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Fan Y, Hu C, Xie X, Weng Y, Chen C, Wang Z, He X, Jiang D, Huang S, Hu Z, Liu F. Effects of diets on risks of cancer and the mediating role of metabolites. Nat Commun 2024; 15:5903. [PMID: 39003294 PMCID: PMC11246454 DOI: 10.1038/s41467-024-50258-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 07/02/2024] [Indexed: 07/15/2024] Open
Abstract
Research on the association between dietary adherence and cancer risk is limited, particularly concerning overall cancer risk and its underlying mechanisms. Using the UK Biobank data, we prospectively investigate the associations between adherence to a Mediterranean diet (MedDiet) or a Mediterranean-Dietary Approaches to Stop Hypertension Diet Intervention for Neurodegenerative Delay diet (MINDDiet) and the risk of overall and 22 specific cancers, as well as the mediating effects of metabolites. Here we show significant negative associations of MedDiet and MINDDiet adherence with overall cancer risk. These associations remain robust across 14 and 13 specific cancers, respectively. Then, a sequential analysis, incorporating Cox regression, elastic net and gradient boost models, identify 10 metabolites associated with overall cancer risk. Mediation results indicate that these metabolites play a crucial role in the association between adherence to a MedDiet or a MINDDiet and cancer risk, independently and cumulatively. These findings deepen our understanding of the intricate connections between diet, metabolites, and cancer development.
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Affiliation(s)
- Yi Fan
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Chanchan Hu
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Xiaoxu Xie
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Yanfeng Weng
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Chen Chen
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Zhaokun Wang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Xueqiong He
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Dongxia Jiang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Shaodan Huang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China.
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, School of Public Health, Peking University, Beijing, China.
| | - Zhijian Hu
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China.
| | - Fengqiong Liu
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China.
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Tsigalou C, Tsolou A, Stavropoulou E, Konstantinidis T, Zafiriou E, Dardiotis E, Tsirogianni A, Bogdanos D. Unraveling the intricate dance of the Mediterranean diet and gut microbiota in autoimmune resilience. Front Nutr 2024; 11:1383040. [PMID: 38818135 PMCID: PMC11137302 DOI: 10.3389/fnut.2024.1383040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 05/07/2024] [Indexed: 06/01/2024] Open
Abstract
The nutritional habits regulate the gut microbiota and increase risk of an autoimmune disease. Western diet is rich in sugars, meat, and poly-unsaturated fatty acids, which lead to dysbiosis of intestinal microbiota, disruption of gut epithelial barrier and chronic mucosal inflammation. In contrast, the Mediterranean Diet (MedDiet) is abundant in ω3 fatty acids, fruits, and vegetables, possessing anti-inflammatory properties that contribute to the restoration of gut eubiosis. Numerous studies have extensively examined the impact of MedDiet and its components on both health and various disease states. Additionally, specific investigations have explored the correlation between MedDiet, microbiota, and the risk of autoimmune diseases. Furthermore, the MedDiet has been linked to a reduced risk of cardiovascular diseases, playing a pivotal role in lowering mortality rates among individuals with autoimmune diseases and comorbidities. The aim of the present review is to specifically highlight current knowledge regarding possible interactions of MedDiet with the patterns of intestinal microbiota focusing on autoimmunity and a blueprint through dietary modulations for the prevention and management of disease's activity and progression.
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Affiliation(s)
- Christina Tsigalou
- Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, University Hospital, Alexandroupolis, Greece
| | - Avgi Tsolou
- Laboratory of Molecular Cell Biology, Cell Cycle and Proteomics, Department of Molecular Biology and Genetics, Democritus University of Thrace, Alexandroupolis, Greece
| | - Elisavet Stavropoulou
- Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, University Hospital, Alexandroupolis, Greece
| | - Theocharis Konstantinidis
- Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, University Hospital, Alexandroupolis, Greece
| | - Efterpi Zafiriou
- Department of Dermatology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Efthymios Dardiotis
- Department of Neurology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Alexandra Tsirogianni
- Department of Immunology-Histocompatibility, Evangelismos General Hospital, Athens, Greece
| | - Dimitrios Bogdanos
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
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Castelló A, Rodríguez-Barranco M, Lope V, Guevara M, Colorado-Yohar S, Dorronsoro A, Quirós JR, Castro-Espin C, Sayon-Orea C, Santiuste C, Amiano P, Lasheras C, Sanchez MJ, Pollán M. High adherence to Western dietary pattern increases breast cancer risk (an EPIC-Spain study). Maturitas 2024; 179:107868. [PMID: 37925868 DOI: 10.1016/j.maturitas.2023.107868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 09/25/2023] [Accepted: 10/10/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE To explore the association between three previously identified and validated dietary patterns (Western, Prudent and Mediterranean) and breast cancer risk by tumour subtype and menopausal status. METHODS Data from the Spanish cohort of the European Prospective Investigation into Cancer and Nutrition study provided epidemiological information (including diet and cancer incidence) from 24,892 women (639 breast cancer cases) recruited between 1992 and 1996. The associations between adherence to the three dietary patterns and breast cancer risk (overall and by tumour subtype) were explored by fitting multivariate Cox proportional hazards regression models stratified by region, among other variables. A possible interaction with menopausal status (changing over time) was explored. RESULTS No clear association of the Prudent and Mediterranean dietary patterns with breast cancer risk was found. When compared with women with a level of adherence to the Western diet in the first quartile, women with a level of adherence in the third (hazard ratio (95 % confidence interval) (HR(95%CI)):1.37 (1.07;1.77)) and fourth quartiles (1.37 (1.03;1.83)); p for curvature of splines = 0.016) showed a non-linear increased risk, especially postmenopausal women (HR (95 % CI) 1.30 (0.98;1.72) in the third and 1.42 (1.04;1.94) in the fourth quartiles; p for curvature of splines = 0.081) and for estrogen or progesterone receptor positive with human epidermal growth factor receptor 2 negative tumours (HR (95 % CI) 1.62 (1.10;2.38) and 1.71 (1.11;2.63) for the third and fourth quartiles respectively; p for curvature of splines = 0.013). CONCLUSIONS Intake of foods such as high-fat dairy products, red and processed meats, refined grains, sweets, caloric drinks, convenience food and sauces might be associated with a higher risk of breast cancer.
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Affiliation(s)
- Adela Castelló
- Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.
| | - Miguel Rodríguez-Barranco
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain; Escuela Andaluza de Salud Pública, 18011 Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain.
| | - Virginia Lope
- Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.
| | - Marcela Guevara
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain; Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain.
| | - Sandra Colorado-Yohar
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain; Department of Epidemiology, Murcia Regional Health Council, IMIB, Murcia, Spain; Research Group on Demography and Health, National Faculty of Public Health, University of Antioquia, Medellín, Colombia
| | - Ane Dorronsoro
- Ministry of Health of the Basque Government, Sub Directorate for Public Health and Addictions of Gipuzkoa, 20013 San Sebastian, Spain; Biodonostia Health Research Institute, Epidemiology of Chronic and Communicable Diseases Group, 20014 San Sebastián, Spain.
| | | | - Carlota Castro-Espin
- Unit of Nutrition and Cancer, Catalan Institute of Oncology-ICO, L'Hospitalet de Llobregat, 08908 Barcelona, Spain; Nutrition and Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
| | - Carmen Sayon-Orea
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain.
| | - Carmen Santiuste
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain; Department of Epidemiology, Murcia Regional Health Council, IMIB, Murcia, Spain.
| | - Pilar Amiano
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain; Ministry of Health of the Basque Government, Sub Directorate for Public Health and Addictions of Gipuzkoa, 20013 San Sebastian, Spain; Biodonostia Health Research Institute, Epidemiology of Chronic and Communicable Diseases Group, 20014 San Sebastián, Spain.
| | - Cristina Lasheras
- Functional Biology Department, University of Oviedo, 33006 Oviedo, Spain.
| | - María-José Sanchez
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain; Escuela Andaluza de Salud Pública, 18011 Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain; Department of Preventive Medicine and Public Health, University of Granada, 18071 Granada, Spain.
| | - Marina Pollán
- Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.
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Nagy S, Petrosky SN, Demory Beckler M, Kesselman MM. The Impact of Modern Dietary Practices on Cancer Risk and Progression: A Systematic Review. Cureus 2023; 15:e46639. [PMID: 37937022 PMCID: PMC10627144 DOI: 10.7759/cureus.46639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/06/2023] [Indexed: 11/09/2023] Open
Abstract
Cancer is a leading cause of mortality around the world, despite continued advancements in the management of cancer. Recent research efforts have shifted to evaluating the role that modifiable risk factors play in cancer risk and development, as diet and nutrition have been found to play a significant role in the onset and progression of cancer. As a result, there has been an increasing focus on the impact of dietary modifications on preventing the onset, progression, and reoccurrence of cancer. In this systematic review, data were collected on three common diets, the Mediterranean diet (MD), ketogenic diet (KD), and plant-based diet, to gain insight into the application of these three dietary modification approaches for risk prevention and limitation of cancer burden. Initially, 4,397 articles were identified from three databases (Ovid, Web of Science, and CINHAL). After removing studies based on the exclusion criteria, only 23 studies were eligible to be included in the systematic review of which 15 evaluated the MD, four assessed the ketogenic diet, and four evaluated the plant-based diet. Each article was considered for its methods, procedures, and findings. The findings indicate that dietary interventions may effectively reduce the odds of cancer development and the advancement of diagnosed cancers. With the introduction of the MD, KD, and plant-based diets, significant improvements in lowering cancer development, recurrence-free status, and limiting tumor growth were noted across numerous cancer types. Currently, the MD has been extensively studied in the literature, and amongst the widest variety of cancer types. Additional information and evaluation are required on the ketogenic and plant-based diets to fully understand their impact on the cancer burden across a wider subset of cancers. Clinicians should evaluate and recommend nutritional adaptations to their patients to limit the development of specific cancers and as an adjunctive therapy to traditional pharmacological treatment options for patients with diagnosed cancers.
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Affiliation(s)
- Stephanie Nagy
- Rheumatology, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Davie, USA
| | - Stephanie N Petrosky
- Nutrition, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Davie, USA
| | - Michelle Demory Beckler
- Microbiology and Immunology, Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Davie, USA
| | - Marc M Kesselman
- Rheumatology, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Davie, USA
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5
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Castelló A, Rodríguez-Barranco M, Pérez-Gómez B, Chirlaque MD, Bonet C, Amiano P, Ardanaz E, Huerta JM, Zamora-Ros R, Quirós JR, Barricarte-Gurrea A, Pollán M, Sanchez MJ. High adherence to Western dietary pattern and prostate cancer risk: findings from the EPIC-Spain cohort. BJU Int 2023; 132:272-282. [PMID: 37073612 DOI: 10.1111/bju.16001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
OBJECTIVE To explore the association between three previously identified dietary patterns (Western, Prudent and Mediterranean) and prostate cancer (PCa) risk by tumour aggressiveness. SUBJECTS AND METHODS The Spanish cohort of the European Prospective Investigation into Cancer and Nutrition study provided dietary and epidemiological information from 15 296 men recruited during the period 1992-1996. The associations between the adherence to the three dietary patterns and PCa risk (global, for Gleason grade groups 6 and >6, and for International Society of Urological Pathology [ISUP] grade 1 + 2 and ISUP grade 3 + 4 + 5) was explored with multivariable Cox proportional hazards regression models stratified by centre and age. RESULTS While no effect on PCa risk was detected for the Prudent and Mediterranean dietary patterns, a suggestion of a detrimental effect of the Western dietary pattern was found (hazard ratio [HR]Q4vsQ1 1.29 [95% confidence interval {CI} 0.96;1.72]). This effect was only observed for Gleason grade group >6 (HRQ3vsQ1 1.61 [95% CI 1.00; 2.59] and HRQ4vsQ1 1.60 [95% CI 0.96; 2.67]) and in particular ISUP grade 3 + 4 + 5 tumours (HRQ2vsQ1 1.97 [95% CI 0.98; 3.93]; HRQ3vsQ1 2.72 (95% CI 1.35; 5.51); HRQ4vsQ1 2.29 [95% CI 1.07; 4.92]). CONCLUSIONS Our results suggest that a high adherence to a healthy diet such as that represented by the Prudent and Mediterranean dietary patterns is not enough to prevent prostate cancer. Additionally, reducing adherence to a Western-type diet seems to be necessary.
