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Junhai Z, Suqi Z, Beiying D, Zongbiao T, Chuan L, Yanrui W, Weiguo D. Causal relationships between dietary habits and Barrett's esophagus risk: a univariable and multivariable Mendelian randomization study. Food Funct 2024; 15:2474-2484. [PMID: 38329234 DOI: 10.1039/d3fo05273g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
Aims: Dietary habits are reported to be associated with Barrett's esophagus (BE) risk; however, whether there is a causal relationship remains controversial. Here, we systematically examined the causal effects of genetically predicted dietary habits on BE risk through a Mendelian randomization (MR) analysis approach. Methods: Data for exposures were obtained from the UK Biobank (UKB), while the summary-level data for outcomes were obtained from a large sample-size GWAS meta-analysis. Genetic variants associated with 17 ordinary dietary habits at the genome-wide significance level were regarded as instrumental variables (IVs). Univariable and multivariable MR analyses were conducted to explore the causal relationships between dietary habits and BE risk. Sensitivity analyses were implemented to evaluate robustness of the results and determine the potential pleiotropy bias. Results: Univariable MR (UVMR) analysis showed that genetic predisposition to alcohol intake frequency, cooked vegetable intake, beef intake, bread intake, fresh fruit intake, salad/raw vegetable intake, and dried fruit intake were associated with BE risk, with all P values <0.05. After adjusting confounders, the effects of four dietary habits on BE risk persisted; multivariable MR (MVMR) analysis revealed that alcohol intake frequency (adjusted odds ratio (OR) = 1.74 (1.34, 2.27); P = 3.42 × 10-5) was causally associated with higher BE risk, the cooked vegetable intake (adjusted OR = 2.64 (1.16, 5.97); P = 0.02) had suggestively increased BE risk, while higher consumption of bread (adjusted OR = 0.54 (0.32-0.91); P = 0.02) and fresh fruit (adjusted OR = 0.34 (0.15, 0.77); P = 0.01) were suggestively associated with lower BE risk. Conclusions: These MR analyses demonstrate evidence of causal relationships between dietary habits and BE risk. These findings provide new insights into targeted dietary intervention strategies for BE prevention.
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Affiliation(s)
- Zhen Junhai
- Department of General Practice, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei Province, China
| | - Zeng Suqi
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei Province, China.
| | - Deng Beiying
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei Province, China.
| | - Tan Zongbiao
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei Province, China.
| | - Liu Chuan
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei Province, China.
| | - Wu Yanrui
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei Province, China.
| | - Dong Weiguo
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei Province, China.
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de Crom TOE, Blekkenhorst L, Vernooij MW, Ikram MK, Voortman T, Ikram MA. Dietary nitrate intake in relation to the risk of dementia and imaging markers of vascular brain health: a population-based study. Am J Clin Nutr 2023; 118:352-359. [PMID: 37536866 DOI: 10.1016/j.ajcnut.2023.05.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/16/2023] [Accepted: 05/22/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Nitric oxide is a free radical that can be produced from dietary nitrate and positively affects cardiovascular health. With cardiovascular health playing an important role in the etiology of dementia, we hypothesized a link between dietary nitrate intake and the risk of dementia. OBJECTIVES This study aimed to find the association of total, vegetable, and nonvegetable dietary nitrate intake with the risk of dementia and imaging markers of vascular brain health, such as total brain volume, global cerebral perfusion, white matter hyperintensity volume, microbleeds, and lacunar infarcts. METHODS Between 1990 and 2009, dietary intake was assessed using food-frequency questionnaires in 9543 dementia-free participants (mean age, 64 y; 58% female) from the prospective population-based Rotterdam Study. Participants were followed up for incidence dementia until January 2020. We used Cox models to determine the association between dietary nitrate intake and incident dementia. Using linear mixed models and logistic regression models, we assessed the association of dietary nitrate intake with changes in imaging markers across 3 consecutive examination rounds (mean interval between images 4.6 y). RESULTS Participants median dietary nitrate consumption was 85 mg/d (interquartile range, 55 mg/d), derived on average for 81% from vegetable sources. During a mean follow-up of 14.5 y, 1472 participants developed dementia. A higher intake of total and vegetable dietary nitrate was associated with a lower risk of dementia per 50-mg/d increase [hazard ratio (HR): 0.92; 95% confidence interval (CI): 0.87, 0.98; and HR: 0.92; 95% CI: 0.86, 0.97, respectively] but not with changes in neuroimaging markers. No association between nonvegetable dietary nitrate intake and the risk of dementia (HR: 1.15; 95% CI: 0.64, 2.07) or changes in neuroimaging markers were observed. CONCLUSIONS A higher dietary nitrate intake from vegetable sources was associated with a lower risk of dementia. We found no evidence that this association was driven by vascular brain health.
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Affiliation(s)
- Tosca O E de Crom
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Lauren Blekkenhorst
- Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Royal Perth Hospital Research Foundation, Perth, Western Australia, Australia
| | - Meike W Vernooij
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands; Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, Netherlands
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands; Department of Neurology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands.
