Vegetables, fruit, and cancer. II. Mechanisms

Adding a Leafy Vegetable Fraction to Diets Decreases the Risk of Red Meat Mortality in MASLD Subjects: Results from the MICOL Cohort

BACKGROUND

Dietary guidelines recommend limiting red meat intake because it has been amply associated with increased cancer mortality, particularly in patients with liver conditions, such as metabolic dysfunction-associated fatty liver disease (MASLD). MASLD is the leading cause of liver dysfunction in the world today, and no specific treatment other than lifestyle correction has yet been established. The aim of this study was to explore the protective role of leafy vegetables when associated with high red meat consumption.

METHODS

The study cohort included 1646 participants assessed during the fourth recall of the MICOL study, subdivided into two groups based on red meat intake (≤50 g/die vs. >50 g/die), in order to conduct a cancer mortality analysis. The prevalence of subjects that consumed >50 g/die was only 15.73%. Leafy vegetable intake was categorized based on median g/die consumption, and it was combined with red meat intake.

CONCLUSIONS

This is the first study to demonstrate that the consumption of about 30 g/die of leafy vegetables reduces the risk of mortality. A strong association with mortality was observed in subjects with MASLD, and the protective role of vegetables was demonstrated.

Dietary Factors Differ Between Young-Onset and Older-Onset Colorectal Cancer Patients

We aimed to evaluate differences in dietary factors between young-onset (diagnosed at ages <50) and older-onset colorectal cancer (CRC). CRC patients diagnosed from 1998 to 2018 reported to the Puget Sound Surveillance, Epidemiology, and End Results registry were recruited using mail and telephone. Consented patients completed questionnaires assessing demographics, medical history, and CRC risk factors, including dietary factors. We used multi-variable logistic regression to calculate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) comparing dietary intake in young-onset vs. older-onset CRC. Analyses included 1,087 young- and 2,554 older-onset CRC patients. Compared to older-onset CRC, young-onset CRC patients had lower intake of vegetables (OR for highest intake vs. lowest = 0.59 CI: 0.55, 0.64) and fruit (OR for highest intake vs. lowest = 0.94 CI: 0.88, 0.99) and higher intake of processed meat (OR for highest intake vs. lowest = 1.82 CI: 1.11, 2.99) and spicy food (OR for highest intake vs. lowest = 1.69 CI: 1.09, 2.61). There was no statistically significant difference between young- and older-onset CRC patients for red meat consumption. Dietary patterns differed between young- and older-onset CRC; young-onset CRC patients had lower intake of vegetables and fruit and higher intakes of processed meat and spicy food.

Healthy dietary patterns, genetic risk, and gastrointestinal cancer incident risk: a large-scale prospective cohort study

BACKGROUND

Dietary patterns have been associated with several cancers, especially gastrointestinal cancer (GIC). However, whether a healthy dietary pattern could modify the risk of GIC among people with different genetic backgrounds is not clear.

OBJECTIVE

The objective of the study was to investigate how dietary patterns and genetic susceptibility contribute to the risk of GIC independently and jointly.

METHODS

This large-scale prospective cohort study included 105,463 participants in UK Biobank who were aged 40-72 y and cancer-free at baseline. Dietary intake (Oxford WebQ) was used to calculate dietary pattern scores including dietary approach to stop hypertension (DASH) score and healthful plant-based diet index (hPDI). Genetic risk was quantified by a polygenic risk score (PRS) comprising 129 known GIC-associated loci. Cox proportional hazards regression was performed to estimate the associations of dietary patterns and PRS with GIC incidence after adjusting for potential confounders.

RESULTS

Over a median follow-up of 11.70 y, 1,661 participants were diagnosed with GIC. DASH and hPDI were associated with 20% and 36% reductions, respectively, in GIC risk. Low PRS was associated with a 30 % decrease in GIC risk (HR: 0.70; 95% CI: 0.62, 0.79). Participants with healthy dietary scores at high-genetic risk had a lower GIC risk with HR of 0.77 (95% CI: 0.60, 0.98) for DASH and 0.66 (95% CI: 0.52, 0.84) for hPDI than those with unhealthy dietary score. Participants with both high-dietary score and low-genetic risk showed the lowest risk of GIC, with HR of 0.58 (95% CI: 0.45, 0.75) for DASH and 0.45 (95% CI: 0.34, 0.58) for hPDI.

CONCLUSIONS

Adherence to DASH and hPDI were associated with a lower risk of some gastrointestinal cancers, and these 2 dietary patterns may partly compensate for genetic predispositions to cancer. Our results advance the development of precision medicine strategies that consider both dietary patterns and genetics to improve gastrointestinal health.

The Association between Circulating Carotenoids and Risk of Breast Cancer: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies

Carotenoids appear to have anticancer effects. Prospective evidence for the relation between serum carotenoids and breast cancer is controversial. The present systematic review and meta-analysis aimed to investigate the link between circulating carotenoids and the risk of breast cancer. We performed a systematic search of PubMed, Scopus, and Web of Science up to 30 November, 2022. Prospective studies on adults aged ≥18 y that have reported risk estimates for the association between circulating carotenoids and breast cancer risk were considered. Study quality was assessed using the Newcastle-Ottawa Scale. A random-effects model was used for combining studies' risk estimates. Dose-response relations were explored through a 1-stage random-effects model. Fifteen publications (17 nested case-control studies and 1 cohort study) with 20,188 participants and 7608 cases were included. We observed an inverse association between the highest level of circulating total carotenoids (relative risk [RR]: 0.76; 95% confidence interval [CI]: 0.62, 0.93; n = 8), α-carotene (RR: 0.77; 95% CI: 0.68, 0.87; n = 13), β-carotene (RR: 0.80; 95% CI: 0.65, 0.98; n = 15), β-cryptoxanthin (RR: 0.85; 95% CI: 0.74, 0.96; n = 11), lycopene (RR: 0.86; 95% CI: 0.76, 0.98; n = 13), and lutein (RR: 0.70; 95% CI: 0.52, 0.93; n = 6) and the risk of breast cancer compared with the lowest level. Additionally, each 10 μg/dL of total carotenoids, α-carotene, β-carotene, and β-cryptoxanthin was associated with 2%, 22%, 4%, and 10% lower risk of breast cancer, respectively. This relationship was stronger at lower levels of total carotenoids and β-cryptoxanthin. The certainty of evidence was rated from very low to low. Most studies were performed among Western nations, which should be acknowledged for extrapolation of findings. Total circulating carotenoids, α-carotene, β-carotene, β-cryptoxanthin, lycopene, and lutein seem to be related to a decreased risk of breast cancer. Our findings could have practical importance for public health. This study was registered at PROSPERO as CRD42023434983.

Role of Mediterranean diet in endocrine diseases: a joint overview by the endocrinologist and the nutritionist

PURPOSE

The purpose of this review is to examine the current evidence on the potential role of Mediterranean diet (MD) in the prevention and management of endocrine disorders and to highlight the importance of interdisciplinary collaboration between endocrinologists and nutritionists.

METHODS

A literature search was conducted using PubMed and Google Scholar databases to identify relevant studies published in English. Studies were selected based on their relevance to the role of MD in the prevention and management of endocrine disorders. The search terms included "Mediterranean diet," "endocrine disorders," "thyroid disorders," "gonadal disorders," and "neuroendocrine tumors".

RESULTS

The studies reviewed suggest that MD may have a beneficial effect in the prevention and management of various endocrine disorders, including thyroid disorders, gonadal disorders, and neuroendocrine tumors. MD has been associated with decreased risk of nodular thyroid disease and thyroid cancer, improved male and female reproductive health, and a potential role in the management of neuroendocrine tumors. MD's anti-inflammatory and antioxidant properties, as well as its high levels of phytochemicals, may play a role in its beneficial effects.

CONCLUSION

Interdisciplinary collaboration between endocrinologists and nutritionists is essential for the optimal management of endocrine disorders, including the potential role of MD in their prevention and management. While further research is needed, the current evidence suggests that MD may have a protective effect against endocrine disorders, and its incorporation into dietary recommendations may be beneficial.

Potential antitumor activity of garlic against colorectal cancer: focus on the molecular mechanisms of action

PURPOSE

The aim of this review is to highlight the potential of garlic phytoconstituents as antitumor agents in colorectal cancer management based on their molecular mechanisms of action, while asking if their consumption, as part of the human diet, might contribute to the prevention of colorectal cancer.

