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Goh CE, Bohn B, Genkinger JM, Molinsky R, Roy S, Paster BJ, Chen CY, Yuzefpolskaya M, Colombo PC, Rosenbaum M, Knight R, Desvarieux M, Papapanou PN, Jacobs DR, Demmer RT. Dietary nitrate intake and net nitrite-generating capacity of the oral microbiome interact to enhance cardiometabolic health: Results from the Oral Infections Glucose Intolerance and Insulin Resistance Study (ORIGINS). MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.10.24305636. [PMID: 38645157 PMCID: PMC11030477 DOI: 10.1101/2024.04.10.24305636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Background We investigated the association between dietary nitrate intake and early clinical cardiometabolic risk biomarkers, and explored whether the oral microbiome modifies the association between dietary nitrate intake and cardiometabolic biomarkers. Methods Cross-sectional data from 668 (mean [SD] age 31 [9] years, 73% women) participants was analyzed. Dietary nitrate intakes and alternative healthy eating index (AHEI) scores were calculated from food frequency questionnaire responses and a validated US food database. Subgingival 16S rRNA microbial genes (Illumina, MiSeq) were sequenced, and PICRUSt2 estimated metagenomic content. The Microbiome Induced Nitric oxide Enrichment Score (MINES) was calculated as a microbial gene abundance ratio representing enhanced net capacity for NO generation. Cardiometabolic risk biomarkers included systolic and diastolic blood pressure, HbA1c, glucose, insulin, and insulin resistance (HOMA-IR), and were regressed on nitrate intake tertiles in adjusted multivariable linear models. Results Mean nitrate intake was 190[171] mg/day. Higher nitrate intake was associated with lower insulin, and HOMA-IR but particularly among participants with low abundance of oral nitrite enriching bacteria. For example, among participants with a low MINES, mean insulin[95%CI] levels in high vs. low dietary nitrate consumers were 5.8[5.3,6.5] vs. 6.8[6.2,7.5] (p=0.004) while respective insulin levels were 6.0[5.4,6.6] vs. 5.9[5.3,6.5] (p=0.76) among partcipants with high MINES (interaction p=0.02). Conclusion Higher dietary nitrate intake was only associated with lower insulin and insulin resistance among individuals with reduced capacity for oral microbe-induced nitrite enrichment. These findings have implications for future precision medicine-oriented approaches that might consider assessing the oral microbiome prior to enrollment into dietary interventions or making dietary recommendations.
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Affiliation(s)
- Charlene E Goh
- Faculty of Dentistry, National University of Singapore, Singapore
| | - Bruno Bohn
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Jeanine M Genkinger
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY, USA
| | - Rebecca Molinsky
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Sumith Roy
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Bruce J Paster
- The Forsyth Institute, Cambridge, MA, USA
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
| | - Ching-Yuan Chen
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, NY, USA
| | - Melana Yuzefpolskaya
- Division of Cardiology, Department of Medicine, New York Presbyterian Hospital, Columbia University, New York, NY, USA
| | - Paolo C Colombo
- Division of Cardiology, Department of Medicine, New York Presbyterian Hospital, Columbia University, New York, NY, USA
| | - Michael Rosenbaum
- Division of Molecular Genetics, Departments of Pediatrics and Medicine, Columbia University, New York, NY, USA
| | - Rob Knight
- Department of Computer Science & Engineering, Jacobs School of Engineering, University of California San Diego, La Jolla, CA, USA
- Department of Bioengineering, University of California San Diego, La Jolla, CA, USA
- Center for Microbiome Innovation, University of California San Diego, La Jolla, CA, USA
| | - Moïse Desvarieux
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- INSERM UMR 1153, Centre de Recherche Epidemiologie et Statistique Paris Sorbonne Cité (CRESS), METHODS Core, Paris, France
| | - Panos N Papapanou
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, NY, USA
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Ryan T Demmer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, College of Medicine and Science
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Skalaban TG, Thompson DA, Madrigal JM, Blount BC, Espinosa MM, Kolpin DW, Deziel NC, Jones RR, Beane Freeman L, Hofmann JN, Ward MH. Nitrate exposure from drinking water and dietary sources among Iowa farmers using private wells. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 919:170922. [PMID: 38350573 DOI: 10.1016/j.scitotenv.2024.170922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/09/2024] [Accepted: 02/10/2024] [Indexed: 02/15/2024]
Abstract
Nitrate levels are increasing in water resources across the United States and nitrate ingestion from drinking water has been associated with adverse health risks in epidemiologic studies at levels below the maximum contaminant level (MCL). In contrast, dietary nitrate ingestion has generally been associated with beneficial health effects. Few studies have characterized the contribution of both drinking water and dietary sources to nitrate exposure. The Agricultural Health Study is a prospective cohort of farmers and their spouses in Iowa and North Carolina. In 2018-2019, we assessed nitrate exposure for 47 farmers who used private wells for their drinking water and lived in 8 eastern Iowa counties where groundwater is vulnerable to nitrate contamination. Drinking water and dietary intakes were estimated using the National Cancer Institute Automated Self-Administered 24-Hour Dietary Assessment tool. We measured nitrate in tap water and estimated dietary nitrate from a database of food concentrations. Urinary nitrate was measured in first morning void samples in 2018-19 and in archived samples from 2010 to 2017 (minimum time between samples: 2 years; median: 7 years). We used linear regression to evaluate urinary nitrate concentrations in relation to total nitrate, and drinking water and dietary intakes separately. Overall, dietary nitrate contributed the most to total intake (median: 97 %; interquartile range [IQR]: 57-99 %). Among 15 participants (32 %) whose drinking water nitrate concentrations were at/above the U.S. Environmental Protection Agency MCL (10 mg/L NO3-N), median intake from water was 44 % (IQR: 26-72 %). Total nitrate intake was the strongest predictor of urinary nitrate concentrations (R2 = 0.53). Drinking water explained a similar proportion of the variation in nitrate excretion (R2 = 0.52) as diet (R2 = 0.47). Our findings demonstrate the importance of both dietary and drinking water intakes as determinants of nitrate excretion.
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Affiliation(s)
- Timothy G Skalaban
- Occupational and Environmental Epidemiology Branch, National Cancer Institute, Rockville, MD, United States of America; Department of Environmental Health Sciences, Yale School of Public Health, Yale University, New Haven, CT, United States of America
| | - Darrin A Thompson
- Center for Health Effects of Environmental Contamination, The University of Iowa, Iowa City, IA, United States of America
| | - Jessica M Madrigal
- Occupational and Environmental Epidemiology Branch, National Cancer Institute, Rockville, MD, United States of America
| | - Benjamin C Blount
- Tobacco and Volatiles Branch, National Center for Environmental Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Maria Morel Espinosa
- Tobacco and Volatiles Branch, National Center for Environmental Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Dana W Kolpin
- U.S. Geological Survey, Central Midwest Water Science Center, Iowa City, IA, United States of America
| | - Nicole C Deziel
- Department of Environmental Health Sciences, Yale School of Public Health, Yale University, New Haven, CT, United States of America
| | - Rena R Jones
- Occupational and Environmental Epidemiology Branch, National Cancer Institute, Rockville, MD, United States of America
| | - Laura Beane Freeman
- Occupational and Environmental Epidemiology Branch, National Cancer Institute, Rockville, MD, United States of America
| | - Jonathan N Hofmann
- Occupational and Environmental Epidemiology Branch, National Cancer Institute, Rockville, MD, United States of America
| | - Mary H Ward
- Occupational and Environmental Epidemiology Branch, National Cancer Institute, Rockville, MD, United States of America.
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Chen D, Parks CG, Beane Freeman LE, Hofmann JN, Sinha R, Madrigal JM, Ward MH, Sandler DP. Ingested nitrate and nitrite and end-stage renal disease in licensed pesticide applicators and spouses in the Agricultural Health Study. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2024; 34:322-332. [PMID: 38191926 PMCID: PMC11142909 DOI: 10.1038/s41370-023-00625-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 11/22/2023] [Accepted: 11/28/2023] [Indexed: 01/10/2024]
Abstract
BACKGROUND Nitrate and nitrite ingestion has been linked to kidney cancer, possibly via the endogenous formation of carcinogenic N-nitroso compounds. These exposures might also contribute to end-stage renal disease (ESRD). OBJECTIVES We investigated associations of drinking water nitrate and dietary nitrate and nitrite intakes (total and by food type) with incident ESRD in the Agricultural Health Study. We also explored modifying effects of vitamin C and heme iron intake, which may affect endogenous nitrosation. METHODS We performed complete case analyses among private pesticide applicators and their spouses. We obtained water nitrate estimates for participants whose primary drinking water source at enrollment (1993-1997) was public water supplies (PWS) or private wells (N = 59,632). Average nitrate concentrations were computed from historical data for PWS users and predicted from random forest models for private well users. Analysis of dietary nitrate and nitrite was restricted to the 30,177 participants who completed the NCI Dietary History Questionnaire during follow-up (1999-2003). Incident ESRD through 2018 was ascertained through linkage with the U.S. Renal Data System. We estimated adjusted hazard ratios (HRs) and 95%CI for associations of tertiles (T) of exposure with ESRD overall and explored effects in strata of vitamin C and heme iron intake. RESULTS We identified 469 incident ESRD cases (206 for dietary analysis). Water nitrate and total dietary nitrate/nitrite were not associated with ESRD, but increased ESRD was associated with nitrate and nitrite from processed meats. We found apparent associations between nitrite and ESRD only among participants with vitamin C SIGNIFICANCE ESRD incidence was associated with dietary nitrate/nitrite from processed meat among all study participants and with total dietary nitrite among participants with lower vitamin C or higher heme iron intake. IMPACT STATEMENT There are few well-established environmental risk factors for end-stage renal disease (ESRD), a worldwide public health challenge. Ingestion of nitrate and nitrite, which may lead to endogenous formation of carcinogenic N-nitroso compounds, has been linked to some cancers and chronic diseases. We investigated these exposures in relation to ESRD in an agricultural cohort. ESRD incidence was associated with dietary nitrate/nitrite from processed meat and with total dietary nitrite among subgroups with lower vitamin C or higher heme iron intake. This study provides preliminary evidence that points to dietary nitrite and possibly dietary nitrate intake as a potential contributor to ESRD.
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Affiliation(s)
- Dazhe Chen
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA
| | - Christine G Parks
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA
| | - Laura E Beane Freeman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD, USA
| | - Jonathan N Hofmann
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD, USA
| | - Rashmi Sinha
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD, USA
| | - Jessica M Madrigal
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD, USA
| | - Mary H Ward
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA.
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Peng Z, Liao Z, Liu S, Lian T, Xu P, Qiu P. Ratiometric colorimetric detection of nitrite using CoMnO 3 nanofibers as an oxidase-like enzyme to induce diazotization reaction. ANALYTICAL METHODS : ADVANCING METHODS AND APPLICATIONS 2023; 15:5341-5350. [PMID: 37794784 DOI: 10.1039/d3ay01290e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
Nitrite is a typical food additive and preservative used in the food industry, which has attracted considerable attention due to its severe adverse effects on human health. Herein, a sensitive and highly selective ratiometric colorimetric sensing platform for the detection of nitrite was created based on a polymetallic oxide nanozyme, CoMnO3 nanofibers (CMO) catalysis integrated with the particular diazotization reaction. The nanozyme has superior oxidase-like activity (Km was 0.105 mM and Vmax was 63.7 × 10-8 M S-1) and could catalyze the oxidation of 3,3',5,5'-tetramethylbenzidine (TMB) to oxidized TMB (oxTMB), as CMO could achieve the conversion of oxygen in the solution to superoxide anion (O2˙-). In addition, it is interesting to note that oxTMB can be diazotized in the presence of nitrite under acidic conditions, causing a shift in the ratio of nitrite concentration to the absorbance peaks at 450 and 652 nm (A450/A652). The ratio of A450/A652 exhibited a positive linear relationship with the concentration of nitrite within the concentration range of 0.2-200 μM, with a detection limit of 0.094 μM. Simultaneously, this method was also successful in quantifying the nitrite produced by brined and pickled foods and the dynamic tracking of the nitrite levels in various types of dishes. The analysis method not only offers dual-signal ratio sensing with high sensitivity but also holds the benefit of outstanding selectivity for the use of the particular reaction, which has a wide range of application prospects in food safety management.
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Affiliation(s)
- Zoujun Peng
- Department of Chemistry, Nanchang University, Nanchang 330031, China.
- Institute for Advanced Study, Nanchang University, Nanchang 330031, China
| | - Ziwen Liao
- Department of Chemistry, Nanchang University, Nanchang 330031, China.
- College of Food Science and Technology, Nanchang University, Nanchang 330031, China
| | - Sipei Liu
- Department of Chemistry, Nanchang University, Nanchang 330031, China.
- Institute for Advanced Study, Nanchang University, Nanchang 330031, China
| | - Tao Lian
- Department of Chemistry, Nanchang University, Nanchang 330031, China.
| | - Peng Xu
- Center of Analysis and Testing, Nanchang University, Nanchang 330031, China.
| | - Ping Qiu
- Department of Chemistry, Nanchang University, Nanchang 330031, China.