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Affiliation(s)
- Adela Castelló
- School of Medicine, University of Alcalá, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
- Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Miguel Rodríguez-Barranco
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
- Andalusian School of Public Health, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Beatriz Pérez-Gómez
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
- Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Maria Dolores Chirlaque
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
| | - Catalina Bonet
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Pilar Amiano
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
- Sub-Directorate for Public Health and Addictions of Gipuzkoa, Ministry of Health of the Basque Government, San Sebastian, Spain
- Epidemiology and Public Health Area, Biodonostia Health Research Institute, San Sebastian, Spain
| | - Eva Ardanaz
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
- Instituto de Salud Pública de Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - José María Huerta
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
| | - Raúl Zamora-Ros
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | | | - Aurelio Barricarte-Gurrea
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
- Instituto de Salud Pública de Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Marina Pollán
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
- Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - María-José Sanchez
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
- Andalusian School of Public Health, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
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Eshaghian N, Heidarzadeh-Esfahani N, Akbari H, Askari G, Sadeghi O. Fish consumption and risk of prostate cancer or its mortality: an updated systematic review and dose-response meta-analysis of prospective cohort studies. Front Nutr 2023; 10:1221029. [PMID: 37593679 PMCID: PMC10427873 DOI: 10.3389/fnut.2023.1221029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 07/12/2023] [Indexed: 08/19/2023] Open
Abstract
Since the release of the last meta-analysis on the association between fish intake and prostate cancer risk, several cohort studies have been published. Moreover, none of the previous meta-analyzes examined the dose-response association between fish intake and prostate cancer. Therefore, the current dose-response meta-analysis was conducted to summarize available findings on the associations of fish intake with the risk of prostate cancer in men. Online databases of PubMed, Scopus, and Web of Science were systematically searched up to September 2022. We included prospective cohort studies that examined the associations of fish intake with the risk of prostate cancer (total, localized, and advanced prostate cancer), its mortality, and cancer progression. Summary relative risks (RR) and 95% confidence intervals (CI) were calculated for the highest versus lowest categories of fish intake using random-effects models. Also, linear and non-linear dose-response analyzes were conducted. In total, 25 prospective cohort studies, recruiting 1,216,474 men, were included in the systematic review, and 22 studies were included in the meta-analysis. During the follow-up periods, ranging from 6 to 33 years, a total of 44,722 cases of prostate cancer were recorded. The comparison between the highest and lowest intakes of total fish revealed the summary RRs of 0.97 (95% CI: 0.86-1.10) for total, 1.01 (95% CI: 0.91-1.13) for advanced, and 0.90 (95% CI: 0.72-1.12) for localized prostate cancer, indicating no significant association. Moreover, the summary RR was 0.55 (95% CI: 0.33-0.92) for prostate cancer mortality and 0.84 (95% CI: 0.65-1.10) for prostate cancer progression, indicating an inverse association between fish intake and prostate cancer mortality. Also, in the dose-response analyzes, each 20 gram/day increase in total fish intake was associated with a 12% lower risk of prostate cancer mortality. Our findings support the protective association between total fish intake and the risk of prostate cancer mortality.
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Affiliation(s)
- Niloofar Eshaghian
- Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Neda Heidarzadeh-Esfahani
- Department of Nutritional Science, School of Nutritional Science and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hakimeh Akbari
- Cellular and Molecular Research Center, Gerash University of Medical Sciences, Gerash, Iran
| | - Gholamreza Askari
- Nutrition and Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Omid Sadeghi
- Nutrition and Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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7
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Liu Y, Lu J. A bibliometric analysis of Mediterranean diet on cancer from 2012 to 2021. Front Nutr 2023; 10:1128432. [PMID: 36845049 PMCID: PMC9944434 DOI: 10.3389/fnut.2023.1128432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 01/24/2023] [Indexed: 02/11/2023] Open
Abstract
Background Numerous studies have demonstrated the value of the Mediterranean diet (MD) as a nutritious eating regimen for lowering the risk of cancer. This study aims to discuss the research patterns, existing state, and possible hotspots in implementing the MD for the prevention and treatment of cancer using bibliometrics. Methods The Web of Science Core Collection (WoSCC) was searched for articles on cancer that were related to the MD. CiteSpace, VOSviewer, Microsoft Excel 2019, and R software were utilized for bibliometric analysis and data visualization. Results There were 1,415 articles and reviews published from 2012 to 2021. Annual publication volume showed a continuous upward trend. Italy and Harvard University were the country and institution, respectively, with the highest number of publications on this topic. Nutrients ranked first in the number of documents, number of citations, and the H-index. James R. Hebert was the most productive writer, and Antonia Trichopoulou was the most co-cited author. "Alcohol consumption," "oleic acid," and "low density lipoprotein" were keywords used in earlier publications, while more recent hotspots focused on "gut microbiota," "older adult," and "polyphenol." Conclusion Over the past decade, research on the MD in the field of cancer has received increasing attention. To improve the level of evidence for the beneficial effects of the MD on a range of cancers, more research on molecular mechanisms and better clinical studies are required.
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Affiliation(s)
- Yafeng Liu
- Department of Thoracic Surgery, Shengjing Hospital of China Medical University, Shenyang, China
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Ali A, Manzoor MF, Ahmad N, Aadil RM, Qin H, Siddique R, Riaz S, Ahmad A, Korma SA, Khalid W, Aizhong L. The Burden of Cancer, Government Strategic Policies, and Challenges in Pakistan: A Comprehensive Review. Front Nutr 2022; 9:940514. [PMID: 35938114 PMCID: PMC9355152 DOI: 10.3389/fnut.2022.940514] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 06/23/2022] [Indexed: 01/09/2023] Open
Abstract
Cancer is a severe condition characterized by uncontrolled cell division and increasing reported mortality and diagnostic cases. In 2040, an estimated 28.4 million cancer cases are expected to happen globally. In 2020, an estimated 19.3 million new cancer cases (18.1 million excluding non-melanoma skin cancer) had been diagnosed worldwide, with around 10.0 million cancer deaths. Breast cancer cases have increased by 2.26 million, lung cancer by 2.21 million, stomach by 1.089 million, liver by 0.96 million, and colon cancer by 1.93 million. Cancer is becoming more prevalent in Pakistan, with 19 million new cancer cases recorded in 2020. Food adulteration, gutkha, paan, and nutritional deficiencies are major cancer risk factors that interplay with cancer pathogenesis in this country. Government policies and legislation, cancer treatment challenges, and prevention must be revised seriously. This review presents the current cancer epidemiology in Pakistan to better understand cancer basis. It summarizes current cancer risk factors, causes, and the strategies and policies of the country against cancer.
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Affiliation(s)
- Anwar Ali
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health, Central South University, Changsha, China
- Food and Nutrition Society, Gilgit Baltistan, Pakistan
| | | | - Nazir Ahmad
- Department of Nutritional Science, Government College University Faisalabad, Faisalabad, Pakistan
| | - Rana Muhammad Aadil
- National Institute of Food Science and Technology, University of Agriculture, Faisalabad, Pakistan
| | - Hong Qin
- School of Nutrition and Food Hygiene, Xiangya School of Public Health, Central South University, Changsha, China
| | - Rabia Siddique
- Department of Chemistry, Government College University Faisalabad, Faisalabad, Pakistan
| | - Sakhawat Riaz
- Department of Home Economics, Government College University Faisalabad, Faisalabad, Pakistan
| | - Arslan Ahmad
- Department of Home Economics, Government College University Faisalabad, Faisalabad, Pakistan
| | - Sameh A. Korma
- Department of Food Science, Faculty of Agriculture, Zagazig, Egypt
| | - Waseem Khalid
- Department of Food Sciences, Government College University, Faisalabad, Pakistan
| | - Liu Aizhong
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health, Central South University, Changsha, China
- *Correspondence: Liu Aizhong
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Dietary Patterns and Prostate Cancer: CAPLIFE Study. Cancers (Basel) 2022; 14:cancers14143475. [PMID: 35884536 PMCID: PMC9316982 DOI: 10.3390/cancers14143475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/14/2022] [Accepted: 07/16/2022] [Indexed: 02/04/2023] Open
Abstract
The etiology of prostate cancer (PCa) remains uncertain, and the role of diet is unclear. We aimed to evaluate the role of diet, through dietary patterns, on PCa, considering tumor aggressiveness and extension. The CAPLIFE study is a population-based case-control study including a total of 428 incident PCa cases and 393 controls aged 40-80 years. Dietary information was collected through a validated food frequency questionnaire. Three dietary patterns were identified through principal component analysis: "Mediterranean," "Western," and "Unhealthy," which were categorized into tertiles according to the control group cutoff points. Tumor aggressiveness and extension was determined. Logistic regression models were used to assess the association between dietary patterns and PCa. High adherence to an unhealthy dietary pattern was associated with higher odds of PCa, ORT3vsT1 = 1.52 (95% CI 1.02-2.27), especially for cases with ISUP 1-2 and localized PCa tumors. This association was not observed with a Western or Mediterranean pattern. In conclusion, adherence to an unhealthy diet appears to be associated with higher odds of PCa, especially for cases with ISUP 1-2 and localized PCa tumors.
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10
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Ng CF. One step closer between dietary pattern and cancer prevention. Prostate Cancer Prostatic Dis 2022; 25:385. [PMID: 35440641 DOI: 10.1038/s41391-022-00545-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Chi-Fai Ng
- SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China.
