Mechanistic Evidence for Red Meat and Processed Meat Intake and Cancer Risk: A Follow-up on the International Agency for Research on Cancer Evaluation of 2015

Commentary of the SKLM to the EFSA opinion on risk assessment of N-nitrosamines in food

Dietary exposure to N-nitrosamines has recently been assessed by the European Food Safety Authority (EFSA) to result in margins of exposure that are conceived to indicate concern with respect to human health risk. However, evidence from more than half a century of international research shows that N-nitroso compounds (NOC) can also be formed endogenously. In this commentary of the Senate Commission on Food Safety (SKLM) of the German Research Foundation (DFG), the complex metabolic and physiological biokinetics network of nitrate, nitrite and reactive nitrogen species is discussed with emphasis on its influence on endogenous NOC formation. Pioneering approaches to monitor endogenous NOC have been based on steady-state levels of N-nitrosodimethylamine (NDMA) in human blood and on DNA adduct levels in blood cells. Further NOC have not been considered yet to a comparable extent, although their generation from endogenous or exogenous precursors is to be expected. The evidence available to date indicates that endogenous NDMA exposure could exceed dietary exposure by about 2-3 orders of magnitude. These findings require consolidation by refined toxicokinetics and DNA adduct monitoring data to achieve a credible and comprehensive human health risk assessment.

Is diet related to skin condition? A Mendelian randomization study

Observational studies have revealed associations between various dietary factors and skin conditions. However, the causal relationship between diet and skin condition is still unknown. Data on 17 dietary factors were obtained from the UK Biobank. Data on four skin conditions were derived from the UK Biobank and another large-scale GWAS study. Genetic predictions suggested that the intake of oily fish was associated with a lower risk of skin aging (OR: 0.962, P = 0.036) and skin pigmentation (OR: 0.973, P = 0.033); Tea intake was associated with a lower risk of skin pigmentation (OR: 0.972, P = 0.024); Salad/raw vegetables intake was associated with a lower risk of keratinocyte skin cancer (OR: 0.952, P = 0.007). Coffee intake was associated with increased risk of skin aging (OR: 1.040, P = 0.028); Pork intake was associated with increased risk of skin aging (OR: 1.134, P = 0.020); Beef intake was associated with increased risk of cutaneous melanoma (OR: 1.013, P = 0.016); Champagne plus white wine intake was associated with increased risk of cutaneous melanoma (OR: 1.033, P = 0.004); Bread intake was associated with increased risk of keratinocyte skin cancer (OR: 1.026, P = 0.013). Our study results indicate causal relationships between genetically predicted intake of oily fish, tea, salad/raw vegetables, coffee, pork, beef, champagne plus white wine, and bread and skin conditions.

Plant-Based Diets and Disease Progression in Men With Prostate Cancer

Importance

Plant-based diets are associated with many health and environmental benefits, including primary prevention of fatal prostate cancer, but less is known about postdiagnostic plant-based diet patterns in individuals with prostate cancer.

Objective

To examine whether postdiagnostic plant-based dietary patterns are associated with risk of prostate cancer progression and prostate cancer-specific mortality.

Design, Setting, and Participants

This longitudinal observational cohort study included men with biopsy-proven nonmetastatic prostate cancer (stage ≤T3a) from the diet and lifestyle substudy within the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE) enrolled at 43 urology practices across the US from 1999 to 2018. Participants completed a comprehensive diet and lifestyle questionnaire (including a validated food frequency questionnaire [FFQ]) between 2004 and 2016. Data were analyzed from August 2022 to April 2023.

Exposures

Overall plant-based diet index (PDI) and healthful plant-based diet index (hPDI) scores were calculated from the FFQ.

Main Outcomes and Measures

The primary outcome was prostate cancer progression (recurrence, secondary treatment, bone metastases, or prostate cancer-specific mortality). The secondary outcome was prostate cancer-specific mortality.

Results

Among 2062 participants (median [IQR] age, 65.0 [59.0-70.0] years), 61 (3%) identified as African American, 3 (<1%) identified as American Indian or Alaska Native, 9 (<1%) identified as Asian or Pacific Islander, 15 (1%) identified as Latino, and 1959 (95%) identified as White. Median (IQR) time from prostate cancer diagnosis to FFQ was 31.3 (15.9-62.0) months after diagnosis. During a median (IQR) follow-up of 6.5 (1.3-12.8) years after the FFQ, 190 progression events and 61 prostate cancer-specific mortality events were observed. Men scoring in the highest vs lowest quintile of PDI had a 47% lower risk of progression (HR, 0.53; 95% CI, 0.37-0.74; P for trend = .003). The hPDI was not associated with risk of progression overall. However, among 680 individuals with Gleason grade 7 or higher at diagnosis, the highest hPDI quintile was associated with a 55% lower risk of progression compared with the lowest hPDI quintile (HR 0.45; 95% CI, 0.25-0.81; P for trend = .01); no association was observed in individuals with Gleason grade less than 7.

Conclusions and Relevance

In this cohort study of 2062 men with prostate cancer, higher intake of plant foods after prostate cancer diagnosis was associated with lower risk of cancer progression. These findings suggest nutritional assessment and counseling may be recommended to patients with prostate cancer to help establish healthy dietary practices and support well-being and overall health.

Adding a Leafy Vegetable Fraction to Diets Decreases the Risk of Red Meat Mortality in MASLD Subjects: Results from the MICOL Cohort

BACKGROUND

Dietary guidelines recommend limiting red meat intake because it has been amply associated with increased cancer mortality, particularly in patients with liver conditions, such as metabolic dysfunction-associated fatty liver disease (MASLD). MASLD is the leading cause of liver dysfunction in the world today, and no specific treatment other than lifestyle correction has yet been established. The aim of this study was to explore the protective role of leafy vegetables when associated with high red meat consumption.

METHODS

The study cohort included 1646 participants assessed during the fourth recall of the MICOL study, subdivided into two groups based on red meat intake (≤50 g/die vs. >50 g/die), in order to conduct a cancer mortality analysis. The prevalence of subjects that consumed >50 g/die was only 15.73%. Leafy vegetable intake was categorized based on median g/die consumption, and it was combined with red meat intake.

CONCLUSIONS

This is the first study to demonstrate that the consumption of about 30 g/die of leafy vegetables reduces the risk of mortality. A strong association with mortality was observed in subjects with MASLD, and the protective role of vegetables was demonstrated.

Examining the Role of Nutrition in Cancer Survivorship and Female Fertility: A Narrative Review

Female cancer survivors have a higher chance of experiencing infertility than females without a history of cancer diagnosis. This risk remains high despite advances in fertility treatments. There is a need to augment fertility treatments with cost-effective methods such as nutritional guidance to improve fertility chances. The aim of this review article is to connect the current literature on cancer survivorship nutrition and fertility nutrition, focusing on the importance of integrating nutritional guidance into fertility counseling, assessment, and treatment for female cancer survivors. Consuming a healthful diet comprising whole grains, soy, fruits, vegetables, seafood, and unsaturated fats has improved both female fertility and cancer survivorship. Similarly, maintaining a healthy body weight also improves female fertility and cancer survivorship. Therefore, dietary interventions to support female cancer survivors with fertility challenges are of immense importance. The period of follow-up fertility counseling and assessment after cancer treatment may provide a unique opportunity for implementing nutritional guidance for female cancer survivors. Dietary interventions are a promising strategy to improve pregnancy chances and overall quality of life among female cancer survivors; thus, researchers should investigate perceptions regarding fertility, barriers, and challenges to changing nutrition-related behaviors, and preferences for nutritional guidance to support fertility treatments in this population.

Pathological significance of heme oxygenase-1 as a potential tumor promoter in heme-induced colorectal carcinogenesis

The significance of the heme-metabolizing enzyme heme oxygenase-1 (HMOX1) in the pathogenesis of colorectal cancer (CRC) has not been fully explored. HMOX1 cytoprotection is imperative to limit oxidative stress. However, its roles in preventing carcinogenesis in response to high levels of heme are not thoroughly understood. This study reviews various mechanisms associated with the paradoxical role of HMOX1, which is advantageous for tumor growth, refractoriness, and survival of cancer cells amid oxidative stress in heme-induced CRC. The alternate role of HMOX1 promotes cell proliferation and metastasis through immune modulation and angiogenesis. Inhibiting HMOX1 has been found to reverse tumor promotion. Thus, HMOX1 acts as a conditional tumor promoter in CRC pathogenesis.

