Meat consumption and cancer risk

The protein paradox, carnivore diet & hypertrophy versus longevity.: Short term nutrition and hypertrophy versus longevity

Meat consumption has been a common food selection for humans for millennia. Meat is rich in amino acids, delivers vast amounts of nutrients and assists in short term health and hypertrophy. However, meat consumption can induce the activation of mTOR and IGF-1, accelerated aging, vascular constriction, atherosclerosis, heart disease, increased risk of diabetes, systemic inflammatory effects, cancers (including colorectal and prostate cancers), advanced glycation end products, impaired immune function / increased susceptibility to infection via downstream advanced glycation end product accumulation, polycyclic aromatic hydrocarbon ingestion, increased homocysteine levels among many other pathophysiologies. Research papers showing health benefits of meat consumption versus other papers showing the detriment of meat have led to confusion as many cohorts such as bodybuilding, health and wellness groups, carnivore diet practitioners, online social media longevity groups and more are interested in data that exists across the peer reviewed literature, however, few papers offer a super wide view where meat consumption benefits and pitfalls are taken into account.BackgroundThe need for such a systematic review is high as health enthusiasts incorrectly often quote single data points from papers showing a single benefit from consuming meat. This often leads to a higher consumption of meat. However, not all meat consumption is the same, and not all meat delivers the same benefits or detriments. Therefore, a systematic review of current literature has been performed to extrapolate the data into whether those interested in hypertrophy, short term nutrition and energy, and longevity should consume meat. Aim: The aim of this research is to dispel myths about meat consumption, such as that meat has a one size fits all benefit to all those that consume it regardless of genetics, or that consuming meat-based protein is the same across all meats.MethodsA deep analysis of almost one hundred peer reviewed papers and surveys spanning decades of cohorts having a meat-based diet compared to those consuming a plant based diet has been performed. Further analysis on specific side effects and disease has also been performed.ResultsThe results of our systematic review show clearly that meat is great for hypertrophy, short term nutrition, short term energy requirements, but a very poor choice when it comes to healthy aging and longevity.ConclusionAnimal protein is great for building muscle, short term energy, maintaining high levels of nutrients, but a carnivore diet holds too many adverse long term side effects to be considered a staple for a longevity-based diet. The evidence is very strong, that subjects interested in longevity and aging should shift their protein intake away from red and processed meats, and either toward white meats or plant-based sources if longevity is the goal.

How may we effectively motivate people to reduce the consumption of meat? Results of a meta-analysis of randomized clinical trials

PURPOSE

Excessive meat consumption (MC) is associated with multiple health risks. Additionally, it can undermine environmental sustainability and affect the potential improvement of animal welfare. The aim of this study was to assess the efficacy of literacy interventions (LIs) in reducing MC.

METHODS

Studies assessing the efficacy of LIs addressing health risks, environmental sustainability and/or animal welfare in reducing MC were searched. We used random-effects meta-analysis to estimate the overall efficacy and conducted subgroup analyses to identify the most effective information contents. Additionally, meta-regression analyses investigated participants' age, LI duration, and follow-up length influence on LIs' efficacy.

RESULTS

Fourteen studies involving more than ten thousand subjects were meta-analyzed. The pooled estimate showed that LIs had a small (Hedges's g = 0.15; 95%CI: 0.06-0.25) but statistically significant effect in reducing MC. Subgroup analysis showed that the highest efficacy was achieved when subjects were alarmed about health risks (g = 0.29; 95% CI: -0.02, 0.60), compared to informing about the risks for the environment (g = 0.18; 95% CI: -0.15, 0.51) and for animal welfare (g = 0.02; 95%CI: -0.08, 0.11). The meta-regression analysis indicated that LIs had greater efficacy in younger individuals and when the intervention duration was longer. Conversely, it was suggested that efficacy improves as the length of follow-up increases.

CONCLUSIONS

Informing about health risks related to MC temporarily decreased its intake, while informing about the impact on environmental sustainability or animal welfare was ineffective. Furthermore, long-lasting LIs achieve long-term dietary change toward MC.

Adherence to the Mediterranean Diet and its association with gastric cancer: health benefits from a Planeterranean perspective

The Mediterranean Diet (MD) has garnered increasing attention for its potential protective effects against gastric cancer (GC). The MD's rich content of antioxidants, polyphenols, and other bioactive compounds contributes to its ability to modulate gene expression, inhibit tumor growth, and regulate apoptosis. Studies have shown significant reductions in inflammatory markers such as C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6) among individuals adhering to the MD, suggesting its pivotal role in mitigating chronic inflammation-associated with cancer development. Furthermore, the MD's anti-angiogenic properties, particularly in components like olive oil, red wine, fish, and tomatoes, offer promising avenues for reducing GC risk by inhibiting tumor angiogenesis. Additionally, the MD's influence on intestinal microbiota composition underscores its potential in maintaining immune homeostasis and reducing systemic inflammation, factors crucial in GC prevention. Despite challenges such as variability in dietary adherence scoring systems and the need for further gender and geographical-specific studies, evidence supports the MD as a cost-effective and holistic approach to GC prevention. Emphasizing the role of nutrition in public health is a promising strategy with broad implications for global health and cancer prevention initiatives. Therefore, this review explores the multifaceted impacts of the MD on GC prevention, delving into its anti-inflammatory, anti-angiogenic, and molecular mechanisms.