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11
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Lozano-Lorca M, Salcedo-Bellido I, Olmedo-Requena R, Castaño-Vinyals G, Amiano P, Shivappa N, Hébert JR, Pérez-Gómez B, Gracia-Lavedan E, Gómez-Acebo I, Molina-Barceló A, Barrios-Rodríguez R, Alguacil J, Fernández-Tardón G, Aragonés N, Dierssen-Sotos T, Romaguera D, Pollán M, Kogevinas M, Jiménez-Moleón JJ. Dietary inflammatory index and prostate cancer risk: MCC-Spain study. Prostate Cancer Prostatic Dis 2022; 25:568-575. [PMID: 35418209 DOI: 10.1038/s41391-022-00532-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/02/2022] [Accepted: 03/24/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND The etiology of prostate cancer (PCa) is not well-known, and the role of diet is not well established. We aimed to evaluate the role of the inflammatory power of the diet, measured by the Dietary Inflammatory Index (DII®), on the risk of PCa. METHODOLOGY A population-based multicase-control (MCC-Spain) study was conducted. Information was collected on sociodemographic characteristics, personal and family antecedents, and lifestyles, including diet from a Food Frequency Questionnaire. The inflammatory potential of the diet was assessed using the energy-adjusted Dietary Inflammatory Index (E-DII) based on 30 parameters (a higher score indicates a higher inflammatory capacity of the diet). Tertiles of E-DII were created using the cut-off points from the control group. The International Society of Urology Pathology (ISUP) was grouped as ISUP 1, ISUP 2, or ISUP 3-5. Unconditional logistic regression models were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for the association between E-DII score and PCa risk. RESULTS A total of 928 PCa cases and 1278 population controls were included. Among PCa cases, the mean value of the E-DII score was 0.18 (SD: 1.9) vs. 0.07 (SD: 1.9) in the control group (p = 0.162). Cases with a more pro-inflammatory diet (3rd tertile) had the highest risk of PCa, aORT3vsT1 = 1.30 (95% CI 1.03-1.65) (p-trend = 0.026). When stratifying by ISUP, this risk association was observed only for ISUP 2 and ISUP 3-5, aORT3vsT1 = 1.46 (95% CI 1.02-2.10) and 1.60 (95% CI 1.10-2.34), respectively. CONCLUSION A positive association was observed between consuming a pro-inflammatory diet and PCa in the MCC-Spain population, specifically for an ISUP grade greater or equal than 2.
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Affiliation(s)
- Macarena Lozano-Lorca
- Universidad de Granada. Departamento de Medicina Preventiva y Salud Pública, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Inmaculada Salcedo-Bellido
- Universidad de Granada. Departamento de Medicina Preventiva y Salud Pública, Granada, Spain. .,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain. .,Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain.
| | - Rocío Olmedo-Requena
- Universidad de Granada. Departamento de Medicina Preventiva y Salud Pública, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | - Gemma Castaño-Vinyals
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain.,Instituto de Salud Global de Barcelona (ISGlobal), Barcelona, Spain.,Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra (UPF), Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Pilar Amiano
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain.,Public Health Division of Gipuzkoa, Donostia-San Sebastian, Spain
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - James R Hébert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Beatriz Pérez-Gómez
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain.,Department of Epidemiology for Chronic Diseases, National Center of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Esther Gracia-Lavedan
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain.,Instituto de Salud Global de Barcelona (ISGlobal), Barcelona, Spain.,Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Inés Gómez-Acebo
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain.,Department of Preventive Medicine and Public Health, University of Cantabria-IDIVAL, 39011, Santander, Spain
| | | | - Rocío Barrios-Rodríguez
- Universidad de Granada. Departamento de Medicina Preventiva y Salud Pública, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | - Juan Alguacil
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain.,Centro de Investigación en Recursos Naturales, Salud y Medio Ambiente (RENSMA), Universidad de Huelva, Huelva, Spain
| | - Guillermo Fernández-Tardón
- Health Research Institute of the Principality of Asturias (ISPA), Oncology Institute, University of Oviedo, Oviedo, Asturias, Spain.,Department of Medicine, University of Oviedo, Oviedo, Spain
| | - Nuria Aragonés
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain.,Epidemiology Section, Division of Public Health, Department of Health, Madrid, Spain
| | - Trinidad Dierssen-Sotos
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain.,Department of Preventive Medicine and Public Health, University of Cantabria-IDIVAL, 39011, Santander, Spain
| | - Dora Romaguera
- Instituto de Salud Global de Barcelona (ISGlobal), Barcelona, Spain.,Instituto de Investigación Sanitaria Illes Balears (IdISBa), Palma de Mallorca, Spain.,Consortium for Biomedical Research in Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Marina Pollán
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain.,Department of Epidemiology for Chronic Diseases, National Center of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Manolis Kogevinas
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain.,Instituto de Salud Global de Barcelona (ISGlobal), Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - José-Juan Jiménez-Moleón
- Universidad de Granada. Departamento de Medicina Preventiva y Salud Pública, Granada, Spain. .,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain. .,Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain.
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12
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Fatty Acid Metabolism Reprogramming in Advanced Prostate Cancer. Metabolites 2021; 11:metabo11110765. [PMID: 34822423 PMCID: PMC8618281 DOI: 10.3390/metabo11110765] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 11/01/2021] [Accepted: 11/03/2021] [Indexed: 12/23/2022] Open
Abstract
Prostate cancer (PCa) is a carcinoma in which fatty acids are abundant. Fatty acid metabolism is rewired during PCa development. Although PCa can be treated with hormone therapy, after prolonged treatment, castration-resistant prostate cancer can develop and can lead to increased mortality. Changes to fatty acid metabolism occur systemically and locally in prostate cancer patients, and understanding these changes may lead to individualized treatments, especially in advanced, castration-resistant prostate cancers. The fatty acid metabolic changes are not merely reflective of oncogenic activity, but in many cases, these represent a critical factor in cancer initiation and development. In this review, we analyzed the literature regarding systemic changes to fatty acid metabolism in PCa patients and how these changes relate to obesity, diet, circulating metabolites, and peri-prostatic adipose tissue. We also analyzed cellular fatty acid metabolism in prostate cancer, including fatty acid uptake, de novo lipogenesis, fatty acid elongation, and oxidation. This review broadens our view of fatty acid switches in PCa and presents potential candidates for PCa treatment and diagnosis.
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13
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León-González AJ, Sáez-Martínez P, Jiménez-Vacas JM, Herrero-Aguayo V, Montero-Hidalgo AJ, Gómez-Gómez E, Madrona A, Castaño JP, Espartero JL, Gahete MD, Luque RM. Comparative Cytotoxic Activity of Hydroxytyrosol and Its Semisynthetic Lipophilic Derivatives in Prostate Cancer Cells. Antioxidants (Basel) 2021; 10:antiox10091348. [PMID: 34572980 PMCID: PMC8464900 DOI: 10.3390/antiox10091348] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/30/2021] [Accepted: 08/21/2021] [Indexed: 12/30/2022] Open
Abstract
A high adherence to a Mediterranean diet has been related to numerous beneficial effects in human health, including a lower incidence and mortality of prostate cancer (PCa). Olive oil is an important source of phenolic bioactive compounds, mainly hydroxytyrosol (HT), of this diet. Because of the growing interest of this compound and its derivatives as a cancer chemopreventive agent, we aimed to compare the in vitro effect of HT isolated from olive mill wastewaters and five semisynthetic alkyl ether, ester, and nitro-derivatives against prostate cancer (PCa) cell lines. The effect in cell proliferation was determined in RWPE-1, LNCaP, 22Rv1, and PC-3 cells by resazurin assay, the effect in cell migration by wound healing assay, and tumorsphere and colony formation were evaluated. The changes in key signaling pathways involved in carcinogenesis were assessed by using a phosphorylation pathway profiling array and by Western blotting. Antiproliferative effects of HT and two lipophilic derivatives [hydroxytyrosyl acetate (HT-Ac)/ethyl hydroxytyrosyl ether (HT-Et)] were significantly higher in cancerous PC-3 and 22Rv1 cells than in non-malignant RWPE-1 cells. HT/HT-Ac/HT-Et significantly reduced migration capacity in RWPE-1 and PC-3 and prostatosphere size and colony formation in 22Rv1, whereas only HT-Ac and HT-Et reduced these functional parameters in PC-3. The cytotoxic effect in 22Rv1 cells was correlated with modifications in the phosphorylation pattern of key proteins, including ERK1/2 and AKT. Consistently, HT-Ac and HT-Et decreased p-AKT levels in PC-3. In sum, our results suggest that HT and its lipophilic derivatives could be considered as potential therapeutic tools in PCa.
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Affiliation(s)
- Antonio J. León-González
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), 14004 Cordoba, Spain; (P.S.-M.); (J.M.J.-V.); (V.H.-A.); (A.J.M.-H.); (E.G.-G.); (J.P.C.); (M.D.G.)
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, 14014 Cordoba, Spain
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), 14004 Cordoba, Spain
- Department of Pharmacology, Faculty of Pharmacy, University of Seville, 41012 Seville, Spain
- Correspondence: (A.J.L.-G.); (R.M.L.); Tel.: +34-957213740 (R.M.L.)
| | - Prudencio Sáez-Martínez
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), 14004 Cordoba, Spain; (P.S.-M.); (J.M.J.-V.); (V.H.-A.); (A.J.M.-H.); (E.G.-G.); (J.P.C.); (M.D.G.)
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, 14014 Cordoba, Spain
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), 14004 Cordoba, Spain
| | - Juan M. Jiménez-Vacas
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), 14004 Cordoba, Spain; (P.S.-M.); (J.M.J.-V.); (V.H.-A.); (A.J.M.-H.); (E.G.-G.); (J.P.C.); (M.D.G.)
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, 14014 Cordoba, Spain
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), 14004 Cordoba, Spain
| | - Vicente Herrero-Aguayo
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), 14004 Cordoba, Spain; (P.S.-M.); (J.M.J.-V.); (V.H.-A.); (A.J.M.-H.); (E.G.-G.); (J.P.C.); (M.D.G.)
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, 14014 Cordoba, Spain
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), 14004 Cordoba, Spain
| | - Antonio J. Montero-Hidalgo
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), 14004 Cordoba, Spain; (P.S.-M.); (J.M.J.-V.); (V.H.-A.); (A.J.M.-H.); (E.G.-G.); (J.P.C.); (M.D.G.)
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, 14014 Cordoba, Spain
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), 14004 Cordoba, Spain
| | - Enrique Gómez-Gómez
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), 14004 Cordoba, Spain; (P.S.-M.); (J.M.J.-V.); (V.H.-A.); (A.J.M.-H.); (E.G.-G.); (J.P.C.); (M.D.G.)
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain
- Urology Service, HURS/IMIBIC, 14004 Cordoba, Spain
| | - Andrés Madrona
- Department of Organic and Pharmaceutical Chemistry, Faculty of Pharmacy, University of Seville, 41012 Seville, Spain; (A.M.); (J.L.E.)
| | - Justo P. Castaño
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), 14004 Cordoba, Spain; (P.S.-M.); (J.M.J.-V.); (V.H.-A.); (A.J.M.-H.); (E.G.-G.); (J.P.C.); (M.D.G.)
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, 14014 Cordoba, Spain
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), 14004 Cordoba, Spain
| | - José L. Espartero
- Department of Organic and Pharmaceutical Chemistry, Faculty of Pharmacy, University of Seville, 41012 Seville, Spain; (A.M.); (J.L.E.)
| | - Manuel D. Gahete
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), 14004 Cordoba, Spain; (P.S.-M.); (J.M.J.-V.); (V.H.-A.); (A.J.M.-H.); (E.G.-G.); (J.P.C.); (M.D.G.)
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, 14014 Cordoba, Spain
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), 14004 Cordoba, Spain
| | - Raúl M. Luque
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), 14004 Cordoba, Spain; (P.S.-M.); (J.M.J.-V.); (V.H.-A.); (A.J.M.-H.); (E.G.-G.); (J.P.C.); (M.D.G.)
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, 14014 Cordoba, Spain
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), 14004 Cordoba, Spain
- Correspondence: (A.J.L.-G.); (R.M.L.); Tel.: +34-957213740 (R.M.L.)
