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

What is in a label: Effects of labeling on the preference for plant-based products

Our study investigated the effects of three labels on the preference for plant-based products: plant-based, vegan, and Lenten, referring to products appropriate to consume during religious fasting. We conducted two preregistered experiments to measure the effects of labeling on product preference (Study 1, N = 290) and actual tasting preferences (Study 2, N = 251) in a predominantly meat-eating European society (Serbia). We did not find statistically significant effects of labels on the preference for plant-based products in Study 1. In Study 2, the labels affected the preference for plant-based cheese, with Lenten and plant-based labels being slightly preferred over the vegan label. Labeling did not affect the tasting preference for plant-based milk or prosciutto. Across the two studies, the plant-based products were consistently favorably rated, regardless of the label. Plant-based milk emerged as the most preferred product in both studies. We also found that previous experience with plant-based products, as well as speciesism - endorsement of animal exploitation - consistently predicted preferences for plant-based products, irrespective of the label. These findings underscore the influence of labeling on some plant-based products while also revealing the overall minor impact of labeling on consumer preferences. We further discuss the absence of adverse effects of vegan labeling.

Causal associations between dietary factors with head and neck cancer: A two-sample Mendelian randomization study

Objective

Although an association exists between dietary habits and head and neck cancer (HNC), the direct cause-and-effect connection remains elusive. Our objective was to investigate the causal associations between dietary factors and the likelihood of developing HNC.

Methods

Genome-wide association study (GWAS) summary statistics for dietary habits were screened from the UK Biobank, the OncoArray Oral Cavity and Oropharyngeal Cancer consortium, and the FinnGen biobank for HNC. A two-sample Mendelian randomization (MR) analysis was utilized to establish causality. The primary method of analysis was inverse variance weighting (IVW).

Results

Clear evidence of an inverse association existed between dried fruit intake and HNC in both cohorts (OncoArray consortium: IVW OR = 0.183; 95% CI, 0.037-0.915; p = .03864; FinnGen: IVW OR = 0.281; 95% CI, 0.115-0.688; p = .00547). In addition, fresh fruit (IVW-mre OR = 0.066; 95% CI, 0.011-0.413; p = .00369), beef (IVW OR = 15.094; 95% CI, 1.950-116.853; p = .00934), and lamb/mutton intakes (IVW OR = 5.799; 95% CI, 1.044-32.200; p = .0448) were significantly associated with HNC in the OncoArray consortium cohort.

Conclusions

Dried fruit intake may be a protective factor against HNC. The association of fresh fruit and red meat intakes with HNC warrants careful interpretation. Additional studies are necessary to explore potential mechanisms for further evidence.Level of evidence: III.

Extraction and analytical approaches for the determination of post-food processing major carcinogens: A comprehensive review towards healthier processed food

Different food processing methods, e.g. fermentation, grilling, frying, etc., to improve food sensory attributes or shelf-stability are typically employed in different cuisines worldwide. These methods may illicit in-situ health-hazardous chemicals via thermal or enzymatic-mediated processes or chemical interactions with food preservatives. This review provides a comparative overview of the occurrence, extraction, and determination of the major food carcinogens such as nitrosamines (NAs), biogenic amines (BAs), heterocyclic aromatic amines (HAAs), polycyclic aromatic hydrocarbons (PAHs), ethyl carbamate (EC), and malondialdehyde (MDA). Their carcinogenicity levels vary from group 1 (carcinogenic to humans) e.g. benzo[a]pyrene, group 2A (probably carcinogenic to humans) e.g. N-nitrosodiethylamine, group 2B (possibly carcinogenic to humans) e.g. chrysene or group 3 (non-classifiable as carcinogenic to humans) e.g. MDA. Chromatography-based methods are the most predominant techniques used for their analysis. LC-MS is widely used for both volatile/non-volatile NAs, HAAs, BAs, and EC, whereas GC-MS is applied more for volatile NAs, PAHs and MDA.

Metabolic interplays between the tumour and the host shape the tumour macroenvironment

Metabolic reprogramming of cancer cells and the tumour microenvironment are pivotal characteristics of cancers, and studying these processes offer insights and avenues for cancer diagnostics and therapeutics. Recent advancements have underscored the impact of host systemic features, termed macroenvironment, on facilitating cancer progression. During tumorigenesis, these inherent features of the host, such as germline genetics, immune profile and the metabolic status, influence how the body responds to cancer. In parallel, as cancer grows, it induces systemic effects beyond the primary tumour site and affects the macroenvironment, for example, through inflammation, the metabolic end-stage syndrome of cachexia, and metabolic dysregulation. Therefore, understanding the intricate metabolic interplay between the tumour and the host is a growing frontier in advancing cancer diagnosis and therapy. In this Review, we explore the specific contribution of the metabolic fitness of the host to cancer initiation, progression and response to therapy. We then delineate the complex metabolic crosstalk between the tumour, the microenvironment and the host, which promotes disease progression to metastasis and cachexia. The metabolic relationships among the host, cancer pathogenesis and the consequent responsive systemic manifestations during cancer progression provide new perspectives for mechanistic cancer therapy and improved management of patients with cancer.

Sociodemographic and behavioural determinants of vegetarian main dish selection in a French university cafeteria: A three-month observational study with repeated measures

Reducing meat consumption is crucial for improving population and planetary health. Millions of students regularly eat at university cafeterias, which offer a unique opportunity to promote meat-free meals to new generations by addressing barriers such as accessibility, price, and cooking skills. This study aimed to analyse the individual characteristics associated with the proportion of vegetarian main dish choices in a university cafeteria and to determine whether this behaviour influenced the nutritional quality and environmental impact of student meals. A sample of 257 French students who ate regularly at a large university cafeteria took part in an observational study with repeated measures. They took pictures of their meal trays each time they ate at the cafeteria for three months. They completed an online questionnaire to assess their sociodemographic characteristics and various behavioural determinants of the choice of a vegetarian main dish based on the Capability, Opportunity, Motivation Behaviour (COM-B) framework. Being a woman was the only sociodemographic characteristic significantly associated with more frequent vegetarian main dish selection. The proportion of vegetarian choices was negatively associated with attachment to meat (p < 0.001, η2 = 0.189) and positively associated with environmental knowledge (p = 0.034, η2 = 0.018) and the following food choice motives: animal welfare (p < 0.001, η2 = 0.062), health (p < 0.001, η2 = 0.044), ethics (p = 0.002, η2 = 0.039), natural content (p = 0.010, η2 = 0.026), religion (p = 0.014, η2 = 0.025), and mood (p = 0.022, η2 = 0.020). Students who chose vegetarian main dishes more frequently composed healthier (p = 0.023, η2 = 0.020) and more environmentally friendly meal trays (p < 0.001, η2 = 0.349). These findings highlight the variability in the students' propensity to choose vegetarian main dishes in a university cafeteria and its association with motivational factors in a food environment bound by design.

Global, regional, and national burden of early-onset colorectal cancer and projection to 2050: An analysis based on the Global Burden of Disease Study 2021

OBJECTIVES

Early-onset colorectal cancer (EO-CRC) is becoming increasingly concerning due to its impact on individuals under 50 years old. We explored the burden of EO-CRC to provide information for planning effective management and prevention strategies.

STUDY DESIGN

We conducted secondary analyses to assess the burden of EO-CRC using data from GBD 2021.

METHODS

The incidence, prevalence, deaths, disability-adjusted life years (DALYs) and their rates across 204 countries and territories were obtained from GBD 2021 database. The estimated annual percentage change (EAPC) calculation was used to assess temporal trends in these metrics. Additionally, we reported the proportion of DALYs attributable to risk factors and projected future disease burden till 2050.

RESULTS

The global number of new EO-CRC cases increased from 107,310 in 1990 to 211,890 in 2021. Both age-standardized incidence rate (ASIR) and prevalence rate (ASPR) of EO-CRC showed overall increases over the study period (ASIR: EAPC = 0.96 (0.9-1.02), ASPR: EAPC = 1.5 (1.44-1.55)). However, a decline in ASIR and ASPR was observed in 2020 and 2021. Males consistently showed higher EO-CRC indicators compared to females. Furthermore, projections indicated that deaths and DALYs cases are likely to fluctuate but generally increase by 2050, reaching 85,602 and 4,283,093, respectively.

CONCLUSIONS

The global impact of EO-CRC has increased significantly from 1990 to 2021, revealing notable variations across SDI regions, countries, age groups, and sexes. Besides, deaths and DALYs are predicted to rise by 2050. These results highlight the importance of implementing measures to address the growing burden of EO-CRC globally.