Meat and meat products - a scoping review for Nordic Nutrition Recommendations 2023

Meat is not only a source of several nutrients but also a proposed risk factor for several non-communicable diseases. Here, we describe the totality of evidence for the role of meat intake for chronic disease outcomes, discuss potential mechanistic pathways, knowledge gaps, and limitations of the literature. Use of the scoping review is based on a de novo systematic review (SR) and meta-analysis on the association between poultry intake and cardiovascular disease (CVD) and type 2 diabetes (T2D), qualified SRs (as defined in the Nordic Nutrition Recommendations 2023 project) on meat intake and cancer by the World Cancer Research Fund (WCRF), the International Agency for Research on Cancer (IARC), and a systematic literature search of SRs and meta-analyses. The quality of the SRs was evaluated using a modified AMSTAR 2 tool, and the strength of evidence was evaluated based on a predefined criteria developed by the WCRF. The quality of the SRs was on average critically low. Our findings indicate that the evidence is too limited for conclusions for most of the chronic disease outcomes. However, findings from qualified SRs indicate strong evidence that processed meat increases the risk of colorectal cancer and probable evidence that red meat (unprocessed, processed, or both) increases the risk. The evidence suggests that both unprocessed red meat and processed meat (also including processed poultry meat) are probable risk factors for CVD mortality and stroke, and that total red meat and processed meat are risk factors for CHD. We found no sufficient evidence suggesting that unprocessed red meat, processed red meat, total red meat, or processed meat (including red and white meat) would be protective of any chronic disease. There was also no sufficient evidence to conclude on protective effect of poultry on any chronic diseases; effects on the risk of CVD, stroke, and T2D, to any direction, were regarded as unlikely.

Dietary intake is associated with the prevalence of uterine leiomyoma in Korean women: A retrospective cohort study

OBJECTIVE

Uterine leiomyoma (UL), the most prevalent benign gynecologic tumor among reproductive-aged women, lacks sufficient research on the potential association between dietary intake and its occurrence in Korean women. Addressing this research gap, this study aims to evaluate the potential link between dietary intake and the prevalence of UL in Korean women.

METHODS

In this cross-sectional study, a cohort of 672 women, aged 23 to 73, were enrolled, with 383 (57%) being premenopausal. Dietary intake was assessed using a validated food frequency questionnaire (FFQ), and UL presence was determined through ultrasonography. The analysis focused exclusively on items within ten categories, including vegetables/fruit, vegetables, fruits, red meat, processed meat, poultry, fish, dairy product, milk, and alcohol. Multiple logistic regression models were employed to explore the relationship between dietary intake and the prevalence of UL, calculating odds ratios (ORs) and 95% confidence intervals (CIs) while adjusting for confounding factors.

RESULTS

Within the total cohort, 220 (32.7%) women were diagnosed with UL. High intakes of fish and poultry showed an association with higher UL prevalence. Odds ratios (95% CIs) for the upper quartiles compared to the lower quartiles were 1.68 (1.01-2.81; p trend = 0.05) for fish intake and 1.87 (1.11-3.17; p trend = 0.06) for poultry intake. Conversely, an inverse relationship emerged between dairy product intake and UL prevalence, with an odds ratio of 0.58 (95% CI 0.35-0.96; p trend = 0.05). Stratifying the analysis by menopausal status revealed a parallel pattern, with heightened UL prevalence with fish intake and reduced prevalence with dairy product intake. However, the link between poultry intake and UL prevalence was primarily observed among postmenopausal women. Among premenopausal women, elevated vegetable intake was linked to a decreased UL prevalence (OR 0.45, 95% CI 0.21-0.97 for top vs. bottom quartiles; p trend = 0.01).

CONCLUSION

We found that high consumption of fish and poultry, coupled with low intake of dairy products, correlated with an elevated prevalence of UL. Furthermore, vegetable intake exhibited an inverse relationship with UL prevalence, particularly among premenopausal women.

Replacing red and processed meat with lean or fatty fish and all-cause and cause-specific mortality in Norwegian women. The Norwegian Women and Cancer Study (NOWAC): a prospective cohort study

Nordic Nutrition Recommendations recommend reducing red and processed meat and increasing fish consumption, but the impact of this replacement on mortality is understudied. This study investigated the replacement of red and processed meat with fish in relation to mortality. Of 83 304 women in the Norwegian Women and Cancer Study (NOWAC) study, 9420 died during a median of 21·0 years of follow-up. The hazard ratios (HR) for mortality were estimated using Cox proportional hazards regression with analyses stratified on red and processed meat intake due to non-linearity. Higher processed meat (> 30 g/d), red and processed meat (> 50 g/d), and fatty fish consumption were associated with higher mortality, while red meat and lean fish consumption were neutral or beneficial. Among women with higher processed meat intake (> 30 g/d), replacing 20 g/d with lean fish was associated with lower all-cause (HR 0·92, 95 % CI 0·89, 0·96), cancer (HR 0·92, 95 % CI 0·88, 0·97) and CVD mortality (HR 0·82, 95 % CI 0·74, 0·90), while replacing with fatty fish was associated with lower CVD mortality (HR 0·87, 95 % CI 0·77, 0·97), but not with all-cause or cancer mortality. Replacing processed meat with fish among women with lower processed meat intake (≤ 30 g/d) or replacing red meat with fish was not associated with mortality. Replacing processed meat with lean or fatty fish may lower the risk of premature deaths in Norwegian women, but only in women with high intake of processed meat. These findings suggest that interventions to reduce processed meat intake should target high consumers.

The association between consumption of red and processed meats with metabolic syndrome and its components in obese and overweight women: a cross-sectional study

OBJECTIVES

Previous studies have shown a relation between the consumption of different types of meats and chronic disorders. This study aims to investigate the association between red and processed meat intake with metabolic syndrome (MetS) and its components in healthy obese and overweight women.

METHODS

This cross-sectional study was conducted on Iranian women. The dietary assessment and body composition were measured by a validated food frequency questionnaire (FFQ) and bioelectrical impedance analysis, respectively. Blood samples were collected by standard protocols.

RESULTS

A total of 231 women (mean age 36.47 ± 8.44 years) were included in the current study. After controlling for potential confounders, there was a marginally significant associations between higher intake of processed meat with the MetS (OR:1.01, 95% CI: 0.94,2.94, P:0.06) and high serum triglycerides (TG) (OR:1.27, 95% CI: 0.94,2.98, P:0.07). There was a significant associations between high intake of red meats with lower odds of higher waist circumference (WC) (OR:0.31, 95% CI: 0.10,0.97, P:0.04). Also, there was a significant associations were found between high intake of processed meats with greater odds of having lower high-density lipoprotein cholesterol (HDL-c) (OR:0.64, 95% CI: 0.30,0.95, P:0.03).

CONCLUSIONS

The current study suggests that higher intakes of processed meat may be associated with the MetS in Iranian women with excess body weight, while this was not the case for red meat. More studies however are necessary in different communities to draw definitive conclusions.

The Austrian children's biomonitoring survey 2020 Part B: Mycotoxins, phytotoxins, phytoestrogens and food processing contaminants

This study assessed the levels of environment and food-related exposures in urine of Austrian school children aged six to ten (n = 85) focusing on mycotoxins, phytoestrogens, and food processing by-products using two multi-analyte LC-MS/MS methods. Out of the 55 biomarkers of exposure reported in this study, 22 were quantified in the first void urine samples. Mycotoxins frequently quantified included zearalenone (detection rate 100%; median 0.11 ng/mL), deoxynivalenol (99%; 15 ng/mL), alternariol monomethyl ether (75%; 0.04 ng/mL), and ochratoxin A (19%; 0.03 ng/mL). Several phytoestrogens, including genistein, daidzein, and its metabolite equol, were detected in all samples at median concentrations of 22 ng/mL, 43 ng/mL, and 14 ng/mL, respectively. The food processing by-product 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP), was detected in 4% of the samples (median 0.016 ng/mL). None of the investigated samples contained the tested phytotoxins that were rarely considered for human biomonitoring previously (pyrrolizidine alkaloids, tropane alkaloids, aristolochic acids). When relating estimated exposure to current health-based guidance values, 22% of the children exceeded the tolerable daily intake for deoxynivalenol, and the estimated MOE for OTA indicates possible health risks for some children. The results clearly demonstrate frequent low-level (co-)exposure and warrant further exposome-scale exposure assessments, especially in susceptible sub-populations and longitudinal settings.