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14
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Ferro M, Lucarelli G, Buonerba C, Terracciano D, Boccia G, Cerullo G, Cosimato V. Narrative review of Mediterranean diet in Cilento: longevity and potential prevention for prostate cancer. Ther Adv Urol 2021; 13:17562872211026404. [PMID: 35173812 PMCID: PMC8842148 DOI: 10.1177/17562872211026404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 05/24/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- Matteo Ferro
- Division of Urology, European Institute of Oncology (IEO) - IRCCS, Milan, Italy
| | - Giuseppe Lucarelli
- Department of Emergency and Organ Transplantation – Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy
| | - Carlo Buonerba
- Regional Reference Center for Rare Tumors, Department of Oncology and Hematology, AOU Federico II of Naples, Naples, Campania, Italy
- National Reference Center for Environmental Health, Zoo-prophylactic Institute of Southern Italy, Portici, Italy
| | - Daniela Terracciano
- Department of Translational Medical Sciences, University Federico II, Naples, Campania, Italy
| | - Giovanni Boccia
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Giuseppe Cerullo
- Department of Movement Sciences and Wellbeing, University of Naples “Parthenope”, Naples, Italy
| | - Vincenzo Cosimato
- Division of Laboratory Medicine – Civil Hospital “Maria SS. Addolorata”– Eboli, Salerno, Italy
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15
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Gregg JR, Zhang X, Chapin B, Ward J, Kim J, Davis J, Daniel CR. Adherence to the Mediterranean diet and grade group progression in localized prostate cancer: An active surveillance cohort. Cancer 2021; 127:720-728. [PMID: 33411364 PMCID: PMC9810094 DOI: 10.1002/cncr.33182] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 06/23/2020] [Accepted: 07/23/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND The Mediterranean diet (MD) may be beneficial for men with localized prostate cancer (PCa) on active surveillance (AS) because of its anti-inflammatory, antilipidemic, and chemopreventive properties. This study prospectively investigated adherence to the MD with Gleason score progression and explored associations by diabetes status, statin use, and other factors. METHODS Men with newly diagnosed PCa on an AS protocol (n = 410) completed a baseline food frequency questionnaire, and the MD score was calculated across 9 energy-adjusted food groups. Cox proportional hazards models were fit to evaluate multivariable-adjusted associations of the MD score with progression-free survival; progression was defined as an increase in the Gleason grade group (GG) score over a biennial monitoring regimen. RESULTS In this cohort, 15% of the men were diabetic, 44% of the men used statins, and 76 men progressed (median follow-up, 36 months). After adjustments for clinical factors, higher adherence to the MD was associated with a lower risk of GG progression among all men (hazard ratio [HR] per 1-unit increase in MD score, 0.88; 95% confidence interval [CI], 0.77-1.01), non-White men (HR per 1-unit increase in MD score, 0.64; 95% CI, 0.45-0.92; P for interaction = .07), and men without diabetes (HR per 1-unit increase in MD score, 0.82; 95% CI, 0.71-0.96; P for interaction = .03). When joint effects of the MD score and statin use were examined, a similar risk reduction was observed among men with high MD scores who did not use statins in comparison with men with low/moderate MD scores with no statin use. CONCLUSIONS The MD is associated with a lower risk of GG progression in men on AS, and this is consistent with prior reports about the MD and reduced cancer morbidity and mortality.
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Affiliation(s)
- Justin R. Gregg
- University of Texas MD Anderson Cancer Center, Houston, TX,Joint Corresponding authors: Justin R. Gregg, MD, Mailing address: 1155 Pressler Street, Unit 1373, Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, , Phone: 713-563-1432, Fax: 713-794-4824, Carrie R. Daniel, PhD, Mailing address: 1155 Pressler Street, Unit 1340, Room CPB4.3241, Department of Epidemiology, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, , Phone: 713-563-5783, Fax: 713-563-1367
| | - Xiaotao Zhang
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - Brian Chapin
- University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Jeri Kim
- Merck & Co., Inc. Kenilworth, NJ
| | - John Davis
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - Carrie R. Daniel
- University of Texas MD Anderson Cancer Center, Houston, TX,Joint Corresponding authors: Justin R. Gregg, MD, Mailing address: 1155 Pressler Street, Unit 1373, Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, , Phone: 713-563-1432, Fax: 713-794-4824, Carrie R. Daniel, PhD, Mailing address: 1155 Pressler Street, Unit 1340, Room CPB4.3241, Department of Epidemiology, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, , Phone: 713-563-5783, Fax: 713-563-1367
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16
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Oczkowski M, Dziendzikowska K, Pasternak-Winiarska A, Włodarek D, Gromadzka-Ostrowska J. Dietary Factors and Prostate Cancer Development, Progression, and Reduction. Nutrients 2021; 13:nu13020496. [PMID: 33546190 PMCID: PMC7913227 DOI: 10.3390/nu13020496] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/29/2021] [Accepted: 01/30/2021] [Indexed: 12/24/2022] Open
Abstract
Due to the constantly increasing number of cases, prostate cancer has become one of the most important health problems of modern societies. This review presents the current knowledge regarding the role of nutrients and foodstuff consumption in the etiology and development of prostate malignancies, including the potential mechanisms of action. The results of several in vivo and in vitro laboratory experiments as well as those reported by the clinical and epidemiological research studies carried out around the world were analyzed. The outcomes of these studies clearly show the influence of both nutrients and food products on the etiology and prevention of prostate cancer. Consumption of certain nutrients (saturated and trans fatty acids) and food products (e.g., processed meat products) leads to the disruption of prostate hormonal regulation, induction of oxidative stress and inflammation, and alteration of growth factor signaling and lipid metabolism, which all contribute to prostate carcinogenesis. On the other hand, a high consumption of vegetables, fruits, fish, and whole grain products exerts protective and/or therapeutic effects. Special bioactive functions are assigned to compounds such as flavonoids, stilbenes, and lycopene. Since the influence of nutrients and dietary pattern is a modifiable risk factor in the development and prevention of prostate cancer, awareness of the beneficial and harmful effects of individual food ingredients is of great importance in the global strategy against prostate cancer.
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17
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An updated systematic review and meta-analysis on adherence to mediterranean diet and risk of cancer. Eur J Nutr 2020; 60:1561-1586. [PMID: 32770356 PMCID: PMC7987633 DOI: 10.1007/s00394-020-02346-6] [Citation(s) in RCA: 159] [Impact Index Per Article: 39.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 07/21/2020] [Indexed: 12/20/2022]
Abstract
Purpose The aim of current systematic review was to update the body of evidence on associations between adherence to the Mediterranean diet (MedDiet) and risk of cancer mortality, site-specific cancer in the general population; all-cause, and cancer mortality as well as cancer reoccurrence among cancer survivors. Methods A literature search for randomized controlled trials (RCTs), case–control and cohort studies published up to April 2020 was performed using PubMed and Scopus. Study-specific risk estimates for the highest versus lowest adherence to the MedDiet category were pooled using random-effects meta-analyses. Certainty of evidence from cohort studies and RCTs was evaluated using the NutriGrade scoring system. Results The updated search revealed 44 studies not identified in the previous review. Altogether, 117 studies including 3,202,496 participants were enclosed for meta-analysis. The highest adherence to MedDiet was inversely associated with cancer mortality (RRcohort: 0.87, 95% CI 0.82, 0.92; N = 18 studies), all-cause mortality among cancer survivors (RRcohort: 0.75, 95% CI 0.66, 0.86; N = 8), breast (RRobservational: 0.94, 95% CI 0.90, 0.97; N = 23), colorectal (RRobservational: 0.83, 95% CI 0.76, 0.90; N = 17), head and neck (RRobservational: 0.56, 95% CI 0.44, 0.72; N = 9), respiratory (RRcohort: 0.84, 95% CI 0.76, 0.94; N = 5), gastric (RRobservational: 0.70, 95% CI 0.61, 0.80; N = 7), bladder (RRobservational: 0.87, 95% CI 0.76, 0.98; N = 4), and liver cancer (RRobservational: 0.64, 95% CI 0.54, 0.75; N = 4). Adhering to MedDiet did not modify risk of blood, esophageal, pancreatic and prostate cancer risk. Conclusion In conclusion, our results suggest that highest adherence to the MedDiet was related to lower risk of cancer mortality in the general population, and all-cause mortality among cancer survivors as well as colorectal, head and neck, respiratory, gastric, liver and bladder cancer risks. Moderate certainty of evidence from cohort studies suggest an inverse association for cancer mortality and colorectal cancer, but most of the comparisons were rated as low or very low certainty of evidence. Electronic supplementary material The online version of this article (10.1007/s00394-020-02346-6) contains supplementary material, which is available to authorized users.
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Trudeau K, Rousseau MC, Barul C, Csizmadi I, Parent MÉ. Dietary Patterns Are Associated with Risk of Prostate Cancer in a Population-Based Case-Control Study in Montreal, Canada. Nutrients 2020; 12:E1907. [PMID: 32605059 PMCID: PMC7399998 DOI: 10.3390/nu12071907] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 06/20/2020] [Accepted: 06/25/2020] [Indexed: 12/21/2022] Open
Abstract
This study describes the association between dietary patterns and prostate cancer (PCa) risk in a population-based case-control study conducted in Montreal, Canada (2005-2012). Cases (n = 1919) were histologically confirmed, aged ≤75 years. Concomitantly, controls (n = 1991) were randomly selected from the electoral list and frequency-matched to cases by age (±5 years). During face-to-face interviews, a 63-item food frequency questionnaire focusing on the two years before diagnosis/interview was administered. Three dietary patterns were identified from principal component analysis. Unconditional logistic regression estimated the association between dietary patterns and PCa, adjusting for age, ethnicity, education, family history, and timing of last PCa screening. When comparing scores in the highest vs. lowest quartiles, the Healthy Eating pattern was associated with a decreased risk of overall PCa (Odds ratio (OR) = 0.76, 95% confidence interval (CI) = 0.61, 0.93); this association was stronger for high-grade cancers (OR = 0.66, 95% CI = 0.48, 0.89). By contrast, the Western Sweet and Beverages pattern was associated with an elevated risk of overall PCa (OR = 1.35, 95% CI = 1.10, 1.66). The Western Salty and Alcohol pattern was not associated with PCa risk. These findings suggest that some dietary patterns influence PCa development.
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Affiliation(s)
- Karine Trudeau
- Epidemiology and Biostatistics Unit, Centre Armand-Frappier Santé Biotechnologie, Institut National de la Recherche Scientifique, University of Quebec, Laval, QC H7V 1B7, Canada; (K.T.); (M.-C.R.); (C.B.)
- School of Public Health, Department of Social and Preventive Medicine, University of Montreal, Montreal, QC H3N 1X9, Canada
| | - Marie-Claude Rousseau
- Epidemiology and Biostatistics Unit, Centre Armand-Frappier Santé Biotechnologie, Institut National de la Recherche Scientifique, University of Quebec, Laval, QC H7V 1B7, Canada; (K.T.); (M.-C.R.); (C.B.)
