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Schrenk D, Bignami M, Bodin L, Chipman JK, del Mazo J, Grasl‐Kraupp B, Hogstrand C, Hoogenboom L(R, Leblanc J, Nebbia CS, Nielsen E, Ntzani E, Petersen A, Sand S, Vleminckx C, Wallace H, Barregård L, Benford D, Broberg K, Dogliotti E, Fletcher T, Rylander L, Abrahantes JC, Gómez Ruiz JÁ, Steinkellner H, Tauriainen T, Schwerdtle T. Update of the risk assessment of inorganic arsenic in food. EFSA J 2024; 22:e8488. [PMID: 38239496 PMCID: PMC10794945 DOI: 10.2903/j.efsa.2024.8488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2024] Open
Abstract
The European Commission asked EFSA to update its 2009 risk assessment on arsenic in food carrying out a hazard assessment of inorganic arsenic (iAs) and using the revised exposure assessment issued by EFSA in 2021. Epidemiological studies show that the chronic intake of iAs via diet and/or drinking water is associated with increased risk of several adverse outcomes including cancers of the skin, bladder and lung. The CONTAM Panel used the benchmark dose lower confidence limit based on a benchmark response (BMR) of 5% (relative increase of the background incidence after adjustment for confounders, BMDL05) of 0.06 μg iAs/kg bw per day obtained from a study on skin cancer as a Reference Point (RP). Inorganic As is a genotoxic carcinogen with additional epigenetic effects and the CONTAM Panel applied a margin of exposure (MOE) approach for the risk characterisation. In adults, the MOEs are low (range between 2 and 0.4 for mean consumers and between 0.9 and 0.2 at the 95th percentile exposure, respectively) and as such raise a health concern despite the uncertainties.
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Lai H, Sun M, Liu Y, Zhu H, Li M, Pan B, Wang Q, Yang Q, Cao X, Tian C, Lu Y, Song X, Ding G, Tian J, Yang K, Ge L. White rice consumption and risk of cardiometabolic and cancer outcomes: A systematic review and dose-response meta-analysis of prospective cohort studies. Crit Rev Food Sci Nutr 2023; 63:12476-12487. [PMID: 35852223 DOI: 10.1080/10408398.2022.2101984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
White rice is the food more than half of the world's population depends on. White rice intake can significantly increase the glycemic load of consumers and bring some adverse health effects. However, the quality of evidence implicating white rice in adverse health outcomes remains unclear. To evaluate the association between white rice consumption and the risk of cardiometabolic and cancer outcomes, a systematic review and dose-response meta-analysis of the relevant publications were performed. Twenty-three articles including 28 unique prospective cohorts with 1,527,198 participants proved eligible after a comprehensive search in four databases. For the risk of type 2 diabetes mellitus (T2DM), the pooled RR was 1.18 (16 more per 1000 persons) for comparing the highest with the lowest category of white rice intake, with moderate certainty evidence. Females presented a higher risk (23 more per 1000 persons) in subgroup analysis. And every additional 150 grams of white rice intake per day was associated with a 6% greater risk of T2DM (5 more per 1000 persons) with a linear positive trend. We found no significant associations between white rice intake and risk of cardiovascular diseases (CVD), CVD mortality, cancer, and metabolic syndrome. In conclusion, moderate certainty evidence demonstrated that white rice intake was associated with T2DM risk, with a linear positive trend. However, low to very low certainty of evidence suggested that no substantial associations were found between white rice intake and other cardiometabolic and cancer outcomes. More cohorts are needed to strength the evidence body.
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Affiliation(s)
- Honghao Lai
- Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Mingyao Sun
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China
| | - Yafei Liu
- Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Hongfei Zhu
- Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Mengting Li
- Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Bei Pan
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Qi Wang
- Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Qiuyu Yang
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China
| | - Xiao Cao
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China
| | - Chen Tian
- Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Yao Lu
- Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Xuping Song
- Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Guowu Ding
- Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Jinhui Tian
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Kehu Yang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Long Ge
- Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
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Kasai F, Eshak ES, Tamakoshi A, Iso H. Dietary Manganese Intake and Risk of Liver Cancer in Japanese Men and Women: The JACC Study. Nutr Cancer 2022; 75:154-163. [PMID: 36047063 DOI: 10.1080/01635581.2022.2099912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
We explored the association between dietary manganese intake and the risk of liver cancer in 14,517 men and 21,583 women who participated in the Japan Collaborative Cohort Study for Cancer Risk Assessment. We assessed dietary manganese intake using a food frequency questionnaire and incident liver cancer by reviewing cancer registries. According to manganese intake, we estimated the liver cancer risk by Cox regression analyses. During the 513,657 person-year follow-ups within a median of 17.9 years of 36,100 participants, there were 239 incident cases of liver cancer. The multivariable hazard ratio (HR) (95% confidence interval [CI]; P-trend) for liver cancer risk in the highest vs. the lowest quintiles of dietary manganese intake was 0.56 (0.32-0.99; 0.04) in men and 1.16 (0.56-2.40; 0.79) in women; P-interaction = 0.06. The history of liver disease modified the observed association in men (P-interaction = 0.02), in which the multivariable HR (95%CI) of liver cancer risk comparing the highest vs. lowest quintiles of dietary manganese intake was 0.32 (0.14-0.74) in Japanese men without a history of liver disease, while it was 1.54 (0.62-3.79) in men with a history of liver disease. In conclusion, a higher dietary manganese intake was associated with a lower risk of liver cancer in men without a history of liver disease.
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Affiliation(s)
- Fumiko Kasai
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Ehab S Eshak
- Department of Public Health, Faculty of Medicine, Minia University, Minia, Egypt.,Advanced Clinical Epidemiology, Medical Data Science, Public Health, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Akiko Tamakoshi
- Department of Public Health, Hokkaido University, Graduate School of Medicine, Kita, Sapporo, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.,Institute of Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Shinjuku-Ku, Tokyo, Japan
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Moslehi R, Stagnar C, Srinivasan S, Radziszowski P, Carpenter DO. The possible role of arsenic and gene-arsenic interactions in susceptibility to breast cancer: a systematic review. REVIEWS ON ENVIRONMENTAL HEALTH 2021; 36:523-534. [PMID: 34223716 PMCID: PMC8258236 DOI: 10.1515/reveh-2020-0080] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 12/06/2020] [Indexed: 05/03/2023]
Abstract
The roles of many environmental contaminants in increasing breast cancer risk remain controversial. Arsenic (As) is a major global environmental contaminant and carcinogen. We conducted a systematic review of the role of As and gene-arsenic interactions in susceptibility to breast cancer. Following a systematic literature search using well-defined inclusion/exclusion criteria, a total of 15 epidemiologic studies (two meta-analyses, three systematic reviews, three cohort studies, two case-control studies, and five cross-sectional studies) were reviewed. In addition, several animal, in vitro, in vivo, and in silico (i.e., computer modeling) studies provided mechanistic insights into the association between As and breast cancer. Our review suggests a possible overall main effect of As on breast cancer risk. The evidence for an effect of gene-As interactions on breast cancer risk is strong. Studies that measured levels of As metabolites among participants and/or evaluated interactions between As exposure and genetic or epigenetic factors generally reported positive associations with breast cancer risk. Our analysis of the Comparative Toxicogenomics and the Ingenuity Pathway Analysis Databases provided further evidence for As-gene interactions and their effects on breast cancer-related biologic pathways. Our findings provide potential leads for future epidemiologic studies of As-associated cancer risks and interventions to reduce population exposure.