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Rajendra A, Bondonno NP, Murray K, Zhong L, Rainey-Smith SR, Gardener SL, Blekkenhorst LC, Ames D, Maruff P, Martins RN, Hodgson JM, Bondonno CP. Habitual dietary nitrate intake and cognition in the Australian Imaging, Biomarkers and Lifestyle Study of ageing: A prospective cohort study. Clin Nutr 2023; 42:1251-1259. [PMID: 37331149 DOI: 10.1016/j.clnu.2023.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 04/09/2023] [Accepted: 05/29/2023] [Indexed: 06/20/2023]
Abstract
BACKGROUND & AIMS Dietary nitrate improves cardiovascular health via a nitric oxide (NO) pathway. NO is key to both cardiovascular and brain health. There is also a strong association between vascular risk factors and brain health. Dietary nitrate intake could therefore be associated with better cognitive function and reduced risk of cognitive decline. This is yet to be investigated. The aim of this study was to investigate the association between habitual intake of dietary nitrate from sources where nitrate is naturally present, and cognitive function, and cognitive decline, in the presence or absence of the apolipoprotein E (APOE) ε4 allele. METHODS The study included 1254 older adult participants of the Australian Imaging, Biomarkers and Lifestyle Study of Ageing who were cognitively normal at baseline. Plant-derived, vegetable-derived, animal derived nitrate (not including meat where nitrate is an allowed additive), and total nitrate intakes were calculated from baseline food frequency questionnaires using comprehensive nitrate databases. Cognition was assessed at baseline and every 18 months over a follow-up period of 126 months using a comprehensive neuropsychological test battery. Multivariable-adjusted linear mixed effect models were used to examine the association between baseline nitrate intake and cognition over the 126 months (median [IQR] follow-up time of 36 [18-72] months), stratified by APOE ε4 carrier status. RESULTS In non APOE ε4 carriers, for every 60 mg/day higher intake of plant-derived nitrate at baseline there was an associated higher language score [β (95% CI): 0.10 (0.01, 0.19)] over 126 months, after multivariable adjustments. In APOE ε4 carriers, there was an associated better episodic recall memory [0.24 (0.08, 0.41)] and recognition memory [0.15 (0.01, 0.30)] scores. Similar associations were seen for the intakes of vegetable-derived and total nitrate. Additionally, in APOE ε4 carriers, for every 6 mg/day higher intake of animal-derived nitrate (excluding meat with nitrate as an allowed additive) at baseline there was an associated higher executive function score [β (95% CI): 1.41 (0.42, 2.39)]. We did not find any evidence of an association between dietary nitrate intake and rate of cognitive decline. CONCLUSION Our results suggest that habitual intake of dietary nitrate from sources where nitrate is naturally present impacts cognitive performance in an APOE genotype contingent manner. Further work is needed to validate our findings and understand potential mechanisms underlying the observed effects.
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Affiliation(s)
- Anjana Rajendra
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Nicola P Bondonno
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia; The Danish Cancer Society Research Centre, Copenhagen, Denmark
| | - Kevin Murray
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
| | - Liezhou Zhong
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Stephanie R Rainey-Smith
- Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, Western Australia, Australia; Lifestyle Approaches Towards Cognitive Health Research Group, Murdoch University, Murdoch, Western Australia, Australia; Centre of Excellence for Alzheimer's Disease Research & Care, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia; Australian Alzheimer's Research Foundation, Nedlands, Western Australia, Australia; School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
| | - Samantha L Gardener
- Lifestyle Approaches Towards Cognitive Health Research Group, Murdoch University, Murdoch, Western Australia, Australia; Centre of Excellence for Alzheimer's Disease Research & Care, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia; Australian Alzheimer's Research Foundation, Nedlands, Western Australia, Australia
| | - Lauren C Blekkenhorst
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - David Ames
- National Ageing Research Institute, Royal Melbourne Hospital, Melbourne, Victoria, Australia; Academic Unit for Psychiatry of Old Age, University of Melbourne, Melbourne, Victoria, Australia
| | - Paul Maruff
- The Florey Institute, The University of Melbourne, Parkville, Victoria, Australia; Cogstate Ltd, Melbourne, Victoria, Australia
| | - Ralph N Martins
- Centre of Excellence for Alzheimer's Disease Research & Care, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Jonathan M Hodgson
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia; Medical School, The University of Western Australia, Royal Perth Hospital Research Foundation, Perth, Western Australia, Australia
| | - Catherine P Bondonno
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia; Medical School, The University of Western Australia, Royal Perth Hospital Research Foundation, Perth, Western Australia, Australia.
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Wang SE, Hodge A, Dashti SG, Dixon-Suen SC, Castaño-Rodríguez N, Thomas R, Giles G, Boussioutas A, Kendall B, English DR. Diet and risk of Barrett's oesophagus: Melbourne collaborative cohort study. Br J Nutr 2022; 129:1-10. [PMID: 35837679 PMCID: PMC10011587 DOI: 10.1017/s0007114522002112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 06/29/2022] [Accepted: 07/04/2022] [Indexed: 11/08/2022]
Abstract
Barrett's oesophagus (BE) is the precursor of oesophageal adenocarcinoma, which has become the most common type of oesophageal cancer in many Western populations. Existing evidence on diet and risk of BE predominantly comes from case-control studies, which are subject to recall bias in measurement of diet. We aimed to investigate the potential effect of diet, including macronutrients, carotenoids, food groups, specific food items, beverages and dietary scores, on risk of BE in over 20 000 participants of the Melbourne Collaborative Cohort Study. Diet at baseline (1990-1994) was measured using a food frequency questionnaire. The outcome was BE diagnosed between baseline and follow-up (2007-2010). Logistic regression models were used to estimate OR and 95 % CI for diet in relation to risk of BE. Intakes of leafy vegetables and fruit were inversely associated with risk of BE (highest v. lowest quartile: OR = 0·59; CI: 0·38, 0·94; P-trend = 0·02 and OR = 0·58; CI: 0·37, 0·93; P-trend = 0·02 respectively), as were dietary fibre and carotenoids. Stronger associations were observed for food than the nutrients found in them. Positive associations were observed for discretionary food (OR = 1·54; CI: 0·97, 2·44; P-trend = 0·04) and total fat intake (OR per 10 g/d = 1·11; CI: 1·00, 1·23), the association for fat was less robust in sensitivity analyses. No association was observed for meat, protein, dairy products or diet scores. Diet is a potential modifiable risk factor for BE. Public health and clinical guidelines that incorporate dietary recommendations could contribute to reduction in risk of BE and, thereby, oesophageal adenocarcinoma.