- School of Public Health, Department of Social and Preventive Medicine, University of Montreal, Montreal, QC H3N 1X9, Canada
- University of Montreal Hospital Research Centre, Montreal, QC H2X 0A9, Canada
| | - Christine Barul
- Epidemiology and Biostatistics Unit, Centre Armand-Frappier Santé Biotechnologie, Institut National de la Recherche Scientifique, University of Quebec, Laval, QC H7V 1B7, Canada; (K.T.); (M.-C.R.); (C.B.)
| | - Ilona Csizmadi
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA;
- Department of Community Health Sciences, Cumming School of Medicine, Calgary, AB T2N 4N1, Canada
| | - Marie-Élise Parent
- Epidemiology and Biostatistics Unit, Centre Armand-Frappier Santé Biotechnologie, Institut National de la Recherche Scientifique, University of Quebec, Laval, QC H7V 1B7, Canada; (K.T.); (M.-C.R.); (C.B.)
- School of Public Health, Department of Social and Preventive Medicine, University of Montreal, Montreal, QC H3N 1X9, Canada
- University of Montreal Hospital Research Centre, Montreal, QC H2X 0A9, Canada
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Preventing Lethal Prostate Cancer with Diet, Supplements, and Rx: Heart Healthy Continues to Be Prostate Healthy and "First Do No Harm" Part II. Curr Urol Rep 2020; 21:15. [PMID: 32185555 DOI: 10.1007/s11934-020-0967-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE OF REVIEW To discuss the overall and latest observations of the effect of diet, lifestyle, supplements, and some prescription heart healthy medications for prostate cancer prevention. RECENT FINDINGS The concept of maximizing heart health to prevent aggressive prostate cancer continues to be solidified with the addition of more prospective observational and randomized controlled trial data. Heart healthy is prostate healthy, and heart unhealthy is prostate unhealthy. The primary goal of reducing the risk of all-cause and cardiovascular disease (CVD) morbidity and mortality also coincides with maximizing prostate cancer prevention. The obesity epidemic in children and adults along with recent diverse research has only strengthened the nexus between heart and prostate health. Greater dietary adherence toward a variety of healthy foods is associated with a graded improved probability of CVD and potentially aggressive cancer risk reduction. Preventing prostate cancer via dietary supplements should encourage a "first do no harm," or less is more approach until future evidence can reverse the concerning trend that more supplementation has resulted in either no impact or an increased risk of prostate cancer. Supplements to reduce side effects of some cancer treatments appear to have more encouraging data. A discussion of quality (QC) before utilizing any pill also requires attention. Medications or interventions that potentially improve heart health including statins, aspirin, and metformin (S.A.M.), specific beta-blocker medications, and even preventive vaccines are in general generic, low-cost, "natural," and should continue to garner research interest. A watershed moment in medical education has arrived where the past perception of a diverse number of trees seemingly separated by vast distances, in reality, now appear to exist within the same forest.
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Mediterranean dietary pattern is associated with lower incidence of premenopausal breast cancer in the Seguimiento Universidad de Navarra (SUN) Project. Public Health Nutr 2020; 23:3148-3159. [PMID: 32090723 DOI: 10.1017/s1368980019003835] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Due to the growing interest in the role of dietary patterns (DPs) on chronic diseases, we assessed the association between a posteriori identified DPs in the Seguimiento Universidad de Navarra (SUN) Project - a prospective cohort study in a Mediterranean country - and breast cancer (BC) risk. DESIGN DPs were ascertained through a principal component analysis based on 31 predefined food groups. BC cases were initially identified through self-report or, if deceased, from death certificates or by notification by the next kin. Women reporting BC were asked to provide a copy of their medical report and diagnoses for confirmation purposes. We fitted Cox regression models to assess the association between adherence to the identified DPs and BC risk. SETTING Spanish university graduates. PARTICIPANTS We included 10 713 young and middle-aged - mainly premenopausal - women. RESULTS After a median follow-up of 10·3 years, we identified 100 confirmed and 168 probable incident BC cases. We described two major DPs: 'Western dietary pattern' (WDP) and 'Mediterranean dietary pattern' (MDP). A higher adherence to a WDP was associated with an increased risk of overall BC (multivariable-adjusted HR for confirmed BC Q4 v. Q1 1·70; 95 % CI 0·93, 3·12; P for trend = 0·045). Contrarily, adherence to a MDP was inversely associated with premenopausal BC (multivariable-adjusted HR Q4 v. Q1 0·33; 95 % CI 0·12, 0·91). No significant associations were observed for postmenopausal BC. CONCLUSIONS Whereas a higher adherence to the WDP may increase the risk of BC, a higher adherence to the MDP may decrease the risk of premenopausal BC.
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Livingstone TL, Beasy G, Mills RD, Plumb J, Needs PW, Mithen R, Traka MH. Plant Bioactives and the Prevention of Prostate Cancer: Evidence from Human Studies. Nutrients 2019; 11:nu11092245. [PMID: 31540470 PMCID: PMC6769996 DOI: 10.3390/nu11092245] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 09/06/2019] [Accepted: 09/10/2019] [Indexed: 12/24/2022] Open
Abstract
Prostate cancer has become the most common form of non-cutaneous (internal) malignancy in men, accounting for 26% of all new male visceral cancer cases in the UK. The aetiology and pathogenesis of prostate cancer are not understood, but given the age-adjusted geographical variations in prostate cancer incidence quoted in epidemiological studies, there is increasing interest in nutrition as a relevant factor. In particular, foods rich in phytochemicals have been proposed to reduce the risk of prostate cancer. Epidemiological studies have reported evidence that plant-based foods including cruciferous vegetables, garlic, tomatoes, pomegranate and green tea are associated with a significant reduction in the progression of prostate cancer. However, while there is well-documented mechanistic evidence at a cellular level of the manner by which individual dietary components may reduce the risk of prostate cancer or its progression, evidence from intervention studies is limited. Moreover, clinical trials investigating the link between the dietary bioactives found in these foods and prostate cancer have reported varied conclusions. Herein, we review the plant bioactives for which there is substantial evidence from epidemiological and human intervention studies. The aim of this review is to provide important insights into how particular plant bioactives (e.g., sulfur-containing compounds, carotenoids and polyphenols) present in commonly consumed food groups may influence the development and progression of prostate cancer.
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Affiliation(s)
- Tracey L. Livingstone
- Quadram Institute Bioscience, Norwich Research Park, Norwich, Norfolk NR4 7UQ, UK; (T.L.L.); (J.P.); (P.W.N.); (R.M.)
- Urology Department, Norfolk and Norwich University Hospital, Colney Lane Norwich NR4 7UY, UK;
| | - Gemma Beasy
- Quadram Institute Bioscience, Norwich Research Park, Norwich, Norfolk NR4 7UQ, UK; (T.L.L.); (J.P.); (P.W.N.); (R.M.)
| | - Robert D. Mills
- Urology Department, Norfolk and Norwich University Hospital, Colney Lane Norwich NR4 7UY, UK;
| | - Jenny Plumb
- Quadram Institute Bioscience, Norwich Research Park, Norwich, Norfolk NR4 7UQ, UK; (T.L.L.); (J.P.); (P.W.N.); (R.M.)
| | - Paul W. Needs
- Quadram Institute Bioscience, Norwich Research Park, Norwich, Norfolk NR4 7UQ, UK; (T.L.L.); (J.P.); (P.W.N.); (R.M.)
| | - Richard Mithen
- Quadram Institute Bioscience, Norwich Research Park, Norwich, Norfolk NR4 7UQ, UK; (T.L.L.); (J.P.); (P.W.N.); (R.M.)
- The Liggins Institute, University of Auckland, 84 Park Road, Grafton, Auckland 92019, New Zealand
| | - Maria H. Traka
- Quadram Institute Bioscience, Norwich Research Park, Norwich, Norfolk NR4 7UQ, UK; (T.L.L.); (J.P.); (P.W.N.); (R.M.)
- Correspondence: ; Tel.: +4-4(0)16-032-55194
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Abstract
BACKGROUND Mediterranean dietary pattern has attracted great attention in terms of its effect on human health. However, whether Mediterranean dietary pattern is an independent protective factor for prostate cancer remains controversial. Our goal was to evaluate this association by conducting a meta-analysis of observational studies. METHODS We searched the PubMed and EMBASE database through February 2019 for relevant studies that examined the association between Mediterranean Diet and prostate cancer risk. The combined risk estimates were computed using a DerSimonian random-effects model. RESULTS A total of 10 eligible studies were included in this meta-analysis. The pooled risk estimates and 95% confidence interval (CI) in relation to Mediterranean diet pattern were 0.95 (95% CI: 0.90 to 1.01) for total prostate cancer, 0.93 (95% CI: 0.75 to 1.14) for advanced prostate cancer, 0.96 (95% CI: 0.81 to 1.14) for localized prostate cancer, and 0.92 (95% CI: 0.76 to 1.11) for fatal prostate cancer. There was no evidence of heterogeneity for total (P = .326, I = 12.7%), localized (P = .706, I = 0.0%) and fatal prostate cancer (P = .282, I = 13.0%), but not for advanced prostate cancer (P = .018, I = 63.4%). CONCLUSION This large meta-analysis of observational studies suggests that Mediterranean dietary pattern has no relationship with prostate cancer risk.
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Urquiza-Salvat N, Pascual-Geler M, Lopez-Guarnido O, Rodrigo L, Martinez-Burgos A, Cozar JM, Ocaña-Peinado FM, Álvarez-Cubero MJ, Rivas A. Adherence to Mediterranean diet and risk of prostate cancer. Aging Male 2019. [PMID: 29542389 DOI: 10.1080/13685538.2018.1450854] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
In Europe, countries following the traditional Mediterranean Diet (MeDi), particularly Southern European countries, have lower prostate cancer (PCa) incidence and mortality compared to other European regions. In the present study, we investigated the association between the MeDi and the relative risk of PCa and tumor aggressiveness in a Spanish population. Among individual score components, it has been found that subjects with PCa were less likely to consume olive oil as the main culinary fat, vegetables, fruits and fish than those without. However, these differences were not statistically significative. A high intake of fruit, vegetables and cooked tomato sauce Mediterranean style (sofrito) was related to less PCa aggressiveness. Results showed that there are no differences in the score of adherence to the Mediterranean dietary patterns between cases and controls, with mean values of 8.37 ± 1.80 and 8.25 ± 2.48, respectively. However, MeDi was associated with lower PCa agressiveness according to Gleason score. Hence, relations between Mediterranean dietary patterns and PCa are still inconclusive and merit further investigations. Further large-scale studies are required to clarify the effect of MeDi on prostate health, in order to establish the role of this diet in the prevention of PCa.