- Jiangxi Province Key Laboratory of Modern Analytical Science, Nanchang University, Nanchang 330031, 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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Etemadi A, Buller ID, Hashemian M, Roshandel G, Poustchi H, Espinosa MM, Blount BC, Pfeiffer CM, Keshavarzi B, Flory AR, Nasseri-Moghaddam S, Dawsey SM, Freedman ND, Abnet CC, Malekzadeh R, Ward MH. Urinary nitrate and sodium in a high-risk area for upper gastrointestinal cancers: Golestan Cohort Study ☆. ENVIRONMENTAL RESEARCH 2022; 214:113906. [PMID: 35863453 PMCID: PMC9420831 DOI: 10.1016/j.envres.2022.113906] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 07/05/2022] [Accepted: 07/11/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The epidemiological evidence regarding the carcinogenicity of nitrate and sodium in drinking water is limited, partly because measuring the exposure at the individual level is complex. Most studies have used nitrate in water supplies as a proxy for individual exposure, but dietary intakes and other factors may contribute to the exposure. The present study investigates the factors associated with urinary nitrate and sodium in a high-risk area for esophageal and gastric cancers. METHODS For this cross-sectional study, we used data and samples collected in 2004-2008 during the enrollment phase of the Golestan Cohort Study from a random sample of 349 participants (300 individuals from 24 rural villages and 49 from the city of Gonbad), stratified by average water nitrate in their district, the source of drinking water, and the usual dietary intake of nitrate and sodium. Nitrate, sodium, and creatinine were measured in a spot urine sample collected at the time of interview. We used the provincial cancer registry data to calculate the cumulative incidence rates of esophageal and gastric cancers for each location through June 1, 2020, and used weighted partial Pearson correlation to compare the incidence rates with median urinary nitrate and sodium in each village or the city. RESULTS Among 349 participants (mean age±SD: 50.7 ± 8.6 years), about half (n = 170) used groundwater for drinking, and the use of groundwater was significantly more common in high-elevation locations (75.8%). The geometric mean of the creatinine-corrected urinary nitrate concentration was 68.3 mg/g cr (95%CI: 64.6,72.3), and the corresponding geometric mean for urinary sodium was 150.0 mmoL/g cr (95%CI: 139.6,161.1). After adjusting for confounders, urinary nitrate was associated with being a woman, drinking groundwater, and living in high-elevation locations, but not with estimated dietary intake. Urinary sodium concentration was significantly associated with monthly precipitation at the time of sampling but not with elevation or drinking water source. There were significant positive correlations between both median urinary nitrate and sodium in each location and esophageal cancer incidence rates adjusted for sex and age (r = 0.65 and r = 0.58, respectively, p < 0.01), but not with gastric cancer incidence. CONCLUSION In a rural population at high risk for esophageal and gastric cancers, nitrate excretion was associated with living at a higher elevation and using groundwater for drinking. The associations between nitrate and sodium excretion with esophageal cancer incidence warrant future investigation.
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Affiliation(s)
- Arash Etemadi
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA; Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Ian D Buller
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA; Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Maryam Hashemian
- Departments of Biology, School of Art and Sciences, Utica College, Utica, NY, USA
| | - Gholamreza Roshandel
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maria Morel Espinosa
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Benjamin C Blount
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Christine M Pfeiffer
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Behnam Keshavarzi
- Department of Earth Sciences, College of Science, Shiraz University, Shiraz, Iran
| | | | - Siavosh Nasseri-Moghaddam
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sanford M Dawsey
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Neal D Freedman
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Christian C Abnet
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mary H Ward
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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McMahon NF, Brooker PG, Pavey TG, Leveritt MD. Nitrate, nitrite and nitrosamines in the global food supply. Crit Rev Food Sci Nutr 2022; 64:2673-2694. [PMID: 36168920 DOI: 10.1080/10408398.2022.2124949] [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: 11/03/2022]
Abstract
Inorganic nitrate provided by either nitrate salts or food supplements may improve cardiometabolic health. However, current methods to assess dietary nitrate, nitrite and nitrosamine consumption are inadequate. The purpose of this study was to develop a reference database to estimate the levels of nitrate, nitrite and nitrosamines in the global food supply. A systematic literature search was undertaken; of the 5,747 articles screened, 448 met the inclusion criteria. The final database included data for 1,980 food and beverages from 65 different countries. There were 5,105 unique records for nitrate, 2,707 for nitrite, and 954 for nitrosamine. For ease of use, data were sorted into 12 categories; regarding nitrate and nitrite concentrations in food and beverages, 'vegetables and herbs' were most reported in the literature (n = 3,268 and n = 1,200, respectively). For nitrosamines, 'protein foods of animal origin' were most reported (n = 398 records). This database will allow researchers and practitioners to confidently estimate dietary intake of nitrate, nitrite and nitrosamines. When paired with health data, our database can be used to investigate associations between nitrate intake and health outcomes, and/or exercise performance and could support the development of key dietary nitrate intake guidelines.
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Affiliation(s)
- Nicholas F McMahon
- School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Queensland, Australia
| | - Paige G Brooker
- School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Queensland, Australia
| | - Toby G Pavey
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Michael D Leveritt
- School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Queensland, Australia
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Dietary Nitrate Intake Is Associated with Decreased Incidence of Open-Angle Glaucoma: The Rotterdam Study. Nutrients 2022; 14:nu14122490. [PMID: 35745220 PMCID: PMC9228179 DOI: 10.3390/nu14122490] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 06/10/2022] [Accepted: 06/13/2022] [Indexed: 01/27/2023] Open
Abstract
Previous studies suggest that nitric oxide is involved in the regulation of the intraocular pressure (IOP) and in the pathophysiology of open-angle glaucoma (OAG). However, prospective studies investigating the association between dietary nitrate intake, a source of nitric oxide, and incident (i)OAG risk are limited. We aimed to determine the association between dietary nitrate intake and iOAG, and to evaluate the association between dietary nitrate intake and IOP. From 1991 onwards, participants were followed each five years for iOAG in the Rotterdam Study. A total of 173 participants developed iOAG during follow-up. Cases and controls were matched on age (mean ± standard deviation: 65.7 ± 6.9) and sex (%female: 53.2) in a case:control ratio of 1:5. After adjustment for potential confounders, total dietary nitrate intake was associated with a lower iOAG risk (odds ratio (OR) with corresponding 95% confidence interval (95% CI): 0.95 (0.91-0.98) for each 10 mg/day higher intake). Both nitrate intake from vegetables (OR (95% CI): 0.95 (0.91-0.98) for each 10 mg/day higher intake) and nitrate intake from non-vegetable food sources (OR (95% CI): 0.63 (0.41-0.96) for each 10 mg/day higher intake) were associated with a lower iOAG risk. Dietary nitrate intake was not associated with IOP. In conclusion, dietary nitrate intake was associated with a reduced risk of iOAG. IOP-independent mechanisms may underlie the association with OAG.
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A food composition database for assessing nitrate intake from plant-based foods. Food Chem 2022; 394:133411. [DOI: 10.1016/j.foodchem.2022.133411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 05/31/2022] [Accepted: 06/04/2022] [Indexed: 11/23/2022]
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Medgyesi DN, Trabert B, Sampson J, Weyer PJ, Prizment A, Fisher JA, Beane Freeman LE, Ward MH, Jones RR. Drinking Water Disinfection Byproducts, Ingested Nitrate, and Risk of Endometrial Cancer in Postmenopausal Women. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:57012. [PMID: 35622390 PMCID: PMC9138501 DOI: 10.1289/ehp10207] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 04/21/2022] [Accepted: 04/26/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Disinfection byproducts (DBPs) and N-nitroso compounds (NOC), formed endogenously after nitrate ingestion, are suspected endometrial carcinogens, but epidemiological studies are limited. OBJECTIVES We investigated the relationship of these exposures with endometrial cancer risk in a large prospective cohort. METHODS Among postmenopausal women in the Iowa Women's Health Study cohort, we evaluated two major classes of DBPs, total trihalomethanes (TTHM) and five haloacetic acids (HAA5), and nitrate-nitrogen (NO3-N) in public water supplies (PWS) in relation to incident primary endometrial cancer (1986-2014). For women using their PWS >10y at enrollment (n=10,501; cases=261), we computed historical averages of annual concentrations; exposures were categorized into quantiles and when possible ≥95th percentile. We also computed years of PWS use above one-half the U.S. maximum contaminant level (>½ MCL; 40μg/L TTHM; 30μg/L HAA5; 5mg/L NO3-N). Dietary nitrate/nitrite intakes were estimated from a food frequency questionnaire. We estimated hazard ratios (HR) and 95% confidence intervals (CI) via Cox models adjusted for age, endometrial cancer risk factors [e.g., body mass index, hormone replacement therapy (HRT)], and mutually adjusted for DBPs or NO3-N. We evaluated associations for low-grade (cases=99) vs. high-grade (cases=114) type I tumors. We assessed interactions between exposures and endometrial cancer risk factors and dietary factors influencing NOC formation. RESULTS Higher average concentrations of DBPs (95th percentile: TTHM ≥93μg/L, HAA5 ≥49μg/L) were associated with endometrial cancer risk (TTHM: HR95vsQ1=2.19, 95% CI: 1.41, 3.40; HAA5: HR95vsQ1=1.84, 95% CI: 1.19, 2.83; ptrend<0.01). Associations were similarly observed for women greater than median years of PWS use with levels >½ MCL, in comparison with zero years (TTHM: HR36+vs0y=1.61, 95% CI: 1.18, 2.21; HAA5: HR38+vs0y=1.85, 95% CI: 1.31, 2.62). Associations with DBPs appeared stronger for low-grade tumors (TTHM: HRQ4vsQ1=2.12, 95% CI: 1.17, 3.83; p-trend=0.008) than for high-grade tumors (TTHM: HRQ4vsQ1=1.40, 95% CI: 0.80, 2.44; p-trend=0.339), but differences were not statistically significant (p-heterogeneity=0.43). Associations with TTHM were stronger among ever HRT users than non-HRT users (p-interaction<0.01). We observed no associations with NO3-N in drinking water or diet. DISCUSSION We report novel associations between the highest DBP levels and endometrial cancer for our Iowa cohort that warrant future evaluation. https://doi.org/10.1289/EHP10207.
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Affiliation(s)
- Danielle N. Medgyesi
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute (NCI), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, Maryland, USA
| | - Britton Trabert
- Metabolic Epidemiology Branch, DCEG, NCI, NIH, DHHS, Bethesda, Maryland, USA
| | - Joshua Sampson
- Biostatistics Branch, DCEG, NCI, NIH, DHHS, Bethesda, Maryland, USA
| | - Peter J. Weyer
- Center for Health Effects of Environmental Contamination, University of Iowa, Iowa City, Iowa, USA
| | - Anna Prizment
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Jared A. Fisher
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute (NCI), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, Maryland, USA
| | - Laura E. Beane Freeman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute (NCI), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, Maryland, USA
| | - Mary H. Ward
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute (NCI), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, Maryland, USA
| | - Rena R. Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute (NCI), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, Maryland, USA
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11
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Cressey P, Cridge B. Exposure to nitrate from food and drinking-water in New Zealand. Can these be considered separately? Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2022; 39:838-852. [DOI: 10.1080/19440049.2022.2037725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Peter Cressey
- Institute of Environmental Science and Research, Christchurch, New Zealand
| | - Belinda Cridge
- Institute of Environmental Science and Research, Christchurch, New Zealand
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12
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Ghasemi A. Quantitative aspects of nitric oxide production from nitrate and nitrite. EXCLI JOURNAL 2022; 21:470-486. [PMID: 35391922 PMCID: PMC8983853 DOI: 10.17179/excli2022-4727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 02/02/2022] [Indexed: 11/05/2022]
Abstract
Nitric oxide (NO) is involved in many physiological and pathological processes in the human body. At least two major pathways produce NO: (1) the L-arginine-NO-oxidative pathway in which NO synthase (NOS) enzymes convert L-arginine to NO; (2) the nitrate-nitrite-NO reductive pathway in which NO is produced from the serial reduction of nitrate and nitrite. The deficiency of NO is involved in the pathophysiology of cardiometabolic disorders. Intervention with foods containing nitrate and nitrite can potentially prevent or treat some chronic diseases, including cardiovascular diseases and diabetes. A better understanding of the NO cycle would help develop effective strategies for preventing or treating the disorders in which NO homeostasis is disturbed. This review summarizes quantitative aspects of NO production, emphasizing the nitrate-nitrite-NO pathway. Available data indicates that total NO production by NOS-dependent L-arginine-NO pathway is about 1000 μmol.day-1. Of about 1700 μmol.day-1 ingested nitrate, ~25 % is extracted by the salivary glands and of which ~20 % is converted nitrite. It means that about 5 % of ingested nitrate is converted to nitrite in the oral cavity; assuming that all produced nitrite is reduced to NO in the stomach, it can be calculated that contribution of the nitrate-nitrite-NO pathway to the whole-body NO production is about 85 μmol.day-1 (1700 ×0.05=85) or approximately 100 μmol.day-1. The lower contribution of the nitrate-nitrite-NO pathway does not mean that this pathway has lower importance in the whole-body NO homeostasis. Even in the adequate L-arginine supply, NOS-dependent NO production is insufficient to meet all NO functions, and the nitrate-nitrite-NO pathway must provide the rest. In conclusion, the contribution of the nitrate-nitrite-NO pathway in the whole human body NO production is <10 %, and the nitrate-nitrite-NO pathway is complementary to the NOS-dependent NO production.
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Affiliation(s)
- Asghar Ghasemi
- Endocrine Physiology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran,*To whom correspondence should be addressed: Asghar Ghasemi, Endocrine Physiology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran, No. 24, Parvaneh Street, Velenjak, Tehran, Iran, P.O. Box: 19395-4763; Phone: +98 21 22432500, Fax: +98 21 22416264, E-mail: ,
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13
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Arafa A, Ewis A, Eshak E. Chronic exposure to nitrate in drinking water and the risk of bladder cancer: a meta-analysis of epidemiological evidence. Public Health 2022; 203:123-129. [DOI: 10.1016/j.puhe.2021.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 10/29/2021] [Accepted: 11/26/2021] [Indexed: 11/16/2022]
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14
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Cheng CJ, Kuo YT, Chen JW, Wei GJ, Lin YJ. Probabilistic risk and benefit assessment of nitrates and nitrites by integrating total diet study-based exogenous dietary exposure with endogenous nitrite formation using toxicokinetic modeling. ENVIRONMENT INTERNATIONAL 2021; 157:106807. [PMID: 34418847 DOI: 10.1016/j.envint.2021.106807] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 06/28/2021] [Accepted: 07/27/2021] [Indexed: 06/13/2023]
Abstract
The impacts of dietary nitrates and nitrites on human health have been a controversial topic for many years. However, the risk and benefit assessment of nitrates and nitrites is complicated by the large variation in nitrate and nitrite intake among people and the endogenous nitrite formation in the body. This study conducted a probabilistic risk-benefit assessment of dietary nitrates and nitrites based on internal dose by integrating exogenous and endogenous exposures with human trial data on cardiovascular benefits. A total diet study was carried out to quantify the age-specific dietary intakes of nitrates and nitrites. A previously well-validated human toxicokinetic model was used to predict internal doses for different age groups. In addition, the integrated approach was applied to different populations from different countries/regions based on reported exposure estimates to conduct a comprehensive risk-benefit assessment of dietary nitrates and nitrites. The results demonstrated that vegetable consumption was the main contributor to the internal nitrate and nitrite levels in all age groups. Exposure to nitrates and nitrites exceeding acceptable daily intakes in a variety of foods showed cardiovascular benefits. The probabilistic risk assessment showed that the exposure to nitrates and nitrites did not pose an appreciable health and safety risk. Therefore, the present results suggest that dietary nitrates and nitrites have clear cardiovascular benefits that may outweigh potential risks. Our analysis contributes significantly to addressing the controversy regarding risks and benefits from dietary nitrates and nitrites, and our approach could be applied to other dietary constituents with the potential for both risks and benefits.
