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Sharman R, Harris Z, Ernst B, Mussallem D, Larsen A, Gowin K. Lifestyle Factors and Cancer: A Narrative Review. Mayo Clin Proc Innov Qual Outcomes 2024; 8:166-183. [PMID: 38468817 PMCID: PMC10925935 DOI: 10.1016/j.mayocpiqo.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024] Open
Abstract
Lifestyle factors and their impact on cancer prevention, prognosis, and survivorship are increasingly recognized in the medical literature. Lifestyle factors are primarily defined here as diet and physical activity. We conducted a narrative review of the primary published data, including randomized controlled trials and prospective studies, on the impact of primary lifestyle factors on oncogenesis and clinical outcomes in the preventative and survivorship setting. First, we discuss the oncogenic mechanisms behind primary lifestyle factors (diet, physical activity and, within these 2, obesity). Then, we discuss the impact of adherence to lifestyle guidelines and dietary patterns on cancer incidence based on primary data. Owing to the plethora of published literature, to summarize the data in a more efficient manner, we describe the role of physical activity on cancer incidence using summative systematic reviews. We end by synthesizing the primary data on lifestyle factors in the survivorship setting and conclude with potential future directions. In brief, the various large-scale studies investigating the role diet and physical activity have reported a beneficial effect on cancer prevention and survivorship. Although the impact of single lifestyle factors on cancer incidence risk reduction is generally supported, holistic approaches to address the potential synergistic impact of multiple lifestyle factors together in concert is limited. Future research to identify the potentially synergistic effects of lifestyle modifications on oncogenesis and clinical outcomes is needed, particularly in cancer subtypes beyond colorectal and breast cancers.
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Affiliation(s)
- Reya Sharman
- Division of Hematology Oncology, Department of Medicine, University of Arizona, Tucson, AZ
| | - Zoey Harris
- Division of Hematology and Medical Oncology, Department of Medicine, Mayo Clinic, Phoenix, AZ
| | - Brenda Ernst
- Division of Hematology and Medical Oncology, Department of Medicine, Mayo Clinic, Phoenix, AZ
| | - Dawn Mussallem
- Division of Hematology and Medical Oncology, Department of Medicine, Mayo Clinic, Jacksonville, FL
| | - Ashley Larsen
- Division of Hematology Oncology, Department of Medicine, University of Arizona, Tucson, AZ
| | - Krisstina Gowin
- Division of Hematology Oncology, Department of Medicine, University of Arizona, Tucson, AZ
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Huang R, Lai F, Zhao L, Zhang J, Chen H, Wang S, Chen C, Wang W, Mai Z, Ding Y, Kong D. Associations between dietary inflammatory index and stroke risk: based on NHANES 2005-2018. Sci Rep 2024; 14:6704. [PMID: 38509177 PMCID: PMC10954724 DOI: 10.1038/s41598-024-57267-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 03/15/2024] [Indexed: 03/22/2024] Open
Abstract
The dietary inflammatory index (DII) is a measure of the inflammatory potential of the diet and is closely associated with insulin resistance (IR) and stroke. And IR may play an important role in the development of stroke. Therefore, this study aimed to evaluate the relationship between DII and stroke risk while delving into the potential role of IR in this association. We analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018, performing weighted univariate analyses, logistic regression, and mediation analyses. At baseline, 3.89% of participants developed stroke, and we observed stroke patients exhibited higher DII scores. After adjusting for covariates, compared to participants in the first quartile of DII scores, those in the third quartile and fourth quartile had increased odds of experiencing a stroke (OR: 1.78, 95% CI: 1.18-2.68) and (OR: 1.70, 95% CI: 1.16-2.50), respectively. Moreover, a significant dose-response relationship was observed (P-trend < 0.05). However, there was no observed interaction between DII and homeostatic model assessment-IR (HOMA-IR) concerning stroke risk, and HOMA-IR did not mediate the association between DII and stroke. In summary, our study elucidated the significant association between DII and stroke risk, independent of IR. This insight suggests that an anti-inflammatory diet may serve as an effective strategy for stroke prevention.
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Affiliation(s)
- Ruixian Huang
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, 523808, China
| | - Fengxia Lai
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, 523808, China
| | - Le Zhao
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, 523808, China
| | - Jingjing Zhang
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, 523808, China
| | - Hao Chen
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, 523808, China
| | - Shuang Wang
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, 523808, China
| | - Canjin Chen
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, 523808, China
| | - Wenhao Wang
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, 523808, China
| | - Zhenhua Mai
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, 523808, China.
- Department of Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001, China.
| | - Yuanlin Ding
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, 523808, China.
| | - Danli Kong
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, 523808, China.
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Ganbaatar G, Okami Y, Kadota A, Ganbaatar N, Yano Y, Kondo K, Harada A, Okuda N, Yoshita K, Okamura T, Okayama A, Ueshima H, Miura K. Association of Pro-Inflammatory Diet with Long-Term Risk of All-Cause and Cardiovascular Disease Mortality: NIPPON DATA80. J Atheroscler Thromb 2024; 31:326-343. [PMID: 37813643 PMCID: PMC10918047 DOI: 10.5551/jat.64330] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 08/02/2023] [Indexed: 10/11/2023] Open
Abstract
AIM A pro-inflammatory diet may increase the risk of cardiovascular disease (CVD) and all-cause mortality. However, this remains inconclusive as there is yet no study using a dietary record method that has been conducted in a large general population. Furthermore, an underestimation of the pro-inflammatory diet may exist due to the unmeasured effect of salt intake. Thus, in this study, we aimed to examine how pro-inflammatory diet is associated with the long-term risk of all-cause and CVD mortality in a representative Japanese population. METHODS A national nutrition survey was conducted throughout Japan in 1980. After considering the exclusion criteria, 9284 individuals (56% women aged 30-92 years) were included in this study. In total, 20 dietary parameters derived from 3-day weighed dietary records were used to calculate the dietary inflammatory index (DII). The causes of death were monitored until 2009. The Cox proportional hazards model was used to determine multivariable-adjusted hazard ratios (HRs). Stratified analysis according to salt intake level was also performed. RESULTS Compared with the lowest quartile of DII, multivariable-adjusted HRs (95% confidence intervals) in the highest quartile were 1.28 (1.15, 1.41), 1.35 (1.14, 1.60), 1.48 (1.15, 1.92), 1.62 (1.11, 2.38), and 1.34 (1.03, 1.75) for all-cause mortality, CVD mortality, atherosclerotic CVD mortality, coronary heart disease mortality, and stroke mortality, respectively. Stratified analysis revealed stronger associations among individuals with higher salt intake. CONCLUSIONS As per our findings, a pro-inflammatory diet was determined to be positively associated with the long-term risk of all-cause and CVD mortality in a representative Japanese population. Thus, considering both salt intake and pro-inflammatory diet is deemed crucial for a comprehensive assessment of CVD risk.
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Affiliation(s)
- Gantsetseg Ganbaatar
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- NCD Epidemiology Research Center (NERC), Shiga University of Medical Science, Shiga, Japan
| | - Yukiko Okami
- NCD Epidemiology Research Center (NERC), Shiga University of Medical Science, Shiga, Japan
| | - Aya Kadota
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- NCD Epidemiology Research Center (NERC), Shiga University of Medical Science, Shiga, Japan
| | - Namuun Ganbaatar
- Department of Physical and Occupational therapy, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Yuichiro Yano
- NCD Epidemiology Research Center (NERC), Shiga University of Medical Science, Shiga, Japan
| | - Keiko Kondo
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- NCD Epidemiology Research Center (NERC), Shiga University of Medical Science, Shiga, Japan
| | - Akiko Harada
- NCD Epidemiology Research Center (NERC), Shiga University of Medical Science, Shiga, Japan
| | - Nagako Okuda
- Department of Health Science, Kyoto Prefectural University, Kyoto, Japan
| | - Katsushi Yoshita
- Department of Nutrition, Osaka Metropolitan University Graduate School of Human Life and Ecology, Osaka, Japan>
| | - Tomonori Okamura
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Akira Okayama
- Research Institute of Strategy for Prevention, Tokyo, Japan
| | - Hirotsugu Ueshima
- NCD Epidemiology Research Center (NERC), Shiga University of Medical Science, Shiga, Japan
| | - Katsuyuki Miura
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- NCD Epidemiology Research Center (NERC), Shiga University of Medical Science, Shiga, Japan
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Pannu MK, Constantinou C. Inflammation, Nutrition, and Clinical Outcomes in Breast Cancer Survivors: A Narrative Review. Curr Nutr Rep 2023; 12:643-661. [PMID: 37751147 DOI: 10.1007/s13668-023-00495-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE OF REVIEW Breast cancer (BC) is the leading cause of death among women aged 44-55 years globally. Pro-inflammatory food can cause tissue-level inflammation, thereby creating a carcinogenic microenvironment and promoting breast cancer. The aim of this review is to provide an overview of the association between inflammation and nutrition and clinical outcomes in breast cancer survivors. RECENT FINDINGS Pro-inflammatory diets are associated with a higher mortality risk after diagnosis and worse prognosis after treatment. On the other hand, anti-inflammatory diets may improve tissue-level inflammation and improve the overall prognosis and quality of life of survivors. There is strong evidence that the Mediterranean diet in particular is associated with reduced recurrence risk of breast cancer and improved quality of life of survivors. This narrative review provides evidence that there is a strong association between inflammation, dietary habits, and adverse clinical outcomes in breast cancer survivors. It further discusses the current evidence for the role of dietary management in improving clinical outcomes in breast cancer survivors.
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Affiliation(s)
- Manjinder Kaur Pannu
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, 21 Ilia Papakyriakou, 2414 Engomi, P.O. Box 24005, CY-1700, Nicosia, Cyprus
| | - Constantina Constantinou
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, 21 Ilia Papakyriakou, 2414 Engomi, P.O. Box 24005, CY-1700, Nicosia, Cyprus.
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5
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Castro-Espin C, Bonet C, Crous-Bou M, Katzke V, Le Cornet C, Jannasch F, Schulze MB, Olsen A, Tjønneland A, Dahm CC, Antoniussen CS, Sánchez MJ, Amiano P, Chirlaque MD, Guevara M, Agnoli C, Tumino R, Sacerdote C, De Magistris MS, Sund M, Bodén S, Jensen TE, Olsen KS, Skeie G, Gunter MJ, Rinaldi S, Gonzalez-Gil EM, Weiderpass E, Christakoudi S, Heath AK, Dossus L, Agudo A. Dietary patterns related to biological mechanisms and survival after breast cancer diagnosis: results from a cohort study. Br J Cancer 2023; 128:1301-1310. [PMID: 36737658 PMCID: PMC10050013 DOI: 10.1038/s41416-023-02169-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 01/10/2023] [Accepted: 01/16/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Inflammatory, insulin and oestrogenic pathways have been linked to breast cancer (BC). We aimed to examine the relationship between pre-diagnostic dietary patterns related to these mechanisms and BC survival. METHODS The diabetes risk reduction diet (DRRD), inflammatory score of diet (ISD) and oestrogen-related dietary pattern (ERDP) were calculated using dietary data from the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Cox proportional hazards models were used to assess associations between dietary patterns and overall mortality and competing risk models for associations with BC-specific mortality. RESULTS We included 13,270 BC cases with a mean follow-up after diagnosis of 8.6 years, representing 2340 total deaths, including 1475 BC deaths. Higher adherence to the DRRD score was associated with lower overall mortality (HR1-SD 0.92; 95%CI 0.87-0.96). Greater adherence to pro-inflammatory diets was borderline associated with 6% higher mortality HR1-SD 1.06; 95%CI 1.00-1.12. No significant association with the oestrogen-related dietary pattern was observed. None of the dietary patterns were associated with BC-specific mortality. CONCLUSIONS Greater adherence to an anti-diabetic and anti-inflammatory diet prior to diagnosis is associated with lower overall mortality among BC survivors. Long-term adherence to these dietary patterns could be a means to improve the prognosis of BC survivors.
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Affiliation(s)
- Carlota Castro-Espin
- Unit of Nutrition and Cancer, Catalan Institute of Oncology-ICO, L'Hospitalet de Llobregat, Barcelona, Spain.
