The relationship between vegetable/fruit consumption and gallbladder/bile duct cancer: A population-based cohort study in Japan

Characterizing the relationships between dietary indices, gallstone prevalence and the need for gallbladder surgery in the general US population

Background

The dietary inflammatory index (DII) and composite dietary antioxidant index (CDAI) were developed as tools for use when seeking to assess the potential inflammatory and antioxidant activity of a given diet, respectively. The associations between these indices and gallstone incidence remain largely unexplored.

Objective

The present study sought to clarify how both the DII and the CDAI are related to gallstone incidence and age at first gallbladder surgery among adults in the USA.

Methods

Cross-sectional data from the 2017-2020 cycles of the National Health and Nutrition Examination Survey (NHANES) pertaining to 12,426 individuals were used to conduct the present study. Data from 2 days with 24-h dietary recall were employed when calculating DII and CDAI scores. Relationships between dietary indices and the incidence of gallstones were assessed through logistic regression analyses, while linear regression analyses were employed to characterize how these indices are associated with the age at first gallbladder surgery.

Results

Higher DII scores and lower CDAI scores, which, respectively, denote diets with greater inflammatory potential and reduced antioxidant potential, were found to be associated with higher gallstone incidence even following adjustment for potential confounding factors. Smooth curve fitting suggested that the association between DII and gallstones was nearly linear, whereas that between CDAI and gallstone incidence was nonlinear. Higher DII values were also related to first gallbladder surgery at an earlier age (β = -0.64, 95% CI: -1.26, -0.02).

Conclusion

These results emphasize the benefits of anti-inflammatory diets rich in antioxidants, which may help reduce gallstone incidence among adults in the USA. Higher DII scores may also predict the need for gallbladder surgery at a younger age.

Dietary and other lifestyle factors and their influence on non-communicable diseases in the Western Pacific region

The Western Pacific region is a diverse region experiencing fast economic growth and nutrition transition. We systematically examined 94 cohort studies on the associations of dietary and other lifestyle factors on non-communicable diseases (NCDs) in the region. These studies were mainly from China, Japan, the Republic of Korea, and Singapore. Patterns and changes in lifestyle risk factors for NCDs based on national surveys were examined. They showed some dietary intake improvements over the past three decades, featured as increased consumption of unsaturated oils, fruits, and vegetables, and decreased consumption of sodium and unhealthy fat. Despite a decrease in smoking rate and salt intake, the values remained higher than the global levels in 2019. The ultra-processed food intake in the region increased at a higher rate than the global estimate. National guidelines relevant to NCDs in five selected countries were highlighted. Strong future actions and policies are needed to tackle NCDs.

High intake of cruciferous vegetables reduces the risk of gastrointestinal cancers: results from observational studies

The relationship between cruciferous vegetables (CV) and the risk of gastrointestinal (GI) cancers has been extensively investigated. However, epidemiologic investigations have produced inconsistent results. This meta-analysis investigated the association between CV intake and the risk of GI cancers. Due to the heterogeneity, fixed- or random-effects models were used for the analyses. The final analysis included 81 articles covering 89 studies. In comparison to the lowest consumption categories, the highest consumption categories of CV were associated with a lower risk for all GI cancers [rate ratio (RR): 0.81, 95% confidence interval (95% CI) 0.76-0.87]. Compared to a CV intake of 75 g/day, subjects with CV intake <75 g/day experienced a 7% reduction in risk (RR: 0.93; 95% CI: 0.84-0.96) for each 50 g increase in consumption. A negative correlation was identified between CV intake and the risk of esophageal cancer, gastric cancer, liver cancer, pancreatic cancer, and colorectal cancer (CRC), but not gallbladder cancer (RR: 0.70; 95% CI: 0.38-1.27). High intake of broccoli and cabbage was associated with a decreased risk of gastric cancer (RR: 0.64; 95% CI: 0.47-0.87) and gallbladder cancer (RR: 0.46; 95% CI: 0.29-0.75). These results confirm the association between high intake of CV with a reduced risk of GI cancers.