Positive associations between dietary potential acid load and renal cancer incidence and mortality: Results from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening trial

OBJECTIVES

To explore the relationships between dietary potential acid load and renal cancer (RC) incidence and mortality.

STUDY DESIGN

A prospective cohort study involving 97,166 U S. adults aged 55-74 years.

METHODS

Data utilized in this study were drawn from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO). Dietary potential acid load was assessed by dietary acid load (DAL), potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores using a validated Diet History Questionnaire (DHQ). Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) for RC incidence and mortality with adjustment for potential confounders. Restricted cubic spline (RCS) plots were utilized to reveal whether there were nonlinear associations between the DAL, PRAL, and NEAP scores and RC incidence and mortality.

RESULTS

During a follow-up period of 859,907 and 1,467,573 person-years, 423 RC cases and 221 mortality cases were documented. DAL, PRAL, and NEAP scores were positively associated with RC incidence (DAL: HR 1.41; 95% CI 1.05, 1.90; P-trend = 0.010; PRAL: HR 1.45; 95% CI 1.10, 1.91; P-trend = 0.010; NEAP: HR 1.39; 95% CI 1.04, 1.85; P-trend = 0.029). Similar associations were observed between DAL, PRAL, and NEAP scores and RC mortality. The RCS plots demonstrated a nonlinear association between DAL score and RC risk, while a linear association was observed between DAL score and RC mortality. Similar linear associations were found between PRAL and NEAP scores and RC incidence and mortality.

CONCLUSION

A higher dietary potential acid load was associated with higher risk of RC incidence and mortality in American adults.

Influence of Microbial Transglutaminase on the Formation of Physico-Chemical Properties of Meat Analogs

With growing environmental and health concerns surrounding meat consumption, meat analogs have emerged as sustainable and health-conscious alternatives. A major challenge in developing these products is replicating the fibrous, elastic texture of meat, where microbial transglutaminase (MTG) has shown significant potential. MTG catalyzes protein cross-linking, enhancing the structural integrity of meat analogs. This study aimed to evaluate the effects of MTG concentrations (0%, 0.5%, and 1%) and incubation times (0, 1.5, and 3 h) on the quality and rheological properties of meat analogs. Analogs were tested for pH, protein content, dry matter, fat retention, and thermal loss. Textural properties, including hardness, cohesiveness, gumminess, springiness, and chewiness, were determined using texture profile analysis, while leakage parameters were evaluated through water and fat content tests. Results revealed that higher MTG concentrations and longer incubation times improved protein content (14.34% to 15.55%), dry matter (29.61% to 32.53%), and reduced total leakage (1.262% to 0.634%). Textural properties, including hardness (57.08 N to 83.14 N), gumminess (19.40 N to 30.00 N), and chewiness (17.60 N × mm to 29.58 N × mm), also significantly improved with increasing MTG levels. Thermal loss ranged from 98.37% to 100.9%, showing enhanced retention at higher MTG concentrations. These results support the role of MTG in creating meat analogs with improved meat-like textures, achieved through enhanced protein cross-linking and moisture retention.

Diet and Cancer Metabolism

Diet and exercise are modifiable lifestyle factors known to have a major influence on metabolism. Clinical practice addresses diseases of altered metabolism such as diabetes or hypertension by altering these factors. Despite enormous public interest, there are limited defined diet and exercise regimens for cancer patients. Nevertheless, the molecular basis of cancer has converged over the past 15 years on an essential role for altered metabolism in cancer. However, our understanding of the molecular mechanisms that underlie the impact of diet and exercise on cancer metabolism is in its very early stages. In this work, we propose conceptual frameworks for understanding the consequences of diet and exercise on cancer cell metabolism and tumor biology and also highlight recent developments. By advancing our mechanistic understanding, we also discuss actionable ways that such interventions could eventually reach the mainstay of both medical oncology and cancer control and prevention.

Effect of carnosine on nitrosamine formation in gastric-simulated aqueous and lipid environments

BACKGROUND

Nitrite salts are frequently utilized as meat additives to improve the quality and safety of processed meat products. However, these salts are associated with the formation of carcinogenic nitrosamines. Given its potential regulating effect on the formation of intermediate molecules, such as nitric oxide, it is hypothesized that carnosine, a meat constituent possessing antioxidant activity and other multiple health benefits, could dampen the formation of nitrosamines. The current study therefore assessed the effect of carnosine on nitrosamine formation in both a monophasic aqueous system and a biphasic water-lipid system simulating a gastric environment.

RESULTS

In the monophasic system, relatively high levels of carnosine were required to significantly reduce the formation of different species of nitrosamine compared with the control (no carnosine). While higher levels of some nitrosamines were generated in both phases of the biphasic system, low carnosine concentrations significantly suppressed nitrosamine formation in the aqueous phase, while in the lipid phase, intermediate levels of carnosine were required. At higher carnosine levels, further reduction in nitrosamines was observed in the lipid phase.

CONCLUSIONS

This study demonstrates the capacity of carnosine to reduce nitrosamine formation in aqueous and lipid environments and suggests the potential of dietary carnosine to lower the risks associated with the consumption of processed meat products. © 2024 His Majesty the King in Right of Canada and The Author(s). Journal of the Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry. Reproduced with the permission of the Minister of Agriculture and Agri-Food Canada.

Common questions and misconceptions about protein supplementation: what does the scientific evidence really show?

Protein supplementation often refers to increasing the intake of this particular macronutrient through dietary supplements in the form of powders, ready-to-drink shakes, and bars. The primary purpose of protein supplementation is to augment dietary protein intake, aiding individuals in meeting their protein requirements, especially when it may be challenging to do so through regular food (i.e. chicken, beef, fish, pork, etc.) sources alone. A large body of evidence shows that protein has an important role in exercising and sedentary individuals. A PubMed search of "protein and exercise performance" reveals thousands of publications. Despite the considerable volume of evidence, it is somewhat surprising that several persistent questions and misconceptions about protein exist. The following are addressed: 1) Is protein harmful to your kidneys? 2) Does consuming "excess" protein increase fat mass? 3) Can dietary protein have a harmful effect on bone health? 4) Can vegans and vegetarians consume enough protein to support training adaptations? 5) Is cheese or peanut butter a good protein source? 6) Does consuming meat (i.e., animal protein) cause unfavorable health outcomes? 7) Do you need protein if you are not physically active? 8) Do you need to consume protein ≤ 1 hour following resistance training sessions to create an anabolic environment in skeletal muscle? 9) Do endurance athletes need additional protein? 10) Does one need protein supplements to meet the daily requirements of exercise-trained individuals? 11) Is there a limit to how much protein one can consume in a single meal? To address these questions, we have conducted a thorough scientific assessment of the literature concerning protein supplementation.

Transforming plant proteins into plant-based meat alternatives: challenges and future scope

The global transition towards sustainable living has led to a growing demand for innovative food products that enhance environmental sustainability. Traditional meat production is known for its high energy consumption and significant carbon emissions, necessitating alternative approaches. Plant-based meat (PBM) offers a promising solution to reduce the ecological footprint of animal agriculture. This paper examines various challenges in PBM development, including nutritional equivalence, industrial scalability, organoleptic properties, and digestibility. Addressing these challenges requires interdisciplinary collaboration to ensure consumer acceptance, regulatory compliance, and environmental stewardship. Advanced technologies like nanotechnology, fermentation, and enzymatic hydrolysis, along with automation and repurposing cattle farms, offer solutions to enhance PBM's quality and production efficiency. By integrating these innovations, PBM has the potential to revolutionize the food industry, offering sustainable and nutritious alternatives that meet global dietary needs while significantly reducing environmental impact.

Graphical abstract

Spatiotemporal trends in the burden of colorectal cancer incidence and risk factors at country level from 1990 to 2019

BACKGROUND AND AIM

Worldwide, the incidence of colorectal cancer (CRC) continues to rise and remains a major public health concern. This study aimed to analyze the temporal and spatial trends in CRC incidence and related risk factors at the country level.

METHODS

Data on CRC and related risk factors were obtained from the Global Burden of Disease Study (GBD) 2019 study. Temporal trends were evaluated using estimated annual percentage change while spatial trends were analyzed using spatial autocorrelation and autoregression. Additionally, linear mixed-effects models were employed to identify risk factors linked to CRC incidence.

RESULTS

Globally, from 1990 to 2019, the incidence cases of CRC increased by 157.23%. At the national level, the incidence of CRC increased in most countries, with the highest increases of age-standardized incidence rate (ASIR) in Equatorial Guinea, Vietnam, and China. In both 1990 and 2019, global spatial clustering of CRC ASIR highlighted hotspots in Europe, characterized by elevated CRC ASIR levels. A comparative analysis of risk factors between hotspot countries and others indicated that gender and alcohol use exerted greater influence in hotspots than elsewhere.

