consumption levels. The goal was to optimise nutrient intakes as well as to limit contaminant exposure with the condition being to attain recommended nutritional intakes without exceeding tolerable upper intakes for contaminants and nutrients, while taking into account background intakes. An optimum consumption level was calculated for adults that minimises inorganic arsenic exposure and increases vitamin D intake in the general population. This consumption level guarantees that the consumer reaches the recommended intake for n-3 LC-PUFA, Se and I, while remaining below the tolerable upper intakes for methylmercury, Cd, dioxins, polychlorobiphenyls, Zn, Ca and Cu. This consumption level, which is approximately 200 g/week of certain fatty fish species and approximately 50 g/week of lean fish, molluscs and crustaceans, has to be considered in order to determine food consumption recommendations in a public health perspective.
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Heinze VM, Actis AB. Dietary conjugated linoleic acid and long-chain n-3 fatty acids in mammary and prostate cancer protection: a review. Int J Food Sci Nutr 2011; 63:66-78. [PMID: 21762028 DOI: 10.3109/09637486.2011.598849] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The role of dietary fatty acids on cancer is still controversial. To examine the current literature on the protective role of conjugated linoleic acid (CLA) and marine long-chain fatty acids [eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)] and the risk of breast and prostate cancer, data from 41 case-control and cohort studies and relevant in vitro and animal experiments were included in this 2000-2010 revision. Epidemiological studies on CLA intake or its tissue concentration related to breast and prostate tumorigenesis are not conclusive; EPA and DHA intake have shown important inverse associations just in some studies. Additional research on the analysed association is required.
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Affiliation(s)
- Verónica M Heinze
- Facultad de Ciencias de la Salud, Universidad Adventista del Plata, 25 de Mayo 99, 3103 Libertador San Martín, Entre Ríos, Argentina.
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Meat and egg consumption and risk of breast cancer among Chinese women. Cancer Causes Control 2011; 20:1845-53. [PMID: 19533390 DOI: 10.1007/s10552-009-9377-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2009] [Accepted: 06/03/2009] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The association between meat and egg consumption and breast cancer risk has been examined in previous studies, but the results were inconsistent. We conducted a hospital-based case-control study during June 2007 to August 2008 among Guangdong Chinese women to investigate associations between meat and egg intake and breast cancer risk. METHODS Four hundred and thirty-eight consecutively recruited cases with primary breast cancer were frequency matched to 438 controls by age (5-year interval) and residence (rural/urban). Dietary intake was assessed by face-to-face interviews using a validated food frequency questionnaire. Odds ratios (ORs) and 95% confidence interval (CI) were obtained by using multiple unconditional logistic regression adjusted for various dietary and nondietary confounders. RESULTS We observed a borderline increased association of processed meat intake with breast cancer risk (trend test p = 0.066). The multivariate-adjusted OR of breast cancer risk for the highest versus the lowest quartile was 1.44 (95% CI = 0.97–2.15). No significant association was found between total and red meat, poultry, fish, and egg intake and risk. CONCLUSIONS This study suggested that processed meat intake was associated with a possible increased risk of breast cancer. There was no significant association between consumption of total and red meat, poultry, fish, or egg with breast cancer risk.
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Food and nutrient intakes of French frequent seafood consumers with regard to fish consumption recommendations: results from the CALIPSO study. Br J Nutr 2010; 105:1369-80. [DOI: 10.1017/s0007114510005027] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Besides providing n-3 fatty acids with nutritional and health benefits, seafood consumption may contribute to the reduction of nutrient prevalences of inadequacy. To evaluate the contributions of seafood and other food groups to nutrient intakes of frequent seafood consumers, food consumption was evaluated through an FFQ on 991 French men and women (18–81 years) consuming seafood at least twice a week. Intakes, prevalence of inadequacies, risks of upper limit excess and food contributions to intakes were assessed for thirty-three nutrients. Mean fat contributions to total energy intakes (38·3 and 39·0 % for men and women, respectively) met French recommendations, but mean carbohydrate intakes (40·9 and 39·7 %, respectively) were insufficient. Micronutrient inadequacies were lower than in the French general population, the highest being for vitamin C (41·3 and 40·1 % for men and women, respectively), vitamin E (35·0 and 35·3 % for men and women, respectively) and Mg (37·5 and 25·5 % for men and women, respectively). Upper safety limits (USL) were exceeded mostly for Zn (6·2 %), Ca (3·7 %), retinol (2·0 %) and Cu (0·9 %). Mean contributions of seafood to vitamin D, B12, I and Se intakes ranged 40–65 %. Molluscs and crustaceans significantly contributed to vitamin B12 (13·7 %), Cu (11·4 %), Fe (11·5 %), Zn (8·4 %) and I (6·1 %) intakes, and canned fish contributed to vitamin D intake (13·4 %). Besides fish, contributions of mollusc and crustacean consumption to nutrient intakes should be considered from a public health viewpoint. Consuming seafood at least twice a week induces moderate inadequacies and risks of exceeding USL for some micronutrients, whereas macronutrient intakes remained imbalanced.