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Affiliation(s)
- Cheng-Jih Cheng
- Institute of Food Safety and Health Risk Assessment, National Yang Ming Chiao Tung University, Taipei 112, Taiwan; Institute of Food Safety and Health Risk Assessment, National Yang-Ming University, Taipei 112, Taiwan
| | - Yuh-Ting Kuo
- Institute of Food Safety and Health Risk Assessment, National Yang Ming Chiao Tung University, Taipei 112, Taiwan; Institute of Food Safety and Health Risk Assessment, National Yang-Ming University, Taipei 112, Taiwan
| | - Jein-Wen Chen
- Department of Food and Beverage Management, Cheng Shiu University, Kaohsiung 833, Taiwan; Center for Environmental Toxin and Emerging-Contaminant Research, Cheng Shiu University, Kaohsiung 833, Taiwan; Super Micro Mass Research and Technology Center, Cheng Shiu University, Kaohsiung 833, Taiwan
| | - Guor-Jien Wei
- Institute of Food Safety and Health Risk Assessment, National Yang Ming Chiao Tung University, Taipei 112, Taiwan; Institute of Food Safety and Health Risk Assessment, National Yang-Ming University, Taipei 112, Taiwan; Metabolomics-Proteomics Research Center, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Yi-Jun Lin
- Institute of Food Safety and Health Risk Assessment, National Yang Ming Chiao Tung University, Taipei 112, Taiwan; Institute of Food Safety and Health Risk Assessment, National Yang-Ming University, Taipei 112, Taiwan.
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15
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Buller ID, Patel DM, Weyer PJ, Prizment A, Jones RR, Ward MH. Ingestion of Nitrate and Nitrite and Risk of Stomach and Other Digestive System Cancers in the Iowa Women's Health Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6822. [PMID: 34202037 PMCID: PMC8297261 DOI: 10.3390/ijerph18136822] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/19/2021] [Accepted: 06/21/2021] [Indexed: 12/15/2022]
Abstract
Nitrate and nitrite are precursors in the endogenous formation of N-nitroso compounds (NOC) which are potent animal carcinogens for the organs of the digestive system. We evaluated dietary intakes of nitrate and nitrite, as well as nitrate ingestion from drinking water (public drinking water supplies (PWS)), in relation to the incidence (1986-2014) of cancers of the esophagus (n = 36), stomach (n = 84), small intestine (n = 32), liver (n = 31), gallbladder (n = 66), and bile duct (n = 58) in the Iowa Women's Health Study (42,000 women aged from 50 to 75 in 1986). Dietary nitrate and nitrite were estimated using a food frequency questionnaire and a database of nitrate and nitrite levels in foods. Historical nitrate measurements from PWS were linked to the enrollment address by duration. We used Cox regression to compute hazard ratios (HR) and 95% confidence intervals (CI) for exposure quartiles (Q), tertiles (T), or medians, depending on the number of cancer cases. In adjusted models, nitrite intake from processed meats was associated with an increased risk of stomach cancer (HRQ4vsQ1 = 2.2, CI: 1.2-4.3). A high intake of total dietary nitrite was inversely associated with gallbladder cancer (HRQ4vsQ1 = 0.3, CI: 0.1-0.96), driven by an inverse association with plant sources of nitrite (HRQ4vsQ1 = 0.3, CI: 0.1-0.9). Additionally, small intestine cancer was inversely associated with a high intake of animal nitrite (HRT3vsT1 = 0.2, CI: 0.1-0.7). There were no other dietary associations. Nitrate concentrations in PWS (average, years ≥ 1/2 the maximum contaminant level) were not associated with cancer incidence. Our findings for stomach cancer are consistent with prior dietary studies, and we are the first to evaluate nitrate and nitrite ingestion for certain gastrointestinal cancers.
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Affiliation(s)
- Ian D. Buller
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20850, USA; (I.D.B.); (D.M.P.); (R.R.J.)
- Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Rockville, MD 20850, USA
| | - Deven M. Patel
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20850, USA; (I.D.B.); (D.M.P.); (R.R.J.)
| | - Peter J. Weyer
- Center for Health Effects of Environmental Contamination, University of Iowa, Iowa City, IA 52242, USA;
| | - Anna Prizment
- Masonic Cancer Center, Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN 55455, USA;
| | - Rena R. Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20850, USA; (I.D.B.); (D.M.P.); (R.R.J.)
| | - Mary H. Ward
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20850, USA; (I.D.B.); (D.M.P.); (R.R.J.)
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16
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Sim M, Blekkenhorst LC, Bondonno NP, Radavelli-Bagatini S, Peeling P, Bondonno CP, Magliano DJ, Shaw JE, Woodman R, Murray K, Lewis JR, Daly RM, Hodgson JM. Dietary Nitrate Intake Is Positively Associated with Muscle Function in Men and Women Independent of Physical Activity Levels. J Nutr 2021; 151:1222-1230. [PMID: 33760920 DOI: 10.1093/jn/nxaa415] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/03/2020] [Accepted: 12/01/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Nitrate supplements can improve vascular and muscle function. Whether higher habitual dietary nitrate is associated with better muscle function remains underexplored. OBJECTIVE The aim was to examine whether habitual dietary nitrate intake is associated with better muscle function in a prospective cohort of men and women, and whether the relation was dependent on levels of physical activity. METHODS The sample (n = 3759) was drawn from the Australian Diabetes, Obesity, and Lifestyle Study (AusDiab) (56% female; mean ± SD baseline age: 48.6 ± 11.1 y). Habitual dietary intake was assessed over 12 y by obtaining an average [of at least 2 time points, e.g., baseline (2000/2001) and 2004/2005 and/or 2011/2012] from a food-frequency questionnaire. Nitrate intake was calculated from a validated nitrate database and other published literature. Muscle function was quantified by knee extension strength (KES) and the 8-ft-timed-up-and-go (8ft-TUG) test performed in 2011/2012. Physical activity was assessed by questionnaire. Generalized linear models and logistic regression were used to analyze the data. RESULTS Median (IQR) total nitrate intake was 65 (52-83) mg/d, with ∼81% derived from vegetables. Individuals in the highest tertile of nitrate intake (median intake: 91 mg/d) had 2.6 kg stronger KES (11%) and 0.24 s faster 8ft-TUG (4%) compared with individuals in the lowest tertile of nitrate intake (median intake: 47 mg/d; both P < 0.05). Similarly, individuals in the highest tertile of nitrate intake had lower odds for weak KES (adjusted OR: 0.69; 95% CI: 0.47, 0.73) and slow 8ft-TUG (adjusted OR: 0.63; 95% CI: 0.50, 0.78) compared with those in the lowest tertile. Physical activity did not influence the relationship between nitrate intake and muscle function (KES; P-interaction = 0.86; 8ft-TUG; P-interaction = 0.99). CONCLUSIONS Higher habitual dietary nitrate intake, predominantly from vegetables, could be an effective way to promote lower-limb muscle strength and physical function in men and women.
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Affiliation(s)
- Marc Sim
- Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,Medical School, Royal Perth Hospital Unit, The University Western Australia, Perth, Western Australia, Australia
| | - Lauren C Blekkenhorst
- Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,Medical School, Royal Perth Hospital Unit, The University Western Australia, Perth, Western Australia, Australia
| | - Nicola P Bondonno
- Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,School of Biomedical Sciences, The University Western Australia, Perth, Western Australia, Australia
| | - Simone Radavelli-Bagatini
- Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Peter Peeling
- School of Human Sciences (Exercise and Sports Science), The University Western Australia, Perth, Western Australia, Australia.,Western Australian Institute of Sport, Mt Claremont, Western Australia, Australia
| | - Catherine P Bondonno
- Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,Medical School, Royal Perth Hospital Unit, The University Western Australia, Perth, Western Australia, Australia
| | - Dianna J Magliano
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.,Monash University, School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
| | - Jonathan E Shaw
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.,Monash University, School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
| | - Richard Woodman
- Flinders Centre for Epidemiology and Biostatistics, Flinders University, Adelaide, South Australia, Australia
| | - Kevin Murray
- School of Population and Global Health, The University Western Australia, Perth, Western Australia, Australia
| | - Joshua R Lewis
- Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,Medical School, Royal Perth Hospital Unit, The University Western Australia, Perth, Western Australia, Australia.,Centre for Kidney Research, Children's Hospital at Westmead, School of Public Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Robin M Daly
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Jonathan M Hodgson
- Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,Medical School, Royal Perth Hospital Unit, The University Western Australia, Perth, Western Australia, Australia
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17
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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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18
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Barry KH, Jones RR, Cantor KP, Beane Freeman LE, Wheeler DC, Baris D, Johnson AT, Hosain GM, Schwenn M, Zhang H, Sinha R, Koutros S, Karagas MR, Silverman DT, Ward MH. Ingested Nitrate and Nitrite and Bladder Cancer in Northern New England. Epidemiology 2021; 31:136-144. [PMID: 31577632 DOI: 10.1097/ede.0000000000001112] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND N-nitroso compounds are hypothesized human bladder carcinogens. We investigated ingestion of N-nitroso compound precursors nitrate and nitrite from drinking water and diet and bladder cancer in the New England Bladder Cancer Study. METHODS Using historical nitrate measurements for public water supplies and measured and modeled values for private wells, as well as self-reported water intake, we estimated average nitrate concentrations (mg/L NO3-N) and average daily nitrate intake (mg/d) from 1970 to diagnosis/reference date (987 cases and 1,180 controls). We estimated overall and source-specific dietary nitrate and nitrite intakes using a food frequency questionnaire (1,037 cases and 1,225 controls). We used unconditional logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI). We evaluated interactions with factors that may affect N-nitroso compound formation (i.e., red meat, vitamin C, smoking), and with water intake. RESULTS Average drinking water nitrate concentration above the 95th percentile (>2.07 mg/L) compared with the lowest quartile (≤0.21 mg/L) was associated with bladder cancer (OR = 1.5, 95% CI = 0.97, 2.3; P trend = 0.01); the association was similar for average daily drinking water nitrate intake. We observed positive associations for dietary nitrate and nitrite intakes from processed meat (highest versus lowest quintile OR for nitrate = 1.4, 95% CI = 1.0, 2.0; P trend = 0.04; OR for nitrite = 1.5, 95% CI = 1.0, 2.1; P trend = 0.04, respectively), but not other dietary sources. We observed positive interactions between drinking water nitrate and red meat (P-interaction 0.05) and processed red meat (0.07). CONCLUSIONS Our results suggest the importance of both drinking water and dietary nitrate sources as risk factors for bladder cancer.
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Affiliation(s)
- Kathryn Hughes Barry
- From the Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD.,Department of Epidemiology and Public Health, University of Maryland School of Medicine, and Program in Oncology, University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, MD
| | - Rena R Jones
- From the Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Kenneth P Cantor
- From the Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Laura E Beane Freeman
- From the Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - David C Wheeler
- Department of Biostatistics, Virginia Commonwealth University, Richmond, VA
| | - Dalsu Baris
- From the Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | | | - G Monawar Hosain
- Bureau of Public Health Statistics and Informatics, Department of Health and Human Services, Concord, NH
| | | | - Han Zhang
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Rashmi Sinha
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Stella Koutros
- From the Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Margaret R Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH
| | - Debra T Silverman
- From the Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Mary H Ward
- From the Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
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Kukhtyn M, Salata V, Horiuk Y, Kovalenko V, Ulko L, Prosyanуi S, Shuplyk V, Kornienko L. The influence of the denitrifying strain of Staphylococcus carnosus No. 5304 on the content of nitrates in the technology of yogurt production. POTRAVINARSTVO 2021. [DOI: 10.5219/1492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Contamination of food with nitrates is a generally recognized problem. Milk is the basis for the production of many milk mixtures for baby food, and children are considered to be the most vulnerable category to the harmful influence of nitrates. The purpose of the search was to investigate the denitrification of milk with different amounts of nitrates by the denitrifying microorganisms of Staphylococcus carnosus in the technology of production of sour-milk products. The denitrification process of S. carnosus milk in the amount of 103 CFU.cm-3 was found to reduce the nitrate content by an average of 88.0 ±3.9 mg.kg-1 and in the samples of the first group was 10.3 ±2.4 mg.kg-1, the second 110.7 ±4.1 and the third 214.5 ±6.3 mg.kg-1, respectively. In the search of the denitrification process of S. carnosus milk in the amount of 104 CFU.cm-3, was found that in the ready yogurt in the samples of the first group the amount of nitrates was 1.1 ±0.1 mg.kg-1, in the second group 56.4 ±3.5 mg.kg-1, and in the third 159.5 ±4.1 mg.kg-1 respectively. In the search of the denitrification process of S. carnosus milk in the amount of 105 CFU.cm-3, was found that nitrates were practically absent in the samples of the first group, the second group did not exceed 10 mg.kg-1, and the third was 107.4 ±3.9 mg.kg-1. Therefore, received data indicate the possibility of using strain S. carnosus No. 5304 for denitrification of milk with a high content of nitrates in the technology of production of fermented milk products, in particular yogurt.