- Nutrition and Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Catalina Bonet
- Unit of Nutrition and Cancer, Catalan Institute of Oncology-ICO, L'Hospitalet de Llobregat, Barcelona, Spain
- Nutrition and Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Marta Crous-Bou
- Unit of Nutrition and Cancer, Catalan Institute of Oncology-ICO, L'Hospitalet de Llobregat, Barcelona, Spain
- Nutrition and Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Verena Katzke
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Charlotte Le Cornet
- German Institute of Human Nutrition Potsdam-Rehbruecke, Dept. of Molecular Epidemiology, Arthur-Scheunert-Allee, Nuthetal, Germany
| | - Franziska Jannasch
- German Institute of Human Nutrition Potsdam-Rehbruecke, Dept. of Molecular Epidemiology, Arthur-Scheunert-Allee, Nuthetal, Germany
| | - Matthias B Schulze
- German Institute of Human Nutrition Potsdam-Rehbruecke, Dept. of Molecular Epidemiology, Arthur-Scheunert-Allee, Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany
| | - Anja Olsen
- Danish Cancer Society Research Center, Diet, Cancer and Health, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Diet, Cancer and Health, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | | | - Maria Jose Sánchez
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - Pilar Amiano
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Ministry of Health of the Basque Government, Sub Directorate for Public Health and Addictions of Gipuzkoa, San Sebastian, Spain
- Biodonostia Health Research Institute, Epidemiology of Chronic and Communicable Diseases Group, San Sebastián, Spain
| | - María Dolores Chirlaque
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia University, Murcia, Spain
| | - Marcela Guevara
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Navarra Public Health Institute, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Claudia Agnoli
- Epidemiology and Prevention Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Rosario Tumino
- Hyblean Association for Epidemiological Research, AIRE ONLUS Ragusa, Ragusa, Italy
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital, Turin, Italy
| | | | - Malin Sund
- Department of Surgical and Perioperative Sciences/ Surgery, Umeå University, Umeå, Sweden
- Department of Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Stina Bodén
- Department of Clinical Sciences - Pediatrics, Umeå University, Umeå, Sweden
| | - Torill Enget Jensen
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Karina Standahl Olsen
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Guri Skeie
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Marc J Gunter
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Sabina Rinaldi
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Esther M Gonzalez-Gil
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Elisabete Weiderpass
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Sofia Christakoudi
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Inflammation Biology, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Alicia K Heath
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Laure Dossus
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Antonio Agudo
- Unit of Nutrition and Cancer, Catalan Institute of Oncology-ICO, L'Hospitalet de Llobregat, Barcelona, Spain
- Nutrition and Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
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6
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Becerra‐Tomás N, Balducci K, Abar L, Aune D, Cariolou M, Greenwood DC, Markozannes G, Nanu N, Vieira R, Giovannucci EL, Gunter MJ, Jackson AA, Kampman E, Lund V, Allen K, Brockton NT, Croker H, Katsikioti D, McGinley‐Gieser D, Mitrou P, Wiseman M, Cross AJ, Riboli E, Clinton SK, McTiernan A, Norat T, Tsilidis KK, Chan DSM. Postdiagnosis dietary factors, supplement use and breast cancer prognosis: Global Cancer Update Programme (CUP Global) systematic literature review and meta-analysis. Int J Cancer 2023; 152:616-634. [PMID: 36279902 PMCID: PMC10092903 DOI: 10.1002/ijc.34321] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 09/20/2022] [Accepted: 09/23/2022] [Indexed: 02/01/2023]
Abstract
Little is known about how diet might influence breast cancer prognosis. The current systematic reviews and meta-analyses summarise the evidence on postdiagnosis dietary factors and breast cancer outcomes from randomised controlled trials and longitudinal observational studies. PubMed and Embase were searched through 31st October 2021. Random-effects linear dose-response meta-analysis was conducted when at least three studies with sufficient information were available. The quality of the evidence was evaluated by an independent Expert Panel. We identified 108 publications. No meta-analysis was conducted for dietary patterns, vegetables, wholegrains, fish, meat, and supplements due to few studies, often with insufficient data. Meta-analysis was only possible for all-cause mortality with dairy, isoflavone, carbohydrate, dietary fibre, alcohol intake and serum 25-hydroxyvitamin D (25(OH)D), and for breast cancer-specific mortality with fruit, dairy, carbohydrate, protein, dietary fat, fibre, alcohol intake and serum 25(OH)D. The results, with few exceptions, were generally null. There was limited-suggestive evidence that predefined dietary patterns may reduce the risk of all-cause and other causes of death; that isoflavone intake reduces the risk of all-cause mortality (relative risk (RR) per 2 mg/day: 0.96, 95% confidence interval (CI): 0.92-1.02), breast cancer-specific mortality (RR for high vs low: 0.83, 95% CI: 0.64-1.07), and recurrence (RR for high vs low: 0.75, 95% CI: 0.61-0.92); that dietary fibre intake decreases all-cause mortality (RR per 10 g/day: 0.87, 95% CI: 0.80-0.94); and that serum 25(OH)D is inversely associated with all-cause and breast cancer-specific mortality (RR per 10 nmol/L: 0.93, 95% CI: 0.89-0.97 and 0.94, 95% CI: 0.90-0.99, respectively). The remaining associations were graded as limited-no conclusion.
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Affiliation(s)
- Nerea Becerra‐Tomás
- Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonLondonUK
| | - Katia Balducci
- Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonLondonUK
| | - Leila Abar
- Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonLondonUK
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonLondonUK
- Department of NutritionBjørknes University CollegeOsloNorway
- Department of EndocrinologyMorbid Obesity and Preventive Medicine, Oslo University HospitalOsloNorway
- Unit of Cardiovascular and Nutritional EpidemiologyInstitute of Environmental Medicine, Karolinska InstitutetStockholmSweden
| | - Margarita Cariolou
- Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonLondonUK
| | - Darren C. Greenwood
- Leeds Institute for Data Analytics, Faculty of Medicine and HealthUniversity of LeedsLeedsUK
| | - Georgios Markozannes
- Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonLondonUK
- Department of Hygiene and EpidemiologyUniversity of Ioannina Medical SchoolIoanninaGreece
| | - Neesha Nanu
- Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonLondonUK
| | - Rita Vieira
- Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonLondonUK
| | - Edward L. Giovannucci
- Department of EpidemiologyHarvard T.H. Chan School of Public HealthBostonMassachusettsUSA
- Department of NutritionHarvard T.H. Chan School of Public HealthBostonMassachusettsUSA
| | - Marc J. Gunter
- Nutrition and Metabolism SectionInternational Agency for Research on CancerLyonFrance
| | - Alan A. Jackson
- Faculty of Medicine, School of Human Development and HealthUniversity of SouthamptonSouthamptonUK
- National Institute of Health Research Cancer and Nutrition CollaborationSouthamptonUK
| | - Ellen Kampman
- Division of Human Nutrition and HealthWageningen University & ResearchWageningenThe Netherlands
| | - Vivien Lund
- World Cancer Research Fund InternationalLondonUK
| | - Kate Allen
- World Cancer Research Fund InternationalLondonUK
| | | | - Helen Croker
- World Cancer Research Fund InternationalLondonUK
| | | | | | | | | | - Amanda J. Cross
- Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonLondonUK
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonLondonUK
| | - Steven K. Clinton
- Division of Medical Oncology, The Department of Internal MedicineCollege of Medicine and Ohio State University Comprehensive Cancer Center, Ohio State UniversityColumbusOhioUSA
| | - Anne McTiernan
- Division of Public Health SciencesFred Hutchinson Cancer Research CenterSeattleWashingtonUSA
| | - Teresa Norat
- Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonLondonUK
- World Cancer Research Fund InternationalLondonUK
| | - Konstantinos K. Tsilidis
- Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonLondonUK
- Department of Hygiene and EpidemiologyUniversity of Ioannina Medical SchoolIoanninaGreece
| | - Doris S. M. Chan
- Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonLondonUK
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7
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Zheng J, Tabung FK, Zhang J, Caan B, Hebert JR, Kroenke CH, Ockene J, Shivappa N, Steck SE. Association between dietary inflammatory potential and mortality after cancer diagnosis in the Women's Health Initiative. Br J Cancer 2023; 128:606-617. [PMID: 36482189 PMCID: PMC9938285 DOI: 10.1038/s41416-022-02079-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Chronic inflammation is implicated in cancer prognosis and can be modulated by diet. We examined associations between post-diagnosis dietary inflammatory potential and mortality outcomes among post-menopausal women diagnosed with cancer in the Women's Health Initiative (WHI). METHODS Energy-adjusted dietary inflammatory index scores (E-DII) were calculated from dietary and supplemental intake data collected on the first food frequency questionnaire following the diagnosis of primary invasive cancer for 3434 women in the WHI. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CIs) for risk of death from any cause, cancer, cardiovascular disease (CVD) and other causes by post-diagnosis quartiles of E-DII. Subgroup analyses by cancer stage and grade were performed. RESULTS There were 1156 deaths after a median 13 years of follow-up from the date of a cancer diagnosis. In the multivariable-adjusted analyses, a more anti-inflammatory diet plus supplements after cancer diagnosis was associated with lower all-cause mortality, cancer mortality, CVD mortality and mortality from other causes with HRsQ1vs.Q4 ranging from 0.47 to 0.68 (all P-trends < 0.05). Associations were stronger for cancers diagnosed at more distant stages or moderately differentiated grades. CONCLUSION A more anti-inflammatory diet plus supplements after a cancer diagnosis may improve survival for post-menopausal cancer survivors.
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Affiliation(s)
- Jiali Zheng
- Department of Epidemiology and Biostatistics, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Fred K Tabung
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine and Comprehensive Cancer Center, Columbus, OH, USA
| | - Jiajia Zhang
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Bette Caan
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - James R Hebert
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Connecting Health Innovations, LLC, Columbia, SC, USA
| | - Candyce H Kroenke
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Judith Ockene
- Division of Preventive and Behavioral Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Nitin Shivappa
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Connecting Health Innovations, LLC, Columbia, SC, USA
| | - Susan E Steck
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
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Ji J, Sun CL, Cohen HJ, Synold T, Muss H, Sedrak MS. Inflammation and Clinical Decline After Adjuvant Chemotherapy in Older Adults With Breast Cancer: Results From the Hurria Older Patients Prospective Study. J Clin Oncol 2023; 41:307-315. [PMID: 36126235 PMCID: PMC9839275 DOI: 10.1200/jco.22.01217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/18/2022] [Accepted: 08/08/2022] [Indexed: 01/19/2023] Open
Abstract
PURPOSE Older breast cancer survivors are at increased risk of clinical decline after adjuvant chemotherapy. This study aimed to evaluate whether inflammatory markers assessed before adjuvant chemotherapy are associated with chemotherapy-induced clinical decline in a population of fit older adults with breast cancer. METHODS In a prospective study of women age ≥ 65 years with stage I-III breast cancer treated with chemotherapy, we measured interleukin-6 (IL-6) and C-reactive protein (CRP) prechemotherapy (T1). We assessed frailty status, using a Deficit Accumulation Index (DAI; categorized as robust, prefrail, and frail), at T1 and postchemotherapy (T2). The population of interest was robust women at T1. The primary outcome was chemotherapy-induced decline in frailty status, defined as decline in DAI from robust (T1) to prefrail or frail (T2). Multivariable logistic regression was used to examine the association between inflammatory markers and the primary outcome, adjusted for sociodemographic and clinical characteristics. RESULTS Of the 295 robust women at T1, 76 (26%) experienced chemotherapy-induced decline in frailty status, among whom 66% had high IL-6, 63% had high CRP, and 46% had high IL-6 and CRP at T1. After adjusting for sociodemographic and clinical characteristics, women with high IL-6 and CRP had a > three-fold (odds ratio, 3.52; 95% CI, 1.55 to 8.01; P = .003) odds of chemotherapy-induced decline in frailty status compared with women with low IL-6 and CRP. CONCLUSION In this cohort of older women with early breast cancer who were clinically fit before chemotherapy initiation, high IL-6 and CRP prechemotherapy were associated with chemotherapy-induced decline in frailty status independent of sociodemographic and clinical risk factors. Further research is needed to examine whether inflammatory markers can inform more personalized approaches to treating older breast cancer survivors.
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Affiliation(s)
- Jingran Ji
- City of Hope National Medical Center, Duarte, CA
| | - Can-Lan Sun
- City of Hope National Medical Center, Duarte, CA
| | | | | | - Hyman Muss
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC
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9
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Zhang Y, Wu Y, Zhang Y, Cao D, He H, Cao X, Wang Y, Jia Z, Jiang J. Dietary inflammatory index, and depression and mortality risk associations in U.S. adults, with a special focus on cancer survivors. Front Nutr 2022; 9:1034323. [PMID: 36590206 PMCID: PMC9795013 DOI: 10.3389/fnut.2022.1034323] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction A higher risk for depression and mortality is associated with the inflammatory potential of diet measured through the Dietary Inflammatory Index (DII). The roles of DII in the risk of depression and death in cancer survivors were unclear. We aimed to examine the association between energy-adjusted DII (E-DII) score and risk of depression, and mortality using data from the 2007-2018 National Health and Nutrition Examination Survey (NHANES), with a special focus on cancer survivors. Methods The 24-h dietary recall interview was used as a basis to calculate the E-DII score and the Patient Health Questionnaire-9 (PHQ-9) was used to measure the depressive outcomes. Logistic regression analyses were performed to determine the association between quartiles of E-DII score and depression. Cox proportional hazard regression and competing risk analyses were used to estimate the risks of quartiles of E-DII score or depression on mortality. Results A total of 27,447 participants were included; including 24,694 subjects without cancer and 2,753 cancer survivors. The E-DII score and depression were not distributed differently between the two groups. However, the E-DII scores were positively associated with within each group's depression (all P trend < 0.001) and participants with higher E-DII scores had a higher risk of depression (subjects without cancer: ORQ4 vs Q1: 2.17, 95% CI: 1.75-2.70; cancer survivors: ORQ4 vsQ1: 1.78, 95% CI: 1.09-2.92). The median follow-up time were 87 person-months, a total of 1,701 (4.8%) and 570 (15.2%) all-cause deaths in subjects without cancer and cancer survivors were identified by the end of 2019. The highest E-DII scores quartile was associated with the highest risk of all-cause (HRQ4 vsQ1: 1.90, 95% CI: 1.54-2.35) and cardiovascular disease (CVD) cause death (HRQ4 vsQ1: 2.50, 95% CI: 1.69-2.3.7) in the subjects without cancer. Moreover, participants with depressive symptoms had higher all-cause mortality (HR: 1.29, 95% CI: 1.04-1.59). No significant correlation was found for E-DII scores or depression with all-cause, cancer-cause or CVD-cause mortality in cancer survivors. Conclusion Our findings demonstrate that E-DII score was positively associated with depression risk. A higher E-DII score or depressive symptom may increase the risks of all-cause and CVD-cause mortality only among general subjects.
