Red and processed meat consumption and risk of bladder cancer: a dose-response meta-analysis of epidemiological studies

CD36: The Bridge between Lipids and Tumors

It has been found that the development of some cancers can be attributed to obesity, which is associated with the excessive intake of lipids. Cancer cells undergo metabolic reprogramming, shifting from utilizing glucose to fatty acids (FAs) for energy. CD36, a lipid transporter, is highly expressed in certain kinds of cancer cells. High expressions of CD36 in tumor cells triggers FA uptake and lipid accumulation, promoting rapid tumor growth and initiating metastasis. Meanwhile, immune cells in the tumor microenvironment overexpress CD36 and undergo metabolic reprogramming. CD36-mediated FA uptake leads to lipid accumulation and has immunosuppressive effects. This paper reviews the types of FAs associated with cancer, high expressions of CD36 that promote cancer development and progression, effects of CD36 on different immune cells in the tumor microenvironment, and the current status of CD36 as a therapeutic target for the treatment of tumors with high CD36 expression.

Long Follow-Up Times Weaken Observational Diet-Cancer Study Outcomes: Evidence from Studies of Meat and Cancer Risk

For years, prospective cohort studies of diet and cancer incidence have reported smaller effects than do retrospective case-control (CC) studies. The differences have been attributed to problems with CC studies, including dietary recall bias, poor matching of cases and controls, and confounding. The hypothesis evaluated here is that long follow-up periods between ascertainment of diet and cancer incidence weaken the findings. Prospective studies of cancer incidence with respect to serum 25-hydroxyvitamin D concentration have already shown reduced benefit of higher concentrations for longer follow-up periods. Evaluating that hypothesis for dietary factors involved searching the journal literature for meta-analyses of red meat and processed meat and cancer incidence. I used findings from observational studies for bladder, breast, colorectal, and gastric cancers. To evaluate the effect of duration of follow-up time, I used two approaches. First, I plotted the relative risks for CC studies for gastric cancer with respect to consumption of 100 g/day of red meat and for bladder cancer for 50 g/day of processed meat against the interval between the dietary data and cancer incidence. Second, I compared nested CC studies of meat and cancer incidence for five breast cancer studies and one colorectal cancer study. Both approaches yielded an inverse correlation between interval or follow-up time and relative risk. My findings strongly suggest that diet near time of cancer diagnosis is more important than for longer intervals, that results from meta-analyses should be revised when possible with appropriate adjustments for duration of follow-up, and that dietary guidelines be revised accordingly.

Molecular Markers for Bladder Cancer Screening: An Insight into Bladder Cancer and FDA-Approved Biomarkers

Bladder cancer is one of the most financially burdensome cancers globally, from its diagnostic to its terminal stages. The impact it imposes on patients and the medical community is substantial, exacerbated by the absence of disease-specific characteristics and limited disease-free spans. Frequent recurrences, impacting nearly half of the diagnosed population, require frequent and invasive monitoring. Given the advancing comprehension of its etiology and attributes, bladder cancer is an appealing candidate for screening strategies. Cystoscopy is the current gold standard for bladder cancer detection, but it is invasive and has the potential for undesired complications and elevated costs. Although urine cytology is a supplementary tool in select instances, its efficacy is limited due to its restricted sensitivity, mainly when targeting low-grade tumors. Although most of these assays exhibit higher sensitivity than urine cytology, clinical guidelines do not currently incorporate them. Consequently, it is necessary to explore novel screening assays to identify distinctive alterations exclusive to bladder cancer. Thus, integrating potential molecular assays requires further investigation through more extensive validation studies. Within this article, we offer a comprehensive overview of the critical features of bladder cancer while conducting a thorough analysis of the FDA-approved assays designed to diagnose and monitor its recurrences.

Intermediate and high-risk non-muscle-invasive bladder cancer: an overview of epidemiology, burden, and unmet needs

Bladder cancer ranks among the most common cancers globally. At diagnosis, 75% of patients have non-muscle-invasive bladder cancer (NMIBC). Patients with low-risk NMIBC have a good prognosis, but recurrence and progression rates remain high in intermediate- and high-risk NMIBC, despite the decades-long availability of effective treatments for NMIBC such as intravesical Bacillus Calmette-Guérin (BCG). The present review provides an overview of NMIBC, including its burden and treatment options, and then reviews aspects that counteract the successful treatment of NMIBC, referred to as unmet treatment needs. The scale and reasons for each unmet need are described based on a comprehensive review of the literature, including insufficient adherence to treatment guidelines by physicians because of insufficient knowledge, training, or access to certain therapy options. Low rates of lifestyle changes and treatment completion by patients, due to BCG shortages or toxicities and adverse events as well as their impact on social activities, represent additional areas of potential improvement. Highly heterogeneous evidence for the effectiveness and safety of some treatments limits the comparability of results across studies. As a result, efforts are underway to standardize treatment schedules for BCG, but intravesical chemotherapy schedules remain unstandardized. In addition, risk-scoring models often perform unsatisfactorily due to significant differences between derivation and real-world cohorts. Reporting in clinical trials suffers from a lack of consistent outcomes reporting in bladder cancer clinical trials, paired with an under-representation of racial and ethnic minorities in many trials.

Meat Intake and the Risk of Bladder Cancer: A Systematic Review and Meta-Analysis of Observational Studies

The evidence for the association between meat intake and the risk of bladder cancer (BC) is still inconclusive. A total of 29 studies involving 1,475,125 participants and 18,836 cases of BC were included in the meta-analysis. Among these studies, 11 reported total meat intake, 20 reported red meat intake, 19 reported processed meat intake, 15 reported white meat intake, and 15 reported fish intake. The results suggested that there was an overall increase in BC risk associated with total meat intake (RR = 1.10; 95% confidence interval: 0.92-1.31; I² = 55.20%; P = 0.014), and a higher red meat (RR = 1.23; 95% CI: 1.08-1.39; I² = 51.30%; P = 0.004) or processed meat (RR = 1.16; 95% CI: 1.08-1.25; I² = 28.00%; P = 0.125) intake may increase the risk of BC. In contrast, a higher intake of fish (RR = 0.80; 95% CI: 0.67-0.95; I² = 62.90%; P = 0.001) was inversely associated with the risk of BC. Moreover, we did not observe an association between white meat (RR = 0.96; 95% CI: 0.83-1.10; I² = 53.70%; P = 0.007) and the risk of BC. Our findings suggested that dietary intervention may be an effective approach to preventing BC, which still needs to be confirmed by further well-designed observational studies.

[Practice-relevant dietary recommendations in uro-oncology]

BACKGROUND

A healthy lifestyle is recommended for prevention, during therapy and in the survivorship of various medical conditions.

OBJECTIVES

This article aims to give an overview of the current dietary recommendations and currently discussed topics which are useful for patient counseling.