CONCLUSION

Although from 1990 to 2019, the highest growth in ASIR of CRC has been observed in African, Asian, and Latin American countries, the hotspots are still concentrated in Europe. In the identified hotspots, gender and alcohol use exert a more significant impact on CRC incidence compared with other countries. Thus, we should pay attention to countries where the CRC incidence is increasing and these risk factors.

Effects of sodium tripolyphosphate on the quality and digestion properties of PSE pork

This study aimed to examine the impact of sodium tripolyphosphate (STPP) on the quality and digestive characteristics of PSE pork. The results showed a notable decrease in cooking loss of PSE pork from 29.11% to 25.67% with increasing STPP concentration (P < 0.05). Additionally, the gastric digestibility of PSE pork decreased significantly from 52.01% to 45.81% (P < 0.05). The particle size of digesta decreased significantly after gastrointestinal digestion (P < 0.05). These changes were primarily due to the enhanced cross-linking of proteins through ionic interactions, hydrogen bonds and hydrophobic interactions, and resulted in the embedding of hydrophobic groups and endogenous fluorophores. Furthermore, denser network was formed. These findings give a new insight into considering the impact of STPP on meat nutrition when used to enhance texture and water holding capacity.

Adults' beliefs related to reducing red meat consumption: An exploratory study in the province of Quebec, Canada

A significant consumption of red meat is associated with various issues (e.g. public health, sustainability, animal welfare). This exploratory study aims to identify the perceived advantages and disadvantages, perceived approval and disapproval by important others, and perceived barriers and facilitators pertaining to reducing red meat consumption among adults. An online questionnaire based on the Theory of Planned Behaviour was used to elicit the salient beliefs of 55 red meat eaters living in the province of Quebec (Canada). A content analysis performed by two independent coders revealed that the predominant themes (modal beliefs) included health, environment, saving money, food preferences, social influence, perceptions of the alternatives of meat, and efforts related to change. This study can inform the development of interventions aimed at promoting the reduction of red meat consumption.

Bread Consumption and Cancer Risk: Systematic Review and Meta-Analysis of Prospective Cohort Studies

Because bread can contain potential carcinogens such as acrylamide, and is widely consumed, we conducted a systematic review and meta-analysis to determine whether bread consumption is associated with increased cancer risk. PubMed and Medline databases were searched up to 1 March 2024, for studies that provided hazard ratios (HRs) (or similar) for bread consumption and cancer incidence or mortality. Only prospective cohort studies were included. We used the Preferred Reporting Items of Systematic reviews and Meta-Analyses checklist. Meta-analysis was performed with Cochrane's RevMan 5.4.1 software using a DerSimonian-Laird random-effects model. Heterogeneity was assessed with Cochrane's Q (χ2) and I 2 statistics, and publication bias was assessed with Egger's test. Twenty-four publications met inclusion criteria, including 1,887,074 adults, and were included in the systematic review. Ten publications that provided HRs were included in the meta-analysis for highest compared with lowest intakes, and an additional 7 publications that provided mortality or incident rate ratios or relative risks were included in supplemental meta-analyses. Of 108 reported HRs (or similar), 97 (79%) were either not statistically significant (n = 86) or indicated lower cancer risk (n = 11) associated with the highest intakes of bread. The meta-analysis indicated that bread intake was not associated with site-specific cancer risk [HR: 1.01; 95% confidence interval (CI): 0.89, 1.14; P = 0.92; 8 publications] or total cancer mortality (HR: 0.90; 95% CI: 0.73, 1.11; P = 0.32; 2 publications). Supplemental meta-analyses using all risk estimates in addition to HRs confirmed these findings. Whole-grain bread was associated with a lower site-specific cancer risk, mainly because of reduced colorectal cancer risk. Results of the systematic review and meta-analysis indicate that bread consumption is not associated with increased site-specific cancer risk, whereas high whole-grain/nonwhite bread consumption is associated with lower total cancer mortality and colorectal cancer risk. This study was registered at Clinical Trials Registry of PROSPERO as registration number CRD42023414156.

The role of ultra-processed foods in plant-based diets: associations with human health and environmental sustainability

PURPOSE

Investigate the associations of ultra-processed foods (UPF) in healthful (hPDI) and unhealthful (uPDI) plant-based diets with all-cause mortality, greenhouse gas emissions (GHGE), and blue water consumption (BWC).

METHODS

Analyses were based on 35,030 participants (20-70 years; 74% females) from the EPIC-NL cohort who were followed up from 1993 to 1997 through 2014. Plant-based diet indices (hPDI and uPDI) and UPF consumption were calculated from a validated FFQ, assessed at baseline. Cox proportional hazard and multiple linear regression models were used to estimate associations between combined quartiles of the PDI indices and UPF consumption.

RESULTS

With lower hPDI and higher UPF diets as the reference, we observed the following. Risk estimates of all-cause mortality were 0.98 (95% CI: 0.83, 1.16) for lower UPF consumption, 0.86 (95% CI: 0.68, 1.08) for higher hPDI, and 0.78 (95% CI: 0.66, 0.89) for combined higher hPDI and lower UPF consumption. Results with the uPDI were inconclusive. Mean differences in GHGE and BWC were 1.4% (95% CI: 0.3, 2.4) and 1.6% (95% CI: -0.5, 3.7) for lower UPF consumption, -7.4% (95% CI: -8.6, -6.4) and 9.6% (95% CI: 7.2, 12.0) for higher hPDI, and - 6.8% (95% CI: -7.4, -6.1) and 13.1% (95% CI: 11.6, 14.8) for combined higher hPDI and lower UPF consumption. No apparent conflict between environmental impacts was observed for the uPDI; GHGE and BWC were lower for higher uPDI scores.

CONCLUSION

Mortality risk and environmental impacts were mostly associated with the amount of plant-based foods and to a lesser extent UPF in the diet. Shifting to a more healthful plant-based diet could improve human health and reduce most aspects of environmental impact (GHGE, but not BWC) irrespective of UPF consumption.

Making Sense of the Relationship Between Ultra-Processed Foods, Obesity, and Other Chronic Diseases

Ultra-processed foods (UPFs) is a food category within the NOVA system. The key feature of UPFs are foods that have been highly processed and contain various additives, especially those that are industrially produced. It is claimed that UPFs are inherently unhealthy. The classification system is highly controversial. This paper critically evaluates the evidence. In stark contrast to conventional systems for food classification, the NOVA system disregards the nutritional values of foods. As a result, many foods generally considered to be healthy are included as UPFs, whereas many unhealthy foods are excluded. Epidemiological studies, mainly prospective cohort studies, have consistently reported an association between the intake of UPFs and risk of obesity, cardiovascular disease (CVD), type 2 diabetes, common mental disorders (especially depression), and all-cause mortality. A similar association has been reported for cancer and hypertension, but the supporting evidence is weaker. The most plausible explanation for this is that the associations are largely due to a limited number of unhealthy foods, such as processed meat and sugar-sweetened beverages. Studies of the relationship between UPFs and obesity present a different picture. There is much evidence that suggests that UPFs play a major causal role in obesity. The high contents of fat, sugar, carbohydrates, and sodium commonly present in UPFs makes these foods hyperpalatable. In addition, UPFs typically have a high energy density. As a result of these two features of UPFs, most people consume an excessive energy intake when presented with UPFs. Because UPFs include a wide range of foods, many of which are healthy, it is likely that while many UPFs are obesogenic, many others are not.

Dietary and Nutritional Interventions for the Management of Endometriosis

Endometriosis is a chronic, complex, systemic inflammatory condition that impacts approximately 190 million girls and women worldwide, significantly impacting their quality of life. The effective management of endometriosis requires a multi-disciplinary and holistic approach, one that includes surgical and medical management, such as a laparoscopy and a chronic medical management plan, as well as dietary, nutritional, and lifestyle adjunct interventions, such as pelvic pain physiotherapy and acupuncture. There is growing evidence to support the role of dietary and nutritional interventions in the adjunct management of endometriosis-related pain and gastrointestinal symptoms. However, the implementation of these interventions is often not regulated, as patients with endometriosis often adopt self-management strategies. Diet and nutrition can modulate key players integral to the pathophysiology of endometriosis, such as, but not limited to, inflammation, estrogen, and the microbiome. However, it is unclear as to whether diet plays a role in the prevention or the onset of endometriosis. In this review, we discuss three key players in the pathogenesis of endometriosis-inflammation, estrogen, and the microbiome-and we summarize how diet and nutrition can influence their mechanisms, and consequently, the progression and manifestation of endometriosis. There is a major need for evidence-based, non-invasive adjunct management of this debilitating disease, and diet and nutritional interventions may be suitable.