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Gan F, Wu K, Ma F, Du C. In Situ Determination of Nitrate in Water Using Fourier Transform Mid-Infrared Attenuated Total Reflectance Spectroscopy Coupled with Deconvolution Algorithm. Molecules 2020; 25:molecules25245838. [PMID: 33322008 PMCID: PMC7764078 DOI: 10.3390/molecules25245838] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/07/2020] [Accepted: 12/08/2020] [Indexed: 11/16/2022] Open
Abstract
Fourier transform infrared attenuated total reflectance (FTIR-ATR) spectroscopy has been used to determine the nitrate content in aqueous solutions. However, the conventional water deduction algorithm indicated considerable limits in the analysis of samples with low nitrate concentration. In this study, FTIR-ATR spectra of nitrate solution samples with high and low concentrations were obtained, and the spectra were then pre-processed with deconvolution curve-fitting (without water deduction) combined with partial least squares regression (PLSR) to predict the nitrate content. The results show that the typical absorption of nitrate (1200-1500 cm-1) did not clearly align with the conventional algorithm of water deduction, while this absorption was obviously observed through the deconvolution algorithm. The first principal component of the spectra, which explained more than 95% variance, was linearly related to the nitrate content; the correlation coefficient (R2) of the PLSR model for the high-concentration group was 0.9578, and the ratio of the standard deviation of the prediction set to that of the calibration set (RPD) was 4.22, indicating excellent prediction performance. For the low-concentration group model, R2 and RPD were 0.9865 and 3.15, respectively, which also demonstrated significantly improved prediction capability. Therefore, FTIR-ATR spectroscopy combined with deconvolution curve-fitting can be conducted to determine the nitrate content in aqueous solutions, thus facilitating rapid determination of nitrate in water bodies with varied concentrations.
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Affiliation(s)
- Fangqun Gan
- The State Key Laboratory of Soil and Sustainable Agriculture, Institute of Soil Science Chinese Academy of Sciences, Nanjing 210008, China; (F.G.); (F.M.)
- College of Environment and Ecology, Jiangsu Open University, Nanjing 210017, China;
| | - Ke Wu
- College of Environment and Ecology, Jiangsu Open University, Nanjing 210017, China;
| | - Fei Ma
- The State Key Laboratory of Soil and Sustainable Agriculture, Institute of Soil Science Chinese Academy of Sciences, Nanjing 210008, China; (F.G.); (F.M.)
| | - Changwen Du
- The State Key Laboratory of Soil and Sustainable Agriculture, Institute of Soil Science Chinese Academy of Sciences, Nanjing 210008, China; (F.G.); (F.M.)
- College of Advanced Agricultural Sciences, University of Chinese Academy of Sciences, Beijing 100049, China
- Correspondence: ; Tel.: +86-25-8688-1565
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21
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Moazeni M, Heidari Z, Golipour S, Ghaisari L, Sillanpää M, Ebrahimi A. Dietary intake and health risk assessment of nitrate, nitrite, and nitrosamines: a Bayesian analysis and Monte Carlo simulation. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:45568-45580. [PMID: 32803593 DOI: 10.1007/s11356-020-10494-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 08/11/2020] [Indexed: 05/21/2023]
Abstract
Nitrate, nitrite, and nitrosamines intake from the diet creates human health risks. In this study, nitrate/nitrite intake from diet and its association with nitric oxide (NO) level in humans have been surveyed. Besides nitrate/nitrite, nitrosamines risks were also determined from the diet. This study was conducted as a pilot study; 33 heathy adults participated in and completed the Food Frequency Questionnaire (FFQ) for 3 days. Then, concentrations of nitrate, nitrite, and nitrosamines were studied by the literature review. Also, the association between the intake of nitrate and nitrite with salivary and urinary NO was evaluated by Bayesian bi-variate analysis. Then, the health risk was assessed for nitrate/nitrite from food groups and drinking water, and nitrosamines from food groups based on hazard index (HI) and cancer risk with the Monte Carlo simulation. The nitrate/nitrite intakes had no association with NO level in the saliva and urine samples. The mean of HI value for the mean of 3 days was 3.57 and 0.32 from food groups and drinking water, respectively. The cancer risk amount of nitrosamines from food groups was (1.74 to 2.22) × 10-3 based on 95% confidence interval (CI 95%) values. This study showed the Iranian diet had a high risk, but drinking water consumption was safe based on nitrate/nitrite and nitrosamines for humans. There is a need to determine the concentration of nitrosamines in drinking water in Iran and to recommend for decrease risk of nitrate, nitrite, and nitrosamines exposure by food groups.
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Affiliation(s)
- Malihe Moazeni
- Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
- Student Research Committee, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Heidari
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sahar Golipour
- Student Research Committee, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Environmental Health Engineering, School of Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Leila Ghaisari
- Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
- Student Research Committee, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mika Sillanpää
- Institute of Research and Development, Duy Tan University, Da Nang, 550000, Vietnam
- School of Civil Engineering and Surveying, Faculty of Health, Engineering and Sciences, University of Southern Queensland, West Street, Toowoomba, 4350, QLD, Australia
- Faculty of Environment and Chemical Engineering, Duy Tan University, Da Nang, 550000, Vietnam
| | - Afshin Ebrahimi
- Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
- Environment Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
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22
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Lin YJ, Cheng CJ, Chen JW, Lin Z. Incorporating Exogenous and Endogenous Exposures into Dietary Risk Assessment of Nitrates and Nitrites in Vegetables: A Probabilistic Integrated Toxicokinetic Modeling Approach. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2020; 68:1079-1090. [PMID: 31885263 DOI: 10.1021/acs.jafc.9b06720] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This study aimed to estimate the dietary risk of nitrates and nitrites in vegetables based on internal dose in a probabilistic manner by integrating exogenous exposure based on measured concentrations in vegetables with endogenous exposure using a toxicokinetic (TK) model. We optimized and validated a previous TK model and incorporated Monte Carlo simulations to account for variability across different age populations for predicting internal dose. High levels of nitrates were detected in leafy vegetables (from 545 ± 274 to 1641 ± 873 mg/kg). Nitrite contents of vegetables were generally low (from 1.26 ± 1.40 to 8.20 ± 14.1 mg/kg). The dietary risk was found to be different based on internal versus external dose, suggesting that it is critical to include endogenous nitrite formation into risk assessment. Nitrate and nitrite exposure from vegetables is unlikely to result in appreciable risks for most populations but may be a potential risk for preschoolers.
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Affiliation(s)
- Yi-Jun Lin
- Institute of Food Safety and Health Risk Assessment , National Yang-Ming University , Taipei 11221 , Taiwan
- Institute of Computational Comparative Medicine (ICCM), Department of Anatomy and Physiology, College of Veterinary Medicine , Kansas State University , 1800 Denison Avenue, P200 Mosier Hall , Manhattan , Kansas 66506 , United States
| | - Cheng-Jih Cheng
- Institute of Food Safety and Health Risk Assessment , National Yang-Ming University , Taipei 11221 , Taiwan
| | - Jein-Wen Chen
- Super Micro Mass Research & Technology Center , Cheng Shiu University , Kaohsiung 83347 , Taiwan
| | - Zhoumeng Lin
- Institute of Computational Comparative Medicine (ICCM), Department of Anatomy and Physiology, College of Veterinary Medicine , Kansas State University , 1800 Denison Avenue, P200 Mosier Hall , Manhattan , Kansas 66506 , United States
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23
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Sych J, Kaelin I, Gerlach F, Wróbel A, Le T, FitzGerald R, Pestoni G, Faeh D, Krieger JP, Rohrmann S. Intake of Processed Meat and Association with Sociodemographic and Lifestyle Factors in a Representative Sample of the Swiss Population. Nutrients 2019; 11:E2556. [PMID: 31652799 PMCID: PMC6893731 DOI: 10.3390/nu11112556] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 10/15/2019] [Accepted: 10/15/2019] [Indexed: 11/30/2022] Open
Abstract
Processed meat (PM) intake is associated with health risks, but data are lacking in Switzerland. Using national representative data from a recent menuCH Survey, we first aimed to quantify intake of PM and its subtypes, and second to investigate associations with sociodemographic and lifestyle factors by multivariable regression analysis. PM was consumed by 72% of the population, and mean daily intake was 42.7 g/day (standard error of the mean (SEM) 1.2 g/day), ranging considerably across PM subtypes: highest intake of sausages 18.1 g/day (SEM 0.7 g/day) and lowest of bacon 2.0 g/day (SEM 0.2 g/day). PM intake by women was 4.7 g/1000 kcal lower than men (95% confidence interval (CI): -6.7; -2.7) and 2.9 g/1000 kcal lower in the French- language region compared with the German region (95% CI: 2.4; 8.7). Among sociodemographic and lifestyle factors examined, BMI (obese vs. normal: 5.5 g/1000 kcal, 95% CI: 2.4; 8.7) and current smoking (vs. never smoked: 3.1 g/kcal, 95% CI: 0.6; 5.6) were independently associated with PM intake. The results are a first description of PM intake, separate from other meat types, and which identified associations with two unhealthy lifestyle factors in Switzerland. Such data will contribute to better nutritional recommendations and guidance for public health interventions.
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Affiliation(s)
- Janice Sych
- Institute of Food and Beverage Innovation, ZHAW School of Life Sciences and Facility Management, Einsiedlerstrasse 34, 8820 Wädenswil, Switzerland.
| | - Ivo Kaelin
- Institute of Applied Simulation, ZHAW School of Life Sciences and Facility Management, Einsiedlerstrasse 31a, 8820 Wädenswil, Switzerland.
| | - Fabienne Gerlach
- Institute of Food and Beverage Innovation, ZHAW School of Life Sciences and Facility Management, Einsiedlerstrasse 34, 8820 Wädenswil, Switzerland.
| | - Anna Wróbel
- Institute of Applied Simulation, ZHAW School of Life Sciences and Facility Management, Einsiedlerstrasse 31a, 8820 Wädenswil, Switzerland.
| | - Thu Le
- Institute of Food and Beverage Innovation, ZHAW School of Life Sciences and Facility Management, Einsiedlerstrasse 34, 8820 Wädenswil, Switzerland.
| | - Rex FitzGerald
- Swiss Centre for Applied Human Toxicology (SCAHT) University of Basel, Missionstrasse 64, 4055 Basel, Switzerland.
| | - Giulia Pestoni
- Division of Chronic Disease Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland.
| | - David Faeh
- Division of Chronic Disease Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland.
- Health Department-Nutrition and Dietetics, Bern University of Applied Sciences, 3008 Bern, Switzerland.
| | - Jean-Philippe Krieger
- Division of Chronic Disease Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland.
| | - Sabine Rohrmann
- Division of Chronic Disease Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland.
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24
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van Breda SG, Mathijs K, Sági-Kiss V, Kuhnle GG, van der Veer B, Jones RR, Sinha R, Ward MH, de Kok TM. Impact of high drinking water nitrate levels on the endogenous formation of apparent N-nitroso compounds in combination with meat intake in healthy volunteers. Environ Health 2019; 18:87. [PMID: 31623611 PMCID: PMC6796425 DOI: 10.1186/s12940-019-0525-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 09/22/2019] [Indexed: 05/04/2023]
Abstract
BACKGROUND Nitrate is converted to nitrite in the human body and subsequently can react with amines and amides in the gastrointestinal tract to form N-nitroso compounds (NOCs), which are known to be carcinogenic in animals. Humans can be exposed to nitrate via consumption of drinking water and diet, especially green leafy vegetables and cured meat. The contribution of nitrate from drinking water in combination with meat intake has not been investigated thoroughly. Therefore, in the present pilot study, we examined the effect of nitrate from drinking water, and its interaction with the consumption of white and processed red meat, on the endogenous formation of NOCs, taking into account the intake of vitamin C, a nitrosation inhibitor. METHODS Twenty healthy subjects were randomly assigned to two groups consuming either 3.75 g/kg body weight (maximum 300 g per day) processed red meat or unprocessed white meat per day for two weeks. Drinking water nitrate levels were kept low during the first week (< 1.5 mg/L), whereas in week 2, nitrate levels in drinking water were adjusted to the acceptable daily intake level of 3.7 mg/kg bodyweight. At baseline, after 1 and 2 weeks, faeces and 24 h urine samples were collected for analyses of nitrate, apparent total N-nitroso compounds (ATNC), compliance markers, and genotoxic potential in human colonic Caco-2 cells. RESULTS Urinary nitrate excretion was significantly increased during the high drinking water nitrate period for both meat types. Furthermore, levels of compliance markers for meat intake were significantly increased in urine from subjects consuming processed red meat (i.e. 1-Methylhistidine levels), or unprocessed white meat (i.e. 3-Methylhistidine). ATNC levels significantly increased during the high drinking water nitrate period, which was more pronounced in the processed red meat group. Genotoxicity in Caco-2 cells exposed to faecal water resulted in increased genotoxicity after the interventions, but results were only significant in the low drinking water nitrate period in subjects consuming processed red meat. Furthermore, a positive correlation was found between the ratio of nitrate/vitamin C intake (including drinking water) and the level of ATNC in faecal water of subjects in the processed red meat group, but this was not statistically significant. CONCLUSIONS Drinking water nitrate significantly contributed to the endogenous formation of NOC, independent of the meat type consumed. This implies that drinking water nitrate levels should be taken into account when evaluating the effect of meat consumption on endogenous formation of NOC. TRIAL REGISTRATION Dutch Trialregister: 29707 . Registered 19th of October 2018. Retrospectively registered.
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Affiliation(s)
- Simone G van Breda
- Department of Toxicogenomics, GROW-school for Oncology and Developmental Biology, Maastricht University Medical Center, P.O Box 616, 6200, MD, Maastricht, the Netherlands.
| | - Karen Mathijs
- Department of Toxicogenomics, GROW-school for Oncology and Developmental Biology, Maastricht University Medical Center, P.O Box 616, 6200, MD, Maastricht, the Netherlands
| | - Virág Sági-Kiss
- Department of Food & Nutritional Sciences, University of Reading, Reading, UK
| | - Gunter G Kuhnle
- Department of Food & Nutritional Sciences, University of Reading, Reading, UK
| | - Ben van der Veer
- Department of Toxicogenomics, GROW-school for Oncology and Developmental Biology, Maastricht University Medical Center, P.O Box 616, 6200, MD, Maastricht, the Netherlands
| | - Rena R Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Rashmi Sinha
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Mary H Ward
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Theo M de Kok
- Department of Toxicogenomics, GROW-school for Oncology and Developmental Biology, Maastricht University Medical Center, P.O Box 616, 6200, MD, Maastricht, the Netherlands
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25
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Association of dietary nitrate intake with retinal microvascular structure in older adults. Eur J Nutr 2019; 59:2057-2063. [PMID: 31309281 DOI: 10.1007/s00394-019-02055-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 07/09/2019] [Indexed: 01/17/2023]
Abstract
PURPOSE Existing research suggests that changes to retinal vascular caliber reflect nitric oxide (NO)-dependent endothelial dysfunction. Dietary nitrate is an important source of NO; however, studies on the link between dietary nitrate intake and retinal microvasculature are lacking. We aimed to assess the cross-sectional association between intake of dietary nitrate (from vegetable and non-vegetable sources) and retinal arteriolar and venular caliber among older adults. METHODS Participants from the Blue Mountains Eye Study aged 49+ years with complete data at baseline on diet and retinal vessel measures were analyzed (n = 2813). Dietary intake was assessed using a validated semi-quantitative food-frequency questionnaire. Nitrate intake from vegetable and non-vegetable sources was estimated using a validated comprehensive database and other published data where necessary. Fundus photographs were taken and retinal vascular caliber measured using validated computer-assisted techniques and summarized. RESULTS Participants in the lowest versus highest tertile of vegetable nitrate intake had significantly narrower retinal arterioles: 186.2 ± 0.48 versus 187.6 ± 0.48 µm (multivariable-adjusted p = 0.04). After multivariable adjustment, each 10-unit higher intake of total nitrate and vegetable nitrate was associated with 0.089 ± 0.004 and 0.090 ± 0.004 µm wider retinal arteriolar caliber, respectively, both p = 0.03. Each 10-unit higher vegetable nitrate intake was associated with 0.092 ± 0.005 µm narrower retinal venules (p = 0.05). CONCLUSION Intake of dietary nitrate, particularly from vegetable sources, was associated with beneficial variations in both retinal arteriolar and venular caliber among older adults. Further research into associations between dietary nitrate and the retinal microvasculature could allow for greater understanding and possible prevention of clinical cardiovascular events.
