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Cheng Z, Fu F, Lian Y, Zhan Z, Zhang W. Low-carbohydrate-diet score, dietary macronutrient intake, and depression among adults in the United States. J Affect Disord 2024; 352:125-132. [PMID: 38367707 DOI: 10.1016/j.jad.2024.02.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 02/10/2024] [Accepted: 02/14/2024] [Indexed: 02/19/2024]
Abstract
BACKGROUND The aim was to ascertain whether low-carbohydrate-diet (LCD) score and dietary macronutrient intake are associated with depression. METHODS This cross-sectional study included 23,204 United States adults from the National Health and Nutrition Examination Survey (NHANES) 2005-2018. Dietary macronutrient intake was evaluated by the average of two 24-h dietary recall interviews. LCD score was calculated by summing the 11 quantiles values of the percentages of energy derived from carbohydrate, protein, and fat. Major depression was defined as a nine-item Patient Health Questionnaire score of 10 or more. Logistic regression and restricted cubic spline models were used to explore the relationship between LCD score, dietary macronutrient intake, and depression. RESULTS LCD score was significantly associated with the risk of depression after adjustment for covariates (odds ratio, 0.98; 95 % confidence interval, 0.97-0.99; p < 0.001). Restricted cubic splines showed that the pattern of this inverse association was nonlinear. Among macronutrients, carbohydrate and protein intake was nonlinearly associated with the risk of depression, whereas fat intake was not related to the risk of depression. A decreased risk of depression was observed when the carbohydrate intake was moderate (45.3 %-59.1 %). The pattern of the association between protein intake and the risk of depression was L-shaped. CONCLUSIONS LCD score was inversely associated with the risk of depression in a nonlinear manner in a nationally representative sample of adults from the United States. Furthermore, moderate carbohydrate intake and high protein intake were correlated with a lower risk of depression.
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Affiliation(s)
- Zicheng Cheng
- Department of Neurology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China
| | - Fangwang Fu
- Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yizhi Lian
- Department of Neurology, Affiliated Yueqing Hospital of Wenzhou Medical University, Yueqing, China
| | - Zhenxiang Zhan
- Department of Neurology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China.
| | - Wenyuan Zhang
- Department of Neurology, Affiliated Yueqing Hospital of Wenzhou Medical University, Yueqing, China.
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2
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Zamzam S, Said S, Yaghi J, Faisal FS, Hassan D, Abdul Majeed S, Al Rajabi A, Tayyem R. Dietary Patterns Associated with Breast Cancer in the Middle East: A Scoping Review. Nutrients 2024; 16:579. [PMID: 38474708 DOI: 10.3390/nu16050579] [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: 01/10/2024] [Revised: 02/05/2024] [Accepted: 02/08/2024] [Indexed: 03/14/2024] Open
Abstract
Breast cancer (BC) is the most predominant malignancy in Arab women in the Middle East, and yearly increases in occurrence by 37.5 and mortality rates by 15.2 for every 100,000 in 2019. This review explores the gap in research investigating the role of dietary patterns and BC in Middle Eastern countries. Furthermore, we analyze the evidence connecting these patterns to BC prevalence in the region, discussing implications for public health and preventive strategies. PubMed, ProQuest, and Cochrane databases were searched up to November 2023. Articles published in English from 2000 to 2023 were identified. Our search included dietary patterns (DP), their association with BC and specific to Middle Eastern Regions. The majority of existing research is concentrated in Iran, with limited illustration from Saudi Arabia, Turkey, and Jordan, and a notable absence of studies from other Middle Eastern countries. We found that dietary intervention is closely related to the occurrence, development, and prognosis of BC. Most DPs such as the Dietary Approaches to Stop Hypertension, Mediterranean, Plant-based and Paleolithic diets are identified to decrease the probability of BC by being rich sources of fiber, healthy fats, and vitamins and minerals. However, there are few DPs that increase the risk of BC, because of the existence of foods such as unhealthy fats, low fiber, sugars, and fried foods in those patterns which contribute to increasing the risk factors associated with BC. This review highlights the intricate connection between DPs and the risk of BC in the Middle East, revealing potential protective effects and heightened risks linked to specific dietary elements.