Dietary vitamin D intake and the bladder cancer risk: A pooled analysis of prospective cohort studies

BACKGROUND & AIMS

Diet may play an essential role in the aetiology of bladder cancer (BC). Vitamin D is involved in various biological functions which have the potential to prevent BC development. Besides, vitamin D also influences the uptake of calcium and phosphorus, thereby possibly indirectly influencing the risk of BC. The aim of the present study was to investigate the relation between vitamin D intake and BC risk.

METHODS

Individual dietary data were pooled from ten cohort studies. Food item intake was converted to daily intakes of vitamin D, calcium and phosphorus. Pooled multivariate hazard ratios (HRs), with corresponding 95% confidence intervals (CIs) were obtained using Cox-regression models. Analyses were adjusted for gender, age and smoking status (Model 1), and additionally for the food groups fruit, vegetables and meat (Model 2). Dose-response relationships (Model 1) were examined using a nonparametric test for trend.

RESULTS

In total, 1994 cases and 518,002 non-cases were included in the analyses. The present study showed no significant associations between individual nutrient intake and BC risk. A significant decreased BC risk was observed for high vitamin D intake with moderate calcium and low phosphorus intake (Model 2: HRhigh vitD, mod Ca, low P: 0.77, 95% CI: 0.59-1.00). No significant dose-response analyses were observed.

CONCLUSION

The present study showed a decreased BC risk for high dietary vitamin D intake in combination with low calcium intake and moderate phosphorus intake. The study highlights the importance of examining the effect of a nutrient in combination with complementary nutrients for risk assessment. Future research should focus on nutrients in a wider context and in nutritional patterns.

Risk Factors Related to Esophageal Cancer, a Case-Control Study in Herat Province of Afghanistan

BACKGROUND

The Herat province of Afghanistan is located on the Asian Esophageal Cancer Belt (AECB), a wide area in Central and Eastern Asia where very high rates of esophageal cancer (EC) have been observed. Several risk factors have been reported in the AECB Region by previous studies. Considering lack of information in Afghanistan on this issue, a study was conducted to determine the major risk factors related to EC in order to guide protective measures.

METHODS

A population-based case-control study was performed from July 2015 to August 2016 among 657 EC patients in the Herat Province and 180 histopathological confirmed cases and 189 controls were interviewed. A structured questionnaire was used and face-to-face interviews were conducted.

RESULTS

Low body mass index (BMI), low socio-economic status, family history of EC, consumption of dark tea, very hot beverage and qulurtoroosh were found to be statistically significant for EC and esophageal squamous cell carcinoma (ESCC) in univariate analyses. According to multivariate analyses, sex (OR=2.268; 95% CI=1.238-4.153), very hot beverages (OR=2.253; 95% CI=1.271- 3.996), qulurtoroosh (OR=5.679; 95% CI=1.787-18.815), dark tea (OR=2.757; 95% CI=1.531-4.967), high previous BMI (OR=0.215; 95% CI=0.117-0.431) and low socio-economic status (OR=1.783; 95% CI=1.007-3.177) were associated with ESCC. Being male was found to increase the risk of ESCC with OR=2.268 (95% CI=1.238-4.153).

CONCLUSION

Consuming very hot beverages dark tea and a local food, qulurtoroosh, were found as important risk factors for EC. Our findings warrant further studies and necessitate the implementation of protective measures for EC which is one of the leading cancers in the region.

Dietary B group vitamin intake and the bladder cancer risk: a pooled analysis of prospective cohort studies

PURPOSE

Diet may play an essential role in the aetiology of bladder cancer (BC). The B group complex vitamins involve diverse biological functions that could be influential in cancer prevention. The aim of the present study was to investigate the association between various components of the B group vitamin complex and BC risk.

METHODS

Dietary data were pooled from four cohort studies. Food item intake was converted to daily intakes of B group vitamins and pooled multivariate hazard ratios (HRs), with corresponding 95% confidence intervals (CIs), were obtained using Cox-regression models. Dose-response relationships were examined using a nonparametric test for trend.

RESULTS

In total, 2915 BC cases and 530,012 non-cases were included in the analyses. The present study showed an increased BC risk for moderate intake of vitamin B1 (HRB1: 1.13, 95% CI: 1.00-1.20). In men, moderate intake of the vitamins B1, B2, energy-related vitamins and high intake of vitamin B1 were associated with an increased BC risk (HR (95% CI): 1.13 (1.02-1.26), 1.14 (1.02-1.26), 1.13 (1.02-1.26; 1.13 (1.02-1.26), respectively). In women, high intake of all vitamins and vitamin combinations, except for the entire complex, showed an inverse association (HR (95% CI): 0.80 (0.67-0.97), 0.83 (0.70-1.00); 0.77 (0.63-0.93), 0.73 (0.61-0.88), 0.82 (0.68-0.99), 0.79 (0.66-0.95), 0.80 (0.66-0.96), 0.74 (0.62-0.89), 0.76 (0.63-0.92), respectively). Dose-response analyses showed an increased BC risk for higher intake of vitamin B1 and B12.

