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Sandhu S, Blandon C, Kumar S. Evaluating Risk Factors for Early-Onset Colorectal Cancer in a Large, Prospective Cohort. Dig Dis Sci 2025:10.1007/s10620-025-09055-2. [PMID: 40234296 DOI: 10.1007/s10620-025-09055-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2024] [Accepted: 04/09/2025] [Indexed: 04/17/2025]
Abstract
BACKGROUND Despite the worrisome rise of early-onset colorectal cancer (EOCRC), risk factors have not been definitively established. We use a large, granular database to evaluate risk factors for EOCRC, investigate differences in associations with EOCRC and later-onset CRC (LOCRC), and compare metrics of accelerated aging, a hypothesized driver of EOCRC. METHODS This was a case-control analysis within the UK Biobank. Risk factors for each cancer were identified and compared, including aging measures (chronological age, telomere length, PhenoAge, and homeostatic dysregulation). RESULTS A total of 31,164 persons were matched. We found an increased risk of EOCRC with PRS (OR 1.53; 95% CI 1.19-1.97; p < 0.001). LOCRC was associated with increasing PRS (OR 1.48; 95% CI 1.44 - 1.53; p < 0.001), increasing waist-to-hip ratio (OR 5.81; 95% CI 3.25 - 10.38; p < 0.001), family history of CRC (OR 1.27; 95% CI 1.16 - 1.40; p < 0.001), and history of smoking (OR 1.11; 95% CI 1.03 - 1.19; p = 0.01). Male sex and prior CRC screening were associated with reduced risk of LOCRC. The inclusion of PhenoAge as the measure of aging demonstrated the best model fit for both EOCRC and LOCRC. For each year that PhenoAge exceeded chronological age, the odds of EOCRC increased by 7%, while odds of LOCRC only increased by 1%. CONCLUSIONS Within this study, we find that genetic risk variants are a significant driver of EOCRC risk. Accelerated aging appears to be associated with increased risk of both EOCRC and LOCRC, and measures such as PhenoAge warrant continued study.
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Affiliation(s)
- Sunny Sandhu
- Division of Digestive Health and Liver Diseases, Department of Medicine, Miller School of Medicine at the University of Miami, 1120 NW 14th St, Locator Code C-240, Miami, FL, 33136, USA
| | - Catherine Blandon
- Division of Digestive Health and Liver Diseases, Department of Medicine, Miller School of Medicine at the University of Miami, 1120 NW 14th St, Locator Code C-240, Miami, FL, 33136, USA
| | - Shria Kumar
- Division of Digestive Health and Liver Diseases, Department of Medicine, Miller School of Medicine at the University of Miami, 1120 NW 14th St, Locator Code C-240, Miami, FL, 33136, USA.
- Sylvester Comprehensive Cancer Center, Miller School of Medicine at the University of Miami, 1120 NW 14th St, Locator Code C-240, Miami, FL, 33136, USA.
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Teicholz N, Croft SM, Cuaranta I, Cucuzzella M, Glandt M, Griauzde DH, Jerome-Zapadka K, Kalayjian T, Murphy K, Nelson M, Shanahan C, Nishida JL, Oh RC, Parrella N, Saner EM, Sethi S, Volek JS, Williden M, Wolver S. Myths and Facts Regarding Low-Carbohydrate Diets. Nutrients 2025; 17:1047. [PMID: 40292478 PMCID: PMC11944661 DOI: 10.3390/nu17061047] [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: 12/23/2024] [Revised: 02/15/2025] [Accepted: 03/06/2025] [Indexed: 04/30/2025] Open
Abstract
As the prevalence of chronic diseases persists at epidemic proportions, health practitioners face ongoing challenges in providing effective lifestyle treatments for their patients. Even for those patients on GLP-1 agonists, nutrition counseling remains a crucial strategy for managing these conditions over the long term. This paper aims to address the concerns of patients and practitioners who are interested in a low-carbohydrate or ketogenic diet, but who have concerns about its efficacy, safety, and long-term viability. The authors of this paper are practitioners who have used this approach and researchers engaged in its study. The paper reflects our opinion and is not meant to review low-carbohydrate diets systematically. In addressing common concerns, we hope to show that this approach has been well researched and can no longer be seen as a "fad diet" with adverse health effects such as impaired renal function or increased risk of heart disease. We also address persistent questions about patient adherence, affordability, and environmental sustainability. This paper reflects our perspective as clinicians and researchers engaged in the study and application of low-carbohydrate dietary interventions. While the paper is not a systematic review, all factual claims are substantiated with citations from the peer-reviewed literature and the most rigorous and recent science. To our knowledge, this paper is the first to address potential misconceptions about low-carbohydrate and ketogenic diets comprehensively.
