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Temraz S, Jabbour J, Nassar F, El Helou R, Hadla R, Mezher M, El Lakkiss A, Charafeddine M, Nasr R, Shamseddine A. Can plasma vitamin C predict survival in stage IV colorectal cancer patients? Results of a prospective cohort study. Front Nutr 2023; 10:1110405. [PMID: 36969825 PMCID: PMC10038077 DOI: 10.3389/fnut.2023.1110405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 02/17/2023] [Indexed: 03/08/2023] Open
Abstract
Background and AimsIn light of the inconclusive evidence on the association between vitamin C status and colorectal cancer (CRC) outcome, this study assessed the prognostic value of vitamin C in participants with metastatic CRC (mCRC).MethodsAdults with mCRC and cancer-free controls were recruited in this prospective cohort study to allow for comparison of vitamin C levels with healthy individuals from the same population. Sociodemographic, lifestyle, medical variables, BRAF and KRAS mutations, as well as Vitamin C plasma level and food intake were evaluated. Predictors of diminished vitamin C level were assessed via multivariate logistic regression. Mortality and progression free survival (PFS) among mCRC participants were analyzed based on plasma vitamin C level.ResultsThe cancer group (n = 46) was older (mean age: 60 ± 14 vs. 42 ± 9.6, p = 0.047) and included more males (29% vs. 19%, p < 0.001) than the cancer-free group (n = 45). There was a non-significant difference in the vitamin C intake between the two groups; however, the mean plasma vitamin C level was lower in the cancer group (3.5 ± 3.7 vs. 9.2 ± 5.6 mg/l, p < 0.001). After adjusting for age and gender, the cancer group was more likely to be deficient compared to the cancer-free group [Adjusted Odds Ratio (95%CI): 5.4 (2.1–14)]. There was a non-significant trend for higher mortality in the vitamin C deficient cancer group (31% vs. 12%, p = 0.139). PFS did not differ based on vitamin C deficiency and patients with BRAF and KRAS mutations did not have significant differences in vitamin C levels.ConclusionmCRC patients have lower plasma vitamin C levels than healthy controls. The trend toward higher mortality in the vitamin C deficient cancer group was not statistically significant. Whether this phenomenon affects survival and response to treatment warrants further exploration in phase III clinical trials.
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Affiliation(s)
- Sally Temraz
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Jana Jabbour
- Nutrition Program, Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Beirut, Lebanon
- Department of Clinical Nutrition, American University of Beirut Medical Center, Beirut, Lebanon
| | - Farah Nassar
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Remie El Helou
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ruba Hadla
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Maria Mezher
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ahmed El Lakkiss
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Maya Charafeddine
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Rihab Nasr
- Department of Anatomy, Cell Biology and Physiology, American University of Beirut Medical Center, Beirut, Lebanon
- *Correspondence: Rihab Nasr,
| | - Ali Shamseddine
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- Ali Shamseddine,
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Abi Nader P, Hadla R, Majed L, Mattar L, Sayegh S. Results from the Lebanese 2022 report card on physical activity for children and youth. J Exerc Sci Fit 2023; 21:14-19. [PMID: 36349302 PMCID: PMC9634469 DOI: 10.1016/j.jesf.2022.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 10/18/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022] Open
Abstract
Objective The Lebanese Active Healthy Kids Work Group (LAHKWG) synthesized literature published on physical activity (PA) indicators among ages 5- to 17- year-olds, using a recommended harmonized process by the Active Healthy Kids Global Alliance (AHKGA), to explore Lebanon's performance since its previous report card publication. Methods Peer reviewed literature, national surveys, and gray literature published since 2017, on 10 common AHKGA and two LAHKWG recommended indicators were examined. Common indicators included overall PA, organized sport and PA, active play, active transportation, community and environment, sedentary behaviors, physical fitness, family and peers, school, and government. LAHKWG recommended indicators were sleep and weight status. LAHKWG members reviewed 764 records, of which 28 were selected for full review. A grade was assigned for each indicator using AHKGA's grading rubric and established benchmarks on data from nationally representative samples for children and youth. Results Data from one nationally representative sample were available for ages 13–17 years (i.e., no data <13 years). Five indicators received “Incomplete” (organized sport and PA; active Play; physical fitness; family and peers; community and environment); overall PA received a D-; active transportation and sleep received a D+; school and government received a D; sedentary behaviors received a C; and weight status received a B-. Conclusion The LAHKWG strongly encourages stakeholders to take concrete actions towards prioritizing PA promotion at a national level especially in the education sector. Offering more quality PA opportunities for Lebanese children and youth will be beneficial for their physical and mental health in any context.