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Affiliation(s)
- Sabrina E. Wang
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Allison Hodge
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
| | - S Ghazaleh Dashti
- Clinical Epidemiology and Biostatistics Unit, Murdoch Children’s Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Suzanne C. Dixon-Suen
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Natalia Castaño-Rodríguez
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Kensington, NSW, Australia
| | - Robert Thomas
- Department of Medicine, Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Graham Giles
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
| | - Alex Boussioutas
- Department of Gastroenterology, The Alfred, Melbourne, VIC, Australia
- Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Bradley Kendall
- Department of Medicine, The University of Queensland, Brisbane, QLD, Australia
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Dallas R. English
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
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Kotopoulou S, Zampelas A, Magriplis E. Dietary nitrate and nitrite and human health: a narrative review by intake source. Nutr Rev 2021; 80:762-773. [PMID: 34919725 DOI: 10.1093/nutrit/nuab113] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Nitrate and nitrite are plant nutrients that, although ubiquitous in plant foods, are highly controversial substances in human nutrition because they are also used as additives in processed foods and may be found as contaminants in drinking water. The aim for this narrative review is to provide a thorough insight into the current literature on the relationship between dietary nitrate and nitrite and the health risks and benefits by source of intake. The results highlight beneficial effects of nitrate and nitrite consumption from plant origin on cardiovascular disease and, to date, no positive correlation has been reported with cancer. On the contrary, high intake of these compounds from processed animal-based foods is related to an increased risk of gastro-intestinal cancer. Nitrate in drinking water also raises some concern, because it appears to be related to adverse health effects. The up-to-date debate on the role of nitrate and nitrite in human nutrition seems to be justified and more research is required to verify safe consumption.
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Affiliation(s)
- Sotiria Kotopoulou
- S. Kotopoulou, A. Zampelas, and E. Magriplis are with the Department of Food Science and Human Nutrition, Agricultural University of Athens, Athens, Greece. S. Kotopoulou and A. Zampelas are with the Hellenic Food Authority, Athens, Greece
| | - Antonis Zampelas
- S. Kotopoulou, A. Zampelas, and E. Magriplis are with the Department of Food Science and Human Nutrition, Agricultural University of Athens, Athens, Greece. S. Kotopoulou and A. Zampelas are with the Hellenic Food Authority, Athens, Greece
| | - Emmanuella Magriplis
- S. Kotopoulou, A. Zampelas, and E. Magriplis are with the Department of Food Science and Human Nutrition, Agricultural University of Athens, Athens, Greece. S. Kotopoulou and A. Zampelas are with the Hellenic Food Authority, Athens, Greece
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Filiberti RA, Fontana V, De Ceglie A, Blanchi S, Lacchin T, De Matthaeis M, Ignomirelli O, Cappiello R, Rosa A, D'Onofrio V, Iaquinto G, Conio M. Dietary Habits and Risk of Esophagitis and Barrett's Esophagus: A Multicenter Italian Case-Control Study. Dig Dis Sci 2021; 66:3448-3460. [PMID: 33073332 DOI: 10.1007/s10620-020-06658-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 10/05/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Barrett's esophagus (BE) and esophagitis share potentially modifiable risk factors such as obesity, smoking, and alcohol. The role of diet on BE and esophagitis is still debated. AIMS The objective of this study was to examine the association between some dietary habits and the risk of BE and esophagitis in Italy. METHODS A multicenter case-control study involving 1285 individuals was carried out in 12 areas. Patients with a new diagnosis of BE (320) or esophagitis (359) and a group of endoscopic controls (606) were included. Information on personal history and dietary habits was collected using a structured questionnaire. RESULTS No clear monotonic significant dose-response relationship was found for most of the considered food items. Nevertheless, the most extreme consumption category of red meat, cold cuts, dairy products, and fried foods showed esophagitis risk excesses varying from 19 to 49%. A higher fat rich diet seemed to increase risk by 49% for BE and 94% for esophagitis. A downward tendency in esophagitis (- 27%) and BE risk (- 20%) was found associated with higher frequency of fresh fruit intake. In addition, a statistically significant twofold increased risk for both BE and esophagitis was found for subjects eating late evening snacks more than once every three days in comparison with the lowest intake category (no consumption). CONCLUSIONS BE and esophagitis patients appeared to be more likely than controls to follow a diet rich in fats and poor in fruit and vegetables. Late evening snacks were found to be associated with both disorders.
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Affiliation(s)
- Rosa Angela Filiberti
- Clinical Epidemiology, IRCCS Ospedale Policlinico San Martino, Largo R. Benzi, 16132, Genoa, Italy.