METHODS

The literature with a focus on uro-oncology, on prevention, during cancer therapy and survivorship was reviewed for healthy lifestyle recommendations. In addition, issues perceived in practice were researched, discussed with examples, and critically evaluated.

RESULTS

The current recommendations of the professional associations are intended to encourage all healthy or already ill patients to adopt a healthy lifestyle that includes a balanced diet, physical activity and healthy body weight. Consistent with current evidence, neither general supplementation of dietary supplements nor avoidance of entire food groups (such as meat or dairy products) is recommended.

CONCLUSIONS

In the counseling situation, patients should be encouraged in a healthy lifestyle or supported in an appropriate change of behavior. Any perceived uncertainty or questions from patient's perspective should be clarified and, if necessary, referred to a dietician, oecotrophologist or nutritionist.

Grape skin flour obtained from wine processing as an antioxidant in beef burgers

The objective of this study was to determine the best level of wine making by-product meal (WBM) as a natural antioxidant to replace butylhydroxytoluene (BHT) in beef burger stored at -20 °C for up to 120 days. The treatments consisted of control (basic formulation - BF, without antioxidant); BF with BHT; and BF with WBM0.5, WBM1.0, WBM1.5, and WBM2.0, with 0.5, 1.0, 1.5 and 2.0 g WBM/100 g BF, respectively. Up to 60 days of storage, the lipid oxidation value between BHT and WBM0.5 treatments did not differ and were lower than the values presented by the other treatments. On day 90 and 120, the lipid oxidation values of treatments BHT, WBM0.5, and WBM1.0 did not differ and were lower than the values presented by WBM1.5 and WBM2.0 treatments. Burgers from all treatments with WBM inclusion had crude fiber values above 3 g/100 g. WBM1.5 and WBM2.0 treatments had the worst scores for appearance, aroma, juiciness and tenderness, in addition to the highest cooking losses. WBM can be used at up to 1 g/100 g to replace BHT in frozen beef burgers. Higher levels of WBM inclusion increased lipid oxidation and negatively affected the sensory quality of burgers.

Diet quality, common genetic polymorphisms, and bladder cancer risk in a New England population-based study

PURPOSE

We examined the interaction between common genetic bladder cancer variants, diet quality, and bladder cancer risk in a population-based case-control study conducted in New England.

METHODS

At the time of enrollment, 806 bladder cancer cases and 974 controls provided a DNA sample and completed a diet history questionnaire. Diet quality was assessed using the 2010 Alternate Healthy Eating Index (AHEI-2010) score. Single nucleotide polymorphisms (SNPs) reported in genome-wide association studies to be associated with bladder cancer risk were combined into a polygenic risk score and also examined individually for interaction with the AHEI-2010. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were calculated using logistic regression.

RESULTS

A 1-standard deviation increase in polygenic risk score was associated with higher bladder cancer risk (OR, 1.34; 95% CI 1.21-1.49). Adherence to the AHEI-2010 was not associated with bladder cancer risk (OR, 0.99; 95% CI 0.98-1.00) and the polygenic risk score did not appear to modify the association between the AHEI-2010 and bladder cancer risk. In single-SNP analyses, rs8102137 (bladder cancer risk allele, C) modified the association between the AHEI-2010 total score and bladder cancer risk, with the strongest evidence for the AHEI-2010 long chain fat guideline (OR for TT, 0.92; 95% CI 0.87-0.98; OR for CT, 1.02; 95% CI 0.96-1.08; OR for CC, 1.03; 95% CI 0.93-1.14; p for interaction, 0.02).

CONCLUSIONS

In conclusion, rs8102137 near the cyclin E1 gene ( CCNE1 ) may be involved in gene-diet interactions for bladder cancer risk.

Epidemiology of Bladder Cancer in the Arab World: 2019 Global Burden of Disease Data

BACKGROUND

Urinary bladder cancer (UBC) has unique epidemiology. It is well known that some Arab countries have higher incidence of UBC due to certain risk factors, including schistosomiasis and smoking.

METHODS

We systematically reviewed the Global Burden of Disease study (GBD) database for the year 2019. We queried GBD study database using results tool for UBC in the 22 Arab countries and compared the age-standardized incidence rate (ASIR), death rate (ASDR), mortality-to-incidence ratio (MIR) and Disability-Adjusted Life Years (ASDALYs) in Arab countries with global values.

RESULTS

The Arab population represents 5.6% of the global population. There was an estimated number of 27,503 patients diagnosed with UBC in 2019 in the Arab world. The ASIR for developing UBC in the Arab countries was 9.9/100,000; which is higher than the average global ASIR (6.5/100,000). Specifically, the ASIR was higher than the global average in 11 out of the 22 Arab countries. Notably, the age-specific incidence in Egypt showed that younger individuals had higher incidence of UBC than other countries, reflecting unique epidemiology. It is estimated that 10,532 patients died of UBC in the Arab world in 2019. The average mortality-to-incidence ratio (MIR) was estimated to be 0.448. The burden of UBC as estimated by the number of DALYs in the Arab world was 272,976 years representing 4% of cancer burden in Arab countries and 6.2% of the global DALYs related to UBC.

CONCLUSION

UBC has high incidence in many Arab countries, particularly in North Africa.  Risk factors are known and are modifiable, making prevention the most optimal way to reduce disease burden. High MIR in many Arab countries reflects suboptimal management and a window for improvement.

Dietary consumption of cruciferous vegetables and bladder cancer risk: A systematic review and meta-analysis

Objective

Previous studies on the association of cruciferous vegetables intake with bladder cancer risk have reported inconsistent results. We performed the present meta-analysis to summarize evidence on this association and to quantify the potential dose-response relation based on all available cohort studies.

Methods

A comprehensive literature search of relevant articles up to March 2022 was performed in PubMed and EMBASE. The summary risk estimates with 95% confidence intervals for the highest vs. the lowest intake of cruciferous vegetables were calculated. Dose-response meta-analysis was also performed for studies reporting categorical risk estimates for at least three quantitative levels of cruciferous vegetables intake.

Results

We found that the highest cruciferous vegetables intake was not significantly associated with a lower risk of bladder cancer, compared with the lowest cruciferous vegetables intake category (RR = 0.92, 95% CI 0.80–1.06). Linear dose-response meta-analysis indicated that the pooled RRs for 10 g/day or 1 servings/week increment of cruciferous vegetables intake was not significantly associated with a reduced risk of bladder cancer (P = 0.106 and P = 0.147, respectively). There was no evidence of significant publication bias either with Begg’s test (P = 0.386) or Egger’s test (P = 0.253).

Conclusion

The results of this study did not support the hypothesis that dietary cruciferous vegetables intake was associated with a lower risk of bladder cancer. Further large prospective cohort studies are warranted to confirm our preliminary findings.