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Affiliation(s)
- Syed Zamzam
- Department of Human Nutrition, College of Health Science, Qatar University, Doha P.O. Box 2713, Qatar
| | - Suad Said
- Department of Human Nutrition, College of Health Science, Qatar University, Doha P.O. Box 2713, Qatar
| | - Juman Yaghi
- Department of Human Nutrition, College of Health Science, Qatar University, Doha P.O. Box 2713, Qatar
| | - Fathima Sahar Faisal
- Department of Human Nutrition, College of Health Science, Qatar University, Doha P.O. Box 2713, Qatar
| | - Dana Hassan
- Department of Human Nutrition, College of Health Science, Qatar University, Doha P.O. Box 2713, Qatar
| | - Safa Abdul Majeed
- Department of Human Nutrition, College of Health Science, Qatar University, Doha P.O. Box 2713, Qatar
| | - Ala Al Rajabi
- Department of Human Nutrition, College of Health Science, Qatar University, Doha P.O. Box 2713, Qatar
| | - Reema Tayyem
- Department of Human Nutrition, College of Health Science, Qatar University, Doha P.O. Box 2713, Qatar
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3
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Kahrizsangi MA, Ebrahimi Z, Shateri Z, Mansouri F, Zangene A, Rajabzadeh-Dehkordi M, Nouri M, Rashidkhani B. Carbohydrate quality indices and colorectal cancer risk: a case-control study. BMC Cancer 2023; 23:347. [PMID: 37069525 PMCID: PMC10108463 DOI: 10.1186/s12885-023-10786-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/29/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND Colorectal cancer (CRC) is the fourth and third most common cancer in Iran and the world, respectively. Carbohydrates can lead to the proliferation of cancer cells, including CRC. The current study aimed to investigate the association between glycemic load (GL), insulin load (IL), glycemic index (GI), insulin index (II), low-carbohydrate diet score (LCDS), and carbohydrate quality index (CQI) with CRC odds. METHODS The present case-control study was performed on 71 CRC cases and 142 controls in the Hospital Cancer Organization and three general hospitals in Tehran, Iran. We calculated the dietary GI, GL, IL, II, CQI, and LCDS by a validated food frequency questionnaire. RESULTS The results indicated that people who were in the highest tertile of the GI had higher odds of CRC compared to the lower tertile (in the adjusted model: odds ratio (OR) = 3.89; 95% confidence interval (CI): 1.71-8.84). On the contrary, people who were in the highest tertile of the CQI and LCDS had significantly lower odds of CRC compared to the lower tertile (in the adjusted model: tertile (T) 2-OR = 0.24; 95% CI: 0.11-0.53 and T3-OR = 0.15; 95% CI: 0.06-0.39 for CQI and T2-OR = 0.33; 95% CI: 0.13-0.79 and T3-OR = 0.28; 95% CI: 0.10-0.82 for LCDS). Also, IL was positively associated with the odds of CRC after adjusting for confounding factors (T2-OR = 2.46; CI: 1.08-5.61 and T3- OR = 2.80; 95% CI: 1.07-7.31). Regarding the GL, only individuals who were in the second tertile had significantly higher odds of CRC compared to the first tertile (OR = 2.42; CI: 1.07-5.47). CONCLUSION According to the findings, it is recommended to use a diet with high-quality carbohydrates and low GI and GL to minimize the odds of developing CRC. People should also be encouraged to have a balanced carbohydrate intake.