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26
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Sim M, Lewis JR, Blekkenhorst LC, Bondonno CP, Devine A, Zhu K, Peeling P, Prince RL, Hodgson JM. Dietary nitrate intake is associated with muscle function in older women. J Cachexia Sarcopenia Muscle 2019; 10:601-610. [PMID: 30907070 PMCID: PMC6596394 DOI: 10.1002/jcsm.12413] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 01/27/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND In younger individuals, dietary nitrate supplementation has been shown to improve short-term vascular and muscle function. The role of higher habitual nitrate intake as part of a typical diet on muscle function in ageing has not been investigated. A cross-sectional study of relationships between dietary nitrate and measures of muscle function in older community-dwelling Australian women (n = 1420, ≥70 years) was undertaken. METHODS Participants completed a semi-quantitative food frequency questionnaire assessing dietary intake over the previous year. Total nitrate from vegetables and non-vegetable sources was calculated from a validated instrument that quantified the nitrate content of food recorded within the food frequency questionnaire. Handgrip strength and timed-up-and-go (TUG) were assessed, representing muscle strength and physical function, respectively. Cut-points for weak grip strength (<22 kg) and slow TUG (>10.2 s) were selected due to their association with adverse outcomes. Linear and logistic regressions were used to examine the relationship between total nitrate intake and muscle function measures. RESULTS Mean ± standard deviation (SD) total nitrate intake was 79.5 ± 31.2 mg/day, of which 84.5% came from vegetables. Across the unadjusted tertiles of nitrate intake (<64.2 mg/day; 64.2 to <89.0 mg/day; ≥89.0 mg/day), women in the highest tertile had a 4% stronger grip strength and a 5% faster TUG performance compared with the lowest tertile. In multivariable-adjusted models, each SD higher nitrate intake (31.2 mg/day) was associated with stronger grip strength (per kilogram, β 0.31, P = 0.027) and faster TUG (per second, β -0.27, P = 0.001). The proportion of women with weak grip strength (<22 kg) or slow TUG (>10.2 s) was 61.0% and 36.9%, respectively. Each SD higher nitrate intake (31.2 mg/day) was associated with lower odds for weak grip strength (OR 0.84, 95% CI 0.74-0.95, P = 0.005) and slow TUG (OR 0.86, 95% CI 0.76-0.98, P = 0.021). Compared with women in the lowest tertile of nitrate intake, women in the highest nitrate intake tertile had lower odds for weak grip strength (OR 0.65, 95% CI 0.49-0.87, Ptrend= 0.004) and slow TUG (OR 0.72, 95% CI 0.53-0.97, Ptrend = 0.044). CONCLUSIONS This investigation highlights potential benefits of nitrate-rich diets on muscle strength and physical function in a large cohort of older women. Considering poor muscle strength and physical function is associated with a range of adverse health outcomes such as falling, fractures, cardiovascular disease, and mortality, increasing dietary nitrate, especially though vegetable consumption may be an effective way to limit age-related declines in muscle function.
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Affiliation(s)
- Marc Sim
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Medical School, Royal Perth Hospital Unit, The University Western Australia, Perth, WA, Australia
| | - Joshua R Lewis
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Medical School, Royal Perth Hospital Unit, The University Western Australia, Perth, WA, Australia.,Centre for Kidney Research, Children's Hospital at Westmead, School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Lauren C Blekkenhorst
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Medical School, Royal Perth Hospital Unit, The University Western Australia, Perth, WA, Australia
| | - Catherine P Bondonno
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Medical School, Royal Perth Hospital Unit, The University Western Australia, Perth, WA, Australia
| | - Amanda Devine
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Kun Zhu
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, WA, Australia.,Medical School, Sir Charles Gairdner Unit, The University Western Australia, Perth, WA, Australia
| | - Peter Peeling
- School of Human Sciences (Exercise and Sports Science), The University Western Australia, Perth, WA, Australia.,Western Australian Institute of Sport, Mt Claremont, WA, Australia
| | - Richard L Prince
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, WA, Australia.,Medical School, Sir Charles Gairdner Unit, The University Western Australia, Perth, WA, Australia
| | - Jonathan M Hodgson
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Medical School, Royal Perth Hospital Unit, The University Western Australia, Perth, WA, Australia
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27
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Ke Z, Zhang Q, Huang Q. Potassium Iodide Potentiates Bacterial Killing by Helium Atmospheric Pressure Plasma Jet. ACS OMEGA 2019; 4:8365-8372. [PMID: 31459925 PMCID: PMC6648913 DOI: 10.1021/acsomega.9b00160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 04/12/2019] [Indexed: 05/27/2023]
Abstract
Cold atmospheric plasma (CAP) is an effective new antimicrobial approach that is gaining increasing attention and has a wide range of potential applications in biomedical fields. Among all of the bactericidal factors generated by CAP, the synergy of reactive nitrogen species (RNS) and reactive oxygen species is generally considered as the main reason for its high bactericidal efficiency. However, the produced RNS (such as nitrite) may also pose potential risks to human health. Therefore, it is of significance to keep the high disinfection efficiency of CAP but with producing no or little harmful RNS. In this study, we investigated whether it is possible to improve the disinfection efficiency of CAP without producing the harmful RNS by adding a certain amount of inert halogen salt such as potassium iodide (KI). We found that the inactivation of both Gram-negative and Gram-positive bacteria by helium atmospheric pressure plasma jet (He-APPJ), one form of CAP, is enhanced consistently in the presence of a certain amount of KI. The mechanism of action is due to the fact that the He-APPJ-generated hydrogen peroxide (H2O2) oxidizes the iodide anion to triiodide (I3 -), which contributes to the major bactericidal activity. We believe that the results in this work can be highly relevant to the practical application of plasma for disinfection in the biomedical field.
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Affiliation(s)
- Zhigang Ke
- Key
Laboratory of High Magnetic Field and Ion Beam Physical Biology, Institute
of Technical Biology and Agriculture Engineering, Hefei Institutes
of Physical Science, Chinese Academy of
Sciences, Hefei 230031, China
- University
of Science & Technology of China, Hefei 230026, China
| | - Qifu Zhang
- Key
Laboratory of High Magnetic Field and Ion Beam Physical Biology, Institute
of Technical Biology and Agriculture Engineering, Hefei Institutes
of Physical Science, Chinese Academy of
Sciences, Hefei 230031, China
- University
of Science & Technology of China, Hefei 230026, China
| | - Qing Huang
- Key
Laboratory of High Magnetic Field and Ion Beam Physical Biology, Institute
of Technical Biology and Agriculture Engineering, Hefei Institutes
of Physical Science, Chinese Academy of
Sciences, Hefei 230031, China
- University
of Science & Technology of China, Hefei 230026, China
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28
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Jones RR, DellaValle CT, Weyer PJ, Robien K, Cantor KP, Krasner S, Beane Freeman LE, Ward MH. Ingested nitrate, disinfection by-products, and risk of colon and rectal cancers in the Iowa Women's Health Study cohort. ENVIRONMENT INTERNATIONAL 2019; 126:242-251. [PMID: 30822653 DOI: 10.1016/j.envint.2019.02.010] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 01/11/2019] [Accepted: 02/02/2019] [Indexed: 05/04/2023]
Abstract
BACKGROUND N-nitroso compounds (NOC) formed endogenously after nitrate/nitrite ingestion and disinfection by-products (DBPs) are suspected colorectal carcinogens, but epidemiologic evidence of these associations is limited. OBJECTIVES We investigated the relationship between drinking water exposures and incident colorectal cancers in a cohort of postmenopausal women. METHODS Using historical nitrate-nitrogen (NO3-N) measurements and estimates of total trihalomethanes (TTHM), the sum of 5 or 6 haloacetic acids (HAAs), and individual DBPs in public water supplies (PWS), we computed average exposures and years of exposure above one-half the U.S. maximum contaminant level (>1/2-MCL; >5 mg/L NO3-N and >40 μg/L TTHM). Nitrate/nitrite intakes from dietary sources were estimated using a food frequency questionnaire. We estimated hazard ratios (HR) and 95% confidence intervals (CI) from Cox regression models. We assessed NO3-N interactions with DBPs and with factors influencing endogenous NOC formation. RESULTS We identified 624 colon and 158 rectal cancers (1986-2010) among 15,910 women reporting PWS use >10 years. Ingestion of NO3-N from drinking water was not associated with risk. Colon cancer risks were non-significantly associated with the average TTHM levels >17.7 μg/L (HRQ5vsQ1 = 1.13, CI = 0.89-1.44; ptrend = 0.11) and were elevated for any duration of exposure >1/2-MCL. Rectal cancer risks were associated with the highest TTHM levels (HRQ5vsQ1 = 1.71, CI = 1.00-2.92; ptrend = 0.22) but not with years >1/2-MCL. Bromodichloromethane (HRQ4vsQ1 = 1.89, CI = 1.17-3.00; ptrend = 0.09) and trichloroacetic acid (HRQ4vsQ1 = 1.92, CI = 1.20-3.09; ptrend = 0.18) levels were also associated with risk of rectal cancer. We found no evidence of interaction between TTHM and NO3-N on the risk of either cancer. Dietary analyses yielded a positive colon cancer association with red meat, but not with processed meat intake or estimated nitrate/nitrite from specific dietary sources. CONCLUSIONS Our results suggest that exposure to TTHM in drinking water is associated with increased risk of rectal cancer. Positive findings for individual THMs and HAAs for both colon and rectal cancers require replication in other studies. We found no associations for nitrate overall or in subgroups with presumed higher NOC exposure.
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Affiliation(s)
- Rena R Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, United States.
| | - Curt T DellaValle
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, United States
| | - Peter J Weyer
- Center for Health Effects of Environmental Contamination, University of Iowa, Iowa City, IA, United States
| | - Kim Robien
- George Washington University, Milken Institute School of Public Health, Washington, DC, United States
| | - Kenneth P Cantor
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, United States
| | | | - Laura E Beane Freeman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, United States
| | - Mary H Ward
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, United States
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Vegetable Nitrate Intakes Are Associated with Reduced Self-Reported Cardiovascular-Related Complications within a Representative Sample of Middle-Aged Australian Women, Prospectively Followed up for 15 Years. Nutrients 2019; 11:nu11020240. [PMID: 30678264 PMCID: PMC6412377 DOI: 10.3390/nu11020240] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 01/17/2019] [Accepted: 01/18/2019] [Indexed: 11/26/2022] Open
Abstract
Nitric oxide (NO) facilitates anti-atherosclerotic effects. Vegetables are a major source of dietary nitrate. Experimental data indicates that dietary nitrate can significantly reduce major risk factors for atherosclerosis and subsequent cardiovascular disease (CVD), as nitrate can be metabolized to produce NO via the nitrate-nitrite-NO pathway. The purpose of this study was to prospectively investigate the association between habitual dietary nitrate intakes and the incidence of self-reported CVD-related complications within a representative sample of middle-aged Australian women (1946–1951 cohort of the Australian Longitudinal Study on Women’s Health). Women free from disease at baseline who had completed the food frequency questionnaire data were included. Generalized estimating equations were used to estimate odds ratios (OR) and 95% confidence intervals (95% CI) across quartiles for nitrate intakes. Of the 5324 women included for analysis, there were 1951 new cases of CVD-related complications over 15-years of follow-up. Women reporting higher total dietary nitrate intakes (Q4 > 78.2 mg/day) and vegetable nitrate intakes (Q4 > 64.4 mg/day) were 25% and 27% reduced risk of developing CVD-related complications respectively, compared with women reporting low total (Q1 < 45.5 mg/day) and vegetable nitrate intakes (Q1 < 34.8 mg/day). Our findings were consistent with other observational data indicating that dietary nitrate may explain some of the cardiovascular benefits of vegetable consumption.
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BAHADORAN Z, GHASEMI A, MIRMIRAN P, MEHRABI Y, AZIZI F, HADAEGH F. Estimation and Validation of Dietary Nitrate and Nitrite Intake in Iranian Population. IRANIAN JOURNAL OF PUBLIC HEALTH 2019; 48:162-170. [PMID: 30847325 PMCID: PMC6401587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND The aim of this study was calibration of a nitrate (NO3)/nitrite (NO2) database for estimated its dietary intakes. METHODS Overall, 250 healthy Tehranian adults were assessed in 2015 for dietary intakes of NO3 and NO2 and its serum and urine concentration. Food composition values for NO3 and NO2 were derived from a recent survey conducted on frequently consumed food items among Iranians. The correlation of dietary intakes of NO3/NO2 and its urinary and serum values was evaluated. RESULTS Mean (±SD) intakes of dietary NO3 and NO2 were 505±160 and 7.7±2.2 mg/d, respectively. The correlation coefficient of intake and urinary NO3 was 0.83 (95% CI=0.56-0.91) and 0.57 (95% CI=0.49-0.67) in men and women, respectively. A moderate agreement was also observed between NO2 intake and its urinary levels (r=0.27, 95% CI=0.13-0.37, and 0.29, 95% CI=0.17-0.41, in men and women, respectively). CONCLUSION Using a national database of NO3 and NO2 content of food items along with a valid food frequency questionnaire could provide a valid estimation of dietary intakes of NO3 in the target population.