Dietary B group vitamin intake and the bladder cancer risk: a pooled analysis of prospective cohort studies

PURPOSE

Diet may play an essential role in the aetiology of bladder cancer (BC). The B group complex vitamins involve diverse biological functions that could be influential in cancer prevention. The aim of the present study was to investigate the association between various components of the B group vitamin complex and BC risk.

METHODS

Dietary data were pooled from four cohort studies. Food item intake was converted to daily intakes of B group vitamins and pooled multivariate hazard ratios (HRs), with corresponding 95% confidence intervals (CIs), were obtained using Cox-regression models. Dose-response relationships were examined using a nonparametric test for trend.

RESULTS

In total, 2915 BC cases and 530,012 non-cases were included in the analyses. The present study showed an increased BC risk for moderate intake of vitamin B1 (HRB1: 1.13, 95% CI: 1.00-1.20). In men, moderate intake of the vitamins B1, B2, energy-related vitamins and high intake of vitamin B1 were associated with an increased BC risk (HR (95% CI): 1.13 (1.02-1.26), 1.14 (1.02-1.26), 1.13 (1.02-1.26; 1.13 (1.02-1.26), respectively). In women, high intake of all vitamins and vitamin combinations, except for the entire complex, showed an inverse association (HR (95% CI): 0.80 (0.67-0.97), 0.83 (0.70-1.00); 0.77 (0.63-0.93), 0.73 (0.61-0.88), 0.82 (0.68-0.99), 0.79 (0.66-0.95), 0.80 (0.66-0.96), 0.74 (0.62-0.89), 0.76 (0.63-0.92), respectively). Dose-response analyses showed an increased BC risk for higher intake of vitamin B1 and B12.

CONCLUSION

Our findings highlight the importance of future research on the food sources of B group vitamins in the context of the overall and sex-stratified diet.

Effects of Faba Bean Hull Nanoparticles on Physical Properties, Protein and Lipid Oxidation, Colour Degradation, and Microbiological Stability of Burgers under Refrigerated Storage

The processing of faba beans generates great quantities of hulls, which are high in bioactive compounds with demonstrated radical-inhibiting properties. There is no research on the impact of using faba bean hull nanoparticles (FBH-NPs) to improve the quality and extend the shelf-life of beef products. Hence, the target of this investigation was to assess the inhibiting influence of adding FBH-NPs at two different concentrations (1 and 1.5%) on the physical attributes, lipid and protein oxidation, colour degradation, and microbiological safety of burgers during refrigerated storage (4 ± 1 °C/12 days). The FBH-NPs presented great phenolic content (103.14 ± 0.98 mg GAE/g dw) and antioxidant potential. The water holding capacity and cooking properties in burgers including FBH-NPs were improved during storage. The FBH-NPs significantly (p < 0.05) decreased the reduction rate of redness and lightness during the burger refrigerated storage and the FBH-NPs were more beneficial in preventing cold burger discolouration. In the FBH-NPs-treated burgers, peroxide values, TBARS, and protein carbonyl content were lower than in the control (up to 12 days). The microbiological load of burgers including FBH-NPs was lower than the load of the control during refrigerated storage. The findings revealed that FBH-NPs were more efficient in enhancing the cooking characteristics, retarding lipid or protein oxidation, preventing colour detrition and improving the microbial safety of burgers.

Chlorination by-products in drinking water and risk of bladder cancer - A population-based cohort study

Chlorination by-products have been consistently associated with risk of bladder cancer in case-control studies, but confirmation from large-scale cohort studies is lacking. We assessed the association of drinking water trihalomethanes (THM), a proxy for chlorination by-products, with risk of bladder cancer in 58,672 men and women. Data came from two population-based cohorts, parts of the Swedish Infrastructure for Medical Population-Based Life-Course and Environmental Research (SIMPLER). Individual exposure to THM was assessed by combining residential information with tap water monitoring data. Participants were categorized into non-exposed, low (<15 µg/L) or high (≥15 µg/L) THM exposure. Incident cases were ascertained from 1998 through 2019 via register linkage. During 16 years of follow-up (965,590 person-years), 831 bladder cancer cases were ascertained. We observed no overall association of THM with risk of bladder cancer, hazard ratio for the highest exposed compared to the non-exposed 0.90 (95% confidence interval: 0.73 - 1.11). The null association remained after restricting the analysis to long-term residents and across strata of smoking status and cancer stage. Our results indicate that chlorination by-product exposure at THM concentrations representative of chlorinated drinking waters in most European countries, is not associated with an increased risk of bladder cancer.

In Silico Establishment and Validation of Novel Lipid Metabolism-Related Gene Signature in Bladder Cancer

Background

Aberrant lipid metabolism is an alteration common to many types of cancer. Dysregulation of lipid metabolism is considered a major risk factor for bladder cancer. Accordingly, we focused on genes related to lipid metabolism and screened novel markers for predicting the prognosis of bladder cancer.

Methods

RNA-seq data for bladder cancer were obtained from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. The nonnegative matrix factorization (NMF) algorithm was used to classify the molecular subtypes. Weighted correlation network analysis (WGCNA) was applied to identify coexpressed genes, and least absolute shrinkage and selection operator (LASSO) multivariate Cox analysis was used to construct a prognostic risk model. External validation data and in vitro experiments were used to verify the results from in silico analysis.

Results

Bladder cancer samples were grouped into two clusters based on the NMF algorithm. A total of 1467 genes involved in coexpression modules were identified in WGCNA. We finally established a 5-gene signature (TM4SF1, KCNK5, FASN, IMPDH1, and KCNJ15) that exhibited good stability across different datasets and was also an independent risk factor for prognosis. Furthermore, the predictive efficacy of our model was generally higher than the predictive efficacy of other published models. Distinct risk groups of patients also showed significantly different immune infiltration cell patterns and associations with clinical variables. Moreover, the 5 signature genes were verified in clinical samples by quantitative real-time polymerase chain reaction (qRT-PCR) and immunohistochemistry, which were in agreement with the in silico analysis. For in vitro experiments, knockdown of IMPDH1 markedly inhibited cell proliferation in bladder cancer.

Conclusion

We established a 5-gene prognosis signature based on lipid metabolism in bladder cancer, which could be an effective prognostic indicator.