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Affiliation(s)
- Yuzheng Zhang
- Division of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China,Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Yanhua Wu
- Division of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China
| | - Yangyu Zhang
- Division of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China,Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Donghui Cao
- Division of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China
| | - Hua He
- Division of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China
| | - Xueyuan Cao
- Department of Gastric and Colorectal Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, China
| | - Yuehui Wang
- Department of Geriatrics, The First Hospital of Jilin University, Changchun, China
| | - Zhifang Jia
- Division of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China,Zhifang Jia,
| | - Jing Jiang
- Division of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China,Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China,*Correspondence: Jing Jiang,
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10
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Dietary inflammatory index and breast cancer risk: an updated meta-analysis of observational studies. Eur J Clin Nutr 2022; 76:1073-1087. [PMID: 34728816 DOI: 10.1038/s41430-021-01039-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 10/12/2021] [Accepted: 10/15/2021] [Indexed: 12/15/2022]
Abstract
This updated meta-analysis sought to determine whether the pro-inflammatory potential of diet is a risk factor for breast cancer (BrCa) development, for the first time focusing on the effects of design heterogeneity. The search was performed using Scopus, PubMed, and Embase databases. Data were extracted from twenty-one eligible studies, including eleven cohorts (336,085 participants/20,033 incidence cases), and ten case-control studies (9,833 cases/12,752controls). The random-effect was used to calculate the relative risk (RR) using STATA 16 software. The highest dietary inflammatory index (DII) vs. the lowest category showed 16% increased risk of BrCa (95% CI: 1.06-1.26; I2 = 62.8%, P (I2) < 0.001). This was notable in post-menopausal status (RR = 1.13, 95% CI: 1.04-1.22), women with body mass index (BMI) ≥ 30 kg/m2 (RR = 1.35, 95% CI: 1.07-1.63), and study populations from developing countries (RR = 1.79, 95% CI: 1.12-2.47). Methodological covariates were subject to subgroup meta-analyses and showed stronger results among case-control studies (RR = 1.50, 95% CI: 1.20-1.80), studies considered age-matched controls (RR = 1.56, 95% CI: 1.19-1.93) and hospital-based controls (RR = 2.11, 95% CI: 1.58-2.64), and cohort studies identified by prolong follow-up durations (RR = 1.13, 95% CI: 1.03-1.22). This updated meta-analysis highlighted the pro-inflammatory diet as a risk factor for BrCa, especially among women in post-menopausal status, obese groups, and developing countries. Meta-analysis in methodological subgroups could improve results, less affected by heterogeneity, and suggested subclassification with important implications for future epidemiological designs and even clinical management.
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11
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Zhang J, Feng Y, Yang X, Li Y, Wu Y, Yuan L, Li T, Hu H, Li X, Huang H, Wang M, Huo W, Gao Y, Ke Y, Wang L, Zhang W, Chen Y, Fu X, Hu F, Zhang M, Sun L, Zhang Z, Hu D, Zhao Y. Dose-Response Association of Dietary Inflammatory Potential with All-Cause and Cause-Specific Mortality. Adv Nutr 2022; 13:1834-1845. [PMID: 35524691 PMCID: PMC9526847 DOI: 10.1093/advances/nmac049] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 03/09/2022] [Accepted: 05/03/2022] [Indexed: 01/28/2023] Open
Abstract
Although the association of dietary inflammatory potential, evaluated by the dietary inflammatory index (DII), with all-cause and cause-specific mortality has been reported, evidence remains equivocal, with no relevant dose-response meta-analysis having been conducted. To examine the dose-response association of dietary inflammatory potential with risk of all-cause, cancer, and cardiovascular disease (CVD) mortality, PubMed, Embase, and Web of Science were systematically searched up to August 9, 2021. Cohort studies were included if DII was reported as ≥3 levels or per incremental increase, and if the associations of DII with all-cause, cancer, and CVD mortality were assessed. Generalized least squares regression was used to estimate study-specific dose-response associations, and the random effect model was used to pool the RRs and 95% CIs of all-cause, cancer, and CVD mortality per 1-unit increase in DII. Restricted cubic splines were used to intuitively display the dose-response association between dietary inflammatory potential and mortality. Of the 1415 studies retrieved, 15 articles (17 cohort studies involving 397,641 participants) were included in this meta-analysis. With per 1-unit increase in DII, the risks were significantly increased for all-cause mortality (RR: 1.04; 95% CI: 1.03, 1.05, I2 = 51.8%; P-heterogeneity = 0.009), cancer mortality (RR: 1.02; 95% CI: 1.00, 1.04, I2 = 58.6%; P-heterogeneity = 0.013), and CVD mortality (RR: 1.04; 95% CI: 1.02, 1.06, I2 = 85.7%; P-heterogeneity <0.001), respectively. Restricted cubic splines showed significant positive linear associations between DII and the above 3 outcomes. Our study indicated that proinflammatory diets can increase the risk of all-cause, cancer, and CVD mortality in a linear manner.
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Affiliation(s)
- Jinli Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yifei Feng
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Xingjin Yang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yang Li
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Yuying Wu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Lijun Yuan
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Tianze Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Huifang Hu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Xi Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Hao Huang
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Mengmeng Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Weifeng Huo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yajuan Gao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yamin Ke
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Longkang Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Wenkai Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yaobing Chen
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Xueru Fu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Fulan Hu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Ming Zhang
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Liang Sun
- Department of Social Medicine and Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Zhenzhong Zhang
- School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Dongsheng Hu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yang Zhao
- Address correspondence to YZ (E-mail: )
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12
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Hayati Z, Montazeri V, Shivappa N, Hebert JR, Pirouzpanah S. The association between the inflammatory potential of diet and the risk of histopathological and molecular subtypes of breast cancer in northwestern Iran: Results from the Breast Cancer Risk and Lifestyle study. Cancer 2022; 128:2298-2312. [PMID: 35389510 DOI: 10.1002/cncr.34183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/31/2021] [Accepted: 02/18/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND This study explored the association between diet-associated inflammation and the risk of different molecular subtypes of breast cancer (BrCA) in a large, population-based case-control study conducted in northwestern Iran. METHODS The study consisted of 1007 women with histopathologically confirmed BrCA and 1004 controls admitted to hospitals in Tabriz, northwestern Iran, for nonneoplastic conditions. Dietary Inflammatory Index scores and energy-adjusted Dietary Inflammatory Index (E-DII) scores, with and without supplements, were computed on the basis of dietary intake collected using a validated 136-item food frequency questionnaire. RESULTS Women with the highest E-DII scores (quartile 4) versus those with the lowest E-DII scores (quartile 1) showed a significantly increased BrCA risk (odds ratio for quartile 4 vs quartile 1 [ORQ4vsQ1 ], 1.87; 95% confidence interval [CI], 1.42-2.47), particularly for lobular carcinoma (ORQ4vsQ1 , 3.07; 95% CI, 1.34-7.02). Findings were similar for premenopausal women diagnosed with luminal A BrCA (ORQ4vsQ1 , 2.71; 95% CI, 1.74-4.22) or luminal B BrCA (ORQ4vsQ1 , 2.86; 95% CI, 1.39-5.89). Women consuming the most proinflammatory diets were 3 times more likely to have triple-negative BrCA (ORQ4vsQ1 , 3.00; 95% CI, 1.002-8.96) while compared to luminal A BrCA. The BrCA risk for women consuming diets in the highest half of E-DII scores (E-DII > 0) was 59% greater than the risk for those in the lowest half (95% CI, 1.29-1.97). Also, higher E-DII scores that took into account supplements were associated with larger tumor sizes (T3 > 5 cm; P < .05). CONCLUSIONS A proinflammatory diet, as indicated by higher E-DII scores, appears to increase the risk of BrCA in Iranian women. Large increases in risk were seen in invasive molecular subtypes of BrCA. Anti-inflammatory diets are suggested to prevent the risk of overall BrCA and more aggressive forms of BrCA in particular.
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Affiliation(s)
- Zahra Hayati
- Molecular Medicine Research Center, Biomedicine Institute, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Biochemistry and Dietetics, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.,Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahid Montazeri
- Department of Thoracic Surgery, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.,Department of Nutrition, Connecting Health Innovations LLC, Columbia, South Carolina
| | - James R Hebert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.,Department of Nutrition, Connecting Health Innovations LLC, Columbia, South Carolina
| | - Saeed Pirouzpanah
- Molecular Medicine Research Center, Biomedicine Institute, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Biochemistry and Dietetics, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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13
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Cava E, Marzullo P, Farinelli D, Gennari A, Saggia C, Riso S, Prodam F. Breast Cancer Diet "BCD": A Review of Healthy Dietary Patterns to Prevent Breast Cancer Recurrence and Reduce Mortality. Nutrients 2022; 14:nu14030476. [PMID: 35276833 PMCID: PMC8839871 DOI: 10.3390/nu14030476] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/12/2022] [Accepted: 01/15/2022] [Indexed: 01/27/2023] Open
Abstract
Breast cancer (BC) represents the most common cancer in women, while overweight and obesity are the second preventable cause of cancer. Weight gain and fat accumulation are common after BC diagnosis; moreover, weight gain during the treatment decreases the survival rate and increases the risk of recurrence in breast cancer survivors (BCS). To reduce the risk of second primary cancer or BC recurrence, and all-cause mortality in BCS, multiple interventions have been investigated to obtain reduction in weight, BMI and/or waist circumference. The aim of this narrative review is to analyze evidence on BCS for their risk of recurrence or mortality related to increased weight or fat deposition, and the effects of interventions with healthy dietary patterns to achieve a proper weight and to reduce fat-related risk. The primary focus was on dietary patterns instead of single nutrients and supplements, as the purpose was to investigate on secondary prevention in women free from disease at the end of their cancer treatment. In addition, BC relation with insulin resistance, dietary carbohydrate, and glycemic index/glycemic load is discussed. In conclusion, obesity and overweight, low rates of physical activity, and hormone receptor-status are associated with poorer BC-treatment outcomes. To date, there is a lack of evidence to suggest which dietary pattern is the best approach for weight management in BCS. In the future, multimodal lifestyle interventions with dietary, physical activity and psychological support after BC diagnosis should be studied with the aim of reducing the risk of BC recurrence or mortality.
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Affiliation(s)
- Edda Cava
- Unit of Dietetic and Clinical Nutrition, University Hospital “Maggiore della Carità”, Corso Mazzini 18, 28100 Novara, Italy; (D.F.); (S.R.)
- Correspondence: ; Tel.: +39-0321-373-3275 (ext. 2108)
| | - Paolo Marzullo
- SCDU Endocrinology, Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli 17, 28100 Novara, Italy; (P.M.); (F.P.)
- Laboratory of Metabolic Research, IRCCS Istituto Auxologico Italiano, 28824 Piancavallo, Italy
| | - Deborah Farinelli
- Unit of Dietetic and Clinical Nutrition, University Hospital “Maggiore della Carità”, Corso Mazzini 18, 28100 Novara, Italy; (D.F.); (S.R.)
| | - Alessandra Gennari
- Division of Oncology, University Hospital “Maggiore della Carità”, Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli 17, 28100 Novara, Italy; (A.G.); (C.S.)
| | - Chiara Saggia
- Division of Oncology, University Hospital “Maggiore della Carità”, Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli 17, 28100 Novara, Italy; (A.G.); (C.S.)
| | - Sergio Riso
- Unit of Dietetic and Clinical Nutrition, University Hospital “Maggiore della Carità”, Corso Mazzini 18, 28100 Novara, Italy; (D.F.); (S.R.)
| | - Flavia Prodam
- SCDU Endocrinology, Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli 17, 28100 Novara, Italy; (P.M.); (F.P.)
- Department of Health Sciences, SCDU Endocrinology, Department of Translational Medicine, University of Piemonte Orientale, Via Solaroli 17, 28100 Novara, Italy
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14
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Castro-Espin C, Agudo A. The Role of Diet in Prognosis among Cancer Survivors: A Systematic Review and Meta-Analysis of Dietary Patterns and Diet Interventions. Nutrients 2022; 14:nu14020348. [PMID: 35057525 PMCID: PMC8779048 DOI: 10.3390/nu14020348] [Citation(s) in RCA: 57] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/11/2022] [Accepted: 01/11/2022] [Indexed: 02/06/2023] Open
Abstract
Cancer survival continues to improve in high-income countries, partly explained by advances in screening and treatment. Previous studies have mainly examined the relationship between individual dietary components and cancer prognosis in tumours with good therapeutic response (breast, colon and prostate cancers). The aim of this review is to assess qualitatively (and quantitatively where appropriate) the associations of dietary patterns and cancer prognosis from published prospective cohort studies, as well as the effect of diet interventions by means of randomised controlled trials (RCT). A systematic search was conducted in PubMed, and a total of 35 prospective cohort studies and 14 RCT published between 2011 and 2021 were selected. Better overall diet quality was associated with improved survival among breast and colorectal cancer survivors; adherence to the Mediterranean diet was associated to lower risk of mortality in colorectal and prostate cancer survivors. A meta-analysis using a random-effects model showed that higher versus lower diet quality was associated with a 23% reduction in overall mortality in breast cancer survivors. There was evidence that dietary interventions, generally combined with physical activity, improved overall quality of life, though most studies were in breast cancer survivors. Further cohort and intervention studies in other cancers are needed to make more specific recommendations.
