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Katsimpris A, Antoniadis AG, Dessypris N, Karampinos K, Gogas HJ, Petridou ET. Associations of Dietary Factors with Cutaneous Melanoma: A Case-Control Study in Greece with Literature Review. Oncol Res Treat 2024; 47:206-217. [PMID: 38471487 PMCID: PMC11078323 DOI: 10.1159/000538278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 03/06/2024] [Indexed: 03/14/2024]
Abstract
INTRODUCTION It has been postulated that nutrition may influence the risk for cutaneous melanoma (CM); therefore, we aimed to assess the associations of food groups and individual nutrient intakes with CM in a Greek population. METHODS In this case-control study, 151 patients with histologically confirmed CM, newly diagnosed and treated in the Oncology Department of the "Laikon" University Hospital (Athens, Greece), and 151 age- and sex-matched healthy individuals residing in the Athens metropolitan area, recruited among participants for routine health examinations, were included. All participants completed a questionnaire comprising anthropometric measurements, sociodemographic, lifestyle, and health-related variables. A validated, semiquantitative food frequency questionnaire was used to assess average consumption of 136 food items during the 12 months preceding the onset of disease. Multivariate conditional regression models were used to derive odds ratios (ORs) with 95% confidence intervals (95% CI) regarding the association of nine food groups and seven macronutrients with CM. RESULTS Statistically significant positive associations with CM were found with higher energy intake (OR: 1.67, 95% CI: 1.22-2.30) and intake of saturated fatty acids (OR: 2.28, 95% CI: 1.00-5.28), after adjusting for sun sensitivity, major depression history, and alcohol intake. Inverse associations with higher intake of milk and dairy products (OR: 0.65, 95% CI: 0.48-0.88), fruits (OR: 0.68, 95% CI: 0.51-0.90), added lipids (OR: 0.65, 95% CI: 0.47-0.91), and sugars and syrups (OR: 0.70, 95% CI: 0.53-0.93) were also observed. CONCLUSIONS Beyond intrinsic risk factors, our results support associations of CM with multiple food groups and nutrients; if confirmed by prospective studies, these findings can add further knowledge about this fatal cancer.
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Affiliation(s)
| | - Antonios G. Antoniadis
- First Department of Medicine, Laiko General Hospital, National and Kapodistrian University of Athens, Zografou, Greece
| | - Nick Dessypris
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Zografou, Greece
| | - Konstantinos Karampinos
- Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, Zografou, Greece
| | - Helen J. Gogas
- First Department of Medicine, Laiko General Hospital, National and Kapodistrian University of Athens, Zografou, Greece
| | - Eleni T. Petridou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Zografou, Greece
- Hellenic Society for Social Pediatrics and Health Promotion, Athens, Greece
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Urbano T, Verzelloni P, Malavolti M, Sucato S, Polledri E, Agnoli C, Sieri S, Natalini N, Marchesi C, Fustinoni S, Vinceti M, Filippini T. Influence of dietary patterns on urinary excretion of cadmium in an Italian population: A cross-sectional study. J Trace Elem Med Biol 2023; 80:127298. [PMID: 37713806 DOI: 10.1016/j.jtemb.2023.127298] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 08/23/2023] [Accepted: 09/04/2023] [Indexed: 09/17/2023]
Abstract
INTRODUCTION Cadmium is a toxic heavy metal with detrimental effects on human health. Apart from smoking and occupational factors, diet is the main source of cadmium. However, the relation between adherence to so-called "healthy" dietary patterns and cadmium exposure has not been investigated in detail. In this study, we aimed at assessing such association in a Northern Italian population. METHODS Using a cross-sectional study design, we investigated a population of non-smokers aged 30-60 years in the period 2017-2019. Each subject completed a validated food frequency questionnaire (FFQ) in order to estimate adherence to four dietary patterns, namely the Dietary Approach to Stopping Hypertension-DASH diet, Greek Mediterranean Index-GMI, the Italian Mediterranean Index-IMI, and the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet. We collected a fasting morning urinary sample to measure urinary levels of cadmium and cotinine. The association between increasing adherence to dietary patterns and cadmium exposure was evaluated using a cubic spline regression non-linear model and adjusting for relevant confounders (age, sex, body mass index, urinary cotinine levels, intake of fiber, and alcohol). RESULTS We recruited 137 participants (males/females: 62/75) with median (interquartile range-IQR) age of 47 (IQR: 43-53) years. Median scores for the investigated dietary patterns were 24 (IQR: 21-28), 4 (IQR: 3-6), 4 (IQR: 3-5), and 7.5 (IQR: 6.5-8.5) for DASH, GMI, IMI and MIND diets, respectively. The median urinary cadmium level was 0.21 μg/L (IQR: 0.11-0.34 μg/L). Spline regression analysis showed an inverse linear association between increasing adherence to the DASH and MIND diets and urinary cadmium levels, reaching a plateau at high adherence scores, approximately > 25 and > 9 for DASH and MIND diets, respectively. An increase of cadmium exposure with increasing MIND score also emerged. Conversely, the association was almost null for IMI, and slightly positive for GMI. CONCLUSIONS The present findings suggest that increasing adherence to the DASH and MIND diets are associated with decreased cadmium levels only at moderate level. Overall, these results indicate that public health strategies, including the decrease of cadmium contamination in healthy foods should be implemented.
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Affiliation(s)
- Teresa Urbano
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Pietro Verzelloni
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Marcella Malavolti
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Sabrina Sucato
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Elisa Polledri
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Claudia Agnoli
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Sabina Sieri
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Cristina Marchesi
- Head Office, Azienda USL, IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Silvia Fustinoni
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; IRCCS Ca' Granda Foundation Maggiore Policlinico Hospital, Milan, Italy
| | - Marco Vinceti
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Tommaso Filippini
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; School of Public Health, University of California Berkeley, Berkeley, CA, USA.
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Antiproliferative and Proapoptotic Effects of Erucin, a Diet-Derived H 2S Donor, on Human Melanoma Cells. Antioxidants (Basel) 2022; 12:antiox12010041. [PMID: 36670903 PMCID: PMC9854590 DOI: 10.3390/antiox12010041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/19/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022] Open
Abstract
Melanoma is the most dangerous form of skin cancer and is characterized by chemotherapy resistance and recurrence despite the new promising therapeutic approaches. In the last years, erucin (ERU), the major isothiocyanate present in Eruca sativa, commonly known as rocket salads, has demonstrated great efficacy as an anticancer agent in different in vitro and in vivo models. More recently, the chemopreventive effects of ERU have been associated with its property of being a H2S donor in human pancreatic adenocarcinoma. Here, we investigated the effects of ERU in modulating proliferation and inducing human melanoma cell death by using multiple in vitro approaches. ERU significantly reduced the proliferation of different human melanoma cell lines. A flow cytometry analysis with annexin V/PI demonstrated that ERU was able to induce apoptosis and cell cycle arrest in A375 melanoma cells. The proapoptotic effect of ERU was associated with the modulation of the epithelial-to-mesenchymal transition (EMT)-related cadherins and transcription factors. Moreover, ERU thwarted the migration, invasiveness and clonogenic abilities of A375 melanoma cells. These effects were associated with melanogenesis impairment and mitochondrial fitness modulation. Therefore, we demonstrated that ERU plays an important role in inhibiting the progression of melanoma and could represent a novel add-on therapy for the treatment of human melanoma.
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Kumar P, Brazel D, DeRogatis J, Valerin JBG, Whiteson K, Chow WA, Tinoco R, Moyers JT. The cure from within? a review of the microbiome and diet in melanoma. Cancer Metastasis Rev 2022; 41:261-280. [PMID: 35474500 PMCID: PMC9042647 DOI: 10.1007/s10555-022-10029-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 03/28/2022] [Indexed: 12/17/2022]
Abstract
Therapy for cutaneous melanoma, the deadliest of the skin cancers, is inextricably linked to the immune system. Once thought impossible, cures for metastatic melanoma with immune checkpoint inhibitors have been developed within the last decade and now occur regularly in the clinic. Unfortunately, half of tumors do not respond to checkpoint inhibitors and efforts to further exploit the immune system are needed. Tantalizing associations with immune health and gut microbiome composition suggest we can improve the success rate of immunotherapy. The gut contains over half of the immune cells in our bodies and increasingly, evidence is linking the immune system within our gut to melanoma development and treatment. In this review, we discuss the importance the skin and gut microbiome may play in the development of melanoma. We examine the differences in the microbial populations which inhabit the gut of those who develop melanoma and subsequently respond to immunotherapeutics. We discuss the role of dietary intake on the development and treatment of melanoma. And finally, we review the landscape of published and registered clinical trials therapeutically targeting the microbiome in melanoma through dietary supplements, fecal microbiota transplant, and microbial supplementation.
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Affiliation(s)
- Priyanka Kumar
- Department of Medicine, University of California Irvine, Orange, CA, USA
| | - Danielle Brazel
- Department of Medicine, University of California Irvine, Orange, CA, USA
| | - Julia DeRogatis
- Department of Molecular Biology and Biochemistry, School of Biological Sciences, University of California, Irvine, CA, USA
| | - Jennifer B Goldstein Valerin
- Division of Hematology and Oncology, Department of Medicine, University of California Irvine, 101 The City Drive South, Building 200, Orange, CA, 92868, USA
| | - Katrine Whiteson
- Department of Molecular Biology and Biochemistry, School of Biological Sciences, University of California, Irvine, CA, USA
| | - Warren A Chow
- Division of Hematology and Oncology, Department of Medicine, University of California Irvine, 101 The City Drive South, Building 200, Orange, CA, 92868, USA
| | - Roberto Tinoco
- Department of Molecular Biology and Biochemistry, School of Biological Sciences, University of California, Irvine, CA, USA
| | - Justin T Moyers
- Division of Hematology and Oncology, Department of Medicine, University of California Irvine, 101 The City Drive South, Building 200, Orange, CA, 92868, USA.