Descriptive epidemiology of biliary tract cancer incidence and geographic variation in Japan

OBJECTIVE

The epidemiologic features of each biliary tract cancer (BTC) subtype have not been studied and disclosed in detail. The objective of this study was to provide an up-to-date description of the epidemiologic features of BTC by subtypes, especially in terms of the geographic variation of its incidence.

METHODS

We calculated the age-standardized incidence rate (ASR) of each BTC subtype at national and prefectural levels using the data from the national cancer registry in 2016 and 2017. The geographic distribution of each BTC subtype incidence was assessed by calculating the ASR ratio (ASRR) against median ASR at the prefectural level and reflecting them on the Japanese map.

RESULTS

A total of 58 438 people diagnosed with malignant BTC were registered in the national cancer registry in 2016 and 2017 [12 497 for intrahepatic bile duct cancer (IHBDC), 16 568 for gallbladder cancer (GBC), 24 602 for extrahepatic bile duct cancer (EHBDC), 4613 for ampulla of Vater cancer (AVC) and 158 for others]. ASR was higher in men than in women for IHBDC, EHBDC and AVC, and similar between men and women for GBC. The ASR of EHBDC was approximately 2 times higher than those of the other subtypes for men and similar to that of GBC for women. The geographic distribution of ASRR was different among BTC subtypes, with larger variability in EHBDC, which was remarkably higher in the north-eastern region in both men and women.

CONCLUSION

The pattern of the geographic distribution of incidence in each BTC subtype was different, which suggests different etiology among subtypes.

Elucidation of the potential antioxidant compound and mechanism of mung bean using network pharmacology and in vitro anti-oxidative activity

Mung bean is rich in bioactive components, but the main compound and pharmacological mechanism in reducing oxidative and free radical damage are unclear. Network pharmacology and 2,2′-azino-bis-3-ethylbenzthiazoline-6-sulfonic acid (ABTS) radical scavenging activities were employed to uncover the antioxidant mechanism of potentially active compounds, considering the interactions between mung bean targets and oxidative and free radical damage. These key targets were analyzed by protein–protein interactions (PPIs), and key genes were used to find the biological pathway and therapeutic mechanism by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses. The results showed that five antioxidant components and 18 mung bean targets were screened. β-carotene and vitexin both played a crucial role in mung bean against oxidative and free radical damage, and the ABTS radical scavenging activities of β-carotene and vitexin were 94.84 and 87.79%, which were equivalent to those of vitamin C. Key targets may be AR, HSP90AA1, MYC, and CASP3 for mung bean to exert antioxidant activity. GO and KEGG indicated that mung bean may mainly act on thyroid hormone signaling pathway, estrogen signaling pathway, p53 signaling pathway, etc. In vitro antioxidant activity tests showed that the bioactive ingredients of mung beans had great antioxidant activity. Network pharmacology analysis also revealed the underlying molecular mechanisms of oxidative and free radical damage. This study provides new insights and evidence to explore the bioactive compounds and biological functions of food cereals and legumes, as well as a reference for the functional evaluation of food ingredients and the development of functional foods.

Association between vegetable, fruit, and flavonoid-rich fruit consumption in midlife and major depressive disorder in later life: the JPHC Saku Mental Health Study

We evaluated the association between vegetable and fruit consumption - particularly flavonoid-rich fruits - in mid-life and major depressive disorder (MDD) in later life. We also evaluated the association of nutrients in fruits and vegetables with MDD. Vegetable and fruit consumption and nutrient intake for 1204 individuals were averaged from data obtained in 1995 and 2000. MDD was diagnosed by certified psychiatrists in 2014-2015. Logistic regression was used to examine the odds of MDD according to quintile of vegetable and fruit consumption and quartile of nutrient intake. We fitted two regression models, using hierarchical adjustment for age, sex, employment status, alcohol consumption, current smoking, and physical activity. Bias-corrected and accelerated bootstrap confidence intervals were used to obtain accurate information. In fully adjusted models, the highest quintile of total fruit consumption excluding juice and flavonoid-rich fruit consumption showed decreased odds of MDD compared with the lowest quintile (OR = 0.34, 95% CI = 0.15-0.77; OR = 0.44, 95% CI = 0.20-0.97, respectively). No significant association was found for total vegetables and fruits, total vegetables, or total fruits. No significant association was found for any nutrient. This study provides novel information on the association between MDD and flavonoid-rich fruits.