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Affiliation(s)
- Carlota Castro-Espin
- Unit of Nutrition and Cancer, Catalan Institute of Oncology—ICO, L’Hospitalet de Llobregat, 08908 Barcelona, Spain;
- Nutrition and Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Bellvitge Biomedical Research Institute—IDIBELL, L’Hospitalet de Llobregat, 08908 Barcelona, Spain
| | - Antonio Agudo
- Unit of Nutrition and Cancer, Catalan Institute of Oncology—ICO, L’Hospitalet de Llobregat, 08908 Barcelona, Spain;
- Nutrition and Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Bellvitge Biomedical Research Institute—IDIBELL, L’Hospitalet de Llobregat, 08908 Barcelona, Spain
- Correspondence: ; Tel.: +34-93-2607401
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15
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Omofuma OO, Peterson LL, Turner DP, Merchant AT, Zhang J, Thomson CA, Neuhouser ML, Snetselaar LG, Caan BJ, Shadyab AH, Saquib N, Banack HR, Uribarri J, Steck SE. Dietary Advanced Glycation End-Products and Mortality after Breast Cancer in the Women's Health Initiative. Cancer Epidemiol Biomarkers Prev 2021; 30:2217-2226. [PMID: 34583965 PMCID: PMC8643311 DOI: 10.1158/1055-9965.epi-21-0610] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 08/24/2021] [Accepted: 09/22/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Advanced glycation end-products (AGE) are formed through nonenzymatic glycation of free amino groups in proteins or lipid. They are associated with inflammation and oxidative stress, and their accumulation in the body is implicated in chronic disease morbidity and mortality. We examined the association between postdiagnosis dietary Nε-carboxymethyl-lysine (CML)-AGE intake and mortality among women diagnosed with breast cancer. METHODS Postmenopausal women aged 50 to 79 years were enrolled in the Women's Health Initiative (WHI) between 1993 and 1998 and followed up until death or censoring through March 2018. We included 2,023 women diagnosed with first primary invasive breast cancer during follow-up who completed a food frequency questionnaire (FFQ) after diagnosis. Cox proportional hazards (PH) regression models estimated adjusted hazard ratios (HR) and 95% confidence intervals (CI) of association between tertiles of postdiagnosis CML-AGE intake and mortality risk from all causes, breast cancer, and cardiovascular disease. RESULTS After a median 15.1 years of follow-up, 630 deaths from all causes were reported (193 were breast cancer-related, and 129 were cardiovascular disease-related). Postdiagnosis CML-AGE intake was associated with all-cause (HRT3vsT1, 1.37; 95% CI, 1.09-1.74), breast cancer (HRT3vsT1, 1.49; 95% CI, 0.98-2.24), and cardiovascular disease (HRT3vsT1, 1.91; 95% CI, 1.09-3.32) mortality. CONCLUSIONS Higher intake of AGEs was associated with higher risk of major causes of mortality among postmenopausal women diagnosed with breast cancer. IMPACT Our findings suggest that dietary AGEs may contribute to the risk of mortality after breast cancer diagnosis. Further prospective studies examining dietary AGEs in breast cancer outcomes and intervention studies targeting dietary AGE reduction are needed to confirm our findings.
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Affiliation(s)
- Omonefe O Omofuma
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Lindsay L Peterson
- Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - David P Turner
- Medical University of South Carolina, Charleston, South Carolina
| | - Anwar T Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Jiajia Zhang
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Cynthia A Thomson
- Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | | | | | - Bette J Caan
- Kaiser Permanente, University of California Berkeley, Oakland, California
| | - Aladdin H Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California
| | - Nazmus Saquib
- College of Medicine, Sulaiman AlRajhi University, Saudi Arabia
| | - Hailey R Banack
- School of Public Health and Health Professions, University at Buffalo-SUNY, Buffalo, New York
| | - Jaime Uribarri
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York
| | - Susan E Steck
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.
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16
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Fu JB. The Past, Present, and Future of American Cancer Rehabilitation. Phys Ther Res 2021; 24:187-194. [PMID: 35036251 PMCID: PMC8752820 DOI: 10.1298/ptr.r0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 08/10/2021] [Indexed: 11/23/2022]
Abstract
Cancer rehabilitation in the United States has gone from a small obscure rehabilitation subspecialty to an area of intense interest. American cancer rehab's recent growth can be attributed to the ever increasing number of cancer survivors. The future of cancer rehabilitation may be accelerated by the concept of exercise as cancer medicine.
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Affiliation(s)
- Jack B Fu
- University of Texas MD Anderson Cancer Center, USA
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17
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Overweight and prognosis in triple-negative breast cancer patients: a systematic review and meta-analysis. NPJ Breast Cancer 2021; 7:119. [PMID: 34508075 PMCID: PMC8433348 DOI: 10.1038/s41523-021-00325-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 08/12/2021] [Indexed: 12/31/2022] Open
Abstract
We conducted a systematic review and meta-analysis investigating the association between overweight and outcome in triple-negative breast cancer (TNBC) patients. We searched PubMed and Embase using variations of the search terms triple-negative breast cancer (population), overweight and/or obesity (exposure), and prognosis (outcome). Based on the World Health Organization guidelines for defining overweight, we included longitudinal observational studies, which utilized survival statistics with hazard ratios (HRs) in our analysis. The included studies measured body mass index at the time of diagnosis of TNBC and reported disease-free survival and/or overall survival. Study quality was assessed with the Newcastle-Ottawa Scale and study data were extracted using the Meta-analysis of Observational Studies in Epidemiology (MOOSE) checklist, independently by two authors. Random-effects models were used to combine the effect sizes (HRs), and the results were evaluated and adjusted for possible publication bias. Thirteen studies of 8,944 TNBC patients were included. The meta-analysis showed that overweight was associated with both shorter disease-free survival (HR = 1.26; 95%CI: 1.09–1.46) and shorter overall survival (HR = 1.29; 95%CI: 1.11c1.51) compared to normal-weight. Additionally, our Bayesian meta-analyses suggest that overweight individuals are 7.4 and 9.9 times more likely to have shorter disease-free survival and overall survival, respectively. In conclusion, the available data suggest that overweight is associated with shorter disease-free and overall survival among TNBC patients. The results should be interpreted with caution due to possible publication bias.
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Li Z, Gao Y, Byrd DA, Gibbs DC, Prizment AE, Lazovich D, Bostick RM. Novel Dietary and Lifestyle Inflammation Scores Directly Associated with All-Cause, All-Cancer, and All-Cardiovascular Disease Mortality Risks Among Women. J Nutr 2021; 151:930-939. [PMID: 33693725 PMCID: PMC8030700 DOI: 10.1093/jn/nxaa388] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/16/2020] [Accepted: 11/12/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Exogenous exposures collectively may contribute to chronic, low-grade inflammation and increase risks for major chronic diseases and mortality. We previously developed, validated, and reported a novel, FFQ-based and lifestyle questionnaire-based, inflammation biomarker panel-weighted, predominantly whole foods-based 19-component dietary inflammation score (DIS) and 4-component lifestyle inflammation score (LIS; comprising physical activity, alcohol intake, BMI, and current smoking status). Both scores were more strongly associated with circulating biomarkers of inflammation in 3 populations than were previously reported dietary inflammation indices. Associations of the DIS and LIS with mortality risk have not been reported. OBJECTIVES To investigate separate and joint associations of the DIS and LIS with all-cause, all-cancer, and cardiovascular disease (CVD) mortality risks in the prospective Iowa Women's Health Study (1986-2012; n = 33,155 women, ages 55-69 years, of whom 17,431 died during follow-up, including 4379 from cancer and 6574 from CVD). METHODS We summed each study participant's scores' components, weighted by their published weights, to yield the participant's inflammation score; a higher score was considered more pro-inflammatory. We assessed DIS and LIS mortality associations using multivariable Cox proportional hazards regression. RESULTS Among participants in the highest relative to the lowest DIS and LIS quintiles, the adjusted HRs for all-cause mortality were 1.11 (95% CI: 1.05-1.16) and 1.60 (95% CI: 1.53-1.68), respectively; for all-cancer mortality were 1.07 (95% CI: 0.97-1.17) and 1.51 (95% CI: 1.38-1.66), respectively; and for CVD mortality were 1.12 (95% CI: 1.03-1.21) and 1.79 (95% CI: 1.66-1.94), respectively (all Ptrend values < 0.01). Among those in the highest relative to the lowest joint LIS/DIS quintiles, the HRs for all-cause, all-cancer, and all-CVD mortality were 1.88 (95% CI: 1.71-2.08), 1.82 (95% CI: 1.50-2.20), and 1.92 (95% CI: 1.64-2.24), respectively. CONCLUSIONS More pro-inflammatory diets and lifestyles, separately but especially jointly, may be associated with higher all-cause, all-cancer, and all-CVD mortality risks among women.
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Affiliation(s)
- Zhuoyun Li
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Yasheen Gao
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Doratha A Byrd
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - David C Gibbs
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Anna E Prizment
- Division of Hematology, Oncology and Transplantation, Medical School, University of Minnesota, Minneapolis, MN, USA,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - DeAnn Lazovich
- Division of Hematology, Oncology and Transplantation, Medical School, University of Minnesota, Minneapolis, MN, USA,Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
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Garay-Sevilla ME, Gomez-Ojeda A, González I, Luévano-Contreras C, Rojas A. Contribution of RAGE axis activation to the association between metabolic syndrome and cancer. Mol Cell Biochem 2021; 476:1555-1573. [PMID: 33398664 DOI: 10.1007/s11010-020-04022-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 12/11/2020] [Indexed: 02/07/2023]
Abstract
Far beyond the compelling proofs supporting that the metabolic syndrome represents a risk factor for diabetes and cardiovascular diseases, a growing body of evidence suggests that it is also a risk factor for different types of cancer. However, the involved molecular mechanisms underlying this association are not fully understood, and they have been mainly focused on the individual contributions of each component of the metabolic syndrome such as obesity, hyperglycemia, and high blood pressure to the development of cancer. The Receptor for Advanced Glycation End-products (RAGE) axis activation has emerged as an important contributor to the pathophysiology of many clinical entities, by fueling a chronic inflammatory milieu, and thus supporting an optimal microenvironment to promote tumor growth and progression. In the present review, we intend to highlight that RAGE axis activation is a crosswise element on the potential mechanistic contributions of some relevant components of metabolic syndrome into the association with cancer.
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Affiliation(s)
- Ma Eugenia Garay-Sevilla
- Department of Medical Science, Division of Health Science, University of Guanajuato, Campus León, Guanajuato, Mexico
| | - Armando Gomez-Ojeda
- Department of Medical Science, Division of Health Science, University of Guanajuato, Campus León, Guanajuato, Mexico
| | - Ileana González
- Biomedical Research Labs, Medicine Faculty, Catholic University of Maule, Talca, Chile
| | - Claudia Luévano-Contreras
- Department of Medical Science, Division of Health Science, University of Guanajuato, Campus León, Guanajuato, Mexico
| | - Armando Rojas
- Biomedical Research Labs, Medicine Faculty, Catholic University of Maule, Talca, Chile.
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20
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Lee JE. Diet Before and After Breast Cancer. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1187:545-566. [PMID: 33983599 DOI: 10.1007/978-981-32-9620-6_29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The incidence of breast cancer has dramatically increased recently in several Asian countries. This region has experienced rapid economic growth and demographic and environmental changes. Breast cancer rates vary substantially among countries, with a lower incidence in developing countries than that in Western countries. Given the upward trend of breast cancer incidence in Asian countries and the large variation in incidence around the world, dietary changes may contribute to breast cancer development. In particular, nutrients and foods from animal sources have drawn attention as potential causes of breast cancer given that obesity and energy balance appear to be important factors associated with breast cancer risk. However, prospective cohort and intervention studies do not support the hypothesis that diet in middle life influences breast cancer development. However, recent studies have provided better insight into the roles of dietary factors in specific types of breast cancers, such as estrogen receptor-negative (ER-) breast cancer. Some studies suggest that diet in early life may play a substantial role in breast cancer development, but data and evidence remain limited.Although etiologic and epidemiologic studies have long studied modifiable risk factors for breast cancer incidence, much remains to be explored regarding the role of diet after a breast cancer diagnosis. Several epidemiologic studies have explored the factors that improve breast cancer survival rates, including diet, physical activity, and body mass index (BMI). While there is evidence of the effect of BMI on breast cancer mortality, the effects of changing dietary habits after a breast cancer diagnosis on survival or recurrence are less clear. A report of the World Cancer Research Fund stated that evidence was not sufficient to draw firm conclusions about the effect of diet and nutrition on breast cancer prognosis, but it did suggest a link between diet and breast cancer survival.The global burden of breast cancer is increasing and breast cancer is a major and emerging health problem in both developed and developing countries. For example, the five-year survival rate for Korean breast cancer patients has improved from 78.0% in 1993-1995 to 92.7% in 2012-2016. This improvement emphasizes the importance of supportive care, diet, and quality of life for breast cancer survivors. However, we have limited data of non-Western breast cancer survivors. There is a need to examine the role of diet in breast cancer survival in both Western and non-Western regions.