A global analysis of portion size recommendations in food-based dietary guidelines

Objective

Since large food portion sizes (PS) lead to overconsumption, our objective was to review PS recommendations for commonly consumed food groups reported in Food-Based Dietary Guidelines (FBDGs) globally and to assess variation in PS across countries and regions.

Methods

Consumer-oriented FBDGs from the Food and Agriculture Organization (FAO) online repository were used to evaluate dietary recommendations, PS and number of portions for common food groups. Guidelines were classified for each group as qualitative, quantitative, or missing. A standardized approach was applied to convert PS recommendations given as household measures, cup equivalents, pieces and other measures into grams for cross comparison. Variation of recommended PS of common food groups within and across regions was examined.

Results

Among 96 FBDGs, variations were found both across and within regions. At a regional level, the highest median PS recommendations were seen in Europe for Meat, Fish and Pulses, in the Near East for Dairy products, and in Africa for most grain-based foods. Recommendations for Fruits and Vegetables showed the highest consistency across FBDGs worldwide, whereas guidance on Meat, fish & eggs and Cooked cereals/grains showed discrepancies in the classification of foods into categories, as well as in the number of portions per day.

Discussion

While some variation in PS recommendations across countries can be expected due to cultural and regional dietary practices, inconsistent definitions to refer to a portion and varied derivation methods may further produce discrepancies. Harmonizing development methods for FBDG could help establish more consistent reference portion sizes and therefore provide clearer guidance to consumers.

Beyond the Liver: A Comprehensive Review of Strategies to Prevent Hepatocellular Carcinoma

BACKGROUND/OBJECTIVES

Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality worldwide, primarily developing in the context of chronic liver disease. Traditional prevention has focused on liver-specific interventions like antiviral therapies and surveillance. However, extrahepatic factors also significantly contribute to HCC risk. This review explores comprehensive strategies for HCC prevention, including both hepatic and extrahepatic factors.

METHODS

An extensive literature search of peer-reviewed articles up to October 2024 was conducted, focusing on studies addressing HCC prevention strategies. Studies that focused on both hepatic and extrahepatic factors were included. Data were extracted and synthesized to provide an overview of current prevention strategies and their effectiveness in reducing HCC incidence.

RESULTS

Hepatitis B vaccination and antiviral treatments for hepatitis B and C significantly reduce HCC incidence. Lifestyle modifications-such as reducing alcohol consumption, maintaining a healthy weight through diet and exercise, and smoking cessation-are crucial in lowering HCC risk. Environmental measures to limit exposure to aflatoxins and other hazards also contribute to prevention. Regular surveillance of high-risk groups enables early detection and improves survival rates. Emerging strategies like immunotherapy and gene therapy show potential for further reducing HCC risk.

CONCLUSIONS

A comprehensive approach combining medical interventions, lifestyle changes, and environmental controls is essential for effectively decreasing HCC incidence globally. Implementing these combined measures could significantly reduce the global burden of HCC.

Long-term trends in the burden of breast cancer in China over three decades: a joinpoint regression and age-period-cohort analysis based on Global Burden of Disease 2021

We analyzed the trends in breast cancer (BC) morbidity, prevalence, and mortality among Chinese residents from 1990 to 2021. We then used joinpoint regression to further assess BC morbidity and mortality. We screened the morbidity, mortality, and prevalence of BC in Chinese residents (1990-2021) from the Global Burden of Disease. We used age-period-cohort (APC) modeling to assess the effects of age, period, and cohort on BC morbidity and mortality separately. We also used the joinpoint model to characterize trends in BC morbidity and mortality in China. From 1990 to 2021, age-standardized rates of morbidity have risen significantly, whereas mortality has declined. We discovered that the risk of morbidity and death rose with age by using the APC model. We also found that mortality and morbidity roughly continued to increase over time, and finally, we found that the later the birth cohort, the lower the mortality and the higher the morbidity. From 1990 to 2021, the burden of BC disease in China will continue to rise, and the situation of BC prevention and control will remain severe. Therefore, regular imaging and palpation examinations should be performed in the regular population over 40 years of age. When treating patients with BC, healthcare workers should develop individualized treatment plans to further reduce mortality.

Inhibitory action of antimicrobial peptides against the formation of carcinogenic and mutagenic heterocyclic amines in meat

Thermal processing of meat leads to the development of Maillard's reaction intermediates, and carcinogenic toxicants. For the first time, the effectiveness of three (HX-12A, HX-12B and HX-12C) antimicrobial peptides (AMPs) against the formation of heterocyclic amines (HAs) in chemical and meat model systems. The results showed that AMPs especially 12A and 12C have strong metal chelation potential (48 and 40% at 1 mg/ml) and antioxidant activity (35 and 25% at 1 mg/ml), respectively, which were endorsed by their secondary structure (FTIR analysis) in terms of high β-sheets (1628 cm-1 and 1672 cm-1) in those AMPs. UPLC-MS analysis revealed that 12A and 12C were the most capable AMPs in MeIQx and PhIP-producing chemical models, respectively, whereas 12B promoted the HAs formation even higher than control. In particular, 12C AMP significantly (P < 0.05) decreased the most abundant carcinogenic HAs (PhIP) up to 90% at 9 mg/100 g of fresh meat, whereas 12A inhibited up to 80% of mutagenic HAs at same level compared to control and 12B. Low Field Nuclear Magnetic Resonance (LF-NMR) test showed that inhibitory effect of 12A and 12C was mediated by means of retaining water (lower T22 and T23 relaxation time) inside the macromolecules. This favorable effect was also evidenced by significantly enhanced tryptophan fluorescent intensity. Finally, based on correlation and principle component analysis, the mechanism of action has been proposed. These outcomes recommend that 12A and 12C are potential AMPs for the attenuation of HAs in thermally processed meat-based products.

Preparation and characteristics of soy protein isolate - Sea buckthorn flavone emulsion and their effects of on quality and heterocyclic amines of roasted mutton granules

A soy protein isolate (SPI) - sea buckthorn flavonoid emulsion was developed to study its effects on roasted lamb quality and heterocyclic amine (HAAs) precursors. The emulsion was stable with uniformly dispersed, well-encapsulated droplets averaging 0.1 to 10 μm. CLSM confirmed its good physical stability, small particle size, and uniform dispersion. FTIR the existence of hydrogen bond, hydrophobic interaction and physical adhesion between SPI and sea-buckthorn flavonoids. The emulsion improved lamb pellet texture by reducing chewiness and hardness, increasing adhesion, and decreasing browning. The emulsion-treated roasted mutton showed a 47.95-53.56 % increase in DPPH scavenging activity and MDA content reduction from 60.78 to 17.80 nmol/mg, indicating strong antioxidant activity and lipid oxidation inhibition. For both precursors and HAAs, there was a significant intensity of inhibition, where creatine decreased by about 44.91-68.34 %, glucose by 84.47 %-97.74 %, and the seven HAAs, Norharman, Harman, IQ, MeIQ, MeIQx, AαC, and PhIP, were inhibited by 79.64 %, respectively, 88.76 %, 65.07 %, 87.27 %, 96.16 %, 89.30 % and 49.44 %, respectively. This study aimed to develop a novel soy protein isolate-sea buckthorn flavonoid emulsion and evaluate its potential to improve roasted lamb quality while inhibiting the formation of harmful HAAs.

Effects of High Altitude and Diet on Gastric Disease Severity in Helicobacter pylori Infection in Peru

Helicobacter pylori is a bacterium that infects approximately half of the world's population, being more prevalent in low- and middle-income countries. H. pylori can cause gastritis, peptic ulcer disease, mucosa-associated lymphoid tissue lymphoma, and gastric cancer, which is among the five most frequent cancers worldwide. Other factors such as a diet low in vegetables and high in processed red meat have been associated with gastric cancer. Here, we studied the effects of high altitude and diet on gastric disease severity in H. pylori infection in a multicenter cross-sectional study in Peru (N = 343). We recruited people from villages with distinct eating habits (high meat consumption, mixed, and limited meat consumption diet) in the Andes (Puno), and compared them to people living at sea level with a mixed diet (Lima). H. pylori infection prevalence was higher at high altitude than at sea level. High altitude, diet, and age showed a significant correlation with the severity of gastric disease, whereas H. pylori infection and sex did not. However, high altitude was not found to be a risk factor for intestinal metaplasia, while diet and age were. At high altitude, a meat-rich diet was associated with a higher incidence of metaplasia compared to a plant-based diet. This study provides a comparison of communities living at high altitude with spontaneously different diets, showing that high processed red meat consumption is a risk factor for gastric disease. Further studies are needed to explain this phenomenon and its impact on the development and progression of gastric pathologies.