Dietary Factors and Pancreatic Cancer Risk: An Umbrella Review of Meta-Analyses of Prospective Observational Studies

Dietary factors may be associated with the occurrence of pancreatic cancer. This umbrella review aimed to review and grade the evidence for the associations between dietary factors and pancreatic cancer risk. We searched PubMed, EMBASE, Web of Science, Scopus, Cochrane Database of Systematic Reviews, and CINAHL for eligible literature. We included meta-analyses of randomized controlled trials (RCTs) or prospective observational studies. We used AMSTAR-2, a measurement tool to assess systematic reviews, to evaluate the methodological quality of the included meta-analyses. For each association, we calculated the summary effect size, 95% CI, heterogeneity, number of cases, 95% prediction interval, small-study effect, and excess significance bias. The protocol for this review was registered in the PROSPERO database (CRD42022333669). We included 41 meta-analyses of prospective observational studies describing 59 associations between dietary factors and pancreatic cancer risk. None of the retrieved meta-analyses included RCTs. No association was supported by convincing or highly suggestive evidence; however, there was suggestive evidence of a positive association between fructose intake and pancreatic cancer risk. There was weak evidence for an inverse association of nuts intake or adherence to the Mediterranean diet with pancreatic cancer incidence, and for positive associations between a higher intake of red meat or heavy alcohol intake and pancreatic cancer incidence. The remaining 54 associations were nonsignificant. Consistent with the American Institute for Cancer Research review, this umbrella review found that regular consumption of nuts and reduced intake of fructose, red meat, and alcohol were associated with a lower risk of pancreatic cancer. Emerging weak evidence supported an inverse association between adherence to the Mediterranean diet and pancreatic cancer risk. As some associations were rated as weak and most were considered nonsignificant, further prospective studies are needed to investigate the role of dietary factors and risk of pancreatic cancer. Adv Nutr 2023;xx:xx-xx.

Absorption and Transport Mechanism of Red Meat-Derived N-glycolylneuraminic Acid and Its Damage to Intestinal Barrier Function through the NF-κB Signaling Pathway

N-glycolylneuraminic acid (Neu5Gc) is a specific factor in red meat that induces intestinal disease. Our aim was to investigate the effect of Neu5Gc on the intestinal barrier as well as its mechanism of endocytosis and exocytosis. Ten specific inhibitors were used to explore the mechanism of Neu5Gc endocytosis and exocytosis by Caco-2 cells. Amiloride hydrochloride and cytochalasin D had the strongest inhibitory effect on the endocytosis of Neu5Gc. Sodium azide, dynasore, chlorpromazine hydrochloride, and nystatin also inhibited Neu5Gc endocytosis. Dynasore exhibited a stronger inhibitory effect than that of chlorpromazine hydrochloride or nystatin alone. Exocytosis inhibitors, including nocodazole, brefeldin A, monensin, and bafilomycin A, inhibited the transmembrane transport of Neu5Gc. Monensin promoted the exocytosis of Neu5Gc from Caco-2 cells. In another experiment, we observed no significant inhibitory effects of monensin and brefeldin A. Dietary concentrations of Neu5Gc induced prominent damage to intestinal tight junction proteins zonula occludens-1 (ZO-1), occludin, and claudin-1 and promoted the phosphorylation of IκB-α and P65 to activate the canonical Nuclear Factor kappa-B (NF-κB) pathway. Neu5Gc increased the RNA levels of pro-inflammatory factors IL-1β, IL-6, and TNF-α and inhibited those of anti-inflammatory factors TGF-β and IL-10. BAY, an NF-κB signaling pathway inhibitor, attenuated these changes. Reductions in the levels of ZO-1, occludin, and claudin-1 were recovered in response to BAY. Our data reveal the endocytosis and exocytosis mechanism of Neu5Gc and prove that Neu5Gc can activate the canonical NF-κB signaling pathway, regulate the transcription of inflammatory factors, thereby damaging intestinal barrier function.

Modifiable contributing factors to COVID-19: A comprehensive review

The devastating complications of coronavirus disease 2019 (COVID-19) result from an individual's dysfunctional immune response following the initial severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Multiple toxic stressors and behaviors contribute to underlying immune system dysfunction. SARS-CoV-2 exploits the dysfunctional immune system to trigger a chain of events ultimately leading to COVID-19. The current study identifies eighty immune system dysfunction-enabling toxic stressors and behaviors (hereafter called modifiable contributing factors (CFs)) that also link directly to COVID-19. Each CF is assigned to one of the five categories in the CF taxonomy shown in Section 3.3.: Lifestyle (e.g., diet, substance abuse); Iatrogenic (e.g., drugs, surgery); Biotoxins (e.g., micro-organisms, mycotoxins); Occupational/Environmental (e.g., heavy metals, pesticides); Psychosocial/Socioeconomic (e.g., chronic stress, lower education). The current study shows how each modifiable factor contributes to decreased immune system capability, increased inflammation and coagulation, and increased neural damage and neurodegeneration. It is unclear how real progress can be made in combatting COVID-19 and other similar diseases caused by viral variants without addressing and eliminating these modifiable CFs.

PNPLA3 GENE POLYMORPHISM AND RED MEAT CONSUMPTION INCREASED FIBROSIS RISK IN NASH BIOPSY-PROVEN PATIENTS UNDER MEDICAL FOLLOW-UP IN A TERTIARY CENTER IN SOUTHWEST BRAZIL

BACKGROUND

Recent studies show an increase in nonalcoholic fatty liver disease (NAFLD) in populations with higher consumption of red meat, processed and cooked at high temperatures. On the other hand, the single nucleotide polymorphism rs738409 in the Patatin-like phospholipase domain containing 3 (PNPLA3) gene has been implicated in susceptibility to NAFLD and liver fibrosis. However, the synergistic effect between red meat consumption and the PNPLA3 gene polymorphism in NAFLD has not yet been evaluated.

OBJECTIVE

To evaluate the association between the presence of the polymorphism in the PNPLA3 gene and the consumption of macronutrients, including meat consumption and its cooking method among NAFLD patients.

METHODS

This was a cross-sectional study with 91 patients diagnosed with NAFLD by liver biopsy with genotyping for the polymorphism in the PNPLA3 gene were included. The consumption of calories and macronutrients was verified using the semi-quantitative food frequency questionnaire and the specific questionnaire on meat consumption. PNPLA3 gene polymorphism was analyzed by real-time polymerase chain reaction (RT-PCR) and anthropometric evaluation was realized.

RESULTS

The mean BMI was 32.38±4.58 kg/m² and the waist circumference was 107±10 cm. On liver biopsy, 42% of patients had significant fibrosis (F≥2). The odds ratio of F≥2 was 2.12 for the GG group and 1.54 for the CG group, compared to the CC group. The mean caloric intake was 1170±463.20 kcal/d. The odds ratio in the CC group concerning high red meat consumption in comparison to low consumption was 1.33. For white meat, the odds ratio was 0.8 when comparing high and low intake, also in the CC group.

CONCLUSION

High red meat intake and PNPLA3 gene polymorphism seem to synergistically affect NAFLD and liver fibrosis, requiring confirmation in a larger number of patients and in different populations.