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Cade JE, Taylor EF, Burley VJ, Greenwood DC. Common Dietary Patterns and Risk of Breast Cancer: Analysis From the United Kingdom Women's Cohort Study. Nutr Cancer 2010; 62:300-6. [DOI: 10.1080/01635580903441246] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Zhang C, Ho SC, Lin F, Cheng S, Fu J, Chen Y. Soy product and isoflavone intake and breast cancer risk defined by hormone receptor status. Cancer Sci 2010; 101:501-7. [PMID: 19860847 PMCID: PMC11158760 DOI: 10.1111/j.1349-7006.2009.01376.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The association between soy food consumption and breast cancer risk has been inconsistent. A hospital-based case-control study was conducted to assess the relationship between soy food intake and breast cancer risk according to the estrogen receptor (ER) and/or progesterone receptor (PR) status of breast cancer in Chinese women residing in Guangdong province from June 2007 to August 2008. A total of 438 consecutively recruited cases with primary breast cancer were frequency matched to 438 controls by age (5-year interval) and residence (rural/urban). Dietary intake was assessed by face-to-face interviews using a validated food frequency questionnaire. Odds ratios (OR) and 95% confidence intervals (CI) were obtained by using multiple unconditional logistic regression adjusted for the potential confounders. We observed a statistically significant inverse association between soy isoflavone and soy protein intake with breast cancer risk. The multivariate ORs (95% CIs) of breast cancer risk for the highest quartile compared with the lowest quartile were 0.54 (0.34-0.84) for soy isoflavone and 0.62 (0.40-0.96) for soy protein, respectively. A preventive effect of soy food was found for all subtypes of ER and/or PR status of breast cancer. The inverse association was more evident among premenopausal women. This study suggests that consumption of soy food, soy isoflavone, is inversely associated with the risk of breast cancer. The protective effects of soy did not seem to differ by ER and PR breast cancer status.
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Affiliation(s)
- Caixia Zhang
- Centre of Research and Promotion of Women's Health, School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
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PERRY CS, OTERO JC, PALMER JL, GROSS AS. Risk factors for breast cancer in East Asian women relative to women in the West. Asia Pac J Clin Oncol 2009. [DOI: 10.1111/j.1743-7563.2009.01242.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Robson AA. Preventing diet induced disease: bioavailable nutrient-rich, low-energy-dense diets. Nutr Health 2009; 20:135-66. [PMID: 19835109 DOI: 10.1177/026010600902000205] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
What the World needs is an integrated and sustainable food policy that makes the best and most appropriate use of the technologies at our disposal to promote health and help prevent disease. Diet induced diseases account for the largest burden of chronic illnesses and health problems Worldwide. Historically a lack of knowledge about human nutritional requirements (including for the brain) helped promote diet induced disease. The scientific knowledge currently exists to help prevent many of the current deficiencies and imbalances in human diet. Primary prevention of cardiovascular disease and mental ill health starts, crucially, with maternal nutrition before the inception of pregnancy and continues throughout life of the new born and includes consuming more DHA and EPA omega-3 fats (and their cofactors) and other bioavailable brain nutrients and less high-energy-dense (>2 kcal g(-1)) foods (e.g. land-based cereal, chocolate, alcohol and refined sugar, fat and oil), so tissues synthesize less inflammatory mediators and to lower transient short-lived meal-induced oxidative stress, inflammation, proliferation and impaired nitric oxide (e.g. approximately 0.35-3.5 g DHA/ EPA day(-1) dependant on energy intake and noting the importance of cofactors). Micro- and nanotechnologies are already engineering nano foods for human (and livestock) consumption that may eventually (without excessive consumption) prevent the current diet induced disease epidemic, especially in future generations, by preventing the causal mechanisms of disease. Greater knowledge about the causal mechanisms of disease awaits to be discovered, which could further enhance the human desire to increase longevity in optimum health (creating more problems and challenges for society).