Environmental pollution and cancer

OBJECTIVE

To identify and describe pollutants with carcinogenic potential that contaminate indoor and outdoor air, food and soil.

DATA SOURCE

The descriptors environmental pollutants, occupational cancer, prevention and soil pollutants were used to conduct the research for literature review. Articles published from 2003 to 2024 in the electronic databases Pubmed Medline, Lilacs and Scielo, in Portuguese and English, were included.

SUMMARY OF FINDINGS

There are multiple sources of pollution in the external and internal environments, including motor vehicles, industrial facilities, smoke from tobacco products, agricultural activities, fires and domestic combustion devices. The most important pollutants related to chemical substances include all forms of asbestos, benzene, exhaust gases from gasoline engines, food and water contaminants, such as arsenic and inorganic arsenic compounds, in addition to persistent organic pollutants, such as dioxins. The use of fossil fuels and biomass for domestic heating are also important sources of pollution. The carcinogenic potential of pollutants varies according to the sources of pollution, climate conditions and the region's topography.

CONCLUSIONS

Global environmental pollution is an international public health problem with multiple health effects. Many environmental pollutants are proven to be carcinogenic to adults, while few causes have been scientifically established for children. Pollution is mainly caused by uncontrolled urbanization and industrialization. Preventing environmental exposure to carcinogenic pollutants requires both government regulation and community action and commitment.

The association between empirical dietary inflammatory pattern and risk of cancer and cancer-specific mortality: a systematic review and meta-analysis of prospective cohort studies

Background/aim

Current evidence indicates a correlation between the inflammatory potential of diet and the risk of cancer and cancer-specific mortality. This study aimed to assess the association between empirical dietary inflammatory pattern (EDIP), which has recently been designed based on the inflammatory potential of the diet, and the risk of cancer and cancer-specific mortality.

Methods

A systematic literature search was conducted across the PubMed/Medline, Scopus, and Web of Science databases from January 2016 to March 2024. A random effects model was used to calculate the pooled effect size (ES) and 95% confidence intervals (95% CI). Heterogeneity between studies was assessed using the Cochran Q test and the I 2 statistic.

Results

From the initial 229 records, 24 prospective cohort studies with 2,683,350 participants and 37,091 cancer incidence cases, as well as 20,819 cancer-specific mortality, were included in our study. Pooled results indicated a significant association between higher adherence to the EDIP and an increased risk of total cancer (ES: 1.10; 95% CI: 1.05-1.15; I 2 = 41.1), colorectal cancer (ES: 1.19; 95% CI: 1.11-1.27; I 2 = 41.1), and liver cancer (ES: 1.48; 95% CI: 1.14-1.94; I 2 = 36.9). However, no significant association between increased adherence to the EDIP and an increased risk of ovarian or endometrial cancer was found. Furthermore, greater adherence to the EDIP was significantly associated with an increased risk of cancer-specific mortality (ES: 1.18; 95% CI: 1.05-1.33; I 2 = 45.4).

Conclusion

Our results showed that a diet with higher inflammatory properties is associated with an increased risk of cancer and cancer-specific mortality.

Systematic review registration

PROSPERO registration no. CRD42024496912.

Double-Edged Sword Effect of Diet and Nutrition on Carcinogenic Molecular Pathways in Breast Cancer

Environmental exposure to a mixture of chemical xenobiotics acts as a double-edged sword, promoting or suppressing tumorigenesis and the development of breast cancer (BC). Before anything else, we are what we eat. In this review, we highlight both "the good" and "the bad" sides of the daily human diet and dietary patterns that could influence BC risk (BCR) and incidence. Thus, regularly eating new, diversified, colorful, clean, nutrient-rich, energy-boosting, and raw food, increases apoptosis and autophagy, antioxidation, cell cycle arrest, anti-inflammation, and the immune response against BC cells. Moreover, a healthy diet could lead to a reduction in or the inhibition of genomic instability, BC cell stemness, growth, proliferation, invasion, migration, and distant metastasis. We also emphasize that, in addition to beneficial compounds, our food is more and more contaminated by chemicals with harmful effects, which interact with each other and with endogenous proteins and lipids, resulting in synergistic or antagonistic effects. Thus, a healthy and diverse diet, combined with appropriate nutritional behaviors, can exert anti-carcinogenic effects and improve treatment efficacy, BC patient outcomes, and the overall quality of life of BC patients.

Ultra-processed food consumption and renal cell carcinoma incidence and mortality: results from a large prospective cohort

BACKGROUND

Growing evidence shows that ultra-processed food consumption is associated with the risk of cancer. However, prospective evidence is limited on renal cell carcinoma (RCC) incidence and mortality. In this study, we aimed to examine the association of ultra-processed food consumption and RCC incidence and mortality in a large cohort of US adults.

METHODS

A population-based cohort of 101,688 participants were included from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. Ultra-processed food items were confirmed by using the NOVA food classification system. The consumption of ultra-processed food was expressed as a percentage of total food intake (g/day). Prospective associations were calculated using Cox regression. Restricted cubic spline regression was used to assess nonlinearity. Subgroup analyses were performed to investigate the potential effect modifiers on the incidence and mortality of RCC.

RESULTS

A total of 410 participants developed RCC during a total of 899,731 person-years of follow-up (median 9.41 years) and 230 RCC deaths during 1,533,930 person-years of follow-up (median 16.85 years). In the fully adjusted model, participants in the highest compared with the lowest quintiles of ultra-processed food consumption had a higher risk of RCC (HR quartile 4 vs 1:1.42; 95% CI: 1.06-1.91; Ptrend = 0.004) and mortality (HR quartile 4 vs. quartile 1: 1.64; 95% CI: 1.10-2.43; Ptrend = 0.027). Linear dose-response associations with RCC incidence and mortality were observed for ultra-processed food consumption (all Pnonlinearity > 0.05). The reliability of these results was supported by sensitivity and subgroup analyses.

CONCLUSION

In conclusion, higher consumption of ultra-processed food is associated with an increased risk of RCC incidence and mortality. Limiting ultra-processed food consumption might be a primary prevention method of RCC.

Vitamin B12 Intake and Cancer Risk: Findings from a Case-Control Study in Vietnam

There is inconclusive evidence on the role of dietary intake of vitamin B12 in cancer. We evaluated the association between vitamin B12 intake and cancer risk in a hospital-based case-control study, comprising 3,758 cancer cases and 2,995 controls in Vietnam. Vitamin B12 intake was derived from the validated food frequency questionnaire. Unconditional logistic regression model was used to calculate the odds ratios (ORs), and respective 95% confidence intervals (CIs) for the association between vitamin B12 and cancer risk. There was a U-shaped association between vitamin B12 intake and overall risk of cancer. Individuals with intakes lower than the median intake had a 6% (OR = 1.06, 95% CI: 0.86-1.31)-107% (OR = 2.07, 95% CI: 1.58-2.71), increased risk of cancer (Ptrend<0.001), whereas those with higher intakes than the median intake had a 20% (OR = 1.20, 95% CI: 0.97-1.48)-52% (OR = 1.52, 95% CI: 1.22-1.89) increased risk of cancer (Ptrend<0.04). The excess risk of cancer associated with low intakes of vitamin B12 was observed among esophageal, lung, and breast cancer patients, whereas with high intakes of vitamin B12 among gastric cancer patients. In summary, a U-shaped association between vitamin B12 intake and increased cancer risk was observed in the Vietnamese population.

Bioaccessibility and Caco-2 cell uptake of iron chlorophyllin using a biologically relevant digestion model

Iron deficiency remains a top nutrient deficiency worldwide. Iron chlorophyllin (IC), a compound structurally analogous to heme, utilizes the protoporphyrin ring of chlorophyll to bind iron. IC has previously been shown to deliver more iron to Caco-2 cells than FeSO4, the most common form prescribed for supplementation. However, previous test conditions used digestive conditions outside of those observed in humans. This study sought to assess IC bioaccessibility and Caco-2 cell uptake using physiologically relevant digestive solutions, pH, and incubation time, as compared to other iron sources (i.e., FeSO4, and hemoglobin (Hb)). Co-digestion with ascorbic acid (AA) and albumin was also investigated. Following gastric, duodenal, and jejunal digestion, IC-bound iron was less bioaccessible than iron delivered as FeSO4, and IC-bound iron was less bioaccessible than Hb-bound iron. IC-bound iron bioaccessibility was not affected by AA and was enhanced 2x when co-digested with a low dose of albumin. However, Caco-2 cell incubation with IC-containing digesta increased cell ferritin 2.5x more than FeSO4 alone, and less than Hb. IC with AA or with 400 mg albumin also increased cell ferritin more than IC alone, with the greatest increases observed following incubation of digesta containing IC + AA + 400 mg albumin. These results suggest IC can serve as an improved source of iron for supplementation as compared to FeSO4. These results also support further in vivo investigations of IC-based iron delivery in populations at risk of iron deficiency.