CONCLUSION

Our findings highlight the importance of future research on the food sources of B group vitamins in the context of the overall and sex-stratified diet.

The nutritional impact of replacing dietary meat with meat alternatives in the UK: a modelling analysis using nationally representative data

Dietary patterns high in meat compromise both planetary and human health. Meat alternatives may help to facilitate meat reduction; however, the nutritional implications of displacing meat with meat alternatives does not appear to have been evaluated. Here, the ninth cycle of the National Diet and Nutrition Survey was used as the basis of models to assess the effect of meat substitution on nutritional intake. We implemented three models; model 1 replaced 25 %, 50 %, 75 % or 100 % of the current meat intake with a weighted mean of meat alternatives within the UK market. Model 2 compared different ingredient categories of meat alternative; vegetable, mycoprotein, a combination of bean and pea, tofu, nut and soya. Model 3 compared fortified v. unfortified meat alternatives. The models elicited significant shifts in nutrients. Overall, carbohydrate, fibre, sugars and Na increased, whereas reductions were found for protein, total and saturated fat, Fe and B₁₂. Greatest effects were seen for vegetable-based (+24·63g/d carbohydrates), mycoprotein-based (-6·12g/d total fat), nut-based (-19·79g/d protein, +10·23g/d fibre; -4·80g/d saturated fat, +7·44g/d sugars), soya-based (+495·98mg/d Na) and tofu-based (+7·63mg/d Fe, -2·02μg/d B₁₂). Our results suggest that meat alternatives can be a healthful replacement for meat if chosen correctly. Consumers should choose meat alternatives low in Na and sugar, high in fibre, protein and with high micronutrient density, to avoid compromising nutritional intake if reducing meat intake. Manufacturers and policy makers should consider fortification of meat alternatives with nutrients such as Fe and B₁₂ and focus on reducing Na and sugar content.

Prevention and Reversal of Morbidity in Today's Cardiovascular Patient: Role of Lifestyle Modification and Nutrition in the Current Era

PURPOSE OF REVIEW

The prevalence of cardiovascular disease despite good medical therapy is on the rise, driven by risk factors such as hypertension, diabetes, hypercholesterolemia, and obesity. As healthcare providers, we must seek to better advise patients on preventative strategies through lifestyle changes.

RECENT FINDINGS

Guideline recommendations have been published by professional societies on the prevention of heart disease through lifestyle changes; however, limited education and experience with these lifestyle-modifying methods hinders appropriate counseling and treatment of patients. Robust data support the use of lifestyle medicine to reduce cardiovascular morbidity and risk. These include, a more plant-based whole food diet, regular exercise, stress relief, connectedness, and other lifestyle approaches. This review will help further the understanding of the front-line clinician in cardiovascular prevention.

10-Year Trends in Dietary Intakes in the High- and Low-Risk Areas for Esophageal Cancer: A Population-Based Ecological Study in Northern Iran

BACKGROUND We assessed dietary intakes in the high- and low-risk areas for esophageal cancer (EC) in Golestan province, Northern Iran. METHODS Considering the EC rates, Golestan province was divided into high- and low-risk regions. Data on households' food consumption were obtained from the Statistical Center of Iran. We used multivariable logistic regression to assess the relationships between consumption of main food and EC risk. Adjusted odds ratios (aOR) were calculated. Joint point program was used for time trend analysis and average annual percent changes (AAPC) were reported. RESULTS Overall, 11910 households were recruited during 2006-2015. 4710 (39.5%) households were enrolled from the high-risk region. There were significant positive relationships between high consumption of sweets (aOR = 1.62; 95% CI: 1.24-2.10), oil/fat (aOR = 1.36; 95% CI: 1.04-1.79), and red meat (aOR = 1.33; 95% CI: 1.07-1.65) with EC risk. We found significant negative relationships between high consumption of dairy products (aOR = 0.62; 95% CI: 0.46-0.82), vegetables (aOR = 0.66; 95% CI: 0.50-0.87) and fruit (aOR = 0.72; 95% CI: 0.55-0.95) with the risk of EC. Time trend analysis showed a significant increasing trend in the proportions of households with low consumption of vegetables (AAPC = 4.71, p = 0.01) and dairy products (AAPC = 5.26, p = 0.02) in the low-risk region for EC. CONCLUSION Dietary intakes may be important etiological factors for EC in Northern Iran. Further studies are warranted to assess the role of dietary factors in this high-risk population.

Temporal trends in food group availability and cancer incidence in Africa: an ecological analysis

OBJECTIVE

We evaluated the relationship between food availability, as the only dietary exposure data available across Africa, and age-standardised cancer incidence rates (ASR) in eighteen countries.

