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Dong Y, Wei J, Yang F, Qu Y, Huang J, Shi D. Nutrient-Based Approaches for Melanoma: Prevention and Therapeutic Insights. Nutrients 2023; 15:4483. [PMID: 37892558 PMCID: PMC10609833 DOI: 10.3390/nu15204483] [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: 09/22/2023] [Revised: 10/13/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023] Open
Abstract
Melanoma, a prevalent and lethal form of skin cancer, remains a formidable challenge in terms of prevention and treatment. While significant progress has been made in understanding its pathogenesis and treatment, the quest for effective prevention strategies and therapeutic approaches remains ongoing. Considering the increased advancements in understanding the dynamic interplay between nutrients and melanoma, we aim to offer a refreshed perspective on nutrient-based approaches for melanoma prevention and adjunctive therapy. In contrast to other studies, we have innovatively provided a detailed exposition of the nutrients' influences on melanoma prognosis and treatment. This review firstly examines various nutrients, including antioxidants (namely vitamins A, D, C, and E; selenium; and caffeine), polyunsaturated fatty acids, and flavonoids, for their effects and underlying mechanisms in reducing melanoma risk. Among these nutrients, caffeine shows the most promising potential, as it is supported by multiple cohort studies for its protective effect against melanoma. In contrast, there is a certain degree of inconsistency in the research of other nutrients, possibly due to inherent differences between animal studies and epidemiological research, as well as variations in the definition of nutrient intake. To comprehensively investigate the impact of nutrients on melanoma progression and therapeutic approaches, the following sections will explore how nutrients influence immune responses and other physiological processes. While there is robust support from cell and animal studies regarding the immunomodulatory attributes of vitamins D and zinc, the anti-angiogenic potential of polyphenols, and the cell growth-inhibitory effects of flavonoids, the limited availability of human-based research substantially constrains their practical relevance in clinical contexts. As for utilizing nutrients in adjuvant melanoma treatments, multiple approaches have garnered clinical research support, including the utilization of vitamin D to decrease the postoperative recurrence rates among melanoma patients and the adoption of a high-fiber diet to enhance the effectiveness of immunotherapy. In general, the effects of most nutrients on reducing the risk of melanoma are not entirely clear. However, several nutrients, including vitamin D and dietary fiber, have demonstrated their potential to improve the melanoma prognosis and enhance the treatment outcomes, making them particularly deserving of clinical attention. A personalized and interdisciplinary approach, involving dermatologists, oncologists, nutritionists, and researchers, holds the promise of optimizing melanoma treatment strategies.
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Affiliation(s)
- Yucheng Dong
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China;
| | - Jiaxin Wei
- Department of Emergency Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China;
| | - Fan Yang
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China;
| | - Yang Qu
- Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China;
| | - Jiuzuo Huang
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China;
| | - Di Shi
- Department of Emergency Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China;
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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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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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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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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: 100] [Impact Index Per Article: 16.7] [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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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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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: 43] [Impact Index Per Article: 7.2] [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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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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10
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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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11
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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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12
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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: 15] [Impact Index Per Article: 1.9] [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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13
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Miles SL, Fischer AP, Joshi SJ, Niles RM. Ascorbic acid and ascorbate-2-phosphate decrease HIF activity and malignant properties of human melanoma cells. BMC Cancer 2015; 15:867. [PMID: 26547841 PMCID: PMC4636772 DOI: 10.1186/s12885-015-1878-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 10/30/2015] [Indexed: 12/04/2022] Open