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Pellegrini M, D’Eusebio C, Ponzo V, Tonella L, Finocchiaro C, Fierro MT, Quaglino P, Bo S. Nutritional Interventions for Patients with Melanoma: From Prevention to Therapy-An Update. Nutrients 2021; 13:4018. [PMID: 34836273 PMCID: PMC8624488 DOI: 10.3390/nu13114018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/31/2021] [Accepted: 11/08/2021] [Indexed: 12/17/2022] Open
Abstract
Melanoma is an aggressive skin cancer, whose incidence rates have increased over the past few decades. Risk factors for melanoma are both intrinsic (genetic and familiar predisposition) and extrinsic (environment, including sun exposure, and lifestyle). The recent advent of targeted and immune-based therapies has revolutionized the treatment of melanoma, and research is focusing on strategies to optimize them. Obesity is an established risk factor for several cancer types, but its possible role in the etiology of melanoma is controversial. Body mass index, body surface area, and height have been related to the risk for cutaneous melanoma, although an 'obesity paradox' has been described too. Increasing evidence suggests the role of nutritional factors in the prevention and management of melanoma. Several studies have demonstrated the impact of dietary attitudes, specific foods, and nutrients both on the risk for melanoma and on the progression of the disease, via the effects on the oncological treatments. The aim of this narrative review was to summarize the main literature results regarding the preventive and therapeutic role of nutritional schemes, specific foods, and nutrients on melanoma incidence and progression.
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Affiliation(s)
- Marianna Pellegrini
- Department of Medical Sciences, Division of Endocrinology, Diabetes and Metabolism, University of Torino, 10126 Torino, Italy; (M.P.); (C.D.); (V.P.); (S.B.)
| | - Chiara D’Eusebio
- Department of Medical Sciences, Division of Endocrinology, Diabetes and Metabolism, University of Torino, 10126 Torino, Italy; (M.P.); (C.D.); (V.P.); (S.B.)
| | - Valentina Ponzo
- Department of Medical Sciences, Division of Endocrinology, Diabetes and Metabolism, University of Torino, 10126 Torino, Italy; (M.P.); (C.D.); (V.P.); (S.B.)
| | - Luca Tonella
- Department of Medical Sciences, Dermatologic Clinic, University of Torino, 10126 Torino, Italy; (L.T.); (M.T.F.)
| | - Concetta Finocchiaro
- Dietetic and Clinical Nutrition Unit, “Città della Salute e della Scienza” Hospital, 10126 Torino, Italy;
| | - Maria Teresa Fierro
- Department of Medical Sciences, Dermatologic Clinic, University of Torino, 10126 Torino, Italy; (L.T.); (M.T.F.)
| | - Pietro Quaglino
- Department of Medical Sciences, Dermatologic Clinic, University of Torino, 10126 Torino, Italy; (L.T.); (M.T.F.)
| | - Simona Bo
- Department of Medical Sciences, Division of Endocrinology, Diabetes and Metabolism, University of Torino, 10126 Torino, Italy; (M.P.); (C.D.); (V.P.); (S.B.)
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Abstract
There has been considerable research in recent years on dietary factors and/or nutritional elements that might impact melanoma risk. A wide variety of dietary compounds have been studied, but only a selected group will be discussed in this review. Many have promising in vitro evidence supporting their potential, and some have been associated with decreased melanoma risk in epidemiologic studies; however, data from randomized controlled trials in humans are lacking. Future studies may be able to clarify the potential role of dietary components in melanoma risk reduction.
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Malavolti M, Naska A, Fairweather-Tait SJ, Malagoli C, Vescovi L, Marchesi C, Vinceti M, Filippini T. Sodium and Potassium Content of Foods Consumed in an Italian Population and the Impact of Adherence to a Mediterranean Diet on Their Intake. Nutrients 2021; 13:nu13082681. [PMID: 34444841 PMCID: PMC8401684 DOI: 10.3390/nu13082681] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 07/20/2021] [Accepted: 07/30/2021] [Indexed: 12/25/2022] Open
Abstract
High sodium and low potassium intakes are associated with increased levels of blood pressure and risk of cardiovascular diseases. Assessment of habitual dietary habits are helpful to evaluate their intake and adherence to healthy dietary recommendations. In this study, we determined sodium and potassium food-specific content and intake in a Northern Italy community, focusing on the role and contribution of adherence to Mediterranean diet patterns. We collected a total of 908 food samples and measured sodium and potassium content using inductively coupled plasma mass spectrometry. Using a validated semi-quantitative food frequency questionnaire, we assessed habitual dietary intake of 719 adult individuals of the Emilia-Romagna region. We then estimated sodium and potassium daily intake for each food based on their relative contribution to the overall diet, and their link to Mediterranean diet patterns. The estimated mean sodium intake was 2.15 g/day, while potassium mean intake was 3.37 g/day. The foods contributing most to sodium intake were cereals (33.2%), meat products (24.5%, especially processed meat), and dairy products (13.6%), and for potassium they were meat (17.1%, especially red and white meat), fresh fruits (15.7%), and vegetables (15.1%). Adherence to a Mediterranean diet had little influence on sodium intake, whereas potassium intake was greatly increased in subjects with higher scores, resulting in a lower sodium/potassium ratio. Although we may have underestimated dietary sodium intake by not including discretionary salt use and there may be some degree of exposure misclassification as a result of changes in food sodium content and dietary habits over time, our study provides an overview of the contribution of a wide range of foods to the sodium and potassium intake in a Northern Italy community and of the impact of a Mediterranean diet on intake. The mean sodium intake was above the dietary recommendations for adults of 1.5–2 g/day, whilst potassium intake was only slightly lower than the recommended 3.5 g/day. Our findings suggest that higher adherence to Mediterranean diet patterns has limited effect on restricting sodium intake, but may facilitate a higher potassium intake, thereby aiding the achievement of healthy dietary recommendations.
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Affiliation(s)
- Marcella Malavolti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy; (M.M.); (C.M.); (L.V.); (T.F.)
| | - Androniki Naska
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Mikras Asias 75, 11527 Athens, Greece;
| | - Susan J. Fairweather-Tait
- Norwich Medical School, University of East Anglia, Norwich Research Park, James Watson Road, Norwich NR4 7UQ, UK;
| | - Carlotta Malagoli
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy; (M.M.); (C.M.); (L.V.); (T.F.)
| | - Luciano Vescovi
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy; (M.M.); (C.M.); (L.V.); (T.F.)
| | - Cristina Marchesi
- Head Office, Direzione Generale, Azienda USL-IRCCS di Reggio Emilia, Via Amendola 2, 42122 Reggio Emilia, Italy;
| | - Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy; (M.M.); (C.M.); (L.V.); (T.F.)
- Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA
- Correspondence:
| | - Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy; (M.M.); (C.M.); (L.V.); (T.F.)
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8
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Filippini T, Adani G, Malavolti M, Garuti C, Cilloni S, Vinceti G, Zamboni G, Tondelli M, Galli C, Costa M, Chiari A, Vinceti M. Dietary Habits and Risk of Early-Onset Dementia in an Italian Case-Control Study. Nutrients 2020; 12:nu12123682. [PMID: 33260315 PMCID: PMC7760835 DOI: 10.3390/nu12123682] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 11/17/2020] [Accepted: 11/27/2020] [Indexed: 12/14/2022] Open
Abstract
Risk of early-onset dementia (EOD) might be modified by environmental factors and lifestyles, including diet. The aim of this study is to evaluate the association between dietary habits and EOD risk. We recruited 54 newly-diagnosed EOD patients in Modena (Northern Italy) and 54 caregivers as controls. We investigated dietary habits through a food frequency questionnaire, assessing both food intake and adherence to dietary patterns, namely the Greek-Mediterranean, the Dietary Approaches to Stop Hypertension (DASH), and the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diets. We modeled the relation between dietary factors and risk using the restricted cubic spline regression analysis. Cereal intake showed a U-shaped relation with EOD, with risk increasing above 350 g/day. A high intake (>400 g/day) of dairy products was also associated with excess risk. Although overall fish and seafood consumption showed no association with EOD risk, we found a U-shaped relation with preserved/tinned fish, and an inverse relation with other fish. Similarly, vegetables (especially leafy) showed a strong inverse association above 100 g/day, as did citrus and dry fruits. Overall, sweet consumption was not associated with EOD risk, while dry cake and ice-cream showed a positive relation and chocolate products an inverse one. For beverages, we found no relation with EOD risk apart from a U-shaped relation for coffee consumption. Concerning dietary patterns, EOD risk linearly decreased with the increasing adherence to the MIND pattern. On the other hand, an inverse association for the Greek-Mediterranean and DASH diets emerged only at very high adherence levels. To the best of our knowledge, this is the first study that explores the association between dietary factors and EOD risk, and suggests that adherence to the MIND dietary pattern may decrease such risk.
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Affiliation(s)
- Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy; (T.F.); (G.A.); (M.M.); (C.G.); (S.C.)
| | - Giorgia Adani
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy; (T.F.); (G.A.); (M.M.); (C.G.); (S.C.)
| | - Marcella Malavolti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy; (T.F.); (G.A.); (M.M.); (C.G.); (S.C.)
| | - Caterina Garuti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy; (T.F.); (G.A.); (M.M.); (C.G.); (S.C.)
| | - Silvia Cilloni
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy; (T.F.); (G.A.); (M.M.); (C.G.); (S.C.)
| | - Giulia Vinceti
- Center for Neurosciences and Neurotechnology, Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, 41126 Modena, Italy; (G.V.); (G.Z.)