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Affiliation(s)
- Masoud Amini Kahrizsangi
- Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zohreh Ebrahimi
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Zainab Shateri
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fatemeh Mansouri
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Zangene
- Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Milad Rajabzadeh-Dehkordi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehran Nouri
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Bahram Rashidkhani
- Department of Community Nutrition, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Khoramdad M, Solaymani-Dodaran M, Kabir A, Ghahremanzadeh N, Hashemi EOS, Fahimfar N, Omidi Z, Mansournia MA, Olfatbakh A, Salehiniya H, Haghighat S. Breast cancer risk factors in Iranian women: a systematic review and meta-analysis of matched case-control studies. Eur J Med Res 2022; 27:311. [PMID: 36575538 PMCID: PMC9793603 DOI: 10.1186/s40001-022-00952-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 12/14/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Identifying breast cancer risk factors is a critical component of preventative strategies for this disease. This study aims to identify modifiable and non-modifiable risk factors of breast cancer in Iranian women. METHODS We used international databases (PubMed/Medline, Scopus, Web of Knowledge, and Embase) and national databases (SID, Magiran, and ISC) to retrieve relevant studies until November 13, 2022. The odds ratio (OR) with a 95% confidence interval using the random-effect model was used to estimate the pooled effect. The publication bias was assessed by the Egger and Begg test. A sensitivity analysis was conducted to evaluate the effect of each included study on the final measurement. RESULTS Of the 30,351 retrieved articles, 24 matched case-control records were included with 12,460 participants (5675 newly diagnosed cases of breast cancer and 6785 control). This meta-analysis showed that of the known modifiable risk factors for breast cancer, obesity (vs normal weight) had the highest risk (OR = 2.17, 95% CI 1.47 to 3.21; I2 = 85.7) followed by age at marriage (25-29 vs < 18 years old) (OR = 2.00, 95% CI 1.53 to 2.61; I2 = 0), second-hand smoking (OR = 1.86, 95% CI 1.58 to 2.19; I2 = 0), smoking (OR = 1.83, 95% CI 1.41 to 2.38; I2 = 18.9), abortion history (OR = 1.44, 95% CI 1.02 to 2.05; I2 = 66.3), oral contraceptive use (OR = 1.35, 95% CI 1.11 to 1.63; I2 = 74.1), age at marriage (18-24 vs < 18 years old) (OR: 1.22, 95% CI 1.02 to 1.47; I2 = 0). Of non-modifiable risk factors, history of radiation exposure (OR = 3.48, 95% CI 2.17 to 5.59; I2 = 0), family history of breast cancer (OR = 2.47, 95% CI 1.83 to 3.33; I2 = 73), and age at menarche (12-13 vs ≥ 14 years old) (OR = 1.67, 95% CI 1.31-2.13; I2 = 25.4) significantly increased the risk of breast cancer. CONCLUSIONS Since most risk factors related to breast cancer incidence are modifiable, promoting healthy lifestyles can play an influential role in preventing breast cancer. In women with younger menarche age, a family history of breast cancer, or a history of radiation exposure, screening at short intervals is recommended.
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Affiliation(s)
- Malihe Khoramdad
- grid.411746.10000 0004 4911 7066Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Masoud Solaymani-Dodaran
- grid.411746.10000 0004 4911 7066Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran ,grid.411746.10000 0004 4911 7066Minimally Invasive Surgery Research Center, Hazrat-E-Rasool Hospital, Iran University of Medical Science, Tehran, Iran
| | - Ali Kabir
- grid.411746.10000 0004 4911 7066Minimally Invasive Surgery Research Center, Hazrat-E-Rasool Hospital, Iran University of Medical Science, Tehran, Iran
| | - Neda Ghahremanzadeh
- grid.411746.10000 0004 4911 7066Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Esmat-o-Sadat Hashemi
- grid.417689.5Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| | - Noushin Fahimfar
- grid.411705.60000 0001 0166 0922Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Omidi
- grid.417689.5Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| | - Mohammad Ali Mansournia
- grid.411705.60000 0001 0166 0922Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Asiie Olfatbakh
- grid.417689.5Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| | - Hamid Salehiniya
- grid.411701.20000 0004 0417 4622Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Shahpar Haghighat
- grid.417689.5Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
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5
