Omission of breakfast and risk of gastric cancer in Mexico

Habitually Skipping Breakfast Is Associated with the Risk of Gastrointestinal Cancers: Evidence from the Kailuan Cohort Study

BACKGROUND

Habitually skipping breakfast may promote the initiation and progression of gastrointestinal (GI) cancers, which have never been systematically explored in large-scale prospective studies.

METHODS

We prospectively examined the effects of breakfast frequency on the occurrence of GI cancers among 62,746 participants. The hazard ratios (HRs) and 95% confidence intervals (95% CIs) of GI cancers were calculated by Cox regression. The CAUSALMED procedure was used to perform the mediation analyses.

RESULTS

During a median follow-up of 5.61 (5.18 ~ 6.08) years, 369 incident GI cancer cases were identified. Participants who consumed 1-2 times breakfasts per week exhibited an increased risk of stomach (HR = 3.45, 95% CI: 1.06-11.20) and liver cancer (HR = 3.42, 95% CI: 1.22-9.53). Participants who did not eat breakfast had an elevated risk of esophageal (HR = 2.72, 95% CI: 1.05-7.03), colorectal (HR = 2.32, 95% CI: 1.34-4.01), liver (HR = 2.41, 95% CI: 1.23-4.71), gallbladder, and extrahepatic bile duct cancer (HR = 5.43, 95% CI: 1.34-21.93). In the mediation effect analyses, BMI, CRP, and TyG (fasting triglyceride-glucose) index did not mediate the association between breakfast frequency and the risk of GI cancer incidence (all P for mediation effect > 0.05).

CONCLUSIONS

Habitually skipping breakfast was associated with a greater risk of GI cancers including esophageal, gastric, colorectal, liver, gallbladder, and extrahepatic bile duct cancer.

TRIAL REGISTRATION

Kailuan study, ChiCTR-TNRC-11001489. Registered 24 August, 2011-Retrospectively registered, http://www.chictr.org.cn/showprojen.aspx?proj=8050.

Predictors Of Breakfast Consumption Among Iranian Students: Applying Social Cognitive Theory

Background — Despite the known significance of regular breakfast consumption, skipping or inadequate consumption of breakfast is common among students. Social cognitive theory (SCT) is one of the most effective theories in predicting nutritional behaviors, especially breakfast-related behaviors Objective — This study aimed to determine the factors related to breakfast consumption based on SCT among students of Islamic Azad University Kermanshah Branch. Methods — In this cross-sectional study, 206 students of Islamic Azad University Kermanshah Branch were selected based on availability sampling. An online questionnaire consisting of demographic information scales, SCT variables and breakfast consumption behavior was sent to student groups. Data were analyzed using descriptive statistical tests, chi-square test, linear regression and correlation analysis in SPSS software version 16. Results — On average, students consume breakfast 4.39 times a week. Overall, 17.6% of students had completely ignored breakfast and 42.4% of them ate breakfast irregularly between one and six times a week. Among the components of social cognitive theory, self-efficacy and observational learning predicted 55.7% of changes in breakfast consumption among students (P<0.001). Conclusions — It seems that social cognitive theory is a useful framework for predicting breakfast consumption behavior among young people, and it is possible to improve breakfast consumption behavior by designing and implementing appropriate educational interventions based on this theory.

Breakfast Skipping in a Multi-Ethnic Population of Middle-Aged Men and Relationship With Sociodemographic Variables and Weight Status

Background

Breakfast eating is regarded to be necessary for maintaining a healthy body weight. On the other hand, breakfast skipping has been linked with obesity incidence. This study was carried out to determine the prevalence of breakfast skipping among a multi-ethnic group of middle-aged men living in Saudi Arabia and the association between breakfast skipping and sociodemographic variables and weight status.

Methods

This cross-sectional study included 1,800 middle-aged men aged 36–59 years. Participants' sociodemographic information and frequency of breakfast eating were obtained through personal interviews. The body mass index was determined after measuring body weight and height using standardized methods.

Results

The prevalence of breakfast skipping was 42.1% of the study participants. Nationality was a predictor of breakfast skipping. Bangladeshi participants (N = 100) have the lowest rate of breakfast skipping (9.0%), whilst Saudi participants (N = 161) have the highest rate (73.3%). Weight status was another predictor of breakfast skipping as breakfast skippers had a significantly higher average body mass index (27.1 ± 3.8) than breakfast consumers (26.2 ± 3.5). Overweight/obese participants have a significantly higher breakfast skipping rate (44.9%) than participants with underweight/normal weight (36.6%).