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Affiliation(s)
- Anthony A Robson
- Université de Bretagne Occidentale, IUEM (UMR CNRS 6539), LEMAR, Technopôle Brest-Iroise, Plouzané, France.
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Pala V, Krogh V, Berrino F, Sieri S, Grioni S, Tjønneland A, Olsen A, Jakobsen MU, Overvad K, Clavel-Chapelon F, Boutron-Ruault MC, Romieu I, Linseisen J, Rohrmann S, Boeing H, Steffen A, Trichopoulou A, Benetou V, Naska A, Vineis P, Tumino R, Panico S, Masala G, Agnoli C, Engeset D, Skeie G, Lund E, Ardanaz E, Navarro C, Sánchez MJ, Amiano P, Svatetz CAG, Rodriguez L, Wirfält E, Manjer J, Lenner P, Hallmans G, Peeters PHM, van Gils CH, Bueno-de-Mesquita HB, van Duijnhoven FJB, Key TJ, Spencer E, Bingham S, Khaw KT, Ferrari P, Byrnes G, Rinaldi S, Norat T, Michaud DS, Riboli E. Meat, eggs, dairy products, and risk of breast cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Am J Clin Nutr 2009; 90:602-12. [PMID: 19491385 DOI: 10.3945/ajcn.2008.27173] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND A Western diet is associated with breast cancer risk. OBJECTIVE We investigated the relation of meat, egg, and dairy product consumption with breast cancer risk by using data from the European Prospective Investigation into Cancer and Nutrition (EPIC). DESIGN Between 1992 and 2003, information on diet was collected from 319,826 women. Disease hazard ratios were estimated with multivariate Cox proportional hazard models. RESULTS Breast cancer cases (n = 7119) were observed during 8.8 y (median) of follow-up. No consistent association was found between breast cancer risk and the consumption of any of the food groups under study, when analyzed by both categorical and continuous exposure variable models. High processed meat consumption was associated with a modest increase in breast cancer risk in the categorical model (hazard ratio: 1.10; 95% CI: 1.00, 1.20; highest compared with lowest quintile: P for trend = 0.07). Subgroup analyses suggested an association with butter consumption, limited to premenopausal women (hazard ratio: 1.28; 95% CI: 1.06, 1.53; highest compared with lowest quintile: P for trend = 0.21). Between-country heterogeneity was found for red meat (Q statistic = 18.03; P = 0.05) and was significantly explained (P = 0.023) by the proportion of meat cooked at high temperature. CONCLUSIONS We have not consistently identified intakes of meat, eggs, or dairy products as risk factors for breast cancer. Future studies should investigate the possible role of high-temperature cooking in the relation of red meat intake with breast cancer risk.