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Lei L, Huang J, Zhang L, Hong Y, Hui S, Yang J. Effects of low-carbohydrate diets versus low-fat diets on metabolic risk factors in overweight and obese adults: A meta-analysis of randomized controlled trials. Front Nutr 2022; 9:935234. [PMID: 36017224 PMCID: PMC9397119 DOI: 10.3389/fnut.2022.935234] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 07/14/2022] [Indexed: 11/14/2022] Open
Abstract
Background and aims Low-carbohydrate diets (LCD) and low-fat diets (LFD) have shown beneficial effects on the management of obesity. Epidemiological studies were conducted to compare the effects of the two diets. However, the results were not always consistent. This study aimed to conduct a meta-analysis to compare the long-term effects of LCD and LFD on metabolic risk factors and weight loss in overweight and obese adults. Methods We performed a systematic literature search up to 30 March, 2022 in PubMed, EMBASE, and Cochrane Library. The meta-analysis compared the effects of LCD (carbohydrate intake ≤ 40%) with LFD (fat intake < 30%) on metabolic risk factors and weight loss for ≥6 months. Subgroup analyses were performed based on participant characteristics, dietary energy intake, and the proportions of carbohydrates. Results 33 studies involving a total of 3,939 participants were included. Compared with participants on LFD, participants on LCD had a greater reduction in triglycerides (–0.14 mmol/L; 95% CI, –0.18 to –0.10 mmol/L), diastolic blood pressure (–0.87 mmHg; 95% CI, –1.41 to –0.32 mmHg), weight loss (–1.33 kg; 95% CI, –1.79 to –0.87 kg), and a greater increase in high-density lipoprotein cholesterol (0.07 mmol/L; 95% CI, 0.06 to 0.09 mmol/L) in 6–23 months. However, the decrease of total cholesterol (0.14 mmol/L; 95% CI, 0.07 to 0.20 mmol/L) and low-density lipoprotein cholesterol (0.10 mmol/L; 95% CI, 0.06 to 0.14 mmol/L) was more conducive to LFD in 6–23 months. There was no difference in benefits between the two diets after 24 months. Subgroup analyses showed no significant difference in the reduction of total cholesterol, low-density lipoprotein cholesterol, and blood pressure between the two diets in participants with diabetes, hypertension, or hyperlipidemia. Conclusion The results suggest that LCD and LFD may have specific effects on metabolic risk factors and weight loss in overweight and obese adults over 6 months. At 24 months, the effects on weight loss and improvement of metabolic risk factors were at least the same. These indicated that we might choose different diets to manage the overweight and obese subjects. However, the long-term clinical efficacy and effects of various sources of carbohydrates or fat in the two diets need to be studied in the future.
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Affiliation(s)
- Lifu Lei
- Department of Clinical Nutrition, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China.,Research Center for Metabolic and Cardiovascular Diseases, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Juan Huang
- Department of Clinical Nutrition, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China.,Research Center for Metabolic and Cardiovascular Diseases, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Longlong Zhang
- Research Center for Metabolic and Cardiovascular Diseases, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China.,Department of Endocrinology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yuqin Hong
- Department of Radiology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Suocheng Hui
- Department of Clinical Nutrition, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China.,Research Center for Metabolic and Cardiovascular Diseases, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jian Yang
- Department of Clinical Nutrition, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China.,Research Center for Metabolic and Cardiovascular Diseases, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Sasanfar B, Toorang F, Rostami S, Yeganeh MZ, Ghazi ML, Seyyedsalehi MS, Zendehdel K. The effect of nutrition education for cancer prevention based on health belief model on nutrition knowledge, attitude, and practice of Iranian women. BMC Womens Health 2022; 22:213. [PMID: 35672814 PMCID: PMC9175379 DOI: 10.1186/s12905-022-01802-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 05/27/2022] [Indexed: 11/10/2022] Open
Abstract
Background In recent years, nutrition has received an increasingly important role in the etiology of cancer. Thus, public education about dietary factors associated with cancer risk or prevention could be an important intervention for cancer prevention, particularly in low- and middle-income countries where the burden of cancer is increasing rapidly and the access to care is limited. The age-standardized incidence of breast cancer was 35.8 among Iranian women in 2020. We aimed to study the effect of nutrition education on the knowledge, attitude, and practice of Iranian women towards dietary factors related to cancer.
