1
|
Zheng S, Yan J, Wang J, Wang X, Kang YE, Koo BS, Shan Y, Liu L. Unveiling the Effects of Cruciferous Vegetable Intake on Different Cancers: A Systematic Review and Dose-Response Meta-analysis. Nutr Rev 2024:nuae131. [PMID: 39348271 DOI: 10.1093/nutrit/nuae131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/02/2024] Open
Abstract
CONTEXT Epidemiological studies indicated that cruciferous vegetable intake is associated with positive health outcomes. However, the role of cruciferous vegetables may have differential impacts on various cancers. OBJECTIVE This meta-analysis aims to review recent epidemiological studies on the link between cruciferous vegetables and various cancers. It seeks to identify the optimal intake dose and timing of cruciferous vegetables influencing their association with cancer risk. DATA SOURCES Studies on cruciferous vegetables and cancer were searched in PubMed, NCBI, Web of Science, and Elsevier databases from 1978 to June 2023. DATA EXTRACTION Extracted data from 226 relevant case-control and cohort studies were expressed by standardized mean difference and 95% CI, followed by the subgroup analysis to eliminate heterogeneity. RESULTS Intake of cruciferous vegetables can prevent cancers, with an odds ratio of 0.77 and risk ratio (RR) of 0.96. The intake levels of cruciferous vegetables associated with the risk of colorectal cancer, lung cancer, upper gastrointestinal cancer, gynecological cancer (ovarian cancer and endometrial cancer), bladder cancer, renal cancer, and prostate cancer were found to be 5.41 servings/week, 5.41 servings/week, 5.5 servings/week, 7.4 servings/week, 5.5 servings/week, 4.85 servings/week, and 3 servings/week, respectively. In a cohort followed for 2 to 15 years, limited consumption of cruciferous vegetables was correlated with a higher cancer RR. In the Asian population, cruciferous vegetables had a significant relationship with lung cancer, head and neck squamous cell carcinoma, and esophageal cancer. Conversely, cruciferous vegetables are predominantly associated with colorectal, renal, gynecological, and prostate cancer in the American population. CONCLUSION This study highlights the complex link between cruciferous vegetables and cancer, influenced by factors such as cancer type, region, intake level, and follow-up duration.
Collapse
Affiliation(s)
- Sicong Zheng
- Department of Nutrition, Public Health and Management College, Wenzhou Medical University, Wenzhou, Zhejiang 325035, China
- Department of Medical Science, College of Medicine, Chungnam National University, Daejeon 35015, Republic of Korea
| | - Jielin Yan
- Department of Nutrition, Public Health and Management College, Wenzhou Medical University, Wenzhou, Zhejiang 325035, China
| | - Jiaxin Wang
- Department of Nutrition, Public Health and Management College, Wenzhou Medical University, Wenzhou, Zhejiang 325035, China
- Southern Zhejiang Institute of Radiation Medicine and Nuclear Technology, Wenzhou Medical University, Wenzhou, Zhejiang 325809, China
| | - Xinyi Wang
- Department of Nutrition, Public Health and Management College, Wenzhou Medical University, Wenzhou, Zhejiang 325035, China
- Southern Zhejiang Institute of Radiation Medicine and Nuclear Technology, Wenzhou Medical University, Wenzhou, Zhejiang 325809, China
| | - Yea Eun Kang
- Department of Internal Medicine, College of Medicine, Chungnam National University, Daejeon 35015, Republic of Korea
| | - Bon Seok Koo
- Department of Otolaryngology-Head and Neck Surgery, Research Institute for Medical Science, Chungnam National University, School of Medicine, Daejeon 35015, Republic of Korea
| | - Yujuan Shan
- Department of Nutrition, Public Health and Management College, Wenzhou Medical University, Wenzhou, Zhejiang 325035, China
- Southern Zhejiang Institute of Radiation Medicine and Nuclear Technology, Wenzhou Medical University, Wenzhou, Zhejiang 325809, China
| | - Lihua Liu
- Department of Nutrition, Public Health and Management College, Wenzhou Medical University, Wenzhou, Zhejiang 325035, China
- Southern Zhejiang Institute of Radiation Medicine and Nuclear Technology, Wenzhou Medical University, Wenzhou, Zhejiang 325809, China
| |
Collapse
|
2
|
Vegetable and fruit intake and the risk of bladder cancer: Japan Public Health Center-based prospective study. Br J Cancer 2022; 126:1647-1658. [PMID: 35241777 PMCID: PMC9130325 DOI: 10.1038/s41416-022-01739-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 01/25/2022] [Accepted: 02/03/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Vegetable and fruit consumption may have a protective effect against several types of cancer. However, evidence suggesting that increased intake of vegetables and fruits, their subtypes, or the antioxidant nutrients they contain in abundance decreases the risk of bladder cancer is limited. METHODS This study included 80,952 participants from the Japan Public Health Center-based Prospective Study, who responded to a food frequency questionnaire in a 5-year follow-up survey in 1995-1998 and were followed up until December 2015 to investigate the associations between intake of vegetables and fruits, their subtypes, or the antioxidant nutrients and bladder cancer risk using Cox proportional hazards regression models. RESULTS Within 1,287,514 person-years of follow-up, 401 bladder cancer cases (307 men and 94 women) were diagnosed. No association was found between intake of total vegetable and fruit, total vegetable, total fruit, subtypes of vegetables and fruits, or antioxidant nutrients and bladder cancer risk in both men and women, even in the analyses conducted among men stratified by smoking status. CONCLUSIONS In this population, the consumption of vegetables and fruits was not associated with the risk of bladder cancer.
Collapse
|
3
|
García-Caballero M, Torres-Vargas JA, Marrero AD, Martínez-Poveda B, Medina MÁ, Quesada AR. Angioprevention of Urologic Cancers by Plant-Derived Foods. Pharmaceutics 2022; 14:pharmaceutics14020256. [PMID: 35213989 PMCID: PMC8875200 DOI: 10.3390/pharmaceutics14020256] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/16/2022] [Accepted: 01/18/2022] [Indexed: 02/05/2023] Open
Abstract
The number of cancer cases worldwide keeps growing unstoppably, despite the undeniable advances achieved by basic research and clinical practice. Urologic tumors, including some as prevalent as prostate, bladder or kidney tumors, are no exceptions to this rule. Moreover, the fact that many of these tumors are detected in early stages lengthens the duration of their treatment, with a significant increase in health care costs. In this scenario, prevention offers the most cost-effective long-term strategy for the global control of these diseases. Although specialized diets are not the only way to decrease the chances to develop cancer, epidemiological evidence support the role of certain plant-derived foods in the prevention of urologic cancer. In many cases, these plants are rich in antiangiogenic phytochemicals, which could be responsible for their protective or angiopreventive properties. Angiogenesis inhibition may contribute to slow down the progression of the tumor at very different stages and, for this reason, angiopreventive strategies could be implemented at different levels of chemoprevention, depending on the targeted population. In this review, epidemiological evidence supporting the role of certain plant-derived foods in urologic cancer prevention are presented, with particular emphasis on their content in bioactive phytochemicals that could be used in the angioprevention of cancer.
Collapse
Affiliation(s)
- Melissa García-Caballero
- Department of Molecular Biology and Biochemistry, Faculty of Sciences, University of Malaga, Andalucía Tech, E-29071 Malaga, Spain; (M.G.-C.); (J.A.T.-V.); (A.D.M.); (B.M.-P.); (M.Á.M.)