DESIGN

Ecological study.

SETTING

Availability of food groups and dietary energy was considered for five hypothetical time points: years of collection of ASR (T0) and 5, 10, 15 and 20 preceding years (T-5, T-10, T-15, T-20). Ecological correlations adjusted for human development index, smoking and obesity rates were calculated to evaluate the relationship between food availability and ASR of breast, prostate, colorectal, oesophageal, pancreatic, stomach and thyroid cancer.

RESULTS

Red meat was positively correlated with pancreatic cancer in men (T-20: r-20 = 0·61, P < 0·05), stomach cancer in women (T0: r0 = 0·58, P < 0·05), and colorectal cancer in men (T0: r0 = 0·53, P < 0·05) and women (T-20: r-20 = 0·58, P < 0·05). Animal products including meat, animal fats and higher animal-sourced energy supply tended to be positively correlated with breast, colorectal, pancreatic, stomach and thyroid cancer. Alcoholic beverages were positively correlated to oesophageal cancer in men (r0 = 0·69, P < 0·001) and women (r-20 = 0·72, P < 0·001).

CONCLUSIONS

The present analysis provides initial insights into the impact of alcoholic beverages, and increasing use of animal over plant products, on the incidence of specific cancers in Africa. The findings support the need for epidemiological studies to investigate the role of diet in cancer development in Africa.

Determinants of Adherence to the Mediterranean Diet: Findings from a Cross-Sectional Study in Women from Southern Italy

The Mediterranean diet (MD)—the dietary pattern usually consumed by Mediterranean populations—can help promote a favorable health status and better quality of life. Uncovering the main factors associated with the adherence to MD may be useful in understanding and counteracting the global shift toward a Western diet, which has been documented also in the Mediterranean region. Here, we evaluated the adherence to MD and its major social and behavioral determinants in women from Catania, Southern Italy. This cross-sectional study included 841 women, aged 25–64 years, with no history of severe diseases. Adherence to MD was assessed by the Food Frequency Questionnaire and Mediterranean Diet Score (MDS). Associations between variables were tested by multivariable logistic regression analysis and expressed as an odds ratio (OR) with a 95% confidence interval (CI). Among social factors, medium and high educational levels were associated with an ideal intake of alcohol (OR = 4.059; 95%CI = 1.311–12.570; p = 0.015; OR = 4.258 95%CI = 1.068–16.976; p = 0.040; respectively), living in a couple with ideal intake of cereals (OR = 2.801 95%CI = 1.188–6.602; p = 0.018), and having children with an ideal intake of fruits (OR = 3.149; 95%CI = 1.245–7.762; p = 0.015). With respect to behaviors, current smoking was negatively associated with an ideal intake of meat (OR = 0.449; 95%CI = 0.0220–0.917; p = 0.028), while more engagement in physical activity was associated with an ideal intake of vegetables (OR = 6.148; 95%CI = 1.506–25.104; p = 0.011) and legumes (OR = 5.832; 95%CI = 1.414–24.063; p = 0.015). In line with these findings, moderately or highly physically active women were more likely to show medium or high adherence to MD than those who performed less physical activity (OR = 6.024; 95%CI = 1.192–30.440; p = 0.040; OR = 9.965 95%CI = 1.683–58.993; p = 0.011; respectively). Our results confirm an urgent need for public health strategies, which should take into account determinants of diet quality. Particularly, our study indicates that more engagement in physical activity is a major positive determinant of the adherence to MD.

Hormones in Food as a Potential Risk for Human Reproductive and Health Disorders

In the last 60 years, milk, meat, and egg worldwide consumption per capita increased 2-, 3-, and 5-fold, respectively. In the same period, several studies have reported a drop of semen quality and an increased incidence of cryptorchidism, hypospadias, and some hormone-related cancers (testicular, prostate, breast, endometrial cancer) in humans. A possible reason for these disruptions is increased exposure to exogenous hormones in food of animal origin. Hormones in food are considered to affect the endocrine system and cell signaling and thus disrupt homeostasis in the consumers. Since food safety assurance is a part of the veterinary service, the risk assessment of hormones in food as potential disruptive compounds is a significant challenge. Numerous cohort and epidemiologic studies and meta-analyses have been performed with respect to find an association between the consumption of food of animal origin and particular health disorders. Additionally, several studies in animal models have been performed to explain the mechanisms of disruptive effects of exogenous hormones. Since contradictory results have been reported, there is no general conclusion about the disruptive effects of exogenous hormones. Further experiments on animals in which long-term treatment with exogenous hormones is performed and further comprehensive endocrinological, toxicological, and human epidemiological studies are needed to confirm or deny the role of exogenous hormones in human health disorders. Moreover, long-term exposure to a combination of several exogenous compounds, such as environmental pollutants and dietary hormones and their additive effects, are also not well known and should be a topic for further studies.