Methods In this interventional study, 229 women from public health centers were recruited and underwent three 75-min sessions of education based on the Health Belief Model (HBM). Participants were interviewed by trained interviewers using a validated and reproducible nutrition-related cancer prevention knowledge, attitude, and practice questionnaire (NUTCANKAP) questionnaire designed based on the HBM. Nutritional knowledge, attitude, and practice of participants were assessed through this questionnaire. Three 24-h dietary recalls (one weekend and two nonconsecutive weekdays) were also collected before and one month after the intervention. Results The mean age of the participants was 45.14 years, and the mean BMI was 27.2 kg/m2. After the intervention, the participants had a higher intake of whole grain (p = 0.03) and a lower fat dairy (p = 0.009) and nuts (p = 0.04). However, the intake of high-fat dairy (p = 0.001) decreased after the intervention. We indicated significant differences in knowledge (p < 0.001) and nutritional practice scores (p = 0.01) after education. In addition, after the intervention, there were significant differences in the mean score of the HBM components, except for the perceived self-efficacy. Conclusion Participation in a nutrition education program positively impacted the knowledge and nutritional practices linked to cancer prevention.
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Affiliation(s)
- Bahareh Sasanfar
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, P.O.Box: 13145158, Tehran, Iran
| | - Fatemeh Toorang
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, P.O.Box: 13145158, Tehran, Iran.,Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Rostami
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, P.O.Box: 13145158, Tehran, Iran
| | - Maryam Zarif Yeganeh
- Department of Community Nutrition Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Lafzi Ghazi
- Department of Exercise Physiology, Central Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Monireh Sadat Seyyedsalehi
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, P.O.Box: 13145158, Tehran, Iran.,Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Kazem Zendehdel
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, P.O.Box: 13145158, Tehran, Iran. .,Cancer Biology Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran. .,Breast Diseases Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.
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7
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Akbari A, Sohouli MH, Deliu Lozovanu O, Lotfi M, Nabavizadeh R, Saeidi R. Dietary insulin index and load with risk of breast cancer in a case-control study. Int J Clin Pract 2021; 75:e14883. [PMID: 34534393 DOI: 10.1111/ijcp.14883] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 09/10/2021] [Accepted: 09/13/2021] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE Circulating insulin levels have been positively associated with risk of breast cancer (BrCa); however, it remains unclear whether a diet inducing an elevated insulin response influences Breast risk. METHODS In this study, 250 newly diagnosed breast cancer patients and 250 hospitalised controls were recruited using convenience sampling. The dietary insulin index (DII) was calculated by dividing the dietary insulin load by the total energy intake. RESULTS Compared with those in the lowest tertiles of DII and dietary insulin load (DIL), subjects in the highest tertile were more likely to be overweight, have a family history of breast and other types of cancer and a history of benign breast diseases. After controlling for multiple potential confounders, a significantly increased BrCa odds was observed in the highest tertiles of DII and DIL score compared with the lowest tertiles (odds ratio (OR): 1.46; 95% CI: 0.67-3.19, P = .006) and (OR: 1.87; 95% CI: 0.92-3.80, P = .038), respectively. CONCLUSIONS Our findings suggest that a diet that induces an elevated postprandial insulin response, indicated by higher DII and DIL scores, may increase the odds of BrCa, especially among women.