Abstract
Background Hypoxia inducible factor-1 alpha (HIF-1α) is thought to play a role in melanoma carcinogenesis. Posttranslational regulation of HIF-1α is dependent on Prolyl hydroxylase (PHD 1–3) and Factor Inhibiting HIF (FIH) hydroxylase enzymes, which require ascorbic acid as a co-factor for optimal function. Depleted intra-tumoral ascorbic acid may thus play a role in the loss of HIF-1α regulation in melanoma. These studies assess the ability of ascorbic acid to reduce HIF-1α protein and transcriptional activity in metastatic melanoma and reduce its invasive potential. Methods HIF-1α protein was evaluated by western blot, while transcriptional activity was measured by HIF-1 HRE-luciferase reporter gene activity. Melanoma cells were treated with ascorbic acid (AA) and ascorbate 2-phosphate (A2P) to assess their ability to reduce HIF-1α accumulation and activity. siRNA was used to deplete cellular PHD2 in order to evaluate this effect on AA’s ability to lower HIF-1α levels. A2P’s effect on invasive activity was measured by the Matrigel invasion assay. Data was analyzed by One-way ANOVA with Tukey’s multiple comparisons test, or Student-T test as appropriate, with p < .05 considered significant. Results Supplementation with both AA and A2P antagonized normoxic as well as cobalt chloride- and PHD inhibitor ethyl 3, 4-dihydroxybenzoate induced HIF-1α protein stabilization and transcriptional activity. Knockdown of the PHD2 isoform with siRNA did not impede the ability of AA to reduce normoxic HIF-1α protein. Additionally, reducing HIF-1α levels with A2P resulted in a significant reduction in the ability of the melanoma cells to invade through Matrigel. Conclusion These studies suggest a positive role for AA in regulating HIF-1α in melanoma by demonstrating that supplementation with either AA, or its oxidation-resistant analog A2P, effectively reduces HIF-1α protein and transcriptional activity in metastatic melanoma cells. Our data, while supporting the function of AA as a necessary cofactor for PHD and likely FIH activity, also suggests a potential non-PHD/FIH role for AA in HIF-1α regulation by its continued ability to reduce HIF-1α in the presence of PHD inhibition. The use of the oxidation-resistant AA analog, A2P, to reduce the ability of HIF-1α to promote malignant progression in melanoma cells and enhance their response to therapy warrants further investigation.
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Affiliation(s)
- Sarah L Miles
- Department of Biochemistry and Microbiology, Joan C. Edwards School of Medicine, Marshall University, One John Marshall Drive, Huntington, WV, 25755, USA.
| | - Adam P Fischer
- Department of Biochemistry and Microbiology, Joan C. Edwards School of Medicine, Marshall University, One John Marshall Drive, Huntington, WV, 25755, USA.
| | - Sandeep J Joshi
- Department of Biochemistry and Molecular Biology, University of Maryland School of Medicine, 655 W. Baltimore Street, Baltimore, MD, 21201, USA.
| | - Richard M Niles
- Department of Biochemistry and Microbiology, Joan C. Edwards School of Medicine, Marshall University, One John Marshall Drive, Huntington, WV, 25755, USA.
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14
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15
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de Waure C, Quaranta G, Gualano MR, Cadeddu C, Jovic-Vranes A, Djikanovic B, La Torre G, Ricciardi W. Systematic review of studies investigating the association between dietary habits and cutaneous malignant melanoma. Public Health 2015; 129:1099-113. [PMID: 26212104 DOI: 10.1016/j.puhe.2015.06.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Revised: 02/15/2015] [Accepted: 06/18/2015] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Several papers have dealt with diet as a risk factor for cutaneous malignant melanoma (CMM). This study aimed to synthesize available data on the topic. STUDY DESIGN A systematic review of observational studies assessing the association between dietary habits and CMM was performed. METHODS Electronic databases were used to identify eligible articles. Quality was assessed through the Newcastle-Ottawa scale. Case-control and cohort studies evaluating the intake of food/nutrients through the assessment of dietary habits and the occurrence of CMM were considered eligible. Data comparing the highest and lowest levels of consumption were collected from single studies and described qualitatively as data combination was not possible. Results were reported as percentages on the basis of relative risks and odds ratios. RESULTS Eighteen studies reported in 21 articles were selected. Cohort studies showed better quality than case-control studies. Most articles did not detect any significant association between food/nutrient intake and CMM, except for limited evidence of a protective role associated with fish, vegetables and fruit. Risk reduction was shown to be 35-37%, 40-57% and 34-46%, respectively, in studies reporting significant results. Similarly, few articles showed protective roles of beta-carotene and vitamins A, C, D and E, with risk reduction of 64%, 37-43%, 41%, 15-39% and 50-66%, respectively. CONCLUSION A trend towards reduced risk of CMM associated with higher intake of fish, vegetables and fruit, as well as beta-carotene and vitamins A, C, D and E, has been shown but further research is needed to provide decisive data.