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Affiliation(s)
- Noelia Urquiza-Salvat
- a Legal Medicine and Toxicology Department , University of Granada , Granada , Spain
| | | | - Olga Lopez-Guarnido
- a Legal Medicine and Toxicology Department , University of Granada , Granada , Spain
| | - Lourdes Rodrigo
- a Legal Medicine and Toxicology Department , University of Granada , Granada , Spain
| | - Alba Martinez-Burgos
- c Department of Physiology , Institute of Nutrition and Food Technology, Center of Biomedical Research, University of Granada , Granada , Spain
| | - Jose Manuel Cozar
- b Service of Urology , University Hospital Virgen de las Nieves , Granada , Spain
| | | | - Maria Jesus Álvarez-Cubero
- e Department of Biochemistry and Molecular Biology III, Faculty of Medicine , University of Granada , Granada , Spain
| | - Ana Rivas
- f Nutrition and Food Science Department , University of Granada , Granada , Spain
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Di Francesco S, Robuffo I, Caruso M, Giambuzzi G, Ferri D, Militello A, Toniato E. Metabolic Alterations, Aggressive Hormone-Naïve Prostate Cancer and Cardiovascular Disease: A Complex Relationship. ACTA ACUST UNITED AC 2019; 55:medicina55030062. [PMID: 30866568 PMCID: PMC6473682 DOI: 10.3390/medicina55030062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 01/30/2019] [Accepted: 02/27/2019] [Indexed: 02/06/2023]
Abstract
Background: Epidemiological studies suggest a possible relationship between metabolic alterations, cardiovascular disease and aggressive prostate cancer, however, no clear consensus has been reached. Objective: The aim of the study was to analyze the recent literature and summarize our experience on the association between metabolic disorders, aggressive hormone-naïve prostate cancer and cardiovascular disease. Method: We identified relevant papers by searching in electronic databases such as Scopus, Life Science Journals, and Index Medicus/Medline. Moreover, we showed our experience on the reciprocal relationship between metabolic alterations and aggressive prostate cancer, without the influence of hormone therapy, as well the role of coronary and carotid vasculopathy in advanced prostate carcinoma. Results: Prostate cancer cells have an altered metabolic homeostatic control linked to an increased aggressivity and cancer mortality. The absence of discrimination of risk factors as obesity, systemic arterial hypertension, diabetes mellitus, dyslipidemia and inaccurate selection of vascular diseases as coronary and carotid damage at initial diagnosis of prostate cancer could explain the opposite results in the literature. Systemic inflammation and oxidative stress associated with metabolic alterations and cardiovascular disease can also contribute to prostate cancer progression and increased tumor aggressivity. Conclusions: Metabolic alterations and cardiovascular disease influence aggressive and metastatic prostate cancer. Therefore, a careful evaluation of obesity, diabetes mellitus, dyslipidemia, systemic arterial hypertension, together with a careful evaluation of cardiovascular status, in particular coronary and carotid vascular disease, should be carried out after an initial diagnosis of prostatic carcinoma.
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Affiliation(s)
- Simona Di Francesco
- Department of Medical and Oral Sciences and Biotechnologies, G. D'Annunzio University of Chieti-Pescara, 66100 Chieti, Italy.
- Department of Urological, Biomedical and Translational Sciences, Federiciana University, 87100 Cosenza, Italy.
| | - Iole Robuffo
- Institute of Molecular Genetics, National Research Council, Section of Chieti, 66100 Chieti, Italy.
| | - Marika Caruso
- Department of Medical and Oral Sciences and Biotechnologies, G. D'Annunzio University of Chieti-Pescara, 66100 Chieti, Italy.
- Department of Urological, Biomedical and Translational Sciences, Federiciana University, 87100 Cosenza, Italy.
| | - Giulia Giambuzzi
- Department of Medical and Oral Sciences and Biotechnologies, G. D'Annunzio University of Chieti-Pescara, 66100 Chieti, Italy.
| | - Deborah Ferri
- Department of Medical and Oral Sciences and Biotechnologies, G. D'Annunzio University of Chieti-Pescara, 66100 Chieti, Italy.
| | - Andrea Militello
- Department of Urological, Biomedical and Translational Sciences, Federiciana University, 87100 Cosenza, Italy.
- Urology and Andrology Section, Villa Immacolata Hospital, 01100 Viterbo, Italy.
| | - Elena Toniato
- Department of Medical and Oral Sciences and Biotechnologies, G. D'Annunzio University of Chieti-Pescara, 66100 Chieti, Italy.
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Rodriguez-Sanchez L, Fernández-Navarro P, López-Abente G, Nuñez O, Fernández de Larrea-Baz N, Jimenez-Moleón JJ, Páez Borda Á, Pollán M, Perez-Gomez B. Different spatial pattern of municipal prostate cancer mortality in younger men in Spain. PLoS One 2019; 14:e0210980. [PMID: 30682085 PMCID: PMC6347247 DOI: 10.1371/journal.pone.0210980] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 01/04/2019] [Indexed: 11/25/2022] Open
Abstract
Background Prostate cancer (PC) primarily affects elderly men. However, the specific features of cases diagnosed at younger ages (<65 years) suggest that they may represent a different clinical subtype. Our aim was to assess this suggestion by contrasting the geographical PC mortality and hospital admissions patterns in Spain for all ages to those in younger men. Methods The Spanish National Institute of Statistics supplied data on PC mortality, hospital admission, and population data. We estimated the expected town-specific number of deaths and calculated the standardized mortality ratios. Spatial autoregressive models of Besag-York-Mollié provided smoother municipal estimators of PC mortality risk (all ages; <65 years). We computed the provincial age-standardized rate ratios of PC hospital admissions (all men; <60 years) using Spanish rates as the reference. Results A total of 29,566 PC deaths (6% among those <65 years) were registered between 2010–2014, with three high-mortality risk zones: Northwest Spain; Southwest Andalusia & Granada; and a broad band extending from the Pyrenees Mountains to the north of Valencia. In younger men, the spatial patterns shared the high risk of mortality in the Northwest but not the central band. The PC hospital discharge rates confirmed a North-South gradient but also low mortality/high admission rates in Madrid and Barcelona and the opposite in Southwest Andalusia. Conclusion The consistent high PC mortality/morbidity risk in the Northwest of Spain indicates an area with a real excess of risk. The different spatial pattern in younger men suggests that some factors associated with geographical risk might have differential effects by age. Finally, the regional divergences in mortality and morbidity hint at clinical variability as a source of inequity within Spain.
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Affiliation(s)
- Lara Rodriguez-Sanchez
- Urology Department, Fuenlabrada General Hospital, Fuenlabrada, Spain
- Rey Juan Carlos University, Móstoles, Spain
| | - Pablo Fernández-Navarro
- Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), Madrid, Spain
| | - Gonzalo López-Abente
- Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), Madrid, Spain
| | - Olivier Nuñez
- Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), Madrid, Spain
| | - Nerea Fernández de Larrea-Baz
- Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), Madrid, Spain
| | - Jose Juan Jimenez-Moleón
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), Madrid, Spain
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
- Complejo Hospitales Universitarios, Granada, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - Álvaro Páez Borda
- Urology Department, Fuenlabrada General Hospital, Fuenlabrada, Spain
- Rey Juan Carlos University, Móstoles, Spain
| | - Marina Pollán
- Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), Madrid, Spain
| | - Beatriz Perez-Gomez
- Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), Madrid, Spain
- Cardiovascular & Metabolic Diseases Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- * E-mail:
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Gutiérrez-González E, Castelló A, Fernández-Navarro P, Castaño-Vinyals G, Llorca J, Salas D, Salcedo-Bellido I, Aragonés N, Fernández-Tardón G, Alguacil J, Gracia-Lavedan E, García-Esquinas E, Gómez-Acebo I, Amiano P, Romaguera D, Kogevinas M, Pollán M, Pérez-Gómez B. Dietary Zinc and Risk of Prostate Cancer in Spain: MCC-Spain Study. Nutrients 2018; 11:E18. [PMID: 30577563 PMCID: PMC6356690 DOI: 10.3390/nu11010018] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 12/11/2018] [Accepted: 12/18/2018] [Indexed: 02/05/2023] Open
Abstract
Zinc is a key trace element in normal prostate cell metabolism, and is decreased in neoplastic cells. However, the association between dietary zinc and prostate cancer (PC) in epidemiologic studies is a conflicting one. Our aim was to explore this association in an MCC-Spain case-control study, considering tumor aggressiveness and extension, as well as genetic susceptibility to PC. 733 incident cases and 1228 population-based controls were included for this study. Dietary zinc was assessed using a food frequency questionnaire, and genetic susceptibility was assessed with a single nucleotide polymorphisms (SNP)-based polygenic risk score (PRS). The association between zinc intake and PC was evaluated with mixed logistic and multinomial regression models. They showed an increased risk of PC in those with higher intake of zinc (Odds Ratio (OR) tertile 3vs1: 1.39; 95% Confidence interval (CI):1.00⁻1.95). This association was mainly observed in low grade PC (Gleason = 6 RRR tertile 3vs1: 1.76; 95% CI:1.18⁻2.63) as well as in localized tumors (cT1-cT2a RRR tertile 3vs1: 1.40; 95% CI:1.00⁻1.95) and among those with higher PRS (OR tertile 3vs1: 1.50; 95% CI:0.89⁻2.53). In conclusion, a higher dietary zinc intake could increase the risk of low grade and localized tumors. Men with higher genetic susceptibility0020might also have a higher risk of PC associated with this nutrient intake.
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Affiliation(s)
- Enrique Gutiérrez-González
- Public Health & Preventive Medicine Teaching Unit. National School of Public Health. Carlos III Institute of Health, 28029 Madrid, Spain.
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
| | - Adela Castelló
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
- Department of Epidemiology of Chronic Diseases. National Centre for Epidemiology. Carlos III Institute of Health, 28029 Madrid, Spain.
- Faculty of Medicine, University of Alcalá, 28871 Alcalá de Henares, Spain.
| | - Pablo Fernández-Navarro
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
- Department of Epidemiology of Chronic Diseases. National Centre for Epidemiology. Carlos III Institute of Health, 28029 Madrid, Spain.
| | - Gemma Castaño-Vinyals
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
- ISGlobal, 08036 Barcelona, Spain.
- IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain.
- Universitat Pompeu Fabra (UPF), 08002 Barcelona, Spain.
| | - Javier Llorca
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
- Universidad de Cantabria-IDIVAL, 39011 Santander, Spain.
| | - Dolores Salas
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
- Área de Cáncer y Salud Pública, FISABIO-Salud Pública, 46020 Valencia, Spain.
| | - Inmaculada Salcedo-Bellido
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
- Universidad de Granada-ibs.Granada, 18012 Granada, Spain.
| | - Nuria Aragonés
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
- Cancer epidemiology Section, Public Health Division, Department of Health of Madrid, 28035 Madrid, Spain.
| | - Guillermo Fernández-Tardón
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
- Oncology Institute IUOPA (Instituto Universitario de Oncología del Principado de Asturias), Universidad de Oviedo, 33003 Asturias, Spain.
| | - Juan Alguacil
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
- Centro de Investigación en Recursos Naturales, Salud y Medio Ambiente (RENSMA), Universidad de Huelva, 21004 Huelva, Spain.
| | - Esther Gracia-Lavedan
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
- ISGlobal, 08036 Barcelona, Spain.
- IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain.
| | - Esther García-Esquinas
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, 28029 Madrid, Spain.
| | - Inés Gómez-Acebo
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
- Universidad de Cantabria-IDIVAL, 39011 Santander, Spain.
| | - Pilar Amiano
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
- Public Health Division of Gipuzkoa, BioDonostia Research Health Institute, 20014 San Sebastian, Spain.
| | - Dora Romaguera
- ISGlobal, 08036 Barcelona, Spain.
- Balearic Islands Health Research Institute (IdISBa), University Hospital Son Espases, 07120 Palma de Mallorca, Spain.
- CIBER Fisiopathology of Obesity and Nutrition (CIBER-OBN), Carlos III Institute of Health, 28029 Madrid, Spain.
| | - Manolis Kogevinas
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
- ISGlobal, 08036 Barcelona, Spain.
- IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain.