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Affiliation(s)
- Roxana Moslehi
- School of Public Health, Albany, USA
- Cancer Research Center, University at Albany, State University of
New York (SUNY), Albany, NY, 12144, USA
| | - Cristy Stagnar
- School of Public Health, Albany, USA
- Drukier Institute for Children’s Health, Weill Cornell
Medicine, NY, USA
| | | | | | - David O. Carpenter
- School of Public Health, Albany, USA
- Institute for Health and the Environment, University at Albany,
Albany, NY, USA
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Abuawad A, Bozack AK, Saxena R, Gamble MV. Nutrition, one-carbon metabolism and arsenic methylation. Toxicology 2021; 457:152803. [PMID: 33905762 PMCID: PMC8349595 DOI: 10.1016/j.tox.2021.152803] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 04/20/2021] [Accepted: 04/22/2021] [Indexed: 12/16/2022]
Abstract
Exposure to arsenic (As) is a major public health concern globally. Inorganic As (InAs) undergoes hepatic methylation to form monomethyl (MMAs)- and dimethyl (DMAs)-arsenical species, facilitating urinary As elimination. MMAsIII is considerably more toxic than either InAsIII or DMAsV, and a higher proportion of MMAs in urine has been associated with risk for a wide range of adverse health outcomes. Efficiency of As methylation differs substantially between species, between individuals, and across populations. One-carbon metabolism (OCM) is a biochemical pathway that provides methyl groups for the methylation of As, and is influenced by folate and other micronutrients, such as vitamin B12, choline, betaine and creatine. A growing body of evidence has demonstrated that OCM-related micronutrients play a critical role in As methylation. This review will summarize observational epidemiological studies, interventions, and relevant experimental evidence examining the role that OCM-related micronutrients have on As methylation, toxicity of As, and risk for associated adverse health-related outcomes. There is fairly robust evidence supporting the impact of folate on As methylation, and some evidence from case-control studies indicating that folate nutritional status influences risk for As-induced skin lesions and bladder cancer. However, the potential for folate to be protective for other As-related health outcomes, and the potential beneficial effects of other OCM-related micronutrients on As methylation and risk for health outcomes are less well studied and warrant additional research.
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Affiliation(s)
- Ahlam Abuawad
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Anne K Bozack
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA; Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, USA
| | - Roheeni Saxena
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Mary V Gamble
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.
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The relationship between rice consumption and glioma: a case-control study in adults. Sci Rep 2021; 11:6073. [PMID: 33727597 PMCID: PMC7971041 DOI: 10.1038/s41598-021-85562-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 03/03/2021] [Indexed: 12/07/2022] Open
Abstract
Previous studies have shown the effect of refined grains on various cancers; however, data on the link between rice consumption and brain cancer are scarce. We aimed to investigate the relationship between rice consumption and glioma in Iranian adults. Current hospital-based case–control study was done in Tehran between 2009 and 2011. Cases were individuals with pathologically confirmed glioma in a maximally 1 month of the disease diagnosis (n = 128). Controls were individuals, aged between 20 and 75 years, who were hospitalized or were outpatients referred to other wards of the same hospital (n = 256). Cases and controls were frequently matched in terms of age and gender. Usual dietary intakes of participants, including rice consumption, during the preceding year were examined using a Block-format validated semi-quantitative 126-item food frequency questionnaire. Compared with participants in the lowest tertile of rice consumption (< 181 g/day), those in the highest tertile (≥ 279 g/day) had 2.47 times greater chance for having glioma (OR: 2.47, 95% CI 1.44–4.23). This relationship was also seen when potential confounders including demographic variables, energy and dietary intakes as well as body mass index were taking into account; such that individuals in the top tertile of rice consumption had 2.46 times greater odds of glioma compared with those in the bottom tertile (OR: 2.46, 95% CI 1.01–5.97). We found that rice consumption was positively associated with risk of glioma in adults. Further prospective studies are required to confirm this finding.
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Kazemi A, Barati-Boldaji R, Soltani S, Mohammadipoor N, Esmaeilinezhad Z, Clark CCT, Babajafari S, Akbarzadeh M. Intake of Various Food Groups and Risk of Breast Cancer: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies. Adv Nutr 2020; 12:809-849. [PMID: 33271590 PMCID: PMC8166564 DOI: 10.1093/advances/nmaa147] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/15/2020] [Accepted: 10/20/2020] [Indexed: 01/11/2023] Open
Abstract
Despite increasing evidence for the association of food-based dietary patterns with breast cancer risk, knowledge about the shape of the relationship and the quality of meta-evidence are insufficient. We aimed to summarize the associations between food groups and risks of breast cancer. We performed a systematic literature search of the PubMed and Embase databases up to March 2020. We included cohort, case-cohort, nested case-control studies, and follow-up studies of randomized controlled trials that investigated the relationship between breast cancer risk and at least 1 of the following food groups: red meat, processed meat, fish, poultry, egg, vegetables, fruit, dairy product (overall, milk, yogurt, and cheese), grains/cereals, nuts, legumes, soy, and sugar-sweetened beverages. Summary risk ratios (RRs) and 95% CIs were estimated using a random-effects model for linear and nonlinear relationships. Inverse linear associations were observed for vegetables (RR per 100 g/d, 0.97; 95% CI, 0.95-0.99), fruit (RR per 100 g/d, 0.97; 95% CI, 0.95-0.99), cheese (RR per 30 g/d, 0.95; 95% CI, 0.91-1.00), and soy (RR per 30 g/d, 0.96; 95% CI, 0.94-0.99), while positive associations were observed for red (RR per 100 g/d, 1.10; 95% CI, 1.03-1.18) and processed meat (RR per 50 g/d, 1.18; 95% CI, 1.04-1.33). None of the other food groups were significantly associated with breast cancer risk. A nonlinear association was observed only for milk, such that the intake of >450 g/d increased the risk, while no association was observed for lower intake amounts. High intakes of vegetables, fruit, cheese, and soy products and low intakes of red and processed meat were associated with lower risks of breast cancer. However, causality cannot be inferred from these statistical correlations.