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Affiliation(s)
- Jung Eun Lee
- Department of Food and Nutrition, Seoul National University, Seoul, South Korea.
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21
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Andrijauskaite K, Wargovich MJ. Role of natural products in breast cancer related symptomology: Targeting chronic inflammation. Semin Cancer Biol 2020; 80:370-378. [PMID: 32891720 DOI: 10.1016/j.semcancer.2020.08.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 08/03/2020] [Accepted: 08/16/2020] [Indexed: 02/06/2023]
Abstract
Breast cancer is the most common cancer in women worldwide. There have been many advancements in the treatment of breast cancer leading to an increased population of patients living with this disease. Accumulating evidence suggests that cancer diagnosis and aftermath experienced stress could not only affect the quality of life of cancer patients, but it could also influence their disease outcome. The magnitude of stress experienced by breast cancer patients is often compared to the post-traumatic stress disorder-like symptoms suggested to be mediated by the chronic inflammation including NF-κB, AKt, p53 and other inflammatory pathways. Here, we describe the symptomology of PTSD-like symptoms in breast cancer patients and argue that they may in fact be caused by or maintained through aspects of chronic inflammation mediated by the pro-inflammatory markers. Evidence exists that natural products that might attenuate or lessen the effects of chronic inflammation abound in the diet. We summarize some possible agents that might abate the genesis of symptoms experienced by breast cancer patients while mitigating the effect of inflammation.
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Affiliation(s)
- Kristina Andrijauskaite
- Department of Molecular Medicine, UT Health San Antonio, San Antonio, TX, 78229, United States.
| | - Michael J Wargovich
- Department of Molecular Medicine, UT Health San Antonio, San Antonio, TX, 78229, United States
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Wang K, Sun JZ, Wu QX, Li ZY, Li DX, Xiong YF, Zhong GC, Shi Y, Li Q, Zheng J, Shivappa N, Hébert JR, Foukakis T, Zhang X, Li HY, Xiang TX, Ren GS. Long-term anti-inflammatory diet in relation to improved breast cancer prognosis: a prospective cohort study. NPJ Breast Cancer 2020; 6:36. [PMID: 32821804 PMCID: PMC7426822 DOI: 10.1038/s41523-020-00179-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 07/22/2020] [Indexed: 02/05/2023] Open
Abstract
Inflammation-modulating nutrients and inflammatory markers are established cancer risk factors, however, evidence regarding the association between post-diagnosis diet-associated inflammation and breast cancer survival is relatively sparse. We aimed to examine the association between post-diagnosis dietary inflammatory index (DII®) and risks of all-cause and breast cancer-specific mortality. A total of 1064 female breast cancer survivors in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening (PLCO) Trial prospective cohort, were included in this analysis if they had completed the diet history questionnaire (DHQ). Energy-adjusted DII (E-DIITM) scores were calculated based on food and supplement intake. Cox regression and competing risk models were used to estimate multivariable-adjusted hazards ratios (HRs) and 95% confidence intervals (95% CIs) by E-DII tertile (T) for all-cause and breast cancer-specific mortality. With median follow-up of 14.6 years, there were 296 (27.8%) deaths from all causes and 100 (9.4%) breast cancer-specific death. The E-DII was associated with all-cause mortality (HR T3 vs T1, 1.34; 95% CI, 1.01-1.81; P trend, 0.049, Table 2) and breast cancer mortality (HR T3 vs T1, 1.47; 95% CI, 0.89-2.43; P trend, 0.13; multivariable-adjusted HR for 1-unit increment: 1.10; 95% CI: 1.00-1.22). Non-linear positive dose-response associations with mortality from all causes were identified for E-DII scores (P non-linearity < 0.05). The post-diagnosis E-DII was statistically significantly associated with mortality risk among breast cancer survivors. Long-term anti-inflammatory diet might be a means of improving survival of breast cancer survivors.
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Affiliation(s)
- Kang Wang
- Department of the Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 400016 China
- Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jia-Zheng Sun
- Department of the Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 400016 China
- Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qian-Xue Wu
- Department of the Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 400016 China
| | - Zhu-Yue Li
- West China Hospital/West China School of Nursing, Sichuan University, Chengdu, China
| | - Da-Xue Li
- Department of Breast Surgery, Chongqing Health Center for Women and Children, Chongqing, 400000 China
| | - Yong-Fu Xiong
- The First Department of Hepatobiliary Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637007 China
| | - Guo-Chao Zhong
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yang Shi
- Division of Biostatistics and Data Science, Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA USA
| | - Qing Li
- Department of the Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 400016 China
| | - Jiali Zheng
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208 USA
| | - Nitin Shivappa
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208 USA
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208 USA
- Connecting Health Innovations, LLC, Columbia, SC 29201 USA
| | - James R. Hébert
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208 USA
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208 USA
- Connecting Health Innovations, LLC, Columbia, SC 29201 USA
| | - Theodoros Foukakis
- Department of Oncology-Pathology, Karolinska Institutet, 17164 Stockholm, Sweden
- Breast Center, Theme Cancer, Karolinska University Hospital, 17176 Stockholm, Sweden
| | - Xiang Zhang
- Department of the Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 400016 China
| | - Hong-Yuan Li
- Department of the Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 400016 China
| | - Ting-Xiu Xiang
- Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Guo-Sheng Ren
- Department of the Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 400016 China
- Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Abstract
PURPOSE OF REVIEW Breast cancer is the most common cancer in women, yet conclusive evidence of the effects of dietary modification in breast cancer survivors is lacking. Here, we summarize the literature and highlight important data regarding the association between dietary interventions and breast cancer outcomes. RECENT FINDINGS Long-term follow-up and secondary analysis of the Women's Health Initiative study demonstrated a significant improvement in overall survival for women who were randomized to the low-fat diet pattern compared with those in the usual-diet group. Dietary quality as measured by Healthy Eating Index score was also associated with both a decrease in cancer-specific mortality and overall mortality. Despite current evidence on the role of diet and nutrition in breast cancer outcomes, conclusive data to translate current findings to clinical practice is lacking and requires multidisciplinary prospective research to advance the field.
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DuPré NC, Heng YJ, Raby BA, Glass K, Hart JE, Chu JH, Askew C, Eliassen AH, Hankinson SE, Kraft P, Laden F, Tamimi RM. Involvement of fine particulate matter exposure with gene expression pathways in breast tumor and adjacent-normal breast tissue. ENVIRONMENTAL RESEARCH 2020; 186:109535. [PMID: 32668536 PMCID: PMC7368092 DOI: 10.1016/j.envres.2020.109535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 03/18/2020] [Accepted: 04/12/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Fine particulate matter (PM2.5) has been associated with breast cancer specific mortality, particularly for women with Stage I cancer. We examined the biological pathways that are perturbed by PM2.5 exposures by analyzing gene expression measurements from breast tissue specimens. METHODS The Nurses' Health Studies (NHS and NHSII) are prospective cohorts with archival breast tissue specimens from breast cancer cases. Global gene expression data were ascertained with the Affymetrix Glue Human Transcriptome Array 3.0. PM2.5 was estimated using spatio-temporal models linked to participants' home addresses. All analyses were performed separately in tumor (n = 591) and adjacent-normal (n = 497) samples, and stratified by estrogen receptor (ER) status and stage. We used multivariable linear regression, gene-set enrichment analyses (GSEA), and the least squares kernel machine (LSKM) to assess whether 3-year cumulative average pre-diagnosis PM2.5 exposure was associated with breast-tissue gene expression pathways among predominately Stage I and II women (90.7%) and postmenopausal (81.2%) women. Replication samples (tumor, n = 245; adjacent-normal, n = 165) were measured on Affymetrix Human Transcriptome Array (HTA 2.0). RESULTS Overall, no pathways in the tumor area were significantly associated with PM2.5 exposure. Among 272 adjacent-normal samples from Stage I ER-positive women, PM2.5 was associated with perturbations in the oxidative phosphorylation, protein secretion, and mTORC1 signaling pathways (GSEA and LSKM p-values <0.05); however, results were not replicated in a small set of replication samples (n = 80). CONCLUSIONS PM2.5 was generally not associated with breast tissue gene expression though was suggested to perturb oxidative phosphorylation and regulation of proteins and cellular signaling in adjacent-normal breast tissue. More research is needed on the biological role of PM2.5 that influences breast tumor progression.
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Affiliation(s)
- Natalie C DuPré
- Channing Division of Network Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology and Population Health, University of Louisville School of Public Health and Information Sciences, Louisville, KY, USA.
| | - Yujing J Heng
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Cancer Research Institute, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Benjamin A Raby
- Channing Division of Network Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA; Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Kimberly Glass
- Channing Division of Network Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA, 02215, USA; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, 02215, USA
| | - Jaime E Hart
- Channing Division of Network Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jen-Hwa Chu
- Section of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Catherine Askew
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - A Heather Eliassen
- Channing Division of Network Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Susan E Hankinson
- Channing Division of Network Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Peter Kraft
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, 02215, USA
| | - Francine Laden
- Channing Division of Network Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Rulla M Tamimi
- Channing Division of Network Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Dietary inflammatory index potentially increases blood pressure and markers of glucose homeostasis among adults: findings from an updated systematic review and meta-analysis. Public Health Nutr 2020; 23:1362-1380. [PMID: 31708005 DOI: 10.1017/s1368980019003070] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE In the current meta-analysis, we aimed to systematically review and summarize eligible studies for the association between dietary inflammatory index (DII) and blood pressure, hypertension (HTN) and glucose homeostasis biomarkers. DESIGN/SETTING In a systematic search of PubMed, Scopus and Google Scholar electronic databases up to February 2019, relevant studies were included in the literature review. Observational studies evaluating the association between DII and HTN, hyperglycaemia, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), insulin, homeostatic model assessment of insulin resistance (HOMA-IR) and glycated Hb (HbA1c) were included. PARTICIPANTS Not applicable. RESULTS Total numbers of studies were as follows: OR for DII and HTN (n 12), OR for DII and hyperglycaemia (n 9), HTN prevalence (n 9), mean (sd) of SBP and DII (n 12), mean (sd) of DBP and DII (n 10), mean (sd) of FBS and DII (n 13), mean (sd) of HbA1c and DII (n 3), mean (sd) of insulin and DII (n 6), mean (sd) of HOMA-IR and DII (n 7). Higher DII scores were associated with higher odds of HTN (OR = 1·13; 95 % CI 1·01, 1·27; P < 0·001), SBP (weighted mean difference (WMD) = 1·230; 95 % CI 0·283, 2·177; P = 0·011), FBS (WMD = 1·083; 95 % CI 0·099, 2·068; P = 0·031), insulin (WMD = 0·829; 95 % CI 0·172, 1·486; P = 0·013), HbA1c (WMD = 0·615; 95 % CI 0·268, 0·961; P = 0·001) and HOMA-IR (WMD = 0·192; 95 % CI 0·023, 0·361; P = 0·026) values compared with lowest DII categories. CONCLUSIONS Lower inflammatory content of diets for prevention of cardiovascular risk factors is recommended.
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Farhangi MA, Vajdi M. The association between dietary inflammatory index and risk of central obesity in adults: An updated systematic review and meta-analysis. INT J VITAM NUTR RES 2020; 90:535-552. [PMID: 32129728 DOI: 10.1024/0300-9831/a000648] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Backgrounds: Central obesity, as a pivotal component of metabolic syndrome is associated with numerous co-morbidities. Dietary factors influence central obesity by increased inflammatory status. However, recent studies didn't evaluate the association between central obesity and dietary inflammation index (DII®) that give score to dietary factors according to their inflammatory potential. In the current systematic review and meta-analysis, we summarized the studies that investigated the association between DII® with central obesity indices in the general populations. Methods: In a systematic search from PubMed, SCOPUS, Web of Sciences and Cochrane electronic databases, we collected relevant studies written in English and published until 30 October 2019. The population of included studies were apparently healthy subjects or individuals with obesity or obesity-related diseases. Observational studies that evaluated the association between DII® and indices of central obesity including WC or WHR were included. Results: Totally thirty-two studies were included; thirty studies were cross-sectional and two were cohort studies with 103071 participants. Meta-analysis of observational studies showed that higher DII® scores were associated with 1.81 cm increase in WC (Pooled weighted mean difference (WMD) = 1.813; CI: 0.785-2.841; p = 0.001). Also, a non-significant increase in the odds of having higher WC (OR = 1.162; CI: 0.95-1.43; p = 0.154) in the highest DII category was also observed. In subgroup analysis, the continent, dietary assessment tool and gender were the heterogeneity sources. Conclusion: The findings proposed that adherence to diets with high DII® scores was associated with increased WC. Further studies with interventional designs are necessary to elucidate the causality inference between DII® and central obesity indices.