Cancer Prevention with Resistant Starch in Lynch Syndrome Patients in the CAPP2-Randomized Placebo Controlled Trial: Planned 10-Year Follow-up

ABSTRACT

The CAPP2 trial investigated the long-term effects of aspirin and resistant starch on cancer incidence in patients with Lynch syndrome (LS). Participants with LS were randomized double-blind to 30 g resistant starch (RS) daily or placebo for up to 4 years. We present long-term cancer outcomes based on the planned 10-year follow-up from recruitment, supplemented by National Cancer Registry data to 20 years in England, Wales, and Finland. Overall, 463 participants received RS and 455 participants received placebo. After up to 20 years follow-up, there was no difference in colorectal cancer incidence (n = 52 diagnosed with colorectal cancer among those randomized to RS against n = 53 on placebo) but fewer participants had non-colorectal LS cancers in those randomized to RS (n = 27) compared with placebo (n = 48); intention-to-treat (ITT) analysis [HR, 0.54; 95% confidence interval (CI), 0.33-0.86; P = 0.010]. In ITT analysis, allowing for multiple primary cancer diagnoses among participants by calculating incidence rate ratios (IRR) confirmed the protective effect of RS against non-colorectal cancer LS cancers (IRR, 0.52; 95% CI, 0.32-0.84; P = 0.0075). These effects are particularly pronounced for cancers of the upper GI tract; 5 diagnoses in those on RS versus 21 diagnoses on placebo. The reduction in non-colorectal cancer LS cancers was detectable in the first 10 years and continued in the next decade. For colorectal cancer, ITT analysis showed no effect of RS on colorectal cancer risk (HR, 0.92; 95% CI, 0.62-1.34; P = 0.63). There was no interaction between aspirin and RS treatments. In conclusion, 30 g daily RS appears to have a substantial protective effect against non-colorectal cancer cancers for patients with LS.

PREVENTION RELEVANCE

Regular bowel screening and aspirin reduce colorectal cancer among patients with LS but extracolonic cancers are difficult to detect and manage. This study suggests that RS reduces morbidity associated with extracolonic cancers. See related Spotlight, p. 557.

The role of diet and nutrition related indicators in biliary diseases: an umbrella review of systematic review and meta-analysis

BACKGROUND

Diet and nutrition, as a modifiable risk factor, have been demonstrated to play a significant role in the etiology of biliary diseases, whereas few comprehensive studies have been able to evaluate the strength and quality of these evidence. This umbrella review aims to evaluate the evidence pertaining risk factors for biliary diseases in terms of diet and nutrition-related indicators.

METHODS

An umbrella review method was adopted: evidence from observational studies up to 22 November 2021 were identified using PubMed, Web of Science, the Cochrane database, as well as manual screening. Eligible systematic reviews and meta-analyses were screened according to inclusion and exclusion criteria. The inclusion criteria were: (1) meta analysis or systematic review; (2) The theme of the study is the relationship between diet or nutrition and biliary tract diseases; (3) Summarized and reported OR, RR or HR values and corresponding 95% CI; (4) No restrictions on the use of participants and languages; (5) Only extract the data of biliary tract diseases from multiple health outcomes; (6) Only the most recent studies on the same subject were included. This study had been registered at PROSPERO (CRD42021293908). For each eligible systematic review and meta-analysis, we extracted the data of general characteristics and the main findings. The methodological quality of the meta-analyses included in our study were assessed by AMSTAR2 and the quality of evidence was evaluated by the GRADE.