| | - Vincenzo Fontana
- Clinical Epidemiology, IRCCS Ospedale Policlinico San Martino, Largo R. Benzi, 16132, Genoa, Italy
| | - Antonella De Ceglie
- Gastroenterology, General Hospital, Via Giovanni Borea 56, 18038, Sanremo, IM, Italy
| | - Sabrina Blanchi
- Gastroenterology, General Hospital, Via Giovanni Borea 56, 18038, Sanremo, IM, Italy
| | - Teresa Lacchin
- Policlinico San Giorgio, Gastroenterology, Pordenone, Italy
| | - Marina De Matthaeis
- Gastroenterology, General Hospital, Via Giovanni Borea 56, 18038, Sanremo, IM, Italy
| | - Orazio Ignomirelli
- IRCCS CROB, Digestive Endoscopy, Strada Provinciale di Piano del Conte, 85028, Rionero in Vulture, PZ, Italy
| | - Roberta Cappiello
- Gastroenterology, S. Maria degli Angeli Hospital, Via Montereale 24, 33170, Pordenone, Italy
| | - Alessandra Rosa
- Clinical Epidemiology, IRCCS Ospedale Policlinico San Martino, Largo R. Benzi, 16132, Genoa, Italy
| | - Vittorio D'Onofrio
- Gastroenterology and Digestive Endoscopy, S. G. Moscati Hospital, Contrada Amoretta, 83100, Avellino, Italy
| | - Gaetano Iaquinto
- Divisione di Gastroenterologia, Clinica Santa Rita, Via Appia, 83042, Atripalda, AV, Italy
| | - Massimo Conio
- Gastroenterology, General Hospital, Via Giovanni Borea 56, 18038, Sanremo, IM, Italy
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Vegetable nitrate intake, blood pressure and incident cardiovascular disease: Danish Diet, Cancer, and Health Study. Eur J Epidemiol 2021; 36:813-825. [PMID: 33884541 PMCID: PMC8416839 DOI: 10.1007/s10654-021-00747-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 03/30/2021] [Indexed: 12/28/2022]
Abstract
Whether the vascular effects of inorganic nitrate, observed in clinical trials, translate to a reduction in cardiovascular disease (CVD) with habitual dietary nitrate intake in prospective studies warrants investigation. We aimed to determine if vegetable nitrate, the major dietary nitrate source, is associated with lower blood pressure (BP) and lower risk of incident CVD. Among 53,150 participants of the Danish Diet, Cancer, and Health Study, without CVD at baseline, vegetable nitrate intake was assessed using a comprehensive vegetable nitrate database. Hazard ratios (HRs) were calculated using restricted cubic splines based on multivariable-adjusted Cox proportional hazards models. During 23 years of follow-up, 14,088 cases of incident CVD were recorded. Participants in the highest vegetable nitrate intake quintile (median, 141 mg/day) had 2.58 mmHg lower baseline systolic BP (95%CI − 3.12, − 2.05) and 1.38 mmHg lower diastolic BP (95%CI − 1.66, − 1.10), compared with participants in the lowest quintile. Vegetable nitrate intake was inversely associated with CVD plateauing at moderate intakes (~ 60 mg/day); this appeared to be mediated by systolic BP (21.9%). Compared to participants in the lowest intake quintile (median, 23 mg/day), a moderate vegetable nitrate intake (median, 59 mg/day) was associated with 15% lower risk of CVD [HR (95% CI) 0.85 (0.82, 0.89)]. Moderate vegetable nitrate intake was associated with 12%, 15%, 17% and 26% lower risk of ischemic heart disease, heart failure, ischemic stroke and peripheral artery disease hospitalizations respectively. Consumption of at least ~ 60 mg/day of vegetable nitrate (~ 1 cup of green leafy vegetables) may mitigate risk of CVD.
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Ramezani H, Abhari K, Pilevar Z, Hedayat H, Mohammadi A. Volatile N-nitrosamine, residual nitrite, and ascorbic acid levels in sausages during storage. FOODS AND RAW MATERIALS 2020. [DOI: 10.21603/2308-4057-2020-1-107-114] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Introduction. The increasing global consumption of processed meat products has led to certain concerns. For instance, processed meat products are known to contain carcinogen precursor compounds, thus creating the risk of chronic diseases. The present study was performed to estimate the food safety status of processed meat products available in Iran and evaluate the related effective factors.
Study objects and methods. 140 samples of seven most popular commercial types of cooked sausages were obtained from four major meat factories (A, B, C and D) in 140 samples were collected from seven most popular commercial types of cooked sausages as follows: beef salami 90%, chicken salami 90%, dry cured sausage 70%, dry cured salami 60%, beef sausages 55%, chicken sausages 55% and Frankfurt sausage 40% (n = 5) from four major meat factories (A, B, C and D) in Tehran. The samples were screened for residual nitrite, ascorbic acid, and nitrosamine contents on days 0, 7, 14, 21, and 28. The results indicated that products from meat factory B had lower residual nitrite content in the samples with high content of meat. Beef salami (90% of meat) and Frankfurt sausage (40% of meat) contained the lowest and highest amounts of residual nitrite on day 0 – 73.99 and 177.42 mg of nitrite per 1 kg of meat, respectively.
Results and discussion. Beef salami contained 90% of meat, chicken salami – 90%, dry cured sausage –70%, dry cured salami – 60%, beef sausages – 55%, chicken sausages – 55%, and Frankfurt sausage – 40% (n = 5). Nitrite reduction rates in sausages with a smaller diameter, e.g. Frankfurt sausage, were significantly lower (P < 0.05), compared to salami samples. The difference can be explained by the shorter cooking time. Nitrosamine formation increased during refrigerated storage; however, it was not significant in all samples. During refrigerated storage, nitrosamine formation depended on the level of added nitrite, the amount of residual nitrite, ascorbic acid, pH, and cooking temperature. Ascorbic acid content decreased significantly (P < 0.05) during refrigerated storage.
Conclusion. The findings demonstrate significant correlation between the meat content, cooking time, nitrite content, and nitrosamine formation.
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Affiliation(s)
- Houra Ramezani
- Food Sciences and Technology Department, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences
| | - Khadijeh Abhari
- Food Sciences and Technology Department, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences
| | - Zahra Pilevar
- Food Sciences and Technology Department, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences
| | - Hosseini Hedayat
- Food Sciences and Technology Department, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences
| | - Abdorreza Mohammadi
- Food Sciences and Technology Department, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences
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9
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Babateen AM, Fornelli G, Donini LM, Mathers JC, Siervo M. Assessment of dietary nitrate intake in humans: a systematic review. Am J Clin Nutr 2018; 108:878-888. [PMID: 30321271 DOI: 10.1093/ajcn/nqy108] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 04/27/2018] [Indexed: 02/06/2023] Open
Abstract
Background The nitrate content of foods and water is highly variable, which has implications for the compilation of food-composition databases and assessment of dietary nitrate intake. Objective A systematic review was conducted to ascertain the dietary assessment methods used and to provide estimates of daily nitrate intake in humans. Design Relevant articles were identified by a systematic search of 3 electronic databases (PubMed, Web of Science, and Embase) from inception until February 2018. Observational studies conducted in adult populations and reporting information on dietary assessment methods and daily nitrate intake were included. Ecological analyses were conducted to explore the association of nitrate intake with indexes of economic development [Gross Domestic Product (GDP) and KOF Index of Globalization]. Results A total of 55 articles were included. Forty-two studies investigated associations between nitrate intake and disease risk; 36 (87%) of these studies examined the association between nitrate intake and cancer risk, whereas only 6 studies explored the association of nitrate intake with the risk of diabetes, glaucoma, kidney failure, hypertension, and atherosclerotic vascular disease. The majority of studies used food-frequency questionnaires to assess nitrate intake (n = 43). The median daily nitrate intakes in healthy and patient populations were 108 and 110 mg/d, respectively. We found a significant inverse correlation of nitrate intake with GDP (r = -0.46, P < 0.001) and KOF index (r = -0.31, P = 0.002). Conclusions The median estimated daily nitrate intakes by healthy and patient populations were similar, and these values were below the safe upper intake of daily intake (3.7 mg nitrate ion/kg body weight). However, there is considerable heterogeneity in the application of food-composition tables, which may have implications for the accuracy of estimated daily nitrate intake. The association between nitrate intake and risk of cardiometabolic diseases needs further investigation. The protocol for this systematic review has been registered in the PROSPERO database (https://www.crd.york.ac.uk/prospero; CRD number: 42017060354).