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Affiliation(s)
| | | | | | - Mark Cucuzzella
- Department of Family Medicine, West Virginia University School of Medicine, Morgantown, WV 26506, USA
- Martinsburg Veterans Administration Hospital, Martinsburg, WV 25405, USA
| | | | - Dina H. Griauzde
- Department of Internal Medicine, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
- VA Ann Arbor Healthcare System, Ann Arbor, MI 48105, USA
| | - Karen Jerome-Zapadka
- Valley Gastroenterology Associates, Beaver Falls, PA 15010, USA
- Trajectory Health Partners, Mars, PA 16046, USA
| | - Tro Kalayjian
- Greenwich Hospital, Yale New Haven Health, Greenwich, CT 06830, USA
| | - Kendrick Murphy
- Western North Carolina VA Health Care System, Asheville, NC 28805, USA
| | - Mark Nelson
- Independent Researcher, Chicago, IL 60174, USA
| | | | | | - Robert C. Oh
- Department of Medicine, Stanford University School of Medicine, Palo Alto, CA 94305, USA
- VA Palo Alto Health Care System, Palo Alto, CA 94304, USA
| | - Naomi Parrella
- Department of Family and Preventive Medicine, Rush Medical College, Chicago, IL 60612, USA
- Department of Surgery, Rush Medical College, Chicago, IL 60612, USA
| | - Erin M. Saner
- Department of Family & Community Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
| | - Shebani Sethi
- Metabolic Psychiatry, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Jeff S. Volek
- Department of Human Sciences, The Ohio State University, Columbus, OH 43210, USA
| | | | - Susan Wolver
- Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, VA 23298, USA
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Wolfswinkel SMM, Raghoebar S, Stuber JM, de Vet E, Poelman MP. Can (dynamic) social norms encourage plant-based food purchases? a quasi-experimental study in real-world Dutch supermarkets. BMC Med 2025; 23:150. [PMID: 40069714 PMCID: PMC11899090 DOI: 10.1186/s12916-025-03986-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2024] [Accepted: 03/05/2025] [Indexed: 03/14/2025] Open
Abstract
BACKGROUND Communicating (dynamic) social norms is considered a promising tool to stimulate healthy and sustainable food choices. The aim of the present study was to evaluate to what extent a (dynamic) social norm intervention in real-world supermarkets could increase sales (grams per week) of meat alternatives (i.e. meat substitutes and legumes). METHODS A quasi-experimental study, including three intervention and three control supermarkets, was conducted during a 12-week period. The intervention supermarkets communicated dynamic norms textually on stickers and banners at different in-store locations (e.g. at the entrance, meat aisles). Moreover, the prominence of meat substitutes was (optically) increased and legumes were conveniently placed near the meat and meat substitutes section. Weekly sales data over a period of 75 weeks were obtained, 62 pre-intervention and 13 during intervention. Comparative interrupted time series analyses were conducted to analyse changes in meat alternative sales (in grams) during the intervention period in the intervention supermarkets compared to pre-intervention sales trends and to control supermarkets. Secondary outcomes included meat sales in grams per week and the ratio of protein content of meat alternatives to protein content of meat sales. RESULTS Average meat alternative sales in weekly grams before the intervention were M = 371,931.2 (SD = 113,055.3) in the control supermarkets and M = 299,012.5 (SD = 91,722.8) in the intervention supermarkets. The intervention did not change meat alternative sales in intervention supermarkets compared to pre-implementation sales trends and to control supermarkets (B = - 685.92, 95% CI [- 9904.8; 8525.7]). Sales of meats were also unaffected (B = - 130.91, 95% CI [- 27,127.50; 26,858.33]), as well as the ratio of protein content of meat alternatives to protein content of meat in grams sold per week (B = - 670.54, 95% CI [- 8990.6; 7644.4]). CONCLUSIONS Communicating (dynamic) social norms via textual and environmental cues (i.e. increasing the prominence of meat alternatives in supermarkets) did not increase meat alternative sales nor reduce meat sales. With supermarkets playing an important role in modulating sustainable food choices, more substantial effort or changes are needed to increase plant-based food purchases and lower meat purchases.
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Affiliation(s)
- Sofia M M Wolfswinkel
- Consumption & Healthy Lifestyles Group, Wageningen University & Research, Wageningen, The Netherlands.