An observational and genetic investigation into the association between psoriasis and risk of malignancy

The relationship between psoriasis and site-specific cancers remains unclear. Here, we aim to investigate whether psoriasis is causally associated with site-specific cancers. We use observational and genetic data from the UK Biobank, obtaining GWAS summary data, eQTL analysis data, TCGA data, and GTEx data from public datasets. We perform PheWAS, polygenic risk score analysis, and one-sample and two-sample Mendelian randomization analyses to investigate the potential causal associations between psoriasis and cancers. In the unselected PheWAS analysis, psoriasis is associated with higher risks of 16 types of cancer. Using one-sample Mendelian randomization analyses, it is found that genetically predicted psoriasis is associated with higher risks of anal canal cancer, breast cancer, follicular non-Hodgkin's lymphoma and nonmelanoma skin cancer in women; and lung cancer and kidney cancer in men. Our two-sample Mendelian randomization analysis indicates that psoriasis is causally associated with breast cancer and lung cancer. Gene annotation shows that psoriasis-related genes, such as ERAP1, are significantly different in lung and breast cancer tissues. Taken together, clinical attention to lung cancer and breast cancer may be warranted among patients with psoriasis.

Chinese national clinical practice guidelines on prevention, diagnosis and treatment of early colorectal cancer

BACKGROUND

The incidence and mortality of colorectal cancer (CRC) in China are increasing in recent years. The clarified pathogenesis and detectable precancerous lesions of CRC make it possible to prevent, screen, and diagnose CRC at an early stage. With the development of endoscopic and surgical techniques, the choice of treatment for early CRC is also worth further discussion, and accordingly, a standard follow-up program after treatment needs to be established.

METHODS

This clinical practice guideline (CPG) was developed following the recommended process of the World Health Organization, adopting Grading of Recommendations Assessment, Development and Evaluation (GRADE) in assessing evidence quality, and using the Evidence to Decision framework to formulate clinical recommendations, thereby minimizing bias and increasing transparency of the CPG development process. We used the Reporting Items for practice Guidelines in HealThcare (RIGHT) statement and Appraisal of Guidelines for Research and Evaluation II (AGREE II) as reporting and conduct guides to ensure the guideline's completeness and transparency.

RESULTS

This CPG comprises 46 recommendations concerning prevention, screening, diagnosis, treatment, and surveillance of CRC. In these recommendations, we have indicated protective and risk factors for CRC and made recommendations for chemoprevention. We proposed a suitable screening program for CRC based on the Chinese context. We also provided normative statements for the diagnosis, treatment, and surveillance of CRC based on existing clinical evidence and guidelines.

CONCLUSIONS

The 46 recommendations in this CPG are formed with consideration for stakeholders' values and preferences, feasibility, and acceptability. Recommendations are generalizable to resource-limited settings with similar CRC epidemiology pattern as China.

Fiber and whole grain intakes in relation to liver cancer risk: An analysis in 2 prospective cohorts and systematic review and meta-analysis of prospective studies

BACKGROUND AND AIMS

The association between fiber or whole grain intakes and the risk of liver cancer remains unclear. We assessed the associations between fiber or whole grain intakes and liver cancer risk among 2 prospective studies, and systematically reviewed and meta-analyzed these results with published prospective studies.

APPROACH AND RESULTS

A total of 111,396 participants from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) and 26,085 men from the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study were included. Intakes of total fiber and whole grains were estimated from validated food frequency questionnaires. Study-specific HRs and 95% CI with liver cancer risk were estimated using multivariable-adjusted Cox regression. We systematically reviewed existing literature, and studies were combined in a dose-response meta-analysis. A total of 277 (median follow-up = 15.6 y) and 165 (median follow-up = 16.0 y) cases of liver cancer were observed in Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial and Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study, respectively. Dietary fiber was inversely associated with liver cancer risk in Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (HR 10g/day : 0.69; 95% CI: 0.55-0.86). No significant associations were observed between whole grain intakes and liver cancer risk in either study. Our meta-analysis included 2383 incident liver cancer cases (7 prospective cohorts) for fiber intake and 1523 cases (5 prospective cohorts) for whole grain intake; combined HRs for liver cancer risk were 0.83 (0.76-0.91) per 10 g/day of fiber and 0.92 (0.85-0.99) per 16 g/day (1 serving) of whole grains.

CONCLUSIONS

Dietary fiber and whole grains were inversely associated with liver cancer risk. Further research exploring potential mechanisms and different fiber types is needed.

Nitrate: "the source makes the poison"

Interest in the role of dietary nitrate in human health and disease has grown exponentially in recent years. However, consensus is yet to be reached as to whether consuming nitrate from various food sources is beneficial or harmful to health. Global authorities continue to recommend an acceptable daily intake (ADI) of nitrate of 3.7 mg/kg-bw/day due to concerns over its carcinogenicity. This is despite evidence showing that nitrate consumption from vegetable sources, exceeding the ADI, is associated with decreased cancer prevalence and improvements in cardiovascular, oral, metabolic and neurocognitive health. This review examines the paradox between dietary nitrate and health and disease and highlights the key role of the dietary source and food matrix in moderating this interaction. We present mechanistic and epidemiological evidence to support the notion that consuming vegetable-derived nitrate promotes a beneficial increase in nitric oxide generation and limits toxic N-nitroso compound formation seen with high intakes of nitrate added during food processing or present in contaminated water. We demonstrate the need for a more pragmatic approach to nitrate-related nutritional research and guidelines. Ultimately, we provide an overview of our knowledge in this field to facilitate the various therapeutic applications of dietary nitrate, whilst maintaining population safety.

Association between Dietary Patterns and Cardiometabolic Multimorbidity among Chinese Rural Older Adults

BACKGROUND

The global population is aging rapidly, leading to an increase in the prevalence of cardiometabolic multimorbidity (CMM). This study aims to investigate the association between dietary patterns and CMM among Chinese rural older adults.

METHODS

The sample was selected using a multi-stage cluster random sampling method and a total of 3331 rural older adults were ultimately included. Multivariate logistic regression analysis was used to examine the association between the latent dietary patterns and CMM.

RESULTS

The prevalence of CMM among rural older adults was 44.64%. This study identified four potential categories: "Low Consumption of All Foods Dietary Pattern (C1)", "High Dairy, Egg, and Red Meat Consumption, Low Vegetable and High-Salt Consumption Dietary Pattern (C2)", "High Egg, Vegetable, and Grain Consumption, Low Dairy and White Meat Consumption Dietary Pattern (C3)" and "High Meat and Fish Consumption, Low Dairy and High-Salt Consumption Dietary Pattern (C4)". Individuals with a C3 dietary pattern (OR, 0.80; 95% CI, 0.66-0.98; p = 0.028) and a C4 dietary pattern (OR, 0.70; 95% CI, 0.51-0.97; p = 0.034) significantly reduced the prevalence of CMM compared with the C1 dietary pattern.

CONCLUSIONS

Rural older adults have diverse dietary patterns, and healthy dietary patterns may reduce the risk of CMM.

Spatial metabolomics using mass-spectrometry imaging to decipher the impact of high red meat diet on the colon metabolome in rat

Colorectal cancer (CRC) is the third most common cancer in the world with a higher prevalence in the developed countries, mainly caused by environmental and lifestyle factors such as diet, particularly red meat consumption. The metabolic impact of high red meat consumption on the epithelial part of the colon was investigated using Matrix-Assisted Laser Desorption/Ionization Mass Spectrometry Imaging (MSI), to specifically analyze the epithelial substructure. Ten colons from rats fed for 100 days high red or white meat diet were subjected to untargeted MSI analyses using two spatial resolutions (100 μm and 10 μm) to evaluate metabolite changes in the epithelial part and to visualize the distribution of metabolites of interest within the epithelium crypts. Our results suggest a specific effect of red meat diet on the colonic epithelium metabolism, as evidenced by an increase of purine catabolism products or depletion in glutathione pool, reinforcing the hypothesis of increased oxidative stress with red meat diet. This study also highlighted cholesterol sulfate as another up-regulated metabolite, interestingly localized at the top of the crypts. Altogether, this study demonstrates the feasibility and the added value of using MSI to decipher the effect of high red meat diet on the colonic epithelium.