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Affiliation(s)
- Abrar M Babateen
- Human Nutrition Research Center, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
- Faculty of Applied Medical Sciences, Clinical Nutrition Department, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Gianfranco Fornelli
- Human Nutrition Research Center, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | - Lorenzo M Donini
- Department of Experimental Medicine-Medical Pathophysiology, Food Science and Endocrinology Section, Food Science and Human Nutrition Research Unit, "Sapienza" University of Rome, Rome, Italy
| | - John C Mathers
- Human Nutrition Research Center, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Mario Siervo
- Human Nutrition Research Center, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
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10
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Analysis of Leafy Vegetable Nitrate Using a Modified Spectrometric Method. Int J Anal Chem 2018; 2018:6285867. [PMID: 30174694 PMCID: PMC6098929 DOI: 10.1155/2018/6285867] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 07/02/2018] [Accepted: 07/25/2018] [Indexed: 11/18/2022] Open
Abstract
A quick and cost-effective method to analyze leafy vegetable nitrate on spectrometry was developed and compared with a standard method using high performance liquid chromatography (HPLC). This method was designed to use ion-exchange solid phase extraction (SPE) cartridges in reducing interference from organic matrices to meet the criterion of an existing method for analyzing nitrate in wastewater. Nine vegetables (bok coy, cabbage, celery, Chinese cabbage, Chinese kale, lettuce, mustard green, pak choi, and water spinach) were selected for the method testing with three replicates being conducted for each vegetable. The nitrate contents ranged from 800 to 4,300 μg/g, with bok coy, celery, and pak choi being the highest. Data derived from spectrometry and HPLC were close to each other with most relative errors being within ±10% and were highly correlated with an R square value of 0.969. Stability testing and spike analysis resulted in a mean coefficient of variation lower than 6% and a mean recovery rate of 83.7%, suggesting reliability of the method. In addition, both the cost and time consumption for using this method were lower than the standard method using HPLC or ion chromatography, making this spectrometric method a good alternative for analysis of leafy vegetable nitrate.
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11
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Johnson IT. Cruciferous Vegetables and Risk of Cancers of the Gastrointestinal Tract. Mol Nutr Food Res 2018; 62:e1701000. [PMID: 29573203 DOI: 10.1002/mnfr.201701000] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Revised: 02/09/2018] [Indexed: 12/20/2022]
Abstract
Cancers of the oropharyngeal tissues, oesophagus, stomach, and colorectum are amongst the most common causes of death from cancer throughout the world. Higher consumption of fruits and vegetables is thought to be protective, and cruciferous vegetables are of particular interest because of their unique role as a source of biologically active glucosinolate breakdown products. A literature review of primary studies and meta-analyses indicates that higher consumption of cruciferous vegetables probably reduces the risk of colorectal and gastric cancers by approximately 8% and 19%, respectively. Some studies support the hypothesis that the protective effect against colorectal cancer is modified by genetic polymorphisms of genes regulating the expression of enzymes of the glutathione S-transferase family, but due to contradictory findings the evidence is currently inconclusive. Despite these promising findings, future epidemiological research on the protective effects of cruciferous plants will depend critically upon accurate measurement of dietary exposure, both to the vegetables themselves, and to their active constituents. The development of sensitive chemical assays has facilitated the measurement of urinary excretion of isothiocyanate metabolites as an objective biomarker of intake, but sampling strategies need to be optimized in order to assess long-term exposures at the population level.
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Affiliation(s)
- Ian T Johnson
- Quadram Institute Bioscience, Norwich Research Park, Colney Lane, Norwich, NR4 7UA, United Kingdom
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12
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Can We Use Diet to Effectively Treat Esophageal Disease? A Review of the Current Literature. Curr Gastroenterol Rep 2017; 19:38. [PMID: 28730507 DOI: 10.1007/s11894-017-0578-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE OF REVIEW Esophageal diseases represent a wide variety of conditions affecting esophageal anatomy, physiology, and motility. Therapy focuses on pharmacotherapy and endoscopic or surgical management. Dietary therapy can be considered in management algorithms for specific esophageal diseases. This review focuses on outlining the literature related to dietary therapy in gastroesophageal reflux disease, eosinophilic esophagitis, Barrett's esophagus, and esophageal adenocarcinoma. RECENT FINDINGS Currently, data are strongest for dietary manipulation in eosinophilic esophagitis, specifically the six-food elimination diet. Dietary effects on gastroesophageal reflux disease are less clear, though newer research indicates that increased fiber with reduction in simple sugar intake may improve symptoms. In terms of Barrett's esophagus and esophageal adenocarcinoma, antioxidant intake may affect carcinogenesis, though to an unknown degree. Outcomes data regarding dietary manipulation for the management of esophageal diseases is heterogeneous. Given the rising interest in non-pharmacological treatment options for these patients, continued research is warranted.