METHODS

To gather information on appropriate in vitro, in vivo and human observational studies on this topic, the keywords "Allium sativum", "garlic", "colorectal cancer", "antitumor effect", "in vitro", "in vivo", "garlic consumption" and "colorectal cancer risk" were searched in different combinations in the international databases ScienceDirect, PubMed and Google Scholar. After duplicate and reviews removal, 61 research articles and meta-analyses published between 2000 and 2022 in peer-reviewed journals were found and included in this review.

RESULTS

Garlic (Allium sativum) proves to be a rich source of compounds with antitumor potential. Garlic-derived extracts and several of its individual constituents, especially organosulfur compounds such as allicin, diallyl sulfide, diallyl disulfide, diallyl trisulfide, diallyl tetrasulfide, allylmethylsulfide, S-allylmercaptocysteine, Z-ajoene, thiacremonone and Se-methyl-L-selenocysteine were found to possess cytotoxic, cytostatic, antiangiogenic and antimetastatic activities in different in vitro and in vivo models of colorectal cancer. The molecular mechanisms for their antitumor effects are associated with the modulation of several well-known signaling pathways involved in cell cycle progression, especially G1-S and G2-M transitions, as well as both the intrinsic and extrinsic apoptotic pathways. However, even though in various animal models some of these compounds have chemopreventive effects, based on different human observational studies, a diet rich in garlic is not consistently associated with a lower risk of developing colorectal cancer.

CONCLUSION

Independent of the impact of garlic consumption on colorectal cancer initiation and promotion in humans, its constituents might be good candidates for future conventional and/or complementary therapies, based on their diverse mechanisms of action.

Association between Dietary Indices and Dietary Patterns and Mortality and Cancer Recurrence among Cancer Survivors: An Updated Systematic Review and Meta-Analysis of Cohort Studies

The number of cancer survivors is growing rapidly; however, specific lifestyle recommendations for these patients are still sparse, including dietary approaches. Thus, the aim of the present systematic review and meta-analysis was to examine the associations between adherence to diet-quality indices and dietary patterns on overall mortality, cancer-specific mortality, and cancer recurrence among cancer survivors. The literature search was conducted in PubMed and Web of Science between 18 May 2016 and 22 May 2022 with no language restrictions. Thirty-nine studies were included for quantitative analysis, providing data from 77,412 participants. Adherence to both diet-quality indices and a healthy/prudent dietary pattern was inversely associated with overall mortality (RR, 0.81; 95% CI, 0.77-0.86; RR, 0.80; 95% CI, 0.70-0.92, respectively) and with cancer-specific mortality (RR, 0.86; 95% CI, 0.79-0.94; RR, 0.79; 95% CI, 0.64-0.97, respectively). These associations could be observed following assessment of dietary patterns either pre- and/or postdiagnosis. For unhealthy/western dietary patterns, high adherence was associated with overall mortality (RR, 1.26; 95% CI, 1.08-1.47). Although the certainty of evidence was rated as low, we conclude that there are no reservations against high adherence to healthy dietary patterns or indices in cancer survivors.

Biochemical Evaluation of Some Fruit Characteristics of Blueberry Progenies Obtained from 'Simultan × Duke'

The popularity of Vaccinium corymbosum blueberry cv. has increased over time because its fruits are highly valued for their taste, aroma, and multiple ways of use. A field trial with two genotypes and their hybrids was organized during 2021-2022 at the Research Institute for Fruit Growing Pitesti-Maracineni, Romania. This paper proposes a comparative analysis of the quality of berries in 17 hybrids of the 'Simultan' and 'Duke' cultivars, selected by the size and the soluble solid content, in agreement with the objectives of the blueberry breeding program. The genotype influence on berry weight, total soluble solids, pH, vitamin C, total polyphenols, total flavonoids, total anthocyanins, lycopene, β-carotene, and antioxidant activity was determined considering the climatic factors. The results showed that fruit weight varied between 1.22 and 2.47 g, total soluble solids reached a maximum of 19.22 °Brix, and the pH oscillated between 3.14 and 3.89. Vitamin C content varied from 9.52 to 18.69 mg in 100 g fresh weight, with an average of 14.35 mg/100 g. Total polyphenol, flavonoid, and anthocyanin contents averaged 709.92 mg gallic acid equivalent in 100 g fresh weight, 165.48 mg catechin equivalent in 100 g fresh weight, and 81.88 mg cyanidin-3-O-glucoside equivalent in 100 g fresh weight, respectively. Results show that the strategy of growers to produce blueberries with a large diameter, visually attractive for traders and consumers, is not sufficient for repeat sales. Our study proves that large fruits do not have the highest content of bioactive compounds. Smaller berries had higher polyphenol, lycopene, and β-carotene contents. It is recommended that the selection of the hybrid in the breeding program also takes into account the content of bioactive compounds.

The role of rare earth elements and dietary intake in tongue cancer: a mediation analysis in southeast China

Objective

The current research aimed to examine how dietary intake and rare earth elements may affect the development of tongue cancer.

Methods

The serum levels of 10 rare earth elements (REEs) in 171 cases and 171 healthy matched controls were measured by inductively coupled plasma mass spectrometry (ICP-MS). The conditional logistic regression was used to examine the relationship between dietary intake, serum levels of 10 REEs, and tongue cancer. Mediation effect and multiplicative interaction analysis were then performed to estimate the potential contribution of REEs in dietary intake associated with tongue cancer.

Results

Compared with the control group, patients with tongue cancer consumed significantly less fish, seafood, fruit, green leafy vegetables, and non-green leafy vegetables, with higher serum praseodymium (Pr), dysprosium (Dy), and lanthanum (La) levels, and lower serum cerium (Ce) and scandium (Sc) levels. The interaction effect was observed between some REEs and food categories. Green vegetables' impact on the risk of tongue cancer is partially attributed to the La and Thorium (Th) elements (P < 0.05, the mediated proportion were 14.933% and 25.280%, respectively). The effect of non-green leafy vegetables for tongue cancer mediated via Pr, Dy, and Th (P < 0.05, the mediated proportion were 0.408%, 12.010%, and 8.969%, respectively), and the Sc components in seafood (P < 0.05, the mediated proportion was 26.120%) is partly responsible for their influence on the risk of tongue cancer.

Conclusion

The correlation between REEs and dietary intakes for tongue cancer is compact but intricate. Some REEs interact with food intake to influence tongue cancer, while others act as a mediator.

Dietary Factors and Early-Onset Colorectal Cancer in the United States-an Ecologic Analysis

BACKGROUND

Incidence of early-onset colorectal cancer (EOCRC; e.g., diagnosed before age 50) in the United States has increased substantially since the 1990s but the underlying reasons remain unclear.

METHODS

We examined the ecologic associations between dietary factors and EOCRC incidence in adults aged 25-49 during 1977-2016 in the United States, using negative binomial regression models, accounting for age, period, and race. The models also incorporated an age-mean centering (AMC) approach to address potential confounding by age. We stratified the analysis by sex and computed incidence rate ratio (IRR) for each study factor. Study factor data (for 18 variables) came from repeated national surveys; EOCRC incidence data came from the Surveillance Epidemiology, and End Results Program.

RESULTS

Results suggest that confounding by age on the association with EOCRC likely existed for certain study factors (e.g., calcium intake), and that AMC can alleviate the confounding. EOCRC incidence was positively associated with smoking [IRR (95% confidence interval (CI): 1.17 (1.10-1.24) for men; 1.15 (1.09-1.21) for women] and alcohol consumption [IRR (95% CI), 1.08 (1.04-1.12) for men; 1.08 (1.04-1.11) for women]. No strong associations were found for most other study factors (e.g., fiber and calcium).

CONCLUSIONS

Alcohol consumption was positively associated with EOCRC and has increased among young adults since the 1980s, which may have contributed to the EOCRC incidence increases since the 1990s. The AMC approach may help alleviate age confounding in similar ecologic analyses.

IMPACT

Increases in alcohol consumption may have contributed to the recent increases in colorectal cancer incidence among young adults. See related commentary by Ni et al., p. 164.

Vegetable and fruit intake and colorectal cancer risk by smoking status in adults: The Japan Public Health Center-based Prospective Study

BACKGROUND

Cigarette smoke contains many oxidants and free radicals which may affect the association between vegetable and fruit intake and colorectal cancer (CRC) risk. However, this relationship remains unclear.

OBJECTIVE

This study aimed to investigate the associations between vegetable and fruit intake and CRC risk by smoking status.

METHODS

The Japan Public Health Center-based Prospective Study is a population-based prospective cohort study. Participants completed a self-administered questionnaire in 1995-1999 (baseline survey) and were followed through to 2013. At the baseline survey, 89,283 residents (41,797 men and 47,486 women) aged 45-74 years were included. Participants were asked about their lifestyle and dietary habits. To investigate the association of vegetable and fruit intake with risk of CRC, Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). We analyzed the relationship between vegetable and fruit intake and CRC risk stratified by sex and smoking status.