- Neurology Unit, Modena Policlinico-University Hospital, 41126 Modena, Italy; (M.T.); (C.G.); (A.C.)
| | - Giovanna Zamboni
- Center for Neurosciences and Neurotechnology, Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, 41126 Modena, Italy; (G.V.); (G.Z.)
- Neurology Unit, Modena Policlinico-University Hospital, 41126 Modena, Italy; (M.T.); (C.G.); (A.C.)
| | - Manuela Tondelli
- Neurology Unit, Modena Policlinico-University Hospital, 41126 Modena, Italy; (M.T.); (C.G.); (A.C.)
- Primary care Department, Modena Local Health Authority, 41124 Modena, Italy
| | - Chiara Galli
- Neurology Unit, Modena Policlinico-University Hospital, 41126 Modena, Italy; (M.T.); (C.G.); (A.C.)
- Primary care Department, Modena Local Health Authority, 41124 Modena, Italy
- Department of Neuroscience, Psychology, Pharmacology and Child Health (NeuroFARBA), University of Florence, 50139 Florence, Italy
| | - Manuela Costa
- Neurology Unit of Carpi Hospital, Modena Local Health Authority, 41012 Carpi, Italy;
| | - Annalisa Chiari
- Neurology Unit, Modena Policlinico-University Hospital, 41126 Modena, Italy; (M.T.); (C.G.); (A.C.)
| | - Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy; (T.F.); (G.A.); (M.M.); (C.G.); (S.C.)
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA
- Correspondence: ; Tel.: +39-059-2055481
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9
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Leone A, Martínez-González MÁ, Martin-Gorgojo A, Sánchez-Bayona R, De Amicis R, Bertoli S, Battezzati A, Bes-Rastrollo M. Mediterranean diet, Dietary Approaches to Stop Hypertension, and Pro-vegetarian dietary pattern in relation to the risk of basal cell carcinoma: a nested case-control study within the Seguimiento Universidad de Navarra (SUN) cohort. Am J Clin Nutr 2020; 112:364-372. [PMID: 32492135 DOI: 10.1093/ajcn/nqaa127] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Accepted: 05/07/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The association of dietary pattern with the risk of basal cell carcinoma (BCC) is little understood and has scarcely been investigated. OBJECTIVES We assessed the association of several complete dietary patterns [Mediterranean, Dietary Approaches to Stop Hypertension (DASH), and Pro-vegetarian dietary pattern] with the risk of BCC, conducting a nested case-control study (4 controls for each case). METHODS Cases and controls were selected from the SUN (Seguimiento Universidad de Navarra) cohort using risk set sampling. Cases were identified among subjects free of skin cancer at baseline but who later reported a physician-made BCC diagnosis during the follow-up period. In the cohort we identified 101 incident cases of BCC. RESULTS In multivariable-adjusted conditional logistic regression analyses, better adherence to the Mediterranean diet (highest compared with lowest quintile) was associated with a 72% relative reduction in the odds of BCC (OR: 0.28; 95% CI: 0.10, 0.77; Ptrend = 0.014); the DASH diet was associated with a 68% RR reduction (OR: 0.32; 95% CI: 0.14, 0.76; Ptrend = 0.013) for the comparison between extreme quintiles. No association was found between a Pro-vegetarian dietary pattern and BCC. Higher fruit consumption (highest compared with lowest quintile, OR: 0.27; 95% CI: 0.11, 0.64; Ptrend < 0.001) and low-fat dairy products (OR: 0.39; 95% CI: 0.16, 0.92; Ptrend = 0.014) were associated with a lower BCC risk. CONCLUSIONS Our results suggest that Mediterranean and DASH dietary patterns may be associated with a lower risk of BCC, but confirmatory studies are required.
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Affiliation(s)
- Alessandro Leone
- International Center for the Assessment of Nutritional Status, Department of Food, Environmental and Nutritional Sciences, University of Milan, Milan, Italy
| | - Miguel Á Martínez-González
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain.,Physiopathology of Obesity and Nutrition Networking Biomedical Research Centre (CIBERobn), Spanish National Institute of Health Carlos III, Madrid, Spain.,Navarra's Health Research Institute, Pamplona, Spain.,Department of Nutrition, TH Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Alejandro Martin-Gorgojo
- Dermatology & Venereology Department, "Madrid Salud" Regional Healthcare Agency, Madrid City Council, Madrid, Spain
| | - Rodrigo Sánchez-Bayona
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain.,Department of Medical Oncology, University of Navarra Clinic, Pamplona, Spain
| | - Ramona De Amicis
- International Center for the Assessment of Nutritional Status, Department of Food, Environmental and Nutritional Sciences, University of Milan, Milan, Italy
| | - Simona Bertoli
- International Center for the Assessment of Nutritional Status, Department of Food, Environmental and Nutritional Sciences, University of Milan, Milan, Italy.,Department of Endocrine and Metabolic Diseases, Obesity Unit and Laboratory of Nutrition and Obesity Research, IRCCS (Scientific Institute for Research, Hospitalization, and Healthcare) Italian Auxologic Institute (IAI), Milan, Italy
| | - Alberto Battezzati
- International Center for the Assessment of Nutritional Status, Department of Food, Environmental and Nutritional Sciences, University of Milan, Milan, Italy
| | - Maira Bes-Rastrollo
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain.,Physiopathology of Obesity and Nutrition Networking Biomedical Research Centre (CIBERobn), Spanish National Institute of Health Carlos III, Madrid, Spain.,Navarra's Health Research Institute, Pamplona, Spain
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10
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Malavolti M, Fairweather-Tait SJ, Malagoli C, Vescovi L, Vinceti M, Filippini T. Lead exposure in an Italian population: Food content, dietary intake and risk assessment. Food Res Int 2020; 137:109370. [PMID: 33233072 DOI: 10.1016/j.foodres.2020.109370] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 04/29/2020] [Accepted: 05/28/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIM Lead is a highly toxic heavy metal released into the environment after natural and anthropogenic activities. Excluding populations in occupations where there is possible lead contamination, food is the major source of human exposure. In this study, we determined lead contamination in food and beverages consumed in a Northern Italy community and performed a health risk assessment. METHODS We collected a total of 908 food samples and measured lead levels using inductively coupled plasma mass spectrometry. Using a validated food frequency questionnaire, we assessed the dietary habits and estimated daily lead dietary intakes in a sample of 719 adult individuals. We performed risk assessment using a benchmark dose and margin of exposure approach, based on exposure levels for both adverse effect of systolic blood pressure and chronic kidney disease. RESULTS Foods with the highest lead levels include non-chocolate confectionery (48.7 µg/kg), leafy (39.0 µg/kg) and other vegetables (42.2 µg/kg), and crustaceans and molluscs (39.0 µg/kg). The estimated mean lead intake was 0.155 µg/kg bw-day in all subjects, with little lower intakes in men (0.151 µg/kg bw-day) compared to women (0.157 µg/kg bw-day). Top food contributors were vegetables, cereals, and beverages, particularly wine. In relation to risk assessment, the estimated dietary intake was lower than levels associated with cardiovascular risk and nephrotoxicity. CONCLUSIONS Our study provides an updated assessment of lead food contamination and dietary exposure in a Northern Italian community. The margin of exposure risk assessment approach suggests that risk of detrimental effects due to dietary lead intake is low in the investigated population. Nonetheless, these exposure levels for adverse effects are not reference health standards, and no safety threshold value can be established for lead. As a consequence, other and more subtle adverse effects may still occur in vulnerable and occupationally exposed individuals, particularly in relation to the nervous system.
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Affiliation(s)
- Marcella Malavolti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy
| | | | - Carlotta Malagoli
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy
| | - Luciano Vescovi
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy
| | - Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy; Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, 02118 Boston, MA, USA.
| | - Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy
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11
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Filippini T, Malagoli C, Wise LA, Malavolti M, Pellacani G, Vinceti M. Dietary cadmium intake and risk of cutaneous melanoma: An Italian population-based case-control study. J Trace Elem Med Biol 2019; 56:100-106. [PMID: 31442947 DOI: 10.1016/j.jtemb.2019.08.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 07/31/2019] [Accepted: 08/01/2019] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Exposure to the heavy metal cadmium has been associated with many adverse health effects, such as atherosclerosis, diabetes, and cancer, possibly melanoma. In non-occupationally exposed individuals, food intake is a major source of cadmium exposure, after smoking. We aimed to assess the risk of melanoma in relation to dietary cadmium intake. METHODS Using a population-based case-control study design, we recruited 380 incident cases of newly-diagnosed cutaneous melanoma and 719 matched controls in the Emilia-Romagna Region, Northern Italy in the years 2005-2006. We evaluated dietary intake using a semi-quantitative food frequency questionnaire. We used conditional logistic regression to compute odds ratios (ORs) and 95% confidence intervals (CIs) for melanoma according to quintiles of dietary cadmium intake, adjusting for several potential confounders, and we modeled the association non-parametrically, using restricted cubic splines. RESULTS Median energy-adjusted intake of cadmium was 6.11 μg/day (interquartile range 5.38-6.91) among cases and 5.97 μg/day (5.15-6.79) among controls. For each 1 μg/day-increase in cadmium intake, the OR for melanoma was 1.11 (95% CI 1.00-1.24). Melanoma risk generally increased with increasing quintile of cadmium exposure, with ORs of 1.55 (95% CI 0.99-2.42), 1.54 (95% CI 0.99-2-40), 1.75 (95% CI 1.12-2.75), and 1.65 (95% CI 1.05-2.61) for the second through fifth quintiles, compared with the lowest quintile. Sex-stratified analysis showed ORs per 1 μg/day-increase in cadmium intake of 1.10 (95% CI 0.93-1-29) among men and 1.15 (95% CI 0.99-1.33) among women. Using spline regression analysis, we observed a generally linear increase in melanoma risk up to 6 μg/day of cadmium intake, after which the risk appeared to plateau. CONCLUSIONS We observed a positive non-linear association between dietary cadmium intake and risk of cutaneous melanoma in a Northern Italy population. However, further studies are needed to elucidate this association, due to concerns about exposure misclassification, unmeasured confounding, and the limited and conflicting evidence from epidemiological findings.