RESULTS

A total of 323 articles were searched, among which 24 articles with 83 unique outcomes were identified as eligible. 35 of these outcomes were downgraded in GRADE evaluation as they reported heterogeneity. In short, among 83 unique outcomes, 5 were rated as moderate, 16 as low, and the rest as very low. For the prevention of biliary tract diseases, emphasis should be placed on appropriately increasing the intake of fruits, vegetables, coffee and tea, and reducing the intake of alcohol, raw fish and foods with high nitrate. Meanwhile, weight, blood sugar and lipid levels should be controlled, and diabetes should be actively prevented and treated. Drinking is not recommended to prevent gallstones, although studies have shown that it may reduce the risk of cholecystolithiasis.

CONCLUSIONS

Our study summarizes the current multifaceted evidence on the relationship between dietary and nutritional indicators and biliary diseases, but the quality of all evidence was not high. Evidence from additional high-quality prospective studies are needed in the future.

Vegetable and fruit intake and the risk of bladder cancer: Japan Public Health Center-based prospective study

BACKGROUND

Vegetable and fruit consumption may have a protective effect against several types of cancer. However, evidence suggesting that increased intake of vegetables and fruits, their subtypes, or the antioxidant nutrients they contain in abundance decreases the risk of bladder cancer is limited.

METHODS

This study included 80,952 participants from the Japan Public Health Center-based Prospective Study, who responded to a food frequency questionnaire in a 5-year follow-up survey in 1995-1998 and were followed up until December 2015 to investigate the associations between intake of vegetables and fruits, their subtypes, or the antioxidant nutrients and bladder cancer risk using Cox proportional hazards regression models.

RESULTS

Within 1,287,514 person-years of follow-up, 401 bladder cancer cases (307 men and 94 women) were diagnosed. No association was found between intake of total vegetable and fruit, total vegetable, total fruit, subtypes of vegetables and fruits, or antioxidant nutrients and bladder cancer risk in both men and women, even in the analyses conducted among men stratified by smoking status.

CONCLUSIONS

In this population, the consumption of vegetables and fruits was not associated with the risk of bladder cancer.

Relationship Between Dietary Fiber and Vitamin C Intake and Oral Cancer

Background

Dietary fiber and vitamin C has been reported to play a possible role in tumorigenesis. However, few studies have estimated their association with oral cancer risk. In this project, we investigated the relationship between dietary fiber and vitamin C and oral cancer risk in adults in Southern China.

Methods

382 patients newly diagnosed with oral cancer were matched to 382 hospital derived controls by frequency matching in age and sex. Pre-diagnostic consumption of dietary fiber and vitamin C intake were measured through food frequency questionnaire. Association between nutrients intake and oral cancer risk were evaluated by logistic regression. OR value and 95% confidence interval was calculated.

Results

Intake of dietary fiber and vitamin C was significantly lower in oral cancer patients (8.15 g/day) than in control participants (8.88 g/day). Increased dietary fiber or vitamin C intake was linked to a decreased incidence of OC after adjustment of age, marital status, residence, BMI, occupation, education, tobacco smoking, alcohol consumption and family history of cancer P_trend< 0.001). Compared with the lowest tertile, the adjusted OR of the top tertile of dietary fiber was 0.47 (95 % CI 0.32, 0.68). While the adjusted OR of the highest tertile was 0.60 (95 % CI 0.42, 0.87) compared with the lowest tertile of vitamin C.

Conclusions

Dietary intake of fiber and vitamin C were lower in oral cancer patients than in control participants. Dietary fiber and vitamin C were inversely related to risk of oral cancer risk.

Dietary Total Antioxidant Capacity and Risk of Gall Stone: A Case-Control Study

Background

Since the relation between dietary total antioxidant capacity (DTAC) and the occurrence of gallstone disease (GSD) remains unclear, we conducted, for the first time, a case-control study to clarify this association in the Iranian population.

Methods

In the present case-control study, convenience Sampling was performed. A total of 600 participants (300 case and 300 control) were included. Anthropometric, demographic, physical activity, and nutrient intakes data were obtained from each subject. DTAC was calculated using the US Department of Agriculture's database. The odds ratio (OR) and 95% confidence intervals were assessed using unconditional logistic regression.