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Affiliation(s)
| | - Reza Barati-Boldaji
- Nutrition Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sepideh Soltani
- Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Nazanin Mohammadipoor
- Nurtition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Cian C T Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry, UK
| | - Siavash Babajafari
- Nutrition Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marzieh Akbarzadeh
- Nurtition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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Sanchez TR, Klu YAK, Genkinger JM, Lacey JV, Chung NT, Navas-Acien A. Association between rice consumption and risk of cancer incidence in the California Teachers Study. Cancer Causes Control 2020; 31:1129-1140. [PMID: 32974796 PMCID: PMC7572641 DOI: 10.1007/s10552-020-01350-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 09/16/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE We evaluated the contribution of rice intake, a source of dietary arsenic, to cancer risk in a population of women with likely low arsenic exposure from drinking water and variable rice intake who participated in the California Teachers Study. METHODS Rice consumption was categorized into quartiles (< 9.6, 9.7-15.6, 15.7-42.7, and ≥ 42.8 g/day). Multivariable-adjusted hazard ratios and 95% confidence intervals (95% CI) for incident cancer were estimated comparing rice consumption categories with bladder, breast, kidney, lung, and pancreatic cancer, with progressive adjustment for age, total calories, BMI, race, smoking status, physical activity, and cancer-specific covariates. RESULTS The number of breast, lung, pancreatic, bladder, and kidney cancer cases was 7,351; 1,100; 411; 344; and 238, respectively. The adjusted hazard ratios (95% CI) comparing the highest versus lowest rice intake quartiles were 1.07 (1.00-1.15); 0.87 (0.72-1.04); 0.95 (0.66-1.37); 1.11 (0.81-1.52) and 1.07 (0.72-1.59) for breast, lung, pancreatic, bladder, and kidney cancers, respectively. Results were consistent when rice was modeled as a continuous variable and in analyses stratified by smoking status. CONCLUSION Rice consumption was not associated with risk of kidney, lung or pancreatic cancer, except maybe a small excess risk for breast cancer and a small non-significant excess risk for bladder cancer, comparing the highest versus lowest quartile of rice intake. Due to lower consumption patterns in this cohort, future studies should involve populations for which rice is a staple food and use of an arsenic biomarker.
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Affiliation(s)
- Tiffany R Sanchez
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA.
| | - Yaa Asantewaa Kafui Klu
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| | - Jeanine M Genkinger
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
- Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY, 10032, USA
| | - James V Lacey
- Department of Computational and Quantitative Medicine, Beckman Research Institute, City of Hope, Duarte, CA, 91010, USA
| | - Nadia T Chung
- Department of Computational and Quantitative Medicine, Beckman Research Institute, City of Hope, Duarte, CA, 91010, USA
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
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Yu EYW, Wesselius A, Mehrkanoon S, Brinkman M, van den Brandt P, White E, Weiderpass E, Le Calvez-Kelm F, Gunter M, Huybrechts I, Liedberg F, Skeie G, Tjonneland A, Riboli E, Giles GG, Milne RL, Zeegers MP. Grain and dietary fiber intake and bladder cancer risk: a pooled analysis of prospective cohort studies. Am J Clin Nutr 2020; 112:1252-1266. [PMID: 32778880 PMCID: PMC7657329 DOI: 10.1093/ajcn/nqaa215] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 07/08/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Higher intakes of whole grains and dietary fiber have been associated with lower risk of insulin resistance, hyperinsulinemia, and inflammation, which are known predisposing factors for cancer. OBJECTIVES Because the evidence of association with bladder cancer (BC) is limited, we aimed to assess associations with BC risk for intakes of whole grains, refined grains, and dietary fiber. METHODS We pooled individual data from 574,726 participants in 13 cohort studies, 3214 of whom developed incident BC. HRs, with corresponding 95% CIs, were estimated using Cox regression models stratified on cohort. Dose-response relations were examined using fractional polynomial regression models. RESULTS We found that higher intake of total whole grain was associated with lower risk of BC (comparing highest with lowest intake tertile: HR: 0.87; 95% CI: 0.77, 0.98; HR per 1-SD increment: 0.95; 95% CI: 0.91, 0.99; P for trend: 0.023). No association was observed for intake of total refined grain. Intake of total dietary fiber was also inversely associated with BC risk (comparing highest with lowest intake tertile: HR: 0.86; 95% CI: 0.76, 0.98; HR per 1-SD increment: 0.91; 95% CI: 0.82, 0.98; P for trend: 0.021). In addition, dose-response analyses gave estimated HRs of 0.97 (95% CI: 0.95, 0.99) for intake of total whole grain and 0.96 (95% CI: 0.94, 0.98) for intake of total dietary fiber per 5-g daily increment. When considered jointly, highest intake of whole grains with the highest intake of dietary fiber showed 28% reduced risk (95% CI: 0.54, 0.93; P for trend: 0.031) of BC compared with the lowest intakes, suggesting potential synergism. CONCLUSIONS Higher intakes of total whole grain and total dietary fiber are associated with reduced risk of BC individually and jointly. Further studies are needed to clarify the underlying mechanisms for these findings.
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Affiliation(s)
- Evan Y W Yu
- Department of Complex Genetics and Epidemiology, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
| | - Anke Wesselius
- Department of Complex Genetics and Epidemiology, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
| | - Siamak Mehrkanoon
- Department of Data Science and Knowledge Engineering, Maastricht University, Maastricht, Netherlands
| | - Maree Brinkman
- Department of Complex Genetics and Epidemiology, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
- Department of Clinical Studies and Nutritional Epidemiology, Nutrition Biomed Research Institute, Melbourne, Victoria, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Piet van den Brandt
- Department of Epidemiology, School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, Netherlands
- Department of Epidemiology, School for Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Emily White
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | | | - Marc Gunter
- International Agency for Research on Cancer/WHO, Lyon, France
| | - Inge Huybrechts
- International Agency for Research on Cancer/WHO, Lyon, France
| | - Fredrik Liedberg
- Department of Urology, Skåne University Hospital, Malmö, Sweden
- Institution of Translational Medicine, Lund University, Malmö, Sweden
| | - Guri Skeie
- Department of Community Medicine, UIT The Arctic University of Norway, Tromsø, Norway
| | - Anne Tjonneland
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Graham G Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Roger L Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Maurice P Zeegers
- Department of Complex Genetics and Epidemiology, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
- CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, Netherlands
- School of Cancer Sciences, University of Birmingham, Birmingham, United Kingdom
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10
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Pullella K, Kotsopoulos J. Arsenic Exposure and Breast Cancer Risk: A Re-Evaluation of the Literature. Nutrients 2020; 12:nu12113305. [PMID: 33126678 PMCID: PMC7694128 DOI: 10.3390/nu12113305] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 10/16/2020] [Accepted: 10/25/2020] [Indexed: 12/15/2022] Open
Abstract
Arsenic is a widespread environmental contaminant and recognized carcinogen for the skin, bladder and lungs. In recent years, there has been an increasing number of studies that have investigated the effects of arsenic exposure and cancer risk at other sites, including the breast. However, to date, the association between arsenic exposure and breast cancer risk remains unclear. This article will provide an overview of arsenic metabolism, the clinically important biomarkers commonly used to assess arsenic exposure, and review the epidemiologic studies examining the role of arsenic exposure on breast cancer risk. Given the large burden of disease associated with breast cancer, it is of the upmost importance to identify risk factors and preventative strategies that could reduce cancer incidence. Limiting exposure to endemic environmental toxins, such as arsenic, represents one such strategy. More studies are required to better ascertain this relationship and to develop the public policy necessary to significantly reduce breast cancer incidence.