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Affiliation(s)
- Valeria Pala
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Zhang J, Oxinos G, Maher JH. The effect of fruit and vegetable powder mix on hypertensive subjects: a pilot study. J Chiropr Med 2009; 8:101-6. [DOI: 10.1016/j.jcm.2008.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2008] [Revised: 09/02/2008] [Accepted: 09/23/2008] [Indexed: 11/28/2022] Open
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Kim J, Lim SY, Shin A, Sung MK, Ro J, Kang HS, Lee KS, Kim SW, Lee ES. Fatty fish and fish omega-3 fatty acid intakes decrease the breast cancer risk: a case-control study. BMC Cancer 2009; 9:216. [PMID: 19566923 PMCID: PMC2711973 DOI: 10.1186/1471-2407-9-216] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2009] [Accepted: 06/30/2009] [Indexed: 01/02/2023] Open
Abstract
Background Although it is believed that fish ω-3 fatty acids may decrease breast cancer risk, epidemiological evidence has been inconclusive. This study examined the association between fish and fish ω-3 fatty acids intake with the risk of breast cancer in a case-control study of Korean women. Methods We recruited 358 incident breast cancer patients and 360 controls with no history of malignant neoplasm from the National Cancer Center Hospital between July 2007 and April 2008. The study participants were given a 103-item food intake frequency questionnaire to determine their dietary consumption of fish (fatty and lean fish) and ω-3 fatty acids derived from fish (eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA)). Results Using a multivariate logistic regression model, high intake of fatty fish was associated with a reduced risk for breast cancer in both pre- and postmenopausal women (OR [95% CI] for highest vs. lowest intake quartiles, p for trend: 0.19 [0.08 to 0.45], p < 0.001 for premenopausal women, 0.27 [0.11 to 0.66], p = 0.005 for postmenopausal women). Similarly, reductions in breast cancer risk were observed among postmenopausal subjects who consumed more than 0.101 g of EPA (OR [95% CI]: 0.38 [0.15 to 0.96]) and 0.213 g of DHA (OR [95% CI]: 0.32 [0.13 to 0.82]) from fish per day compared to the reference group who consumed less than 0.014 g of EPA and 0.037 g of DHA per day. Among premenopausal women, there was a significant reduction in breast cancer risk for the highest intake quartiles of ω-3 fatty acids (ORs [95% CI]: 0.46 [0.22 to 0.96]), compared to the reference group who consumed the lowest quartile of intake. Conclusion These results suggest that high consumption of fatty fish is associated with a reduced risk for breast cancer, and that the intake of ω-3 fatty acids from fish is inversely associated with postmenopausal breast cancer risk.
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Affiliation(s)
- Jeongseon Kim
- Cancer Epidemiology Branch, Division of Cancer Epidemiology and Management, Research Institute, National Cancer Center, Gyeonggi, South Korea.
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Zhang CX, Ho SC, Chen YM, Fu JH, Cheng SZ, Lin FY. Greater vegetable and fruit intake is associated with a lower risk of breast cancer among Chinese women. Int J Cancer 2009; 125:181-8. [PMID: 19358284 DOI: 10.1002/ijc.24358] [Citation(s) in RCA: 124] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The effect of vegetable and fruit consumption on breast cancer risk is controversial. We examined the association between vegetable and fruit intake and breast cancer risk in a hospital-based case-control study conducted in Guangdong, China. Four hundred and thirty-eight cases were frequency matched to 438 controls by age (5-year interval) and residence (rural/urban). Dietary intake was assessed by face-to-face interviews using a validated food frequency questionnaire. Multivariate logistic regression was used to estimate the odds ratios (ORs) and 95% confidence interval (CI) after adjusting for various potential confounders. Total vegetable and fruit intake was found to be inversely associated with breast cancer risk. The ORs of the highest quartile relative to the lowest quartile of total vegetable and fruit intake were 0.28 (95% CI 0.18-0.43) and 0.53 (95% CI 0.34-0.82), respectively. Consumption of individual vegetable and fruit groups such as dark green leafy vegetables, cruciferous vegetables, carrots and tomatoes, banana, watermelon/papaya/cantaloupe were all inversely and significantly related with breast cancer risk. An inverse association was also observed for vitamin A, carotene, vitamin C, vitamin E, and fiber intake. These data indicate that greater intake of vegetables and fruits is associated with a decreased risk of breast cancer among Chinese women residing in Guangdong.