Diet and Esophageal Cancer Risk: An Umbrella Review of Systematic Reviews and Meta-Analyses of Observational Studies

Diet may play an important role in the occurrence of esophageal cancer (EC). The aim of this umbrella review was to grade the evidence for the association between dietary factors and EC risk. A protocol for this review was registered with the PROSPERO database (CRD42021283232). Publications were identified by searching PubMed, EMBASE, Web of Science, Cochrane Database of Systematic Reviews, and CINAHL databases. Only systematic reviews and meta-analyses of observational studies (cohort studies, case-cohort studies, nested case-control studies) were eligible. AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews) was used to assess the methodological quality of included systematic reviews. For each association, random-effects pooled effect size, 95% CI, number of cases, 95% prediction interval, heterogeneity, small-study effect, and excess significance bias were calculated to grade the evidence. From 882 publications, 107 full-text articles were evaluated for eligibility, and 20 systematic reviews and meta-analyses describing 32 associations between dietary factors and EC risk were included in the present umbrella review. By assessing the strength and validity of the evidence, 1 association (positively associated with alcohol intake) was supported by highly suggestive evidence and 1 (inversely associated with calcium intake) showed a suggestive level of evidence. Evidence for 7 associations was weak (positively associated with red meat and processed-meat intake; inversely associated with whole grains, fruits, green leafy vegetables, green tea, and zinc intake). The remaining 23 associations were nonsignificant. In conclusion, the findings of this umbrella review emphasize that habitually consuming calcium, whole grains, fruits, green leafy vegetables, green tea, and zinc and reducing alcohol, red meat, and processed-meat intake are associated with a lower risk of EC. Since this umbrella review included only observational study data and some of the associations were graded as weak, caution should be exercised in interpreting these relations.

Familial Esophageal Cancer in Taihang Mountain, China: An Era of Personalized Medicine Based on Family and Population Perspective

In the Taihang Mountain areas, known as the “esophageal cancer zone” in China, the incidence of esophageal cancer (ESCA) ranks the first in the country and shows a familial and regional clustering trend. Taihang Mountain areas are located in a mountainous area, with inconvenient transportation, limited living conditions, unbalanced diet, and poor nutrition. Ninety percent of the pathological types of ESCA in Taihang Mountain areas are squamous cell carcinoma, among which the risk factors have not been well understood. These areas are usually remote villages and mountains with low population mobility, large family members, similar environmental factors, and a clear and stable genetic background. Therefore, according to the current situation, second-generation sequencing and multigroup analysis technology are used to analyze the familial ESCA patients; disease-related genetic variation are located; and then disease-related susceptibility genes associated with ESCA are screened and analyzed. Health education, tobacco control, endoscopic screening, and other health management projects for suspected and high-risk patients in areas with a high incidence of ESCA can be carried out for screening and early diagnosis, and the incidence of ESCA in Taihang Mountain areas can be reduced. A comprehensive continuous care pattern based on traditional medical nursing to track, monitor, evaluate, and intervene with patients diagnosed with ESCA to facilitate them with medications guidance, dietary guidance, and timely health problem-solving is established. Furthermore, statistical analysis of epidemiology, gene sequencing, and family genetics information can be performed on patients with ESCA in the Taihang Mountains areas to clarify the relationship between genetic phenotype and genotype during the occurrence of ESCA.

Food-Borne Chemical Carcinogens and the Evidence for Human Cancer Risk

Commonly consumed foods and beverages can contain chemicals with reported carcinogenic activity in rodent models. Moreover, exposures to some of these substances have been associated with increased cancer risks in humans. Food-borne carcinogens span a range of chemical classes and can arise from natural or anthropogenic sources, as well as form endogenously. Important considerations include the mechanism(s) of action (MoA), their relevance to human biology, and the level of exposure in diet. The MoAs of carcinogens have been classified as either DNA-reactive (genotoxic), involving covalent reaction with nuclear DNA, or epigenetic, involving molecular and cellular effects other than DNA reactivity. Carcinogens are generally present in food at low levels, resulting in low daily intakes, although there are some exceptions. Carcinogens of the DNA-reactive type produce effects at lower dosages than epigenetic carcinogens. Several food-related DNA-reactive carcinogens, including aflatoxins, aristolochic acid, benzene, benzo[a]pyrene and ethylene oxide, are recognized by the International Agency for Research on Cancer (IARC) as causes of human cancer. Of the epigenetic type, the only carcinogen considered to be associated with increased cancer in humans, although not from low-level food exposure, is dioxin (TCDD). Thus, DNA-reactive carcinogens in food represent a much greater risk than epigenetic carcinogens.

The role of diet in genotoxicity of fecal water derived from IBD patients and healthy controls

Certain dietary factors with anti-inflammatory and/or anti-cancer properties would be a promising preventive strategy for inflammatory bowel disease (IBD) patients against developing colitis-associated colorectal cancer (CAC). In this study, fecal water (FW) was obtained from 80 IBD patients and 20 healthy controls (HCs). The comet assay was applied to determine the DNA damage induced by FW, and the protective potential of FW against hydrogen peroxide (H₂O₂) induced DNA damage in Caco-2 cells. Information on diet was obtained via food frequency questionnaires. The results showed that FW from IBD patients, especially patients with flares, induced higher levels of direct DNA damage in Caco-2 cells and showed less protection against H₂O₂-induced DNA damage, when compared to HCs. The DNA damage induced by FW was positively associated with consumption of processed meat and sugary foods, and nutrient intakes including heme iron and added sugars, whereas negatively correlated to intakes of soy products, and a dietary pattern characterized by high consumption of potatoes, white meat, nuts and seeds, eggs, legumes and soy products. FW from subjects with high coffee consumption protected against H₂O₂-induced DNA damage. These results can help to develop potential preventive strategies for IBD patients to reduce the CAC risk.

Adherence to a western dietary pattern and risk of invasive ductal and lobular breast carcinomas: a case-control study

Little is known about the role of diet in the risk of invasive ductal carcinoma (IDC) and invasive lobular carcinoma (ILC) of the breast, the most common histological subtypes of breast cancer (BC). This is because, the majority of studies on the association of diet and the risk of BC are focused on single food items, and studies considering the overall diet in terms of dietary patterns are limited. Also, the potential heterogeneity in the impact of Western diet (WD) on histological subtypes of BC is not established. This, the age-frequency-matched case–control study included 1009 incident BC cases and 1009 healthy controls. The required data was obtained from the patients’ medical files and interviews using a previously validated researcher-designed questionnaire for collecting data on socio-economic and anthropometric statuses and a valid food frequency questionnaire (FFQ) to measure the participants’ dietary intake. We used multinomial logistic regression, and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. A positive and significant association was observed between higher adherence to a WD and risk of IDC (OR comparing highest with the lowest tertile: 2.45, 95% CI 1.88, 3.17; p-trend < 0.001), whereas no significant association was observed between adherence to the WD and the risk of ILC (OR comparing highest with the lowest tertile: 1.63, 95% CI 0.63, 3.25) (p for heterogeneity = 0.03). The results of an analysis stratified by menopausal status suggested a similar pattern. We provided evidence that adherence to a WD raises the risk of IDC, but not ILC, suggesting different etiological mechanisms for IDC and ILC.

The Isocaloric Substitution of Plant-Based and Animal-Based Protein in Relation to Aging-Related Health Outcomes: A Systematic Review

Plant-based and animal-based protein intake have differential effects on various aging-related health outcomes, but less is known about the health effect of isocaloric substitution of plant-based and animal-based protein. This systematic review summarized current evidence of the isocaloric substitutional effect of plant-based and animal-based protein on aging-related health outcomes. PubMed and Embase databases were searched for epidemiologic observational studies published in English up to 15 March 2021. Studies that included adults ≥18 years old; use of a nutritional substitution model to define isocaloric substitution of plant protein and animal protein; health outcomes covering mortality, aging-related diseases or indices; and reported association estimates with corresponding 95% confidence intervals were included. Nine cohort studies and 3 cross-sectional studies were identified, with a total of 1,450,178 subjects included in this review. Consistent and significant inverse association of substituting plant protein for various animal proteins on all-cause mortality was observed among 4 out of 5 studies with relative risks (RRs) from 0.54 to 0.95 and on cardiovascular disease (CVD) mortality among all 4 studies with RRs from 0.58 to 0.91. Among specific animal proteins, the strongest inverse association on all-cause and CVD mortality was identified when substituting plant protein for red and/or processed meat protein, with the effect mainly limited to bread, cereal, and pasta protein when replacing red meat protein. Isocaloric substitution of plant-based protein for animal-based protein might prevent all-cause and CVD-specific mortality. More studies are needed on this topic, particularly for cancer incidence and other specific aging-related diseases.