Fruit and vegetable consumption and anemia among adult non-pregnant women: Ghana Demographic and Health Survey

BACKGROUND

Anemia is the most widely prevalent form of micronutrient deficiency that affects over a quarter of the global population. Evidence suggests that the burden of anemia is higher in the developing countries with women of reproductive age and children being the most at-risk groups. The most common causes are believed to be malnutrition and low bioavailability of micronutrients, which usually result from poor dietary habits and inadequate intake of food rich in micronutrients such as fresh fruits and vegetables. Regular consumption of F&V was shown to have protective effect against NCDs; however, evidence on this protective effect against micronutrient deficiency diseases are limited.

OBJECTIVES

(1) To measure the prevalence of anemia among adult non-pregnant women in Ghana, and (2) to investigate if there is any cross-sectional relationship between F&V consumption and anemia.

METHODS

This is a cross-sectional study based on data extracted from the Ghana Demographic and Health Survey, 2008. Subjects were 4,290 non-pregnant women aged between 15 and 49 years. Hemoglobin levels were measured by HemoCue® hemoglobin-meter. Association between anemia and F&V consumption was assessed by multivariable regression methods.

RESULTS

Findings indicate that well over half (57.9%) of the women were suffering from anemia of some level. The percentage of women consuming at least five servings of fruits and vegetables a day were 5.4% and 2.5% respectively. Results of multivariable analysis indicated that among urban women, consumption of <5 servings fruits/day was associated with significantly higher odds of severe [AOR = 9.27; 95% CI [5.15-16.70]] and moderate anemia [AOR = 6.63; 95% CI [4.21-10.44]], and consumption of <5 servings of vegetables/day was associated with higher odds of moderate anemia [AOR = 2.39; 95% CI [1.14-5.02]] compared with those who consumed >5 servings/day.

CONCLUSION

The findings indicate that urban women who did not maintain WHO recommended level of F&V consumption bear a significantly higher likelihood of being moderate to severely anemic.

Red and processed meat intake and cancer risk: Results from the prospective NutriNet-Santé cohort study

The International Agency for Research on Cancer (WHO-IARC) classified red meat and processed meat as probably carcinogenic and carcinogenic for humans, respectively. These conclusions were mainly based on studies concerning colorectal cancer, but scientific evidence is still limited for other cancer locations. In this study, we investigated the prospective associations between red and processed meat intakes and overall, breast, and prostate cancer risk. This prospective study included 61,476 men and women of the French NutriNet-Santé cohort (2009-2015) aged ≥35 y and who completed at least three 24 hrs dietary records during the first year of follow-up. The risk of developing cancer was compared across sex-specific quintiles of red and processed meat intakes by multivariable Cox models. 1,609 first primary incident cancer cases were diagnosed during follow-up, among which 544 breast cancers and 222 prostate cancers. Red meat intake was associated with increased risk of overall cancers [HR_Q5vs.Q1 =1.31 (1.10-1.55), p_trend  = 0.01) and breast cancer (HR_Q5vs.Q1  = 1.83 (1.33-2.51), p_trend  = 0.002]. The latter association was observed in both premenopausal [HR_Q5vs.Q1 =2.04 (1.03-4.06)] and postmenopausal women [HR_Q5vs.Q1 =1.79 (1.26-2.55)]. No association was observed between red meat intake and prostate cancer risk. Processed meat intake was relatively low in this study (cut-offs for the 5th quintile = 46 g/d in men and 29 g/d in women) and was not associated with overall, breast or prostate cancer risk. This large cohort study suggested that red meat may be involved carcinogenesis at several cancer locations (other than colon-rectum), in particular breast cancer. These results are consistent with mechanistic evidence from experimental studies.

Does the increasing trend of colorectal cancer incidence in jeddah reflect a rise in the Kingdom of Saudi Arabia?

BACKGROUND

The aim of this study was to outline the trend in the incidence of colorectal cancer (CRC) in the city of Jeddah, Kingdom of Saudi Arabia (KSA), for comparison with previously published national CRC data.

MATERIALS AND METHODS

A retrospective data analysis was performed on all cases of CRC diagnosed between January 2000 and December 2006 amongst Saudi patients in Jeddah using data retrieved from the Saudi Cancer Registry (SCR). Descriptive analysis was performed and results were compared to national CRC data from the SCR.

RESULTS

In Jeddah, 644 cases of CRC were diagnosed during the time period, accounting for 15% of all CRC cases in KSA. Males were more commonly affected than females (58% versus 42%). The male preponderance of CRC was similar to that observed at a national level. In Jeddah, the incidence was higher among those >45 years (77.0%), and the mean age at diagnosis was 57 years. At diagnosis, 10% of patients presented with localized disease; 25% presented with distant metastasis and the remaining patients had various stages of regional extension. Adenocarcinomas accounted for 72% of cases. Statistical analysis did not reveal any clinically significant differences between cases diagnosed in Jeddah and those diagnosed throughout KSA.

CONCLUSIONS

The increased trend in the incidence of CRC in Jeddah between 2000 and 2006 mirrors the recent trend in KSA. This highlights the magnitude of this healthcare hazard, not only in Jeddah, but also across the country and supports the need for preventive measures and early detection of the disease.