Genesis and Mechanism of Some Cancer Types and an Overview on the Role of Diet and Nutrition in Cancer Prevention

Cancer is a major disease with a high mortality rate worldwide. In many countries, cancer is considered to be the second most common cause of death after cardiovascular disease. The clinical management of cancer continues to be a challenge as conventional treatments, such as chemotherapy and radiation therapy, have limitations due to their toxicity profiles. Unhealthy lifestyle and poor dietary habits are the key risk factors for cancer; having a healthy diet and lifestyle may minimize the risk. Epidemiological studies have shown that a high fruit and vegetable intake in our regular diet can effectively reduce the risk of developing certain types of cancers due to the high contents of antioxidants and phytochemicals. In vitro and in vivo studies have shown that phytochemicals exert significant anticancer effects due to their free radical scavenging capacity potential. There has been extensive research on the protective effects of phytochemicals in different types of cancers. This review attempts to give an overview of the etiology of different types of cancers and assesses the role of phytonutrients in the prevention of cancers, which makes the present review distinct from the others available.

Dietary patterns and risk of bladder cancer: a systematic review and meta-analysis

BACKGROUND

Several studies have investigated the relationship between dietary patterns and the risk of bladder cancer (BC) in different regions including Europe, the United States, and Asia, with no conclusive evidence. A meta-analysis was undertaken to integrate the most recent information on the relationship between a data-driven Western diet (WD), the Mediterranean diet (MD), and dietary-inflammatory-index (DII) and the risk of BC.

METHOD

We looked for published research into the relationship between dietary patterns and the incidence of BC in the PubMed/Medline, Cochrane Library, Web of Science, and Scopus databases up until February 2021. Using a multivariate random-effects model, we compared the highest and lowest categories of WD, MD and DII patterns and provided the relative risk (RR) or odds ratios (OR) and 95 percent confidence intervals (CIs) for the relevant relationships.

RESULTS

The analysis comprised 12 papers that were found to be suitable after scanning the databases. Both case-control (OR 0.73, 95% CI: 0.52, 0.94; I2 = 49.9%, n = 2) and cohort studies (RR 0.93, 95% CI: 0.88, 0.97; I2 = 63%, n = 4) found a substantial inverse association between MD and BC. In addition, although cohort studies (RR 1.53, 95% CI 1.37, 1.70; I2 = 0%, n = 2) showed a direct association between WD and BC, case-control studies (OR 1.33, 95% CI 0.81, 1.88; I2 = 68.5%, n = 2) did not. In cohort studies, we found no significant association between DII and BC (RR 1.02, 95% CI 0.93, 1.12; I2 = 38.5%, n = 2). In case-control studies, however, a strong direct association between DII and BC was discovered (RR 2.04, 95% CI 1.23, 2.85; I2 = 0%, n = 2).

CONCLUSION

The current meta-analysis showed that MD and WD have protective and detrimental effects on BC risk, respectively. No significant association between DII and the risk of BC was observed. More research is still needed to confirm the findings. Additional study is warranted to better understand the etiological mechanisms underlying how different dietary patterns affect BC.

TRIAL REGISTRATION

Protocol registration number: CRD42020155353. Database for protocol registration: The international prospective register of systematic reviews database (PROSPERO). Data of registration: August 2020.

Global, regional and national burden of bladder cancer and its attributable risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease study 2019

Introduction

The current study determined the level and trends associated with the incidence, death and disability rates for bladder cancer and its attributable risk factors in 204 countries and territories, from 1990 to 2019, by age, sex and sociodemographic index (SDI; a composite measure of sociodemographic factors).

Methods

Various data sources from different countries, including vital registration and cancer registries were used to generate estimates. Mortality data and incidence data transformed to mortality estimates using the mortality to incidence ratio (MIR) were used in a cause of death ensemble model to estimate mortality. Mortality estimates were divided by the MIR to produce incidence estimates. Prevalence was calculated using incidence and MIR-based survival estimates. Age-specific mortality and standardised life expectancy were used to estimate years of life lost (YLLs). Prevalence was multiplied by disability weights to estimate years lived with disability (YLDs), while disability-adjusted life years (DALYs) are the sum of the YLLs and YLDs. All estimates were presented as counts and age-standardised rates per 100 000 population.

Results

Globally, there were 524 000 bladder cancer incident cases (95% uncertainty interval 476 000 to 569 000) and 229 000 bladder cancer deaths (211 000 to 243 000) in 2019. Age-standardised death rate decreased by 15.7% (8.6 to 21.0), during the period 1990–2019. Bladder cancer accounted for 4.39 million (4.09 to 4.70) DALYs in 2019, and the age-standardised DALY rate decreased significantly by 18.6% (11.2 to 24.3) during the period 1990–2019. In 2019, Monaco had the highest age-standardised incidence rate (31.9 cases (23.3 to 56.9) per 100 000), while Lebanon had the highest age-standardised death rate (10.4 (8.1 to 13.7)). Cabo Verde had the highest increase in age-standardised incidence (284.2% (214.1 to 362.8)) and death rates (190.3% (139.3 to 251.1)) between 1990 and 2019. In 2019, the global age-standardised incidence and death rates were higher among males than females, across all age groups and peaked in the 95+ age group. Globally, 36.8% (28.5 to 44.0) of bladder cancer DALYs were attributable to smoking, more so in males than females (43.7% (34.0 to 51.8) vs 15.2% (10.9 to 19.4)). In addition, 9.1% (1.9 to 19.6) of the DALYs were attributable to elevated fasting plasma glucose (FPG) (males 9.3% (1.6 to 20.9); females 8.4% (1.6 to 19.1)).

Conclusions

There was considerable variation in the burden of bladder cancer between countries during the period 1990–2019. Although there was a clear global decrease in the age-standardised death, and DALY rates, some countries experienced an increase in these rates. National policy makers should learn from these differences, and allocate resources for preventative measures, based on their country-specific estimates. In addition, smoking and elevated FPG play an important role in the burden of bladder cancer and need to be addressed with prevention programmes.

Consumption of red meat and processed meat and cancer incidence: a systematic review and meta-analysis of prospective studies