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Affiliation(s)
- Atieh Akbari
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Hassan Sohouli
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Mojtaba Lotfi
- Department of Pediatric Endocrinology and Metabolism, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Raheleh Nabavizadeh
- Pediatric Gastroenterology, Hepatology and Nutrition Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Saeidi
- Department of Pediatric Endocrinology and Metabolism, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Faculty of Medicine, Mofid Children's Hospital, Neonatal Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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8
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Sasanfar B, Toorang F, Mohebbi E, Zendehdel K, Azadbakht L. Dietary carbohydrate quality and risk of breast cancer among women. Nutr J 2021; 20:93. [PMID: 34823559 PMCID: PMC8620945 DOI: 10.1186/s12937-021-00752-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 11/10/2021] [Indexed: 12/31/2022] Open
Abstract
Background A few studies have examined the relationship between carbohydrate quality index (CQI) and risk of breast cancer (BC) among women in Middle Eastern countries. We studied the associations between carbohydrate quality index and the risk of BC in overall and by menopausal status. Methods In this case-control study, dietary intake of 461 women with pathologically confirmed BC within the past year were examined. The same information were collected for 495 apparently healthy controls using a 168-item validated FFQ. Carbohydrate quality was determined by considering four criteria including: ratio of solid carbohydrates to total carbohydrates, dietary fiber intake, GI and the ratio of whole grains to total grains. Results Mean GI and GL of participants were totally 57.5 ± 7.2 and 245.7 ± 64.7, respectively. A trend toward significant association was seen between GI and odds of BC in the whole population; such that after stratifying analysis by menopausal status, premenopausal women in the highest quartile of GI were 1.85 times higher likely to have BC than those in the lowest quartile (95% CI: 1.12, 3.07, P = 0.01). We found that women with the greatest CQI had lower odds for BC, compared with those with the lowest CQI (0.63; 95% CI: 0.43–0.94, P = 0.03). This association was remained after stratifying analysis by menopausal status in premenopausal (0.55; 95% CI: 0.34–0.90, P = 0.04). Conclusion We found that GI was directly and CQI inversely associated with odds of BC. In order to determine the effects of dietary carbohydrate quality prospective cohort studies are needed.
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Affiliation(s)
- Bahareh Sasanfar
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, P.O.Box 13145158, Tehran, Iran
| | - Fatemeh Toorang
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, P.O.Box 13145158, Tehran, Iran.,Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran
| | - Elham Mohebbi
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, P.O.Box 13145158, Tehran, Iran.,Pathology and Stem Cell Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Kazem Zendehdel
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, P.O.Box 13145158, Tehran, Iran. .,Cancer Biology Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran. .,Breast Diseases Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran. .,Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. .,Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
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9
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Toorang F, Sasanfar B, Esmaillzadeh A, Zendehdel K. Adherence to the DASH Diet and Risk of Breast Cancer. Clin Breast Cancer 2021; 22:244-251. [PMID: 34588148 DOI: 10.1016/j.clbc.2021.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 06/15/2021] [Accepted: 07/20/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND The Dietary Approach to Stop Hypertension (DASH) eating pattern has been recommended as a healthy dietary plan by several international guidelines. However, data on the association between the DASH diet and breast cancer is limited. This study investigated the association between the DASH dietary pattern and risk of breast cancer. MATERIALS AND METHODS This is a hospital-based case-control study conducted between 2014 and 2016 in the Cancer Institute of Iran. Patients with histopathologically confirmed breast cancer were recruited. Controls were healthy subjects who were frequency matched to cases by residential place and age (±10 years). A validated 168-item Food Frequency Questionnaire was applied to assess the dietary intake of participants. Physical activity was assessed using the Global Physical Activity Questionnaire. The DASH dietary pattern scores were calculated using the method introduced by Fung. Unconditional logistic regression, in which potential confounders were taken into account, was applied to determine the association between adherence to the DASH dietary pattern and odds of breast cancer. RESULTS The study participants comprised 477 patients with breast cancer and 507 healthy controls. In the total population, patients with breast cancer were slightly older (45.9 vs. 43.9 years, P = .02), had slightly higher BMI (21.9 vs. 20.2, P = .01) and were less physically active (20 vs. 27 MET h/wk. P < .01) than controls. In Model A, which was adjusted for age and energy intake, adherence to the DASH dietary pattern substantially reduced breast cancer risk in the total population (OR for comparing extreme tertiles: 0.62; 95% CI 0.44-0.78; Ptrend = 0.004). Even after controlling for more cofounders, greatest adherence to DASH diet was associated with a 34% reduction in risk of breast cancer (OR 0.66; 95% CI 0.46, 0.94; Ptrend = 0.03). In premenopausal women, adherence to the DASH dietary pattern was insignificantly associated with a 32% reduction in breast cancer risk. This risk reduction was 38% in postmenopausal women, which was also not found to be significant CONCLUSION: Adherence to the DASH dietary pattern could be associated with an approximately 30% reduction in risk of breast cancer. However, further studies, in particular studies with prospective design, are required to confirm this claim.