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Jabbour J, Rihawi Y, Khamis AM, Ghamlouche L, Tabban B, Safadi G, Hammad N, Hadla R, Zeidan M, Andari D, Azar RN, Nasser N, Chakhtoura M. Long Term Weight Loss Diets and Obesity Indices: Results of a Network Meta-Analysis. Front Nutr 2022; 9:821096. [PMID: 35479754 PMCID: PMC9037142 DOI: 10.3389/fnut.2022.821096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 01/24/2022] [Indexed: 12/30/2022] Open
Abstract
Background Scientists have been investigating efficient interventions to prevent and manage obesity. This network meta-analysis (NMA) compared the effect of different diets [moderate macronutrients (MMs), low fat/high carbohydrate (LFHC), high fat/low carbohydrate (HFLC), and usual diet (UD)] on weight, body mass index (BMI), and waist circumference (WC) changes at ≥12 months. Methods We searched Medline, Embase, PubMed databases, and the Cochrane Library. We systematically assessed randomized controlled trials (RCTs) evaluating dietary interventions on adults (mean BMI ≥ 25 kg/m2) receiving active dietary counseling for ≥12 months. We pooled the data using a random-effect NMA. We assessed the quality of the included RCTs using the Cochrane risk of bias (ROB) tool. Results We included 36 trials, 14 of which compared HFLC with MM diets. Compared with UD, all diets were associated with a significant weight loss (WL) at ≥12 months, HFLC [mean difference in kg (95% CI): −5.5 (−7.6; −3.4)], LFHC [−5.0 (−7.1; −2.9)] and MM [−4.7 (−6.8; −2.7)]. HFLC, compared with MM diet, was associated with a slightly higher WL (of −0.77 kg) and drop in BMI (of −0.36 kg/m2), while no significant difference was detected in other dietary comparisons. WC was lower with all diets compared to UD, with no significant difference across specific diets. There was no significant interaction of the results with the pre-specified sub-groups. The ROB was moderate to high, mostly related to unclear allocation concealment, high dropout rate and unclear or lack of blinding of participants, providers, and outcome assessors. Conclusion Dietary interventions extending over ≥12 months are superior to UD in inducing weight, BMI and WC loss. HFLC might be associated with a slightly higher WL compared with MM diets. Systematic Trial Registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=103116, PROSPERO (CRD42018103116).
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Affiliation(s)
- Jana Jabbour
- Nutrition Department, School of Health Sciences, Modern University for Business and Sciences, Beirut, Lebanon.,Department of Clinical Nutrition, American University of Beirut Medical Center, Beirut, Lebanon
| | - Yasmin Rihawi
- Department of Clinical Nutrition, American University of Beirut Medical Center, Beirut, Lebanon
| | - Assem M Khamis
- York Medical School, University of Hull, York, United Kingdom
| | - Layal Ghamlouche
- Department of Clinical Nutrition, American University of Beirut Medical Center, Beirut, Lebanon.,Research & Programmes Department, Qualisus Consulting, Byblos, Lebanon
| | - Bayan Tabban
- Department of Clinical Nutrition, American University of Beirut Medical Center, Beirut, Lebanon
| | - Gloria Safadi
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Nour Hammad
- Department of Clinical Nutrition, American University of Beirut Medical Center, Beirut, Lebanon.,Duke Global Health Institute, Duke University, Durham, NC, United States
| | - Ruba Hadla
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Marwa Zeidan
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Dana Andari
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon.,Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
| | - Riwa Nour Azar
- Department of Clinical Nutrition, American University of Beirut Medical Center, Beirut, Lebanon.,The European School of Management and Technology, Berlin, Germany
| | - Nadine Nasser