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Affiliation(s)
- Mahdieh Abbasalizad Farhangi
- Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahdi Vajdi
- Research Center for Evidence Based Medicine, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
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Maumy L, Harrissart G, Dewaele P, Aljaber A, Bonneau C, Rouzier R, Eliès A. Impact des régimes alimentaires sur la mortalité et le risque de récidive de cancer du sein : revue de la littérature. Bull Cancer 2020; 107:61-71. [DOI: 10.1016/j.bulcan.2019.08.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 08/05/2019] [Accepted: 08/09/2019] [Indexed: 01/14/2023]
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Karavasiloglou N, Pestoni G, Faeh D, Rohrmann S. Post-Diagnostic Diet Quality and Mortality in Females with Self-Reported History of Breast or Gynecological Cancers: Results from the Third National Health and Nutrition Examination Survey (NHANES III). Nutrients 2019; 11:nu11112558. [PMID: 31652816 PMCID: PMC6893621 DOI: 10.3390/nu11112558] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 10/17/2019] [Accepted: 10/18/2019] [Indexed: 12/20/2022] Open
Abstract
High quality diets are associated with favorable disease and mortality outcomes in various populations; little and conflicting information is available for female cancer survivors. We investigated the association of post-diagnostic diet quality with mortality in female cancer survivors. Data from 230 women with a previous breast, or gynecological (i.e., ovarian, cervical or uterine) cancer diagnosis in the Third National Health and Nutrition Examination Survey were analyzed. The Healthy Eating Index (HEI) and the Mediterranean Diet Score (MDS) were calculated based on a 24-hour dietary recall interview. Cox proportional hazards regression models were used to calculate multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CI). Higher HEI score was associated with lower mortality (HRHEI total = 0.97, 95% CI: 0.95-0.98, 1 unit increase), but the association for MDS failed to reach statistical significance (HRMDS total = 0.87, 95% CI: 0.74-1.04). In subgroup analyses, a statistically significant inverse association was observed between the HEI and mortality; for the MDS, no statistically significant association was apparent. Higher post-diagnostic HEI score was inversely associated with mortality in female cancer survivors, suggesting a protective effect when adhering to the diet captured by the HEI. Additional studies are required in order to investigate underlying mechanisms of the mortality-adherence association.
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Affiliation(s)
- Nena Karavasiloglou
- Division of Chronic Disease Epidemiology, Institute for Epidemiology, Biostatistics and Prevention (EBPI), University of Zurich, Hirschengraben 84, CH-8001 Zurich, Switzerland.
- Cancer Registry Zurich and Zug, University Hospital Zurich, Zurich, Switzerland, Vogelsangstrasse 10, CH-8001 Zurich, Switzerland.
| | - Giulia Pestoni
- Division of Chronic Disease Epidemiology, Institute for Epidemiology, Biostatistics and Prevention (EBPI), University of Zurich, Hirschengraben 84, CH-8001 Zurich, Switzerland.
- Cancer Registry Zurich and Zug, University Hospital Zurich, Zurich, Switzerland, Vogelsangstrasse 10, CH-8001 Zurich, Switzerland.
| | - David Faeh
- Division of Chronic Disease Epidemiology, Institute for Epidemiology, Biostatistics and Prevention (EBPI), University of Zurich, Hirschengraben 84, CH-8001 Zurich, Switzerland.
- Health Department-Nutrition and Dietetics, Bern University of Applied Sciences, Falkenplatz 24, CH-3012 Bern, Switzerland.
| | - Sabine Rohrmann
- Division of Chronic Disease Epidemiology, Institute for Epidemiology, Biostatistics and Prevention (EBPI), University of Zurich, Hirschengraben 84, CH-8001 Zurich, Switzerland.
- Cancer Registry Zurich and Zug, University Hospital Zurich, Zurich, Switzerland, Vogelsangstrasse 10, CH-8001 Zurich, Switzerland.
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Liu X, Li Y, Ma Q, Wang Y, Song AL. Withaferin-A Inhibits Growth of Drug-Resistant Breast Carcinoma by Inducing Apoptosis and Autophagy, Endogenous Reactive Oxygen Species (ROS) Production, and Inhibition of Cell Migration and Nuclear Factor kappa B (Nf-κB)/Mammalian Target of Rapamycin (m-TOR) Signalling Pathway. Med Sci Monit 2019; 25:6855-6863. [PMID: 31512681 PMCID: PMC6754708 DOI: 10.12659/msm.916931] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 05/06/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The main purpose of this study was to assess in vitro and in vivo the anticancer effect of withaferin-A in human breast carcinoma cells (MDA-MB-231), and to assess its effects on autophagy, cell apoptosis, ROS production, cell migration and invasion, and Nf-kappaB/m-TOR signalling pathway. MATERIAL AND METHODS Proliferation of MDA-MB-231 cells at various doses of the drug was studied by CCK8 cell viability assay. Effects on cell apoptosis were studied by fluorescence microscopy in combination with flow cytometry and Western blot analysis. Effects on autophagy were evaluated by transmission electron microscopy and Western blot. Effects on cellular migration were examined in vitro by wound healing assay. RESULTS The results indicated that withaferin-A led to significant reduction of MDA-MB-231 cell viability. The anticancer action of withaferin-A was shown to be due to the stimulation of autophagy, which was accompanied by enhancement of LC3 expression. Withaferin-A prompted mitochondrial apoptosis, which was also associated with increased level of Bax and decreased Bcl-2 in MDA-MB-231 cells. It was also observed that withaferin-A has decreases cellular migration and invasion of the tested human breast cancer cells. The effects of withaferin-A were also investigated in vivo, and it was found that this molecule could inhibit the growth of tumor xenografts in tested mice. Withaferin-A led to suppression of the Nf-kappaB/m-TOR signalling pathway. CONCLUSIONS In brief, the withaferin-A molecule has great potential as an anticancer agent against drug-resistant breast cancer, and as such needs to be further studied in detail.
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Phillips CM, Chen LW, Heude B, Bernard JY, Harvey NC, Duijts L, Mensink-Bout SM, Polanska K, Mancano G, Suderman M, Shivappa N, Hébert JR. Dietary Inflammatory Index and Non-Communicable Disease Risk: A Narrative Review. Nutrients 2019; 11:E1873. [PMID: 31408965 PMCID: PMC6722630 DOI: 10.3390/nu11081873] [Citation(s) in RCA: 180] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 07/30/2019] [Accepted: 08/05/2019] [Indexed: 12/13/2022] Open
Abstract
There are over 1,000,000 publications on diet and health and over 480,000 references on inflammation in the National Library of Medicine database. In addition, there have now been over 30,000 peer-reviewed articles published on the relationship between diet, inflammation, and health outcomes. Based on this voluminous literature, it is now recognized that low-grade, chronic systemic inflammation is associated with most non-communicable diseases (NCDs), including diabetes, obesity, cardiovascular disease, cancers, respiratory and musculoskeletal disorders, as well as impaired neurodevelopment and adverse mental health outcomes. Dietary components modulate inflammatory status. In recent years, the Dietary Inflammatory Index (DII®), a literature-derived dietary index, was developed to characterize the inflammatory potential of habitual diet. Subsequently, a large and rapidly growing body of research investigating associations between dietary inflammatory potential, determined by the DII, and risk of a wide range of NCDs has emerged. In this narrative review, we examine the current state of the science regarding relationships between the DII and cancer, cardiometabolic, respiratory and musculoskeletal diseases, neurodevelopment, and adverse mental health outcomes. We synthesize the findings from recent studies, discuss potential underlying mechanisms, and look to the future regarding novel applications of the adult and children's DII (C-DII) scores and new avenues of investigation in this field of nutritional research.
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Affiliation(s)
- Catherine M Phillips
- HRB Centre for Diet and Health Research, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland.
- HRB Centre for Diet and Health Research, School of Public Health, University College Cork, Western Gateway Building, Western Rd, Cork, Co. Cork, Ireland.
| | - Ling-Wei Chen
- HRB Centre for Diet and Health Research, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland
| | - Barbara Heude
- Research Team on the Early Life Origins of Health (EAROH), Centre for Research in Epidemiology and Statistics (CRESS), INSERM, Université de Paris, F-94807 Villejuif, France
| | - Jonathan Y Bernard
- Research Team on the Early Life Origins of Health (EAROH), Centre for Research in Epidemiology and Statistics (CRESS), INSERM, Université de Paris, F-94807 Villejuif, France
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK
| | - Liesbeth Duijts
- The Generation R Study Group, Erasmus MC, University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
- Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center, P.O. Box 2060, 3000 CB Rotterdam, The Netherlands
- Department of Pediatrics, Division of Neonatology, Erasmus MC, University Medical Center, P.O. Box 2060, 3000 CB Rotterdam, The Netherlands
| | - Sara M Mensink-Bout
- The Generation R Study Group, Erasmus MC, University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
- Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center, P.O. Box 2060, 3000 CB Rotterdam, The Netherlands
| | - Kinga Polanska
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland
| | - Giulia Mancano
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK
| | - Matthew Suderman
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK
| | - Nitin Shivappa
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - James R Hébert
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
- Connecting Health Innovations LLC, Columbia, SC 29201, USA
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Karavasiloglou N, Pestoni G, Wanner M, Faeh D, Rohrmann S. Healthy lifestyle is inversely associated with mortality in cancer survivors: Results from the Third National Health and Nutrition Examination Survey (NHANES III). PLoS One 2019; 14:e0218048. [PMID: 31242220 PMCID: PMC6594599 DOI: 10.1371/journal.pone.0218048] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 05/24/2019] [Indexed: 01/08/2023] Open
Abstract
Individual lifestyle behaviors have been associated with prolonged survival in cancer survivors, but little information is available on the association between combined lifestyle behaviors and mortality in this population. Data from 522 cancer survivors participating in the Third National Health and Nutrition Examination Survey (NHANES III) were analyzed. Behaviors pertaining to lifetime healthy body weight maintenance, physical activity, smoking, diet quality (assessed by the Healthy Eating Index) and moderate alcohol consumption were combined in a lifestyle score (range 0-5). Cox proportional hazards regression models were used to calculate multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CI). Both in continuous and categorical models, the lifestyle score was statistically significantly associated with lower mortality in the total study population (HRcontinuous = 0.81, 95% CI: 072, 0.90, per 1 unit increase; HR1-2 vs. 0 total = 0.71, 95% CI: 0.56, 0.92; HR3-5 vs. 0 total = 0.57, 95% CI: 0.38, 0.85, in the fully adjusted model) and in sex-specific analyses. Cancer survivors with high or moderate lifestyle score had lower risk of premature death compared to survivors with zero lifestyle score. Future studies are required in order to verify our findings and to investigate underlying mechanisms of the mortality-adherence association.