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Affiliation(s)
- Fatemeh Toorang
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran; Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahareh Sasanfar
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran; Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Ahmad Esmaillzadeh
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran; Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Kazem Zendehdel
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran; Cancer Biology Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, I.R. Iran; Breast Diseases Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, I.R. Iran.
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Adherence to low-carbohydrate diet in relation to gastric cancer: findings from a case-control study in Iran. Eur J Cancer Prev 2021; 30:297-303. [PMID: 34103461 DOI: 10.1097/cej.0000000000000627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study examined the association between adherence to low carbohydrate diet (LCD) and risk of gastric cancer (GC). This hospital-based case-control study was conducted in Iran Cancer Institute, Tehran, Iran between 2010 and 2012. Totally, 178 patients with GC and 276 apparently healthy controls participated in this study. Cases were histo-pathologically confirmed GC patients aged ≥40 years diagnosed with GC in the last year. Dietary intakes were assessed using a validated 146-item Diet History Questionnaire. We computed the LCD score trough the protocol explained by Halton. Patients with GC were older (60.8 vs. 53.2 years, P < 0.001) and more likely to be male (74.2 vs. 63.8%, P = 0.02), married (97.8 vs. 86.6%, P < 0.001) and illiterate (62.4% vs. 26.1%, P < 0.001) than controls. Before adjusting for covariates, adherence to LCD-diet was not associated with risk of GC [odds ratio (OR) 1.31; 95% confidence interval (CI) 0.82-2.09 for highest vs. lowest tertile; Ptrend < 0.26]. Adjustments for several potential confounders including H-pylori infection and BMI, participants in the highest tertile of LCD score were 7% more likely to have GC than those in the lowest tertile; however, it was not statistically significant (OR 1.07; 95% CI 0.59-1.95 for highest vs. lowest tertile; Ptrend < 0.79). No significant association was also seen between adherence to animal- or vegetable-based LCD diet and risk of GC. In conclusion, we failed to find any evidence on the association between consumption of LCD and odds of GC. Further studies, in particular of prospective design, are required to confirm these findings.
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Hosseini F, Imani H, Sheikhhossein F, Majdi M, Ghanbari M, Shab-Bidar S. Dietary Carbohydrate Quality and Quantity and Risk of Breast Cancer among Iranian Women. Nutr Cancer 2021; 74:916-926. [PMID: 34180312 DOI: 10.1080/01635581.2021.1942931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE This study investigated the association between quality and quantity of carbohydrate by assessing low carbohydrates diet score (LCDS), carbohydrate quality score (CQI), glycemic index (GI), dietary glycemic load (GL), and dietary carbohydrate intake, and risk of breast cancer (BrCa) among Iranian women. METHODS This hospital-based case-control study was carried out in the Cancer Research Center of Imam Khomeini hospital, Iran. We included One hundred and fifty newly diagnosed BrCa cases and one hundred and fifty healthy controls in this study. Socio-demographic and dietary data and anthropometric measures were recorded. RESULTS We found that a higher CQI than a lower score was associated with a decrease in odds of BrCa (P = 0.04). After adjusting for potential confounders, we observed that CQI was not associated with BrCa development (P = 0.05). An increase in odds of BrCa among women in the highest tertiles of GL (P = 0.12), GI (P = 0.48), and dietary carbohydrate intake (P = 0.06) was seen, which was not statistically significant. There was also a non-significant lower chance of having BrCa with adherence to the LCDS (P = 0.09). CONCLUSION Our findings suggest that CQI was not related to BrCa risk among Iranian women. This relation deserves to be investigated in prospective studies.