Epidemiological breast cancer prediction by country: A novel machine learning approach

Breast cancer remains a significant contributor to cancer-related deaths among women globally. We seek for this study to examine the correlation between the incidence rates of breast cancer and newly identified risk factors. Additionally, we aim to utilize machine learning models to predict breast cancer incidence at a country level. Following an extensive review of the available literature, we have identified a range of recently studied risk factors associated with breast cancer. Subsequently, we gathered data on these factors and breast cancer incidence rates from numerous online sources encompassing 151 countries. To evaluate the relationship between these factors and breast cancer incidence, we assessed the normality of the data and conducted Spearman's correlation test. Furthermore, we refined six regression models to forecast future breast cancer incidence rates. Our findings indicate that the incidence of breast cancer is most positively correlated with the average age of women in a country, as well as factors such as meat consumption, CO2 emissions, depression, sugar consumption, tobacco use, milk intake, mobile cells, alcohol consumption, pesticides, and oral contraceptive use. As for prediction, the CatBoost Regressor successfully predicted future breast cancer incidence with an R squared value of 0.84 ± 0.03. An increased incidence of breast cancer is mainly associated with dietary habits and lifestyle. Our findings and recommendations can serve as a baseline for developing educational programs intended to heighten awareness amongst women in countries with heightened risk.

Obesity-Associated Colorectal Cancer

Colorectal cancer (CRC) affects approximately 2 million people worldwide. Obesity is the major risk factor for CRC. In addition, obesity contributes to a chronic inflammatory stage that enhances tumor progression through the secretion of proinflammatory cytokines. In addition to an increased inflammatory response, obesity-associated cancer presents accrued molecular factors related to cancer characteristics, such as genome instability, sustained cell proliferation, telomere dysfunctions, angiogenesis, and microbial alteration, among others. Despite the evidence accumulated over the last few years, the treatments for obesity-associated CRC do not differ from the CRC treatments in normal-weight individuals. In this review, we summarize the current knowledge on obesity-associated cancer, including its epidemiology, risk factors, molecular factors, and current treatments. Finally, we enumerate possible new therapeutic targets that may improve the conditions of obese CRC patients. Obesity is key for the development of CRC, and treatments resulting in the reversal of obesity should be considered as a strategy for improving antineoplastic CRC therapies.

Red and Processed Meat Intake, Polygenic Risk and the Prevalence of Colorectal Neoplasms: Results from a Screening Colonoscopy Population

High red and processed meat intake and genetic predisposition are risk factors of colorectal cancer (CRC). However, evidence of their independent and joint associations on the risk of colorectal neoplasms is limited. We assessed these associations among 4774 men and women undergoing screening colonoscopy. Polygenic risk scores (PRSs) were calculated based on 140 loci related to CRC. We used multiple logistic regression models to evaluate the associations of red and processed meat intake and PRS with the risk of colorectal neoplasms. Adjusted odds ratios (aORs) were translated to genetic risk equivalents (GREs) to compare the strength of the associations with colorectal neoplasm risk of both factors. Compared to ≤1 time/week, processed meat intake >1 time/week was associated with a significantly increased risk of colorectal neoplasm [aOR (95% CI): 1.28 (1.12-1.46)]. This risk increase was equivalent to the risk increase associated with a 19 percentile higher PRS. The association of red meat intake with colorectal neoplasm was weaker and did not reach statistical significance. High processed meat intake and PRS contribute to colorectal neoplasm risk independently. Limiting processed meat intake may offset a substantial proportion of the genetically increased risk of colorectal neoplasms.

In Healthy Pathways of Dietary Changes, a Very Rapid Reduction of Red Meat Is Possible, but Specific Diet Changes Are Required for Full Reduction-A Graph-Based Analysis

BACKGROUND

Although reducing meat consumption is becoming increasingly popular in Western countries, such a transition to a sustainable diet may pose some nutritional risks.

OBJECTIVES

We aim to analyze the pathways for reaching a low-meat healthy diet and the changes in other food categories needed to rapidly decrease total red meat consumption.

METHODS

We used a recently developed method based on graph theory to represent all possible pathways of stepwise changes that avoid nutritional deficiencies toward a target healthy diet. Initial and target diets were defined as the daily consumption of 33 food groups. For each sex, 3 initial diets were taken from the French representative survey third individual and national study on food consumption survey as the mean observed diet and low (first quintile) and high (fifth quintile) meat consumption. Target diets were identified using multicriteria optimization to minimize the long-term health risk (HR) of chronic diseases while ensuring nutritional adequacy. The Dijkstra algorithm was used to identify the optimal pathways between the initial and target diets, with the aim of reducing meat consumption as quickly as possible and thus minimizing long-term HRs.

RESULTS

Unprocessed red meat was easily minimized in the first steps of the pathways regardless of sex and initial level of meat consumption. However, processed meat could only be decreased later and required prior changes such as increases in fruit, vegetables, and oily fish. During total red meat minimization in females, securing adequate intakes of bioavailable iron had the most substantial impact on the other dietary changes needed.

CONCLUSIONS

Immediate reduction of red meat consumption is possible on the pathway to a healthy diet that avoids any nutrient deficiency. However, early increases in fruit, vegetables, and fish are required before minimizing total red meat early in the diet.

Association between dietary carotenoid intake and breast cancer risk: a case-control study among Korean women

The association between dietary carotenoids and breast cancer (BC) risks were inconsistent. Therefore, this study investigated the association between dietary carotenoid and BC risks among Korean women. We recruited participants from the National Cancer Centre of Korea. Odds ratios and 95% confidence intervals were calculated with a logistic regression model. There was an inverse association between dietary carotenoid subclasses and BC risks; in particular, a higher intake of β-carotene and lutein/zeaxanthin was associated with reduced BC risks. After subgroup analysis with estrogen receptor (ER)/progesterone receptor (PR) status, there was similar trend among ER-/PR- women. We further investigated which foods contribute to the carotenoid intake. A higher intake of radish leaves, kale, and bracken was associated with lowered BC risks. Accordingly, dietary carotenoid, particularly β-carotene and lutein/zeaxanthin, appears to be associated with a lower risk of BC among Korean women.

Causal association of dietary factors with five common cancers: univariate and multivariate Mendelian randomization studies

Background

Daily dietary habits are closely related to human health, and long-term unhealthy dietary intake, such as excessive consumption of alcohol and pickled foods, may promote the development of cancers. However, comprehensive research on the causal relationship between dietary habits and cancer is lacking. Therefore, this study aimed to reveal the potential causal link between dietary risk factors and the prognosis of cancer-related to genetic susceptibility.

Methods

GWAS (Genome-Wide Association Studies) summary data on dietary habits and five common types of cancer and their pathological subtypes were obtained from the UK Biobank and various cancer association consortia. A univariable two-sample Mendelian randomization (UVMR) and FDR correction analysis was conducted to explore the causal relationships between 45 dietary habits and five common types of cancer and their histopathological subtypes. In addition, multivariable Mendelian randomization analysis (MVMR) was performed to adjust for traditional risk factors for dietary habits, and the direct or indirect effects of diet on cancer were evaluated. Finally, the prognostic impact of selected instrumental variables on cancer was analyzed using an online data platform.

Results

In the UVMR analysis, four dietary habits were identified as risk factors for cancer, while five dietary habits were identified as protective factors. Among the latter, one dietary habit showed a significant association with cancer even after FDR correction, indicating a potential causal relationship. The MVMR analysis revealed that weekly beer and cider intake, may act as an independent risk factor for cancer development. Other causal associations between dietary habits and cancer risk may be mediated by intermediate factors. In the prognostic analysis, the SNPs (Single Nucleotide Polymorphisms) of average weekly beer and cider intake were set as independent risk factors and were found to significantly impact overall survival (OS) and cancer-specific survival (CSS) in lung cancer.

Conclusion

This causal relationship study supports the notion that adjusting daily dietary habits and specific dietary interventions may decrease the risk of cancer.

Non-genetic factors and breast cancer: an umbrella review of meta-analyses

BACKGROUND

Previous research has found associations between various non-genetic factors and breast cancer (BrCa) risk. This study summarises and appraises the credibility of the available evidence on the association between non-genetic factors and BrCa risk.