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Affiliation(s)
- Nena Karavasiloglou
- Division of Chronic Disease Epidemiology, Institute for Epidemiology, Biostatistics and Prevention, University of Zurich, Zurich, Switzerland
- Cancer Registry Zurich and Zug, University Hospital Zurich, Zurich, Switzerland
| | - Giulia Pestoni
- Division of Chronic Disease Epidemiology, Institute for Epidemiology, Biostatistics and Prevention, University of Zurich, Zurich, Switzerland
- Cancer Registry Zurich and Zug, University Hospital Zurich, Zurich, Switzerland
| | - Miriam Wanner
- Division of Chronic Disease Epidemiology, Institute for Epidemiology, Biostatistics and Prevention, University of Zurich, Zurich, Switzerland
- Cancer Registry Zurich and Zug, University Hospital Zurich, Zurich, Switzerland
| | - David Faeh
- Division of Chronic Disease Epidemiology, Institute for Epidemiology, Biostatistics and Prevention, University of Zurich, Zurich, Switzerland
- Health Department–Nutrition and Dietetics, Bern University of Applied Sciences, Bern, Switzerland
| | - Sabine Rohrmann
- Division of Chronic Disease Epidemiology, Institute for Epidemiology, Biostatistics and Prevention, University of Zurich, Zurich, Switzerland
- Cancer Registry Zurich and Zug, University Hospital Zurich, Zurich, Switzerland
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Garcia-Arellano A, Martínez-González MA, Ramallal R, Salas-Salvadó J, Hébert JR, Corella D, Shivappa N, Forga L, Schröder H, Muñoz-Bravo C, Estruch R, Fiol M, Lapetra J, Serra-Majem L, Ros E, Rekondo J, Toledo E, Razquin C, Ruiz-Canela M, Alonso A, Barrio Lopez M, Basterra-Gortari F, Benito Corchon S, Bes-Rastrollo M, Beunza J, Carlos S, Cervantes S, de Irala J, de la Rosa P, de la Fuente C, Donat-Vargas C, Donazar M, Fernandez Montero A, Gea A, Goni-Ochandorena E, Guillen-Grima F, Lahortiga F, Llorca J, Lopez del Burgo C, Mari-Sanchıs A, Marti A, Mendonça R, Nuñez-Cordoba J, Pimenta A, Rico A, Ruiz Zambrana A, Sayon-Orea C, Toledo-Atucha J, Vazquez Ruiz Z, Zazpe Garcıa I, Sánchez- Tainta A, Buil-Cosiales P, Díez-Espino J, Sanjulian B, Martínez J, Marti A, Serrano-Martínez M, Basterra-Gortari F, Extremera-Urabayen J, Garcia-Pérez L, Arroyo-Azpa C, Barcena A, Oreja-Arrayago C, Lasanta-Sáez M, Cia-Lecumberri P, Elcarte-Lopez T, Artal-Moneva F, Esparza-López J, Figuerido-Garmendia E, Tabar-Sarrias J, Fernández- Urzainqui L, Ariz-Arnedo M, Cabeza-Beunza J, Pascual-Pascual P, Martínez-Mazo M, Arina-Vergara E, Macua-Martínez T, Pascual Pascual P, Garcés Ducar M, Martí Massó R, Villanueva Moreno R, Parra-Osés A, Serra-Mir M, Pérez-Heras A, Viñas C, Casas R, Medina-Remon A, Villanueva P, Baena J, García M, Oller M, Amat J, Duaso I, García Y, Iglesias C, Simón C, Quinzavos L, Parra L, Liroz M, Benavent J, Clos J, Pla I, Amorós M, Bonet M, Martín M, Sánchez M, Altirriba J, Manzano E, Altés A, Cofán M, Valls-Pedret C, Sala-Vila A, Doménech M, Bulló M, Basora-Gallisa J, González R, Molina C, Mena G, Martínez P, Ibarrola N, Sorlí J, García Roselló J, Martin F, Tort N, Isach A, Babio N, Salas-Huetos A, Becerra-Tomás N, Rosique- Esteban N, Hernandez P, Canudas S, Papandreou C, Ferreira C, Cabre M, Mestres G, Paris F, Llauradó M, Pedret R, Basells J, Vizcaino J, Segarra R, Giardina S, Guasch-Ferré M, Díaz-López A, Fernández-Ballart J, Balanza R, Tello S, Vila J, de la Torre R, Muñoz-Aguayo D, Elosua R, Marrugat J, Schröder H, Molina N, Maestre E, Rovira A, Castañer O, Farré M, Sorli J, Carrasco P, Ortega-Azorín C, Asensio E, Osma R, Barragán R, Francés F, Guillén M, González J, Sáiz C, Portolés O, Giménez F, Coltell O, Fernández-Carrión R, Guillem-Sáiz P, González-Monje I, Quiles L, Pascual V, Riera C, Pages M, Godoy D, Carratalá-Calvo A, Sánchez-Navarro S, Valero-Barceló C, Salaverria I, Hierro TD, Algorta J, Francisco S, Alonso A, San Vicente J, Casi A, Sanz E, Felipe I, Rekondo J, Loma-Osorio A, Fernandez-Crehuet J, Garcia-Rodriguez A, Wärnberg J, Benitez Pont R, Bianchi Alba M, Navajas R, Gómez-Huelgas R, Martínez-González J, Velasco García V, de Diego Salas J, Baca Osorio A, Gil Zarzosa J, Sánchez Luque J, Vargas López E, Romaguera D, García-Valdueza M, Proenza A, Prieto R, Frontera G, Munuera S, Vivó M, Bestard F, Munar J, Coll L, Fiol F, Ginard M, Jover A, García J, Santos-Lozano J, Ortega-Calvo M, Leal M, Martínez E, Mellado L, Miró-Moriano L, Domínguez-Espinaco C, Vaquero- Diaz S, Iglesias P, Román P, Corchado Y, Lozano-Rodríguez J, Lamuela-Raventós R, López- Sabater M, Castellote-Bargalló A, Quifer-Rada P, Tresserra-Rimbau A, Alvarez-Pérez J, Díez Benítez E, Bautista Castaño I, Maldonado Díaz I, Sanchez-Villegas A, Férnandez- Rodríguez M, Sarmiendo de la Fe F, Simón García C, Falcón Sanabria I, Macías Gutiérrez B, Santana Santana A, de la Cruz E, Galera A, Pintó-Salas X, Trias F, Sarasa I, Rodríguez M, Corbella X, Corbella E, Goday A, Muñoz M, Cabezas C, Vinyoles E, Rovira M, Garcia L, Baby P, Ramos A, Mengual L, Roura P, Yuste M, Guarner A, Rovira A, Santamaria M, Mata M, de Juan C, Brau A, Fernandez M, Gutierrez E, Murillo C, Garcia J, Tafalla M, Bobe I, Díaz A, Araque M, Solis E, Cervello T, Montull I, Tur J, Portillo M, Sáez G. Dietary inflammatory index and all-cause mortality in large cohorts: The SUN and PREDIMED studies. Clin Nutr 2019; 38:1221-1231. [PMID: 30651193 DOI: 10.1016/j.clnu.2018.05.003] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 04/24/2018] [Accepted: 05/02/2018] [Indexed: 12/22/2022]
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Wu Z, Wang C, Huang M, Tao Z, Yan W, Du Y. Naturally Occurring Sesquiterpene Lactone-Santonin, Exerts Anticancer Effects in Multi-Drug Resistant Breast Cancer Cells by Inducing Mitochondrial Mediated Apoptosis, Caspase Activation, Cell Cycle Arrest, and by Targeting Ras/Raf/MEK/ERK Signaling Pathway. Med Sci Monit 2019; 25:3676-3682. [PMID: 31101800 PMCID: PMC6540632 DOI: 10.12659/msm.915246] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 01/31/2019] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Sesquiterpene lactones have gained tremendous attention owing to their potent anticancer properties. The main focus of this study was to evaluate the anticancer effects of a naturally occurring sesquiterpene lactone, santonin, against human breast cancer SK-BR-3 cells. MATERIAL AND METHODS Cell counting kit 8 assay was used for the determination of cell viability. Apoptosis was detected by DAPI (4',6-diamidino-2-phenylindole) and annexin V/propidium iodide (IP) staining. Flow cytometry was used for cell cycle analysis and western blotting was used for the estimation of protein expression. RESULTS Results showed that santonin exerts significant anti-proliferative effects on the SK-BR-3 breast cancer cells in a concentration dependent manner. Santonin showed an IC₅₀ of 16 µM against SK-BR-3 cells. DAPI staining showed that santonin caused DNA fragmentation in the SK-BR-3 cells, which is indicative of apoptosis. Annexin V/PI staining showed that apoptotic cell percentage increased up to 34.32% at 32 µM concentration of santonin. Santonin also caused an increase in the expression of Bax, caspase-3, and caspase-9, and a decrease in the expression of Bcl-2. Santonin also caused the arrest of the SK-BR-3 cells at the G2/M phase of the cell cycle and suppressed the expression of cyclin A and B1. Finally, santonin could also block the Raf/MEK/ERK pathway in breast cancer cells. CONCLUSIONS The findings of this study suggest the potential for the naturally occurring sesquiterpene lactone santonin in breast cancer treatment and also suggest that it could be developed as a promising anticancer agent.
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Affiliation(s)
- Zhiqiang Wu
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China
- Department of Musculoskeletal Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China
| | - Chenchen Wang
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China
| | - Mingzhu Huang
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China
| | - Zhonghua Tao
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China
| | - Wangjun Yan
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China
- Department of Musculoskeletal Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China
| | - Yiqun Du
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China
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Post-cancer diagnosis dietary inflammatory potential is associated with survival among women diagnosed with colorectal cancer in the Women's Health Initiative. Eur J Nutr 2019; 59:965-977. [PMID: 30955051 DOI: 10.1007/s00394-019-01956-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 03/24/2019] [Indexed: 12/21/2022]
Abstract
PURPOSE Dietary factors may influence colorectal cancer (CRC) survival through effects on inflammation. We examined the association between post-CRC diagnosis inflammatory potential of diet and all-cause and cancer-specific mortality in the Women's Health Initiative. METHODS The study included 463 postmenopausal women who developed CRC during follow-up and completed a food frequency questionnaire (FFQ), on average 1.7 years after diagnosis. Women were followed from CRC diagnosis until death, censoring, or the end of follow-up in October 2014. Energy-adjusted dietary inflammatory index (E-DII)® scores were calculated from the FFQ and dietary supplement inventory. Cox proportional hazards models were fitted to estimate multivariable-adjusted HRs and 95% confidence intervals (CIs) for all-cause, total cancer, and CRC-specific mortality with the most pro-inflammatory E-DII scores (tertile 3) as referent. RESULTS After a median 11.6 years of follow-up, 162 deaths occurred, including 77 from CRC. Lowest tertile (i.e., most anti-inflammatory) E-DII scores from diet plus supplements were associated with significantly lower all-cause mortality (HRT1vsT3 = 0.49; 95% CI 0.31-0.79) compared to the most pro-inflammatory E-DII tertile. Modest associations with total cancer mortality or CRC-specific mortality were observed, though 95% CIs included 1. CONCLUSIONS Consuming a dietary pattern and supplements with more anti-inflammatory potential after CRC diagnosis may improve overall survival among postmenopausal women.
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Hébert JR, Shivappa N, Wirth MD, Hussey JR, Hurley TG. Perspective: The Dietary Inflammatory Index (DII)-Lessons Learned, Improvements Made, and Future Directions. Adv Nutr 2019; 10:185-195. [PMID: 30615051 PMCID: PMC6416047 DOI: 10.1093/advances/nmy071] [Citation(s) in RCA: 242] [Impact Index Per Article: 48.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 07/20/2018] [Accepted: 08/20/2018] [Indexed: 12/22/2022] Open
Abstract
The literature on the role of inflammation in health has grown exponentially over the past several decades. Paralleling this growth has been an equally intense focus on the role of diet in modulating inflammation, with a doubling in the size of the literature approximately every 4 y. The Dietary Inflammatory Index (DII) was developed to provide a quantitative means for assessing the role of diet in relation to health outcomes ranging from blood concentrations of inflammatory cytokines to chronic diseases. Based on literature from a variety of different study designs ranging from cell culture to observational and experimental studies in humans, the DII was designed to be universally applicable across all human studies with adequate dietary assessment. Over the past 4 y, the DII has been used in >200 studies and forms the basis for 12 meta-analyses. In the process of conducting this work, lessons were learned with regard to methodologic issues related to total energy and nutrient intake and energy and nutrient densities. Accordingly, refinements to the original algorithm have been made. In this article we discuss these improvements and observations that we made with regard to misuse and misinterpretation of the DII and provide suggestions for future developments.
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Affiliation(s)
- James R Hébert
- Cancer Prevention and Control Program
- Department of Epidemiology and Biostatistics, Arnold School of Public Health
| | - Nitin Shivappa
- Cancer Prevention and Control Program
- Department of Epidemiology and Biostatistics, Arnold School of Public Health
| | - Michael D Wirth
- Cancer Prevention and Control Program
- Department of Epidemiology and Biostatistics, Arnold School of Public Health
- College of Nursing, University of South Carolina, Columbia, SC
| | - James R Hussey
- Department of Epidemiology and Biostatistics, Arnold School of Public Health
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Lemanne D, Maizes V. Advising Women Undergoing Treatment for Breast Cancer: A Narrative Review. J Altern Complement Med 2018; 24:902-909. [PMID: 30247957 DOI: 10.1089/acm.2018.0150] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
A majority of women undergoing conventional treatment for breast cancer also undertake complementary and integrative approaches. Practitioners knowledgeable about the evidence base behind common integrative approaches can help patients attain improved quality of life, and at times, improved survival. Evidence-based recommendations include the following: a plant-based diet for general health after diagnosis, and carbohydrate restriction for patients with estrogen receptor-positive postmenopausal breast cancer may be prudent. Other dietary recommendations include a 13-h daily overnight fast. Carefully selected patients may choose to fast the day before and the day of chemotherapy to decrease side effects. Specific food recommendations include avoidance or limitation of alcohol, and liberal culinary use of cruciferous vegetables, coffee, green tea, soy, and flaxseed. Promising supplements include diindolylmethane and melatonin. Omega 3 fatty acids may help with bone density in patients on aromatase inhibitors, but may increase chemotherapy resistance. Findings regarding the usefulness of multivitamins, vitamin D, vitamin C, and vitamin E are weak and/or mixed different exercise modalities may have different effects and thus play different roles in breast cancer therapy. Aerobic and resistance training combined during breast cancer chemotherapy may confer a survival benefit, while yoga may improve outcome in lymphedema patients. Current evidence suggests that meditation, yoga, breathing, music therapy, guided imagery, and hypnosis may improve mood and quality of life during breast cancer treatment. Acupuncture is useful for treating side effects of breast cancer therapies, including hot flushes, aromatase inhibitor-induced joint pain, chemotherapy-induced peripheral neuropathy, and vulvodynia. Vaginal moisturizers and vaginal rings supplying low-dose estrogen can be useful in the treatment of symptoms of estrogen-deprivation states caused by breast cancer treatments; such symptoms include vaginal dryness, dyspareunia, and sexual dysfunction. Carbon dioxide laser technology can rejuvenate atrophied vaginal mucosa and relieve dyspareunia, allowing avoidance of estrogen therapy. Tertiary sexual health centers are available for referral.