- IBIMA (Biomedical Research Institute of Malaga), E-29071 Malaga, Spain
| | - José Antonio Torres-Vargas
- Department of Molecular Biology and Biochemistry, Faculty of Sciences, University of Malaga, Andalucía Tech, E-29071 Malaga, Spain; (M.G.-C.); (J.A.T.-V.); (A.D.M.); (B.M.-P.); (M.Á.M.)
- IBIMA (Biomedical Research Institute of Malaga), E-29071 Malaga, Spain
| | - Ana Dácil Marrero
- Department of Molecular Biology and Biochemistry, Faculty of Sciences, University of Malaga, Andalucía Tech, E-29071 Malaga, Spain; (M.G.-C.); (J.A.T.-V.); (A.D.M.); (B.M.-P.); (M.Á.M.)
- IBIMA (Biomedical Research Institute of Malaga), E-29071 Malaga, Spain
| | - Beatriz Martínez-Poveda
- Department of Molecular Biology and Biochemistry, Faculty of Sciences, University of Malaga, Andalucía Tech, E-29071 Malaga, Spain; (M.G.-C.); (J.A.T.-V.); (A.D.M.); (B.M.-P.); (M.Á.M.)
- IBIMA (Biomedical Research Institute of Malaga), E-29071 Malaga, Spain
- CIBER de Enfermedades Cardiovasculares (CIBERCV), E-28019 Madrid, Spain
| | - Miguel Ángel Medina
- Department of Molecular Biology and Biochemistry, Faculty of Sciences, University of Malaga, Andalucía Tech, E-29071 Malaga, Spain; (M.G.-C.); (J.A.T.-V.); (A.D.M.); (B.M.-P.); (M.Á.M.)
- IBIMA (Biomedical Research Institute of Malaga), E-29071 Malaga, Spain
- CIBER de Enfermedades Raras (CIBERER), E-29071 Malaga, Spain
| | - Ana R. Quesada
- Department of Molecular Biology and Biochemistry, Faculty of Sciences, University of Malaga, Andalucía Tech, E-29071 Malaga, Spain; (M.G.-C.); (J.A.T.-V.); (A.D.M.); (B.M.-P.); (M.Á.M.)
- IBIMA (Biomedical Research Institute of Malaga), E-29071 Malaga, Spain
- CIBER de Enfermedades Raras (CIBERER), E-29071 Malaga, Spain
- Correspondence:
| |
Collapse
|
4
|
Xenou D, Tzelves L, Terpos E, Stamatelopoulos K, Sergentanis TN, Psaltopoulou T. Consumption of Fruits, Vegetables and Bladder Cancer Risk: A Systematic Review and Meta-Analysis of Prospective Cohort Studies. Nutr Cancer 2021; 74:2003-2016. [PMID: 34726552 DOI: 10.1080/01635581.2021.1985146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We examined the association between fruit/vegetable consumption and bladder cancer (BC) risk in a systematic review and meta-analysis of prospective cohort studies stratifying results by gender, smoking status and geographical region. Eligible studies were sought in MEDLINE and EMBASE up to April 20, 2020. Random-effects (DerSimonian-Laird) models were implemented for the calculation of pooled relative risks (RRs) and 95% confidence intervals (CI). Fifteen eligible studies were identified (1,993,881 subjects, 11,097 BC cases). Vegetable consumption (pooled RR = 0.95, 95% CI: 0.87-1.04, n = 10) as well as combined fruit/vegetable consumption was not associated with BC risk. Regarding fruit intake, the overall protective trend did not reach significance (pooled RR = 0.91, 95%CI: 0.81-1.02, n = 11); we found however a significant association in East Asians. A trend toward a protective association with citrus fruit consumption was also noted (pooled RR = 0.83, 95%CI: 0.69-1.01, n = 6), once again with a significant effect in East Asians. Moreover, no association was found regarding the subgroups of leafy vegetables, dark green vegetables, and berries. Single studies pointed to a reduced BC risk in never smoking males consuming cruciferous vegetables and East Asians consuming yellow vegetables. In conclusion, our study reveals possible protective effects; larger studies are needed to investigate the emerging trends.
Collapse
Affiliation(s)
- Dimitra Xenou
- Department of Clinical Therapeutics, "Alexandra" Hospital, Medical School, National University of Athens, Athens, Greece
| | - Lazaros Tzelves
- 2nd Department of Urology, Sismanoglio Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelos Terpos
- Department of Clinical Therapeutics, "Alexandra" Hospital, Medical School, National University of Athens, Athens, Greece
| | - Kimon Stamatelopoulos
- Department of Clinical Therapeutics, "Alexandra" Hospital, Medical School, National University of Athens, Athens, Greece
| | - Theodoros N Sergentanis
- Department of Clinical Therapeutics, "Alexandra" Hospital, Medical School, National University of Athens, Athens, Greece
| | - Theodora Psaltopoulou
- Department of Clinical Therapeutics, "Alexandra" Hospital, Medical School, National University of Athens, Athens, Greece
| |
Collapse
|
5
|
Yu EYW, Wesselius A, Mehrkanoon S, Goosens M, Brinkman M, van den Brandt P, Grant EJ, White E, Weiderpass E, Le Calvez-Kelm F, Gunter MJ, Huybrechts I, Riboli E, Tjonneland A, Masala G, Giles GG, Milne RL, Zeegers MP. Vegetable intake and the risk of bladder cancer in the BLadder Cancer Epidemiology and Nutritional Determinants (BLEND) international study. BMC Med 2021; 19:56. [PMID: 33685459 PMCID: PMC7942172 DOI: 10.1186/s12916-021-01931-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 01/29/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Although a potential inverse association between vegetable intake and bladder cancer risk has been reported, epidemiological evidence is inconsistent. This research aimed to elucidate the association between vegetable intake and bladder cancer risk by conducting a pooled analysis of data from prospective cohort studies. METHODS Vegetable intake in relation to bladder cancer risk was examined by pooling individual-level data from 13 cohort studies, comprising 3203 cases among a total of 555,685 participants. Pooled multivariate hazard ratios (HRs), with corresponding 95% confidence intervals (CIs), were estimated using Cox proportional hazards regression models stratified by cohort for intakes of total vegetable, vegetable subtypes (i.e. non-starchy, starchy, green leafy and cruciferous vegetables) and individual vegetable types. In addition, a diet diversity score was used to assess the association of the varied types of vegetable intake on bladder cancer risk. RESULTS The association between vegetable intake and bladder cancer risk differed by sex (P-interaction = 0.011) and smoking status (P-interaction = 0.038); therefore, analyses were stratified by sex and smoking status. With adjustment of age, sex, smoking, energy intake, ethnicity and other potential dietary factors, we found that higher intake of total and non-starchy vegetables were inversely associated with the risk of bladder cancer among women (comparing the highest with lowest intake tertile: HR = 0.79, 95% CI = 0.64-0.98, P = 0.037 for trend, HR per 1 SD increment = 0.89, 95% CI = 0.81-0.99; HR = 0.78, 95% CI = 0.63-0.97, P = 0.034 for trend, HR per 1 SD increment = 0.88, 95% CI = 0.79-0.98, respectively). However, no evidence of association was observed among men, and the intake of vegetable was not found to be associated with bladder cancer when stratified by smoking status. Moreover, we found no evidence of association for diet diversity with bladder cancer risk. CONCLUSION Higher intakes of total and non-starchy vegetable are associated with reduced risk of bladder cancer for women. Further studies are needed to clarify whether these results reflect causal processes and potential underlying mechanisms.