RESULTS

During follow-up, 2261 participants were diagnosed with CRC. Overall, vegetable and fruit intake were not associated with CRC risk in either sex. When stratified by sex and smoking status, CRC risk among male never smokers was inversely associated with intake of vegetables and fruit combined (HR: 0.72; 95% CI: 0.53, 0.98; highest vs lowest quartile p trend = 0.01) and fruit alone (HR: 0.62; 95% CI: 0.45, 0.86; p trend < 0.01).

CONCLUSIONS

Cigarette smoking may affect the association between vegetable and fruit intake and CRC risk among men.

Esophagus cancer and essential trace elements

Numerous epidemiological and laboratory studies on essential trace elements have reported protective associations in developing various cancer types, including esophagus cancer (EC). However, the results are not always consistent. Some essential trace elements could play a vital role in preventing esophagus cancer. Some showed no association with esophageal cancer risk, while others harmed individuals. This article reviews the association between the intake or supplementation of essential trace elements (especially zinc, copper, iron, and selenium) and the risk of esophageal cancer. Generally, zinc intake may decrease the risk of esophageal cancer (EC), especially in high esophageal squamous cell carcinoma (ESCC) prevalence regions. The association between copper supplementation and EC remains uncertain. Total iron consumption is thought to be associated with lower EC risk, while heme iron intake may be associated with higher EC risk. Selenium intake showed a protective effect against EC, especially for those individuals with a low baseline selenium level. This review also prospects the research direction of the association between EC and essential trace elements.

Mediterranean Diet and Thyroid: An Interesting Alliance

The Mediterranean diet, recognized as being cultural heritage by UNESCO, is mostly plant-based and includes a high consumption of whole-grain, fruit, and vegetables with a moderate consumption of alcohol during meals. Thus, it provides a small amount of saturated fatty acids and a high quantity of antioxidants and fiber. For this reason, it has been considered to have an important role in preventing cardiovascular diseases, chronic kidney diseases, type 2 diabetes mellitus, and cancer, but its relationship with thyroid function and diseases is still under debate. The aim of this review was to search for the possible correlation between the Mediterranean diet and thyroid function, and to critically evaluate the pathophysiological link between selected food intake and thyroid disorders.

The influence of dietary vegetables and fruits on endometrial cancer risk: a meta-analysis of observational studies

Fruits and vegetables store many bioactive compounds and micronutrients, making their consumption ideal for maintaining good health. A previous meta-analysis in 2007 provided evidence that high vegetable and cruciferous vegetable intake might help prevent endometrial cancer (EC) development. The current study purposely explored the favorable effects of vegetables, fruits, and their other specific types using a review of the most recent papers. We conducted a systematic search through August 2021 in the PubMed and EMBASE databases on this topic, through which twenty-seven studies, consisting of 21 case-control and 6 cohort studies, were obtained. The results showed that vegetables (pooled odds ratio [OR], relative risk [RR], hazard ratio [HR] = 0.76, 95% confidence interval [CI] 0.63-0.91), cruciferous vegetables (pooled OR = 0.81, 95% CI 0.70-0.94), dark green and yellow/orange combined vegetables (pooled OR = 0.64, 95% CI 0.42-0.97), and fruits (pooled OR = 0.81, 95% CI 0.70-0.92) were strongly associated with a reduced risk of EC. These results were primarily based on studies of high quality and exhibited either by case-control only or a combination of case-control and cohort studies. Additionally, the results varied by geographic location, such as Western areas, the US, and Italy. This meta-analysis suggested that the consumption of fruits and vegetables has beneficial effects on EC risk and that specific kinds of fruits and vegetables should be recommended differently due to their outstanding bioactive components.

Adherence to a priori-Defined Diet Quality Indices Throughout the Early Disease Course Is Associated With Survival in Head and Neck Cancer Survivors: An Application Involving Marginal Structural Models

No studies, to date, have scrutinized the role of a priori dietary patterns on prognosis following a head and neck squamous cell carcinoma (HNSCC) diagnosis. The purpose of this analysis was to evaluate the associations between adherence to six a priori defined diet quality indices (including AHEI-2010, aMED, DASH, and three low-carbohydrate indices) throughout the first 3 years of observation and all-cause and cancer-specific mortalities in 468 newly diagnosed HNSCC patients from the University of Michigan Head and Neck Specialized Program of Research Excellence (UM-SPORE). The dietary intake data were measured using a food frequency questionnaire administered at three annual time points commencing at study entry. Deaths and their causes were documented throughout the study using various data sources. Marginal structural Cox proportional hazards models were used to evaluate the role of diet quality, as a time-varying covariate, on mortality. There were 93 deaths from all causes and 74 cancer-related deaths adjudicated throughout the observation period. There was a strong inverse association between adherence to the AHEI-2010, all-cause mortality (HR_Q5–Q1:0.07, 95% CI:0.01–0.43, p_trend:0.04), and cancer-specific mortality (HR_Q5–Q1:0.15, 95% CI:0.02–1.07, p_trend:0.04). Other more modest associations were noted for the low-carbohydrate indices. In sum, higher adherence to the AHEI-2010 and a plant-based low-carbohydrate index throughout the first 3 years since diagnosis may bolster survival and prognosis in newly diagnosed patients with HNSCC.

Diet and Risk of Gastric Cancer: An Umbrella Review

Several dietary exposures have been associated with gastric cancer (GC), but the associations are often heterogenous and may be afflicted by inherent biases. In the context of an Umbrella Review (UR), we provide an overview and a critical evaluation of the strength and quality, and evidence classification of the associations of diet-related exposures in relation to the risk of GC. We searched PubMed and Scopus for eligible meta-analyses of observational studies published in English from inception to 12 December 2021, and for any identified association, we applied robust epidemiological validity evaluation criteria and individual study quality assessment using AMSTAR. We screened 3846 titles/abstracts and assessed 501 full articles for eligibility, of which 49 were included in the analysis, investigating 147 unique exposures in relation to GC, cardia (GCC) or non-cardia (GNCC) cancer. Supported by suggestive evidence, positive associations were found comparing the highest vs. lowest categories for: heavy (>42 g/day) alcohol consumption (Relative Risk (RR) = 1.42, 95% Confidence Interval (CI): 1.20−1.67), salted fish consumption (RR = 1.56, 95% CI:1.30−1.87) and waist circumference (RR = 1.48, 95% CI:1.24−1.78) and an inverse association for the healthy lifestyle index (RR = 0.60, 95% CI:0.48−0.74) in relation to GC. Additionally, a positive association was found comparing obese individuals (Body Mass Index (BMI) ≥ 30) to normal-weight individuals (BMI: 18.5−25) (RR = 1.82, 95% CI:1.32−2.49) in relation to GCC. Most of the meta-analyses were of medium-to-high quality (median items: 7.0, interquartile range: 6−9). Maintaining a normal body weight and adopting healthy dietary choices, in particular, limiting the consumption of salt-preserved foods and alcohol, can reduce the risk of gastric cancer.

The association between adherence to MIND diet and risk of breast cancer: A case-control study

OBJECTIVES

Recently, a new eating pattern called "Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND)" has been coined. This study was aimed to examine the association between adherence to the MIND diet and risk of breast cancer (BC) among Iranian women.

METHODS

In this hospital-based case-control study, 150 newly diagnosed BC cases and 150 age-matched controls were included. All cases were pathologically confirmed BC patients, with no history of any type of other pathologically confirmed cancers. Controls were selected from visitors, relatives and friends of non-cancer patients in other wards, which had no family relationship with cases. Dietary intakes of study participants were assessed using a validated 147-item semi-quantitative food frequency questionnaire (FFQ). The MIND diet score was computed based on participants' dietary intakes obtained from FFQ, Regression logistic models were used to examine the association between the MIND diet score and BC.

RESULTS

Examining the whole study population, we found no significant association between the MIND diet score and odds of BC, either before (ORs for comparing T3 vs. T1: 0.818; 95% CI: 0.469-1.42, P-trend = .48) or after controlling for potential confounders (ORs for T3 vs. T1: 1.32; 95% CI: 0.31-5.64, P-trend = .633). This was also the case for pre-menopausal and post-menopausal when analyzed separately. We also failed to find any significant association between the MIND diet score and odds of BC after controlling for potential confounders in both pre-menopausal and post-menopausal.

CONCLUSION

In conclusion, we found that adherence to the MIND diet was not associated with odds of BC in this case-control study. Further studies are required to confirm these findings.