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Affiliation(s)
- Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences - Section of Public Health, University of Modena and Reggio Emilia, Modena, Italy
| | - Carlotta Malagoli
- Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences - Section of Public Health, University of Modena and Reggio Emilia, Modena, Italy
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, USA
| | - Marcella Malavolti
- Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences - Section of Public Health, University of Modena and Reggio Emilia, Modena, Italy
| | - Giovanni Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Italy
| | - Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences - Section of Public Health, University of Modena and Reggio Emilia, Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, USA.
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12
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Mahamat-Saleh Y, Cervenka I, Al Rahmoun M, Savoye I, Mancini FR, Trichopoulou A, Boutron-Ruault MC, Kvaskoff M. Mediterranean dietary pattern and skin cancer risk: A prospective cohort study in French women. Am J Clin Nutr 2019; 110:993-1002. [PMID: 31380561 DOI: 10.1093/ajcn/nqz173] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 07/09/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The Mediterranean diet (MD) has been reported to be associated with lower cancer risk. However, while previous studies explored major single components of the MD, only 1 previous study has investigated adherence to the MD in relation to melanoma risk. OBJECTIVE The aim of this study was to explore the relations between adherence to the MD and the risk of skin cancer, including melanomas, basal cell carcinomas (BCCs), and squamous cell carcinomas (SCCs). DESIGN Etude Epidémiologique auprès de femmes de la Mutuelle Générale de l'Education Nationale (E3N) is a prospective cohort of 98,995 French women aged 40-65 y in 1990. Dietary data were collected via a validated food questionnaire in 1993. Adherence to the MD was assessed using a 9-unit dietary score that incorporates intakes of fruit, vegetables, legumes, cereal products, olive oil, fish, dairy products, meat products, and alcohol. We used Cox proportional hazards regression models to compute HRs and 95% CIs adjusted for age and main known skin cancer risk factors. RESULTS From 1993 to 2008, a total of 2003 skin cancer cases were ascertained among 67,332 women, including 404 melanomas, 1367 BCCs, and 232 SCCs. Score of adherence to the MD was associated with lower risk of skin cancer (HR: 0.83; 95% CI: 0.73, 0.93 for high compared with low score, Ptrend = 0.001). MD score was also inversely and linearly associated with risks of melanoma (HR: 0.72; 95% CI: 0.54, 0.96; Ptrend = 0.02) and BCC (HR: 0.77; 95% CI: 0.66, 0.90; Ptrend = 0.0006) but not SCC (HR: 1.08; 95% CI: 0.75, 1.55; Ptrend = 0.68), although with no heterogeneity across skin cancer types (Pheterogeneity = 0.23). CONCLUSION These findings suggest that adherence to the MD is associated with a lower skin cancer risk in women, particularly melanoma and BCC. If confirmed in future research, these findings may have important implications in skin cancer prevention.
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Affiliation(s)
- Yahya Mahamat-Saleh
- Centre for Research in Epidemiology and Population Health (CESP) - School of Medicine, Université Paris Sud - School of Medicine, Université Versailles Saint-Quentin-en-Yvelines (UVSQ); INSERM (French National Institute for Health and Medical Research), Université Paris Saclay, Villejuif, France.,Gustave Roussy, Villejuif, France
| | - Iris Cervenka
- Centre for Research in Epidemiology and Population Health (CESP) - School of Medicine, Université Paris Sud - School of Medicine, Université Versailles Saint-Quentin-en-Yvelines (UVSQ); INSERM (French National Institute for Health and Medical Research), Université Paris Saclay, Villejuif, France.,Gustave Roussy, Villejuif, France
| | - Marie Al Rahmoun
- Centre for Research in Epidemiology and Population Health (CESP) - School of Medicine, Université Paris Sud - School of Medicine, Université Versailles Saint-Quentin-en-Yvelines (UVSQ); INSERM (French National Institute for Health and Medical Research), Université Paris Saclay, Villejuif, France.,Gustave Roussy, Villejuif, France
| | - Isabelle Savoye
- Belgian Health Care Knowledge Centre (KCE), Brussels, Belgium
| | - Francesca Romana Mancini
- Centre for Research in Epidemiology and Population Health (CESP) - School of Medicine, Université Paris Sud - School of Medicine, Université Versailles Saint-Quentin-en-Yvelines (UVSQ); INSERM (French National Institute for Health and Medical Research), Université Paris Saclay, Villejuif, France.,Gustave Roussy, Villejuif, France
| | - Antonia Trichopoulou
- Hellenic Health Foundation, Athens, Greece.,WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Marie-Christine Boutron-Ruault
- Centre for Research in Epidemiology and Population Health (CESP) - School of Medicine, Université Paris Sud - School of Medicine, Université Versailles Saint-Quentin-en-Yvelines (UVSQ); INSERM (French National Institute for Health and Medical Research), Université Paris Saclay, Villejuif, France.,Gustave Roussy, Villejuif, France
| | - Marina Kvaskoff
- Centre for Research in Epidemiology and Population Health (CESP) - School of Medicine, Université Paris Sud - School of Medicine, Université Versailles Saint-Quentin-en-Yvelines (UVSQ); INSERM (French National Institute for Health and Medical Research), Université Paris Saclay, Villejuif, France.,Gustave Roussy, Villejuif, France
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13
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Malagoli C, Malavolti M, Farnetani F, Longo C, Filippini T, Pellacani G, Vinceti M. Food and Beverage Consumption and Melanoma Risk: A Population-Based Case-Control Study in Northern Italy. Nutrients 2019; 11:E2206. [PMID: 31547443 PMCID: PMC6769978 DOI: 10.3390/nu11092206] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 09/09/2019] [Accepted: 09/10/2019] [Indexed: 02/06/2023] Open
Abstract
It has been suggested that diet may influence the risk of melanoma, but few studies are available on this topic. We assessed the relation between food consumption and the risk of cutaneous melanoma in a Northern Italy population. We carried out a population-based case-control study involving 380 cases of melanoma and 719 age- and sex-matched controls. Dietary habits were established through a self-administered semi-quantitative food frequency questionnaire. We computed the odds ratios (ORs) of melanoma and the corresponding 95% confidence intervals (CIs) according to tertiles of daily intake of each food item, using multiple logistic regression models adjusted for major confounding factors. We observed an indication of a positive association between melanoma risk and consumption of cereals and cereal products (OR = 1.32; 95% CI 0.89-1.96, higher vs. lowest tertile), sweets (OR = 1.22; 95% CI 0.84-1.76), chocolate, candy bars. etc., (OR = 1.51; 95% CI 1.09-2.09) and cabbages (OR = 1.51; 95% CI 1.09-2.09). Conversely, an inverse association with disease risk was found for the intake of legumes (OR = 0.77; 95% CI 0.52-1.13), olive oil (OR = 0.77; 95% CI 0.51-1.16), eggs (OR = 0.58; 95% CI 0.41-0.82), and onion and garlic (OR = 0.80; 95% CI 0.52-1.14). No relationship was observed with beverage consumption. Our results suggest potentially adverse effects on melanoma risk of foods characterized by high contents of refined flours and sugars, while suggesting a protective role for eggs and two key components of the Mediterranean diet, legumes and olive oil. These associations warrant further investigation and, if confirmed, they might have important public health implications for the reduction of melanoma incidence through dietary modification.
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Affiliation(s)
- Carlotta Malagoli
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Section of Public Health-Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via G. Campi 287, 41125 Modena, Italy.
| | - Marcella Malavolti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Section of Public Health-Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via G. Campi 287, 41125 Modena, Italy.
| | - Francesca Farnetani
- Dermatologic Unit, University of Modena and Reggio Emilia, Via Del Pozzo 71, 41124 Modena, Italy.
| | - Caterina Longo
- Dermatologic Unit, University of Modena and Reggio Emilia, Via Del Pozzo 71, 41124 Modena, Italy.
| | - Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Section of Public Health-Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via G. Campi 287, 41125 Modena, Italy.
| | - Giovanni Pellacani
- Dermatologic Unit, University of Modena and Reggio Emilia, Via Del Pozzo 71, 41124 Modena, Italy.
| | - Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Section of Public Health-Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via G. Campi 287, 41125 Modena, Italy.
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA.