Collapse
Affiliation(s)
- Evan Yi-Wen Yu
- Department of Complex Genetics and Epidemiology, School of Nutrition and Translational Research in Metabolism, Maastricht University, Universiteitssingel 40 (Room C5.570), 6229 ER, Maastricht, the Netherlands
- CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Anke Wesselius
- Department of Complex Genetics and Epidemiology, School of Nutrition and Translational Research in Metabolism, Maastricht University, Universiteitssingel 40 (Room C5.570), 6229 ER, Maastricht, the Netherlands.
| | - Siamak Mehrkanoon
- Department of Data Science and Knowledge Engineering, Maastricht University, Maastricht, The Netherlands
| | - Mieke Goosens
- Department of General Practice, Katholieke Universiteit Leuven, ACHG-KU Leuven, Leuven, Belgium
| | - Maree Brinkman
- Department of Complex Genetics and Epidemiology, School of Nutrition and Translational Research in Metabolism, Maastricht University, Universiteitssingel 40 (Room C5.570), 6229 ER, Maastricht, the Netherlands
- Department of Clinical Studies and Nutritional Epidemiology, Nutrition Biomed Research Institute, Melbourne, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria, 3004, Australia
| | - Piet van den Brandt
- Department of Epidemiology, Schools for Oncology and Developmental Biology and Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Eric J Grant
- Department of Epidemiology Radiation Effects Research Foundation, Hiroshima, Japan
| | - Emily White
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Elisabete Weiderpass
- International Agency for Research on Cancer World Health Organization, Lyon, France
| | | | - Marc J Gunter
- International Agency for Research on Cancer World Health Organization, Lyon, France
| | - Inge Huybrechts
- International Agency for Research on Cancer World Health Organization, Lyon, France
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Anne Tjonneland
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Giovanna Masala
- Molecular and Lifestyle Epidemiology Branch, Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network ISPRO, Florence, Italy
| | - Graham G Giles
- Cancer Epidemiology Division, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria, 3004, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Melbourne, Victoria, 3010, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, 3168, Australia
| | - Roger L Milne
- Cancer Epidemiology Division, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria, 3004, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Melbourne, Victoria, 3010, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, 3168, Australia
| | - Maurice P Zeegers
- Department of Complex Genetics and Epidemiology, School of Nutrition and Translational Research in Metabolism, Maastricht University, Universiteitssingel 40 (Room C5.570), 6229 ER, Maastricht, the Netherlands
- CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
- School of Cancer Sciences, University of Birmingham, Birmingham, UK
| |
Collapse
|
6
|
Jochems SHJ, Reulen RC, van Osch FHM, Witlox WJA, Goossens ME, Brinkman M, Giles GG, Milne RL, van den Brandt PA, White E, Weiderpass E, Huybrechts I, Hémon B, Agudo A, Bueno-de-Mesquita B, Cheng KK, van Schooten FJ, Bryan RT, Wesselius A, Zeegers MP. Fruit consumption and the risk of bladder cancer: A pooled analysis by the Bladder Cancer Epidemiology and Nutritional Determinants Study. Int J Cancer 2020; 147:2091-2100. [PMID: 32285440 DOI: 10.1002/ijc.33008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 01/14/2020] [Accepted: 02/03/2020] [Indexed: 12/24/2022]
Abstract
While the association between fruit consumption and bladder cancer risk has been extensively reported, studies have had inadequate statistical power to investigate associations between types of fruit and bladder cancer risk satisfactorily. Fruit consumption in relation to bladder cancer risk was investigated by pooling individual data from 13 cohort studies. Cox regression models with attained age as time scale were used to estimate hazard ratios (HRs) for intakes of total fruit and citrus fruits, soft fruits, stone fruits, tropical fruits, pome fruits and fruit products. Analyses were stratified by sex, smoking status and bladder cancer subtype. During on average 11.2 years of follow-up, 2836 individuals developed incident bladder cancer. Increasing fruit consumption (by 100 g/day) was inversely associated with the risk of bladder cancer in women (HR = 0.92; 95% CI 0.85-0.99). Although in women the association with fruit consumption was most evident for higher-risk nonmuscle invasive bladder cancer (NMIBC; HR = 0.72; 95% CI 0.56-0.92), the test for heterogeneity by bladder cancer subtype was nonsignificant (P-heterogeneity = .14). Increasing fruit consumption (by 100 g/day) was not associated with bladder cancer risk in men (HR = 0.99; 95% CI 0.94-1.03), never smokers (HR = 0.96; 95% CI 0.88-1.05), former smokers (HR = 0.98; 95% CI 0.92-1.05) or current smokers (HR = 0.95; 95% CI 0.89-1.01). The consumption of any type of fruit was not found to be associated with bladder cancer risk (P values > .05). Our study supports no evidence that the consumption of specific types of fruit reduces the risk of bladder cancer. However, increasing total fruit consumption may reduce bladder cancer risk in women.
Collapse
Affiliation(s)
- Sylvia H J Jochems
- Department of Complex Genetics and Epidemiology, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Raoul C Reulen
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Frits H M van Osch
- Department of Complex Genetics and Epidemiology, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Willem J A Witlox
- Department of Complex Genetics and Epidemiology, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
- Maastricht University Medical Centre+, Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht, The Netherlands
| | - Maria E Goossens
- Cancer Centre of Sciensano, OD Public Health and Surveillance, Brussels, Belgium
| | - Maree Brinkman
- Department of Complex Genetics and Epidemiology, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
- Department of Clinical Studies and Nutritional Epidemiology, Nutrition Biomed Research Institute, Melbourne, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Graham G Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Roger L Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Piet A van den Brandt
- Department of Epidemiology, Schools for Oncology and Developmental Biology and Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Emily White
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Elisabete Weiderpass
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
| | - Inge Huybrechts
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
| | - Bertrand Hémon
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
| | - Antonio Agudo
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Bas Bueno-de-Mesquita
- Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London, UK
- Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kar K Cheng
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Frederik J van Schooten
- Department of Pharmacology and Toxicology, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Richard T Bryan
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Anke Wesselius
- Department of Complex Genetics and Epidemiology, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Maurice P Zeegers
- Department of Complex Genetics and Epidemiology, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
- CAPHRI School for Public Health and Primary Care, University of Maastricht, Maastricht, The Netherlands
| |
Collapse
|
7
|
Miclean M, Cadar O, Levei L, Senila L, Ozunu A. Metal contents and potential health risk assessment of crops grown in a former mining district (Romania). JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART. B, PESTICIDES, FOOD CONTAMINANTS, AND AGRICULTURAL WASTES 2018; 53:595-601. [PMID: 29842846 DOI: 10.1080/03601234.2018.1473966] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 04/18/2018] [Indexed: 06/08/2023]
Abstract
The Cd, Cu, Pb and Zn contents in home-grown crops in a former mining district were determined in order to evaluate the non-carcinogenic long-term potential health risk related to crop consumption. The potential health risk was investigated by estimating the daily intake and the hazard quotients. For all crop categories, the daily intake and the target hazard quotient were below the threshold values for Cd, Cu, and Zn. The daily intake of Pb exceeded the oral reference dose, while the target hazard quotient for vegetables was above 1, indicating a potential health risk. The total target hazard quotient for the individual metals decreased in the following order: Pb>Cd>Cu>Zn. This study confirmed that the daily consumption of crops grown in contaminated soils could pose health risks to humans.