The relationship between processed meat, red meat, and risk of types of cancer: A Mendelian randomization study

Background

Observational studies have suggested processed and red meat may increase the risk of cancer. However, the causal effects and direction between them were still unclear. We conducted two-sample Mendelian randomization (MR) analysis to evaluate the causal effect of processed meat and red meat on the risk of nine common types of cancer, namely, lung, ovarian, endometrial, breast, kidney, gastric, prostate, skin, and oropharyngeal cancer.

Methods

Genome-wide association studies (GWAS) for processed meat and red meat (pork, beef, and mutton) were obtained from the UK Biobank. GWAS of types of cancer in this study were extracted from the genetic consortia and the FinnGen consortium. The inverse variance weighted (IVW) was carried out as the main method for two-sample MR analysis. Sensitivity analyses were used to assess the robustness of the results.

Results

Genetically predicted processed meat intake was causally associated with increased risk of lung cancer (OR [odds ratio] = 1.923, 95% CI = 1.084-3.409, P = 0.025). There is no convincing evidence for the associations between genetically determined processed meat, red meat, and the risk of other cancers we studied.

Conclusion

Our results suggested that intake of processed meat may increase the risk of lung cancer. These findings provided no evidence to support that consumption of processed and red meat has a large effect on the risk of other cancers we studied. Further research is needed to clarify the results.

Amino Acids and Lipids Associated with Long-Term and Short-Term Red Meat Consumption in the Chinese Population: An Untargeted Metabolomics Study

Red meat (RM) consumption is correlated with multiple health outcomes. This study aims to identify potential biomarkers of RM consumption in the Chinese population and evaluate their predictive ability. We selected 500 adults who participated in the 2015 China Health and Nutrition Survey and examined their overall metabolome differences by RM consumption by using elastic-net regression, then evaluate the predictivity of a combination of filtered metabolites; 1108 metabolites were detected. In the long-term RM consumption analysis 12,13-DiHOME, androstenediol (3α, 17α) monosulfate 2, and gamma-Glutamyl-2-aminobutyrate were positively associated, 2-naphthol sulfate and S-methylcysteine were negatively associated with long-term high RM consumption, the combination of metabolites prediction model evaluated by area under the receiver operating characteristic curve (AUC) was 70.4% (95% CI: 59.9–80.9%). In the short-term RM consumption analysis, asparagine, 4-hydroxyproline, and 3-hydroxyisobutyrate were positively associated, behenoyl sphingomyelin (d18:1/22:0) was negatively associated with short-term high RM consumption. Combination prediction model AUC was 75.6% (95% CI: 65.5–85.6%). We identified 10 and 11 serum metabolites that differed according to LT and ST RM consumption which mainly involved branch-chained amino acids, arginine and proline, urea cycle and polyunsaturated fatty acid metabolism. These metabolites may become a mediator of some chronic diseases among high RM consumers and provide new evidence for RM biomarkers.

A Standardized Assessment of Processed Red Meat and Processed Poultry Intake in the US Population Aged ≥2 Years Using NHANES

BACKGROUND

Standardized methods are needed to investigate intake patterns of processed meat subtypes, considering health concerns surrounding processed meat intake.

OBJECTIVES

The objectives of this study were to create a standardized method of disaggregating processed meat into processed red meat and processed poultry and describe intake patterns of the US population aged ≥2 y.

METHODS

Two researchers independently manually disaggregated processed meat from the Food Patterns Equivalents Database into processed red meat and processed poultry based on available information from the Foods and Nutrient Database for Dietary Studies. We created an SAS program (called Processed Meat Categories) to mimic the manual coding. We used the program to describe intake patterns and trends over time of processed red meat and processed poultry using 24-h recalls from 2007-2008 through 2017-2018 NHANES data with SAS survey-weighted procedures for complex surveys.

RESULTS

The SAS program had high agreement with the manual code (Pearson concordance correlation ≥0.95). Of the US population aged ≥2 y, 46.8% (95% CI: 45.3, 48.2%) reported consuming any processed meat, 42.5% (95% CI: 41.0, 43.9%) reported consuming processed red meat, and 11.3% (95% CI: 10.2, 12.4%) reported consuming processed poultry. Most [74.1 ± 0.13% (SEM)] processed meat reported was red meat compared with poultry, and 32.1 ± 0.01% of total red meat and 13.7 ± 0.01% of total poultry reported were processed. Prevalence of processed poultry intake increased from 9.5% (95% CI: 8.9, 10.1%) in 2007-2010 to 11.3% (95% CI: 10.2, 12.4%) in 2015-2018 (P < 0.0001), but mean intake amount did not change. Prevalence of processed red meat intake did not change over time, but mean intake decreased from 0.8 ± 0.03 ounce-equivalents in 2007-2010 to 0.7 ± 0.02 ounce-equivalents (P = 0.0058) in 2015-2018.

CONCLUSIONS

The Processed Meat Categories SAS program is a tool available for researchers to standardize estimates of processed meat subtypes for future dietary patterns research. Intake of total processed meat did not change in the United States, but intake amount of processed red meat decreased and the prevalence of processed poultry consumers increased.

An insight into the risk factors of brain tumors and their therapeutic interventions

Brain tumors are an abnormal growth of cells in the brain, also known as multifactorial groups of neoplasm. Incidence rates of brain tumors increase rapidly, and it has become a leading cause of tumor related deaths globally. Several factors have potential risks for intracranial neoplasm. To date, the International Agency for Research on Cancer has classified the ionizing radiation and the N-nitroso compounds as established carcinogens and probable carcinogens respectively. Diagnosis of brain tumors is based on histopathology and suitable imaging techniques. Labeled amino acids and fluorodeoxyglucose with or without contrast-enhanced MRI are used for the evaluation of tumor traces. T2-weighted MRI is an advanced diagnostic implementation, used for the detection of low-grade gliomas. Treatment decisions are based on tumor size, location, type, patient's age and health status. Conventional therapeutic approaches for tumor treatment are surgery, radiotherapy and chemotherapy. While the novel strategies may include targeted therapy, electric field treatments and vaccine therapy. Inhibition of cyclin-dependent kinase inhibitors is an attractive tumor mitigation strategy for advanced-stage cancers; in the future, it may prove to be a useful targeted therapy. The blood-brain barrier poses a major hurdle in the transport of therapeutics towards brain tissues. Moreover, nanomedicine has gained a vital role in cancer therapy. Nano drug delivery system such as liposomal drug delivery has been widely used in the cancer treatment. Liposome encapsulated drugs have improved therapeutic efficacy than free drugs. Numerous treatment therapies for brain tumors are in advanced clinical research.

Effect on health from consumption of meat and meat products

The aim of this study was to investigate the effects of dietary sodium nitrite and meat on human health. Sodium nitrite in processed meat is known to be one of the main precursors of carcinogens, such as N-nitroso compounds. However, we previously found that processed meat is not the primary source of sodium nitrite; nitrate or the conversion of nitrate in vegetables are contribute to generate more than 70% Sodium nitrite or nitrate containing compounds in body. Although the heavy consumption of meat is likely to cause various diseases, meat intake is not the only cause of colorectal cancer. Our review indicates that sodium nitrite derived from foods and endogenous nitric oxide may exhibit positive effects on human health, such as preventing cardiovascular disease or improving reproductive function. Therefore, further epidemiological studies considering various factors, such as cigarette consumption, alcohol consumption, stress index, salt intake, and genetic factors, are required to reliably elucidate the effects of dietary sodium nitrite and meat on the incidence of diseases, such as colorectal cancer.