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Affiliation(s)
- Fatemeh Hosseini
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Hossein Imani
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Fatemeh Sheikhhossein
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Maryam Majdi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Mahtab Ghanbari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
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Sangsefidi ZS, Salehi-Abarghouei A, Sangsefidi ZS, Mirzaei M, Hosseinzadeh M. The relation between low carbohydrate diet score and psychological disorders among Iranian adults. Nutr Metab (Lond) 2021; 18:16. [PMID: 33516257 PMCID: PMC7847167 DOI: 10.1186/s12986-021-00546-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 01/18/2021] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Since evidence regarding to low carbohydrate diet (LCD) and psychiatric disorders is little and controversial, this study aimed to assess relation between LCD score and psychological disorders including depression, anxiety, and stress among a large representative sample of Iranian adult population in Yazd city, Iran. METHODS This cross-sectional analysis was conducted on data of 7165 persons who participated in the recruitment phase of Yazd Health Study (YaHS) and Taghzieh Mardom-e-Yazd (TAMIZ) study. Dietary intakes were evaluated by a validated semi-quantitative food frequency questionnaire. LCD score was calculated for each person according to summing up assigned scores to deciles of percentages of energy from macronutrients. Assessment of psychological disorders was also conducted by the validated Iranian version of depression, anxiety and stress scale questionnaire (DASS 21). Eventually, association between adherence to LCD and psychological disorders was evaluated via logistic regression. RESULTS After adjusting the confounders, women in the third quartile of LCD score might had 38% lower chance of depression versus those in the first quartile (odds ratio (OR) = 0.62, confidence interval (CI) = 0.42-0.93). However, no significant relationship was observed for other psychological disorders. CONCLUSIONS More adherences to LCD might be associated with lower chance of depression only among women. Further studies special prospective studies are required to validate these results.
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Affiliation(s)
- Zohreh Sadat Sangsefidi
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Amin Salehi-Abarghouei
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Zahra Sadat Sangsefidi
- Psychiatry and Behavioral Sciences Research Center, Ibn-e-Sina Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masoud Mirzaei
- Yazd Cardiovascular Research Centre, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mahdieh Hosseinzadeh
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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Toorang F, Sasanfar B, Hadji M, Esmaillzadeh A, Zendehdel K. Adherence to "dietary approaches to stop hypertension" eating plan in relation to gastric cancer. Nutr J 2020; 19:40. [PMID: 32393262 PMCID: PMC7216586 DOI: 10.1186/s12937-020-00560-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 05/04/2020] [Indexed: 01/10/2023] Open
Abstract
Background Although adherence to “Dietary Approaches to Stop Hypertension” (DASH) dietary pattern has been linked with reduced risk of several cancers. To our knowledge no studies have examined the association between the DASH dietary pattern and risk of gastric cancer. This study was performed to investigate the association between adherence to the DASH dietary pattern and odds of gastric cancer in Iran. Methods This hospital-based case-control study was conducted on 178 histo-pathologically confirmed patients with gastric cancer and 276 sex-matched healthy controls. A validated 146-item Diet History Questionnaire (DHQ) was used to assess participants’ usual dietary intakes. The DASH dietary pattern scores were calculated using the method introduced by Fung. Unconditional logistic regression, in which potential confounders were taken into account, was applied to determine the association of adherence to the DASH dietary pattern and odds of gastric cancer. Results Mean age of cases and controls were 60.8 and 53.2 y, respectively. After controlling for age, sex and energy intakes, participants in the highest tertile were 62% less likely to have gastric cancer than those in the lowest tertile (OR 0.38; 95% CI 0.22,0.65; Ptrend < 0.004). Further adjustment for other potential confounders, including education, marital status, residential place, alcohol intake and smoking, did not change the association dramatically (OR 0.44; 95% CI 0.25, 0.78; Ptrend = 0.005). Even after additional controlling for H-Pylori infection and BMI, greatest adherence to the DASH dietary pattern was associated with a 54% decreased risk of gastric cancer (OR 0.46; 95% CI 0.26, 0.83; Ptrend = 0.01). Conclusions Adherence to the DASH dietary pattern was associated with lower gastric cancer risk in this case-control study.
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Affiliation(s)
- Fatemeh Toorang
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahareh Sasanfar
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, I, Tehran, R, Iran
| | - Maryam Hadji
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.,Faculty of social science, Tampere University, Tampere, Finland
| | - Ahmad Esmaillzadeh
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, I, Tehran, R, Iran. .,Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. .,Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Kazem Zendehdel
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. .,Cancer Biology Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, P.O. Box: 13145158, Tehran, I.R, Iran. .,Breast Diseases Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, I, Tehran, R, Iran.
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