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Affiliation(s)
- Zahra BAHADORAN
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Asghar GHASEMI
- Endocrine Physiology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvin MIRMIRAN
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Corresponding Author:
| | - Yadollah MEHRABI
- Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun AZIZI
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad HADAEGH
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Association of Dietary Nitrate Intake with the 15-Year Incidence of Age-Related Macular Degeneration. J Acad Nutr Diet 2018; 118:2311-2314. [PMID: 30342988 DOI: 10.1016/j.jand.2018.07.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 07/15/2018] [Accepted: 07/17/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Dietary nitrate, found predominantly in green leafy vegetables and beetroot, is a precursor of nitric oxide. Under- or overproduction of nitric oxide is implicated in the etiology of several eye diseases. However, the potential influence of dietary nitrate intake on age-related macular degeneration (AMD) risk has not been assessed. OBJECTIVE To investigate the temporal association between dietary nitrate intake (from both vegetable and nonvegetable sources) and the 15-year incidence of AMD, independent of potential confounders. DESIGN A longitudinal cohort study conducted from 1992-1994 to 2007-2009. PARTICIPANTS/SETTING The Blue Mountains Eye Study is a population-based study of adults aged 49+ at baseline, from a region west of Sydney, Australia. At baseline, 2,856 participants with complete dietary data and AMD information were examined, and of these, 2,037 participants were re-examined 15 years later and thus included in incidence analysis. MAIN OUTCOMES MEASURED Incidence of AMD (main outcome) was assessed from retinal photographs. Dietary intake was assessed using a semiquantitative food-frequency questionnaire. Nitrate intake from vegetables and nonvegetable sources was calculated by use of a validated comprehensive database. RESULTS After adjusting for age, sex, smoking, energy intake, fish consumption, and AMD risk alleles (complement factor H and age-related maculopathy susceptibility-2 single nucleotide polymorphisms), participants in the third quartile compared with those in the first quartile (reference group) of total nitrate and total vegetable nitrate intake had reduced risk of incident early AMD: odds ratio (OR) 0.61 (95% CI 0.41 to 0.90) and OR 0.65 (95% CI 0.44 to 0.96), respectively. Significant associations were not observed between the fourth vs first quartile of total nitrate and vegetable nitrate intake with incident early AMD: OR 0.74 (95% CI 0.51 to 1.08) and OR 0.69 (95% CI 0.47 to 1.00), respectively. Nonsignificant associations were also observed with 15-year incidence of late AMD and total nonvegetable nitrate intake. CONCLUSIONS These novel findings could have important implications, if the association between total nitrate intake and vegetable nitrate intake and 15-year incidence of early AMD is confirmed in other observational or intervention studies.
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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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Liu AH, Bondonno CP, Russell J, Flood VM, Lewis JR, Croft KD, Woodman RJ, Lim WH, Kifley A, Wong G, Mitchell P, Hodgson JM, Blekkenhorst LC. Relationship of dietary nitrate intake from vegetables with cardiovascular disease mortality: a prospective study in a cohort of older Australians. Eur J Nutr 2018; 58:2741-2753. [PMID: 30238316 DOI: 10.1007/s00394-018-1823-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 09/12/2018] [Indexed: 12/30/2022]
Abstract
PURPOSE Short-term trials indicate inorganic nitrate and nitrate-rich vegetables may have vascular health benefits. However, few observational studies have explored the relationship between nitrate intake and long-term cardiovascular disease (CVD) outcomes. The primary aim of this study was to investigate the association of nitrate intake from vegetables with CVD mortality in a sample of older Australians. METHODS A subgroup of participants without diabetes or major CVD at baseline (1992-1994) were included from the Blue Mountains Eye Study, a population-based cohort study of men and women aged ≥ 49 years. Diets were evaluated using a validated food frequency questionnaire at baseline, 5 years and 10 years of follow-up. Vegetable nitrate intake was estimated using a comprehensive vegetable nitrate database. Cox proportional hazard regression was used to explore the association between vegetable nitrate intake and CVD mortality. RESULTS During 14 years of follow-up, 188/2229 (8.4%) participants died from CVD. In multivariable-adjusted analysis, participants in quartile 2 [69.5-99.6 mg/day; HR 0.53 (95% CI 0.35, 0.82)], quartile 3 [99.7-137.8 mg/day; HR 0.51 (95% CI 0.32, 0.80)], and quartile 4 [> 137.8 mg/day; HR 0.63 (95% CI 0.41, 0.95)] of vegetable nitrate intake had lower hazards for CVD mortality compared to participants in quartile 1 (< 69.5 mg/day). CONCLUSIONS In older Australian men and women, vegetable nitrate intake was inversely associated with CVD mortality, independent of lifestyle and cardiovascular risk factors. These findings confirm a recent report that intake of vegetable nitrate lowers the risk of CVD mortality in older women and extend these findings to older men.
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Affiliation(s)
- Alex H Liu
- Medical School, Royal Perth Hospital Unit, The University of Western Australia, Perth, WA, Australia
| | - Catherine P Bondonno
- Medical School, Royal Perth Hospital Unit, The University of Western Australia, Perth, WA, Australia.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Joanna Russell
- School of Health and Society, Faculty of Social Sciences, The University of Wollongong, Wollongong, Australia
| | - Victoria M Flood
- Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia.,Western Sydney Local Health District, Westmead Hospital, Westmead, NSW, Australia
| | - Joshua R Lewis
- Medical School, Royal Perth Hospital Unit, The University of Western Australia, Perth, WA, Australia.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Centre for Kidney Research, Children's Hospital at Westmead, Westmead, NSW, Australia.,School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Kevin D Croft
- Medical School, Royal Perth Hospital Unit, The University of Western Australia, Perth, WA, Australia
| | - Richard J Woodman
- Flinders Centre for Epidemiology and Biostatistics, Flinders University, Adelaide, SA, Australia
| | - Wai H Lim
- Department of Renal Medicine, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Annette Kifley
- Centre for Vision Research, Department of Ophthalmology, Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia
| | - Germaine Wong
- Centre for Kidney Research, Children's Hospital at Westmead, Westmead, NSW, Australia.,School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Paul Mitchell
- Centre for Vision Research, Department of Ophthalmology, Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia
| | - Jonathan M Hodgson
- Medical School, Royal Perth Hospital Unit, The University of Western Australia, Perth, WA, Australia.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Lauren C Blekkenhorst
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.
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Dietary Nitrate and Diet Quality: An Examination of Changing Dietary Intakes within a Representative Sample of Australian Women. Nutrients 2018; 10:nu10081005. [PMID: 30071671 PMCID: PMC6116056 DOI: 10.3390/nu10081005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 07/27/2018] [Accepted: 07/31/2018] [Indexed: 11/24/2022] Open
Abstract
Dietary nitrate is increasingly linked to a variety of beneficial health outcomes. Our purpose was to estimate dietary nitrate consumption and identify key dietary changes which have occurred over time within a representative sample of Australian women. Women from the 1946–1951 cohort of the Australian Longitudinal Study on Women’s Health with complete food frequency questionnaire data for both 2001 and 2013 were included for analysis. Dietary nitrate intakes were calculated using key published nitrate databases. Diet quality scores including the Australian Recommended Food Score, the Mediterranean Diet Score and the Nutrient Rich Foods Index were calculated along with food group serves as per the Australian Dietary Guidelines. Wilcoxon matched pairs tests were used to test for change in dietary intakes and Spearman’s correlations were used to examine associations. In our sample of 8161 Australian women, dietary nitrate intakes were on average 65–70 mg/day, and we detected a significant increase in dietary nitrate consumption over time (+6.57 mg/day). Vegetables were the primary source of dietary nitrate (81–83%), in particular lettuce (26%), spinach (14–20%), beetroot (10–11%), and celery (7–8%) contributed primarily to vegetable nitrate intakes. Further, increased dietary nitrate intakes were associated with improved diet quality scores (r = 0.3, p < 0.0001). Although there is emerging evidence indicating that higher habitual dietary nitrate intakes are associated with reduced morbidity and mortality, future work in this area should consider how dietary nitrate within the context of overall diet quality can facilitate health to ensure consistent public health messages are conveyed.
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Abstract
BACKGROUND N-nitroso compounds formed endogenously after nitrate/nitrite ingestion are animal renal carcinogens. Previous epidemiologic studies of drinking water nitrate did not evaluate other potentially toxic water contaminants, including the suspected renal carcinogen chloroform. METHODS In a cohort of postmenopausal women in Iowa (1986-2010), we used historical measurements to estimate long-term average concentrations of nitrate-nitrogen (NO3-N) and disinfection by-products (DBP) in public water supplies. For NO3-N and the regulated DBP (total trihalomethanes [THM] and the sum of five haloacetic acids [HAA5]), we estimated the number of years of exposure above one-half the current maximum contaminant level (>½-MCL NO3-N; >5 mg/L). Dietary intakes were assessed via food frequency questionnaire. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) with Cox models, and evaluated interactions with factors influencing N-nitroso compound formation. RESULTS We identified 125 incident kidney cancers among 15,577 women reporting using water from public supplies >10 years. In multivariable models, risk was higher in the 95th percentile of average NO3-N (HRp95vsQ1 = 2.3; CI: 1.2, 4.3; Ptrend = 0.33) and for any years of exposure >½-MCL; adjustment for total THM did not materially change these associations. There were no independent relationships with total THM, individual THMs chloroform and bromodichloromethane, or with haloacetic acids. Dietary analyses yielded associations with high nitrite intake from processed meats but not nitrate or nitrite overall. We found no interactions. CONCLUSIONS Relatively high nitrate levels in public water supplies were associated with increased risk of renal cancer. Our results also suggest that nitrite from processed meat is a renal cancer risk factor.
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36
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Blekkenhorst LC, Bondonno NP, Liu AH, Ward NC, Prince RL, Lewis JR, Devine A, Croft KD, Hodgson JM, Bondonno CP. Nitrate, the oral microbiome, and cardiovascular health: a systematic literature review of human and animal studies. Am J Clin Nutr 2018; 107:504-522. [PMID: 29635489 DOI: 10.1093/ajcn/nqx046] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 11/21/2017] [Indexed: 12/25/2022] Open
Abstract
Background Dietary nitrate is an important source of nitric oxide (NO), a molecule critical for cardiovascular health. Nitrate is sequentially reduced to NO through an enterosalivary nitrate-nitrite-NO pathway that involves the oral microbiome. This pathway is considered an important adjunct pathway to the classical l-arginine-NO synthase pathway. Objective The objective of this study was to systematically assess the evidence for dietary nitrate intake and improved cardiovascular health from both human and animal studies. Design A systematic literature search was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines by using key search terms in Medline and EMBASE databases and defined inclusion and exclusion criteria. Results Thirty-seven articles on humans and 14 articles on animals were included from 12,541 screened references. Data on the effects of dietary nitrate on blood pressure, endothelial function, ischemic reperfusion injury, arterial stiffness, platelet function, and cerebral blood flow in both human and animal models were identified. Beneficial effects of nitrate on vascular health have predominantly been observed in healthy human populations, whereas effects in populations at risk of cardiovascular disease are less clear. Few studies have investigated the long-term effects of dietary nitrate on cardiovascular disease clinical endpoints. In animal studies, there is evidence that nitrate improves blood pressure and endothelial function, particularly in animal models with reduced NO bioavailability. Nitrate dose seems to be a critical factor because there is evidence of cross-talk between the 2 pathways of NO production. Conclusions Evidence for a beneficial effect in humans at risk of cardiovascular disease is limited. Furthermore, there is a need to investigate the long-term effects of dietary nitrate on cardiovascular disease clinical endpoints. Further animal studies are required to elucidate the mechanisms behind the observed effects.
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Affiliation(s)
- Lauren C Blekkenhorst
- Medical School, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Nicola P Bondonno
- Medical School, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia
| | - Alex H Liu
- Medical School, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia
| | - Natalie C Ward
- Medical School, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia.,School of Biomedical Sciences and Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Richard L Prince
- Medical School, Queen Elizabeth Medical Center Unit, University of Western Australia, Nedlands, Western Australia, Australia
| | - Joshua R Lewis
- Medical School, Queen Elizabeth Medical Center Unit, University of Western Australia, Nedlands, Western Australia, Australia
| | - Amanda Devine
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Kevin D Croft
- Medical School, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia
| | - Jonathan M Hodgson
- Medical School, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Catherine P Bondonno
- Medical School, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
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MONITORING THE CONTENT OF NITRATES IN VEGETABLES AND THE INFLUENCE OF THE PICKLING TECHNOLOGY ON THE DENITRIFICATION PROCESS. EUREKA: LIFE SCIENCES 2018. [DOI: 10.21303/2504-5695.2018.00528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The aim of the work was to determine the concentration of nitrites in vegetable products (tomatoes, cucumbers, white cabbage, table beet, carrot, potatoes, onion and green onion, lettuce, spinach and parsley), realized at markets of the cities Ternopil, Kamianets-Podilskyi and Chernivtsi (Ukraine), to separate the distribution of nitrates in vegetables and also to study the influence of lactic microflora on the nitrate content at pickling tomatoes. It was established, that vegetables with the maximum exceed of maximum permissible concentration (MPC) by the nitrate content up to 1,6 times for products of closed soil are realized at markets. For open soil MPC exceed was in average 2,1 times. It was revealed, that most realized samples of tomatoes and leaf salad vegetables have the over-normative exceed of nitrates up to 35 %, and onion – the least one – 20 %. It was established, that nitrates accumulate in different parts of a fruit. In cucumbers, carrot, potato and table beet, the least quantity of nitrates accumulate in the external part of vegetables (near the surface), and the most one – in the central part. At the same time in cabbage and tomatoes, on the contrary, the least quantity – in the central part, the most one – in the area near the base of vegetables (stump). It was established, that at pickling tomatoes with the nitrate content within MPC lactic fermentation takes place with the intensive growth of titrated acidity, the decrease of the nitrate content takes place at this process. Under conditions of pickling tomatoes with the nitrate content two times more than MPC, the pickling process is a bit decelerated, but the nitrate content decreases to the safe level in a finished product. It was established, that vegetables with the nitrates quantity within 1500 mg/kg and more cannot be used in the pickling technology because of the bacteriological influence of nitrates on lactic microflora. Vegetables with such nitrate content must be obligatory condemned.