Cabbage and Sauerkraut Consumption in Adolescence and Adulthood and Breast Cancer Risk among US-Resident Polish Migrant Women

Background: Breast cancer (BC) incidence and mortality are lower in Poland than in the United States (US). However, Polish-born migrant women to US approach the higher BC mortality rates of US women. We evaluated the association between consumption of cabbage/sauerkraut foods and BC risk in Polish-born migrants to US. Methods: We conducted a case–control study of BC among Polish-born migrants in Cook County and the Detroit Metropolitan Area. Cases (n = 131) were 20–79 years old with histological/cytological confirmation of invasive BC. Population-based controls (n = 284) were frequency matched to cases on age and residence. Food frequency questionnaires assessed diet during adulthood and age 12–13 years. Odds ratios (OR) and 95% confidence intervals (95% CI) were estimated with conditional logistic regression. Consumption of total, raw/short-cooked, and long-cooked cabbage/sauerkraut foods was categorized as low, medium, or high (frequency of servings/week). Results: Higher consumption of total and raw/short-cooked cabbage/sauerkraut foods, during both adolescence and adulthood, was associated with a significantly lower BC risk. Consumption of long-cooked cabbage/sauerkraut foods was low and not significantly associated with risk. The multivariate OR for total cabbage/sauerkraut consumption, high vs. low (>4 vs. ≤2 servings/week) during adolescence was 0.36 (95% CI = 0.18–0.71, p_trend < 0.01) and 0.50 (95% CI = 0.23–1.06, p_trend = 0.08) during adulthood. For raw/short-cooked cabbage/sauerkraut (>3 vs. ≤1.5 servings/week), the ORs were 0.35 (95% CI = 0.16–0.72, p_trend < 0.01) during adolescence and 0.37 (95% CI = 0.17–0.78, p_trend < 0.01) during adulthood. For joint adolescent/adult consumption of raw/short-cooked cabbage/sauerkraut foods, (high, high) vs. (low, low), the OR was 0.23 (95% CI = 0.07–0.65). The significant association for high adolescent consumption of raw/short-cooked cabbage/sauerkraut foods and reduced BC risk was consistent across all levels of consumption in adulthood. Conclusion: Greater consumption of total and raw/short-cooked cabbage/sauerkraut foods either during adolescence or adulthood was associated with significantly reduced BC risk among Polish migrant women. These findings contribute to the growing literature suggesting a protective effect of a potentially modifiable factor, cruciferous vegetable intake, on breast cancer risk.

Formulation and Evaluation of Resveratrol Loaded Cubosomal Nanoformulation for Topical Delivery

AIM

The aim of the study was to formulate, characterize, and evaluate the Resveratrol- loaded Cubosomes (RC) for topical application.

BACKGROUND

Resveratrol (RV) is a nutraceutical compound with exciting pharmacological potential in different diseases, including cancers. Many studies on resveratrol have been reported for anti- melanoma activity. Due to its low bioavailability, the therapeutic activities of resveratrol are strongly limited. Hence, an approach with nanotechnology has been made to increase its activity through transdermal drug delivery.

OBJECTIVE

To formulate, characterize, and evaluate the resveratrol-loaded cubosomes (RC). To evaluate Resveratrol-loaded Cubosomal Gel (RC-Gel) for its topical application.

METHODS

RC was formulated by homogenization technique and optimized using a 2-factor 3-level factorial design. Formulated RCs were characterized for particle size, zeta potential, and entrapment efficiency. Optimized RC was evaluated for in vitro release and stability study. Optimized RC was further formulated into cubosomal gel (RC-Gel) using carbopol and evaluated for drug permeation and deposition. Furthermore, developed RC-Gel was evaluated for its topical application using skin irritancy, toxicity, and in vivo local bioavailability studies.

RESULTS

The optimized RC indicated cubic-shaped structure with mean particle size, entrapment efficiency, and zeta potential were 113±2.36 nm, 85.07 ± 0.91%, and -27.40 ± 1.40 mV, respectively. In vitro drug release of optimized RC demonstrated biphasic drug release with the diffusion-controlled release of resveratrol (RV) (87.20 ± 3.91%). The RC-Gel demonstrated better drug permeation and deposition in mice skin layers. The composition of RC-Gel has been proved non-irritant to mice skin. In vivo local bioavailability study depicted the good potential of RC-Gel for skin localization.

CONCLUSION

The RC nanoformulation proposes a promising drug delivery system for melanoma treatment simply through topical application.

Higher Fruits and Vegetables Consumption Is not Associated with Risk of Breast Cancer in Iranian Women

We aimed to investigate the association of fruits and vegetables (FVs) and their all subgroups intakes with breast cancer (BC) risk in Iranian women.

The present case-control study conducted on 150 age-matched women with newly diagnosed BC and apparently healthy controls. Anthropometric measures were collected and eventually, the mean intakes of total FVs and each subgroup were obtained from a validated 147-item food frequency questionnaire. Multivariate regression analysis was used to estimate odds ratios (OR) with 95% confidence intervals (CI).

Our findings revealed that the intake of only dark yellow vegetable was significantly higher in BC patients (P = 0.03) after controlling for covariates. OR of BC across tertiles of FVs intake, showed that there was not any statistical association of total FVs (OR: 1.83, CI: 0.54-6.24, P-trend = 0.3) and their subgroups intakes with BC risk. Except for berry fruits intake which was adversely associated with BC risk (OR: 0.36, CI: 0.09-1.37, P-trend = 0.02).

Our findings did not support the hypothesis that higher total FVs and their subgroups intakes reduce BC risk and suggested that only higher berry fruits intake may have an association with lower BC risk.

An umbrella review of the evidence associating diet and cancer risk at 11 anatomical sites

There is evidence that diet and nutrition are modifiable risk factors for several cancers, but associations may be flawed due to inherent biases. Nutritional epidemiology studies have largely relied on a single assessment of diet using food frequency questionnaires. We conduct an umbrella review of meta-analyses of observational studies to evaluate the strength and validity of the evidence for the association between food/nutrient intake and risk of developing or dying from 11 primary cancers. It is estimated that only few single food/nutrient and cancer associations are supported by strong or highly suggestive meta-analytic evidence, and future similar research is unlikely to change this evidence. Alcohol consumption is positively associated with risk of postmenopausal breast, colorectal, esophageal, head & neck and liver cancer. Consumption of dairy products, milk, calcium and wholegrains are inversely associated with colorectal cancer risk. Coffee consumption is inversely associated with risk of liver cancer and skin basal cell carcinoma.

Intestinal anti-inflammatory activity of Ulva ohnoi oil in DSS-induced experimental mouse model

This study was conducted to examine the physiological activity of Ulva ohnoi, some of which may be used for food or natural products but could disturbing coastal ecosystems due to large scale green-tide, to check values of U. ohnoi oil through experimental results. U. ohnoi oil was extracted from bulk of Ulva biomass to confirm its antioxidant and antibacterial activity, and the efficacy of U. ohnoi oil in the state of inflammation was confirmed through animal experiments. To confirm the anti-inflammatory effect, a mouse model induced with DSS was used. As a result of measuring NO using plasma after induction of inflammation, the amount of NO produced in the U. ohnoi oil group was decreased compared to the control group. Expression of inflammatory cytokines TNF-α, IL-6, and IL-1β was decreased compared to the control group. As a result of observing H&E staining, lower crypt loss and inflammatory cell infiltration were found in the U. ohnoi oil group compared to the control group. Consequently, U. ohnoi oil appears to have great anti-inflammatory properties.

Patterns of Nutrient Intake in Relation to Gastric Cancer: A Case Control Study

Gastric Cancer (GC) is the most common cancer among Iranian men. We conducted a case-control study to investigate the association between patterns of nutrient intake and the risk of GC in Iran. We enrolled 178 GC patients and 271 controls matched for age and sex. We collected dietary intakes using a validated diet history questionnaire. We performed factor analysis on 28 nutrients using multivariate logistic regression models on tertiles of factor scores and estimated odds ratios (OR) and 95% confidence intervals (95% CI). We identified three nutrient patterns. The first pattern included pantothenic acid, riboflavin, zinc, animal protein, and calcium. Selenium, thiamin, carbohydrate, vegetable protein, niacin and low intake of vitamin E loaded the second pattern, and the third pattern was abundant in fiber, carotene, vitamin C and A. We found no significant association between GC and any of the dietary patterns. However, in the first patterns, men in the highest tertile had significantly higher odds of GC than the lowest (OR = 2.15, 95% CI: 1.13-4.09, p trend = 0.02). A dietary pattern loaded by animal products may increase the risk of GC among Iranian men. Larger studies are required to approve these findings in overall and in different subgroups.Supplemental data for this article is available online at https://doi.org/10.1080/01635581.2021.1931697.