Results

The participants in the highest quartile of DTAC had a significantly lower OR for gallstone than the lowest quartile, which remained significant after further adjustment for age, sex, and education (model 2: OR, 0.34; 95% CI, 0.16-0.71). In addition, after adjustment for age, sex, education, BMI, physical activity, and energy, the results revealed that participants with the highest quartile of DTAC had 71% lower odds of gallstone than those with the lowest quartile (model 3: OR, 0.29; 95% CI, 0.11-0.78).

Conclusions

The results of the present study demonstrated that the DTAC had an inverse association with GSD incident. However, interventional approaches are needed to confirm the relation between DTAC and GSD prevention.

Vegetable, Fruit Consumption and Risk of Biliary Cancer: Evidence from a Meta-Analysis

BACKGROUND AND OBJECTIVE

This meta-analysis was performed to assess the association between vegetable and fruit (VF) consumption and biliary cancer risk.

METHOD

Relevant studies were identified by a search of MEDLINE and Embase databases. The summary relative risks (RRs) with 95% confidence intervals (CIs) for the highest vs. lowest consumption and dose-response analyses were assessed.

RESULTS

Fourteen studies were eligible. The summary RRs associated with the risk of biliary cancer for the highest vs. lowest were 0.48 (n = 10; 95% CI: 0.22-0.74; Q = 68.27, P_{heterogeneity} < 0.001, I² = 86.8%) for vegetable consumption and 0.47 (n = 13; 95% CI: 0.32-0.61; Q = 32.68, P_{heterogeneity} = 0.001, I² = 63.3%) for fruit consumption. Dose-response associations were analyzed for every 100 gram/day increment: for vegetable (n = 8; RR = 0.31, 95%CI: 0.20-0.47; P_{non-linearity} = 0.35) and for fruit (n = 8; RR = 0.89, 95%CI: 0.66-1.18; P_{non-linearity} = 0.20). There was no publication bias among studies (P_Begg = 0.53, P_Egger = 0.84 for vegetable; P_Begg = 0.95, P_Egger = 0.64 for fruit).

CONCLUSION

This meta-analysis indicated that VF consumption may significantly reduce the risk of biliary cancer. Further well-designed prospective studies are warranted to confirm our findings.

Biologically Active Compounds in Selected Organic and Conventionally Produced Dried Fruits

A growing demand for organic foods is driven by consumers′ perception that they are more nutritious. However, while there is a number of scientific studies showing some superior qualities of organically grown fruit and vegetables, including, i.e., higher content of phenolics, some vitamins and antioxidant activity, scientific research looking into the quality of processed organic products is very limited. At the same time the consumption of processed, convenient foods, with a long shelf-life, is rapidly increasing all over the world. Among the processed fruit-based products, dried fruits are recognized by consumers as one of the best snacks, highly nutritious and containing a large amount of fibre. In the presented experiment, four types of organic and conventionally produced dried fruits were examined: Apricots, apple rings, cranberries, and prunes. The concentrations of polyphenols (in all products) and carotenoids (in apricots) were measured using high performance liquid chromatography (HPLC). The study confirms that dry fruits can be undoubtedly considered as a rich source of polyphenols, however, a large variation in the concentrations of these compounds among different brands of products was also pointed: 219.03 ± 3.90–296.96 ± 2.86 mg 100 g⁻¹ in dried apricots, 95.24 ± 15.12–627.71 ± 48.64 mg 100 g⁻¹ in dried apple rings, 14.64 ± 0.43–203.09 ± 7.96 mg 100 g⁻¹ in dried cranberries, and 134.65 ± 12.27–422.44 ± 9.00 mg 100 g⁻¹ in prunes. Carotenoids concentrations in dried apricots ranged from 2.72 ± 0.31 to 17.49 ± 0.17 µg g⁻¹. Among the tested dried fruits, only in the case of apricots organic products were characterized by the higher contents of phenolics and carotenoids compared to the conventional brands. In the case of other products there was either no consistent significant production system effect, or the concentrations of the analyzed phenolic compounds were higher in conventional products.