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38
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Quist AJL, Inoue-Choi M, Weyer PJ, Anderson KE, Cantor KP, Krasner S, Freeman LEB, Ward MH, Jones RR. Ingested nitrate and nitrite, disinfection by-products, and pancreatic cancer risk in postmenopausal women. Int J Cancer 2017; 142:251-261. [PMID: 28921575 DOI: 10.1002/ijc.31055] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 08/11/2017] [Accepted: 09/01/2017] [Indexed: 12/11/2022]
Abstract
Nitrate and nitrite are precursors of N-nitroso compounds (NOC), probable human carcinogens that cause pancreatic tumors in animals. Disinfection by-products (DBP) exposures have also been linked with digestive system cancers, but few studies have evaluated relationships with pancreatic cancer. We investigated the association of pancreatic cancer with these drinking water contaminants and dietary nitrate/nitrite in a cohort of postmenopausal women in Iowa (1986-2011). We used historical monitoring and treatment data to estimate levels of long-term average nitrate and total trihalomethanes (TTHM; the sum of the most prevalent DBP class) and the duration exceeding one-half the maximum contaminant level (>½ MCL; 5 mg/L nitrate-nitrogen, 40 µg/L TTHM) among participants on public water supplies (PWS) >10 years. We estimated dietary nitrate and nitrite intakes using a food frequency questionnaire. We computed hazard ratios (HR) and 95% confidence intervals (CI) using Cox regression and evaluated nitrate interactions with smoking and vitamin C intake. We identified 313 cases among 34,242 women, including 152 with >10 years PWS use (N = 15,710). Multivariable models of average nitrate showed no association with pancreatic cancer (HRp95vs. Q1 = 1.16, 95% CI: 0.51-2.64). Associations with average TTHM levels were also null (HRQ4vs. Q1 = 0.70, 95% CI:0.42-1.18). We observed no trend with increasing years of exposure to either contaminant at levels >½ MCL. Positive associations were suggested in the highest dietary nitrite intake from processed meat (HRp95vs. Q1 = 1.66, 95% CI 1.00-2.75;ptrend = 0.05). We found no interactions of nitrate with known modifiers of endogenous NOC formation. Our results suggest that nitrite intake from processed meat may be a risk factor for pancreatic cancer.
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Affiliation(s)
- Arbor J L Quist
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD.,Department of Epidemiology, Gillings School of Public Health, University of North Carolina, Chapel Hill, NC
| | - Maki Inoue-Choi
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Peter J Weyer
- Center for Health Effects of Environmental Contamination, University of Iowa, Iowa City, IA
| | - Kristin E Anderson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN.,Prevention and Etiology Research Program, Masonic Cancer Center, University of Minnesota, Minneapolis, MN
| | - Kenneth P Cantor
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | | | - Laura E Beane Freeman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Mary H Ward
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Rena R Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
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Sun L, Subar AF, Bosire C, Dawsey SM, Kahle LL, Zimmerman TP, Abnet CC, Heller R, Graubard BI, Cook MB, Petrick JL. Dietary Flavonoid Intake Reduces the Risk of Head and Neck but Not Esophageal or Gastric Cancer in US Men and Women. J Nutr 2017; 147:1729-1738. [PMID: 28724656 PMCID: PMC5572494 DOI: 10.3945/jn.117.251579] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 04/02/2017] [Accepted: 06/14/2017] [Indexed: 01/28/2023] Open
Abstract
Background: Flavonoids are bioactive polyphenolic compounds found in fruits, vegetables, and beverages of plant origin. Previous studies have shown that flavonoid intake reduces the risk of certain cancers; however, few studies to date have examined associations of flavonoids with upper gastrointestinal cancers or used prospective cohorts.Objective: Our study examined the association between intake of flavonoids (anthocyanidins, flavan-3-ols, flavanones, flavones, flavonols, and isoflavones) and risk of head and neck, esophageal, and gastric cancers.Methods: The NIH-AARP Diet and Health Study is a prospective cohort study that consists of 469,008 participants. Over a mean 12-y follow-up, 2453 head and neck (including 1078 oral cavity, 424 pharyngeal, and 817 laryngeal), 1165 esophageal (890 adenocarcinoma and 275 squamous cell carcinoma), and 1297 gastric (625 cardia and 672 noncardia) cancer cases were identified. We used Cox proportional hazards regression models to estimate HRs and CIs for the associations between flavonoid intake assessed at study baseline and cancer outcomes. For 56 hypotheses examined, P-trend values were adjusted using the Benjamini-Hochberg (BH) procedure for false discovery rate control.Results: The highest quintile of total flavonoid intake was associated with a 24% lower risk of head and neck cancer (HR: 0.76; 95% CI: 0.66, 0.86; BH-adjusted 95% CI: 0.63, 0.91; P-trend = 0.02) compared with the lowest quintile. Notably, anthocyanidins were associated with a 28% lower risk of head and neck cancer (HR: 0.72; 95% CI: 0.62, 0.82; BH-adjusted 95% CI: 0.59, 0.87; P-trend = 0.0005), and flavanones were associated with a 22% lower risk of head and neck cancer (HR: 0.78; 95% CI: 0.68, 0.89; BH-adjusted 95% CI: 0.64, 0.94; P-trend: 0.02). No associations between flavonoid intake and risk of esophageal or gastric cancers were found.Conclusions: Our results indicate that flavonoid intake is associated with lower head and neck cancer risk. These associations suggest a protective effect of dietary flavonoids on head and neck cancer risk, and thus potential as a risk reduction strategy.
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Affiliation(s)
- Lucy Sun
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA;,Divisions of Cancer Epidemiology and Genetics and
| | - Amy F Subar
- Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD
| | | | | | | | | | | | - Ruth Heller
- Divisions of Cancer Epidemiology and Genetics and,Department of Statistics and Operations Research, Tel Aviv University, Tel Aviv-Yafo, Israel
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Blekkenhorst LC, Bondonno CP, Lewis JR, Devine A, Woodman RJ, Croft KD, Lim WH, Wong G, Beilin LJ, Prince RL, Hodgson JM. Association of dietary nitrate with atherosclerotic vascular disease mortality: a prospective cohort study of older adult women. Am J Clin Nutr 2017; 106:207-216. [PMID: 28566306 DOI: 10.3945/ajcn.116.146761] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 05/03/2017] [Indexed: 11/14/2022] Open
Abstract
Background: Nitrate-rich vegetables lower blood pressure and improve endothelial function in humans. It is not known, however, whether increased consumption of nitrate-rich vegetables translates to a lower risk of atherosclerotic vascular disease (ASVD) mortality.Objective: The objective was to investigate the association of nitrate intake from vegetables with ASVD mortality.Design: A total of 1226 Australian women aged 70-85 y without prevalent ASVD and/or diabetes were recruited in 1998 and were studied for 15 y. We assessed demographic and ASVD risk factors at baseline (1998), and we used a validated food-frequency questionnaire to evaluate dietary intake. Nitrate intake from vegetables was calculated by use of a newly developed comprehensive database. The primary outcome was any death attributed to ASVD ascertained by using linked data that were provided via the Western Australian Data Linkage system. We used Cox proportional hazards modeling to examine the association between nitrate intake and ASVD mortality before and after adjustment for lifestyle and cardiovascular disease risk factors.Results: During a follow-up period of 15,947 person-years, 238 of 1226 (19.4%) women died of ASVD-related causes. The mean ± SD vegetable nitrate intake was 67.0 ± 29.2 mg/d. Each SD higher vegetable nitrate intake was associated with a lower risk of ASVD mortality in both unadjusted [HR: 0.80 (95% CI: 0.70, 0.92), P = 0.002] and multivariable-adjusted [HR: 0.79 (95% CI: 0.68, 0.93), P = 0.004] analyses. This relation was attenuated after further adjustment for diet quality [HR: 0.85 (95% CI: 0.72, 1.01), P = 0.072]. Higher vegetable nitrate intake (per SD) also was associated with a lower risk of all-cause mortality [multivariable-adjusted HR: 0.87 (95% CI: 0.78, 0.97), P = 0.011].Conclusions: Nitrate intake from vegetables was inversely associated with ASVD mortality independent of lifestyle and cardiovascular disease risk factors in this population of older adult women without prevalent ASVD or diabetes. These results support the concept that nitrate-rich vegetables may reduce the risk of age-related ASVD mortality. This trial was registered at www.anzctr.org.au as ACTRN12617000640303.
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Affiliation(s)
- Lauren C Blekkenhorst
- School of Medicine and Pharmacology, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia;
| | - Catherine P Bondonno
- School of Medicine and Pharmacology, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Joshua R Lewis
- School of Medicine and Pharmacology, Queen Elizabeth Medical Centre Unit, University of Western Australia, Nedlands, Western Australia, Australia.,Centre for Kidney Research, Children's Hospital at Westmead, Westmead, New South Wales, Australia.,School of Public Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Amanda Devine
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Richard J Woodman
- Flinders Centre for Epidemiology and Biostatistics, Flinders University, Adelaide, South Australia, Australia; and
| | - Kevin D Croft
- School of Medicine and Pharmacology, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia
| | - Wai H Lim
- Centre for Kidney Research, Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Centre for Transplant and Renal Research, Westmead Hospital, Westmead, New South Wales, Australia.,Department of Renal Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Germaine Wong
- Centre for Kidney Research, Children's Hospital at Westmead, Westmead, New South Wales, Australia.,School of Public Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Lawrence J Beilin
- School of Medicine and Pharmacology, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia
| | - Richard L Prince
- School of Medicine and Pharmacology, Queen Elizabeth Medical Centre Unit, University of Western Australia, Nedlands, Western Australia, Australia.,Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Jonathan M Hodgson
- School of Medicine and Pharmacology, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
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Bondonno CP, Blekkenhorst LC, Prince RL, Ivey KL, Lewis JR, Devine A, Woodman RJ, Lundberg JO, Croft KD, Thompson PL, Hodgson JM. Association of Vegetable Nitrate Intake With Carotid Atherosclerosis and Ischemic Cerebrovascular Disease in Older Women. Stroke 2017; 48:1724-1729. [PMID: 28596448 DOI: 10.1161/strokeaha.117.016844] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Revised: 04/18/2017] [Accepted: 05/08/2017] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND PURPOSE A short-term increase in dietary nitrate (NO3-) improves markers of vascular health via formation of nitric oxide and other bioactive nitrogen oxides. Whether this translates into long-term vascular disease risk reduction has yet to be examined. We investigated the association of vegetable-derived nitrate intake with common carotid artery intima-media thickness (CCA-IMT), plaque severity, and ischemic cerebrovascular disease events in elderly women (n=1226). METHODS Vegetable nitrate intake, lifestyle factors, and cardiovascular disease risk factors were determined at baseline (1998). CCA-IMT and plaque severity were measured using B-mode carotid ultrasound (2001). Complete ischemic cerebrovascular disease hospitalizations or deaths (events) over 14.5 years (15 032 person-years of follow-up) were obtained from the West Australian Data Linkage System. RESULTS Higher vegetable nitrate intake was associated with a lower maximum CCA-IMT (B=-0.015, P=0.002) and lower mean CCA-IMT (B=-0.012, P=0.006). This relationship remained significant after adjustment for lifestyle and cardiovascular risk factors (P≤0.01). Vegetable nitrate intake was not a predictor of plaque severity. In total 186 (15%) women experienced an ischemic cerebrovascular disease event. For every 1 SD (29 mg/d) higher intake of vegetable nitrate, there was an associated 17% lower risk of 14.5-year ischemic cerebrovascular disease events in both unadjusted and fully adjusted models (P=0.02). CONCLUSIONS Independent of other risk factors, higher vegetable nitrate was associated with a lower CCA-IMT and a lower risk of an ischemic cerebrovascular disease event.
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Affiliation(s)
- Catherine P Bondonno
- From the School of Medicine and Pharmacology, Royal Perth Hospital Unit (C.P.B., L.C.B., K.D.C., J.M.H.) and School of Medicine and Pharmacology, Sir Charles Gairdner Hospital (R.L.P.), University of Western Australia, Perth, WA; Departments of Endocrinology and Diabetes (R.L.P.) and Cardiovascular Medicine (P.L.T.), Sir Charles Gairdner Hospital, Perth, WA, Australia; Department of Nutrition and Epidemiology, Harvard T H Chan School of Public Health, Boston, MA (K.L.I.); South Australian Health and Medical Research Institute, Infection and Immunity Theme, School of Medicine, Flinders University, Adelaide, Australia (K.L.I.); School of Public Health, Sydney Medical School, The University of Sydney, NSW, Australia (J.R.L.); Centre for Kidney Research, Children's Hospital at Westmead, NSW, Australia (J.R.L.); School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia (C.P.B., A.D., J.M.H.); Discipline of General Practice, Flinders University, Adelaide, SA, Australia (R.J.W.); and Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden (J.O.L.).
| | - Lauren C Blekkenhorst
- From the School of Medicine and Pharmacology, Royal Perth Hospital Unit (C.P.B., L.C.B., K.D.C., J.M.H.) and School of Medicine and Pharmacology, Sir Charles Gairdner Hospital (R.L.P.), University of Western Australia, Perth, WA; Departments of Endocrinology and Diabetes (R.L.P.) and Cardiovascular Medicine (P.L.T.), Sir Charles Gairdner Hospital, Perth, WA, Australia; Department of Nutrition and Epidemiology, Harvard T H Chan School of Public Health, Boston, MA (K.L.I.); South Australian Health and Medical Research Institute, Infection and Immunity Theme, School of Medicine, Flinders University, Adelaide, Australia (K.L.I.); School of Public Health, Sydney Medical School, The University of Sydney, NSW, Australia (J.R.L.); Centre for Kidney Research, Children's Hospital at Westmead, NSW, Australia (J.R.L.); School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia (C.P.B., A.D., J.M.H.); Discipline of General Practice, Flinders University, Adelaide, SA, Australia (R.J.W.); and Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden (J.O.L.)