Consumption of red meat and processed meat and cancer incidence: a systematic review and meta-analysis of prospective studies

Red meat and processed meat consumption has been hypothesized to increase risk of cancer, but the evidence is inconsistent. We performed a systematic review and meta-analysis of prospective studies to summarize the evidence of associations between consumption of red meat (unprocessed), processed meat, and total red and processed meat with the incidence of various cancer types. We searched in MEDLINE and EMBASE databases through December 2020. Using a random-effect meta-analysis, we calculated the pooled relative risk (RR) and 95% confidence intervals (CI) of the highest versus the lowest category of red meat, processed meat, and total red and processed meat consumption in relation to incidence of various cancers. We identified 148 published articles. Red meat consumption was significantly associated with greater risk of breast cancer (RR = 1.09; 95% CI = 1.03-1.15), endometrial cancer (RR = 1.25; 95% CI = 1.01-1.56), colorectal cancer (RR = 1.10; 95% CI = 1.03-1.17), colon cancer (RR = 1.17; 95% CI = 1.09-1.25), rectal cancer (RR = 1.22; 95% CI = 1.01-1.46), lung cancer (RR = 1.26; 95% CI = 1.09-1.44), and hepatocellular carcinoma (RR = 1.22; 95% CI = 1.01-1.46). Processed meat consumption was significantly associated with a 6% greater breast cancer risk, an 18% greater colorectal cancer risk, a 21% greater colon cancer risk, a 22% greater rectal cancer risk, and a 12% greater lung cancer risk. Total red and processed meat consumption was significantly associated with greater risk of colorectal cancer (RR = 1.17; 95% CI = 1.08-1.26), colon cancer (RR = 1.21; 95% CI = 1.09-1.34), rectal cancer (RR = 1.26; 95% CI = 1.09-1.45), lung cancer (RR = 1.20; 95% CI = 1.09-1.33), and renal cell cancer (RR = 1.19; 95% CI = 1.04-1.37). This comprehensive systematic review and meta-analysis study showed that high red meat intake was positively associated with risk of breast cancer, endometrial cancer, colorectal cancer, colon cancer, rectal cancer, lung cancer, and hepatocellular carcinoma, and high processed meat intake was positively associated with risk of breast, colorectal, colon, rectal, and lung cancers. Higher risk of colorectal, colon, rectal, lung, and renal cell cancers were also observed with high total red and processed meat consumption.

Metabolic Evidence Rather Than Amounts of Red or Processed Meat as a Risk on Korean Colorectal Cancer

The incidence of colorectal cancer (CRC) has increased in Korea, a newly-industrialized Asian country, with the dramatic increase of meat intake. To assess the risks of red or processed meat consumption on CRC, we performed a case-control study with biological monitoring of urinary1-OHP, PhIP, and MeIQx for the meat exposure; dG-C8 MeIQx and dG-C8 PhIP for HCA-induced DNA adducts; and homocysteine and C-reactive protein (CRP) in blood as well as malondialdehyde (MDA) and 31fatty acids in urine for inflammation and lipid alteration. We further analyzed global DNA methylation and expression of 15 CRC-related genes. As a result, the consumption of red or processed meat was not higher in the cases than in the controls. However, urinary MeIQx and PhIP were associated with the intake of red meat and urinary 1-OHP. MDA and multiple fatty acids were related to the exposure biomarkers. Most of the 31 fatty acids and multiple saturated fatty acids were higher in the cases than in the controls. Finally, the cases showed upregulation of PTGS2, which is related to pro-inflammatory fatty acids. This study describes indirect mechanisms of CRC via lipid alteration with a series of processes including exposure to red meat, alteration of fatty acids, and relevant gene expression.

Dietary Patterns and Hepatocellular Carcinoma Risk among US Adults

The objective of this study was to assess the association between dietary patterns and risk of hepatocellular carcinoma (HCC) among US adults in a hospital-based case-control study. We analyzed data from 641 cases and 1002 controls recruited at The University of Texas MD Anderson Cancer Center during 2001-2018. Cases were patients with a pathologically or radiologically confirmed new diagnosis of HCC; controls were cancer-free spouses of patients with cancers other than gastrointestinal, lung, liver, or head and neck cancer. Cases and controls were frequency-matched by age and sex. Dietary patterns were identified by principal component analysis. Odds ratios (ORs) and corresponding confidence intervals (CIs) were computed using unconditional logistic regression with adjustment for major HCC risk factors, including hepatitis B virus and hepatitis C virus infection. A vegetable-based dietary pattern was inversely associated with HCC risk (highest compared with lowest tertile: OR 0.66, 95% CI 0.46-0.94). A Western diet pattern was directly associated with HCC risk (highest compared with lowest tertile: OR 1.79, 95% CI 1.19-2.69). These findings emphasize the potential role of dietary intake in HCC prevention and clinical management.

Direct Alkylation of Deoxyguanosine by Azaserine Leads to O6-Carboxymethyldeoxyguanosine

The O⁶-alkylguanosine adduct O⁶-carboxymethyldeoxyguanosine (O⁶-CMdG) has been detected at elevated levels in blood and tissue samples from colorectal cancer patients and from healthy volunteers after consuming red meat. The diazo compound l-azaserine leads to the formation of O⁶-CMdG as well as the corresponding methyl adduct O⁶-methyldeoxyguanosine (O⁶-MedG) in cells and is therefore in wide use as a chemical probe in cellular studies concerning DNA damage and mutation. However, there remain knowledge gaps concerning the chemical basis of DNA adduct formation by l-azaserine. To characterize O⁶-CMdG formation by l-azaserine, we carried out a combination of chemical and enzymatic stability and reactivity studies supported by liquid chromatography tandem mass spectrometry for the simultaneous quantification of O⁶-CMdG and O⁶-MedG. We found that l-azaserine is stable under physiological and alkaline conditions as well as in active biological matrices but undergoes acid-catalyzed hydrolysis. We show, for the first time, that l-azaserine reacts directly with guanosine (dG) and oligonucleotides to form an O⁶-serine-CMdG (O⁶-Ser-CMdG) adduct. Moreover, by characterizing the reaction of dG with l-azaserine, we demonstrate that O⁶-Ser-CMdG forms as an intermediate that spontaneously decomposes to form O⁶-CMdG. Finally, we quantified levels of O⁶-CMdG and O⁶-MedG in a human cell line exposed to l-azaserine and found maximal adduct levels after 48 h. The findings of this work elucidate the chemical basis of how l-azaserine reacts with deoxyguanosine and support its use as a chemical probe for N-nitroso compound exposure in carcinogenesis research, particularly concerning the identification of pathways and factors that promote adduct formation.

Healthfulness Assessment of Recipes Shared on Pinterest: Natural Language Processing and Content Analysis

Background

Although Pinterest has become a popular platform for distributing influential information that shapes users’ behaviors, the role of recipes pinned on Pinterest in these behaviors is not well understood.

Objective

This study aims to explore the patterns of food ingredients and the nutritional content of recipes posted on Pinterest and to examine the factors associated with recipes that engage more users.

Methods

Data were collected from Pinterest between June 28 and July 12, 2020 (207 recipes and 2818 comments). All samples were collected via 2 new user accounts with no search history. A codebook was developed with a raw agreement rate of 0.97 across all variables. Content analysis and natural language processing sentiment analysis techniques were employed.

Results

Recipes using seafood or vegetables as the main ingredient had, on average, fewer calories and less sodium, sugar, and cholesterol than meat- or poultry-based recipes. For recipes using meat as the main ingredient, more than half of the energy was obtained from fat (277/490, 56.6%). Although the most followed pinners tended to post recipes containing more poultry or seafood and less meat, recipes with higher fat content or providing more calories per serving were more popular, having more shared photos or videos and comments. The natural language processing–based sentiment analysis suggested that Pinterest users weighted taste more heavily than complexity (225/2818, 8.0%) and health (84/2828, 2.9%).

Conclusions

Although popular pinners tended to post recipes with more seafood or poultry or vegetables and less meat, recipes with higher fat and sugar content were more user-engaging, with more photo or video shares and comments. Data on Pinterest behaviors can inform the development and implementation of nutrition health interventions to promote healthy recipe sharing on social media platforms.

A posteriori dietary patterns and their association with systemic low-grade inflammation in adults: a systematic review and meta-analysis

CONTEXT

A posteriori dietary patterns are promising ways of uncovering potential public health strategies for the prevention of systemic, low-grade, inflammation-related, chronic noncommunicable diseases.

OBJECTIVE

To investigate and summarize the current evidence on the association between a posteriori dietary patterns and systemic, low-grade inflammation in adults.

DATA SOURCES

MEDLINE, EMBASE, Web of Science, and LILACS were searched.

DATA EXTRACTION

Data screening, extraction, and quality assessment were performed independently by 2 investigators. Meta-analysis with random effects was conducted. Differences and similarities between reduced rank regression-derived dietary patterns were assessed.