- Universitat Pompeu Fabra (UPF), 08002 Barcelona, Spain.
| | - Marina Pollán
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
- Department of Epidemiology of Chronic Diseases. National Centre for Epidemiology. Carlos III Institute of Health, 28029 Madrid, Spain.
| | - Beatriz Pérez-Gómez
- Public Health & Preventive Medicine Teaching Unit. National School of Public Health. Carlos III Institute of Health, 28029 Madrid, Spain.
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
- Department of Epidemiology of Chronic Diseases. National Centre for Epidemiology. Carlos III Institute of Health, 28029 Madrid, Spain.
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Preventing Lethal Prostate Cancer with Diet, Supplements, and Rx: Heart Healthy Continues to Be Prostate Healthy and "First Do No Harm" Part I. Curr Urol Rep 2018; 19:104. [PMID: 30368693 DOI: 10.1007/s11934-018-0846-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW To discuss the overall and latest observations of the effect of diet, lifestyle, supplements, and some prescription heart healthy medications for prostate cancer prevention. RECENT FINDINGS The concept of maximizing heart health to prevent aggressive prostate cancer continues to be solidified with the addition of more prospective observational and randomized controlled trial data. Heart healthy is prostate healthy, but heart unhealthy is prostate unhealthy. The primary goal of reducing the risk of all-cause and cardiovascular disease (CVD) morbidity and mortality also allows for maximizing prostate cancer prevention. The obesity epidemic in children and adults along with recent diverse research has only strengthened the nexus between heart and prostate health. Greater dietary adherence toward a variety of healthy foods is associated with a graded improved probability of CVD and potentially aggressive cancer risk reduction. Preventing prostate cancer via dietary supplements should encourage a "first do no harm", or less is more approach until future evidence can reverse the concerning trend that more supplementation has resulted in either no impact or an increased risk of prostate cancer. Supplements to reduce side effects of some cancer treatments appear to have more encouraging data. Medications that improve heart health including statins, aspirin, and metformin (S.A.M.), and specific beta-blocker medications are primarily generic or low-cost and should continue to garner research interest. A watershed moment in medical education has arrived where the past perception of a diverse number of trees seemingly separated by vast distances, in reality, now appear to exist within the same forest.
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Adherence to Mediterranean diet and prostate cancer risk in Sicily: population-based case-control study. Int J Impot Res 2018; 31:269-275. [PMID: 30337696 DOI: 10.1038/s41443-018-0088-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 08/19/2018] [Accepted: 09/24/2018] [Indexed: 12/22/2022]
Abstract
Prostate cancer (PCa) is the second most frequently diagnosed cancer and the sixth leading cause of death from cancer worldwide. Countries following a Mediterranean-type dietary pattern, has been reported to have lower PCa incidence and mortality compared with other European regions. A population-based case-control study has been conducted from January 2015 to December 2016 in a single institution of the municipality of Catania, southern Italy. A total of 118 PCa and 238 population-based controls were collected. Controls had significantly higher adherence to the Mediterranean diet, which was evident for several subgroups (including age groups, overweight and obese men, current smokers, alcohol intake, low and medium physical activity levels). PCa cases were found to consume lower amount of vegetables (223 g/d vs. 261 g/d; p = 0.001), legumes (34.26 g/d vs. 53.55 g/d; p = 0.003), and fish (47.75 g/d vs. 58.3 g/d) than controls; other differences emerged were related to alcohol intake (12.37 g/d vs 5.07 g/d; p < 0.01), cereals (254.06 g/d vs.235.94 g/d; p < 0.001), dairy (196 g/d vs. 166 g/d; p < 0.001), and meat consumption (98.09 g/d vs. 70.15 g/d; p < 0.001). However, no statistically significant differences between cases and controls were found regarding fruit, legumes, and olive oil consumption. The Mediterranean diet score was inversely associated with lower likelihood of having PCa in a linear manner (odds ratio [OR]: 0.86 [95% CI 0.77-0.96]). Specifically, individuals in the highest group of adherence had 78% less likelihood of have PCa and 14% less likelihood for each point increase of the score. The model adjusted for total polyphenol intake showed still a significant inverse association between adherence to the Mediterranean diet and PCa, but the relation was no more linear and not significant for one-point increase of the score (OR: 0.88 [95% CI 0.77-1.01]). In our cohorts of Italian men, we observed that high adherence to the Mediterranean diet was inversely associated with likelihood of having PCa cancer.
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Castelló A, Fernández de Larrea N, Martín V, Dávila-Batista V, Boldo E, Guevara M, Moreno V, Castaño-Vinyals G, Gómez-Acebo I, Fernández-Tardón G, Peiró R, Olmedo-Requena R, Capelo R, Navarro C, Pacho-Valbuena S, Pérez-Gómez B, Kogevinas M, Pollán M, Aragonés N. High adherence to the Western, Prudent, and Mediterranean dietary patterns and risk of gastric adenocarcinoma: MCC-Spain study. Gastric Cancer 2018; 21:372-382. [PMID: 29139048 DOI: 10.1007/s10120-017-0774-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 10/10/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND The influence of dietary habits on the development of gastric adenocarcinoma is not clear. The objective of the present study was to explore the association of three previously identified dietary patterns with gastric adenocarcinoma by sex, age, cancer site, and morphology. METHODS MCC-Spain is a multicase-control study that included 295 incident cases of gastric adenocarcinoma and 3040 controls. The association of the Western, Prudent, and Mediterranean dietary patterns-derived in another Spanish case-control study-with gastric adenocarcinoma was assessed using multivariable logistic regression models with random province-specific intercepts and considering a possible interaction with sex and age. Risk according to tumor site (cardia, non-cardia) and morphology (intestinal/diffuse) was evaluated using multinomial regression models. RESULTS A high adherence to the Western pattern increased gastric adenocarcinoma risk [odds ratiofourth_vs._first_quartile (95% confidence interval), 2.09 (1.31; 3.33)] even at low levels [odds ratiosecond_vs._first_quartile (95% confidence interval), 1.63 (1.05; 2.52)]. High adherence to the Mediterranean dietary pattern could prevent gastric adenocarcinoma [odds ratiofourth_vs._first_quartile (95% confidence interval), 0.53 (0.34; 0.82)]. Although no significant heterogeneity of effects was observed, the harmful effect of the Western pattern was stronger among older participants and for non-cardia adenocarcinomas, whereas the protective effect of the Mediterranean pattern was only observed among younger participants and for non-cardia tumors. CONCLUSION Decreasing the consumption of fatty and sugary products and of red and processed meat in favor of an increase in the intake of fruits, vegetables, legumes, olive oil, nuts, and fish might prevent gastric adenocarcinoma.
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Affiliation(s)
- Adela Castelló
- Cancer Epidemiology Unit, National Centre for Epidemiology, Instituto de Salud Carlos III, Av/Monforte de Lemos, 5, 28029, Madrid, Spain. .,Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Carlos III Institute of Health, Av/Monforte de Lemos, 5, 28029, Madrid, Spain. .,Faculty of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain.
| | - Nerea Fernández de Larrea
- Cancer Epidemiology Unit, National Centre for Epidemiology, Instituto de Salud Carlos III, Av/Monforte de Lemos, 5, 28029, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Carlos III Institute of Health, Av/Monforte de Lemos, 5, 28029, Madrid, Spain
| | - Vicente Martín
- The Research Group in Gene-Environment and Health Interactions, Vegazana Campus, University of León, León, Spain
| | - Verónica Dávila-Batista
- The Research Group in Gene-Environment and Health Interactions, Vegazana Campus, University of León, León, Spain
| | - Elena Boldo
- Cancer Epidemiology Unit, National Centre for Epidemiology, Instituto de Salud Carlos III, Av/Monforte de Lemos, 5, 28029, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Carlos III Institute of Health, Av/Monforte de Lemos, 5, 28029, Madrid, Spain
| | - Marcela Guevara
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Carlos III Institute of Health, Av/Monforte de Lemos, 5, 28029, Madrid, Spain.,Public Health Institute of Navarra, IdiSNA, Pamplona, Spain
| | - Víctor Moreno
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Carlos III Institute of Health, Av/Monforte de Lemos, 5, 28029, Madrid, Spain.,Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Campus de Bellvitge, L'Hospitalet de Llobregat, Spain.,Unit of Biomarkers and Susceptibility, Cancer Prevention and Control Program, Catalan Institute of Oncology (ICO), IDIBELL, Gran Via km 2.7, 08907, L'Hospitalet de Llobregat, Spain
| | - Gemma Castaño-Vinyals
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Carlos III Institute of Health, Av/Monforte de Lemos, 5, 28029, Madrid, Spain.,ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | | | | | - Rosana Peiró
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Carlos III Institute of Health, Av/Monforte de Lemos, 5, 28029, Madrid, Spain.,Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana FISABIO-Salud Pública, Valencia, Spain
| | - Rocío Olmedo-Requena
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Carlos III Institute of Health, Av/Monforte de Lemos, 5, 28029, Madrid, Spain.,Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Complejo Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
| | - Rocio Capelo
- Centro de Investigación en Salud y Medio Ambiente (CYSMA), Universidad de Huelva, Huelva, Spain
| | - Carmen Navarro
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Carlos III Institute of Health, Av/Monforte de Lemos, 5, 28029, Madrid, Spain.,Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain.,Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain
| | | | - Beatriz Pérez-Gómez
- Cancer Epidemiology Unit, National Centre for Epidemiology, Instituto de Salud Carlos III, Av/Monforte de Lemos, 5, 28029, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Carlos III Institute of Health, Av/Monforte de Lemos, 5, 28029, Madrid, Spain
| | - Manolis Kogevinas
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Carlos III Institute of Health, Av/Monforte de Lemos, 5, 28029, Madrid, Spain.,ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Marina Pollán
- Cancer Epidemiology Unit, National Centre for Epidemiology, Instituto de Salud Carlos III, Av/Monforte de Lemos, 5, 28029, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Carlos III Institute of Health, Av/Monforte de Lemos, 5, 28029, Madrid, Spain
| | - Nuria Aragonés
- Cancer Epidemiology Unit, National Centre for Epidemiology, Instituto de Salud Carlos III, Av/Monforte de Lemos, 5, 28029, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Carlos III Institute of Health, Av/Monforte de Lemos, 5, 28029, Madrid, Spain
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30
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Bagheri A, Nachvak SM, Rezaei M, Moravridzade M, Moradi M, Nelson M. Dietary patterns and risk of prostate cancer: a factor analysis study in a sample of Iranian men. Health Promot Perspect 2018; 8:133-138. [PMID: 29744309 PMCID: PMC5935817 DOI: 10.15171/hpp.2018.17] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 02/22/2018] [Indexed: 01/03/2023] Open
Abstract
Background: Prostate cancer is one of the most common types of cancer with a high mortality rate. The current study was conducted to investigate the relationship between dietary patterns and prostate cancer risk among Iranian men. Methods: This case-control study was conducted in Kermanshah province in western Iran in November 2016. Fifty patients with prostate cancer were selected as cases and 150 healthy men matched for age and body mass index (BMI) were selected as controls. Dietary intake data were collected by a semi-quantitative food frequency questionnaire (FFQ). Food items were grouped according to the similarity of nutrient profiles. The main dietary patterns were identified by factor analysis. Results: After adjustment for potential confounders, a healthy dietary pattern was associated with decreased risk of prostate cancer (highest versus lowest tertile OR:0.24; 95% CI: 0.07-0.81;trend p: 0.025). An unhealthy dietary pattern was related to increased risk of prostate cancer(highest versus lowest tertile OR:3.4; 95% CI: 1.09-10.32; trend p: 0.037). Conclusion: This study shows that an unhealthy dietary pattern was associated with increased risk of prostate cancer. However, a healthy dietary pattern was associated with decreased risk of prostate cancer.