Cross-sectional study on the relationship between the Mediterranean Diet Score and blood lipids

BACKGROUND

Blood lipids are cardiovascular health indicators. High LDL cholesterol values and/or high total cholesterol (TC)/HDL cholesterol ratios are positively related with cardiovascular mortality. Evidence suggests that a Mediterranean diet can reduce the incidence of cardiovascular diseases. Adherence to the Mediterranean diet is often measured by the Mediterranean Diet Score (MDS). However, the association between the Mediterranean diet and blood lipid profiles seems still inconclusive. The aim of this study was to investigate the relationship between the MDS, its different components and blood lipid profiles.

METHODS

A sample of 506 women and 707 men (aged 18-75 years) was recruited. Three-day diet records were used to calculate the MDS. Blood samples were analyzed for serum TC, LDL and HDL cholesterol. ANOVA was used to analyze blood lipids across the MDS tertiles. A multivariate linear regression analysis was performed to investigate the associations between the MDS, its components and blood lipids, adjusted for several confounders. All analyses were stratified by gender.

RESULTS

Few gender-specific associations were found between the MDS, its components and blood lipids. Only in men, the total MDS was negatively related with LDL cholesterol and the ratio TC/HDL cholesterol while positively with HDL cholesterol. In women, respectively two (MUFA/SFA and cereals) and in men three (fruits & nuts, meat and alcohol) of the nine MDS components were related with blood lipids.

CONCLUSIONS

Analyses investigating the relationship between the MDS, its components and blood lipid profiles indicate only limited influence of the Mediterranean diet on blood lipids. More associations were detected in men compared to women.

Mediterranean diet is associated on symptoms of depression and anxiety in patients with bronchiectasis

BACKGROUND

The aim was to measure symptoms of depression and anxiety in patients with bronchiectasis and evaluate their relationship with a Mediterranean diet.

METHODS

This cross-sectional study recruited patients with bronchiectasis at four Spanish centers. Patients completed the hospital anxiety and depression scale (HADS) and the Mediterranean diet questionnaire (PREDIMED). Demographic, health and outcome data were recorded from medical charts. Logistic regression was used to determine the predictors of elevated symptoms of depression and anxiety (HADS≥11).

RESULTS

Of the 205 participants recruited, 37 (18.0%) had elevated anxiety-related scores and 26 (12.7%) had elevated depression-related scores (HADS≥11). Increased symptoms of depression were significantly associated with being unemployed, a lower education, older age, comorbidity, major dyspnea, worse quality of life (QOL) and a lower PREDIMED score. Increased symptoms of anxiety were significantly associated with more exacerbations, worse QOL and a lower PREDIMED score. Regression analyses indicated that, after adjustment, QOL and the PREDIMED score predicted elevated symptoms of depression and QOL predicted elevated symptoms of anxiety.

CONCLUSIONS

The prevalence of elevated symptoms of depression and anxiety is high in patients with bronchiectasis and greater adherence to a Mediterranean diet is associated with a lower likelihood of having these symptoms, particularly for depression.

Colorectal cancer in the Kingdom of Saudi Arabia: need for screening

BACKGROUND AND OBJECTIVES

Colorectal cancer (CRC) is a major health problem in the Kingdom of Saudi Arabia (KSA). Our aim was to characterize the epidemiology of CRC in the Saudi population.

DESIGN AND SETTING

Retrospective analysis of all cases of CRC recorded in the Saudi Cancer Registry (SCR) between January 2001 and December 2006 amongst Saudi citizens in KSA.

PATIENTS AND METHODS

Data were retrieved from the database of the SCR. Descriptive statistics was performed using SPSS.

RESULTS

A total of 4,201 cases of CRC were registered in the SCR. The incidence of CRC increased between 2001 and 2006. The mean age of patients at the time of diagnosis was 58 years; most patients were above 45 years of age (n=3322; 79.1%). At the time of diagnosis, 977 patients (23.0%) presented with localized disease and 1,018 (24.0%) had distant metastasis. The most frequent pathological variant was adenocarcinoma (73%), with grade 2 (moderately differentiated) being the most common grade among all variants (61%). For all cancer grades, the frequency of CRC was significantly higher among patients >45 years (P=0.004), who presented with more advanced disease (stages III and IV) (P=0.012). Based on logistic regression, age >45 years was associated with advanced regional presentation (P=0.001). Tumor grade was associated with advanced regional presentation and metastasis.

CONCLUSION

There was an increase in the incidence of CRC between 2001 and 2006. The age at the time of diagnosis was low when compared with reports from developed countries. A nationwide approach is needed to encourage and illustrate the importance of screening programs.

Consumption of dairy and meat in relation to breast cancer risk in the Black Women's Health Study

PURPOSE

Dairy and meat consumption may impact breast cancer risk through modification of hormones (e.g., estrogen), through specific nutrients (e.g., vitamin D), or through products formed in processing/cooking (e.g., heterocyclic amines). Results relating meat and dairy intake to breast cancer risk have been conflicting. Thus, we examined the risk of breast cancer in relation to intake of dairy and meat in a large prospective cohort study.