Role of microbial dysbiosis in the pathogenesis of esophageal mucosal disease: A paradigm shift from acid to bacteria?

Genomic sequencing, bioinformatics, and initial speciation (e.g., relative abundance) of the commensal microbiome have revolutionized the way we think about the “human” body in health and disease. The interactions between the gut bacteria and the immune system of the host play a key role in the pathogenesis of gastrointestinal diseases, including those impacting the esophagus. Although relatively stable, there are a number of factors that may disrupt the delicate balance between the luminal esophageal microbiome (EM) and the host. These changes are thought to be a product of age, diet, antibiotic and other medication use, oral hygiene, smoking, and/or expression of antibiotic products (bacteriocins) by other flora. These effects may lead to persistent dysbiosis which in turn increases the risk of local inflammation, systemic inflammation, and ultimately disease progression. Research has suggested that the etiology of gastroesophageal reflux disease-related esophagitis includes a cytokine-mediated inflammatory component and is, therefore, not merely the result of esophageal mucosal exposure to corrosives (i.e., acid). Emerging evidence also suggests that the EM plays a major role in the pathogenesis of disease by inciting an immunogenic response which ultimately propagates the inflammatory cascade. Here, we discuss the potential role for manipulating the EM as a therapeutic option for treating the root cause of various esophageal disease rather than just providing symptomatic relief (i.e., acid suppression).

Dietary patterns and risk of nasopharyngeal carcinoma: a population-based case-control study in southern China

BACKGROUND

Dietary factors, such as consumption of preserved foods, fresh vegetables, and fruits, have been linked to the risk of nasopharyngeal carcinoma (NPC). However, little is known about associations between dietary patterns and the risk of NPC in NPC-endemic areas.

OBJECTIVES

We aimed to evaluate whether dietary patterns are associated with NPC risk.

METHODS

We studied 2554 newly diagnosed NPC patients aged 20-74 y living in 3 endemic regions of southern China, and 2648 population-based controls frequency-matched to case patients by age, sex, and region, between 2010 and 2014. Dietary components were derived from food frequency data in adulthood and adolescence using principal component analysis. Four dietary components were identified and highly similar in adulthood and adolescence. We used multivariable unconditional logistic regression to calculate ORs with 95% CIs for the association between dietary patterns and NPC risk.

RESULTS

Compared with the lowest quartile, individuals in the highest quartile of the "plant-based factor" in adulthood had a 52% (OR: 0.48; 95% CI: 0.38, 0.59) decreased risk of NPC, and those in the highest quartile of the "animal-based factor" had a >2-fold (OR: 2.26; 95% CI: 1.85, 2.77) increased risk, with a monotonic dose-response trend (P-trend < 0.0001). Similar but weaker associations were found in adolescence. High intakes of the "preserved-food factor" were associated with increased NPC risk in both periods, although stronger associations were found in adolescence. Results from joint analysis and sensitivity analyses indicated that dietary factors in adulthood might be more stable and robust predictors of NPC risk than those in adolescence.

CONCLUSIONS

Our results deliver compelling evidence that plant- and animal-based dietary factors are associated with NPC risk, and provide more insights on the associations of diets and cancer risk that may assist healthy diet recommendations.

Diet as a possible influencing factor in thyroid cancer incidence: the point of view of the nutritionist

The incidence of differentiated thyroid cancer has increased in the last decades all over the world. Different environmental factors are possible perpetrators of this exponential growth. Nutritional factors are among the main environmental factors studied for thyroid cancer in recent years. This review aims to overview the main dietary factors involved in thyroid cancer risk, providing specific nutrition recommendations from the endocrinological Nutritionist point of view. Among the single food, fish and shellfish are the primary natural source of iodine, selenium and vitamin D in the human diet. These nutrients are essential for the synthesis of thyroid hormones; however, their consumption is not consistently related to thyroid cancer risk. The high intake of fruit and vegetables, probably due to their vitamin and antioxidant content, shows a weak inverse association with thyroid cancer risk. Alcohol, meat, or other food groups/nutrients showed no significant effect on thyroid cancer. In conclusion, to date, no definite association among dietary factors, specific dietary patterns, and thyroid cancer, and its clinical severity and aggressiveness have been found. However, it is essential to underline that in the future, prospective studies should be carried out to precisely evaluate the qualitative and quantitative intake of nutrients by patients to establish with more confidence a potential correlation between food intake and the occurrence and development of thyroid cancer.

Vegetables, Potatoes and Their Products as Sources of Energy and Nutrients to the Average Diet in Poland

The aim of our study was to analyse vegetables, potatoes and their products as sources of energy and nutrients in the average diet in Poland. Representative data of the 2016 Household Budget Survey from 36,886 households were used. This is the largest study sample in Poland, so we generalized the conclusions to the whole population using the statement ‘average diet’. We analysed three main product groups: vegetables, vegetable products, and potatoes and potatoes products, dividing them into 14 subgroups (e.g., tomatoes, cabbage, carrots, other vegetables, and mushrooms). The percentages of energy, protein, carbohydrates, total fat, nine vitamins (thiamine, riboflavin, niacin, vitamin B6, folate, vitamin C, vitamin A, vitamin D, and vitamin E), seven minerals (calcium, phosphorus, sodium, potassium, iron, magnesium and zinc), and fibre from the analysed food subgroups are presented. Additionally, the influence of household characteristics on the supply of energy and nutrients from each subgroup of vegetables, potatoes, and their products was evaluated using cluster analysis. In the analysis, R programme and Kohonen neural networks were applied. Our study showed that vegetables, potatoes, and their products provide 7.3% of daily dietary energy supply. Vegetables contribute more than 20% of the supply of six nutrients: vitamin C (51.8%), potassium (32.5%), folate (31.0%), vitamin A (30.6%), vitamin B6 (27.8%), and magnesium (20.2%), as well as fibre (31.8%). Cluster analysis distinguished three clusters that differed in nutritional supply from vegetables, potatoes, and their products. Educational level, income measured by quintile groups, village size, socio-economic characteristics, urbanization degree, and land use were the most important factors determining differences between clusters.

Colorectal Cancer and Diet: Risk Versus Prevention, Is Diet an Intervention?

Colorectal cancer is the third most common cause of cancer in men and women in the world. Epidemiologic research approximates that half of colon cancer risk is preventable by modifiable risk factors, including diet. This article reviews prior studies involving certain food items and their relation to colorectal cancer, to elucidate whether diet can be a potential intervention.

Role of Diet in Colorectal Cancer Incidence: Umbrella Review of Meta-analyses of Prospective Observational Studies

IMPORTANCE

Several meta-analyses have summarized evidence for the association between dietary factors and the incidence of colorectal cancer (CRC). However, to date, there has been little synthesis of the strength, precision, and quality of this evidence in aggregate.

OBJECTIVE

To grade the evidence from published meta-analyses of prospective observational studies that assessed the association of dietary patterns, specific foods, food groups, beverages (including alcohol), macronutrients, and micronutrients with the incidence of CRC.

DATA SOURCES

MEDLINE, Embase, and the Cochrane Library were searched from database inception to September 2019.

EVIDENCE REVIEW

Only meta-analyses of prospective observational studies with a cohort study design were eligible. Evidence of association was graded according to established criteria as follows: convincing, highly suggestive, suggestive, weak, or not significant.

RESULTS

From 9954 publications, 222 full-text articles (2.2%) were evaluated for eligibility, and 45 meta-analyses (20.3%) that described 109 associations between dietary factors and CRC incidence were selected. Overall, 35 of the 109 associations (32.1%) were nominally statistically significant using random-effects meta-analysis models; 17 associations (15.6%) demonstrated large heterogeneity between studies (I2 > 50%), whereas small-study effects were found for 11 associations (10.1%). Excess significance bias was not detected for any association between diet and CRC. The primary analysis identified 5 (4.6%) convincing, 2 (1.8%) highly suggestive, 10 (9.2%) suggestive, and 18 (16.5%) weak associations between diet and CRC, while there was no evidence for 74 (67.9%) associations. There was convincing evidence of an association of intake of red meat (high vs low) and alcohol (≥4 drinks/d vs 0 or occasional drinks) with the incidence of CRC and an inverse association of higher vs lower intakes of dietary fiber, calcium, and yogurt with CRC risk. The evidence for convincing associations remained robust following sensitivity analyses.

CONCLUSIONS AND RELEVANCE

This umbrella review found convincing evidence of an association between lower CRC risk and higher intakes of dietary fiber, dietary calcium, and yogurt and lower intakes of alcohol and red meat. More research is needed on specific foods for which evidence remains suggestive, including other dairy products, whole grains, processed meat, and specific dietary patterns.