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Affiliation(s)
- Katherine Pullella
- Department of Nutritional Sciences, University of Toronto, Toronto, ON M5S 1A1, Canada;
- Women’s College Research Institute, Women’s College Hospital, Toronto, ON M5S 1B2, Canada
| | - Joanne Kotsopoulos
- Women’s College Research Institute, Women’s College Hospital, Toronto, ON M5S 1B2, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
- Correspondence: ; Tel.: +416-351-3732 x 2126
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11
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Karagas MR, Punshon T, Davis M, Bulka CM, Slaughter F, Karalis D, Argos M, Ahsan H. Rice Intake and Emerging Concerns on Arsenic in Rice: a Review of the Human Evidence and Methodologic Challenges. Curr Environ Health Rep 2019; 6:361-372. [PMID: 31760590 PMCID: PMC7745115 DOI: 10.1007/s40572-019-00249-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Rice is a major staple food worldwide and a dietary source of arsenic. We therefore summarized the state of the epidemiologic evidence on whether rice consumption relates to health outcomes associated with arsenic exposure. RECENT FINDINGS While epidemiologic studies have reported that higher rice consumption may increase the risk of certain chronic conditions, i.e., type 2 diabetes, most did not consider specific constituents of rice or other sources of arsenic exposure. Studies that examined rice intake stratified by water concentrations of arsenic found evidence of increasing trends in cardiovascular disease risk, skin lesions, and squamous cell skin cancers and bladder cancer associated with higher rice consumption. Further studies are needed to understand the health impacts of arsenic exposure from rice consumption taking into account all sources of rice intake and potential confounding by other dietary constituents or contaminants and arsenic exposure from sources such as water.
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Affiliation(s)
- Margaret R Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, NH, 03756, USA.
| | - Tracy Punshon
- Department of Biological Sciences, Dartmouth College, Hanover, NH, 03755, USA
| | - Matt Davis
- Department of Systems, Populations and Leadership, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Catherine M Bulka
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Francis Slaughter
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, NH, 03756, USA
| | - Despina Karalis
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, NH, 03756, USA
| | - Maria Argos
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Habibul Ahsan
- Department of Public Health Sciences, University of Chicago, Chicago, IL, 60637, USA
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12
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Yang J, McDowell A, Kim EK, Seo H, Lee WH, Moon CM, Kym SM, Lee DH, Park YS, Jee YK, Kim YK. Development of a colorectal cancer diagnostic model and dietary risk assessment through gut microbiome analysis. Exp Mol Med 2019; 51:1-15. [PMID: 31582724 PMCID: PMC6802675 DOI: 10.1038/s12276-019-0313-4] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 06/09/2019] [Accepted: 06/25/2019] [Indexed: 12/15/2022] Open
Abstract
Colorectal cancer (CRC) is the third most common form of cancer and poses a critical public health threat due to the global spread of westernized diets high in meat, cholesterol, and fat. Although the link between diet and colorectal cancer has been well established, the mediating role of the gut microbiota remains elusive. In this study, we sought to elucidate the connection between the gut microbiota, diet, and CRC through metagenomic analysis of bacteria isolated from the stool of CRC (n = 89) and healthy (n = 161) subjects. This analysis yielded a dozen genera that were significantly altered in CRC patients, including increased Bacteroides, Fusobacterium, Dorea, and Porphyromonas prevalence and diminished Pseudomonas, Prevotella, Acinetobacter, and Catenibacterium carriage. Based on these altered genera, we developed two novel CRC diagnostic models through stepwise selection and a simplified model using two increased and two decreased genera. As both models yielded strong AUC values above 0.8, the simplified model was applied to assess diet-based CRC risk in mice. Mice fed a westernized high-fat diet (HFD) showed greater CRC risk than mice fed a regular chow diet. Furthermore, we found that nonglutinous rice, glutinous rice, and sorghum consumption reduced CRC risk in HFD-fed mice. Collectively, these findings support the critical mediating role of the gut microbiota in diet-induced CRC risk as well as the potential of dietary grain intake to reduce microbiota-associated CRC risk. Further study is required to validate the diagnostic prediction models developed in this study as well as the preventive potential of grain consumption to reduce CRC risk.
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Affiliation(s)
- Jinho Yang
- MD Healthcare Inc., Seoul, Republic of Korea
- Department of Health and Safety Convergence Science, Korea University, Seoul, Republic of Korea
| | | | | | - Hochan Seo
- MD Healthcare Inc., Seoul, Republic of Korea
| | - Won Hee Lee
- MD Healthcare Inc., Seoul, Republic of Korea
| | - Chang-Mo Moon
- Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Sung-Min Kym
- Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Dong Ho Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - Young Soo Park
- Department of Internal Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - Young-Koo Jee
- Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea.
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13
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Marciniak W, Derkacz R, Muszyńska M, Baszuk P, Gronwald J, Huzarski T, Cybulski C, Jakubowska A, Falco M, Dębniak T, Lener M, Oszurek O, Pullella K, Kotsopoulos J, Sun P, Narod SA, Lubiński J. Blood arsenic levels and the risk of familial breast cancer in Poland. Int J Cancer 2019; 146:2721-2727. [PMID: 31348523 PMCID: PMC7154768 DOI: 10.1002/ijc.32595] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 06/05/2019] [Accepted: 06/18/2019] [Indexed: 12/31/2022]
Abstract
Arsenic is recognized as a potent carcinogen at high concentrations, but the relationship between environmental arsenic and breast cancer risk has not well been studied. Most research has focused on the effect of arsenic in populations with high endemic exposure, and not in populations with arsenic levels within normal limits. We sought to determine if blood arsenic levels predict the risk of breast and other cancers risk among women in northern Poland. The cohort consisted of 1,702 healthy women, aged 40 and above, identified between 2010 and 2017. Blood arsenic level was determined by inductively coupled plasma mass spectrometry. After an average of 4.5 years of follow‐up (range 0.7–7.3 years), there were 110 incident cases of cancer diagnosed in the cohort, including 68 cases of breast cancer. Women in the highest quartile of arsenic had a highly significant 13‐fold increased risk of developing breast cancer, compared to women in the lowest quartile (hazard ratio [HR] = 13.2; 95% confidence interval [CI] 4.02–43.0). Results were similar for arsenic and all incident cancers (HR quartile 4 vs. quartile 1 = 13.3; 95% CI 4.78–37.0). If confirmed, our study suggests that the blood arsenic level may be a useful predictive marker of cancer risk in women. What's new? Arsenic has long been recognized as a potent carcinogen at high concentrations. But can it affect cancer risk at “normal,” environmental concentrations? In this Polish study, the authors found that women whose blood levels of arsenic were in the highest quartile had a 13‐fold increased risk of developing breast cancer, compared to women in the lowest quartile. If confirmed in further studies, these results suggests that blood arsenic level may be a useful predictive marker of cancer risk in women.