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14
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Vollono L, Falconi M, Gaziano R, Iacovelli F, Dika E, Terracciano C, Bianchi L, Campione E. Potential of Curcumin in Skin Disorders. Nutrients 2019; 11:E2169. [PMID: 31509968 PMCID: PMC6770633 DOI: 10.3390/nu11092169] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 08/05/2019] [Accepted: 08/15/2019] [Indexed: 12/12/2022] Open
Abstract
Curcumin is a compound isolated from turmeric, a plant known for its medicinal use. Recently, there is a growing interest in the medical community in identifying novel, low-cost, safe molecules that may be used in the treatment of inflammatory and neoplastic diseases. An increasing amount of evidence suggests that curcumin may represent an effective agent in the treatment of several skin conditions. We examined the most relevant in vitro and in vivo studies published to date regarding the use of curcumin in inflammatory, neoplastic, and infectious skin diseases, providing information on its bioavailability and safety profile. Moreover, we performed a computational analysis about curcumin's interaction towards the major enzymatic targets identified in the literature. Our results suggest that curcumin may represent a low-cost, well-tolerated, effective agent in the treatment of skin diseases. However, bypass of limitations of its in vivo use (low oral bioavailability, metabolism) is essential in order to conduct larger clinical trials that could confirm these observations. The possible use of curcumin in combination with traditional drugs and the formulations of novel delivery systems represent a very promising field for future applicative research.
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Affiliation(s)
- Laura Vollono
- Dermatology Unit, Department of "Medicina dei Sistemi", University of Rome Tor Vergata, Via Montpellier, 1-00133 Rome, Italy
| | - Mattia Falconi
- Department of Biology, University of Rome "Tor Vergata", Via della Ricerca Scientifica, 1-00133 Rome, Italy
| | - Roberta Gaziano
- Microbiology Section, Department of Experimental Medicine, University of Rome Tor Vergata, Via Montpellier, 1-00133 Rome, Italy
| | - Federico Iacovelli
- Department of Biology, University of Rome "Tor Vergata", Via della Ricerca Scientifica, 1-00133 Rome, Italy
| | - Emi Dika
- Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of Bologna, Via Massarenti, 1-40138 Bologna, Italy
| | - Chiara Terracciano
- Neurology Unit, Guglielmo de Saliceto Hospital, 29121-29122 Piacenza, Italy
| | - Luca Bianchi
- Dermatology Unit, Department of "Medicina dei Sistemi", University of Rome Tor Vergata, Via Montpellier, 1-00133 Rome, Italy
| | - Elena Campione
- Dermatology Unit, Department of "Medicina dei Sistemi", University of Rome Tor Vergata, Via Montpellier, 1-00133 Rome, Italy.
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15
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Ali Mohsenpour M, Fallah-Moshkani R, Ghiasvand R, Khosravi-Boroujeni H, Mehdi Ahmadi S, Brauer P, Salehi-Abargouei A. Adherence to Dietary Approaches to Stop Hypertension (DASH)-Style Diet and the Risk of Cancer: A Systematic Review and Meta-Analysis of Cohort Studies. J Am Coll Nutr 2019; 38:513-525. [PMID: 31140934 DOI: 10.1080/07315724.2018.1554460] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Objective: Several investigators have proposed a protective association between dietary approaches to stop hypertension (DASH) style diet and risk of cancers; however, they have had inconsistent results. The present study aimed to systematically review the prospective cohort studies and if possible quantify the overall effect using meta-analysis. Methods: PubMed, Scopus, and Google Scholar were searched for cohort studies published up to July 2018. Relative risks (RRs) that were reported for fully adjusted models and their confidence intervals were extracted for meta-analysis. The random effects model was used to combine the RRs. Results: Seventeen studies were eligible to be included in the systematic review, from which nine reports assessed the association between the DASH diet and risk of mortality from all cancer types, four assessed incidence of colorectal cancer, and two studies assessed the risk of colon and rectal cancer separately. Four studies examined the association with the incidence of other cancers (breast, hepatic, endometrial, and lung cancer). Meta-analysis showed that high adherence to DASH is associated with a decreased mortality from all cancer types (RR = 0.84, 95% confidence interval [95%CI]: 0.81-0.86). Participants with the highest adherence to the DASH diet had a lower risk of developing colorectal (RR = 0.79, 95%CI: 0.75-0.83), colon (RR = 0.80, 95%CI: 0.74-0.87), and rectal (RR = 0.84, 95%CI: 0.74-0.96) cancers compared to those with the lowest adherence. Conclusion: DASH-style diet should be suggested as a healthy approach associated with decreased risk of cancer in the community. Prospective studies exploring the association for other cancer types and from regions other than the United States are highly recommended.
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Affiliation(s)
- Mohammad Ali Mohsenpour
- a Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences , Yazd , Iran.,b Department of Nutrition School of Public Health, Shahid Sadoughi University of Medical Sciences , Yazd , Iran
| | - Roohallah Fallah-Moshkani
- c Food Security Research Center, Isfahan University of Medical Sciences , Isfahan , Iran.,d Department of Community Nutrition School of Nutrition and Food Science, Isfahan University of Medical Sciences , Isfahan , Iran
| | - Reza Ghiasvand
- c Food Security Research Center, Isfahan University of Medical Sciences , Isfahan , Iran.,d Department of Community Nutrition School of Nutrition and Food Science, Isfahan University of Medical Sciences , Isfahan , Iran
| | - Hossein Khosravi-Boroujeni
- e Menzies Health Institute Queensland, and Public Health School of Medicine, Griffith University , Gold Coast Campus , Queensland , Australia
| | - Seyed Mehdi Ahmadi
- f Department of Family Relations and Applied Nutrition, University of Guelph , Guelph , Ontario , Canada
| | - Paula Brauer
- f Department of Family Relations and Applied Nutrition, University of Guelph , Guelph , Ontario , Canada
| | - Amin Salehi-Abargouei
- a Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences , Yazd , Iran.,b Department of Nutrition School of Public Health, Shahid Sadoughi University of Medical Sciences , Yazd , Iran
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16
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Ombra MN, Paliogiannis P, Stucci LS, Colombino M, Casula M, Sini MC, Manca A, Palomba G, Stanganelli I, Mandalà M, Gandini S, Lissia A, Doneddu V, Cossu A, Palmieri G. Dietary compounds and cutaneous malignant melanoma: recent advances from a biological perspective. Nutr Metab (Lond) 2019; 16:33. [PMID: 31139235 PMCID: PMC6528337 DOI: 10.1186/s12986-019-0365-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 05/12/2019] [Indexed: 12/31/2022] Open
Abstract
Cutaneous malignant melanoma is a heterogeneous disease, being the consequence of specific genetic alterations along several molecular pathways. Despite the increased knowledge about the biology and pathogenesis of melanoma, the incidence has grown markedly worldwide, making it extremely important to develop preventive measures. The beneficial role of correct nutrition and of some natural dietary compounds in preventing malignant melanoma has been widely demonstrated. This led to numerous studies investigating the role of several dietary attitudes, patterns, and supplements in the prevention of melanoma, and ongoing research investigates their impact in the clinical management and outcomes of patients diagnosed with the disease. This article is an overview of recent scientific advances regarding specific dietary compounds and their impact on melanoma development and treatment.
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Affiliation(s)
- Maria Neve Ombra
- 1Institute of Food Sciences, National Research Council, Avellino, Italy
| | - Panagiotis Paliogiannis
- 2Department of Medical, Surgical and Experimental Sciences, University of Sassari, Viale San Pietro 43, 07100 Sassari, Italy
| | - Luigia Stefania Stucci
- 3Department of Biomedical Sciences and Human Oncology, University of Bari 'Aldo Moro', Bari, Italy
| | - Maria Colombino
- 4Institute of Biomolecular Chemistry, National Research Council, Sassari, Italy
| | - Milena Casula
- 4Institute of Biomolecular Chemistry, National Research Council, Sassari, Italy
| | - Maria Cristina Sini
- 4Institute of Biomolecular Chemistry, National Research Council, Sassari, Italy
| | - Antonella Manca
- 4Institute of Biomolecular Chemistry, National Research Council, Sassari, Italy
| | - Grazia Palomba
- 4Institute of Biomolecular Chemistry, National Research Council, Sassari, Italy
| | - Ignazio Stanganelli
- 5Istituto Scientifico Romagnolo per Studio e Cura Tumori (IRST-IRCCS), Meldola, Italy
| | - Mario Mandalà
- 6Medical Oncology, "Papa Giovanni XXIII" Hospital, Bergamo, Italy
| | - Sara Gandini
- 7Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy
| | - Amelia Lissia
- 2Department of Medical, Surgical and Experimental Sciences, University of Sassari, Viale San Pietro 43, 07100 Sassari, Italy
| | - Valentina Doneddu
- 2Department of Medical, Surgical and Experimental Sciences, University of Sassari, Viale San Pietro 43, 07100 Sassari, Italy
| | - Antonio Cossu
- 2Department of Medical, Surgical and Experimental Sciences, University of Sassari, Viale San Pietro 43, 07100 Sassari, Italy
| | - Giuseppe Palmieri
- 4Institute of Biomolecular Chemistry, National Research Council, Sassari, Italy
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Mehta A, Hasija Y. Meta-analyses of associations of obesity with risk of melanoma and acne based on case-control studies. BIOMEDICAL DERMATOLOGY 2019. [DOI: 10.1186/s41702-019-0041-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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18
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Filippini T, Tancredi S, Malagoli C, Cilloni S, Malavolti M, Violi F, Vescovi L, Bargellini A, Vinceti M. Aluminum and tin: Food contamination and dietary intake in an Italian population. J Trace Elem Med Biol 2019; 52:293-301. [PMID: 30732896 DOI: 10.1016/j.jtemb.2019.01.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 01/20/2019] [Accepted: 01/22/2019] [Indexed: 12/13/2022]
Abstract
Aluminum and tin are ubiquitous in the environment. In normal biological systems, however, they are present only in trace amounts and have no recognized biological functions in humans. High exposure to these metals can result in adverse health effects such as neurodegenerative diseases. In non-occupationally exposed subjects, diet is the primary source of exposure. In this study, we aimed at estimating dietary aluminum and tin intake in an Italian adult population. We measured aluminum and tin concentrations through inductively-coupled plasma mass spectrometry in 908 food samples. We also estimated dietary intake of these two metals, by using a validated semi-quantitative food-frequency questionnaire administered to 719 subjects (319 men and 400 women) recruited from the general population of the Emilia Romagna region, Northern Italy. We found the highest aluminum levels in legumes, sweets, and cereals, while the highest tin levels were in sweets, meat and seafood. The estimated median daily dietary intake of aluminum was 4.1 mg/day (Interquartile range - IQR: 3.3-5.2), with a major contribution from beverages (28.6%), cereals (16.9%), and leafy vegetables (15.2%). As for tin, we estimated a median intake of 66.8 μg/day (IQR: 46.7-93.7), with a major contribution from vegetables (mainly tomatoes) (24.9%), fruit (15.5%), aged cheese (12.2%), and processed meat (10.4%). This study provides an updated estimate of the dietary intake of aluminum and tin in a Northern-Italy adult population, based on data from a validated food-frequency questionnaire. The intake determined for this population does not exceed the established thresholds of tolerable intake.