Diet and sedentary behaviour in relation to cancer survival. A report from the national health and nutrition examination survey linked to the U.S. mortality registry

BACKGROUND & AIMS

Cancer is the second most common chronic disease and cause of death in the United States. Our aim was to evaluate the associations of sedentary behavior and nutrient intakes with total and cancer-specific mortality among US cancer survivors.

METHODS

Data from 2371 cancer survivors collected by the US National Health and Nutrition Examination Survey between 1999 and 2014 were linked to the US mortality registry. Multivariable adjusted Cox proportional hazard models were used to estimate the hazard ratios (HR) and 95% confidence intervals (CI) for all-cause and cancer-specific mortality associated with sedentary time and nutrient intakes. The interaction between time spent on sedentary activities and nutrient intake was evaluated on additive and multiplicative scales.

RESULTS

During a median observational period of 5.7 years, 532 total deaths occurred among cancer survivors, of which 180 were cancer-specific. A monotonic increasing linear relationship between time spent sitting and all-cause mortality was observed (HR = 1.15, 95% CI = 1.03, 1.28 per one standard deviation increment). The highest versus the lowest tertiles of intakes of dietary fiber, carotene, niacin, thiamine, riboflavin, vitamin B6, vitamin B12, and vitamin C were inversely associated with all-cause and cancer-specific mortality (HRs = 0.48 to 0.75). The inverse associations with all-cause mortality were more pronounced for combinations of low sedentary behaviour and high intakes of dietary fiber, carotenoids, vitamin B12, and vitamin C.

CONCLUSION

Our findings support recommendations for cancer survivors to reduce time spent sedentary and to follow a balanced diet with adequate intakes of dietary fiber and micronutrients.

Effect of Using Vegetable Powders as Nitrite/Nitrate Sources on the Physicochemical Characteristics of Cooked Pork Products

This study investigated the potential for using vegetable powders as a natural replacement for sodium nitrite and their effects on the physicochemical characteristics of alternatively cured pork products. We analyzed pork products subjected to four treatments: control (0.015% sodium nitrite), Chinese cabbabe powder (CCP) treatment (0.4% Chinese cabbage powder), radish powder (RP) treatment (0.4% radish powder), and spinach powder (SP) treatment (0.4% spinach powder). Among the vegetable powders prepared in this study, SP had the highest (p<0.05) nitrate content, while CCP had the lowest (p<0.05). The cooking yields from these treatments were not significantly different from each other. However, the products with vegetable powders had higher (p<0.05) pH and thiobarbituric acid reactive substances values than the control. Pork products with vegetable powders also showed lower CIE L* values and higher CIE b* values than the nitrite-added control. RP treatment had similar (p>0.05) CIE a* values to the control, while SP treatment had the lowest (p<0.05) CIE a* values. The residual nitrite content was lower (p<0.05) in the vegetable powder added pork products than in the control, although nitrosyl hemochrome and total pigment contents in the CCP and RP treatments were similar (p>0.05) to those in the control. The control, CCP, and RP treatments showed curing efficiencies greater than 80%, indicating that CCP and RP would be promising potential replacements for sodium nitrite. The results of this study suggest that RP may be a suitable natural replacement for sodium nitrite to produce alternatively cured meat products, compared to other leafy vegetable powders.

Associations between nutritional factors and KRAS mutations in colorectal cancer: a systematic review

BACKGROUND

Between 30 and 50% of colon tumors have mutations in the Kirsten-ras (KRAS) gene, which have a large nutritional attributable risk. Despite its high frequency in colorectal cancer (CRC), data to support specific associations between KRAS mutations in CRC and diet are sparse. Here, we conducted a systematic review to summarize the current epidemiological evidence on the association between various dietary factors and KRAS mutations.

METHODS

PubMed, Science Direct, and Cochrane databases were searched for relevant studies published until December 31, 2019, using inclusion and exclusion criteria in accordance with PRISMA guidelines. We analyzed the studies to find associations between nutritional factors and CRC tumors with KRAS mutations in humans.

RESULTS

We identified 28 relevant studies to include in this systematic review. In-depth analyses showed unclear associations between nutritional factors and KRAS mutations in CRC. Most epidemiological studies in the same nutrient or food often reported conflicting and/or inconclusive findings, whereas for some dietary factors, the results were homogeneous.

CONCLUSIONS

Further research using a more robust prospective cohort study is needed to lend more credence to the epidemiological associations found between KRAS mutations and dietary factors.

Dietary Risk Factors Associated with Development of Gastric Cancer in Nepal: A Hospital-Based Case-Control Study

Objectives

Gastric cancer (GC) is one of the most prevalent neoplasms and a leading cause of mortality globally. To our knowledge, its relationship with dietary factors is not adequately studied and understood in the Nepalese context. This study is aimed at exploring the relationship between the possible dietary risk factors responsible for gastric cancer in Nepal.

Methods

A hospital-based matched case-control study was conducted in two specialized cancer hospitals in Nepal. A total of 237 participants (79 cases and 158 controls) were included in the study. Patients diagnosed within one year (incidence case) with histologically confirmed gastric cancer were taken as cases, and healthy visitors of gastric and nongastric cancer patients without past and present history or not a suspected information of gastric cancer were included as controls. A face-to-face interview was conducted using a semi-structured food frequency questionnaire. Backward stepwise conditional logistic regression was used to estimate the magnitude of the association between the independent variables and gastric cancer. Results were presented as the crude odds ratio (COR) and adjusted odds ratio (AOR) with 95% confidence intervals (CI). A P value < 0.05 was considered statistically significant.

Results

In the adjusted multivariable conditional logistic regression model, an increased risk of gastric cancer was more likely to have higher odds among those respondents who had a high consumption of processed meat (AOR = 3.99, 95% CI: 0.90-17.66), preferences of a high amount of fats/oil (AOR = 4.64, 95% CI: 1.56-13.72), and preferences of high amounts of salts (AOR = 4.18, 95% CI: 1.30-13.44). Conversely, those respondents who consumed higher amounts of fruits (AOR = 0.21, 95% CI: 0.07-0.65) were seen to have lower odds of gastric cancer.

Conclusions

Our study found an increased risk of gastric cancer with frequent consumption of red meat, processed meat, high preferences of salt, fats/oil, and condiments. Regular consumption of fruits had a protective effect against gastric cancer. Providing nutrition education, public awareness, and lifestyle modification are primary steps to promote the avoidance of risk factors and change unhealthy dietary habits to prevent gastric cancer in Nepal.

Reduce, Reuse, Recycle for Food Waste: A Second Life for Fresh-Cut Leafy Salad Crops in Animal Diets

The world's population is growing rapidly, which means that the environmental impact of food production needs to be reduced and that food should be considered as something precious and not wasted. Moreover, an urgent challenge facing the planet is the competition between the food produced for humans and the feed for animals. There are various solutions such as the use of plant/vegetable by-products (PBPs) and former foodstuffs, which are the co/by-products of processing industries, or the food losses generated by the food production chain for human consumption. This paper reviews the by-co-products derived from the transformation of fresh-cut leafy salad crops. A preliminary nutritional evaluation of these materials is thus proposed. Based on their composition and nutritional features, in some cases similar to fresh forage and grasses, this biomass seems to be a suitable feedstuff for selected farm animals, such as ruminants. In conclusion, although the present data are not exhaustive and further studies are needed to weigh up the possible advantages and disadvantages of these materials, fresh-cut leafy salad crops represent a potential unconventional feed ingredient that could help in exploiting the circular economy in livestock production, thereby improving sustainability.

Association between Adherence to "Dietary Approaches to Stop Hypertension" Eating Plan and Breast Cancer

Despite the favorable association of components of "dietary approaches to stop hypertension (DASH)" diet and breast cancer (BC), limited data are available linking the whole DASH diet to BC. The aim of the present study was to examine the association between adherence to DASH eating plan and odds of BC in Iranian women. This population-based case-control study was conducted among women aged ≥30 years, who were residing in Isfahan, Iran. Cases were 350 patients with newly diagnosed stage I-IV breast cancer, for whom in-situ or invasive status of BC was confirmed by physical examination and mammography. Controls were 700 age-matched apparently healthy individuals who were randomly selected from general population. Dietary data were collected using a validated 106-item Willett-format semi-quantitative dish-based food frequency questionnaire. To investigate participants' adherence to DASH diet, we created DASH scores based on foods and nutrients emphasized or minimized in the DASH diet. After controlling for potential confounders, individuals in the highest quartile of the DASH diet score had 85% lower odds of breast cancer than women in the bottom quartile (OR: 0.15; 95% CIs: 0.09-0.24). Stratified analysis by menopausal status revealed such association in postmenopausal women (OR: 0.11; 95% CI: 0.06-0.19), but not in premenopausal women (OR: 0.60; 95% CI: 0.14-2.59). In addition, when stratified by BMI status, we found statistically significant inverse association between adherence to the DASH eating pattern and odds of breast cancer among normal-weight (OR for comparing extreme quartiles: 0.13; 95% CI: 0.07-0.24; P-trend < 0.001) and obese women (0.13; 0.05-0.34; P-trend < 0.001). In conclusion, our findings indicated an inverse association between adherence to the DASH eating plan and odds of breast cancer among Iranian women. Further, prospective studies are required to confirm our findings.