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13
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Abstract
Oesophageal cancer is the sixth most common cause of cancer-related death worldwide and is therefore a major global health challenge. The two major subtypes of oesophageal cancer are oesophageal squamous cell carcinoma (OSCC) and oesophageal adenocarcinoma (OAC), which are epidemiologically and biologically distinct. OSCC accounts for 90% of all cases of oesophageal cancer globally and is highly prevalent in the East, East Africa and South America. OAC is more common in developed countries than in developing countries. Preneoplastic lesions are identifiable for both OSCC and OAC; these are frequently amenable to endoscopic ablative therapies. Most patients with oesophageal cancer require extensive treatment, including chemotherapy, chemoradiotherapy and/or surgical resection. Patients with advanced or metastatic oesophageal cancer are treated with palliative chemotherapy; those who are human epidermal growth factor receptor 2 (HER2)-positive may also benefit from trastuzumab treatment. Immuno-oncology therapies have also shown promising early results in OSCC and OAC. In this Primer, we review state-of-the-art knowledge on the biology and treatment of oesophageal cancer, including screening, endoscopic ablative therapies and emerging molecular targets, and we discuss best practices in chemotherapy, chemoradiotherapy, surgery and the maintenance of patient quality of life.
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Affiliation(s)
- Elizabeth C. Smyth
- Department of Gastrointestinal Oncology, Royal Marsden Hospital, London & Sutton. United Kingdom
| | - Jesper Lagergren
- Division of Cancer Studies, King's College London, United Kingdom
- Upper Gastrointestinal Surgery, Department of Molecular medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, 17176 Stockholm, Sweden
| | | | - Florian Lordick
- University Cancer Center Leipzig, University Medicine Leipzig, Leipzig, Germany
| | - Manish A. Shah
- Sandra and Edward Meyer Cancer Center at Weill Cornell Medicine, New York-Presbyterian Hospital, New York. United States
| | - Pernilla Lagergren
- Surgical care science, Department of Molecular medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, 171 76 Stockholm, Sweden
| | - David Cunningham
- Department of Gastrointestinal Oncology, Royal Marsden Hospital, London & Sutton. United Kingdom
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14
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Abstract
Dietary nitrate is mainly obtained from vegetables, especially green leafy vegetables and beetroot. As a result of early research, dietary nitrate is currently viewed as a contaminant linked to increased risks of stomach cancer and methaemoglobinaemia. Consequently, nitrate levels are restricted in certain vegetables and in water supplies to ensure exposure levels remain below an acceptable daily intake of 3·7 mg/kg per d. The average nitrate intake in the UK is approximately 70 mg/d, although some population groups, such as vegetarians, may consume three times that amount. However, recent studies in the last decade suggest that dietary nitrate can significantly reduce systolic blood pressure via the nitrate-nitrite-NO pathway. A small, downward shift in systolic blood pressure across the population could significantly reduce the incidence of hypertension and mortality from CVD such as stroke. Interestingly, vegetarians tend to have lower levels of blood pressure than omnivores and epidemiological studies suggest that vegetarians have lower risks of CVD. Recent evidence is mainly focused on the acute effects of dietary nitrate supplementation and there is a lack of data looking at the chronic effects of high nitrate consumption in humans. Nevertheless, due to potential health benefits, some authors are recommending that nitrate should be considered as a nutrient necessary for health, rather than as a contaminant which needs to be restricted. This review will discuss the emerging role of dietary nitrate in the control of blood pressure and whether there is sufficient evidence to state that nitrate is a 'new' nutrient.
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15
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Zhao Z, Pu Z, Yin Z, Yu P, Hao Y, Wang Q, Guo M, Zhao Q. Dietary fruit, vegetable, fat, and red and processed meat intakes and Barrett's esophagus risk: a systematic review and meta-analysis. Sci Rep 2016; 6:27334. [PMID: 27256629 PMCID: PMC4891687 DOI: 10.1038/srep27334] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 05/16/2016] [Indexed: 12/20/2022] Open
Abstract
The relationships between dietary fruit, vegetable, fat, and red and processed meat intakes and Barrett’s esophagus (BE) risk remain inconclusive. We conducted a systematic review and meta-analysis to summarize the available evidence on these issues. PubMed, EMBASE and the Cochrane Library were searched for studies published from inception through October 2015. A total of eight studies were included in this analysis. Fruit intake was not associated with BE risk (OR = 0.65, 95% CI = 0.37–1.13), but vegetable intake was strongly associated with BE risk (OR = 0.45, 95% CI = 0.29–0.71). Saturated fat, red meat and processed meat intakes were not associated with BE risk with OR = 1.25 (95% CI = 0.82–1.91), OR = 0.85 (95% CI = 0.61–1.17) and OR = 1.03 (95% CI = 0.73–1.46), respectively. Dietary vegetable not fruits intake may be associated with decreased BE risk. Fat and red and processed meat intakes may not contribute to an increased BE risk. Well-designed, large prospective studies with better established dose-response relationships are needed to further validate these issues.