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Affiliation(s)
- Amir Bagheri
- Nutritional Science Department, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Seyed Mostafa Nachvak
- Nutritional Science Department, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mansour Rezaei
- Department of Biostatistics, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mozhgan Moravridzade
- Nutritional Science Department, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mahmoudreza Moradi
- Department of Urology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Michael Nelson
- Department of Nutrition and Dietetics, King's College London, London, United Kingdom
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31
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Castelló A, Amiano P, Fernández de Larrea N, Martín V, Alonso MH, Castaño-Vinyals G, Pérez-Gómez B, Olmedo-Requena R, Guevara M, Fernandez-Tardon G, Dierssen-Sotos T, Llorens-Ivorra C, Huerta JM, Capelo R, Fernández-Villa T, Díez-Villanueva A, Urtiaga C, Castilla J, Jiménez-Moleón JJ, Moreno V, Dávila-Batista V, Kogevinas M, Aragonés N, Pollán M. Low adherence to the western and high adherence to the mediterranean dietary patterns could prevent colorectal cancer. Eur J Nutr 2018; 58:1495-1505. [PMID: 29582162 DOI: 10.1007/s00394-018-1674-5] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 03/22/2018] [Indexed: 01/14/2023]
Abstract
PURPOSE To assess if the associations found between three previously identified dietary patterns with breast, prostate and gastric cancer are also observed for colorectal cancer (CRC). METHODS MCC-Spain is a multicase-control study that collected information of 1629 incident cases of CRC and 3509 population-based controls from 11 Spanish provinces. Western, Prudent and Mediterranean data-driven dietary patterns-derived in another Spanish case-control study-were reconstructed in MCC-Spain. Their association with CRC was assessed using mixed multivariable logistic regression models considering a possible interaction with sex. Risk by tumor site (proximal colon, distal colon, and rectum) was evaluated using multinomial regression models. RESULTS While no effect of the Prudent pattern on CRC risk was observed, a high adherence to the Western dietary pattern was associated with increased CRC risk for both males [ORfourth(Q4) vs. first(Q1)quartile (95% CI): 1.45 (1.11;1.91)] and females [ORQ4 vs. Q1 (95% CI): 1.50 (1.07;2.09)] but seem to be confined to distal colon [ORfourth(Q4) vs. first(Q1)quartile (95% CI): 2.02 (1.44;2.84)] and rectal [ORQ4 vs. Q1 (95% CI): 1.46 (1.05;2.01)] tumors. The protective effect of the Mediterranean dietary pattern against CRC was observed for both sexes [males: ORQ4 vs. Q1 (95% CI): 0.71 (0.55;0.92); females: ORQ4 vs. Q1 (95% CI): 0.56 (0.40;0.77)] and for all cancer sites: proximal colon [ORQ4 vs. Q1 (95% CI): 0.70 (0.51;0.97)], distal colon [ORQ4 vs. Q1 (95% CI): 0.65 (0.48;0.89)], and rectum (ORQ4 vs. Q1 (95% CI): 0.60 (0.45;0.81)]. CONCLUSION Our results are consistent with most of the associations previously found between these patterns and breast, prostate and gastric cancer risk and indicate that consuming whole fruits, vegetables, legumes, olive oil, nuts, and fish and avoiding red and processed meat, refined grains, sweets, caloric drinks, juices, convenience food, and sauces might reduce CRC risk.
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Affiliation(s)
- Adela Castelló
- Cancer Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain.
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain.
- Faculty of Medicine, University of Alcalá, Campus Universitario-C/ 19, Av. de Madrid, Km 33,600, 28871, Alcalá de Henares, Madrid, Spain.
| | - Pilar Amiano
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain
- Public Health Department of Gipuzkoa, Government of the Basque Country, Avenida Navarra, 4, 20013, San Sebastián, Spain
- Biodonostia Research Institute, Paseo Dr Beguiristain s/n, 20014, San Sebastián, Spain
| | - Nerea Fernández de Larrea
- Cancer Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain
| | - Vicente Martín
- The Research Group in Gene-Environment and Health Interactions, Vegazana Campus, University of León, Campus Vegazana, s/n, 24071, León, Spain
| | - Maria Henar Alonso
- Unit of Biomarkers and Susceptibility, Cancer Prevention and Control Program, Catalan Institute of Oncology (ICO) and IDIBELL, Gran Via km 2.7, 08907, L'Hospitalet de Llobregat, Spain
- Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Campus de Bellvitge, Pavelló de Govern, Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Spain
| | - Gemma Castaño-Vinyals
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Carrer del Doctor Aiguader 88, 08003, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Carrer del Doctor Aiguader 88, 08003, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Carrer del Doctor Aiguader 88, 08003, Barcelona, Spain
| | - Beatriz Pérez-Gómez
- Cancer Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain
| | - Rocío Olmedo-Requena
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Av, de la Investigación, 11, 18016, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Complejo Hospitales Universitarios de Granada/Universidad de Granada, Edificio Licinio de la Fuente, Calle Dr. Azpitarte, 4, 18012, Granada, Spain
| | - Marcela Guevara
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain
- Public Health Institute of Navarra, Calle Leyre 15, 31003, Pamplona, Spain
| | - Guillermo Fernandez-Tardon
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain
- IUOPA, University of Oviedo, Facultad de Medicina, Planta 7, Campus de El Cristo B, 33006, Oviedo, Spain
| | - Trinidad Dierssen-Sotos
- Universidad de Cantabria, IDIVAL, Avenida Cardenal Herrera Oria s/n, 39011, Santander, Spain
| | - Cristobal Llorens-Ivorra
- Centro de Salud Pública de Dénia, Consellería de Sanidad Universal y Salud Pública, Plaza Jaime I, 5, 03700, Denia, Spain
| | - Jose María Huerta
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, C/ Luis Fontes Pagán nº 9-1ª planta, C.P.-30003, Murcia, Spain
| | - Rocío Capelo
- Centro de Investigación en Salud y Medio Ambiente (CYSMA), Universidad de Huelva, Campus Universitario de El Carmen, 21071, Huelva, Spain
| | - Tania Fernández-Villa
- The Research Group in Gene-Environment and Health Interactions, Vegazana Campus, University of León, Campus Vegazana, s/n, 24071, León, Spain
| | - Anna Díez-Villanueva
- Unit of Biomarkers and Susceptibility, Cancer Prevention and Control Program, Catalan Institute of Oncology (ICO) and IDIBELL, Gran Via km 2.7, 08907, L'Hospitalet de Llobregat, Spain
| | - Carmen Urtiaga
- Biodonostia Research Institute, Paseo Dr Beguiristain s/n, 20014, San Sebastián, Spain
| | - Jesús Castilla
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain
- Public Health Institute of Navarra, Calle Leyre 15, 31003, Pamplona, Spain
| | - Jose Juan Jiménez-Moleón
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Av, de la Investigación, 11, 18016, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Complejo Hospitales Universitarios de Granada/Universidad de Granada, Edificio Licinio de la Fuente, Calle Dr. Azpitarte, 4, 18012, Granada, Spain
| | - Víctor Moreno
- Unit of Biomarkers and Susceptibility, Cancer Prevention and Control Program, Catalan Institute of Oncology (ICO) and IDIBELL, Gran Via km 2.7, 08907, L'Hospitalet de Llobregat, Spain
- Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Campus de Bellvitge, Pavelló de Govern, Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Spain
| | - Verónica Dávila-Batista
- The Research Group in Gene-Environment and Health Interactions, Vegazana Campus, University of León, Campus Vegazana, s/n, 24071, León, Spain
| | - Manolis Kogevinas
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Carrer del Doctor Aiguader 88, 08003, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Carrer del Doctor Aiguader 88, 08003, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Carrer del Doctor Aiguader 88, 08003, Barcelona, Spain
| | - Nuria Aragonés
- Cancer Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain
| | - Marina Pollán
- Cancer Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain
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Schwingshackl L, Schwedhelm C, Galbete C, Hoffmann G. Adherence to Mediterranean Diet and Risk of Cancer: An Updated Systematic Review and Meta-Analysis. Nutrients 2017; 9:E1063. [PMID: 28954418 PMCID: PMC5691680 DOI: 10.3390/nu9101063] [Citation(s) in RCA: 375] [Impact Index Per Article: 53.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 09/05/2017] [Accepted: 09/21/2017] [Indexed: 12/12/2022] Open
Abstract
The aim of the present systematic review and meta-analysis was to gain further insight into the effects of adherence to Mediterranean Diet (MedD) on risk of overall cancer mortality, risk of different types of cancer, and cancer mortality and recurrence risk in cancer survivors. Literature search was performed using the electronic databases PubMed, and Scopus until 25 August 2017. We included randomized trials (RCTs), cohort (for specific tumors only incidence cases were used) studies, and case-control studies. Study-specific risk ratios, hazard ratios, and odds ratios (RR/HR/OR) were pooled using a random effects model. Observational studies (cohort and case-control studies), and intervention trials were meta-analyzed separately. The updated review process showed 27 studies that were not included in the previous meta-analysis (total number of studies evaluated: 83 studies). An overall population of 2,130,753 subjects was included in the present update. The highest adherence score to a MedD was inversely associated with a lower risk of cancer mortality (RRcohort: 0.86, 95% CI 0.81 to 0.91, I² = 82%; n = 14 studies), colorectal cancer (RRobservational: 0.82, 95% CI 0.75 to 0.88, I² = 73%; n = 11 studies), breast cancer (RRRCT: 0.43, 95% CI 0.21 to 0.88, n = 1 study) (RRobservational: 0.92, 95% CI 0.87 to 0.96, I² = 22%, n = 16 studies), gastric cancer (RRobservational: 0.72, 95% CI 0.60 to 0.86, I² = 55%; n = 4 studies), liver cancer (RRobservational: 0.58, 95% CI 0.46 to 0.73, I² = 0%; n = 2 studies), head and neck cancer (RRobservational: 0.49, 95% CI 0.37 to 0.66, I² = 87%; n = 7 studies), and prostate cancer (RRobservational: 0.96, 95% CI 0.92 to 1.00, I² = 0%; n = 6 studies). Among cancer survivors, the association between the adherence to the highest MedD category and risk of cancer mortality, and cancer recurrence was not statistically significant. Pooled analyses of individual components of the MedD revealed that the protective effects appear to be most attributable to fruits, vegetables, and whole grains. The updated meta-analysis confirms an important inverse association between adherence to a MedD and cancer mortality and risk of several cancer types, especially colorectal cancer. These observed beneficial effects are mainly driven by higher intakes of fruits, vegetables, and whole grains. Moreover, we were able to report for the first time a small decrease in breast cancer risk (6%) by pooling seven cohort studies.
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Affiliation(s)
- Lukas Schwingshackl
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany.
| | - Carolina Schwedhelm
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany.
| | - Cecilia Galbete
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, 14558 Nuthetal, Germany.
| | - Georg Hoffmann
- Department of Nutritional Sciences, University of Vienna, Althanstraße 14, 1090 Vienna, Austria.
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