Collapse
Affiliation(s)
- Mirela Miclean
- a INCDO INOE 2000, Research Institute for Analytical Instrumentation , Cluj-Napoca , Romania
- b Somes-Tisa Water Basin Administration , Cluj-Napoca , Romania
| | - Oana Cadar
- a INCDO INOE 2000, Research Institute for Analytical Instrumentation , Cluj-Napoca , Romania
| | - Levente Levei
- a INCDO INOE 2000, Research Institute for Analytical Instrumentation , Cluj-Napoca , Romania
- c Babes-Bolyai University, Environmental Science and Engineering Faculty , Cluj-Napoca , Romania
| | - Lacrimoara Senila
- a INCDO INOE 2000, Research Institute for Analytical Instrumentation , Cluj-Napoca , Romania
| | - Alexandru Ozunu
- c Babes-Bolyai University, Environmental Science and Engineering Faculty , Cluj-Napoca , Romania
| |
Collapse
|
8
|
Barbosa ALA, Vermeulen SHHM, Aben KK, Grotenhuis AJ, Vrieling A, Kiemeney LA. Smoking intensity and bladder cancer aggressiveness at diagnosis. PLoS One 2018; 13:e0194039. [PMID: 29570711 PMCID: PMC5865728 DOI: 10.1371/journal.pone.0194039] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 02/25/2018] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE To explore the relation between cigarette smoking intensity and bladder cancer aggressiveness at first diagnosis. METHODS Patients diagnosed with urinary bladder cancer (BC) between 1995-2011 under the age of 75 years were retrospectively identified from the Netherlands Cancer Registry and invited for a study on genetic and lifestyle risk factors for BC. Information on patients' self-reported smoking history was retrieved by means of a postal questionnaire. Tumors were stratified regarding the risk of progression defined by tumor stage and grade. Multinomial logistic regression was used to analyze the relation between smoking intensity and aggressiveness of the tumor. RESULTS The UBC study population comprised 323 (17.4%) never smokers, 870 (46.8%) former cigarette smokers, and 630 (33.9%) current cigarette smokers. A higher smoking amount was a risk factor of getting high-risk non-muscle invasive bladder cancer (NMIBC) compared with low-risk NMIBC in ever and former cigarette smokers (OR: 1.02 per cigarette smoked, 95% CI: 1.00-1.03 and OR: 1.03, 95% CI: 1.01-1.05, respectively). A statistically significant dose-response increase in the risk of a more aggressive cancer type (high-risk NMIBC and MIBC) was observed with increasing smoking duration among former smokers (p for trend 0.035 and 0.008, respectively). No significant association of the evaluated smoking intensity variables was observed in current smokers. A longer time of smoking cessation correlated with a lower odds of a more aggressive cancer. CONCLUSION We observed a weak increase in the risk of a more aggressive tumor type with increasing smoking intensity in former smokers, but this association was absent in current smokers. This conflicting result may suggest that there is no strong relation between smoking intensity and bladder cancer aggressiveness. Analyses of prospective studies with longitudinal smoking assessment may provide a more definitive answer to the research question.
Collapse
Affiliation(s)
- André L. A. Barbosa
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
- Federal University of Bahia, Salvador, Brazil
| | - Sita H. H. M. Vermeulen
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Katja K. Aben
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
- Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
| | - Anne J. Grotenhuis
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Alina Vrieling
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Lambertus A. Kiemeney
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
- Department of Urology, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
| |
Collapse
|
9
|
Westhoff E, Wu X, Kiemeney LA, Lerner SP, Ye Y, Huang M, Dinney CP, Vrieling A, Tu H. Dietary patterns and risk of recurrence and progression in non-muscle-invasive bladder cancer. Int J Cancer 2017; 142:1797-1804. [PMID: 29235103 DOI: 10.1002/ijc.31214] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 11/18/2017] [Accepted: 11/22/2017] [Indexed: 01/01/2023]
Abstract
The association of dietary factors with urinary bladder cancer prognosis has scarcely been investigated, and results of studies conducted to date are inconsistent. We investigated whether empirically derived dietary patterns are associated with risks of recurrence and progression in non-muscle-invasive bladder cancer (NMIBC) patients. Data from 595 newly diagnosed NMIBC patients from an ongoing prospective cohort study were used to derive dietary patterns using exploratory factor analysis. Factor scores were calculated and then categorized in sex-specific tertiles. Multivariable-adjusted proportional hazards regression models were used to estimate hazard ratios and 95% confidence intervals for the associations between tertiles of adherence to the dietary patterns and risks of recurrence and progression. We identified four dietary patterns: "fruits and vegetables," "Western," "low-fat," and "Tex-Mex." Patients in the highest tertile of adherence to the Western pattern experienced a 1.48 times higher risk of recurrence (95% CI 1.06-2.06) compared to patients in the lowest tertile. No statistically significant associations of a Western diet with risk of progression or of the other dietary patterns with risk of recurrence and progression were found. Overall, we found that adherence to a Western diet was associated with a higher risk of recurrence but further studies are needed to confirm our findings.
Collapse
Affiliation(s)
- Ellen Westhoff
- Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Xifeng Wu
- Department of Epidemiology, The University of Texas M.D. Anderson Cancer Center, Houston, TX
| | - Lambertus A Kiemeney
- Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Seth P Lerner
- Scott Department of Urology, Baylor College of Medicine, Houston, TX
| | - Yuanqing Ye
- Department of Epidemiology, The University of Texas M.D. Anderson Cancer Center, Houston, TX
| | - Maosheng Huang
- Department of Epidemiology, The University of Texas M.D. Anderson Cancer Center, Houston, TX
| | - Colin P Dinney
- Department of Urology, The University of Texas M.D. Anderson Cancer Center, Houston, TX
| | - Alina Vrieling
- Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Huakang Tu
- Department of Epidemiology, The University of Texas M.D. Anderson Cancer Center, Houston, TX
| |
Collapse
|
10
|
Wu Y, Zhang X, Li Z, Yan H, Qin J, Li T. Formononetin inhibits human bladder cancer cell proliferation and invasiveness via regulation of miR-21 and PTEN. Food Funct 2017; 8:1061-1066. [PMID: 28139790 DOI: 10.1039/c6fo01535b] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The isoflavone formononetin is the main active component of Astragalus membranaceus and possesses anti-tumorigenic properties. However, the role of formononetin in human bladder cancer (BCa) has not been fully elucidated. The aim of the present study was to investigate the anti-tumor effects of formononetin on BCa cells and its potential molecular mechanism. T24 cells were treated with different concentrations of formononetin, and then the cell proliferation was assessed by MTT assay, cell apoptosis by Hoechst 33258 stain assay, cell invasiveness by transwell invasion assay, microRNA-21 (miR-21) expression by real-time PCR and the protein level of phosphatase and tensin homolog (PTEN) and phosphorylated homolog of Akt (p-Akt) by western blotting. The results showed that formononetin significantly inhibited the proliferation of T24 cells in a time- and dose-dependent manner. T24 cells treated with formononetin displayed obvious morphological changes of apoptosis and lower invasiveness. In addition, miR-21 expression was significantly decreased in formononetin-treated T24 cells, followed by increase of PTEN, and down-regulation of p-Akt. Collectively, these results suggest that formononetin exerts an anti-carcinogenic effect on BCa in vitro, which might be due to miR-21-mediated regulation of the PTEN/Akt pathway.