METHODS

In the Black Women's Health Study, 1,268 incident breast cancer cases were identified among 52,062 women during 12 years of follow-up. Multivariable (MV) relative risks (RRs) and 95 % confidence intervals (CIs) were calculated using Cox proportional hazards models.

RESULTS

Null associations were observed for total milk (MV RR = 1.05, 95 % CI 0.74-1.46 comparing ≥1,000-0 g/week) and total meat (MV RR = 1.04, 95 % CI 0.85-1.28 comparing ≥1,000 < 400 g/week) intake and risk of breast cancer. Associations with intakes of specific types of dairy, specific types of meat, and dietary calcium and vitamin D were also null. The associations were not modified by reproductive (e.g., parity) or lifestyle factors (e.g., smoking). Associations with estrogen receptor (ER) positive (+), ER negative (-), progesterone receptor (PR) +, PR-, ER+/PR+, and ER-/PR- breast cancer were generally null.

CONCLUSIONS

This analysis of African-American women provides little support for associations of dairy and meat intake with breast cancer risk.

[The dietary risk factors for colorectal cancer related to meat consumption]

The integrative review is one of the methodologies used for evidence-based practice which, in this study, had the objective of surveying and synthesizing the evidence available in the literature regarding the dietary risks for colorectal cancer related to the consumption of meat. The search was made using the LILACS, MEDLINE, CINAHL, and COCHRANE Library databases, and six studies considered pertinent to the consumption of meat were found. Meta-analyses showed that there is an association between the consumption of red meat and an increased risk for colorectal cancer from 28% to 35%, whereas processed meats are associated with a rise in risk from 20% to 49%. Evidence shows that the consumption of red meat, processed meat, and total meat consumption are risk factors for developing polyps and colorectal cancer. The search did not yield any studies referring to the consumption of chicken or fish as risk factors.

Increased fat-free body mass and no adverse effects on blood lipid concentrations 4 weeks after additional meat consumption in comparison with an exclusion of meat in the diet of young healthy women

Aims. To investigate whether changes of meat consumption can affect body composition and laboratory parameters in healthy, normal weight, young women without the aim to reduce body weight. Research Design and Methods. Women volunteered to eat low-fat meat in addition to their habitual diet (M) or to exclude meat products from their diet (NOM). After 4 weeks M and NOM were crossed over between subjects. Changes in nutrient intake, morphometrics and plasma parameters were compared during M and NOM. Results. Daily protein intake (means ± SD) was 2.25 ± 0.35 (25.2% of energy) and 1.15 ± 0.26 g/kg (14.0% of energy) during M and NOM, respectively. Fat-free body mass (FFM) increased during M (0.7 ± 1.0 kg, P = .02) and decreased during NOM (-0.8 ± 0.8 kg, P = .003). Body fat mass was unchanged. Concentrations of total cholesterol (-7%), LDL-cholesterol (-8%), and glucose (-4%) deceased significantly after M. Fasting glutamine concentrations were decreased by M and increased by NOM. Conclusions. Additional meat intake can increase FFM without adverse effects on blood lipid concentrations. Long-term studies are required. Urinary excretion of 3-methylhistidine could represent a biomarker for meat protein consumption.

Trends in meat consumption in the USA

OBJECTIVE

To characterize the trends, distribution, potential determinants and public health implications of meat consumption within the USA.

DESIGN

We examined temporal trends in meat consumption using food availability data from the FAO and US Department of Agriculture (USDA), and further evaluated the meat intake by type (red, white, processed) in the National Health and Nutrition Examination Surveys (NHANES) linked to the MyPyramid Equivalents Database (MPED).

RESULTS

Overall meat consumption has continued to rise in the USA and the rest of the developed world. Despite a shift towards higher poultry consumption, red meat still represents the largest proportion of meat consumed in the USA (58 %). Twenty-two per cent of the meat consumed in the USA is processed. According to the NHANES 2003-2004, total meat intake averaged 128 g/d. The type and quantities of meat reported varied by education, race, age and gender.

CONCLUSIONS

Given the plausible epidemiological evidence for red and processed meat intake in cancer and chronic disease risk, understanding the trends and determinants of meat consumption in the USA, where meat is consumed at more than three times the global average, should be particularly pertinent to researchers and other public health professionals aiming to reduce the global burden of chronic disease.