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Affiliation(s)
- Wojciech Marciniak
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland.,Read-Gene SA, Grzepnica, Poland
| | - Róża Derkacz
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland.,Read-Gene SA, Grzepnica, Poland
| | - Magdalena Muszyńska
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland.,Read-Gene SA, Grzepnica, Poland
| | - Piotr Baszuk
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland.,Read-Gene SA, Grzepnica, Poland
| | - Jacek Gronwald
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland.,Read-Gene SA, Grzepnica, Poland
| | - Tomasz Huzarski
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland.,Read-Gene SA, Grzepnica, Poland.,Department of Clinical Genetics and Pathology, University of Zielona Góra, Zielona Góra, Poland
| | - Cezary Cybulski
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland.,Read-Gene SA, Grzepnica, Poland
| | - Anna Jakubowska
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland.,Read-Gene SA, Grzepnica, Poland
| | - Michał Falco
- Radiation Oncology Department, West Pomeranian Oncology Center, Szczecin, Poland
| | - Tadeusz Dębniak
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland.,Read-Gene SA, Grzepnica, Poland
| | - Marcin Lener
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Oleg Oszurek
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | | | - Joanne Kotsopoulos
- Women's College Research Institute, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Ping Sun
- Women's College Research Institute, Toronto, Ontario, Canada
| | - Steven A Narod
- Women's College Research Institute, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Jan Lubiński
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland.,Read-Gene SA, Grzepnica, Poland
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14
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Fang X, Sun R, Hu Y, Wang H, Guo Y, Yang B, Pi J, Xu Y. miRNA-182-5p, via HIF2α, contributes to arsenic carcinogenesis: evidence from human renal epithelial cells. Metallomics 2019; 10:1607-1617. [PMID: 30334557 DOI: 10.1039/c8mt00251g] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Chronic exposure to high levels of arsenic has been associated with high risks for many cancers, including renal cell carcinoma (RCC). However the underlying mechanisms are not clear. In the present study, chronic arsenite exposure (2 μM or 5 μM, 30 weeks) induced malignant transformation of HK-2 human renal epithelial cells as indicated by elevated colony formation (6.2- and 5.4-fold increase, respectively), secreted MMP-9 activity (10.1- and 11.3-fold increase, respectively) and proliferation rate (1.2- and 1.3-fold increase in 72 h, respectively). Lipid accumulation, typical of clear cell RCC, was observed in arsenic-transformed (As-TM) cells. Overexpression of hypoxia-inducible factor 2α (HIF2α) and suppression of carnitine palmitoyltransferase 1A (CPT1A) were found at the level of mRNA (1.5- and 0.49-fold of control, respectively) and protein (4.0- and 0.28-fold of control, respectively) after exposure to 2 μM arsenite for 20 weeks. Silencing of HIF2α significantly attenuated arsenite-induced malignant phenotypes and lipid accumulation. Inactivation of Von Hippel-Lindau (VHL) and impaired protein degradation of HIF2α were not found in As-TM cells. Expression of miR-182-5p and miR-802 in As-TM cells was 42.4% and 54.0% of control, respectively (p < 0.05). The levels of mRNA and protein of HIF2α were increased 2.4 folds and 1.6 folds of negative control in response to the miR-182-5p inhibitor, respectively, but decreased to 58.1% and 50.1% of negative control in response to miR-182-5p mimics, respectively. No significant alteration was observed in HIF2α expression when miR-802 was silenced. Our data provide further evidence for the carcinogenic role of arsenic in the kidney. Moreover, the miR-182-5p/HIF2α pathway is indicated to be involved in malignant transformation of human renal epithelial cells under arsenite exposure.
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Affiliation(s)
- Xin Fang
- School of Public Health, China Medical University, No. 77 Puhe Road, Shenbei New District, Shenyang, Liaoning, P. R. China110122.
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15
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Oberoi S, Devleesschauwer B, Gibb HJ, Barchowsky A. Global burden of cancer and coronary heart disease resulting from dietary exposure to arsenic, 2015. ENVIRONMENTAL RESEARCH 2019; 171:185-192. [PMID: 30665120 DOI: 10.1016/j.envres.2019.01.025] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 01/08/2019] [Accepted: 01/10/2019] [Indexed: 06/09/2023]
Abstract
Arsenic is a ubiquitous, naturally occurring metalloid that poses a significant risk for human cancer and non-cancer diseases. It is now evident that arsenic contamination in food, especially rice and grains, presents a significant exposure to hundreds of millions of individuals worldwide. However, the disease risk from chronic exposure to the low amounts of arsenic found in food remains to be established. Thus, this research estimates the global burdens of disease expressed as Disability-Adjusted Life Years (DALYs) for lung, skin and bladder cancers, as well as coronary heart disease (CHD) attributable to inorganic arsenic in food. To determine foodborne inorganic arsenic exposures worldwide, we used the World Health Organization (WHO) estimates of food consumption in 17 country clusters, in conjunction with the reported measurements of total and inorganic arsenic in different foods. We estimated cancer potency factors for arsenic related bladder and lung cancers, and from US Environmental Protection Agency risk estimates for skin cancer to calculate the cancer incidence in males and females within each of the WHO member states. Summary relative risk estimates and population attributable fractions were developed to estimate the YLD, YLL, and DALYs for arsenic-induced CHD. The findings indicate that, globally, each year the combined DALYs for all cancers attributable to inorganic arsenic in food are approximately 1.4 million with variation in global distribution based on population and food consumption patterns. The global burden of CHD attributable to foodborne inorganic arsenic also varied with WHO region and may contribute as much as 49 million DALYs. However, in contrast to cancer burden, there is a threshold effect for arsenic-associated CHD with no increased risk of heart disease at the expected lower bound of arsenic consumption in food. These estimates indicate that foodborne arsenic exposure causes a significant yet avoidable global burden of human disease.
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Affiliation(s)
- Shilpi Oberoi
- Department of Environmental and Occupational Health, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium; Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
| | - Herman J Gibb
- Gibb Epidemiology Consulting LLC, Arlington, VA, USA; George Washington University Milken Institute School of Public Health, Washington, D.C., USA
| | - Aaron Barchowsky
- Department of Pharmacology and Chemical Biology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Department of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, PA, USA
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16
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Tsuji JS, Chang ET, Gentry PR, Clewell HJ, Boffetta P, Cohen SM. Dose-response for assessing the cancer risk of inorganic arsenic in drinking water: the scientific basis for use of a threshold approach. Crit Rev Toxicol 2019; 49:36-84. [DOI: 10.1080/10408444.2019.1573804] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
| | - Ellen T. Chang
- Exponent, Inc., Menlo Park, CA and Stanford Cancer Institute, Stanford, CA, USA
| | | | | | - Paolo Boffetta
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Samuel M. Cohen
- Havlik-Wall Professor of Oncology, Department of Pathology and Microbiology and the Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA
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17