Red meat and processed meat consumption has been hypothesized to increase risk of cancer, but the evidence is inconsistent. We performed a systematic review and meta-analysis of prospective studies to summarize the evidence of associations between consumption of red meat (unprocessed), processed meat, and total red and processed meat with the incidence of various cancer types. We searched in MEDLINE and EMBASE databases through December 2020. Using a random-effect meta-analysis, we calculated the pooled relative risk (RR) and 95% confidence intervals (CI) of the highest versus the lowest category of red meat, processed meat, and total red and processed meat consumption in relation to incidence of various cancers. We identified 148 published articles. Red meat consumption was significantly associated with greater risk of breast cancer (RR = 1.09; 95% CI = 1.03-1.15), endometrial cancer (RR = 1.25; 95% CI = 1.01-1.56), colorectal cancer (RR = 1.10; 95% CI = 1.03-1.17), colon cancer (RR = 1.17; 95% CI = 1.09-1.25), rectal cancer (RR = 1.22; 95% CI = 1.01-1.46), lung cancer (RR = 1.26; 95% CI = 1.09-1.44), and hepatocellular carcinoma (RR = 1.22; 95% CI = 1.01-1.46). Processed meat consumption was significantly associated with a 6% greater breast cancer risk, an 18% greater colorectal cancer risk, a 21% greater colon cancer risk, a 22% greater rectal cancer risk, and a 12% greater lung cancer risk. Total red and processed meat consumption was significantly associated with greater risk of colorectal cancer (RR = 1.17; 95% CI = 1.08-1.26), colon cancer (RR = 1.21; 95% CI = 1.09-1.34), rectal cancer (RR = 1.26; 95% CI = 1.09-1.45), lung cancer (RR = 1.20; 95% CI = 1.09-1.33), and renal cell cancer (RR = 1.19; 95% CI = 1.04-1.37). This comprehensive systematic review and meta-analysis study showed that high red meat intake was positively associated with risk of breast cancer, endometrial cancer, colorectal cancer, colon cancer, rectal cancer, lung cancer, and hepatocellular carcinoma, and high processed meat intake was positively associated with risk of breast, colorectal, colon, rectal, and lung cancers. Higher risk of colorectal, colon, rectal, lung, and renal cell cancers were also observed with high total red and processed meat consumption.

The association between meat and fish consumption and bladder cancer risk: a pooled analysis of 11 cohort studies

Evidence on the effects of meat consumption from different sources on the risk of bladder cancer (BC) is limited and controversial. Therefore, this study aimed to evaluate the associations between meat consumption and BC risk using a pooled data approach. Individual data from 11 prospective cohorts comprising 2848 BC cases and 515,697 non-cases with a total of 5,498,025 person-years of follow-up was pooled and analysed to investigate the potential associations between total red meat and products, red meat, processed meat, poultry and total fish and BC risk. Hazard ratios (HRs), with corresponding 95% confidence intervals (CIs), were estimated using Cox regression models stratified on cohort. Overall, an increased BC risk was found for high intake of organ meat (HR comparing highest with lowest tertile: 1.18, 95% CI: 1.03, 1.36, p-trend = 0.03). On the contrary, a marginally inverse association was observed for total fish intake and BC risk among men (HR comparing highest with lowest tertile: 0.79, 95% CI 0.65, 0.97, p-trend = 0.04). No associations were observed for other meat sources. Results of this prospective study suggest that organ meat consumption may be associated with BC development. Replication in large-scale prospective studies and investigation of possible causal mechanisms is needed.

Interventions to reduce meat consumption by appealing to animal welfare: Meta-analysis and evidence-based recommendations

Reducing meat consumption may improve human health, curb environmental damage, and limit the large-scale suffering of animals raised in factory farms. Most attention to reducing consumption has focused on restructuring environments where foods are chosen or on making health or environmental appeals. However, psychological theory suggests that interventions appealing to animal welfare concerns might operate on distinct, potent pathways. We conducted a systematic review and meta-analysis evaluating the effectiveness of these interventions. We searched eight academic databases and extensively searched grey literature. We meta-analyzed 100 studies assessing interventions designed to reduce meat consumption or purchase by mentioning or portraying farm animals, that measured behavioral or self-reported outcomes related to meat consumption, purchase, or related intentions, and that had a control condition. The interventions consistently reduced meat consumption, purchase, or related intentions at least in the short term with meaningfully large effects (meta-analytic mean risk ratio [RR] = 1.22; 95% CI: [1.13, 1.33]). We estimated that a large majority of population effect sizes (71%; 95% CI: [59%, 80%]) were stronger than RR = 1.1 and that few were in the unintended direction. Via meta-regression, we identified some specific characteristics of studies and interventions that were associated with effect size. Risk-of-bias assessments identified both methodological strengths and limitations of this literature; however, results did not differ meaningfully in sensitivity analyses retaining only studies at the lowest risk of bias. Evidence of publication bias was not apparent. In conclusion, animal welfare interventions preliminarily appear effective in these typically short-term studies of primarily self-reported outcomes. Future research should use direct behavioral outcomes that minimize the potential for social desirability bias and are measured over long-term follow-up.

Towards refining World Cancer Research Fund/American Institute for Cancer Research cancer prevention recommendations for red and processed meat intake: insights from Alberta's Tomorrow Project cohort

Current cancer prevention recommendations advise limiting red meat intake to <500 g/week and avoiding consumption of processed meat, but do not differentiate the source of processed meat. We examined the associations of processed meat derived from red v. non-red meats with cancer risk in a prospective cohort of 26 218 adults who reported dietary intake using the Canadian Diet History Questionnaire. Incidence of cancer was obtained through data linkage with Alberta Cancer Registry with median follow-up of 13·3 (interquartile range (IQR) 5·1) years. Multivariable Cox proportional hazards regression models were adjusted for covariates and stratified by age and sex. The median consumption (g/week) of red meat, processed meat from red meat and processed meat from non-red meat was 267·9 (IQR 269·9), 53·6 (IQR 83·3) and 11·9 (IQR 31·8), respectively. High intakes (4th Quartile) of processed meat from red meat were associated with increased risk of gastrointestinal cancer adjusted hazard ratio (AHR): 1·68 (95 % CI 1·09, 2·57) and colorectal cancers AHR: 1·90 (95 % CI 1·12, 3·22), respectively, in women. No statistically significant associations were observed for intakes of red meat or processed meat from non-red meat. Results suggest that the carcinogenic effect associated with processed meat intake may be limited to processed meat derived from red meats. The findings provide preliminary evidence towards refining cancer prevention recommendations for red and processed meat intake.

Red and processed meat consumption and cancer outcomes: Umbrella review

The purpose of this umbrella review was to evaluate the quality of evidence, validity and biases of the associations between red and processed meat consumption and multiple cancer outcomes according to existing systematic reviews and meta-analyses. The umbrella review identified 72 meta-analyses with 20 unique outcomes for red meat and 19 unique outcomes for processed meat. Red meat consumption was associated with increased risk of overall cancer mortality, non-Hodgkin lymphoma (NHL), bladder, breast, colorectal, endometrial, esophageal, gastric, lung and nasopharyngeal cancer. Processed meat consumption might increase the risk of overall cancer mortality, NHL, bladder, breast, colorectal, esophageal, gastric, nasopharyngeal, oral cavity and oropharynx and prostate cancer. Dose-response analyses revealed that 100 g/d increment of red meat and 50 g/d increment of processed meat consumption were associated with 11%-51% and 8%-72% higher risk of multiple cancer outcomes, respectively, and seemed to be not correlated with any benefit.