RESULTS

Healthy dietary patterns are inversely and the Western dietary pattern is positively associated with inflammation (r = -0.13, 95% confidence interval -0.20 to -0.06; and r = 0.11, 95% confidence interval, 0.09-0.12, respectively). Reduced rank regression-derived anti-inflammatory dietary patterns are consistently characterized by high intake of fresh fruits and inflammatory dietary patterns are consistently characterized by high intake of red and processed meat and low intake of vegetables.

CONCLUSION

Favoring the substitution of a Westernized diet for a healthy diet may lower inflammation, which might improve the prevention of some chronic noncommunicable diseases.

Differences in dietary habits of people with vs without irritable bowel syndrome and their association with symptom and psychological status: A pilot study

BACKGROUND

Previous studies have demonstrated that dietary factors are involved in irritable bowel syndrome (IBS), but the role of diet was evaluated mostly based on food frequency questionnaire. Whether food categories, quantity per time, and intake frequency are different between IBS patients and non-IBS individuals has not been clearly clarified.

AIM

To explore differences in dietary habits of people with vs without IBS and their correlation with symptom and psychological status.

METHODS

A total of 220 questionnaires were administered in a community population and the Rome IV criteria was applied to diagnose IBS. The dietary questionnaire used in this study was multidimensional from food categories, quantity per time, and intake frequency, in contrast to "yes or no" classification used in previous studies. Questionnaires including IBS symptom severity scale (IBS-SSS), IBS quality of life, visceral sensitivity index, hospital anxiety and depression score (HADS), and gastrointestinal symptom rating scale were used to assess the participants. Rank sum test was used to compare the quantity per time and intake frequency between IBS patients and non-IBS participants. The correlation between psychological factors and diet was evaluated by Spearman correlation analysis. Logistic regression analysis was used to assess the possible dietary risk factors for IBS.

RESULTS

In total, 203 valid questionnaires were collected (response rate 92.3%). Twenty-five participants met the Rome IV criteria for IBS, including 15 (60.0%) women and 10 (40.0%) men. Compared with the non-IBS group, the quantity per time and intake frequency of soybean and its products, spicy food, and dry-fried nuts were statistically significant in IBS participants (P < 0.05). They were positively associated with IBS-SSS and HADS anxiety and depression scores (P < 0.05). Besides, seafood, soft drinks, vegetables, and fruits differed only in quantity per time. The intake frequencies of egg, barbecue, and coarse grain were statistically significant in IBS patients (P < 0.05). We also found that the frequency of soybean and its products (≥ 7 times/week, odds ratio = 11.613, 95% confidence interval: 2.145-62.855, P = 0.004) was an independent risk factor for IBS.

CONCLUSION

Both quantity per time and intake frequency, especially soybean, differ between IBS patients and non-IBS participants. Dietary habits might play potential roles in the pathophysiology of IBS.

Towards refining World Cancer Research Fund/American Institute for Cancer Research cancer prevention recommendations for red and processed meat intake: insights from Alberta's Tomorrow Project cohort

Current cancer prevention recommendations advise limiting red meat intake to <500 g/week and avoiding consumption of processed meat, but do not differentiate the source of processed meat. We examined the associations of processed meat derived from red v. non-red meats with cancer risk in a prospective cohort of 26 218 adults who reported dietary intake using the Canadian Diet History Questionnaire. Incidence of cancer was obtained through data linkage with Alberta Cancer Registry with median follow-up of 13·3 (interquartile range (IQR) 5·1) years. Multivariable Cox proportional hazards regression models were adjusted for covariates and stratified by age and sex. The median consumption (g/week) of red meat, processed meat from red meat and processed meat from non-red meat was 267·9 (IQR 269·9), 53·6 (IQR 83·3) and 11·9 (IQR 31·8), respectively. High intakes (4th Quartile) of processed meat from red meat were associated with increased risk of gastrointestinal cancer adjusted hazard ratio (AHR): 1·68 (95 % CI 1·09, 2·57) and colorectal cancers AHR: 1·90 (95 % CI 1·12, 3·22), respectively, in women. No statistically significant associations were observed for intakes of red meat or processed meat from non-red meat. Results suggest that the carcinogenic effect associated with processed meat intake may be limited to processed meat derived from red meats. The findings provide preliminary evidence towards refining cancer prevention recommendations for red and processed meat intake.

Genotoxic effect of meat consumption: A mini review

In 2015, the International Agency for Research on Cancer classified the consumption of processed meat as carcinogenic to humans (Group 1) and red meat as probably carcinogenic to humans (Group 2A) based on sufficient data from animal models and epidemiological studies. However, research characterising the mechanisms underlying this carcinogenic process in humans are limited, particularly with respect to measures of direct DNA damage. The current review sought to evaluate and summarize the recent literature, published since 2000, regarding the associations of meat consumption and three biomarkers of genotoxicity in humans: DNA strand breaks (measured using the comet assay), DNA adducts, and micronucleus formation. After screening 230 potential articles, 35 were included, and then were classified as experimental or observational in design, the latter of which were further categorized according to their dietary assessment approach. Among the 30 observational studies, 4 of which used two different assays, 3 of 5 comet assay studies, 13 of 20 DNA adduct studies, and 7 of 9 micronucleus studies reported a positive association between meat consumption and DNA damage. Among the 5 experimental studies, 1 of 1 using the comet assay, 3 of 3 measuring DNA adducts and 0 of 1 measuring micronuclei reported significant positive associations with meat consumption. Nevertheless, common limitations among the selected publications included small sample size, and poor methodological reporting of both exposure and outcome measures. Moreover, the vast majority of studies only measured DNA damage in one biological sample using a single assay and we cannot exclude the possibility of publication bias. Ultimately, our review of the literature, published since 2000, revealed a preponderance of studies that support mechanisms of genotoxicity in playing an important role in the meat-cancer association.

Dietary Factors and Prostate Cancer Development, Progression, and Reduction

Due to the constantly increasing number of cases, prostate cancer has become one of the most important health problems of modern societies. This review presents the current knowledge regarding the role of nutrients and foodstuff consumption in the etiology and development of prostate malignancies, including the potential mechanisms of action. The results of several in vivo and in vitro laboratory experiments as well as those reported by the clinical and epidemiological research studies carried out around the world were analyzed. The outcomes of these studies clearly show the influence of both nutrients and food products on the etiology and prevention of prostate cancer. Consumption of certain nutrients (saturated and trans fatty acids) and food products (e.g., processed meat products) leads to the disruption of prostate hormonal regulation, induction of oxidative stress and inflammation, and alteration of growth factor signaling and lipid metabolism, which all contribute to prostate carcinogenesis. On the other hand, a high consumption of vegetables, fruits, fish, and whole grain products exerts protective and/or therapeutic effects. Special bioactive functions are assigned to compounds such as flavonoids, stilbenes, and lycopene. Since the influence of nutrients and dietary pattern is a modifiable risk factor in the development and prevention of prostate cancer, awareness of the beneficial and harmful effects of individual food ingredients is of great importance in the global strategy against prostate cancer.

Carcinogenesis: Failure of resolution of inflammation?

Inflammation in the tumor microenvironment is a hallmark of cancer and is recognized as a key characteristic of carcinogens. However, the failure of resolution of inflammation in cancer is only recently being understood. Products of arachidonic acid and related fatty acid metabolism called eicosanoids, including prostaglandins, leukotrienes, lipoxins, and epoxyeicosanoids, critically regulate inflammation, as well as its resolution. The resolution of inflammation is now appreciated to be an active biochemical process regulated by endogenous specialized pro-resolving lipid autacoid mediators which combat infections and stimulate tissue repair/regeneration. Environmental and chemical human carcinogens, including aflatoxins, asbestos, nitrosamines, alcohol, and tobacco, induce tumor-promoting inflammation and can disrupt the resolution of inflammation contributing to a devastating global cancer burden. While mechanisms of carcinogenesis have focused on genotoxic activity to induce mutations, nongenotoxic mechanisms such as inflammation and oxidative stress promote genotoxicity, proliferation, and mutations. Moreover, carcinogens initiate oxidative stress to synergize with inflammation and DNA damage to fuel a vicious feedback loop of cell death, tissue damage, and carcinogenesis. In contrast, stimulation of resolution of inflammation may prevent carcinogenesis by clearance of cellular debris via macrophage phagocytosis and inhibition of an eicosanoid/cytokine storm of pro-inflammatory mediators. Controlling the host inflammatory response and its resolution in carcinogen-induced cancers will be critical to reducing carcinogen-induced morbidity and mortality. Here we review the recent evidence that stimulation of resolution of inflammation, including pro-resolution lipid mediators and soluble epoxide hydrolase inhibitors, may be a new chemopreventive approach to prevent carcinogen-induced cancer that should be evaluated in humans.