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18
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Signes-Pastor AJ, Scot Zens M, Seigne J, Schned A, Karagas MR. Rice Consumption and Incidence of Bladder Cancer in the United States Population. Epidemiology 2019; 30:e4-e5. [PMID: 30721170 PMCID: PMC6368392 DOI: 10.1097/ede.0000000000000955] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Antonio J Signes-Pastor
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Lebanon, New Hampshire Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Lebanon, New Hampshire,
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19
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Xiao Y, Ke Y, Wu S, Huang S, Li S, Lv Z, Yeoh EK, Lao X, Wong S, Kim JH, Colditz GA, Tamimi RM, Su X. Association between whole grain intake and breast cancer risk: a systematic review and meta-analysis of observational studies. Nutr J 2018; 17:87. [PMID: 30241536 PMCID: PMC6201708 DOI: 10.1186/s12937-018-0394-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 04/04/2018] [Indexed: 12/29/2022] Open
Abstract
Background Epidemiological studies have found that high whole grain intake may be associated with a reduced risk of breast cancer. However, the evidence has not been consistent. We conducted a meta-analysis to quantitatively assess the association between whole grain intake and breast cancer risk. Methods Relevant observational studies were identified by searching PubMed, Embase, Cochrane library databases, and Google Scholar through April 2017. Summary relative risk (RR) estimates were calculated using random-effects meta-analysis. Results A total of 11 studies, including 4 cohort and 7 case-control studies and involving 131,151 participants and 11,589 breast cancer cases, were included in the current meta-analysis. The pooled RR of breast cancer for those with high versus low whole grain intake was 0.84 (95% confidence interval [CI]: 0.74 to 0.96, p = 0.009; I2 = 63.8%, pfor heterogeneity = 0.002). Subgroup analysis by study design found a significant inverse association in the case-control studies (RR: 0.69; 95% CI: 0.56 to 0.87, p = 0.001; I2 = 58.2%, p for heterogeneity = 0.026), but not in the cohort studies (RR, 0.96; 95% CI: 0.82 to 1.14, p = 0.69; I2 = 66.7%, p for heterogeneity = 0.029). In addition, stratified analysis suggested that sample size could be a potential source of heterogeneity. Conclusions Results of the current meta-analysis suggest that high intake of whole grains might be inversely associated with a reduced risk of breast cancer, and the inverse association was only observed in case-control but not cohort studies. More large-scale cohort studies are needed to confirm the inverse association observed. Electronic supplementary material The online version of this article (10.1186/s12937-018-0394-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yunjun Xiao
- Shenzhen Key Laboratory of Molecular Epidemiology, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Yuebin Ke
- Shenzhen Key Laboratory of Molecular Epidemiology, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Shuang Wu
- Shenzhen Key Laboratory of Molecular Epidemiology, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Suli Huang
- Shenzhen Key Laboratory of Molecular Epidemiology, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Siguo Li
- Shenzhen Key Laboratory of Molecular Epidemiology, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Ziquan Lv
- Shenzhen Key Laboratory of Molecular Epidemiology, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Eng-Kiong Yeoh
- School of Public Health and Primary Care, Faculty of Medicine, School of Public Health, Prince of Wales Hospital, The Chinese University of Hong Kong, Room 508, Shatin, New Territories, Hong Kong, China
| | - Xiangqian Lao
- School of Public Health and Primary Care, Faculty of Medicine, School of Public Health, Prince of Wales Hospital, The Chinese University of Hong Kong, Room 508, Shatin, New Territories, Hong Kong, China
| | - Samuel Wong
- School of Public Health and Primary Care, Faculty of Medicine, School of Public Health, Prince of Wales Hospital, The Chinese University of Hong Kong, Room 508, Shatin, New Territories, Hong Kong, China
| | - Jean Hee Kim
- School of Public Health and Primary Care, Faculty of Medicine, School of Public Health, Prince of Wales Hospital, The Chinese University of Hong Kong, Room 508, Shatin, New Territories, Hong Kong, China
| | - Graham A Colditz
- Alvin J. Siteman Cancer Center and Department of Surgery, Washington University School of Medicine, St. Louis, USA
| | - Rulla M Tamimi
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA. .,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA.
| | - Xuefen Su
- School of Public Health and Primary Care, Faculty of Medicine, School of Public Health, Prince of Wales Hospital, The Chinese University of Hong Kong, Room 508, Shatin, New Territories, Hong Kong, China.
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20
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Nachman KE, Punshon T, Rardin L, Signes-Pastor AJ, Murray CJ, Jackson BP, Guerinot ML, Burke TA, Chen CY, Ahsan H, Argos M, Cottingham KL, Cubadda F, Ginsberg GL, Goodale BC, Kurzius-Spencer M, Meharg AA, Miller MD, Nigra AE, Pendergrast CB, Raab A, Reimer K, Scheckel KG, Schwerdtle T, Taylor VF, Tokar EJ, Warczak TM, Karagas MR. Opportunities and Challenges for Dietary Arsenic Intervention. ENVIRONMENTAL HEALTH PERSPECTIVES 2018; 126:84503. [PMID: 30235424 PMCID: PMC6375412 DOI: 10.1289/ehp3997] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 07/16/2018] [Accepted: 07/20/2018] [Indexed: 05/18/2023]
Abstract
The diet is emerging as the dominant source of arsenic exposure for most of the U.S. population. Despite this, limited regulatory efforts have been aimed at mitigating exposure, and the role of diet in arsenic exposure and disease processes remains understudied. In this brief, we discuss the evidence linking dietary arsenic intake to human disease and discuss challenges associated with exposure characterization and efforts to quantify risks. In light of these challenges, and in recognition of the potential longer-term process of establishing regulation, we introduce a framework for shorter-term interventions that employs a field-to-plate food supply chain model to identify monitoring, intervention, and communication opportunities as part of a multisector, multiagency, science-informed, public health systems approach to mitigation of dietary arsenic exposure. Such an approach is dependent on coordination across commodity producers, the food industry, nongovernmental organizations, health professionals, researchers, and the regulatory community. https://doi.org/10.1289/EHP3997.
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Affiliation(s)
- Keeve E Nachman
- Risk Sciences and Public Policy Institute, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
- Johns Hopkins Center for a Livable Future, Johns Hopkins University, Baltimore, Maryland, USA
| | - Tracy Punshon
- Department of Biological Sciences, Dartmouth College, Hanover, New Hampshire, USA
- Dartmouth Superfund Research Program, Hanover, New Hampshire, USA
- Dartmouth Children's Environmental Health and Disease Prevention Research Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
| | - Laurie Rardin
- Dartmouth Superfund Research Program, Hanover, New Hampshire, USA
| | - Antonio J Signes-Pastor
- Dartmouth Superfund Research Program, Hanover, New Hampshire, USA
- Dartmouth Children's Environmental Health and Disease Prevention Research Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Carolyn J Murray
- Dartmouth Children's Environmental Health and Disease Prevention Research Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
| | - Brian P Jackson
- Dartmouth Superfund Research Program, Hanover, New Hampshire, USA
- Department of Earth Sciences, Dartmouth College, Hanover, New Hampshire, USA
| | - Mary Lou Guerinot
- Department of Biological Sciences, Dartmouth College, Hanover, New Hampshire, USA
| | - Thomas A Burke
- Risk Sciences and Public Policy Institute, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Celia Y Chen