Adherence to a Western dietary pattern and risk of bladder cancer: A pooled analysis of 13 cohort studies of the Bladder Cancer Epidemiology and Nutritional Determinants international study

Little is known about the association of diet with risk of bladder cancer. This might be due to the fact that the majority of studies have focused on single food items, rather than dietary patterns, which may better capture any influence of diet on bladder cancer risk. We aimed to investigate the association between a measure of Western dietary pattern and bladder cancer risk. Associations between adherence to a Western dietary pattern and risk of developing bladder cancer were assessed by pooling data from 13 prospective cohort studies in the "BLadder cancer Epidemiology and Nutritional Determinants" (BLEND) study and applying Cox regression analysis. Dietary data from 580 768 study participants, including 3401 incident cases, and 577 367 noncases were analyzed. A direct and significant association was observed between higher adherence to a Western dietary pattern and risk of bladder cancer (hazard ratio (HR) comparing highest with lowest tertile scores: 1.54, 95% confidence interval (CI): 1.37, 1.72; P-trend = .001). This association was observed for men (HR comparing highest with lowest tertile scores: 1.72; 95% CI: 1.51, 1.96; P-trend = .001), but not women (P-het = .001). Results were consistent with HR above 1.00 after stratification on cancer subtypes (nonmuscle-invasive and muscle-invasive bladder cancer). We found evidence that adherence to a Western dietary pattern is associated with an increased risk of bladder cancer for men but not women.

Catalog of exogenous risk factors for bladder carcinogenesis

PURPOSE OF REVIEW

The aim of this article is to provide an overview of recent findings regarding the risk factors for bladder cancer.

RECENT FINDINGS

Most of the available data derive from retrospective analysis. Smoking represents the most common and important risk factor. Occupational, dietary, and environmental exogenic carcinogen exposure, as well as several lifestyle factors, can increase the risk of developing bladder cancer.

SUMMARY

Bladder cancer is a common malignancy worldwide. Cigarette smoking, exposure to aromatic amines and arsenic are known risk factors for bladder cancer. Evidence on other modifiable risk factors such as carcinogen exposure derived from the diet or environment as well as occupational hazards is still weak. Medical conditions leading to chronic inflammation, altering insulin resistance, negatively modulating the immune system and/or genetic alterations may have a role in bladder cancer carcinogenesis. Further studies are, however, necessary to identify possible exogenic risk factors, as well as their interactions, that partake in the carcinogenesis of bladder cancer.

Country-Level Relationships of the Human Intake of N and P, Animal and Vegetable Food, and Alcoholic Beverages with Cancer and Life Expectancy

BACKGROUND

The quantity, quality, and type (e.g., animal and vegetable) of human food have been correlated with human health, although with some contradictory or neutral results. We aimed to shed light on this association by using the integrated data at country level.

METHODS

We correlated elemental (nitrogen (N) and phosphorus (P)) compositions and stoichiometries (N:P ratios), molecular (proteins) and energetic traits (kilocalories) of food of animal (terrestrial or aquatic) and vegetable origin, and alcoholic beverages with cancer prevalence and mortality and life expectancy (LE) at birth at the country level. We used the official databases of United Nations (UN), Food and Agriculture Organization of the United Nations (FAO), Organization for Economic Co-operation and Development (OECD), World Bank, World Health Organization (WHO), U.S. Department of Agriculture, U.S. Department of Health, and Eurobarometer, while also considering other possibly involved variables such as income, mean age, or human development index of each country.

RESULTS

The per capita intakes of N, P, protein, and total intake from terrestrial animals, and especially alcohol were significantly and positively associated with prevalence and mortality from total, colon, lung, breast, and prostate cancers. In contrast, high per capita intakes of vegetable N, P, N:P, protein, and total plant intake exhibited negative relationships with cancer prevalence and mortality. However, a high LE at birth, especially in underdeveloped countries was more strongly correlated with a higher intake of food, independent of its animal or vegetable origin, than with other variables, such as higher income or the human development index.

CONCLUSIONS

Our analyses, thus, yielded four generally consistent conclusions. First, the excessive intake of terrestrial animal food, especially the levels of protein, N, and P, is associated with higher prevalence of cancer, whereas equivalent intake from vegetables is associated with lower prevalence. Second, no consistent relationship was found for food N:P ratio and cancer prevalence. Third, the consumption of alcoholic beverages correlates with prevalence and mortality by malignant neoplasms. Fourth, in underdeveloped countries, reducing famine has a greater positive impact on health and LE than a healthier diet.

Are the Chinese Moving toward a Healthy Diet? Evidence from Macro Data from 1961 to 2017

The change in diet structure is one of the critical features of social transformation, and diet structure is directly related to human health. In China, with rapid economic development, changes in the diet structure of the population have begun and are proceeding at a fairly rapid rate. In order to reveal how the Chinese diet is approaching or deviating from the nutritional goal, a novel index, NDBI (National Dietary Balance Index), is developed in this study to investigate the Chinese diet from 1961 to 2017 at a national level. The results show that the Chinese diet has transitioned from the under-intake stage to the over-intake stage. Before the 1980s, Chinese people ate all foods inadequately except staple foods; after the 1980s, the issue of under-intake began to fade, and the intake of meats even became excessive. The intake of staple foods is always excessive during this period. Currently, the Chinese diet is still unhealthy because of the inadequate intake of dairy products and the excessive intake of staple foods and meats. By evaluating diet structure on a national level, this study can help people to better understand how the Chinese diet deviated from the nutritional goal and provides information for policymakers intervening in China’s food consumption.

Association between Nutrient-Based Dietary Patterns and Bladder Cancer in Italy

Limited knowledge is available on dietary patterns and bladder cancer risk. We analyzed data from an Italian case-control study carried out between 2003 and 2014, including 690 incident bladder cancer cases and 665 hospital-controls. We derived nutrient-based dietary patterns applying principal component factor analysis on 28 selected nutrients. We categorized factor scores according to quartiles, and estimated the odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) through logistic regression models, adjusted for major confounding factors. We identified four dietary patterns named "Animal products", "Vitamins and fiber", "Starch-rich", and "Animal unsaturated fatty acids". We found an inverse association between the "Vitamins and fiber" pattern and bladder cancer (OR = 0.70, 95% CI: 0.48-0.99, IV versus I quartile category). Inverse relationships of borderline significance were also found for the "Animal products" and the "Animal unsaturated fatty acids" dietary patterns. No significant association was evident for the "Starch-rich" pattern. The current study allowed us to identify major dietary patterns in this Italian population. Our study confirms available evidence and shows that scoring high on a fruit-and-vegetables pattern provides beneficial effects on bladder cancer risk.