- Department of Clinical Nutrition, American University of Beirut Medical Center, Beirut, Lebanon.,Access to Nutrition Initiative, Utrecht, Netherlands
| | - Marlene Chakhtoura
- Calcium Metabolism and Osteoporosis Program, WHO Collaborating Center for Metabolic Bone Disorders, American University of Beirut Medical Center, Beirut, Lebanon
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Nassar F, Hadla R, El Helou R, Kreidieh F, Bejjany R, Mukherji D, Shamseddine A, Nasr R, Temraz S. P-232 Prognostic inflammatory and microRNA biomarkers in stage IV colorectal cancer patients. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Nassar FJ, Msheik ZS, Itani MM, Helou RE, Hadla R, Kreidieh F, Bejjany R, Mukherji D, Shamseddine A, Nasr RR, Temraz SN. Circulating miRNA as Biomarkers for Colorectal Cancer Diagnosis and Liver Metastasis. Diagnostics (Basel) 2021; 11:diagnostics11020341. [PMID: 33669508 PMCID: PMC7921943 DOI: 10.3390/diagnostics11020341] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 02/05/2021] [Accepted: 02/07/2021] [Indexed: 12/17/2022] Open
Abstract
Colorectal cancer (CRC) is the second leading cause of cancer deaths worldwide. Stage IV CRC patients have poor prognosis with a five-year survival rate of 14%. Liver metastasis is the main cause of mortality in CRC patients. Since current screening tests have several drawbacks, effective stable non-invasive biomarkers such as microRNA (miRNA) are needed. We aim to investigate the expression of miRNA (miR-21, miR-19a, miR-23a, miR-29a, miR-145, miR-203, miR-155, miR-210, miR-31, and miR-345) in the plasma of 62 Lebanese Stage IV CRC patients and 44 healthy subjects using RT-qPCR, as well as to evaluate their potential for diagnosis of advanced CRC and its liver metastasis using the Receiver Operating Characteristics (ROC) curve. miR-21, miR-145, miR-203, miR-155, miR-210, miR-31, and miR-345 were significantly upregulated in the plasma of surgery naïve CRC patients when compared to healthy individuals. We identified two panels of miRNA that could be used for diagnosis of Stage IV CRC (miR-21 and miR-210) with an area under the curve (AUC) of 0.731 and diagnostic accuracy of 69% and liver metastasis (miR-210 and miR-203) with an AUC = 0.833 and diagnostic accuracy of 72%. Panels of specific circulating miRNA, which require further validation, could be potential non-invasive diagnostic biomarkers for CRC and liver metastasis.
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Affiliation(s)
- Farah J. Nassar
- Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon; (F.J.N.); (R.E.H.); (R.H.); (F.K.); (R.B.); (D.M.); (A.S.)
| | - Zahraa S. Msheik
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon; (Z.S.M.); (M.M.I.)
| | - Maha M. Itani
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon; (Z.S.M.); (M.M.I.)
| | - Remie El Helou
- Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon; (F.J.N.); (R.E.H.); (R.H.); (F.K.); (R.B.); (D.M.); (A.S.)
| | - Ruba Hadla
- Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon; (F.J.N.); (R.E.H.); (R.H.); (F.K.); (R.B.); (D.M.); (A.S.)
| | - Firas Kreidieh
- Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon; (F.J.N.); (R.E.H.); (R.H.); (F.K.); (R.B.); (D.M.); (A.S.)
| | - Rachelle Bejjany
- Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon; (F.J.N.); (R.E.H.); (R.H.); (F.K.); (R.B.); (D.M.); (A.S.)
| | - Deborah Mukherji
- Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon; (F.J.N.); (R.E.H.); (R.H.); (F.K.); (R.B.); (D.M.); (A.S.)
| | - Ali Shamseddine
- Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon; (F.J.N.); (R.E.H.); (R.H.); (F.K.); (R.B.); (D.M.); (A.S.)
| | - Rihab R. Nasr
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon; (Z.S.M.); (M.M.I.)
- Correspondence: (R.R.N.); (S.N.T.)
| | - Sally N. Temraz
- Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon; (F.J.N.); (R.E.H.); (R.H.); (F.K.); (R.B.); (D.M.); (A.S.)
- Correspondence: (R.R.N.); (S.N.T.)
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