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Affiliation(s)
- C de Waure
- Department of Public Health, Catholic University of the Sacred Heart, Rome, Italy.
| | - G Quaranta
- Department of Public Health, Catholic University of the Sacred Heart, Rome, Italy
| | - M R Gualano
- Department of Public Health, University of Turin, Turin, Italy
| | - C Cadeddu
- Department of Public Health, Catholic University of the Sacred Heart, Rome, Italy
| | - A Jovic-Vranes
- Institute of Social Medicine, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - B Djikanovic
- Institute of Social Medicine, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - G La Torre
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - W Ricciardi
- Department of Public Health, Catholic University of the Sacred Heart, Rome, Italy
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16
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Malagoli C, Malavolti M, Agnoli C, Crespi CM, Fiorentini C, Farnetani F, Longo C, Ricci C, Albertini G, Lanzoni A, Veneziano L, Virgili A, Pagliarello C, Santini M, Fanti PA, Dika E, Sieri S, Krogh V, Pellacani G, Vinceti M. Diet Quality and Risk of Melanoma in an Italian Population. J Nutr 2015; 145:1800-7. [PMID: 26108541 PMCID: PMC4516764 DOI: 10.3945/jn.114.209320] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 06/02/2015] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Some results from laboratory and epidemiologic studies suggest that diet may influence the risk of melanoma, but convincing evidence for a role of single nutrients or food items is lacking. Diet quality, which considers the combined effect of multiple food items, may be superior for examining this relation. OBJECTIVE We sought to assess whether diet quality, evaluated with the use of 4 different dietary indexes, is associated with melanoma risk. METHODS In this population-based case-control study, we analyzed the relation between 4 diet quality indexes, the Healthy Eating Index 2010 (HEI-2010), Dietary Approaches to Stop Hypertension (DASH) index, Greek Mediterranean Index (GMI), and Italian Mediterranean Index (IMI), and melanoma risk in a northern Italian community, with the use of data from 380 cases and 719 matched controls who completed a semiquantitative food frequency questionnaire. RESULTS In the overall sample, we found an inverse association between disease risk and the HEI-2010 and DASH index, but not the Mediterranean indexes, adjusting for potential confounders (skin phototype, body mass index, energy intake, sunburn history, skin sun reaction, and education). However, in sex stratified analyses, the association appeared only in women (P-trend: 0.10 and 0.04 for the HEI-2010 and DASH index, respectively). The inverse relations were stronger in women younger than age 50 y than in older women, for whom the GMI and IMI scores also showed an inverse association with disease risk (P-trend: 0.05 and 0.02, respectively). CONCLUSIONS These results suggest that diet quality may play a role in cutaneous melanoma etiology among women.
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Affiliation(s)
- Carlotta Malagoli
- Center for Environmental, Genetic, and Nutritional Epidemiology, Department of Diagnostic, Clinical, and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Marcella Malavolti
- Center for Environmental, Genetic, and Nutritional Epidemiology, Department of Diagnostic, Clinical, and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Claudia Agnoli
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Catherine M Crespi
- Department of Biostatistics, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA
| | - Chiara Fiorentini
- Dermatologic Unit, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Caterina Longo
- Dermatologic Unit, University of Modena and Reggio Emilia, Modena, Italy
| | - Cinzia Ricci
- Dermatologic Unit, Santa Maria Nuova Hospital, Reggio Emilia, Italy
| | | | - Anna Lanzoni
- Dermatologic Unit, Bellaria Hospital, Bologna, Italy
| | | | | | | | | | | | - Emi Dika
- Dermatologic Unit, University of Bologna, Bologna, Italy
| | - Sabina Sieri
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Giovanni Pellacani
- Dermatologic Unit, University of Modena and Reggio Emilia, Modena, Italy
| | - Marco Vinceti
- Center for Environmental, Genetic, and Nutritional Epidemiology, Department of Diagnostic, Clinical, and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy;
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