β-Carotene Supplementation and Lung Cancer Incidence in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study: The Role of Tar and Nicotine

INTRODUCTION

The Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study demonstrated that β-carotene supplementation increases lung cancer incidence in smokers. Further, cigarettes with higher tar and nicotine content are associated with a higher risk of lung cancer. However, no studies have examined whether the increased risk associated with β-carotene supplementation in smokers varies by the tar or nicotine content of cigarettes.

METHODS

The ATBC Study was a randomized, double-blind intervention trial conducted in southwest Finland. A total of 29 133 male smokers, aged 50-69 years, were enrolled and randomly assigned to one of four groups (α-tocopherol, β-carotene, both, or placebo). Cox proportional hazards models were used to estimate the hazard ratio (HR) and 95% confidence intervals (CI) of lung cancer risk by β-carotene trial assignment stratified by a priori categories of cigarette tar and nicotine content.

RESULTS

The β-carotene supplementation group had significantly higher risk of developing lung cancer in all categories of tar content (yes vs. no β-carotene supplementation-ultralight cigarettes [≤7 mg tar]: HR = 1.31, 95% CI = 0.91 to 1.89; nonfiltered cigarettes [≥21 mg tar]: HR = 1.22, 95% CI = 0.91 to 1.64; p for interaction = .91). Similarly, there was no interaction with nicotine content (yes vs. no β-carotene supplementation-ventilated cigarettes [≤0.8 µg nicotine]: HR = 1.23, 95% CI = 0.98 to 1.54; nonfiltered cigarettes [≥1.3 µg nicotine]: HR = 1.22, 95% CI = 0.91 to 1.64; p for interaction = .83).

CONCLUSION

These findings support the conclusion that supplementation with β-carotene increases the risk of lung cancer in smokers regardless of the tar or nicotine content of cigarettes smoked. Our data suggest that all smokers should continue to avoid β-carotene supplementation.

IMPLICATIONS

Previous studies demonstrated that β-carotene supplementation increases risk of lung cancer in smokers. This study moves the field forward by examining the potential for modification of risk of lung cancer with different levels of tar and nicotine in cigarettes smoked, as interaction with carcinogens in these components of cigarette smoke is hypothesized to be the mechanism by which β-carotene increases risk. Our study provides evidence that the increased risk of lung cancer in smokers who take β-carotene supplements is not dependent upon the tar or nicotine level of cigarettes smoked and suggests that all smokers should continue to avoid β-carotene supplementation.

Specific memory B cell response in humans upon infection with highly pathogenic H7N7 avian influenza virus

H7 avian influenza viruses represent a major public health concern, and worldwide outbreaks raise the risk of a potential pandemic. Understanding the memory B cell response to avian (H7) influenza virus infection in humans could provide insights in the potential key to human infection risks. We investigated an epizootic of the highly pathogenic A(H7N7) in the Netherlands, which in 2003 led to infection of 89 persons and one fatal case. Subtype-specificity of antibodies were determined for confirmed H7N7 infected individuals (cases) (n = 19), contacts of these cases (n = 21) and a comparison group controls (n = 16), by microarray, using recombinant hemagglutinin (HA)1 proteins. The frequency and specificity of memory B cells was determined by detecting subtype-specific antibodies in the culture supernatants from in vitro stimulated oligoclonal B cell cultures, from peripheral blood of cases and controls. All cases (100%) had high antibody titers specific for A(H7N7)2003 (GMT > 100), whereas H7-HA1 antigen binding was detected in 29% of contacts and 31% of controls, suggesting that some of the H7 reactivity stems from cross reactive antibodies. To unravel homotypic and heterotypic responses, the frequency and specificity of memory B cells were determined in 2 cases. Ten of 123 HA1 reactive clones isolated from the cases bound to only H7- HA1, whereas 5 bound both H7 and other HA1 antigens. We recovered at least four different epitopal reactivities, though none of the H7 reactive antibodies were able to neutralize H7 infections in vitro. Our study serologically confirms the infection with H7 avian influenza viruses, and shows that H7 infection triggers a mixture of strain -specific and cross-reactive antibodies.

Nutrient-wide association study of 92 foods and nutrients and breast cancer risk

BACKGROUND

Several dietary factors have been reported to be associated with risk of breast cancer, but to date, unequivocal evidence only exists for alcohol consumption. We sought to systematically assess the association between intake of 92 foods and nutrients and breast cancer risk using a nutrient-wide association study.

METHODS

Using data from 272,098 women participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, we assessed dietary intake of 92 foods and nutrients estimated by dietary questionnaires. Cox regression was used to quantify the association between each food/nutrient and risk of breast cancer. A false discovery rate (FDR) of 0.05 was used to select the set of foods and nutrients to be replicated in the independent Netherlands Cohort Study (NLCS).

RESULTS

Six foods and nutrients were identified as associated with risk of breast cancer in the EPIC study (10,979 cases). Higher intake of alcohol overall was associated with a higher risk of breast cancer (hazard ratio (HR) for a 1 SD increment in intake = 1.05, 95% CI 1.03-1.07), as was beer/cider intake and wine intake (HRs per 1 SD increment = 1.05, 95% CI 1.03-1.06 and 1.04, 95% CI 1.02-1.06, respectively), whereas higher intakes of fibre, apple/pear, and carbohydrates were associated with a lower risk of breast cancer (HRs per 1 SD increment = 0.96, 95% CI 0.94-0.98; 0.96, 95% CI 0.94-0.99; and 0.96, 95% CI 0.95-0.98, respectively). When evaluated in the NLCS (2368 cases), estimates for each of these foods and nutrients were similar in magnitude and direction, with the exception of beer/cider intake, which was not associated with risk in the NLCS.

CONCLUSIONS

Our findings confirm a positive association of alcohol consumption and suggest an inverse association of dietary fibre and possibly fruit intake with breast cancer risk.

Metformin protects Escherichia coli from bleomycin-induced bactericide via enhanced generation of hydrogen peroxide

Bleomycin is a glycopeptide antibiotic that is widely employed in the therapy of a range of lymphomas and germ cell tumours. But the therapeutic efficacy of bleomycin is limited by development of lung fibrosis. The cytotoxicity of bleomycin is mostly ascribed to mitochondrial DNA (mtDNA) damage, while a protective effect of metformin against bleomycin-induced lung fibrosis results from the inhibition of mitochondrial complex I. Since mitochondria and bacteria have certain similarities in structure and function, we used Escherichia coli for simplification in the present work to investigate the relationship between metformin and bleomycin with apparently opposite effects on mitochondrial DNA damage. Bleomycin lethality to E. coli was ameliorated by metformin treatment accompanying further increase of the level of reactive oxygen species. Catalase but not superoxide dismutases attenuated the protective effect of metformin. Meanwhile, treatment with hydrogen peroxide enhanced the protection, indicating that metformin may protect E. coli from bleomycin-induced bactericide via enhanced generation of hydrogen peroxide. Moreover, silibinin, a hepatoprotective polyphenolic flavonoid attenuates the cytotoxicity of bleomycin to E. coli via enhanced generation of hydrogen peroxide as well. This bacterial model in place of mitochondria can provide us with easier screening for the molecules with capability of reducing the bleomycin side effect.

Body size and dietary risk factors for aggressive prostate cancer: a case-control study

PURPOSE

Diet and body size may affect the risk of aggressive prostate cancer (APC), but current evidence is inconclusive.

METHODS

A case-control study was conducted in men under 75 years of age recruited from urology practices in Victoria, Australia; 1,254 with APC and 818 controls for whom the presence of prostate cancer had been excluded by biopsy. Dietary intakes were assessed using a validated food frequency questionnaire. Multivariable unconditional logistic regression estimated odds ratios and confidence intervals for hypothesized risk factors, adjusting for age, family history of prostate cancer, country of birth, socioeconomic status, smoking, and other dietary factors.