METHODS

We conducted an umbrella review of meta-analyses. Medline, Scopus, and the Cochrane databases were systematically searched for meta-analyses examining non-genetic factors and BrCa incidence or mortality. The strength of the evidence was graded in four categories (i.e., weak, suggestive, highly suggestive, convincing).

RESULTS

A total of 781 meta-analyses from 280 publications were evaluated and graded. We included exposures related to anthropometric measurements, biomarkers, breast characteristics and diseases, diet and supplements, environment, exogenous hormones, lifestyle and social factors, medical history, medication, reproductive history, and pregnancy. The largest number of examined associations was found for the category of diet and supplements and for exposures such as aspirin use and active smoking. The statistically significant (P-value < 0.05) meta-analyses were 382 (49%), of which 204 (53.4%) reported factors associated with increased BrCa risk. Most of the statistically significant evidence (n = 224, 58.6%) was graded as weak. Convincing harmful associations with heightened BrCa risk were found for increased body mass index (BMI), BMI and weight gain in postmenopausal women, oral contraceptive use in premenopausal women, increased androstenedione, estradiol, estrone, and testosterone concentrations, high Breast Imaging Reporting and Data System (BIRADS) classification, and increased breast density. Convincing protective factors associated with lower BrCa risk included high fiber intake and high sex hormone binding globulin (SHBG) levels while highly suggestive protective factors included high 25 hydroxy vitamin D [25(OH)D] levels, adherence to healthy lifestyle, and moderate-vigorous physical activity.

CONCLUSIONS

Our findings suggest some highly modifiable factors that protect from BrCa. Interestingly, while diet was the most studied exposure category, the related associations failed to reach higher levels of evidence, indicating the methodological limitations in the field. To improve the validity of these associations, future research should utilise more robust study designs and better exposure assessment techniques. Overall, our study provides knowledge that supports the development of evidence-based BrCa prevention recommendations and guidance, both at an individual level and for public health initiatives.

TRIAL REGISTRATION

PROSPERO CRD42022370675.

Predictors of Meat Reduction: The Case of Slovenia

Health, environmental, and animal advocacy organisations emphasise reducing or eliminating high meat consumption due to its adverse effects on health, sustainability, climate change, and animal welfare. Increasingly, people are deciding to reduce their meat consumption frequency. Our study aimed to examine predictors of meat reduction among Slovenian consumers, focusing on gender, age, partner and children status, size of residential settlement, socioeconomic status, and political orientation. We conducted a survey using non-probability sampling. We examined demographic, socioeconomic, and political predictors of individuals' self-assessed intent to reduce meat consumption in the month following the survey. Additionally, we analysed respondents' meat reduction during the three years prior. A correlation analysis revealed that higher age and education levels were significantly positively correlated with meat reduction patterns. An ordinal logistic regression analysis indicated that age was the only significant predictor of meat reduction intentions and past behaviour. Our findings suggest that middle-aged and elderly individuals are more likely than younger adults to report meat reduction behaviours. Future public health interventions should tailor approaches to different age groups, and, in particular, target younger individuals. Educational campaigns should highlight the health and environmental benefits of reducing meat and animal product consumption, particularly in primary and secondary schools.

Advances in Diet and Physical Activity in Breast Cancer Prevention and Treatment

There is currently a growing interest in diets and physical activity patterns that may be beneficial in preventing and treating breast cancer (BC). Mounting evidence indicates that indeed, the so-called Mediterranean diet (MedDiet) and regular physical activity likely both help reduce the risk of developing BC. For those who have already received a BC diagnosis, these interventions may decrease the risk of tumor recurrence after treatment and improve quality of life. Studies also show the potential of other dietary interventions, including fasting or modified fasting, calorie restriction, ketogenic diets, and vegan or plant-based diets, to enhance the efficacy of BC therapies. In this review article, we discuss the biological rationale for utilizing these dietary interventions and physical activity in BC prevention and treatment. We highlight published and ongoing clinical studies that have applied these lifestyle interventions to BC patients. This review offers valuable insights into the potential application of these dietary interventions and physical activity as complimentary therapies in BC management.

Choline consumption reduces CVD risk via body composition modification

Despite extensive research on the relationship between choline and cardiovascular disease (CVD), conflicting findings have been reported. We aim to investigate the relationship between choline and CVD. Our analysis screened a retrospective cohort study of 14,663 participants from the National Health and Nutrition Examination Survey conducted between 2013 and 2018. Propensity score matching and restricted cubic splines was used to access the association between choline intake and the risk of CVD. A two-sample Mendelian randomization (MR) analysis was conducted to examine the potential causality. Additionally, sets of single cell RNA-sequencing data were extracted and analyzed, in order to explore the role of choline metabolism pathway in the progression and severity of the CVD and the underlying potential mechanisms involved. The adjusted odds ratios and 95% confidence intervals for stroke were 0.72 (0.53-0.98; p = 0.035) for quartile 3 and 0.54 (0.39-0.75; p < 0.001) for quartile 4. A stratified analysis revealed that the relationship between choline intake and stroke varied among different body mass index and waist circumference groups. The results of MR analysis showed that choline and phosphatidylcholine had a predominantly negative causal effect on fat percentage, fat mass, and fat-free mass, while glycine had opposite effects. Results from bioinformatics analysis revealed that alterations in the choline metabolism pathway following stroke may be associated with the prognosis. Our study indicated that the consumption of an appropriate quantity of choline in the diet may help to protect against CVD and the effect may be choline-mediated, resulting in a healthier body composition. Furthermore, the regulation of the choline metabolism pathway following stroke may be a promising therapeutic target.

Microbiota and detrimental protein derived metabolites in colorectal cancer

Colorectal cancer (CRC) is the third leading cancer in incidence and the second leading cancer in mortality worldwide. There is growing scientific evidence to support the crucial role of the gut microbiota in the development of CRC. The gut microbiota is the complex community of microorganisms that inhabit the host gut in a symbiotic relationship. Diet plays a crucial role in modulating the risk of CRC, with a high intake of red and processed meat being a risk factor for the development of CRC. The production of metabolites derived from protein fermentation by the gut microbiota is considered a crucial element in the interaction between red and processed meat consumption and the development of CRC. This paper examines several metabolites derived from the bacterial fermentation of proteins associated with an increased risk of CRC. These metabolites include ammonia, polyamines, trimethylamine N-oxide (TMAO), N-nitroso compounds (NOC), hydrogen sulphide (H2S), phenolic compounds (p-cresol) and indole compounds (indolimines). These compounds are depicted and reviewed for their association with CRC risk, possible mechanisms promoting carcinogenesis and their relationship with the gut microbiota. Additionally, this paper analyses the evidence related to the role of red and processed meat intake and CRC risk and the factors and pathways involved in bacterial proteolytic fermentation in the large intestine.

Association between dietary patterns and the risk of all-cause mortality among old adults with obstructive sleep apnea

BACKGROUND

Obstructive sleep apnea (OSA) was associated with the increased cardiovascular events and all-cause mortality. And anti-inflammatory dietary has potential to improve the prognosis of OSA. This study aimed to investigate the association of anti-inflammatory dietary patterns with all-cause mortality among individuals with OSA.

METHODS

This retrospective cohort study involved 1522 older adults with OSA from 2005 to 2008 in the National Health and Nutrition Examinations Survey (NHANES). Mortality status was determined by routine follow-up through December 31, 2019, using the National Death Index. Anti-inflammatory dietary patterns included Alternate Mediterranean Diet Score (aMED), Healthy Eating Index-2015 (HEI-2015), and Alternate Healthy Eating Index-2010 (AHEI-2010). Weighted Cox proportional hazard regression models were performed to investigate the association between anti-inflammatory dietary pattern and all-cause mortality.

RESULTS

After a median follow-up of 131 months, 604 participants were recorded all-cause mortality. The mean age of OSA patients was 68.99 years old, of whom 859 were male (52.34%). Higher adherence of aMED (HR = 0.61, 95%CI: 0.48 to 0.78) and HEI-2015 (HR = 0.75, 95%CI: 0.60 to 0.95) were associated with lower all-cause mortality risk in the elderly with OSA. Conversely, no association was found between AHEI-2010 dietary pattern and all-cause mortality in individuals with OSA. In the component analysis of aMED, it was found that a higher intake of vegetables and olive oil potentially contributes to the reduction all-cause mortality risk in the elderly with OSA (HR = 0.60, 95%CI: 0.48 to 0.76; HR = 0.67, 95%CI: 0.63 to 0.71).

CONCLUSION

Higher adherence to the aMED and the HEI-2015 was associated with a lower risk of all-cause mortality in OSA. Future interventions in the elderly with OSA should considering adopting anti-inflammatory dietary patterns.