Hair protein and amino acid 13C and 15N abundances take more than 4 weeks to clearly prove influences of animal protein intake in young women with a habitual daily protein consumption of more than 1 g per kg body weight

A high protein or meat intake might be a risk factor for metabolic disorders. Stable isotopic abundances (SIA) of hair can be used as biomarkers for animal protein intake due to characteristic isotopic patterns of food proteins. We investigated if an additional meat intake (M, 200 g pork fillet/day) or an omission of meat and meat products (NOM) can influence the natural (15)N and (13)C SIA within 4 weeks in hair and plasma of young women. The daily protein intake (means +/- SD) was 1.40 +/- 0.29, 2.25 +/- 0.35, and 1.15 +/- 0.26 g/kg at baseline, during M, and during NOM, respectively. At baseline the animal protein intake correlated with bulk SIA of hair ((15)N: R(2) = 0.416; (13)C: R(2) = 0.664; n = 14). However, isotope ratio mass spectrometry (IRMS) analyses have not shown that hair and plasma SIA were changed significantly after M or NOM. Possible reasons were discussed. Urinary SIA were significantly lower after M than after NOM ((15)N: p = 0.039; (13)C: p = 0.006) and close to those of pork fillet. Characteristic patterns of SIA were measured in individual amino acids (AA) by gas chromatography/combustion isotope ratio mass spectrometry (GC/C/IRMS). The results confirmed considerable differences in SIA between AA (delta(15)N, up to 22 per thousand; delta(13)C, up to 31 per thousand). Plots of (15)N versus (13)C abundances in hair revealed characteristic differences between indispensable and dispensable AA. The intervention-dependent changes of AA-specific SIA were not as clear as expected. Although the AA-specific SIA may reveal more detailed characteristics of physiological conditions, further methodological research is required. We suggest that the SIA of leucine can be potential markers of protein intake. The reliability of SIA as biomarkers of protein intake still have to be tested in longer lasting intervention studies in humans. The results may have implications in the assessment for possible benefits and risks of protein consumption.

Intakes of red meat, processed meat, and meat mutagens increase lung cancer risk

Red and processed meat intake may increase lung cancer risk. However, the epidemiologic evidence is inconsistent and few studies have evaluated the role of meat mutagens formed during high cooking temperatures. We investigated the association of red meat, processed meat, and meat mutagen intake with lung cancer risk in Environment And Genetics in Lung cancer Etiology, a population-based case-control study. Primary lung cancer cases (n = 2,101) were recruited from 13 hospitals within the Lombardy region of Italy examining approximately 80% of the cases from the area. Noncancer population controls (n = 2,120), matched to cases on gender, residence, and age, were randomly selected from the same catchment area. Diet was assessed in 1,903 cases and 2,073 controls and used in conjunction with a meat mutagen database to estimate intake of heterocyclic amines (HCA) and benzo(a)pyrene (BaP). Multivariable odds ratios (OR) and 95% confidence intervals (95% CI) for sex-specific tertiles of intake were calculated using unconditional logistic regression. Red and processed meat were positively associated with lung cancer risk (highest-versus-lowest tertile: OR, 1.8; 95% CI, 1.5-2.2; P trend < 0.001 and OR, 1.7; 95% CI, 1.4-2.1; P trend < 0.001, respectively); the risks were strongest among never smokers (OR, 2.4; 95% CI, 1.4-4.0; P trend = 0.001 and OR, 2.5; 95% CI, 1.5-4.2; P trend = 0.001, respectively). HCAs and BaP were significantly associated with increased risk of lung cancer. When separated by histology, significant positive associations for both meat groups were restricted to adenocarcinoma and squamous cell carcinoma but not small cell carcinoma of the lung. In summary, red meat, processed meat, and meat mutagens were independently associated with increased risk of lung cancer.

Adherence to Mediterranean diet and health status: meta-analysis

OBJECTIVE

To systematically review all the prospective cohort studies that have analysed the relation between adherence to a Mediterranean diet, mortality, and incidence of chronic diseases in a primary prevention setting.

DESIGN

Meta-analysis of prospective cohort studies.

DATA SOURCES

English and non-English publications in PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials from 1966 to 30 June 2008. Studies reviewed Studies that analysed prospectively the association between adherence to a Mediterranean diet, mortality, and incidence of diseases; 12 studies, with a total of 1 574,299 subjects followed for a time ranging from three to 18 years were included.

RESULTS

The cumulative analysis among eight cohorts (514,816 subjects and 33,576 deaths) evaluating overall mortality in relation to adherence to a Mediterranean diet showed that a two point increase in the adherence score was significantly associated with a reduced risk of mortality (pooled relative risk 0.91, 95% confidence interval 0.89 to 0.94). Likewise, the analyses showed a beneficial role for greater adherence to a Mediterranean diet on cardiovascular mortality (pooled relative risk 0.91, 0.87 to 0.95), incidence of or mortality from cancer (0.94, 0.92 to 0.96), and incidence of Parkinson's disease and Alzheimer's disease (0.87, 0.80 to 0.96).

CONCLUSIONS

Greater adherence to a Mediterranean diet is associated with a significant improvement in health status, as seen by a significant reduction in overall mortality (9%), mortality from cardiovascular diseases (9%), incidence of or mortality from cancer (6%), and incidence of Parkinson's disease and Alzheimer's disease (13%). These results seem to be clinically relevant for public health, in particular for encouraging a Mediterranean-like dietary pattern for primary prevention of major chronic diseases.