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Affiliation(s)
- Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy.
| | - Stefano Tancredi
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy
| | - Carlotta Malagoli
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy
| | - Silvia Cilloni
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy
| | - Marcella Malavolti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy
| | - Federica Violi
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy
| | - Luciano Vescovi
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy
| | - Annalisa Bargellini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy
| | - Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, USA
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Filippini T, Cilloni S, Malavolti M, Violi F, Malagoli C, Tesauro M, Bottecchi I, Ferrari A, Vescovi L, Vinceti M. Dietary intake of cadmium, chromium, copper, manganese, selenium and zinc in a Northern Italy community. J Trace Elem Med Biol 2018; 50:508-517. [PMID: 29548610 DOI: 10.1016/j.jtemb.2018.03.001] [Citation(s) in RCA: 102] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 02/26/2018] [Accepted: 03/02/2018] [Indexed: 02/06/2023]
Abstract
This study provides the dietary intakes of six trace elements (cadmium, chromium, copper, manganese, selenium and zinc), generally characterized by both nutritional and toxicological features depending on their exposure. Being diet the most relevant source of exposure to trace elements in non-professionally exposed subjects, we measured content of these trace elements in foods composing the typical Italian diet using inductively coupled plasma-mass spectrometry, and assessing dietary habits using a validated semi-quantitative food frequency questionnaire we eventually estimated dietary daily intake of trace elements in a Northern Italian community. In the 890 analyzed food samples, the main contributors to cadmium intake are cereals, vegetables and sweets, while cereals, beverages and vegetable are to primary source of manganese. The primary contributors for copper are cereals, fresh fruits and vegetables, while for chromium are beverages, cereals and meat. The main source of selenium intake are cereals and meat, followed by fish, seafood and milk and dairy products, while of zinc intake are meat, cereals, milk and dairy products. In our Italian population sample, the estimated median (interquartile range) dietary daily intakes are 5.00 (3.17-7.65), 56.70 (36.08-86.70) and 66.53 (40.04-101.32) μg/day for cadmium, chromium and selenium, and corresponding figures are 0.98 (0.61-1.49), 2.34 (1.46-3.52) and 8.50 (5.21-12.48) mg/day for copper, manganese and zinc. The estimated intakes are generally within the average intake reported in other European populations, and in such cases well above the daily dietary intakes recommended by national international agencies, avoiding the risk of excess or deficiency. The present estimated intake data can be used to examine a specific trace element of interest and would afford enhanced health protection from those trace elements characterized by both nutritional and toxicological effects.
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Affiliation(s)
- Tommaso Filippini
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 287 Via Campi, 41125 Modena, Italy
| | - Silvia Cilloni
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 287 Via Campi, 41125 Modena, Italy
| | - Marcella Malavolti
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 287 Via Campi, 41125 Modena, Italy
| | - Federica Violi
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 287 Via Campi, 41125 Modena, Italy
| | - Carlotta Malagoli
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 287 Via Campi, 41125 Modena, Italy
| | - Marina Tesauro
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Italy
| | - Ilaria Bottecchi
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 287 Via Campi, 41125 Modena, Italy
| | - Angela Ferrari
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 287 Via Campi, 41125 Modena, Italy
| | | | - Marco Vinceti
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 287 Via Campi, 41125 Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
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20
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Yang K, Fung TT, Nan H. An Epidemiological Review of Diet and Cutaneous Malignant Melanoma. Cancer Epidemiol Biomarkers Prev 2018; 27:1115-1122. [PMID: 30018150 DOI: 10.1158/1055-9965.epi-18-0243] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 06/01/2018] [Accepted: 07/09/2018] [Indexed: 11/16/2022] Open
Abstract
Incidence of cutaneous malignant melanoma has continued to rise despite public efforts to promote sun protection behaviors among populations at risk. However, dietary factors may also affect the development of melanoma. In the past few decades, findings from epidemiologic and experimental research have linked consumption of several foods and other nutrients to the risk of melanoma. Caffeine has been associated with a lower risk of melanoma, and citrus fruits and alcohol with increased risk. Associations between polyunsaturated fatty acid, niacin/nicotinamide, folate, and vitamin D with melanoma remain controversial. Diet likely influences melanoma development through several potential mechanisms, such as enhancing UV-induced apoptosis and increasing photosensitivity. We conducted a narrative review to summarize recent epidemiologic studies of diet and melanoma based on published literature. Given the high prevalence of the food items and nutrients covered in this review and the decades-long rising melanoma incidence worldwide, the associations we discuss may have important public health implications in terms of reducing melanoma incidence through dietary modification. Cancer Epidemiol Biomarkers Prev; 27(10); 1115-22. ©2018 AACR.
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Affiliation(s)
- Keming Yang
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana
| | - Teresa T Fung
- Department of Nutrition, Simmons College, Boston, Massachusetts
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Hongmei Nan
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana.
- IU Melvin and Bren Simon Cancer Center, Indiana University, Indianapolis, Indiana
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21
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The Design, Development and Evaluation of the Vegetarian Lifestyle Index on Dietary Patterns among Vegetarians and Non-Vegetarians. Nutrients 2018; 10:nu10050542. [PMID: 29701727 PMCID: PMC5986422 DOI: 10.3390/nu10050542] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 04/24/2018] [Accepted: 04/25/2018] [Indexed: 12/11/2022] Open
Abstract
Traditionally, healthful diets and lifestyles have been examined only in relation to single nutrients, foods, or food groups in terms of dietary exposure. An alternative approach is to conceptualize an index based on vegetarian food pyramid guidelines as a measure of overall diet and lifestyle quality. Our objectives were to: (1) develop the Vegetarian Lifestyle Index (VLI); and (2) evaluate adherence to the Vegetarian Food Guide Pyramid (VFGP) among a low-risk population of Adventists. The index was based on the operationalization of 14 dietary and lifestyle components. All components were equally weighted. Higher score reflected greater adherence to the VFGP. The analytic sample (n = 90,057) comprised 47.7% non-vegetarians, 5.6% semi-, 10.1% pesco-, and 29.0% lacto-ovo-vegetarians, and 7.7% vegans, of which 1.1% were current smokers and 9.9% were alcohol consumers. Population mean VLI score was 7.43 (SD = 1.75) ranging from 1 to 12.5. Non-vegetarians (6.14; 95% confidence interval (CI), 6.06⁻6.21) had a significantly lower mean compared to semi- (7.31; 95% CI, 7.22⁻7.40), pesco- (7.41; 95% CI, 7.32⁻7.49), and lacto-ovo-vegetarians (8.16; 95% CI, 8.08⁻8.24), as well as vegans (8.88; 95% CI, 8.78⁻8.96). Vegetarians scored on average 1.18 to 2.73 more points than their non-vegetarian counterparts. Results demonstrate that the index has strong discriminant ability across distinct dietary patterns. Additionally, the VLI provides a useful measure of diet and lifestyle adherence to further refine vegetarian food pyramid guidelines.
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Filippini T, Malavolti M, Cilloni S, Wise LA, Violi F, Malagoli C, Vescovi L, Vinceti M. Intake of arsenic and mercury from fish and seafood in a Northern Italy community. Food Chem Toxicol 2018; 116:20-26. [PMID: 29626577 DOI: 10.1016/j.fct.2018.04.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 03/27/2018] [Accepted: 04/04/2018] [Indexed: 11/29/2022]
Abstract
Regular consumption of fish is generally recommended by authorities because fish is an important source of essential nutrients. However, the presence of potentially toxic contaminants in fish has raised many concerns about the food's safety for human health. In the present study, we used a validated semi-quantitative food frequency questionnaire to assess the dietary habits of a representative sample of 719 individuals (319 males and 400 females) aged 18-87 years residing in Northern Italy. We estimated weekly dietary intakes of Arsenic (As) and Mercury (Hg), and we compared them with safety standards set by the European Food Safety Authority. In this population, fish was the main contributor to As and Hg intake. The highest levels of As were in sardine, sole/flounder and cephalopods, and of Hg in the biggest, predatory fish. About the other foods, cereals were the second contributor to the intake of these elements, especially rice for As and bread for Hg, and high levels of As and Hg were also found in mushrooms, coffee and wine. Average weekly intake of both contaminants was below recommended safety limits.