Advancing Aptamers as Molecular Probes for Cancer Theranostic Applications-The Role of Molecular Dynamics Simulation

Theranostics cover emerging technologies for cell biomarking for disease diagnosis and targeted introduction of drug ingredients to specific malignant sites. Theranostics development has become a significant biomedical research endeavor for effective diagnosis and treatment of diseases, especially cancer. An efficient biomarking and targeted delivery strategy for theranostic applications requires effective molecular coupling of binding ligands with high affinities to specific receptors on the cancer cell surface. Bioaffinity offers a unique mechanism to bind specific target and receptor molecules from a range of non-targets. The binding efficacy depends on the specificity of the affinity ligand toward the target molecule even at low concentrations. Aptamers are fragments of genetic materials, peptides, or oligonucleotides which possess enhanced specificity in targeting desired cell surface receptor molecules. Aptamer-target binding results from several inter-molecular interactions including hydrogen bond formation, aromatic stacking of flat moieties, hydrophobic interaction, electrostatic, and van der Waals interactions. Advancements in Systematic Evolution of Ligands by Exponential Enrichment (SELEX) assay has created the opportunity to artificially generate aptamers that specifically bind to desired cancer and tumor surface receptors with high affinities. This article discusses the potential application of molecular dynamics (MD) simulation to advance aptamer-mediated receptor targeting in targeted cancer therapy. MD simulation offers real-time analysis of the molecular drivers of the aptamer-receptor binding and generate optimal receptor binding conditions for theranostic applications. The article also provides an overview of different cancer types with focus on receptor biomarking and targeted treatment approaches, conventional molecular probes, and aptamers that have been explored for cancer cells targeting.

Relationship between Meat/Fish Consumption and Biliary Tract Cancer: The Japan Public Health Center-Based Prospective Study

BACKGROUND

The effect of meat and fish consumption on cancer risk has been well studied in humans. However, studies related to biliary tract cancer (BTC) are scarce.

METHODS

We examined the association between meat and fish consumption and the risk of BTC in a population-based prospective cohort study in Japan. HRs and 95% confidence intervals (CI) were estimated using the Cox proportional hazard model.

RESULTS

During 1995 and 1999, 43,177 men and 49,323 women ages 45 to 74 years were enrolled and followed up for 607,757.0 person-years (men) and 728,820.3 person-years (women) until 2012, during which time 217 male and 162 female BTC cases were identified. Higher total meat consumption was significantly associated with a decreased BTC risk in men (HR for the highest vs. lowest quartiles = 0.66; 95% CI, 0.44-0.98; P _trend = 0.011) but not in women. Similar association was observed with red meat, but no association was observed with poultry. Fish was not associated with BTC risk. We further analyzed each BTC subtype to confirm the observed association with BTC. However, significant association with each BTC subtype was not observed, although a trend of decreased extrahepatic bile duct cancer risk was observed.

CONCLUSIONS

BTC risk was lower among men who consumed more meat, particularly red meat, in Japan.

IMPACT

This is the first prospective study that evaluated the relationship between meat and BTC. This may provide important suggestions to elucidate the etiology of BTC.

Review on Bile Acids: Effects of the Gut Microbiome, Interactions with Dietary Fiber, and Alterations in the Bioaccessibility of Bioactive Compounds

Bile acids are cholesterol-derived steroid molecules that serve various metabolic functions, particularly in the digestion of lipids. Gut microbes produce unconjugated and secondary bile acids through deconjugation and dehydroxylation reactions, respectively. Alterations in the gut microbiota have profound effects on bile acid metabolism, which can result in the development of gastrointestinal and metabolic diseases. Emerging research shows that diets rich in dietary fiber have substantial effects on the microbiota and human health. Plant-based foods are primary sources of bioactive compounds and dietary fiber, which are metabolized by microbes to produce different metabolites. However, the bioaccessibility of these compounds are not well-defined. In this review, we discuss the interaction of bile acids with dietary fiber, the gut microbiota, and their role in the bioaccessibility of bioactive compounds. To understand the possible mechanism by which bile acids bind fiber, molecular docking was performed between different dietary fiber and bile salts.