- Department of Biological Sciences, Dartmouth College, Hanover, New Hampshire, USA
- Dartmouth Superfund Research Program, Hanover, New Hampshire, USA
| | - Habibul Ahsan
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois, USA
| | - Maria Argos
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois, USA
| | - Kathryn L Cottingham
- Department of Biological Sciences, Dartmouth College, Hanover, New Hampshire, USA
- Dartmouth Children's Environmental Health and Disease Prevention Research Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
| | - Francesco Cubadda
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità - Italian National Institute of Health, Rome, Italy
| | - Gary L Ginsberg
- Yale School of Public Health, 60 College St, New Haven, Connecticut, USA
| | - Britton C Goodale
- Dartmouth Superfund Research Program, Hanover, New Hampshire, USA
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Margaret Kurzius-Spencer
- Department of Pediatrics, College of Medicine, University of Arizona, Tucson, Arizona, USA
- Department of Community, Environment and Policy, Mel & Enid College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Andrew A Meharg
- Institute for Global Food Security, Queen's University Belfast, David Keir Building, Malone Road, Belfast, BT9 5BN, Northern Ireland, UK
| | - Mark D Miller
- Western States Pediatric Environmental Health Specialty Unit, University of California, San Francisco, San Francisco, California, USA
| | - Anne E Nigra
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
| | | | - Andrea Raab
- Department of Chemistry, University of Aberdeen, Aberdeen, UK
| | - Ken Reimer
- Royal Military College, Kingston, Ontario, Canada
| | - Kirk G Scheckel
- Land and Materials Management Division, National Risk Management Research Laboratory, United States Environmental Protection Agency, Cincinnati, Ohio, USA
| | - Tanja Schwerdtle
- Institute of Nutritional Sciences, University of Potsdam, Germany
| | - Vivien F Taylor
- Dartmouth Superfund Research Program, Hanover, New Hampshire, USA
- Department of Earth Sciences, Dartmouth College, Hanover, New Hampshire, USA
| | - Erik J Tokar
- National Toxicology Program Laboratory, National Toxicology Program, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Todd M Warczak
- Department of Biological Sciences, Dartmouth College, Hanover, New Hampshire, USA
| | - Margaret R Karagas
- Dartmouth Superfund Research Program, Hanover, New Hampshire, USA
- Dartmouth Children's Environmental Health and Disease Prevention Research Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
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21
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Bolan S, Kunhikrishnan A, Chowdhury S, Seshadri B, Naidu R, Ok YS. Comparative analysis of speciation and bioaccessibility of arsenic in rice grains and complementary medicines. CHEMOSPHERE 2017; 182:433-440. [PMID: 28528310 DOI: 10.1016/j.chemosphere.2017.04.126] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 04/07/2017] [Accepted: 04/24/2017] [Indexed: 06/07/2023]
Abstract
In many countries, rice grains and complementary medicines are important sources of arsenic (As) consumption. The objective of this study was to compare the speciation and bioaccessibility of As in selected rice grains and complementary medicines. A number of rice grain samples, and a range of herbal and ayurvedic medicines were analyzed for total As, speciation of As using sequential fractionation and extended x-ray absorption fine structure (EXAFS) techniques, and bioaccessibility of As using an in vitro extraction test. The daily intake of As through the uptake of these As sources was compared with the safety guidelines for As. The results demonstrated higher levels of As in ayurvedic medicines compared to herbal medicines and rice grains. The sequential fractionation showed the dominance of organic-bound As species in rice grains and herbal medicines, however, inorganic-bound As species dominated the ayurvedic medicines. This implies that As is derived from plant uptake in herbal medicines and rice grains, and from inorganic mineral input in ayurvedic medicines. Arsenic bioaccessibility was higher in ayurvedic than herbal medicines and rice grains, suggesting that inorganic As added as a mineral therapeutic input is more bioaccessible than organic As species derived from plant uptake. This study also showed a positive relationship between soluble As fractions and bioaccessibility indicating that solubility is an important factor controlling bioaccessibility. The daily intake values for As as estimated by total As content are likely to exceed the safe threshold level in rice grains that are enriched with As.
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Affiliation(s)
- S Bolan
- Global Centre for Environmental Remediation, University of Newcastle, NSW 2308, Australia; Cooperative Research Centre for Contamination Assessment and Remediation of the Environment (CRC CARE), University of Newcastle, NSW 2308, Australia
| | - A Kunhikrishnan
- Department of Agro-Food Safety, National Institute of Agricultural Science, Wanju, Jeollabuk-do 55365, Republic of Korea
| | - S Chowdhury
- Department of Soil Science, Sher-e-Bangla Agricultural University, Dhaka 1207, Bangladesh
| | - B Seshadri
- Global Centre for Environmental Remediation, University of Newcastle, NSW 2308, Australia; Cooperative Research Centre for Contamination Assessment and Remediation of the Environment (CRC CARE), University of Newcastle, NSW 2308, Australia.
| | - R Naidu
- Global Centre for Environmental Remediation, University of Newcastle, NSW 2308, Australia; Cooperative Research Centre for Contamination Assessment and Remediation of the Environment (CRC CARE), University of Newcastle, NSW 2308, Australia
| | - Y S Ok
- O-Jeong Eco-Resilience Institute (OJERI), Division of Environmental Science and Ecological Engineering, Korea University, Seoul, Republic of Korea.
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Aoki Y, Yee J, Mortensen ME. Blood cadmium by race/hispanic origin: The role of smoking. ENVIRONMENTAL RESEARCH 2017; 155:193-198. [PMID: 28231546 PMCID: PMC5615218 DOI: 10.1016/j.envres.2017.02.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 02/14/2017] [Accepted: 02/16/2017] [Indexed: 05/27/2023]
Abstract
BACKGROUND There have been increasing concerns over health effects of low level exposure to cadmium, especially those on bones and kidneys. OBJECTIVE To explore how age-adjusted geometric means of blood cadmium in adults varied by race/Hispanic origin, sex, and smoking status among U.S. adults and the extent to which the difference in blood cadmium by race/Hispanic origin and sex may be explained by intensity of smoking, a known major source of cadmium exposure. METHODS Our sample included 7,368 adults from National Health and Nutrition Examination Survey (NHANES) 2011-2014. With direct age adjustment, geometric means of blood cadmium and number of cigarettes smoked per day were estimated for subgroups defined by race/Hispanic origin, smoking status, and sex using interval regression, which allows mean estimation in the presence of left- and right-censoring. RESULTS Among never and former smoking men and women, blood cadmium tended to be higher for non-Hispanic Asian adults than adults of other race/Hispanic origin. Among current smokers, who generally had higher blood cadmium than never and former smokers, non-Hispanic white, black, and Asian adults had similarly elevated blood cadmium compared to Hispanic adults. A separate analysis revealed that non-Hispanic white adults tended to have the highest smoking intensity regardless of sex, than adults of the other race/Hispanic origin groups. CONCLUSIONS The observed pattern provided evidence for smoking as a major source of cadmium exposure, yet factors other than smoking also appeared to contribute to higher blood cadmium of non-Hispanic Asian adults.
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Affiliation(s)
- Yutaka Aoki
- Centers for Disease Control and Prevention, National Center for Health Statistics, Division of Health and Nutrition Examination Surveys, 3311 Toledo Rd, Hyattsville, MD 20782, USA.