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Affiliation(s)
- Dawn Lemanne
- 1 The University of Arizona Center for Integrative Medicine , Tucson, Arizona.,2 Oregon Integrative Oncology , Ashland, Oregon.,3 National Institute of Integrative Medicine , Melbourne, Australia
| | - Victoria Maizes
- 1 The University of Arizona Center for Integrative Medicine , Tucson, Arizona
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Zuniga KE, Parma DL, Muñoz E, Spaniol M, Wargovich M, Ramirez AG. Dietary intervention among breast cancer survivors increased adherence to a Mediterranean-style, anti-inflammatory dietary pattern: the Rx for Better Breast Health Randomized Controlled Trial. Breast Cancer Res Treat 2018; 173:145-154. [PMID: 30259284 DOI: 10.1007/s10549-018-4982-9] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 09/24/2018] [Indexed: 12/21/2022]
Abstract
PURPOSE The goal of this education and culinary-based dietary intervention was to increase adherence to a Mediterranean-style, anti-inflammatory dietary pattern in breast cancer survivors (BCS) by promoting the consumption of anti-inflammatory foods, herbs, and spices. METHODS Overweight and obese, early-stage, BCS were randomized to the Intervention (n = 76) or Control (n = 77). The 6-month intervention included monthly nutrition and cooking workshops, Motivational Interviewing telephone calls, and individualized newsletters. Control participants received monthly informational brochures and no navigational services. Dietary intakes were collected via questionnaire and 3-day food records at baseline and 6 months. RESULTS One hundred twenty-five BCS (n = 60 I; n = 65 C) completed post-testing (81.7%) and were included in analyses. Adherence to Mediterranean diet guidelines significantly increased in the intervention group, but not in the control group (+ 22.5% vs. + 2.7%, P < 0.001). Upon further analysis of adherence to individual dietary guidelines, the intervention group significantly improved adherence to only three guidelines: consuming ≥ 3 servings of fish or shellfish/week, reducing red meat intake to < 1 serving/day, and limiting consumption of commercial sweets and baked goods to < 3 times/week. The intervention arm increased the use of spices and herbs compared to control (+ 146.2% vs. +33.3%, P < 0.001), including significantly more frequent consumption of cinnamon, turmeric, garlic, ginger, black pepper, and rosemary. CONCLUSION An education and culinary-based intervention in BCS successfully increased adherence to a more Mediterranean-style, anti-inflammatory dietary pattern by increasing the consumption of anti-inflammatory foods, spices, and herbs and decreasing the consumption of pro-inflammatory foods.
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Affiliation(s)
- Krystle E Zuniga
- School of Family and Consumer Sciences, Nutrition and Foods, Texas State University, San Marcos, USA.
| | - Dorothy Long Parma
- Department of Epidemiology and Biostatistics, Institute for Health Promotion Research, UT Health San Antonio, San Antonio, USA
| | - Edgar Muñoz
- Department of Epidemiology and Biostatistics, Institute for Health Promotion Research, UT Health San Antonio, San Antonio, USA
| | - Mackenzie Spaniol
- Department of Epidemiology and Biostatistics, Institute for Health Promotion Research, UT Health San Antonio, San Antonio, USA
| | - Michael Wargovich
- Department of Molecular Medicine, UT Health San Antonio, San Antonio, USA
| | - Amelie G Ramirez
- Department of Epidemiology and Biostatistics, Institute for Health Promotion Research, UT Health San Antonio, San Antonio, USA
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Shivappa N, Niclis C, Coquet JB, Román MD, Hébert JR, Diaz MDP. Increased inflammatory potential of diet is associated with increased odds of prostate cancer in Argentinian men. Cancer Causes Control 2018; 29:803-813. [PMID: 30019102 PMCID: PMC6108929 DOI: 10.1007/s10552-018-1056-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 07/12/2018] [Indexed: 12/11/2022]
Abstract
PURPOSE Various aspects of diet, including specific food items and nutrients, have been shown to modulate inflammation and have been implicated in the etiology of prostate cancer (PrCA). No study examining the role of diet-associated inflammation in PrCA has been conducted in Latin America. METHOD We examined the association between the Dietary Inflammatory Index (DII®) and PrCA in a population-based case-control study in Córdoba, Argentina. A total of 153 incident cases of PrCA and 309 controls frequency matched on sex, age (± 5 years), and place of residence were recruited from 2008 to 2015. The DII was developed to determine the inflammatory potential of individuals' diets and was computed from a validated food frequency questionnaire using nutrient data from diet only. Multi-level logistic regression models were fit to evaluate the association between DII scores and PrCA, adjusting for age, body mass index, energy intake, and occupational exposure as first-level covariates and family history of prostate cancer as the second-level variable. Odds ratios were estimated in all subject and stratified by BMI (< 30 vs. ≥ 30 kg/m2). RESULTS Men in the most pro-inflammatory group (tertile 3) had 50% higher odds of having PrCA compared to men in the most anti-inflammatory group (tertile 1) (ORtertile3 vs. tertile1 1.50; 95% CI 1.24-1.80). The odds of prostate cancer were higher in obese men (n = 109, ORtertile3 vs. tertile1 1.81; 95% CI 1.45-2.27), while no association was found among non-obese men (n = 375, ORtertile3 vs. tertile1 0.93; 95% CI 0.25-3.51). CONCLUSIONS A pro-inflammatory diet, reflected by higher DII scores, was positively associated with PrCA occurrence. Based on these results and those from other studies, steps should be taken to promote a diet rich in anti-inflammatory foods, in order to reduce risk of PrCA and other chronic diseases. Future studies should explore this association in a prospective setting.
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Affiliation(s)
- Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, 29208, USA.
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.
- Connecting Health Innovations LLC, Columbia, SC, 29201, USA.
| | - Camila Niclis
- Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Córdoba - Consejo Nacional de Investigaciones Científicas y Técnicas, Haya de la Torre Esq. Enfermera Gordillo, 5016, Ciudad Universitaria, Córdoba, Argentina
- Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Enrique Barros s/n, 5016, Ciudad Universitaria, Córdoba, Argentina
| | - Julia Becaria Coquet
- Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Córdoba - Consejo Nacional de Investigaciones Científicas y Técnicas, Haya de la Torre Esq. Enfermera Gordillo, 5016, Ciudad Universitaria, Córdoba, Argentina
- Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Enrique Barros s/n, 5016, Ciudad Universitaria, Córdoba, Argentina
| | - María D Román
- Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Córdoba - Consejo Nacional de Investigaciones Científicas y Técnicas, Haya de la Torre Esq. Enfermera Gordillo, 5016, Ciudad Universitaria, Córdoba, Argentina
- Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Enrique Barros s/n, 5016, Ciudad Universitaria, Córdoba, Argentina
| | - James R Hébert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
- Connecting Health Innovations LLC, Columbia, SC, 29201, USA
| | - María Del Pilar Diaz
- Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Córdoba - Consejo Nacional de Investigaciones Científicas y Técnicas, Haya de la Torre Esq. Enfermera Gordillo, 5016, Ciudad Universitaria, Córdoba, Argentina
- Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Enrique Barros s/n, 5016, Ciudad Universitaria, Córdoba, Argentina
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Correa-Rodríguez M, González-Jiménez E, Rueda-Medina B, Tovar-Gálvez MI, Ramírez-Vélez R, Correa-Bautista JE, Schmidt-RioValle J. Dietary inflammatory index and cardiovascular risk factors in Spanish children and adolescents. Res Nurs Health 2018; 41:448-458. [PMID: 30168607 DOI: 10.1002/nur.21904] [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: 12/20/2017] [Accepted: 07/26/2018] [Indexed: 01/22/2023]
Abstract
Dietary inflammatory potential is an established risk factor for adverse cardiovascular events. In this study we analyzed the relation between the Dietary Inflammatory Index (DII) and cardiovascular risk factors, based on anthropometric, body composition, blood pressure, and heart rate parameters in children and adolescents. We conducted a cross-sectional study of 428 Spanish schoolchildren (mean age 12.32 ± 1.84), whose DII was calculated, based on a 24-hr diet recall over 3 days. Anthropometric measurements were taken, and body composition analyzed by bioelectrical impedance analysis. Blood pressure and heart rate parameters were assessed with an automatic monitor. Pubertal stage was assessed based on Tanner criteria. We analyzed the DII both as a continuous variable and as a category variable based on quartiles. Linear regression analysis revealed that the DII was significantly associated with waist to height ratio (WHtR) (p = .026; B = 0.128, 95% CI [.001-.016]) after adjusting for age, sex, total energy intake, and Tanner stage. All macro- and micronutrient intakes were found to be higher in the DII Q1 (anti-inflammatory diet) except for caffeine. This study provides preliminary evidence of a significant association between the DII and WHtR, an index of cardiovascular risk. The results obtained indicate that the inflammatory potential of the diet may play a role in children and adolescents becoming overweight or developing obesity. Future studies in young people should be conducted to validate and further explore these relationships.
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Affiliation(s)
| | | | | | | | - Robinson Ramírez-Vélez
- Centro de Estudios para la Medición de la Actividad Física «CEMA», Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogota, DC 111221, Colombia
| | - Jorge E Correa-Bautista
- Centro de Estudios para la Medición de la Actividad Física «CEMA», Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogota, DC 111221, Colombia
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Imbalanced Nutrient Intake in Cancer Survivors from the Examination from the Nationwide Health Examination Center-Based Cohort. Nutrients 2018; 10:nu10020212. [PMID: 29443930 PMCID: PMC5852788 DOI: 10.3390/nu10020212] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 02/04/2018] [Accepted: 02/06/2018] [Indexed: 12/18/2022] Open
Abstract
This study was conducted to examine the nutrient intake status of cancer survivors. A total of 5224 cancer survivors, 19,926 non-cancer individuals without comorbidities (non-cancer I), and 20,622 non-cancer individuals with comorbidities, matched by age, gender, and recruitment center location were included in the analysis. Generally, the proportion of total energy from carbohydrates was higher and the proportion from fat was lower in cancer survivors. The odds ratios (ORs) for total energy (OR = 0.92, 95% confidence interval (CI) = 0.86–0.99), proportion of total energy from fat (OR = 0.54, 95% CI = 0.35–0.83), and protein (OR = 0.85, 95% CI = 0.79–0.90) were significantly lower, and the OR for the proportion of total energy from carbohydrates was higher (OR = 1.21, 95% CI = 1.10–1.33) in the cancer survivors than in non-cancer I. Additionally, the cancer survivors’ protein, vitamin B1, vitamin B2, niacin, and phosphorus intakes were lower, whereas their vitamin C intake was higher. When divided by cancer type, the ORs for the carbohydrate percentages were significantly higher in the colon and breast cancer survivors, whereas protein intake was lower in gastric, breast, and cervical cancer survivors. The nutrient intake patterns in Asian cancer survivors are poor, with higher carbohydrate and lower fat and protein intakes.
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Shivappa N, Godos J, Hébert JR, Wirth MD, Piuri G, Speciani AF, Grosso G. Dietary Inflammatory Index and Cardiovascular Risk and Mortality-A Meta-Analysis. Nutrients 2018; 10:nu10020200. [PMID: 29439509 PMCID: PMC5852776 DOI: 10.3390/nu10020200] [Citation(s) in RCA: 190] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 01/29/2018] [Accepted: 02/09/2018] [Indexed: 01/25/2023] Open
Abstract
Diet and chronic inflammation have been suggested to be risk factors in the development of cardiovascular disease (CVD) and related mortality. The possible link between the inflammatory potential of diet measured through the Dietary Inflammatory Index (DII®) and CVD has been investigated in several populations across the world. The aim of this study was to conduct a meta-analysis on studies exploring this association. Data from 14 studies were eligible, of which two were case-control, eleven were cohort, and one was cross-sectional. Results from the random-effects meta-analysis showed a positive association between increasing DII, indicating a pro-inflammatory diet, and CVD. Individuals in the highest versus the lowest (reference) DII category showed a 36% increased risk of CVD incidence and mortality, with moderate evidence of heterogeneity (relative risk (RR) = 1.36, 95% confidence interval (CI): 1.19, 1.57; heterogeneity index I2 = 69%, p < 0.001). When analyzed as a continuous variable, results showed an increased risk of CVD risk and mortality of 8% for each one-point increase in the DII score. Results remained unchanged when analyses were restricted to the prospective studies. Results of our meta-analysis support the importance of adopting a healthier anti-inflammatory diet for preventing CVD incidence and related mortality. In conclusion, a pro-inflammatory diet is associated with increased risk of CVD and CVD mortality. These results further substantiate the utility of DII as tool to characterize the inflammatory potential of diet and to predict CVD incidence and mortality.
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Affiliation(s)
- Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA.
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.
- Connecting Health Innovations, LLC, Columbia, SC 29201, USA.
| | - Justyna Godos
- NNEdPro Global Centre for Nutrition and Health, St John's Innovation Centre, Cambridge CB4 0WS, UK.
| | - James R Hébert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA.
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.
- Connecting Health Innovations, LLC, Columbia, SC 29201, USA.
| | - Michael D Wirth
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA.
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.
- Connecting Health Innovations, LLC, Columbia, SC 29201, USA.
- College of Nursing, University of South Carolina, Columbia, SC 29208, USA.
| | - Gabriele Piuri
- Inflammation Society, 18 Woodlands Park, Bexley DA52EL, UK.
| | | | - Giuseppe Grosso
- NNEdPro Global Centre for Nutrition and Health, St John's Innovation Centre, Cambridge CB4 0WS, UK.
- Integrated Cancer Registry of Catania-Messina-Siracusa-Enna, Azienda Ospedaliera Universitaria Policlinico Vittorio Emanuele, 95123 Catania, Italy.
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