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Affiliation(s)
- Zhanwei Zhao
- Xijing Hospital of Digestive Diseases, The Fourth Military Medical University, 127 Changle Western Road, Xi'an, Shaanxi Province 710032, China
| | - Zhongshu Pu
- Xijing Hospital of Digestive Diseases, The Fourth Military Medical University, 127 Changle Western Road, Xi'an, Shaanxi Province 710032, China.,Department of Epidemiology, School of Public Health, The Fourth Military Medical University, 127 Changle Western Road, Xi'an, Shaanxi Province 710032, China
| | - Zifang Yin
- Xijing Hospital of Digestive Diseases, The Fourth Military Medical University, 127 Changle Western Road, Xi'an, Shaanxi Province 710032, China.,Shaanxi Maternal and Child Health Hospital, Shaanxi Province, China
| | - Pengfei Yu
- Xijing Hospital of Digestive Diseases, The Fourth Military Medical University, 127 Changle Western Road, Xi'an, Shaanxi Province 710032, China
| | - Yiming Hao
- Xijing Hospital of Digestive Diseases, The Fourth Military Medical University, 127 Changle Western Road, Xi'an, Shaanxi Province 710032, China
| | - Qian Wang
- Xijing Hospital of Digestive Diseases, The Fourth Military Medical University, 127 Changle Western Road, Xi'an, Shaanxi Province 710032, China
| | - Min Guo
- Xijing Hospital of Digestive Diseases, The Fourth Military Medical University, 127 Changle Western Road, Xi'an, Shaanxi Province 710032, China
| | - Qingchuan Zhao
- Xijing Hospital of Digestive Diseases, The Fourth Military Medical University, 127 Changle Western Road, Xi'an, Shaanxi Province 710032, China
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16
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Ireland CJ, Thompson SK, Laws TA, Esterman A. Risk factors for Barrett’s esophagus: a scoping review. Cancer Causes Control 2016; 27:301-23. [DOI: 10.1007/s10552-015-0710-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 12/22/2015] [Indexed: 02/08/2023]
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17
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Pusung M, Zeki S, Fitzgerald R. Genomics of Esophageal Cancer and Biomarkers for Early Detection. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016; 908:237-63. [PMID: 27573775 DOI: 10.1007/978-3-319-41388-4_12] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
In-depth molecular characterization of esophageal oncogenesis has improved over the recent years. Advancement in molecular biology and bioinformatics has led to better understanding of its genomic landscape. More specifically, analysis of its pathogenesis at the genetic level has uncovered the involvement of a number of tumor suppressor genes, cell cycle regulators, and receptor tyrosine kinases. Due to its poor prognosis, the development of clinically applicable biomarkers for diagnosis, progression, and treatment has been the focus of many research studies concentrating on upper gastrointestinal malignancies. As in other cancers, early detection and subsequent intervention of the preneoplastic condition significantly improves patient outcomes. Currently, clinically approved surveillance practices heavily depend on expensive, invasive, and sampling-error-prone endoscopic procedures. There is, therefore, a great demand to establish clearly reliable biomarkers that could identify those patients at higher risk of neoplastic progression and hence would greatly benefit from further monitoring and/or intervention. This chapter will present the most recent advances in the analysis of the esophageal cancer genome serving as basis for biomarker development.
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Affiliation(s)
- Mark Pusung
- MRC Cancer Unit, University of Cambridge, Cambridge, UK
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18
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Realdon S, Antonello A, Arcidiacono D, Dassie E, Cavallin F, Fassan M, Nardi MT, Alberti A, Rugge M, Battaglia G. Adherence to WCRF/AICR lifestyle recommendations for cancer prevention and the risk of Barrett's esophagus onset and evolution to esophageal adenocarcinoma: results from a pilot study in a high-risk population. Eur J Nutr 2015; 55:1563-71. [PMID: 26155779 DOI: 10.1007/s00394-015-0975-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Accepted: 06/29/2015] [Indexed: 02/07/2023]
Abstract
PURPOSE While adherence to the World Cancer Research Fund (WCRF) guidelines on lifestyle and cancer was recently proven to be associated with an increased risk of esophageal cancer, no investigation has yet been carried out on its role on Barrett's esophagus (BE) development and its progression to esophageal adenocarcinoma (EAC). The primary aim of this study was to evaluate the role of adherence to WCRF lifestyle recommendations in BE onset and progression. The secondary aim was to investigate the association between disease progression and specific aspects of diet and lifestyle. METHODS Established risk factors for BE and EAC development and adherence to WCRF guidelines were assessed in 107 consecutive patients undergoing an upper gastrointestinal endoscopy for symptoms suggesting gastroesophageal reflux (GERD) and a suspected diagnosis of BE/dysplasia on BE. Patients were divided according to histology: those with GERD without metaplasia, with non-dysplastic BE, with low-grade dysplasia, with high-grade dysplasia or with early EAC. The four groups were expressed as an ordered categorical variable of disease progression. An ordered logit model was estimated to identify the independent predictors of disease progression. RESULTS Adherence to WCRF guidelines was identified as independent protective factor (OR 0.51, 95 % CI 0.37-0.67) of disease progression. Disease progression was associated with reduced adherence to guidelines on physical activity (from 48.2 to 5.3 %, p = 0.001), sedentary habits (from 33.3 to 0 %, p = 0.03), fruit consumption (from 37.0 to 5.6 %, p = 0.02) and processed meat consumption (from 51.9 to 10.5 %, p = 0.002). CONCLUSION Adherence to WCRF guidelines has a protective factor in BE onset and its evolution to EAC.
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Affiliation(s)
- Stefano Realdon
- Digestive Endoscopy Unit, Veneto Institute of Oncology IOV - I.R.C.S.S., Via Gattamelata 64, 35128, Padua, Italy.