RESULTS

Positive associations with APC (odds ratio, 95% confidence intervals, highest vs. lowest category or quintile) were observed for body mass index (1.34, 1.02-1.78, P_trend = 0.04), and trouser size (1.54, 1.17-2.04, P_trend = 0.001). Intakes of milk and all dairy products were inversely associated with APC risk (0.71, 9.53-0.96, P_trend = 0.05, and 0.64, 0.48-0.87, P_trend = 0.012, respectively), but there was little evidence of an association with other dietary variables (P_trend > 0.05).

CONCLUSIONS

We confirmed previous evidence for a positive association between body size and risk of APC, and suggest that consumption of dairy products, and milk more specifically, is inversely associated with risk.

Characterization of Aroma-Active Compounds, Phenolics, and Antioxidant Properties in Fresh and Fermented Capers (Capparis spinosa) by GC-MS-Olfactometry and LC-DAD-ESI-MS/MS

Caper (Capparis spinosa) is an important food ingredient whose fresh parts, particularly the flower buds, are consumed as a starter with olives, cheese, and nuts, or are used as a component in other foods. It is one of the most popular species of aromatic plants grown in the Mediterranean zone. Fermentation makes the caper edible and affects the overall aroma as well as sensory and nutritional characteristics. This study aimed to evaluate the changes in aroma, aroma-active, and phenolic compounds of caper as affected by fermentation. Purge and trap method was used for the extraction of the aroma compounds, while gas chromatography-mass spectrometry olfactometry and Liquid chromatography coupled to diode array detection and electrospray ionization tandem mass spectrometry (LC-DAD-ESI-MS/MS) were employed for the detection of aroma-active compounds and phenolics, respectively. The results showed that the total amount of aroma compounds decreased drastically (62,616 to 21,471 µg/kg) in fermented sample. Twelve and 10 aroma-active compounds were detected in fresh and fermented caper buds, respectively, for the first time by the application of aroma extract dilution analysis. Among these compounds, methyl isothiocyanate (flavor dilution [FD] factor = 512) in fresh caper and acetic acid (FD factor = 128) in the fermented caper had the highest FD factor. With regard to the phenolic compounds, a total of 16 components were identified in fresh and fermented capers. As observed in aroma compounds, the total phenolic concentration decreased as a result of fermentation. Two phenolic compounds being kaempferol-3-O-glucosyl-rhamnosyl-glucoside and isorhamnetin hexoside were newly identified in caper. PRACTICAL APPLICATIONS: Capparis spinosa is one of the most popular sources of different secondary metabolites of interest to consumers. The results of the present study showed that the fermentation process of the capers is highly influential on the neutral composition of the sample. The total concentrations of aroma and phenolic compounds were reduced by 66% and 78%, respectively, in response to fermentation process.

Healthy dietary patterns and risk and survival of breast cancer: a meta-analysis of cohort studies

PURPOSES

Dietary patterns have been found to be associated with the overall cancer risk and survival. However, the associations of healthy dietary patterns and breast cancer remain unclear. We aimed to conduct a meta-analysis of prospective cohort studies to estimate the pooled results of the association of healthy dietary patterns with breast cancer risk and survival.

METHODS

PubMed, EMBASE, and Web of Science were searched for literature published until June 24th, 2018 that examined the associations between healthy dietary patterns and breast cancer risk and survival. Risk ratios (RRs) and 95% confidence intervals (CIs) were calculated by using a random-effects model for meta-analysis.

RESULTS

There were 32 articles retrieved for the meta-analysis, with 27 for breast cancer risk and five for breast cancer survival. There was a statistically significant lower risk of breast cancer associated with healthy dietary patterns (RR = 0.93, 95% CI: 0.88, 0.98). Subgroup analysis results suggested that there was an inverse association between breast cancer risk and posterori-derived healthy patterns, but no statistically significant associations were found in other stratified subgroups (a priori-derived diet, study region, menopausal status, or breast cancer subtypes). Healthy dietary patterns were associated inversely with all-cause mortality (RR = 0.76, 95% CI: 0.63, 0.92); however, no association was found for breast cancer-specific mortality.

CONCLUSIONS

The results suggested that healthy dietary patterns might be associated with a reduced risk of breast cancer and all-cause mortality among breast cancer patients. It could be clinically relevant to promote healthy dietary patterns for breast cancer prevention and improve survival among breast cancer patients.

Effect of Aslagh Capsule, a Traditional Compound Herbal Product on Oligomenorrhea in Patients with Polycystic Ovary Syndrome: A Three-Arm, Open-label, Randomized, Controlled Trial

Background:

Oligomenorrhea is a common complaint in patients with polycystic ovary syndrome (PCOS). There are some useful medicinal recommendations such as Aslagh product (include fennel fruits, carrot seeds, chaste tree fruits) in Iranian traditional medicine for the treatment of oligomenorrhea in PCOS. Hence, the present investigation was designed to compare Aslagh capsule with metformin on the oligomenorrhea.

Materials and Methods:

One hundred fifty women aged between 18-43 years with oligomenorrhea due to PCOS were randomly divided into Aslagh, metformin, and Aslagh + metformin groups. The occurrence of menstrual bleeding was considered as the primary outcome. Menstrual cyclicity, duration, and volume of the bleeding were also evaluated.

Results:

Occurrence of menstrual bleeding was 87.2% in all patients, with no significant difference between the three groups (P> 0.05). Menstrual cyclicity significantly improved from baseline in Aslagh and Aslagh + metformin groups (P=0.02). Duration of menstrual bleeding was significantly higher in Aslagh group in the first and the second menstrual bleeding cycle compared to the other two groups (P<0.05). No significant change was observed in the volume of the bleeding after the intervention in any of the three groups. The occurrence of menstrual bleeding in Aslagh group was significantly (P=0.03) higher than the other two groups in the fourth month (drug-free period).

Conclusion:

Aslagh capsule showed beneficial effects similar to metformin in the treatment of oligomenorrhea in PCOS women and could be suggested for use as an alternative treatment in these patients.

Fruit and Vegetable Intake is Inversely Associated with Cancer Risk in Mexican-Americans

Objective: There is inconsistent evidence and limited data in the Hispanic population concerning fruit and vegetable intake and cancer risk. This study explored the effect of fruit and vegetable intake on cancer risk in Mexican-Americans. Methods: Participants in this cross-sectional study were drawn from the Cameron County Hispanic Cohort. Consumption of fruits and vegetables were assessed using a validated questionnaire. Cancer was self-reported by the participants based on being told by a health care provider that they had cancer. Results: Among 2,381 participants with available dietary data, 82 reported a diagnosis of cancer. Participants who met recommendations of five or more servings of fruit and vegetable per day had a significantly 86% lower risk for reported cancer compared with those who did not meet recommendations, after adjusting for other covariates. Every portion increment of total fruit and vegetable intake was significantly associated with the reduced cancer risk by 11% with the adjustment of other covariates. Conclusions: Fruit and vegetable intake was inversely associated with cancer risk in Mexican-Americans. Improving the consumption of fruit and vegetable might be an effective area for further research as part of a strategy for cancer prevention and control among Mexican-Americans independent of other factors.

Association Between Nitrite and Nitrate Intake and Risk of Gastric Cancer: A Systematic Review and Meta-Analysis

BACKGROUND Studies have shown inconsistent associations of nitrite and nitrate intake with the risk of gastric cancer or its associated mortality. We performed a meta-analysis of observational studies to evaluate the correlation of nitrite and nitrate intake with the risk of gastric cancer. MATERIAL AND METHODS We searched for studies reporting effect estimates and 95% confidence intervals (CIs) of gastric cancer in PubMed, EMBASE, and the Cochrane Library through November 2018. The summary results of the included studies were pooled using a random-effects model. RESULTS Eighteen case-control and 6 prospective cohort studies recruiting 800 321 participants were included in this study. The summary results indicated that the highest (odds ratio [OR], 1.27; 95%CI, 1.03-1.55; P=0.022) or moderate (OR: 1.12; 95%CI, 1.01-1.26; P=0.037) nitrite intake were associated with a higher risk of gastric cancer. However, we noted that high (OR, 0.81; 95%CI, 0.68-0.97; P=0.021) or moderate (OR, 0.86; 95%CI, 0.75-0.99; P=0.036) nitrate intakes were associated with a reduced risk of gastric cancer. These associations differed when stratified by publication year, study design, country, the percentage of male participants, assessment of exposure, adjusted model, and study quality. CONCLUSIONS High or moderate nitrite intake was associated with higher risk of gastric cancer, whereas high or moderate nitrate intake was correlated with lower risk of gastric cancer.