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Affiliation(s)
- Tommaso Filippini
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center - Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 287 Via Campi, 41125 Modena, Italy
| | - Marcella Malavolti
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center - Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 287 Via Campi, 41125 Modena, Italy
| | - Silvia Cilloni
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center - Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 287 Via Campi, 41125 Modena, Italy
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Federica Violi
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center - Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 287 Via Campi, 41125 Modena, Italy
| | - Carlotta Malagoli
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center - Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 287 Via Campi, 41125 Modena, Italy
| | | | - Marco Vinceti
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center - Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 287 Via Campi, 41125 Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
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23
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Diet composition and serum levels of selenium species: A cross-sectional study. Food Chem Toxicol 2018; 115:482-490. [PMID: 29621579 DOI: 10.1016/j.fct.2018.03.048] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 03/14/2018] [Accepted: 03/30/2018] [Indexed: 12/13/2022]
Abstract
Selenium is a trace element of both nutritional and toxicological interest, depending on its dose and chemical form. Diet is the primary source of exposure for most individuals. We sought to investigate the influence of food intake on serum levels of selenium species. Among fifty subjects randomly selected from a Northern Italian population, we assessed dietary habits using a validated semi-quantitative food frequency questionnaire. We also measured circulating levels of selenium species in serum using high pressure liquid chromatography associated with inductively-coupled plasma dynamic reaction cell mass spectrometer. Circulating levels of inorganic selenium, the most toxic selenium species, were positively associated with intake of fish, legumes and dry fruits, and inversely associated with intake of dairy products and mushrooms. Concerning the organic selenium species, selenoproteinP-bound selenium was inversely associated with intake of fish, fresh fruits, vegetables, and legumes, while selenocysteine-bound selenium positively associated with intake of fresh fruit, potato, legume and mushroom. In the present study, intakes of different foods were correlated with different types of selenium species. These results have important public health implications when assessing the nutritional and toxicological potential of diet composition with reference to selenium exposure.
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24
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Nabavi SM, Russo GL, Tedesco I, Daglia M, Orhan IE, Nabavi SF, Bishayee A, Nagulapalli Venkata KC, Abdollahi M, Hajheydari Z. Curcumin and Melanoma: From Chemistry to Medicine. Nutr Cancer 2018; 70:164-175. [PMID: 29300102 DOI: 10.1080/01635581.2018.1412485] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Melanoma is the most deadly form of skin cancer, with about 48,000 deaths each year worldwide. Growing evidence suggests that individual nutrients or dietary patterns might have important roles in the prevention of melanoma. Considering that melanoma is a potentially life-threatening cancer, novel protective and adjuvant treatments are needed to improve its prognosis. Curcumin is a bioactive substance extracted from rhizome of Curcuma longa L. Its global market is expected to grow in the next few years, especially in the pharmaceutical industry, due to its numerous physiological and pharmacological properties. For this review, we collected the available data on the protective and therapeutic role of curcumin against melanoma. We also discuss the chemistry, dietary sources, bioavailability, and metabolism of curcumin, and the mechanisms of action of its potential anticancer effects at the molecular level. Current challenges and future directions for research are also critically discussed.
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Affiliation(s)
- Seyed Mohammad Nabavi
- a Applied Biotechnology Research Center , Baqiyatallah University of Medical Sciences , Tehran , Iran
| | - Gian Luigi Russo
- b Institute of Food Sciences, National Research Council , Avellino , Italy
| | - Idolo Tedesco
- b Institute of Food Sciences, National Research Council , Avellino , Italy
| | - Maria Daglia
- c Department of Drug Sciences , Medicinal Chemistry and Pharmaceutical Technology Section, University of Pavia , Pavia , Italy
| | - Ilkay Erdogan Orhan
- d Department of Pharmacognosy , Faculty of Pharmacy, Gazi University , Ankara , Turkey
| | - Seyed Fazel Nabavi
- a Applied Biotechnology Research Center , Baqiyatallah University of Medical Sciences , Tehran , Iran
| | - Anupam Bishayee
- e Department of Pharmaceutical Sciences , College of Pharmacy, Larkin University , Miami , Florida , USA
| | | | - Mohammad Abdollahi
- f Toxicology and Diseases Group , Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences , Tehran , Iran
| | - Zohreh Hajheydari
- g Department of Dermatology , Boo-Ali Sina (Avicenna) Hospital, Faculty of Medicine, Mazandaran University of Medical Sciences , Sari , Iran
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Jessri M, Ng AP, L'Abbé MR. Adapting the Healthy Eating Index 2010 for the Canadian Population: Evidence from the Canadian National Nutrition Survey. Nutrients 2017; 9:E910. [PMID: 28825674 PMCID: PMC5579703 DOI: 10.3390/nu9080910] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 07/20/2017] [Accepted: 07/27/2017] [Indexed: 01/24/2023] Open
Abstract
The Healthy Eating Index (HEI) is a diet quality index shown to be associated with reduced chronic disease risk. Older versions of the HEI have been adapted for Canadian populations; however, no Canadian modification of the Healthy Eating Index-2010 (HEI-2010) has been made. The aims of this study were: (a) to develop a Canadian adaptation of the HEI-2010 (i.e., Healthy Eating Index-Canada 2010 (HEI-C 2010)) by adapting the recommendations of the HEI-2010 to Canada's Food Guide (CFG) 2007; (b) to evaluate the validity and reliability of the HEI-C 2010; and (c) to examine relationships between HEI-C 2010 scores with diet quality and the likelihood of being obese. Data from 12,805 participants (≥18 years) were obtained from the Canadian Community Health Survey Cycle 2.2. Weighted multivariate logistic regression was used to test the association between compliance to the HEI-C 2010 recommendations and the likelihood of being obese, adjusting for errors in self-reported dietary data. The total mean error-corrected HEI-C 2010 score was 50.85 ± 0.35 out of 100. Principal component analysis confirmed multidimensionality of the HEI-C 2010, while Cronbach's α = 0.78 demonstrated internal reliability. Participants in the fourth quartile of the HEI-C 2010 with the healthiest diets were less likely to consume refined grains and empty calories and more likely to consume beneficial nutrients and foods (p-trend < 0.0001). Lower adherence to the index recommendations was inversely associated with the likelihood of being obese; this association strengthened after correction for measurement error (Odds Ratio: 1.41; 95% Confidence Interval: 1.17-1.71). Closer adherence to Canada's Food Guide 2007 assessed through the HEI-C 2010 was associated with improved diet quality and reductions in the likelihood of obesity when energy intake and measurement errors were taken into account. Consideration of energy requirements and energy density in future updates of Canada's Food Guide are important and necessary to ensure broader application and usability of dietary quality indexes developed based on this national nutrition guideline.
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Affiliation(s)
- Mahsa Jessri
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, 150 College St., Toronto, ON M5S 3E2, Canada.
| | - Alena Praneet Ng
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, 150 College St., Toronto, ON M5S 3E2, Canada.
| | - Mary R L'Abbé
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, 150 College St., Toronto, ON M5S 3E2, Canada.
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Filippini T, Michalke B, Grill P, Malagoli C, Malavolti M, Vescovi L, Sieri S, Krogh V, Cherubini A, Maffeis G, Lucchini R, Ferrante M, Vinceti M. Determinants of serum manganese levels in an Italian population. Mol Med Rep 2017; 15:3340-3349. [PMID: 28339021 DOI: 10.3892/mmr.2017.6379] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 02/13/2017] [Indexed: 11/06/2022] Open
Abstract
Manganese (Mn) is both essential and toxic for humans, mainly depending on the total levels and its species. Main sources of exposure include food and air pollution, particularly motorized traffic. We sought to determine the potential influence of these sources on serum total levels of Mn and Mn species. We selected a random sample of municipality residents from an Italian urban municipality, from whom we collected detailed personal information, dietary habits and a blood sample for serum Mn determination. We also assessed outdoor air Mn exposure, by modeling levels of particulate matter ≤10 µm (PM10) from motorized traffic at the residence of geocoded subjects. Serum Mn species generally showed higher levels in males and positive correlation with age, while no such differences were found according to smoking habits or use of dietary supplements. Among nutrients, only iron intake showed a relation with Mn [an inverse correlation with Mn‑ferritin (Mn‑Fer) and a direct one with inorganic‑Mn (Inorg‑Mn)]. Meat consumption directly correlated and fish and seafood inversely correlated with total Mn, Mn‑transferrin (Mn‑Tf) and Mn-citrate (Mn-Cit). Fruits and vegetables, including legumes and nuts, generally showed a positive correlation with all Mn species, especially Mn‑Cit, and an inverse one with Inorg‑Mn. Odds ratios (ORs) of having serum Mn levels above median value increased with increasing PM10 tertiles, with an OR for highest‑to‑lowest tertile of 7.40 (1.36‑40.25) in multivariate analysis. Analyses for Mn species did not highlight a clear comparable pattern. In conclusion, our results seem to demonstrate that PM10 exposure positively influences total Mn serum levels, while single Mn species show conflicting results.