Influence of Alcohol and Red Meat Consumption on Life Expectancy: Results of 164 Countries from 1992 to 2013

Background: High consumption of red meat, which is carcinogenic to humans, and misuse or abuse of alcohol drinking increase premature death and shortened life expectancy. The aim of this study was to examine the association of alcohol and red meat consumption with life expectancy (LE) by analyzing data from 164 countries using an ecological approach. Design: This was a longitudinal ecological study using data from the United Nation’s (UN) Food and Agriculture Organization (FAO) for 164 countries over the period 1992–2013. In regression analysis, the relationship of alcohol and red meat consumption with LE was estimated using a pooled ordinary least squares regression model. Alcohol and red meat consumption were measured every 5 years. Results: The consumption of alcohol and red meat in high-income countries (HIC) was about 4 times (36.8–143.0 kcal/capita/day) and 5 times (11.2–51.9 kcal/capita/day) higher than that in low-income countries (LIC). Red meat and alcohol consumption had a negative estimated effect on LE in HIC (b = −1.616 p = < 0.001 and b = −0.615, p = 0.003). Alcohol consumption was negatively associated with LE for all income groups, while positive relationships were found for all estimates associated with gross national income (GNI). Conclusions: Red meat and alcohol consumption appeared to have a negative impact on LE in high-income countries (HIC) and upper-middle-income countries (UMIC), although it had no significant association with LE in low-income countries (LIC) or lower-middle-income countries (LMIC). This study suggests reviewing the policies on the gradual reduction of alcohol abuse and the high consumption of red meat, particularly HIC and UMIC.

Reducing meat consumption by appealing to animal welfare: protocol for a meta-analysis and theoretical review

BACKGROUND

Reducing meat consumption may improve human health, curb environmental damage and greenhouse gas emissions, and limit the large-scale suffering of animals raised in factory farms. Previous work has begun to develop interventions to reduce individual meat consumption, often by appealing directly to individual health motivations. However, research on nutritional behavior change suggests that interventions additionally linking behavior to ethical values, identity formation, and existing social movements may be particularly effective and longer-lasting. Regarding meat consumption, preliminary evidence and psychological theory suggest that appeals related to animal welfare may have considerable potential to effectively leverage these elements of human psychology. We aim to conduct a systematic review and quantitative meta-analysis evaluating the effectiveness of animal welfare-related appeals on actual or intended meat consumption or purchasing. Our investigation will critically synthesize the current state of knowledge regarding psychological mechanisms of intervening on individual meat consumption and empirically identify the psychological characteristics underlying the most effective animal welfare-based interventions.

METHODS

We will systematically search eight academic databases and extensively search unpublished grey literature. We will include studies that assess interventions intended to reduce meat consumption or purchase through the mention or portrayal of animal welfare, that measure outcomes related to meat consumption or purchase, and that have a control condition. Eligible studies may recruit from any human population, be written in any language, and be published or released any time. We will meta-analyze the studies, reporting the pooled point estimate and additional metrics that describe the distribution of potentially heterogeneous effects. We will assess studies' risk of bias and conduct sensitivity analyses for publication bias. We describe possible follow-up analyses to investigate hypothesized moderators of intervention effectiveness.

DISCUSSION

The findings of the proposed systematic review and meta-analysis, including any identified methodological limitations of the existing literature, could inform the design of successful evidence-based interventions with broad potential to improve human, animal, and environmental well-being.

SYSTEMATIC REVIEW REGISTRATION

The protocol was preregistered via the Open Science Framework (https://osf.io/d3y56/registrations).

Food consumption, meat cooking methods and diet diversity and the risk of bladder cancer

BACKGROUND

Since food metabolites are eliminated by the urinary tract, several studies have investigated the association between diet and bladder cancer risk. Recently, the World Cancer Research Fund International/American Institute for Cancer Research (WCRF/AICR) suggested a potential beneficial effect of some foods (mainly vegetables, fruit, and milk) in the development of bladder cancer. We investigated the association between food groups and bladder cancer risk, seeking insights into food diversity as well as meat cooking methods.

METHODS

Data were derived from an Italian multicentre case-control study, conducted between 2003 and 2014, including 690 bladder cancer cases and 665 frequency-matched controls. Odds ratios (ORs) and the corresponding 95% confidence intervals (95%CIs) for various dietary aspects were estimated by unconditional logistic regression models adjusted for energy intake and the major known risk factors for bladder cancer.

RESULTS

Comparing the highest versus the lowest quartiles, consumption of vegetables (OR = 0.62; 95%CI: 0.44-0.88) and milk/yogurt (OR = 0.62; 95%CI: 0.44-0.87) reduced the risk of bladder cancer. Conversely, consumption of meat increased bladder cancer risk with an OR of 1.57 (95%CI: 1.07-2.31), particularly when the meat was stewed (OR = 1.47; 95%CI: 1.03-2.09) or roasted (OR = 1.41; 95%CI: 1.00-1.99). There was a suggestion that a diversified diet reduced the risk of bladder cancer, but this was not significant.

CONCLUSIONS

Our study consolidates the role of diet in bladder cancer aetiology, showing a reduced risk for vegetable and milk/yogurt consumption and an increased risk for meat consumption, especially when the meat is stewed or roasted.

Processed Meat Intake and Bladder Cancer Risk in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cohort

BACKGROUND

The association between processed meat intake and bladder cancer risk has been evaluated by several observational studies with inconsistent results.

METHODS

In a cohort of 101,721 subjects in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, we analyzed the association of processed meat intake with bladder cancer risk.

RESULTS

After a median of 12.5 years of follow-up, 776 new cases of bladder cancer were identified. Intake of processed red meat was significantly associated with the incidence of bladder cancer after multivariate adjustment [highest vs. lowest quintile: HR, 1.47; 95% confidence interval (CI), 1.12-1.93; P _trend = 0.008]. In contrast, there was only a suggestive but not significant association between intake of total processed meat and bladder cancer risk after multivariable adjustment (highest vs. lowest quintile: HR, 1.16; 95% CI, 0.89-1.50; P _trend = 0.073).

CONCLUSIONS

This large prospective study suggests that intake of processed red meat is associated with a higher risk of bladder cancer.

IMPACT

Bladder cancer risk is increased with cumulative intake of processed red meat.

Characteristics of Selected Antioxidative and Bioactive Compounds in Meat and Animal Origin Products

Meat and meat products have a high nutritional value. Besides major components, meat is rich in bioactive components, primarily taurine, l-carnitine, choline, alpha-lipoic acid, conjugated linoleic acid, glutathione, creatine, coenzyme Q10 and bioactive peptides. Many studies have reported their antioxidant and health-promoting properties connected with their lipid-lowering, antihypertensive, anti-inflammatory, immunomodulatory activity and protecting the organism against oxidative stress. The antioxidant activity of meat components results, among others, from the capability of scavenging reactive oxygen and nitrogen species, forming complexes with metal ions and protecting cells against damage. This review is focused to gather accurate information about meat components with antioxidant and biological activity.