CdS/TiO2 Nanocomposite-Based Photoelectrochemical Sensor for a Sensitive Determination of Nitrite in Principle of Etching Reaction

The CdS/TiO₂ nanocomposite (NC) photoelectrochemical (PEC) sensor was constructed based on a new sensing strategy for nitrite assay. The CdS etching process caused by nitrite-in-acid solution was confirmed and applied to nitrite sensing. The CdS etching phenomenon occurring on the sensor led to an obvious reduction in the photocurrent response under visible-light irradiation, which responded to the nitrite concentration. The CdS/TiO₂ NC-based PEC sensor exhibited excellent performance on nitrite detection. The linear range for nitrite determination was from 1-100 and 100-500 μM, and the sensitivity of the PEC sensor was 2.91 and 0.186 μA μM^-1 cm^-2, respectively. The detection limit of the sensor was 0.56 μM (S/N = 3). In addition, the PEC sensor was also equipped with advantages such as good selectivity, excellent stability, low background, and recyclability. Satisfying results were obtained for the nitrite assay in real samples by such a PEC sensor. In summary, this work contributed a fresh idea to precisely determinate nitrite through PEC sensing.

Mediterranean diet and breast cancer risk: a narrative review

Breast cancer is the second most frequent type of cancer worldwide and the most commonly occurring malignancy in women, and its incidence is increasing in most developed and developing countries. There is growing evidence that lifestyle factors, in particular diet may be associated with higher breast cancer risk. Some evidence exists regarding the benefit of Mediterranean diet on reduced risk of breast cancer in premenopausal and postmenopausal women. The protective effect of the Mediterranean diet against the risk of breast cancer, is primarily due to principal foods of this nutritional pattern. The principal components of the Mediterranean diet, such as fruits and vegetables, olive oil, fish and red wine have important antioxidants properties due to their high content of substances like polyphenols, flavonoids, carotenoids and fibers, along with a favorable fatty acid profile, that in turn could reduce the risk of breast cancer. Considering the severity of breast cancer and the increasing incidence in the world, there is an increasing interest in promoting prevention strategies in order to reduce the incidence. The aim of this paper is to provide a general overview of the current evidence on the relationship between breast cancer and Mediterranean diet, in premenopausal and postmenopausal women, and to emphasize the potential role of Mediterranean Diet as an effective tool in primary prevention. The possible molecular mechanisms underlying this association will be also pointed out.

Validation and adaptation of the empirical dietary inflammatory pattern across nations: A test case

OBJECTIVE

The empirical dietary inflammatory pattern (EDIP) assesses the inflammatory potential of diet in the US population. The aim of this study was to assess the applicability of the EDIP to a Brazilian population.

METHODS

Data from 19- to 75-y-old participants of two editions of the cross-sectional population-based Health Survey of Sao Paulo (HS-SP) were used to validate the EDIP (n = 269; HS-SP 2008), develop an EDIP adapted to a Sao Paulo population, the EDIP-SP (n = 441; HS-SP 2008), and replicate EDIP-SP results in an independent sample (n = 501; HS-SP 2015). Dietary data was assessed through two 24-h recalls and one validated food frequency questionnaire. Plasma C-reactive protein (CRP), and nine other inflammatory biomarkers were determined. EDIP was tested for its association with the 10 inflammatory biomarkers. For development of the EDIP-SP, 21 food groups and their contributions to plasma CRP levels were modeled using a stepwise multiple linear regression adjusted for age and sex.

RESULTS

The EDIP was not associated with concentrations of inflammatory biomarkers in a Brazilian population. The components of EDIP-SP were processed meats (β = 0.27; P = 0.082), fruits and vegetables (β = -0.12; P = 0.018), and rice and beans (β = -0.27; P = 0.007). EDIP-SP significantly predicted dietary quality (β = -6.1; P < 0.001) and its inflammatory potential was replicated among men (β = 0.36; P = 0.01), but not among women (β = 0.05; P = 0.82).

CONCLUSION

EDIP was adapted to the Sao Paulo population. EDIP-SP, composed of high processed meat intake and low intake of fruits and vegetables, and rice and beans, constitutes an important tool to investigate dietary quality based on its inflammatory potential, in Brazilian populations.

Global Profiling of Toxicologically Relevant Metabolites in Urine: Case Study of Reactive Aldehydes

Among the numerous unknown metabolites representative of our exposure, focusing on toxic compounds should provide more relevant data to link exposure and health. For that purpose, we developed and applied a global method using data independent acquisition (DIA) in mass spectrometry to profile specifically electrophilic compounds originating metabolites. These compounds are most of the time toxic, due to their chemical reactivity toward nucleophilic sites present in biomacromolecules. The main line of cellular defense against these electrophilic molecules is conjugation to glutathione, then metabolization into mercapturic acid conjugates (MACs). Interestingly, MACs display a characteristic neutral loss in MS/MS experiments that makes it possible to detect all the metabolites displaying this characteristic loss, thanks to the DIA mode, and therefore to highlight the corresponding reactive metabolites. As a proof of concept, our workflow was applied to the toxicological issue of the oxidation of dietary polyunsaturated fatty acids, leading in particular to the formation of toxic alkenals, which lead to MACs upon glutathione conjugation and metabolization. By this way, dozens of MACs were detected and identified. Interestingly, multivariate statistical analyses carried out only on extracted HRMS signals of MACs yield a better characterization of the studied groups compared to results obtained from a classic untargeted metabolomics approach.

Lifestyle and dietary environmental factors in colorectal cancer susceptibility

Colorectal cancer (CRC) incidence changes with time and by variations in diet and lifestyle, as evidenced historically by migrant studies and recently by extensive epidemiologic evidence. The worldwide heterogeneity in CRC incidence is strongly suggestive of etiological involvement of environmental exposures, particularly lifestyle and diet. It is established that physical inactivity, obesity and some dietary factors (red/processed meats, alcohol) are positively associated with CRC, while healthy lifestyle habits show inverse associations. Mechanistic evidence shows that lifestyle and dietary components that contribute to energy excess are linked with increased CRC via metabolic dysfunction, inflammation, oxidative stress, bacterial dysbiosis and breakdown of gut barrier integrity while the reverse is apparent for components associated with decreased risk. This chapter will review the available evidence on lifestyle and dietary factors in CRC etiology and their underlying mechanisms in CRC development. This short review will also touch upon available information on potential gene-environment interactions, molecular sub-types of CRC and anatomical sub-sites within the colorectum.

Increased risk of esophageal squamous cell carcinoma associated with frequent and long-term consumption of salted meat and salted fat

Objective

This study aimed to investigate the association between the consumption of salted meat and salted fat and esophageal cancer risk among individuals with normal esophageal mucosa or esophagitis.

Methods

This case-control study enrolled 216 individuals from Yanting County. Information on the consumption of salted meat and salted fat was collected using a food-frequency questionnaire validated among Yanting people.

Results

Higher intake frequencies (≥once a week) of salted meat and salted fat were associated with 2.40-fold and 7.37-fold increased risks of esophageal cancer among individuals with normal esophageal mucosa, while long-term intakes (≥6 months) increased the risks by 6.87-fold and 85.45-fold, respectively. Similarly, the odds ratios (ORs) of patients with esophagitis developing esophageal cancer from frequent intakes of salted meat and salted fat were 6.48 and 5.05, respectively, and the ORs associated with long-term intakes were 44.38 and 74.90, respectively.

Conclusions

Frequent and long-term consumption of salted meat and salted fat could increase the risk of esophageal cancer in individuals from Yanting with normal esophageal mucosa or esophagitis. Efforts should thus be made to reduce the consumption of these foods among people in this region.