Conclusion

The rate of breakfast skipping is relatively high among middle-aged men living in Saudi Arabia. The data support a link between breakfast skipping and sociodemographic variables and weight status.

A Medical Decision Support System to Assess Risk Factors for Gastric Cancer Based on Fuzzy Cognitive Map

Gastric cancer (GC), one of the most common cancers around the world, is a multifactorial disease and there are many risk factors for this disease. Assessing the risk of GC is essential for choosing an appropriate healthcare strategy. There have been very few studies conducted on the development of risk assessment systems for GC. This study is aimed at providing a medical decision support system based on soft computing using fuzzy cognitive maps (FCMs) which will help healthcare professionals to decide on an appropriate individual healthcare strategy based on the risk level of the disease. FCMs are considered as one of the strongest artificial intelligence techniques for complex system modeling. In this system, an FCM based on Nonlinear Hebbian Learning (NHL) algorithm is used. The data used in this study are collected from the medical records of 560 patients referring to Imam Reza Hospital in Tabriz City. 27 effective features in gastric cancer were selected using the opinions of three experts. The prediction accuracy of the proposed method is 95.83%. The results show that the proposed method is more accurate than other decision-making algorithms, such as decision trees, Naïve Bayes, and ANN. From the perspective of healthcare professionals, the proposed medical decision support system is simple, comprehensive, and more effective than previous models for assessing the risk of GC and can help them to predict the risk factors for GC in the clinical setting.

Breakfast consumption pattern and its association with overweight and obesity among university students: a population-based study

PURPOSE

To determine the association between breakfast consumption habit and overweight and obesity in a sample of Iranian university students.

METHODS

A sample of 78,905 university students, aged 18 years or older, was recruited from 28 provinces in Iran to assess breakfast consumption pattern. Breakfast consumption habit was evaluated using a pre-tested questionnaire. Weight and height were measured using standard protocol and then body mass index (BMI) was calculated. Overweight (obesity included) and obesity were defined as BMI ≥ 25 and BMI ≥ 30 kg/m², respectively.

RESULTS

Mean age of participants was 21.50 ± 4.01. After controlling for potential confounders, participants who ate breakfast > 4 days/week had 15% lower risk of overweight compared with those who ate < 1 day/week (OR: 0.85, 95% CI 0.78-0.92). Such significant association was also seen in female students (OR: 0.82, 95% CI 0.72-0.93); however, it was marginally significant in male ones (OR: 0.89, 95% CI 0.79-1.00). In addition, a significant inverse association was found between breakfast consumption and obesity (OR: 0.74, 95% CI 0.64-0.85) such that after adjusting for potential confounders, students who consumed breakfast > 4 days/week were 33% less likely to be obese compared with those who consumed it < 1 day/week (OR: 0.67, 95% CI 0.57-0.78). Such significant inverse association was also seen in either gender.

CONCLUSIONS

Breakfast consumption was inversely associated with odds of overweight and obesity in university students.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive studies.

The Mexican consensus on the detection and treatment of early gastric cancer

Gastric cancer is one of the most frequent neoplasias in the digestive tract and is the result of premalignant lesion progression in the majority of cases. Opportune detection of those lesions is relevant, given that timely treatment offers the possibility of cure. There is no consensus in Mexico on the early detection of gastric cancer, and therefore, the Asociación Mexicana de Gastroenterología brought together a group of experts and produced the "Mexican consensus on the detection and treatment of early gastric cancer" to establish useful recommendations for the medical community. The Delphi methodology was employed, and 38 recommendations related to early gastric cancer were formulated. The consensus defines early gastric cancer as that which at diagnosis is limited to the mucosa and submucosa, irrespective of lymph node metástasis. In Mexico, as in other parts of the world, factors associated with early gastric cancer include Helicobacter pylori infection, a family history of the disease, smoking, and diet. Chromoendoscopy, magnification endoscopy, and equipment-based image-enhanced endoscopy are recommended for making the diagnosis, and accurate histopathologic diagnosis is invaluable for making therapeutic decisions. The endoscopic treatment of early gastric cancer, whether dissection or resection of the mucosa, should be preferred to surgical management, when similar oncologic cure results can be obtained. Endoscopic surveillance should be individualized.

Risk factors associated with gastric cancer in Mexico: education, breakfast and chili

BACKGROUND AND AIM

the aim of the study was to use a validated questionnaire to identify factors associated with the development of gastric cancer (GC) in the Mexican population.