| | - Jennifer Yee
- Centers for Disease Control and Prevention, National Center for Health Statistics, Division of Health and Nutrition Examination Surveys, 3311 Toledo Rd, Hyattsville, MD 20782, USA; Centers for Disease Control and Prevention, Center for Surveillance, Epidemiology, and Laboratory Services, Division of Scientific Education and Professional Development, Epidemiology Elective Program, MS E-92, 1600 Clifton Rd, NE, Atlanta, GA 30329, USA; Georgetown University Medical Center, Department of Family Medicine, 4000 Reservoir Road, N.W., Washington D.C 20057, USA
| | - Mary E Mortensen
- Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Laboratory Sciences, MS F-20, 4770 Buford Highway, Atlanta, GA 30341, USA
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Azam SMGG, Sarker TC, Naz S. Factors affecting the soil arsenic bioavailability, accumulation in rice and risk to human health: a review. Toxicol Mech Methods 2016; 26:565-579. [DOI: 10.1080/15376516.2016.1230165] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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24
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Lifetime grain consumption and breast cancer risk. Breast Cancer Res Treat 2016; 159:335-45. [PMID: 27510186 DOI: 10.1007/s10549-016-3910-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 07/11/2016] [Indexed: 10/21/2022]
Abstract
We evaluated individual grain-containing foods and whole and refined grain intake during adolescence, early adulthood, and premenopausal years in relation to breast cancer risk in the Nurses' Health Study II. Grain-containing food intakes were reported on a baseline dietary questionnaire (1991) and every 4 years thereafter. Among 90,516 premenopausal women aged 27-44 years, we prospectively identified 3235 invasive breast cancer cases during follow-up to 2013. 44,263 women reported their diet during high school, and from 1998 to 2013, 1347 breast cancer cases were identified among these women. Cox proportional hazards regression was used to estimate relative risks (RR) and 95 % confidence intervals (95 % CI) of breast cancer for individual, whole and refined grain foods. After adjusting for known breast cancer risk factors, adult intake of whole grain foods was associated with lower premenopausal breast cancer risk (highest vs. lowest quintile: RR 0.82; 95 % CI 0.70-0.97; P trend = 0.03), but not postmenopausal breast cancer. This association was no longer significant after further adjustment for fiber intake. The average of adolescent and early adulthood whole grain food intake was suggestively associated with lower premenopausal breast cancer risk (highest vs lowest quintile: RR 0.74; 95 % CI 0.56-0.99; P trend = 0.09). Total refined grain food intake was not associated with risk of breast cancer. Most individual grain-containing foods were not associated with breast cancer risk. The exceptions were adult brown rice which was associated with lower risk of overall and premenopausal breast cancer (for each 2 servings/week: RR 0.94; 95 % CI 0.89-0.99 and RR 0.91; 95 % CI 0.85-0.99, respectively) and adult white bread intake which was associated with increased overall breast cancer risk (for each 2 servings/week: RR 1.02; 95 % CI 1.01-1.04), as well as breast cancer before and after menopause. Further, pasta intake was inversely associated with overall breast cancer risk. Our results suggest that high whole grain food intake may be associated with lower breast cancer risk before menopause. Fiber in whole grain foods may mediate the association with whole grains.
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Aune D, Keum N, Giovannucci E, Fadnes LT, Boffetta P, Greenwood DC, Tonstad S, Vatten LJ, Riboli E, Norat T. Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies. BMJ 2016; 353:i2716. [PMID: 27301975 PMCID: PMC4908315 DOI: 10.1136/bmj.i2716] [Citation(s) in RCA: 532] [Impact Index Per Article: 66.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To quantify the dose-response relation between consumption of whole grain and specific types of grains and the risk of cardiovascular disease, total cancer, and all cause and cause specific mortality. DATA SOURCES PubMed and Embase searched up to 3 April 2016. STUDY SELECTION Prospective studies reporting adjusted relative risk estimates for the association between intake of whole grains or specific types of grains and cardiovascular disease, total cancer, all cause or cause specific mortality. DATA SYNTHESIS Summary relative risks and 95% confidence intervals calculated with a random effects model. RESULTS 45 studies (64 publications) were included. The summary relative risks per 90 g/day increase in whole grain intake (90 g is equivalent to three servings-for example, two slices of bread and one bowl of cereal or one and a half pieces of pita bread made from whole grains) was 0.81 (95% confidence interval 0.75 to 0.87; I(2)=9%, n=7 studies) for coronary heart disease, 0.88 (0.75 to 1.03; I(2)=56%, n=6) for stroke, and 0.78 (0.73 to 0.85; I(2)=40%, n=10) for cardiovascular disease, with similar results when studies were stratified by whether the outcome was incidence or mortality. The relative risks for morality were 0.85 (0.80 to 0.91; I(2)=37%, n=6) for total cancer, 0.83 (0.77 to 0.90; I(2)=83%, n=11) for all causes, 0.78 (0.70 to 0.87; I(2)=0%, n=4) for respiratory disease, 0.49 (0.23 to 1.05; I(2)=85%, n=4) for diabetes, 0.74 (0.56 to 0.96; I(2)=0%, n=3) for infectious diseases, 1.15 (0.66 to 2.02; I(2)=79%, n=2) for diseases of the nervous system disease, and 0.78 (0.75 to 0.82; I(2)=0%, n=5) for all non-cardiovascular, non-cancer causes. Reductions in risk were observed up to an intake of 210-225 g/day (seven to seven and a half servings per day) for most of the outcomes. Intakes of specific types of whole grains including whole grain bread, whole grain breakfast cereals, and added bran, as well as total bread and total breakfast cereals were also associated with reduced risks of cardiovascular disease and/or all cause mortality, but there was little evidence of an association with refined grains, white rice, total rice, or total grains. CONCLUSIONS This meta-analysis provides further evidence that whole grain intake is associated with a reduced risk of coronary heart disease, cardiovascular disease, and total cancer, and mortality from all causes, respiratory diseases, infectious diseases, diabetes, and all non-cardiovascular, non-cancer causes. These findings support dietary guidelines that recommend increased intake of whole grain to reduce the risk of chronic diseases and premature mortality.
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Affiliation(s)
- Dagfinn Aune
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - NaNa Keum
- Department of Nutrition, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Edward Giovannucci
- Department of Nutrition, Harvard T H Chan School of Public Health, Boston, MA, USA Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Lars T Fadnes
- Centre for International Health, Department of Global Public Health and Primary Care and Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Paolo Boffetta
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Darren C Greenwood
- Biostatistics Unit, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, UK
| | - Serena Tonstad
- Section of Preventive Cardiology, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital Ullevål, Oslo, Norway
| | - Lars J Vatten
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Teresa Norat
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
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Scrafford CG, Barraj LM, Tsuji JS. Considerations when using longitudinal cohort studies to assess dietary exposure to inorganic arsenic and chronic health outcomes. Food Chem Toxicol 2016; 93:111-8. [PMID: 27155067 DOI: 10.1016/j.fct.2016.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 04/26/2016] [Accepted: 05/04/2016] [Indexed: 11/17/2022]
Abstract
Dietary arsenic exposure and chronic health outcomes are of interest, due in part to increased awareness and data available on inorganic arsenic levels in some foods. Recent concerns regarding levels of inorganic arsenic, the primary form of arsenic of human health concern, in foods are based on extrapolation from adverse health effects observed at high levels of inorganic arsenic exposure; the potential for the occurrence of these health effects from lower levels of dietary inorganic arsenic exposure has not been established. In this review, longitudinal cohort studies are evaluated for their utility in estimating dietary inorganic arsenic exposure and quantifying statistically reliable associations with health outcomes. The primary limiting factor in longitudinal studies is incomplete data on inorganic arsenic levels in foods combined with the aggregation of consumption of foods with varying arsenic levels into a single category, resulting in exposure misclassification. Longitudinal cohort studies could provide some evidence to evaluate associations of dietary patterns related to inorganic arsenic exposure with risk of arsenic-related diseases. However, currently available data from longitudinal cohort studies limit causal analyses regarding the association between inorganic arsenic exposure and health outcomes. Any conclusions should therefore be viewed with knowledge of the analytical and methodological limitations.
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Affiliation(s)
- Carolyn G Scrafford
- Center for Chemical Regulation and Food Safety, Exponent, Inc., 1150 Connecticut Avenue, NW, Washington DC, 20036, USA.
| | - Leila M Barraj
- Center for Chemical Regulation and Food Safety, Exponent, Inc., 1150 Connecticut Avenue, NW, Washington DC, 20036, USA
| | - Joyce S Tsuji
- Toxicology and Mechanistic Biology, Exponent, Inc., 15375 SE 30th Place, Suite 250, Bellevue, WA, 98007, USA
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