Collapse
Affiliation(s)
- Yiying Wu
- Department of Pharmacology, School of Pharmacy, Chengdu Medical College, Chengdu 610083, China
| | - Xing Zhang
- Key Laboratory of Tumor Immunology and Microenvironmental Regulation, Guilin Medical University, Guilin 541004, China
| | - Zhengzhao Li
- Department of Emergency, Second Affiliated Hospital of Guangxi Medical University, Nanning 530023, China
| | - Haibiao Yan
- Institute of Urology and Nephrology, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China.
| | - Jian Qin
- Department of Radiation Oncology of Clinical Cancer Center, the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China.
| | - Tianyu Li
- Institute of Urology and Nephrology, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China.
| |
Collapse
|
11
|
Piyathilake C. Dietary factors associated with bladder cancer. Investig Clin Urol 2016; 57 Suppl 1:S14-25. [PMID: 27326403 PMCID: PMC4910759 DOI: 10.4111/icu.2016.57.s1.s14] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 03/22/2016] [Indexed: 12/02/2022] Open
Abstract
It is biologically plausible for dietary factors to influence bladder cancer risk considering that beneficial as well as harmful components of a diet are excreted through the urinary tract and in direct contact with the epithelium of the bladder. However, studies that investigated the association between dietary factors and bladder cancer (BC) risk have largely reported inconsistent results. The macronutrient intake and risk of BC could have yield inconsistent results across studies because of lack of details on the type, source and the quantities of different dietary fatty acids consumed. There is evidence to suggest that consumption of processed meat may increase BC risk. Dietary carbohydrate intake does not appear to be directly associated with BC risk. Even though a large number of studies have investigated the association between fruit/vegetable consumption/micronutrients in those and BC risk, they have yielded inconsistent results. Gender-specific subgroup analysis, details of how fruits and vegetables are consumed (raw vs. cooked), adequate control for smoking status/aggressiveness of the cancer and consideration of genetic make-up may clarify these inconsistent results. There is no strong evidence to suggest that supplementation with any common micronutrient is effective in reducing BC risk. These limitations in published research however do not totally eclipse the observation that a diet rich in fruits and vegetables and low in processed meat along with especially smoking cessation may convey some protective effects against BC risk.
Collapse
Affiliation(s)
- Chandrika Piyathilake
- Department of Nutrition Sciences, University of Alabama at Birmingham (UAB), Birmingham, AL, USA
| |
Collapse
|
12
|
Xu C, Zeng XT, Liu TZ, Zhang C, Yang ZH, Li S, Chen XY. Fruits and vegetables intake and risk of bladder cancer: a PRISMA-compliant systematic review and dose-response meta-analysis of prospective cohort studies. Medicine (Baltimore) 2015; 94:e759. [PMID: 25929912 PMCID: PMC4603065 DOI: 10.1097/md.0000000000000759] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Clinical practice recommends eating ≥2.5 cups of fruits and vegetables (FVs) each day for cancer prevention, in which the evidence from epidemiological studies for the association between FVs intake and bladder cancer (BC) prevention is inconsistent.We searched the PubMed, Embase, and Willy online Library for relevant studies published up to September 27, 2014. Prospective cohort studies investigated FVs intake, and the risk of BC with ≥3 categories of exposure was included. A dose-response meta-analysis was carried out to evaluate the association between FVs intake and risk of BC.Fourteen cohorts with 17 studies including 9447 cases were identified. No evidence of nonlinear association was examined between FVs intake and risk of BC. The summarized relevant risk (RR) of every 0.2 serving increment a day was 1.00 (95%CI: 0.99, 1.00; P = 0.17; I = 41.7%; n = 14) for total fruits; 0.99 (95%CI: 0.96, 1.01; P = 0.28; I = 37.0%; n = 13) for total vegetables; and 0.99 (95%CI: 0.97, 1.01; P = 0.24; I = 57.5%; n = 8) for both FVs. In further analysis, we observed inverse association between every 0.2 serving increment of green leafy vegetables intake a day and risk of BC (RR = 0.98, 95%CI: 0.96, 0.99; I = 0.0%; P < 0.01; Power = 0.76; n = 6), but neither for cruciferous vegetables (RR = 0.97, 95%CI: 0.93, 1.01; P = 0.19; I = 55.8%; n = 8) nor for citrus (RR = 1.00, 95%CI: 1.00, 1.00; P = 0.83; I = 0.0%; n = 7). Subgroup analysis showed consistent results.Little evidence supports a beneficial effect for total fruits, vegetables, both FVs, and citrus intake against bladder cancer. Green leafy vegetables may help prevent bladder cancer.
Collapse
Affiliation(s)
- Chang Xu
- From the Department of Urology (CX, T-ZL, Z-HY, SL, X-YC); Center for Evidence-Based and Translational Medicine, Zhongnan Hospital (CX, X-TZ, T-ZL, CZ, SL); and Center for Evidence-Based and Translational Medicine, Wuhan University, Wuhan, PR China (X-TZ, SL)
| | | | | | | | | | | | | |
Collapse
|
13
|
Potter JD. Nutritional epidemiology--there's life in the old dog yet! Cancer Epidemiol Biomarkers Prev 2014; 24:323-30. [PMID: 25515549 DOI: 10.1158/1055-9965.epi-14-1327] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Consideration is given to the idea that the nutritional epidemiology of cancer is dead, as some in the media have claimed. The basis for the claim does not lie in science nor has anyone with relevant knowledge made such a statement-although that, too, has been claimed. Evidence is adduced for the importance of past achievements of nutritional epidemiology. Attention is similarly drawn to recent contributions. In particular, I note the state of play of cancer and plant foods, fat and breast cancer, meat and cancer, vegetarians, intervention studies, migrant studies, and westernization of diet and lifestyle. Some next steps and some currently important questions are outlined.
Collapse
Affiliation(s)
- John D Potter
- Centre for Public Health Research, Massey University, Wellington, New Zealand. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington.
| |
Collapse
|
14
|
Vieira AR, Vingeliene S, Chan DSM, Aune D, Abar L, Navarro Rosenblatt D, Greenwood DC, Norat T. Fruits, vegetables, and bladder cancer risk: a systematic review and meta-analysis. Cancer Med 2014; 4:136-46. [PMID: 25461441 PMCID: PMC4312127 DOI: 10.1002/cam4.327] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Revised: 07/22/2014] [Accepted: 07/31/2014] [Indexed: 01/21/2023] Open
Abstract
Smoking is estimated to cause about half of all bladder cancer cases. Case-control studies have provided evidence of an inverse association between fruit and vegetable intake and bladder cancer risk. As part of the World Cancer Research/American Institute for Cancer Research Continuous Update Project, we conducted a systematic review and meta-analysis of prospective studies to assess the dose-response relationship between fruit and vegetables and incidence and mortality of bladder cancer. We searched PubMed up to December 2013 for relevant prospective studies. We conducted highest compared with lowest meta-analyses and dose-response meta-analyses using random effects models to estimate summary relative risks (RRs) and 95% confidence intervals (CIs), and used restricted cubic splines to examine possible nonlinear associations. Fifteen prospective studies were included in the review. The summary RR for an increase of 1 serving/day (80 g) were 0.97 (95% CI: 0.95-0.99) I(2) = 0%, eight studies for fruits and vegetables, 0.97 (95% CI: 0.94-1.00, I(2) = 10%, 10 studies) for vegetables and 0.98 (95% CI: 0.96-1.00, I(2) = 0%, 12 studies) for fruits. Results were similar in men and women and in current, former and nonsmokers. Amongst fruits and vegetables subgroups, for citrus fruits the summary RR for the highest compared with the lowest intake was 0.87 (95% CI: 0.76-0.99, I(2) = 0%, eight studies) and for cruciferous vegetables there was evidence of a nonlinear relationship (P = 0.001). The current evidence from cohort studies is not consistent with a role for fruits and vegetables in preventing bladder cancer.