METHODS

the study included cases and controls that were paired by sex and ± 10 years of age at diagnosis. In relation to cases, 46 patients with a confirmed histopathological diagnosis of adenocarcinoma-type GC, as reported in the hospital records, were selected, and 46 blood bank donors from the same hospital were included as controls. The previously validated Questionnaire to Find Factors Associated with Gastric Cancer (QUFA-GC©) was used to collect data. Odds ratio (OR) and 95% confidence interval (IC) were estimated via univariate analysis (paired OR). Multivariate analysis was performed by logistic regression. A decision tree was constructed using the J48 algorithm.

RESULTS

an association was found by univariate analysis between GC risk and a lack of formal education, having smoked for ≥ 10 years, eating rapidly, consuming very hot food and drinks, a non-suitable breakfast within two hours of waking, pickled food and capsaicin. In contrast, a protective association against GC was found with taking recreational exercise and consuming fresh fruit and vegetables. No association was found between the development of GC and having an income that reflected poverty, using a refrigerator, perception of the omission of breakfast and time period of alcoholism. In the final multivariate analysis model, having no formal education (OR = 17.47, 95% CI = 5.17-76.69), consuming a non-suitable breakfast within two hours of waking (OR = 8.99, 95% CI = 2.85-35.50) and the consumption of capsaicin ˃ 29.9 mg capsaicin per day (OR = 3.77, 95% CI = 1.21-13.11) were factors associated with GC.

CONCLUSIONS

an association was found by multivariate analysis between the presence of GC and education, type of breakfast and the consumption of capsaicin. These variables are susceptible to intervention and can be identified via the QUFA-GC

Polymorphisms in HLA-DQ genes, together with age, sex, and Helicobacter pylori infection, as potential biomarkers for the early diagnosis of gastric cancer

BACKGROUND

Polymorphisms in inflammation-related genes are factors associated with the development of gastroduodenal diseases in Helicobacter pylori-infected individuals.

MATERIALS AND METHODS

We aimed to analyze polymorphisms in HLA-DQ, together with other host and H. pylori variables as risk factors for precancerous and cancerous gastric lesions. 1052 individuals were studied, including nonatrophic gastritis (NAG), intestinal metaplasia (IM), gastric cancer (GC) or duodenal ulcer (DU) patients, and healthy volunteers.

RESULTS

Patients with alleles DQA*01:01 (OR 0.78), *01:02 (OR 0.29), *01:03 (OR 0.31), and DQB*02:01/02 (OR 0.40) showed a reduced risk for GC. A multivariate logistic regression analyses showed that patients with homozygote genotypes DQA1*03:01 (OR 7.27) and DQA1*04:01 (OR 8.99) and DQB1*05:01:01 (OR 12.04) were at significantly increased risk for GC. Multivariate analyses also demonstrated that age (OR>10.0) and gender (OR>2.0) were variables that influenced significantly the risk for GC, while H. pylori infection (OR>2.5) increased the risk for IM.

CONCLUSIONS

We identified HLA-DQ alleles associated with IM and GC, and confirm that age, sex, and H. pylori infection are variables that also influence the risk for disease. The use of multiple markers, HLA-DQ alleles, age, sex, and H. pylori infection may be useful biomarkers for the early diagnosis of patients with IM and GC.

Gastric cancer research in Mexico: A public health priority

This study aimed review studies conducted on Mexican patients diagnosed with gastric cancer and/or diseases associated with its development, in which at least one Mexican institute has participated, and to assess their contributions to the primary and secondary prevention of this disease. A search of the Medline database was conducted using the following keywords: gastric/stomach cancer, Mexico. Studies of the Mexican population were selected in which at least one Mexican Institute had participated and where the findings could support public policy proposals directed towards the primary or secondary prevention of gastric cancer. Of the 148 studies found in the Medline database, 100 were discarded and 48 were reviewed. According to the analysis presented, these studies were classified as: epidemiology of gastric cancer (5/48); risk factors and protectors relating to gastric cancer (9/48); relationship between Helicobacter pylori and pathologies associated with gastric cancer and the development of the disease (16/48); relationship between the Epstein-Barr virus and pathologies associated with gastric cancer and the development of the disease (3/48); molecular markers for the development of diseases associated with gastric cancer and gastric cancer (15/48). Mexico requires a program for the prevention and control of gastric cancer based on national health indicators. This should be produced by a multidisciplinary committee of experts who can propose actions that are relevant in the current national context. The few studies of gastric cancer conducted on the Mexican population in national institutes highlight the poor connection that currently exists between the scientific community and the health sector in terms of resolving this health issue. Public policies for health research should support projects with findings that can be translated into benefits for the population. This review serves to identify national research groups studying gastric cancer in the Mexican population.