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Affiliation(s)
- Tommaso Filippini
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, I‑41125 Modena, Italy
| | - Bernhard Michalke
- Helmholtz Zentrum München, Research Center for Environmental Health, Research Unit Analytical BioGeoChemistry, D‑85764 Neuherberg, Germany
| | - Peter Grill
- Helmholtz Zentrum München, Research Center for Environmental Health, Research Unit Analytical BioGeoChemistry, D‑85764 Neuherberg, Germany
| | - Carlotta Malagoli
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, I‑41125 Modena, Italy
| | - Marcella Malavolti
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, I‑41125 Modena, Italy
| | - Luciano Vescovi
- Laboratory of Environmental Chemistry, IREN, I-42123 Reggio Emilia, Italy
| | - Sabina Sieri
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori I‑20133 Milan, Italy
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori I‑20133 Milan, Italy
| | | | | | - Roberto Lucchini
- Section of Occupational Medicine, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, I‑25125 Brescia, Italy
| | - Margherita Ferrante
- Department of Medical, Surgical Sciences and Advanced Technologies 'G.F. Ingrassia', University of Catania, I‑95123 Catania, Italy
| | - Marco Vinceti
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, I‑41125 Modena, Italy
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27
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Filippini T, Ferrari A, Michalke B, Grill P, Vescovi L, Salvia C, Malagoli C, Malavolti M, Sieri S, Krogh V, Bargellini A, Martino A, Ferrante M, Vinceti M. Toenail selenium as an indicator of environmental exposure: A cross-sectional study. Mol Med Rep 2017; 15:3405-3412. [DOI: 10.3892/mmr.2017.6388] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 02/09/2017] [Indexed: 11/06/2022] Open
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28
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Malavolti M, Malagoli C, Crespi CM, Brighenti F, Agnoli C, Sieri S, Krogh V, Fiorentini C, Farnetani F, Longo C, Ricci C, Albertini G, Lanzoni A, Veneziano L, Virgili A, Pagliarello C, Feliciani C, Fanti PA, Dika E, Pellacani G, Vinceti M. Glycaemic index, glycaemic load and risk of cutaneous melanoma in a population-based, case-control study. Br J Nutr 2017; 117:432-438. [PMID: 28196548 DOI: 10.1017/s000711451700006x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Glycaemic index (GI) and glycaemic load (GL) are indicators of dietary carbohydrate quantity and quality and have been associated with increased risk of certain cancers and type 2 diabetes. Insulin resistance has been associated with increased melanoma risk. However, GI and GL have not been investigated for melanoma. We present the first study to examine the possible association of GI and GL with melanoma risk. We carried out a population-based, case-control study involving 380 incident cases of cutaneous melanoma and 719 age- and sex-matched controls in a northern Italian region. Dietary GI and GL were computed for each subject using data from a self-administered, semi-quantitative food frequency questionnaire. We computed the odds ratio (OR) for melanoma according to quintiles of distribution of GL and GL among controls. A direct association between melanoma risk and GL emerged in females (OR 2·38; 95 % CI 1·25, 4·52 for the highest v. the lowest quintile of GL score, P for trend 0·070) but not in males. The association in females persisted in the multivariable analysis after adjusting for several potential confounders. There was no evidence of an association between GI and melanoma risk. GL might be associated with melanoma risk in females.
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Affiliation(s)
- Marcella Malavolti
- 1Department of Biomedical, Metabolic and Neural Sciences,Research Center for Environmental, Genetic, and Nutritional Epidemiology (CREAGEN),University of Modena and Reggio Emilia,41125 Modena,Italy
| | - Carlotta Malagoli
- 1Department of Biomedical, Metabolic and Neural Sciences,Research Center for Environmental, Genetic, and Nutritional Epidemiology (CREAGEN),University of Modena and Reggio Emilia,41125 Modena,Italy
| | - Catherine M Crespi
- 2Department of Biostatistics and Jonsson Comprehensive Cancer Center,University of California Los Angeles Fielding School of Public Health,Los Angeles,CA 90095-1772,USA
| | - Furio Brighenti
- 3Department of Food Science,University of Parma,43121 Parma,Italy
| | - Claudia Agnoli
- 4Epidemiology and Prevention Unit,Fondazione IRCCS Istituto Nazionale dei Tumori,20133 Milan,Italy
| | - Sabina Sieri
- 4Epidemiology and Prevention Unit,Fondazione IRCCS Istituto Nazionale dei Tumori,20133 Milan,Italy
| | - Vittorio Krogh
- 4Epidemiology and Prevention Unit,Fondazione IRCCS Istituto Nazionale dei Tumori,20133 Milan,Italy
| | - Chiara Fiorentini
- 5Dermatologic Unit,University of Modena and Reggio Emilia,41124 Modena,Italy
| | - Francesca Farnetani
- 5Dermatologic Unit,University of Modena and Reggio Emilia,41124 Modena,Italy
| | - Caterina Longo
- 5Dermatologic Unit,University of Modena and Reggio Emilia,41124 Modena,Italy
| | - Cinzia Ricci
- 6Dermatologic Unit,Santa Maria Nuova Hospital-IRCCS,42123 Reggio Emilia,Italy
| | - Giuseppe Albertini
- 6Dermatologic Unit,Santa Maria Nuova Hospital-IRCCS,42123 Reggio Emilia,Italy
| | - Anna Lanzoni
- 7Dermatologic Unit,Bellaria Hospital,40124 Bologna,Italy
| | | | | | | | | | | | - Emi Dika
- 10Dermatologic Unit,University of Bologna,40138 Bologna,Italy
| | - Giovanni Pellacani
- 5Dermatologic Unit,University of Modena and Reggio Emilia,41124 Modena,Italy
| | - Marco Vinceti
- 1Department of Biomedical, Metabolic and Neural Sciences,Research Center for Environmental, Genetic, and Nutritional Epidemiology (CREAGEN),University of Modena and Reggio Emilia,41125 Modena,Italy
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Teas J, Irhimeh MR. Melanoma and brown seaweed: an integrative hypothesis. JOURNAL OF APPLIED PHYCOLOGY 2017; 29:941-948. [PMID: 28458463 PMCID: PMC5387006 DOI: 10.1007/s10811-016-0979-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 10/01/2016] [Accepted: 10/02/2016] [Indexed: 05/08/2023]
Abstract
Although relatively rare, melanoma accounts for 2 % of cancer diagnoses globally and accounts for about 1 % of all cancer deaths. Worldwide, the annual incidence of melanoma is 272,000 cases which vary hugely, ranging from Japan where it is incredibly infrequent, to Queensland, Australia, where it is nearly 100 times higher. Based on epidemiology and laboratory studies, there is compelling evidence suggesting that seaweed might be protective against different types of cancers such as breast cancer in seaweed consuming populations. By comparing countries where melanoma is more common with countries where it is infrequent, it is possible to construct a hypothesis for how consuming brown seaweeds which may hold clues to the differences in melanoma susceptibility between Japanese and Western nations. Unlike in these other countries, where melanoma incidence has increased dramatically over the last two decades, in Japan, rates have remained remarkably low and stable. There is limited evidence from clinical studies and animal models that have used whole seaweed or isolated fractions from seaweed and measured changes in biomarkers. They have demonstrated the effectiveness of seaweed at inhibiting melanoma development and progression. In this review, the various results will be described. Although there are several effective fractions, it is proposed that consuming whole seaweeds may hold additional benefits that could be lost by consuming only a single extract.
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Affiliation(s)
- Jane Teas
- Thomas Cooper Library Fellow, University of South Carolina, Columbia, SC 29208 USA
| | - Mohammad R. Irhimeh
- Cell and Tissue Therapies Western Australia, Royal Perth Hospital, Perth, WA 6000 Australia
- Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, Crawley, Perth, WA 6009 Australia
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Filippini T, Michalke B, Malagoli C, Grill P, Bottecchi I, Malavolti M, Vescovi L, Sieri S, Krogh V, Cherubini A, Maffeis G, Modenesi M, Castiglia P, Vinceti M. Determinants of serum cadmium levels in a Northern Italy community: A cross-sectional study. ENVIRONMENTAL RESEARCH 2016; 150:219-226. [PMID: 27309722 DOI: 10.1016/j.envres.2016.06.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 04/29/2016] [Accepted: 06/02/2016] [Indexed: 05/21/2023]
Abstract
INTRODUCTION Cadmium (Cd) is a heavy metal and a serious environmental hazard to humans. Some uncertainties still exist about major sources of Cd exposure in non-occupationally exposed subjects in addition to cigarette smoking, such as diet and outdoor air pollution. We sought to determine the influence of these sources on a biomarker of exposure, serum Cd concentration. METHODS We recruited 51 randomly selected residents from an Italian urban community, from whom we obtained detailed information about dietary habits and smoking habits, and a blood sample for serum Cd determination. We also assessed outdoor air Cd exposure, by modeling outdoor air levels of particulate matter ≤10µm (PM10) from motorized traffic at geocoded subjects' residence. RESULTS In crude analysis, regression beta coefficients for dietary Cd, smoking and PM10 on serum Cd levels were 0.03 (95% CI -0.83 to 0.88), 6.96 (95% CI -0.02 to 13.95) and 0.62 (95% CI -0.19 to 1.43), respectively. In the adjusted analysis, regression beta coefficients were -0.34 (95% CI -1-40 to 0.71), 5.81 (95% CI -1.43 to 13.04) and 0.47 (95% CI -0.35 to 1.29), respectively. CONCLUSION Cigarette smoking was the most important factor influencing serum Cd in our non-occupationally exposed population, as expected, while dietary Cd was not associated with this biomarker. Outdoor air pollution, as assessed through exposure to particulate matter generated by motorized traffic, was an additional source of Cd exposure.
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Affiliation(s)
- Tommaso Filippini
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy
| | - Bernhard Michalke
- Helmholtz-Zentrum Berlin für Materialien und Energie GmbH, Berlin, Hahn-Meitner-Platz 1, 14109 Berlin, Germany
| | - Carlotta Malagoli
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy
| | - Peter Grill
- Helmholtz-Zentrum Berlin für Materialien und Energie GmbH, Berlin, Hahn-Meitner-Platz 1, 14109 Berlin, Germany
| | - Ilaria Bottecchi
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy
| | - Marcella Malavolti
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy
| | | | - Sabina Sieri
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezia 1, 20133 Milan, Italy
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezia 1, 20133 Milan, Italy
| | | | | | | | - Paolo Castiglia
- Hygiene and Preventive Medicine, Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Marco Vinceti
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy.
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