Collapse
Affiliation(s)
- Ana R Vieira
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | | | | | | | | | | | | | | |
Collapse
|
15
|
Struijk EA, May AM, Beulens JWJ, Fransen HP, de Wit GA, Boer JMA, Onland-Moret NC, Hoekstra J, van der Schouw YT, Bueno-de-Mesquita HB, Peeters PHM. Adherence to the Dutch Guidelines for a Healthy Diet and cancer risk in the European Prospective Investigation into Cancer and Nutrition-Netherlands (EPIC-NL) cohort. Public Health Nutr 2014; 17:2546-53. [PMID: 24192305 PMCID: PMC10282203 DOI: 10.1017/s1368980013002966] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Revised: 10/02/2013] [Accepted: 10/07/2013] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To examine the association between adherence to the Dutch Guidelines for a Healthy Diet created by the Dutch Health Council in 2006 and overall and smoking-related cancer incidence. DESIGN Prospective cohort study. SETTING Adherence to the guidelines, which includes one recommendation on physical activity and nine on diet, was measured using an adapted version of the Dutch Healthy Diet (DHD) index. The score ranged from 0 to 90 with a higher score indicating greater adherence to the guidelines. We estimated the hazard ratios (HR) and 95 % confidence intervals for the association between the DHD index (in tertiles and per 20-point increment) at baseline and cancer incidence at follow-up. SUBJECTS We studied 35 608 men and women aged 20-70 years recruited into the European Prospective Investigation into Cancer and Nutrition-Netherlands (EPIC-NL) study during 1993-1997. RESULTS After an average follow-up of 12·7 years, 3027 cancer cases were documented. We found no significant association between the DHD index (tertile 3 v. tertile 1) and overall (HR = 0·97; 95 % CI 0·88, 1·07) and smoking-related cancer incidence (HR = 0·89; 95 % CI 0·76, 1·06) after adjustment for relevant confounders. Excluding the components physical activity or alcohol from the score did not change the results. None of the individual components of the DHD index was significantly associated with cancer incidence. CONCLUSIONS In the present study, participants with a high adherence to the Dutch Guidelines for a Healthy Diet were not at lower risk of overall or smoking-related cancer. This does not exclude that other components not included in the DHD index may be associated with overall cancer risk.
Collapse
Affiliation(s)
- Ellen A Struijk
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, PO Box 85500, 3508 GA Utrecht, The Netherlands
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Anne M May
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, PO Box 85500, 3508 GA Utrecht, The Netherlands
| | - Joline WJ Beulens
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, PO Box 85500, 3508 GA Utrecht, The Netherlands
| | - Heidi P Fransen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, PO Box 85500, 3508 GA Utrecht, The Netherlands
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - G Ardine de Wit
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, PO Box 85500, 3508 GA Utrecht, The Netherlands
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Jolanda MA Boer
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - N Charlotte Onland-Moret
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, PO Box 85500, 3508 GA Utrecht, The Netherlands
| | - Jeljer Hoekstra
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Yvonne T van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, PO Box 85500, 3508 GA Utrecht, The Netherlands
| | - H Bas Bueno-de-Mesquita
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Petra HM Peeters
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, PO Box 85500, 3508 GA Utrecht, The Netherlands
| |
Collapse
|
16
|
Zamora-Ros R, Sacerdote C, Ricceri F, Weiderpass E, Roswall N, Buckland G, St-Jules DE, Overvad K, Kyrø C, Fagherazzi G, Kvaskoff M, Severi G, Chang-Claude J, Kaaks R, Nöthlings U, Trichopoulou A, Naska A, Trichopoulos D, Palli D, Grioni S, Mattiello A, Tumino R, Gram IT, Engeset D, Huerta JM, Molina-Montes E, Argüelles M, Amiano P, Ardanaz E, Ericson U, Lindkvist B, Nilsson LM, Kiemeney LA, Ros M, Bueno-de-Mesquita HB, Peeters PHM, Khaw KT, Wareham NJ, Knaze V, Romieu I, Scalbert A, Brennan P, Wark P, Vineis P, Riboli E, González CA. Flavonoid and lignan intake in relation to bladder cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Br J Cancer 2014; 111:1870-80. [PMID: 25121955 PMCID: PMC4453722 DOI: 10.1038/bjc.2014.459] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 07/16/2014] [Accepted: 07/20/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND There is growing evidence of the protective role of dietary intake of flavonoids and lignans on cancer, but the association with bladder cancer has not been thoroughly investigated in epidemiological studies. We evaluated the association between dietary intakes of total and subclasses of flavonoids and lignans and risk of bladder cancer and its main morphological type, urothelial cell carcinoma (UCC), within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. METHODS A cohort of 477 312 men and women mostly aged 35-70 years, were recruited in 10 European countries. At baseline, dietary flavonoid and lignan intakes were estimated using centre-specific validated questionnaires and a food composition database based on the Phenol-Explorer, the UK Food Standards Agency and the US Department of Agriculture databases. RESULTS During an average of 11 years of follow-up, 1575 new cases of primary bladder cancer were identified, of which 1425 were UCC (classified into aggressive (n=430) and non-aggressive (n=413) UCC). No association was found between total flavonoid intake and bladder cancer risk. Among flavonoid subclasses, significant inverse associations with bladder cancer risk were found for intakes of flavonol (hazard ratio comparing fifth with first quintile (HRQ5-Q1) 0.74, 95% confidence interval (CI): 0.61-0.91; P-trend=0.009) and lignans (HRQ5-Q1 0.78, 95% CI: 0.62-0.96; P-trend=0.046). Similar results were observed for overall UCC and aggressive UCC, but not for non-aggressive UCC. CONCLUSIONS Our study suggests an inverse association between the dietary intakes of flavonols and lignans and risk of bladder cancer, particularly aggressive UCC.