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Affiliation(s)
- Cai-Xia Zhang
- Department of Community and Family Medicine, School of Public Health, Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China
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Dietary patterns and risk of cancer of various sites in the Norwegian European Prospective Investigation into Cancer and Nutrition cohort: the Norwegian Women and Cancer study. Eur J Cancer Prev 2009; 18:69-75. [PMID: 19077568 DOI: 10.1097/cej.0b013e328305a091] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
An indicator of common diets among groups of individuals can be found by identifying dietary patterns. We found previously six dietary patterns in the Norwegian European Prospective Investigation into Cancer and Nutrition cohort and labelled them fish, healthy, average, western, bread and alcohol. We examined the relationship between the different patterns and risk of total cancer, breast cancer and gastrointestinal cancers in 34 471 women from the Norwegian European Prospective Investigation into Cancer and Nutrition cohort, in which there were 1355 cancer cases. The hazard ratios and their corresponding 95% confidence intervals were estimated using Cox proportional hazards regression. Stratified analysis on menopausal status and smoking status was performed. Alcohol, meat, fish and fruit and vegetable consumption are suspected to have an influence on different cancers; thus we decided to perform stratified analysis on high versus low consumption of the above-mentioned variables as well. We found no overall relationship between cancers and the six different dietary patterns in this study. When stratifying on alcohol consumption, fruit and vegetable consumption and fatty fish consumption, there was a statistically higher risk of total cancer and breast cancer with high alcohol consumption, and a significantly higher risk of breast cancer with low consumption of fruit and vegetables or with low consumption of fatty fish in the western group only. A significantly higher risk of total cancer with low intake of fatty fish in the alcohol group was also observed.
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Thiébaut ACM, Chajès V, Gerber M, Boutron-Ruault MC, Joulin V, Lenoir G, Berrino F, Riboli E, Bénichou J, Clavel-Chapelon F. Dietary intakes of omega-6 and omega-3 polyunsaturated fatty acids and the risk of breast cancer. Int J Cancer 2009; 124:924-31. [PMID: 19035453 DOI: 10.1002/ijc.23980] [Citation(s) in RCA: 105] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Experimental studies suggest detrimental effects of omega-6 polyunsaturated fatty acids (PUFA), and beneficial effects of omega-3 PUFAs on mammary carcinogenesis, possibly in interaction with antioxidants. However, PUFA food sources are diverse in human diets and few epidemiologic studies have examined whether associations between dietary PUFAs and breast cancer risk vary according to food sources or antioxidant intakes. The relationship between individual PUFA intakes estimated from diet history questionnaires and breast cancer risk was examined among 56,007 French women. During 8 years of follow-up, 1,650 women developed invasive breast cancer. Breast cancer risk was not related to any dietary PUFA overall; however, opposite associations were seen according to food sources, suggesting other potential effects than PUFA per se. Breast cancer risk was inversely associated with alpha-linolenic acid (ALA) intake from fruit and vegetables [highest vs. lowest quintile, hazard ratio (HR) 0.74; 95% confidence interval (CI) 0.63, 0.88; p trend < 0.0001], and from vegetable oils (HR 0.83; 95% CI 0.71, 0.97; p trend 0.017). Conversely, breast cancer risk was positively related to ALA intake from nut mixes (p trend 0.004) and processed foods (p trend 0.068), as was total ALA intake among women in the highest quintile of dietary vitamin E (p trend 0.036). A significant interaction was also found between omega-6 and long-chain omega-3 PUFAs, with breast cancer risk inversely related to long-chain omega-3 PUFAs in women belonging to the highest quintile of omega-6 PUFAs (p interaction 0.042). These results emphasize the need to consider food sources, as well as interactions between fatty acids and with antioxidants, when evaluating associations between PUFA intakes and breast cancer risk.