| | - Richard L Prince
- From the School of Medicine and Pharmacology, Royal Perth Hospital Unit (C.P.B., L.C.B., K.D.C., J.M.H.) and School of Medicine and Pharmacology, Sir Charles Gairdner Hospital (R.L.P.), University of Western Australia, Perth, WA; Departments of Endocrinology and Diabetes (R.L.P.) and Cardiovascular Medicine (P.L.T.), Sir Charles Gairdner Hospital, Perth, WA, Australia; Department of Nutrition and Epidemiology, Harvard T H Chan School of Public Health, Boston, MA (K.L.I.); South Australian Health and Medical Research Institute, Infection and Immunity Theme, School of Medicine, Flinders University, Adelaide, Australia (K.L.I.); School of Public Health, Sydney Medical School, The University of Sydney, NSW, Australia (J.R.L.); Centre for Kidney Research, Children's Hospital at Westmead, NSW, Australia (J.R.L.); School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia (C.P.B., A.D., J.M.H.); Discipline of General Practice, Flinders University, Adelaide, SA, Australia (R.J.W.); and Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden (J.O.L.)
| | - Kerry L Ivey
- From the School of Medicine and Pharmacology, Royal Perth Hospital Unit (C.P.B., L.C.B., K.D.C., J.M.H.) and School of Medicine and Pharmacology, Sir Charles Gairdner Hospital (R.L.P.), University of Western Australia, Perth, WA; Departments of Endocrinology and Diabetes (R.L.P.) and Cardiovascular Medicine (P.L.T.), Sir Charles Gairdner Hospital, Perth, WA, Australia; Department of Nutrition and Epidemiology, Harvard T H Chan School of Public Health, Boston, MA (K.L.I.); South Australian Health and Medical Research Institute, Infection and Immunity Theme, School of Medicine, Flinders University, Adelaide, Australia (K.L.I.); School of Public Health, Sydney Medical School, The University of Sydney, NSW, Australia (J.R.L.); Centre for Kidney Research, Children's Hospital at Westmead, NSW, Australia (J.R.L.); School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia (C.P.B., A.D., J.M.H.); Discipline of General Practice, Flinders University, Adelaide, SA, Australia (R.J.W.); and Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden (J.O.L.)
| | - Joshua R Lewis
- From the School of Medicine and Pharmacology, Royal Perth Hospital Unit (C.P.B., L.C.B., K.D.C., J.M.H.) and School of Medicine and Pharmacology, Sir Charles Gairdner Hospital (R.L.P.), University of Western Australia, Perth, WA; Departments of Endocrinology and Diabetes (R.L.P.) and Cardiovascular Medicine (P.L.T.), Sir Charles Gairdner Hospital, Perth, WA, Australia; Department of Nutrition and Epidemiology, Harvard T H Chan School of Public Health, Boston, MA (K.L.I.); South Australian Health and Medical Research Institute, Infection and Immunity Theme, School of Medicine, Flinders University, Adelaide, Australia (K.L.I.); School of Public Health, Sydney Medical School, The University of Sydney, NSW, Australia (J.R.L.); Centre for Kidney Research, Children's Hospital at Westmead, NSW, Australia (J.R.L.); School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia (C.P.B., A.D., J.M.H.); Discipline of General Practice, Flinders University, Adelaide, SA, Australia (R.J.W.); and Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden (J.O.L.)
| | - Amanda Devine
- From the School of Medicine and Pharmacology, Royal Perth Hospital Unit (C.P.B., L.C.B., K.D.C., J.M.H.) and School of Medicine and Pharmacology, Sir Charles Gairdner Hospital (R.L.P.), University of Western Australia, Perth, WA; Departments of Endocrinology and Diabetes (R.L.P.) and Cardiovascular Medicine (P.L.T.), Sir Charles Gairdner Hospital, Perth, WA, Australia; Department of Nutrition and Epidemiology, Harvard T H Chan School of Public Health, Boston, MA (K.L.I.); South Australian Health and Medical Research Institute, Infection and Immunity Theme, School of Medicine, Flinders University, Adelaide, Australia (K.L.I.); School of Public Health, Sydney Medical School, The University of Sydney, NSW, Australia (J.R.L.); Centre for Kidney Research, Children's Hospital at Westmead, NSW, Australia (J.R.L.); School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia (C.P.B., A.D., J.M.H.); Discipline of General Practice, Flinders University, Adelaide, SA, Australia (R.J.W.); and Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden (J.O.L.)
| | - Richard J Woodman
- From the School of Medicine and Pharmacology, Royal Perth Hospital Unit (C.P.B., L.C.B., K.D.C., J.M.H.) and School of Medicine and Pharmacology, Sir Charles Gairdner Hospital (R.L.P.), University of Western Australia, Perth, WA; Departments of Endocrinology and Diabetes (R.L.P.) and Cardiovascular Medicine (P.L.T.), Sir Charles Gairdner Hospital, Perth, WA, Australia; Department of Nutrition and Epidemiology, Harvard T H Chan School of Public Health, Boston, MA (K.L.I.); South Australian Health and Medical Research Institute, Infection and Immunity Theme, School of Medicine, Flinders University, Adelaide, Australia (K.L.I.); School of Public Health, Sydney Medical School, The University of Sydney, NSW, Australia (J.R.L.); Centre for Kidney Research, Children's Hospital at Westmead, NSW, Australia (J.R.L.); School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia (C.P.B., A.D., J.M.H.); Discipline of General Practice, Flinders University, Adelaide, SA, Australia (R.J.W.); and Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden (J.O.L.)
| | - Jon O Lundberg
- From the School of Medicine and Pharmacology, Royal Perth Hospital Unit (C.P.B., L.C.B., K.D.C., J.M.H.) and School of Medicine and Pharmacology, Sir Charles Gairdner Hospital (R.L.P.), University of Western Australia, Perth, WA; Departments of Endocrinology and Diabetes (R.L.P.) and Cardiovascular Medicine (P.L.T.), Sir Charles Gairdner Hospital, Perth, WA, Australia; Department of Nutrition and Epidemiology, Harvard T H Chan School of Public Health, Boston, MA (K.L.I.); South Australian Health and Medical Research Institute, Infection and Immunity Theme, School of Medicine, Flinders University, Adelaide, Australia (K.L.I.); School of Public Health, Sydney Medical School, The University of Sydney, NSW, Australia (J.R.L.); Centre for Kidney Research, Children's Hospital at Westmead, NSW, Australia (J.R.L.); School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia (C.P.B., A.D., J.M.H.); Discipline of General Practice, Flinders University, Adelaide, SA, Australia (R.J.W.); and Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden (J.O.L.)
| | - Kevin D Croft
- From the School of Medicine and Pharmacology, Royal Perth Hospital Unit (C.P.B., L.C.B., K.D.C., J.M.H.) and School of Medicine and Pharmacology, Sir Charles Gairdner Hospital (R.L.P.), University of Western Australia, Perth, WA; Departments of Endocrinology and Diabetes (R.L.P.) and Cardiovascular Medicine (P.L.T.), Sir Charles Gairdner Hospital, Perth, WA, Australia; Department of Nutrition and Epidemiology, Harvard T H Chan School of Public Health, Boston, MA (K.L.I.); South Australian Health and Medical Research Institute, Infection and Immunity Theme, School of Medicine, Flinders University, Adelaide, Australia (K.L.I.); School of Public Health, Sydney Medical School, The University of Sydney, NSW, Australia (J.R.L.); Centre for Kidney Research, Children's Hospital at Westmead, NSW, Australia (J.R.L.); School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia (C.P.B., A.D., J.M.H.); Discipline of General Practice, Flinders University, Adelaide, SA, Australia (R.J.W.); and Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden (J.O.L.)
| | - Peter L Thompson
- From the School of Medicine and Pharmacology, Royal Perth Hospital Unit (C.P.B., L.C.B., K.D.C., J.M.H.) and School of Medicine and Pharmacology, Sir Charles Gairdner Hospital (R.L.P.), University of Western Australia, Perth, WA; Departments of Endocrinology and Diabetes (R.L.P.) and Cardiovascular Medicine (P.L.T.), Sir Charles Gairdner Hospital, Perth, WA, Australia; Department of Nutrition and Epidemiology, Harvard T H Chan School of Public Health, Boston, MA (K.L.I.); South Australian Health and Medical Research Institute, Infection and Immunity Theme, School of Medicine, Flinders University, Adelaide, Australia (K.L.I.); School of Public Health, Sydney Medical School, The University of Sydney, NSW, Australia (J.R.L.); Centre for Kidney Research, Children's Hospital at Westmead, NSW, Australia (J.R.L.); School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia (C.P.B., A.D., J.M.H.); Discipline of General Practice, Flinders University, Adelaide, SA, Australia (R.J.W.); and Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden (J.O.L.)
| | - Jonathan M Hodgson
- From the School of Medicine and Pharmacology, Royal Perth Hospital Unit (C.P.B., L.C.B., K.D.C., J.M.H.) and School of Medicine and Pharmacology, Sir Charles Gairdner Hospital (R.L.P.), University of Western Australia, Perth, WA; Departments of Endocrinology and Diabetes (R.L.P.) and Cardiovascular Medicine (P.L.T.), Sir Charles Gairdner Hospital, Perth, WA, Australia; Department of Nutrition and Epidemiology, Harvard T H Chan School of Public Health, Boston, MA (K.L.I.); South Australian Health and Medical Research Institute, Infection and Immunity Theme, School of Medicine, Flinders University, Adelaide, Australia (K.L.I.); School of Public Health, Sydney Medical School, The University of Sydney, NSW, Australia (J.R.L.); Centre for Kidney Research, Children's Hospital at Westmead, NSW, Australia (J.R.L.); School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia (C.P.B., A.D., J.M.H.); Discipline of General Practice, Flinders University, Adelaide, SA, Australia (R.J.W.); and Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden (J.O.L.)
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Etemadi A, Sinha R, Ward MH, Graubard BI, Inoue-Choi M, Dawsey SM, Abnet CC. Mortality from different causes associated with meat, heme iron, nitrates, and nitrites in the NIH-AARP Diet and Health Study: population based cohort study. BMJ 2017; 357:j1957. [PMID: 28487287 PMCID: PMC5423547 DOI: 10.1136/bmj.j1957] [Citation(s) in RCA: 166] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Objective To determine the association of different types of meat intake and meat associated compounds with overall and cause specific mortality.Design Population based cohort study.Setting Baseline dietary data of the NIH-AARP Diet and Health Study (prospective cohort of the general population from six states and two metropolitan areas in the US) and 16 year follow-up data until 31 December 2011.Participants 536 969 AARP members aged 50-71 at baseline.Exposures Intake of total meat, processed and unprocessed red meat (beef, lamb, and pork) and white meat (poultry and fish), heme iron, and nitrate/nitrite from processed meat based on dietary questionnaire. Adjusted Cox proportional hazards regression models were used with the lowest fifth of calorie adjusted intakes as reference categories.Main outcome measure Mortality from any cause during follow-up.Results An increased risk of all cause mortality (hazard ratio for highest versus lowest fifth 1.26, 95% confidence interval 1.23 to 1.29) and death due to nine different causes associated with red meat intake was observed. Both processed and unprocessed red meat intakes were associated with all cause and cause specific mortality. Heme iron and processed meat nitrate/nitrite were independently associated with increased risk of all cause and cause specific mortality. Mediation models estimated that the increased mortality associated with processed red meat was influenced by nitrate intake (37.0-72.0%) and to a lesser degree by heme iron (20.9-24.1%). When the total meat intake was constant, the highest fifth of white meat intake was associated with a 25% reduction in risk of all cause mortality compared with the lowest intake level. Almost all causes of death showed an inverse association with white meat intake.Conclusions The results show increased risks of all cause mortality and death due to nine different causes associated with both processed and unprocessed red meat, accounted for, in part, by heme iron and nitrate/nitrite from processed meat. They also show reduced risks associated with substituting white meat, particularly unprocessed white meat.
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Affiliation(s)
- Arash Etemadi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20850, USA
| | - Rashmi Sinha
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20850, USA
| | - Mary H Ward
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20850, USA
| | - Barry I Graubard
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20850, USA
| | - Maki Inoue-Choi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20850, USA
| | - Sanford M Dawsey
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20850, USA
| | - Christian C Abnet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20850, USA
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Blekkenhorst LC, Prince RL, Ward NC, Croft KD, Lewis JR, Devine A, Shinde S, Woodman RJ, Hodgson JM, Bondonno CP. Development of a reference database for assessing dietary nitrate in vegetables. Mol Nutr Food Res 2017; 61. [DOI: 10.1002/mnfr.201600982] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 12/21/2016] [Accepted: 12/23/2016] [Indexed: 01/31/2023]
Affiliation(s)
- Lauren C. Blekkenhorst
- School of Medicine and Pharmacology; University of Western Australia; Royal Perth Hospital Unit Perth WA Australia
| | - Richard L. Prince
- School of Medicine and Pharmacology; University of Western Australia; QEII Medical Centre Unit Perth WA Australia
| | - Natalie C. Ward
- School of Medicine and Pharmacology; University of Western Australia; Royal Perth Hospital Unit Perth WA Australia
- School of Biomedical Sciences and Curtin Health and Innovation Research Institute; Curtin University; Perth WA Australia
| | - Kevin D. Croft
- School of Medicine and Pharmacology; University of Western Australia; Royal Perth Hospital Unit Perth WA Australia
| | - Joshua R. Lewis
- School of Medicine and Pharmacology; University of Western Australia; QEII Medical Centre Unit Perth WA Australia
- Centre for Kidney Research; Children's Hospital at Westmead; Westmead NSW Australia
- School of Public Health; Sydney Medical School; The University of Sydney; Sydney NSW Australia
| | - Amanda Devine
- School of Medical and Health Sciences; Edith Cowan University; Joondalup WA Australia
| | - Sujata Shinde
- School of Medicine and Pharmacology; University of Western Australia; Royal Perth Hospital Unit Perth WA Australia
| | - Richard J. Woodman
- Flinders Centre for Epidemiology and Biostatistics; Flinders University; Adelaide SA Australia
| | - Jonathan M. Hodgson
- School of Medicine and Pharmacology; University of Western Australia; Royal Perth Hospital Unit Perth WA Australia
- School of Medical and Health Sciences; Edith Cowan University; Joondalup WA Australia
| | - Catherine P. Bondonno
- School of Medicine and Pharmacology; University of Western Australia; Royal Perth Hospital Unit Perth WA Australia
- School of Medical and Health Sciences; Edith Cowan University; Joondalup WA Australia
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