Collapse
Affiliation(s)
- R Zamora-Ros
- Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC), Lyon, France
| | - C Sacerdote
- Center for Cancer Prevention (CPO-Piemonte), and Human Genetic Foundation (HuGeF), Torino, Italy
| | - F Ricceri
- Center for Cancer Prevention (CPO-Piemonte), and Human Genetic Foundation (HuGeF), Torino, Italy
| | - E Weiderpass
- Department of Community Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
- Cancer Registry of Norway, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Samfundet Folkhälsan, Helsinki, Finland
| | - N Roswall
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - G Buckland
- Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - D E St-Jules
- Department of Nutrition, Harvard School of Public Health, Boston, MA, USA
| | - K Overvad
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
| | - C Kyrø
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - G Fagherazzi
- Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health team, Villejuif, France
- Paris South University, UMRS 1018, Villejuif, France
- IGR, F-94805, Villejuif, France
| | - M Kvaskoff
- Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health team, Villejuif, France
- Paris South University, UMRS 1018, Villejuif, France
- IGR, F-94805, Villejuif, France
| | - G Severi
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Molecular, Environmental, Genetic, and Analytic Epidemiology, The University of Melbourne, Melbourne, Victoria, Australia
| | - J Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - R Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - U Nöthlings
- Department of Nutrition and Food Sciences, Nutritional Epidemiology, University of Bonn, Bonn, Germany
| | - A Trichopoulou
- Hellenic Health Foundation, Athens, Greece
- Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece
| | - A Naska
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece
| | - D Trichopoulos
- Hellenic Health Foundation, Athens, Greece
- Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
| | - D Palli
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute-ISPO, Florence, Italy
| | - S Grioni
- Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A Mattiello
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - R Tumino
- Cancer Registry and Histopathology Unit, ‘Civic MP Arezzo' Hospital, ASP Ragusa, Italy
| | - I T Gram
- Department of Community Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
| | - D Engeset
- Department of Community Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
| | - J M Huerta
- Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - E Molina-Montes
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Andalusian School of Public Health, Granada, Spain
| | | | - P Amiano
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Public Health Department of Gipuzkoa, BioDonostia Research Institute, Health Department of Basque Region, San Sebastián, Spain
| | - E Ardanaz
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Public Health Institute of Navarra, Pamplona, Spain
| | - U Ericson
- Diabetes and Cardiovascular disease, Genetic Epidemiology, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - B Lindkvist
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - L M Nilsson
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
- Arcum, Arctic Research Centre at Umeå University, Umeå, Sweden
| | - L A Kiemeney
- Department for Health Evidence and Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - M Ros
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Department of Epidemiology, Biostatistics and HTA, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - H B Bueno-de-Mesquita
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands
- School of Public Health, Imperial College, London, UK
| | - P H M Peeters
- School of Public Health, Imperial College, London, UK
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - K-T Khaw
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - N J Wareham
- MRC Epidemiology Unit, Cambridge University, Institute of Metabolic Science, Cambridge, UK
| | - V Knaze
- Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC), Lyon, France
| | - I Romieu
- Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC), Lyon, France
| | - A Scalbert
- Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC), Lyon, France
| | - P Brennan
- Genetic Epidemiology Group, Section of Genetics, International Agency for Research on Cancer (IARC), Lyon, France
| | - P Wark
- School of Public Health, Imperial College, London, UK
| | - P Vineis
- School of Public Health, Imperial College, London, UK
| | - E Riboli
- School of Public Health, Imperial College, London, UK
| | - C A González
- Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| |
Collapse
|
17
|
Yao B, Yan Y, Ye X, Fang H, Xu H, Liu Y, Li S, Zhao Y. Intake of fruit and vegetables and risk of bladder cancer: a dose-response meta-analysis of observational studies. Cancer Causes Control 2014; 25:1645-58. [PMID: 25248495 DOI: 10.1007/s10552-014-0469-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2014] [Accepted: 09/09/2014] [Indexed: 01/01/2023]
Abstract
BACKGROUND Observational studies suggest an association between fruit and vegetables intake and risk of bladder cancer, but the results are controversial. METHODS We therefore summarized the evidence from observational studies in categorical, linear, and nonlinear, dose-response meta-analysis. Pertinent studies were identified by searching EMBASE and PubMed from their inception to August 2013. RESULTS Thirty-one observational studies involving 12,610 cases and 1,121,649 participants were included. The combined rate ratio (RR, 95 % CI) of bladder cancer for the highest versus lowest intake was 0.83 (0.69-0.99) for total fruit and vegetables, 0.81 (0.70-0.93) for total vegetables, 0.77 (0.69-0.87) for total fruit, 0.84 (0.77-0.91) for cruciferous vegetables, 0.79 (0.68-0.91) for citrus fruits, and 0.74 (0.66-0.84) for yellow-orange vegetables. Subgroup analysis showed study design and gender as possible sources of heterogeneity. A nonlinear relationship was found of citrus fruits intake with risk of bladder cancer (P for nonlinearity = 0.018), and the RRs (95 % CI) of bladder cancer were 0.87 (0.78-0.96), 0.80 (0.67-0.94), 0.79 (0.66-0.94), 0.79 (0.65-0.96), and 0.79 (0.64-0.99) for 30, 60, 90, 120, and 150 g/day. A nonlinear relationship was also found of yellow-orange vegetable intake with risk of bladder cancer risk (P for nonlinearity = 0.033). Some evidence of publication bias was observed for fruit, citrus fruits, and yellow-orange vegetables. CONCLUSION This meta-analysis supports the hypothesis that intakes of fruit and vegetables may reduce the risk of bladder cancer. Future well-designed studies are required to confirm this finding.
Collapse
Affiliation(s)
- Baodong Yao
- Shanghai Minhang Center for Disease Control and Prevention, 965 Zhongyi Road, Shanghai, 201101, China
| | | | | | | | | | | | | | | |
Collapse
|
18
|
Bradbury KE, Appleby PN, Key TJ. Fruit, vegetable, and fiber intake in relation to cancer risk: findings from the European Prospective Investigation into Cancer and Nutrition (EPIC). Am J Clin Nutr 2014; 100 Suppl 1:394S-8S. [PMID: 24920034 DOI: 10.3945/ajcn.113.071357] [Citation(s) in RCA: 195] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Fruit, vegetables, and certain components of plant foods, such as fiber, have long been thought to protect against cancer. The European Prospective Investigation into Cancer and Nutrition (EPIC) is a prospective cohort that includes >500,000 participants from 10 European countries and has made a substantial contribution to knowledge in this research area. The purpose of this article is to summarize the findings published thus far from the EPIC study on the associations between fruit, vegetable, or fiber consumption and the risk of cancer at 14 different sites. The risk of cancers of the upper gastrointestinal tract was inversely associated with fruit intake but was not associated with vegetable intake. The risk of colorectal cancer was inversely associated with intakes of total fruit and vegetables and total fiber, and the risk of liver cancer was also inversely associated with the intake of total fiber. The risk of cancer of the lung was inversely associated with fruit intake but was not associated with vegetable intake; this association with fruit intake was restricted to smokers and might be influenced by residual confounding due to smoking. There was a borderline inverse association of fiber intake with breast cancer risk. For the other 9 cancer sites studied (stomach, biliary tract, pancreas, cervix, endometrium, prostate, kidney, bladder, and lymphoma) there were no reported significant associations of risk with intakes of total fruit, vegetables, or fiber.