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GREEN M, RAINA V. Epidemiology, screening and diagnosis of breast cancer in the Asia-Pacific region: Current perspectives and important considerations. Asia Pac J Clin Oncol 2008. [DOI: 10.1111/j.1743-7563.2008.00191.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Dórea JG. Persistent, bioaccumulative and toxic substances in fish: human health considerations. THE SCIENCE OF THE TOTAL ENVIRONMENT 2008; 400:93-114. [PMID: 18653214 DOI: 10.1016/j.scitotenv.2008.06.017] [Citation(s) in RCA: 93] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2008] [Revised: 06/09/2008] [Accepted: 06/12/2008] [Indexed: 05/26/2023]
Abstract
Fish are important dietary items that provide essential nutrients. Fish however, bioaccumulate monomethyl mercury (MMHg) and organo-halogenated pollutants (OHP) that are persistent bioaccumulative and toxic substances (PBTS). Unlike man-made OHP, MMHg is mainly of natural origin but background concentrations of aquatic systems are determined by the environmental Hg-methylating potential. Industrial activities can modulate environmental discharges and fish bioaccumulation of PBTS. Fish and seafood consumption are associated with human body load of PBTS, but farming practices that utilize fishmeal increase the terrestrial food chain resulting in farm-animal accumulation of PBTS. These substances are neurotoxic and endocrine active that can impact humans and wild life, but chemical characteristics of MMHg and OHP modulate interactions with animal tissues. MMHg is protein reactive with a faster metabolism (months) than OHP that are stored and slowly (years) metabolized in fat tissues. Except for brain-Hg, neither Hg nor OHP in tissues are markers of toxic effects; however, deficits in neurobehavioral test-scores of children have been shown in some fish-eating populations. These deficits are transient and within normal range, and are not prodromes of neurological diseases. Although population studies show that consumption of fish at current levels of contamination do not explain neurological disorders, endocrine activity remains controversial. Understanding risk of hazard caused by fish-PBTS consumption requires a wide range of expertise. We discuss chemical, toxic, metabolic, and ecological characteristics associated with PBTS in fish. There are proven health outcome derived from fish consumption, while risk of exposure to avoidable PBTS is a chance that can be minimized by societal actions.
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Affiliation(s)
- José G Dórea
- Faculdade de Ciências da Saúde, Universidade de Brasília, Brasília, Brazil.
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Lima FELD, Latorre MDRDDO, Costa MJDC, Fisberg RM. Diet and cancer in Northeast Brazil: evaluation of eating habits and food group consumption in relation to breast cancer. CAD SAUDE PUBLICA 2008; 24:820-8. [DOI: 10.1590/s0102-311x2008000400012] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2007] [Accepted: 08/24/2007] [Indexed: 11/21/2022] Open
Abstract
A hospital-based case-control study was performed from August 2002 to November 2003 in Northeast Brazil. Eighty-nine women were recruited with histologically confirmed breast cancer (age 30-80 years), matched for age with 94 controls. Food consumption of cases and controls was evaluated by foods and food groups, categorized in consumption tertiles. Odds ratio (OR) and 95% confidence intervals (95%CI) were obtained through unconditional logistic regression. Intake of fruits and juices, beans, and dairy products showed a strong association with reduced risk of breast cancer. Consumption of red and fried meat was positively associated with risk of breast cancer (red meat - OR = 4.30; 95%CI: 1.74-10.67; p for trend = 0.00). No association was observed in vegetable and sausage meat groups and breast cancer. Red and fried meat may be risk factors, and intake of fruit, beans, and dairy products may protect against breast cancer.
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Abstract
Most of the early studies published on soy and breast cancer were not designed to test the effect of soy; the assessment of soy intake was usually crude and few potential confounders were considered in the analysis. In this review, we focused on studies with relatively complete assessment of dietary soy exposure in the targeted populations and appropriate consideration for potential confounders in the statistical analysis of study data. Meta-analysis of the 8 (1 cohort, 7 case-control) studies conducted in high-soy-consuming Asians show a significant trend of decreasing risk with increasing soy food intake. Compared to the lowest level of soy food intake (<or=5 mg isoflavones per day), risk was intermediate (OR=0.88, 95% confidence interval (CI)=0.78-0.98) among those with modest ( approximately 10 mg isoflavones per day) intake and lowest (OR=0.71, 95% CI=0.60-0.85) among those with high intake (>or=20 mg isoflavones per day). In contrast, soy intake was unrelated to breast cancer risk in studies conducted in the 11 low-soy-consuming Western populations whose average highest and lowest soy isoflavone intake levels were around 0.8 and 0.15 mg per day, respectively. Thus, the evidence to date, based largely on case-control studies, suggest that soy food intake in the amount consumed in Asian populations may have protective effects against breast cancer.
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Nutrition and breast cancer among sporadic cases and gene mutation carriers: An overview. ACTA ACUST UNITED AC 2008; 32:52-64. [DOI: 10.1016/j.cdp.2008.01.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2008] [Indexed: 11/22/2022]
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