Association between Outdoor Air Pollution and Childhood Leukemia: A Systematic Review and Dose-Response Meta-Analysis

BACKGROUND

A causal link between outdoor air pollution and childhood leukemia has been proposed, but some older studies suffer from methodological drawbacks. To the best of our knowledge, no systematic reviews have summarized the most recently published evidence and no analyses have examined the dose-response relation.

OBJECTIVE

We investigated the extent to which outdoor air pollution, especially as resulting from traffic-related contaminants, affects the risk of childhood leukemia.

METHODS

We searched all case-control and cohort studies that have investigated the risk of childhood leukemia in relation to exposure either to motorized traffic and related contaminants, based on various traffic-related metrics (number of vehicles in the closest roads, road density, and distance from major roads), or to measured or modeled levels of air contaminants such as benzene, nitrogen dioxide, 1,3-butadiene, and particulate matter. We carried out a meta-analysis of all eligible studies, including nine studies published since the last systematic review and, when possible, we fit a dose-response curve using a restricted cubic spline regression model.

RESULTS

We found 29 studies eligible to be included in our review. In the dose-response analysis, we found little association between disease risk and traffic indicators near the child's residence for most of the exposure range, with an indication of a possible excess risk only at the highest levels. In contrast, benzene exposure was positively and approximately linearly associated with risk of childhood leukemia, particularly for acute myeloid leukemia, among children under 6 y of age, and when exposure assessment at the time of diagnosis was used. Exposure to nitrogen dioxide showed little association with leukemia risk except at the highest levels.

DISCUSSION

Overall, the epidemiologic literature appears to support an association between benzene and childhood leukemia risk, with no indication of any threshold effect. A role for other measured and unmeasured pollutants from motorized traffic is also possible. https://doi.org/10.1289/EHP4381.

Changes in food intake from 2005 to 2010 by a cohort of black rural and urban African men and women in the North West Province of South Africa: the PURE-NWP-SA study

OBJECTIVE

We have shown that nutrient intakes of rural and urban black Africans in the North West Province (NWP) of South Africa (SA) followed the typical nutrition transition pattern upon urbanization and modernization. The current study aimed to examine and report on the changes in food intakes from 2005 to 2010 in rural and urban black South Africans participating in the PURE-NWP-SA study.Design/Setting/SubjectsThe PURE-NWP-SA study recruited 2010 volunteers aged 35-70 years in 2005, from which detailed food intakes, measured with a validated quantified FFQ, for 1858 participants were available. In 2010, food intakes of a cohort of 1154 of these participants were measured.

RESULTS

Median energy intake increased in men and women in both rural and urban areas from 2005 to 2010. Changes in food intake were interpreted keeping these changes in energy intake and the contribution of foods and food groups to total energy intake in mind. No 'new' foods were eaten in 2010, but more participants consumed certain foods and products in 2010 than in 2005. Beneficial changes were increased intakes of vegetables, fruit and milk in most groups. The contribution of cooked staple porridges and bread made from fortified maize and bread flour decreased and therefore also did their contribution to micronutrient intakes.

CONCLUSIONS

By promoting and supporting observed beneficial changes such as increased intakes of milk, vegetables and fruit by appropriate policies and educational interventions, it should be possible to steer the nutrition transition in this population into a positive direction.

Mediterranean Diet and Bladder Cancer Risk in Italy

Previous studies have reported that Mediterranean diet is inversely related to the risk of several neoplasms; however, limited epidemiological data are available for bladder cancer. Thus, we examined the association between Mediterranean diet and this neoplasm in an Italian multicentric case-control study consisting of 690 bladder cancer cases and 665 controls. We assessed the adherence to the Mediterranean diet via a Mediterranean Diet Score (MDS), which represents the major characteristics of the Mediterranean diet and ranges from 0 to 9 (from minimal to maximal adherence, respectively). We derived odds ratios (ORs) of bladder cancer according to the MDS score from multiple logistic regression models, allowing for major confounding factors. The ORs of bladder cancer were 0.72 (95% confidence interval, CI, 0.54–0.98) for MDS of 4–5 and 0.66 (95% CI, 0.47–0.93) for MDS of 6–9 (p for trend = 0.02) compared to MDS = 0–3. Results were similar in strata of sex, age, and education, while the risk appeared somewhat lower in never-smokers and patients with pT1–pT4 bladder carcinomas. Among individual components of the MDS, we observed inverse associations for greater consumption of legumes, vegetables, and fish. In our study, which was carried out on an Italian population, the higher adherence to the Mediterranean diet was related to a lower risk of bladder cancer.

Novel treatment strategies for chronic kidney disease: insights from the animal kingdom

Many of the >2 million animal species that inhabit Earth have developed survival mechanisms that aid in the prevention of obesity, kidney disease, starvation, dehydration and vascular ageing; however, some animals remain susceptible to these complications. Domestic and captive wild felids, for example, show susceptibility to chronic kidney disease (CKD), potentially linked to the high protein intake of these animals. By contrast, naked mole rats are a model of longevity and are protected from extreme environmental conditions through mechanisms that provide resistance to oxidative stress. Biomimetic studies suggest that the transcription factor nuclear factor erythroid 2-related factor 2 (NRF2) offers protection in extreme environmental conditions and promotes longevity in the animal kingdom. Similarly, during months of fasting, immobilization and anuria, hibernating bears are protected from muscle wasting, azotaemia, thrombotic complications, organ damage and osteoporosis - features that are often associated with CKD. Improved understanding of the susceptibility and protective mechanisms of these animals and others could provide insights into novel strategies to prevent and treat several human diseases, such as CKD and ageing-associated complications. An integrated collaboration between nephrologists and experts from other fields, such as veterinarians, zoologists, biologists, anthropologists and ecologists, could introduce a novel approach for improving human health and help nephrologists to find novel treatment strategies for CKD.

Carcinogenicity of consumption of red meat and processed meat: A review of scientific news since the IARC decision

In October 2015, the International Agency for Research on Cancer (IARC) issued a press release on the results of the evaluation of the carcinogenicity of red and processed meat. Based on the accumulated scientific literature, the consumption of red meat was classified as "probably carcinogenic to humans" and processed meat as "carcinogenic to humans". Given the importance of this topic, this review was aimed at revising the current state-of-the-art on the carcinogenicity of red and processed meat, some time after the IARC decision. Some new epidemiological studies and new reviews clearly supporting the IARC decision have been published during these months. However, a number of gaps still exist. It is basic to establish the mechanisms leading to the increased risk of colorectal cancer (CRC) and other cancers arising from red and processed meat consumption. Another important pending issue is to establish the role of known/suspected carcinogens contained in uncooked or unprocessed meats, as well as the influence of cooking. Finally, it would be highly recommended to conduct new epidemiological studies to elucidate whether the consumption of white meat, such as pork and/or poultry, are -positively or inversely-associated with an increased risk of CRC and other types of cancer.