Collapse
Affiliation(s)
- Kathryn E Bradbury
- From the Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Paul N Appleby
- From the Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Timothy J Key
- From the Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| |
Collapse
|
19
|
Buckland G, Ros MM, Roswall N, Bueno-de-Mesquita HB, Travier N, Tjonneland A, Kiemeney LA, Sacerdote C, Tumino R, Ljungberg B, Gram IT, Weiderpass E, Skeie G, Malm J, Ehrnström R, Chang-Claude J, Mattiello A, Agnoli C, Peeters PH, Boutron-Ruault MC, Fagherazzi G, Clavel-Chapelon F, Nilsson LM, Amiano P, Trichopoulou A, Oikonomou E, Tsiotas K, Sánchez MJ, Overvad K, Quirós JR, Chirlaque MD, Barricarte A, Key TJ, Allen NE, Khaw KT, Wareham N, Riboli E, Kaaks R, Boeing H, Palli D, Romieu I, Romaguera D, Gonzalez CA. Adherence to the Mediterranean diet and risk of bladder cancer in the EPIC cohort study. Int J Cancer 2014; 134:2504-11. [PMID: 24226765 DOI: 10.1002/ijc.28573] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Revised: 09/09/2013] [Accepted: 09/11/2013] [Indexed: 12/19/2022]
Abstract
There is growing evidence of the protective role of the Mediterranean diet (MD) on cancer. However, to date no epidemiological study has investigated the influence of the MD on bladder cancer. We evaluated the association between adherence to the MD and risk of urothelial cell bladder cancer (UCC), according to tumor aggressiveness, in the European Prospective Investigation into Cancer and Nutrition (EPIC). The analysis included 477,312 participants, recruited from ten European countries between 1991 and 2000. Information from validated dietary questionnaires was used to develop a relative Mediterranean diet score (rMED), including nine dietary components. Cox regression models were used to assess the effect of the rMED on UCC risk, while adjusting for dietary energy and tobacco smoking of any kind. Stratified analyses were performed by sex, BMI, smoking status, European region and age at diagnosis. During an average follow-up of 11 years, 1,425 participants (70.9% male) were diagnosed with a first primary UCC. There was a negative but non-significant association between a high versus low rMED score and risk of UCC overall (HR: 0.84 [95% CI 0.69, 1.03]) and risk of aggressive (HR: 0.88 [95% CI 0.61, 1.28]) and non-aggressive tumors (HR: 0.78 [95% CI 0.54, 1.14]). Although there was no effect modification in the stratified analyses, there was a significant 34% (p = 0.043) decreased risk of UCC in current smokers with a high rMED score. In EPIC, the MD was not significantly associated with risk of UCC, although we cannot exclude that a MD may reduce risk in current smokers.
Collapse
Affiliation(s)
- G Buckland
- Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Algaba A, Guerra I, Castaño &A, Poza GDL, Castellano VM, López M, Bermejo F. Risk of cancer, with special reference to extra-intestinal malignancies, in patients with inflammatory bowel disease. World J Gastroenterol 2013; 19:9359-9365. [PMID: 24409063 PMCID: PMC3882409 DOI: 10.3748/wjg.v19.i48.9359] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2013] [Revised: 09/20/2013] [Accepted: 10/22/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To determine the incidence and characteristics of intestinal and extra-intestinal cancers among patients with inflammatory bowel disease in a Spanish hospital and to compare them with those of the local population.
METHODS: This was a prospective, observational, 7-year follow-up, cohort study. Cumulative incidence, incidence rates based on person-years of follow-up and relative risk were calculated for patients with inflammatory bowel disease and compared with the background population. The incidence of cancer was determined using a hospital-based data registry from Hospital Universitario de Fuenlabrada. Demographic data and details about time from diagnosis of inflammatory bowel disease to occurrence of cancer, disease extent, inflammatory bowel disease treatment, cancer therapy and cancer evolution were also collected in the inflammatory bowel disease cohort.
RESULTS: Eighteen of 590 patients with inflammatory bowel disease developed cancer [cumulative incidence = 3% (95%CI: 1.58-4.52) vs 2% (95%CI: 1.99-2.11) in the background population; RR = 1.5; 95%CI: 0.97-2.29]. The cancer incidence among inflammatory bowel disease patients was 0.53% (95%CI: 0.32-0.84) per patient-year of follow-up. Patients with inflammatory bowel disease had a significantly increased relative risk of urothelial carcinoma (RR = 5.23, 95%CI: 1.95-13.87), appendiceal mucinous cystadenoma (RR = 36.6, 95%CI: 7.92-138.4), neuroendocrine carcinoma (RR = 13.1, 95%CI: 1.82-29.7) and rectal carcinoid (RR = 8.94, 95%CI: 1.18-59.7). Colorectal cancer cases were not found.
CONCLUSION: The overall risk of cancer did not significantly increase in our inflammatory bowel disease patients. However, there was an increased risk of urinary bladder cancer and, with less statistical power, an increased risk of appendiceal mucinous cystadenoma and of neuroendocrine tumors. Colorectal cancer risk was low in our series.
Collapse
|
21
|
Pasman WJ, van Erk MJ, Klöpping WAA, Pellis L, Wopereis S, Bijlsma S, Hendriks HFJ, Kardinaal AFM. Nutrigenomics approach elucidates health-promoting effects of high vegetable intake in lean and obese men. GENES AND NUTRITION 2013; 8:507-21. [PMID: 23595524 PMCID: PMC3755133 DOI: 10.1007/s12263-013-0343-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Accepted: 03/14/2013] [Indexed: 01/02/2023]
Abstract
We aimed to explore whether vegetable consumption according to guidelines has beneficial health effects determined with classical biomarkers and nutrigenomics technologies. Fifteen lean (age 36 ± 7 years; BMI 23.4 ± 1.7 kg m−2) and 17 obese (age 40 ± 6 years; BMI 30.3 ± 2.4 kg m−2) men consumed 50- or 200-g vegetables for 4 weeks in a randomized, crossover trial. Afterward, all subjects underwent 4 weeks of energy restriction (60 % of normal energy intake). Despite the limited weight loss of 1.7 ± 2.4 kg for the lean and 2.1 ± 1.9 kg for the obese due to energy restriction, beneficial health effects were found, including lower total cholesterol, LDL cholesterol and HbA1c concentrations. The high vegetable intake resulted in increased levels of plasma amino acid metabolites, decreased levels of 9-HODE and prostaglandin D3 and decreased levels of ASAT and ALP compared to low vegetable intake. Adipose tissue gene expression changes in response to vegetable intake were identified, and sets of selected genes were submitted to network analysis. The network of inflammation genes illustrated a central role for NFkB in (adipose tissue) modulation of inflammation by increased vegetable intake, in lean as well as obese subjects. In obese subjects, high vegetable intake also resulted in changes related to energy metabolism, adhesion and inflammation. By inclusion of sensitive omics technologies and comparing the changes induced by high vegetable intake with changes induced by energy restriction, it has been shown that part of vegetables’ health benefits are mediated by changes in energy metabolism, inflammatory processes and oxidative stress.
Collapse
Affiliation(s)
- W J Pasman
- TNO, P.O. Box 360, 3700 AJ, Zeist, The Netherlands,
| | | | | | | | | | | | | | | |
Collapse
|
22
|
Isa F, Xie LP, Hu Z, Zhong Z, Hemelt M, Reulen RC, Wong YC, Tam PC, Yang K, Chai C, Zeng X, Deng Y, Zhong WD, Zeegers MP. Dietary consumption and diet diversity and risk of developing bladder cancer: results from the South and East China case–control study. Cancer Causes Control 2013; 24:885-95. [DOI: 10.1007/s10552-013-0165-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Accepted: 01/31/2013] [Indexed: 01/08/2023]
|