| | - Alessandro Antonello
- Digestive Endoscopy Unit, Veneto Institute of Oncology IOV - I.R.C.S.S., Via Gattamelata 64, 35128, Padua, Italy
| | - Diletta Arcidiacono
- Venetian Institute for Molecular Medicine, Via Orus 2, 35128, Padua, Italy.,Department of Surgery, Oncology and Gastroenterology, University of Padua, Via Giustiniani 2, 35128, Padua, Italy
| | - Elisa Dassie
- Venetian Institute for Molecular Medicine, Via Orus 2, 35128, Padua, Italy
| | - Francesco Cavallin
- Oncological Surgery Unit, Veneto Institute of Oncology IOV - I.R.C.S.S., Via Gattamelata 64, 35128, Padua, Italy
| | - Matteo Fassan
- Department of Medicine, Surgical Pathology and Cytopathology, University of Padua, Via Giustiniani 2, 35128, Padua, Italy
| | - Maria Teresa Nardi
- Clinical Nutrition Unit, Veneto Institute of Oncology IOV - I.R.C.S.S., Via Gattamelata 64, 35128, Padua, Italy
| | - Alfredo Alberti
- Venetian Institute for Molecular Medicine, Via Orus 2, 35128, Padua, Italy.,Department of Molecular Medicine, University of Padua, Via Giustiniani 2, 35128, Padua, Italy
| | - Massimo Rugge
- Department of Medicine, Surgical Pathology and Cytopathology, University of Padua, Via Giustiniani 2, 35128, Padua, Italy
| | - Giorgio Battaglia
- Digestive Endoscopy Unit, Veneto Institute of Oncology IOV - I.R.C.S.S., Via Gattamelata 64, 35128, Padua, Italy
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19
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Nathanson BH, Navab F. Letter: future directions for epidemiological studies of Barrett's oesophagus. Aliment Pharmacol Ther 2015; 41:910-1. [PMID: 25846389 DOI: 10.1111/apt.13132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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20
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Abnet CC, Corley DA, Freedman ND, Kamangar F. Diet and upper gastrointestinal malignancies. Gastroenterology 2015; 148:1234-1243.e4. [PMID: 25680671 PMCID: PMC4414068 DOI: 10.1053/j.gastro.2015.02.007] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 02/02/2015] [Accepted: 02/05/2015] [Indexed: 02/06/2023]
Abstract
Diet is believed to modulate cancer risk and this relationship has been widely studied in the gastrointestinal tract. Observational epidemiologic studies have provided most of the evidence about the effects of diet on cancer risk because clinical trials to determine nutritional exposures are often impossible, impractical, or unaffordable. Although a few foods or nutrients are thought to protect against specific types of cancer, it seems clear that the strength and even direction of dietary associations (increasing or decreasing risk) is organ-site- and even histology-specific, along the gastrointestinal tract. Although some hypotheses are supported by a substantial body of observational data (drinking hot maté [an infusion of the herb Ilex Paraguarensis] contributes to esophageal cancer), there are not much data to support others. We discuss some highly touted hypotheses and draw interim conclusions about what is known and what could be done to improve the level of evidence. The complex nature of diet and its associations can be productively investigated with disease-specific studies. However, public health recommendations for normal-risk individuals regarding diet and gastrointestinal cancer should probably emphasize the importance of eating for overall health rather than eating specific foods to reduce risk for specific cancers.
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Affiliation(s)
- Christian C. Abnet
- Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD,Address for Correspondence: Christian Abnet, PhD, MPH, Senior Investigator, Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Dr Rm 6e344 MSC 9768, Bethesda MD 20892, Office: (240) 276-7213, Mobile: (240) 505-6299,
| | - Douglas A. Corley
- Division of Research, Kaiser Permanente of Northern California, Oakland, CA
| | - Neal D. Freedman
- Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
| | - Farin Kamangar
- Department of Public Health Analysis, School of Community Health and Policy, Morgan State University, Baltimore, MD,Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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21
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Dawsey SM, Fagundes RB, Jacobson BC, Kresty LA, Mallery SR, Paski S, van den Brandt PA. Diet and esophageal disease. Ann N Y Acad Sci 2015; 1325:127-37. [PMID: 25266021 DOI: 10.1111/nyas.12528] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The following, from the 12th OESO World Conference: Cancers of the Esophagus, includes commentaries on macronutrients, dietary patterns, and risk of adenocarcinoma in Barrett's esophagus; micronutrients, trace elements, and risk of Barrett's esophagus and esophageal adenocarcinoma; the role of mate consumption in the development of squamous cell carcinoma; the relationship between energy excess and development of esophageal adenocarcinoma; and the nutritional management of the esophageal cancer patient.
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Affiliation(s)
- Sanford M Dawsey
- Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
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22
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Petrick JL, Li N, McClain KM, Steck SE, Gammon MD. Dietary Risk Reduction Factors for the Barrett's Esophagus-Esophageal Adenocarcinoma Continuum: A Review of the Recent Literature. Curr Nutr Rep 2015; 4:47-65. [PMID: 25750765 PMCID: PMC4349493 DOI: 10.1007/s13668-014-0108-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Esophageal adenocarcinoma (EA) incidence is among the most rapidly increasing of any cancer type in the U.S., and prognosis is poor. Prevalence of the potential precursor lesion, Barrett's esophagus (BE), is also increasing. Candidates for safe and effective risk reduction strategies are needed, potentially including dietary components. In this qualitative review, we summarize recently published epidemiologic studies, in context of earlier work, on dietary intake and BE-EA outcomes. Potential cohort study/intervention trial candidates which could be increased to reduce BE-EA development include intake of: (1) fruits and vegetables; vegetables; fruit (EA only); (2) β-carotene and vitamins C and E; (3) folate (EA only); and (4) total fiber (EA only). Also, (5) red and processed meat intake could be targeted for dietary reduction/omission to reduce EA development. Few dietary constituents have been evaluated among EA patients to examine associations with mortality, thus interventions conducted among EA patients are premature.
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Affiliation(s)
- Jessica L. Petrick
- Department of Epidemiology, 135 Dauer Drive, University of North Carolina, Chapel Hill, NC, 27599, phone: 919-966-7430, fax: 919-966-2089
| | - Nan Li
- Department of Epidemiology, 135 Dauer Drive, University of North Carolina, Chapel Hill, NC, 27599, phone: 919-966-7430, fax: 919-966-2089
| | - Kathleen M. McClain
- Department of Epidemiology, 135 Dauer Drive, University of North Carolina, Chapel Hill, NC, 27599, phone: 919-966-7430, fax: 919-966-2089
| | - Susan E. Steck
- Department of Epidemiology and Biostatistics, 915 Greene Street, University of South Carolina, Columbia, SC 29208; phone: 803-576-5638, fax: 803-576-5624
| | - Marilie D. Gammon
- Department of Epidemiology, 135 Dauer Drive, CB# 7435, University of North Carolina, Chapel Hill, NC, 27599-7435, phone: 919-966-7421, 919-966-2089
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