| | - Sanne Raghoebar
- Consumption & Healthy Lifestyles Group, Wageningen University & Research, Wageningen, The Netherlands
| | - Josine M Stuber
- Epidemiology and Data Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health, Amsterdam, The Netherlands
| | - Emely de Vet
- Consumption & Healthy Lifestyles Group, Wageningen University & Research, Wageningen, The Netherlands
- Tilburg School of Humanities and Digital Sciences, University College Tilburg, Tilburg University, Tilburg, The Netherlands
| | - Maartje P Poelman
- Consumption & Healthy Lifestyles Group, Wageningen University & Research, Wageningen, The Netherlands
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4
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Liang S, Zhou Y, Zhang Q, Yu S, Wu S. Ultra-processed foods and risk of all-cause mortality: an updated systematic review and dose-response meta-analysis of prospective cohort studies. Syst Rev 2025; 14:53. [PMID: 40033461 PMCID: PMC11874696 DOI: 10.1186/s13643-025-02800-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2024] [Accepted: 02/14/2025] [Indexed: 03/05/2025] Open
Abstract
BACKGROUND Ultra-processed food (UPF) consumption has been steadily increasing globally, yet the associated risk of all-cause mortality remains unclear. We aimed to assess the risk of all-cause mortality of UPFs via an updated systematic review and dose-response meta-analysis. METHODS A comprehensive literature search was conducted in PubMed, Embase, and Cochrane Library for studies published until July 2, 2024, in addition to referred studies included in the previous systematic review. Prospective cohort studies assessing the association between NOVA classification-defined UPF consumption and all-cause mortality were included. Dose-response meta-analysis via a random-effect model was used to combine the results with hazard ratio (HR) as an effect measure. RESULTS Overall, 18 studies with 1,148,387 participants (173,107 deaths) were identified. Compared to the lowest, participants with the highest UPF consumption had a 15% increased risk of all-cause mortality (HR = 1.15, 95% CI 1.09-1.22; I2 = 83.0%). Furthermore, a 10% higher risk of all-cause mortality was detected with each 10% increment in UPF consumption (HR = 1.10, 95% CI 1.04-1.16; I2 = 91.0%). Dose-response analysis showed a positive linear association (Pdose-response < 0.001). Moreover, subgroups and sensitivity analyses indicated consistent findings, while meta-regression analyses suggested sex distributions partially explained heterogeneity, with a higher risk of all-cause mortality in males. CONCLUSIONS Our updated meta-analysis, incorporating a greater number of newly published cohort studies using NOVA classification with the largest sample size to date, strengthens the evidence linking higher UPF consumption to increased all-cause mortality risk. Strategies such as dietary guidelines and policies for limiting UPF consumption worldwide should be encouraged. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42023467226.
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Affiliation(s)
- Shuming Liang
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Disease, State Key Laboratory of Digestive Health, Beijing, 100050, China
| | - Yesheng Zhou
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Disease, State Key Laboratory of Digestive Health, Beijing, 100050, China
| | - Qian Zhang
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Disease, State Key Laboratory of Digestive Health, Beijing, 100050, China
| | - Shuang Yu
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Disease, State Key Laboratory of Digestive Health, Beijing, 100050, China
| | - Shanshan Wu
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Disease, State Key Laboratory of Digestive Health, Beijing, 100050, China.
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Antonio J, Evans C, Ferrando AA, Stout JR, Antonio B, Cinteo H, Harty P, Arent SM, Candow DG, Forbes SC, Kerksick CM, Pereira F, Gonzalez D, Kreider RB. Common questions and misconceptions about protein supplementation: what does the scientific evidence really show? J Int Soc Sports Nutr 2024; 21:2341903. [PMID: 38626029 PMCID: PMC11022925 DOI: 10.1080/15502783.2024.2341903] [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: 08/14/2023] [Accepted: 04/07/2024] [Indexed: 04/18/2024] Open
Abstract
Protein supplementation often refers to increasing the intake of this particular macronutrient through dietary supplements in the form of powders, ready-to-drink shakes, and bars. The primary purpose of protein supplementation is to augment dietary protein intake, aiding individuals in meeting their protein requirements, especially when it may be challenging to do so through regular food (i.e. chicken, beef, fish, pork, etc.) sources alone. A large body of evidence shows that protein has an important role in exercising and sedentary individuals. A PubMed search of "protein and exercise performance" reveals thousands of publications. Despite the considerable volume of evidence, it is somewhat surprising that several persistent questions and misconceptions about protein exist. The following are addressed: 1) Is protein harmful to your kidneys? 2) Does consuming "excess" protein increase fat mass? 3) Can dietary protein have a harmful effect on bone health? 4) Can vegans and vegetarians consume enough protein to support training adaptations? 5) Is cheese or peanut butter a good protein source? 6) Does consuming meat (i.e., animal protein) cause unfavorable health outcomes? 7) Do you need protein if you are not physically active? 8) Do you need to consume protein ≤ 1 hour following resistance training sessions to create an anabolic environment in skeletal muscle? 9) Do endurance athletes need additional protein? 10) Does one need protein supplements to meet the daily requirements of exercise-trained individuals? 11) Is there a limit to how much protein one can consume in a single meal? To address these questions, we have conducted a thorough scientific assessment of the literature concerning protein supplementation.
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Affiliation(s)
- Jose Antonio
- Nova Southeastern University, Department of Health and Human Performance, Davie, FL, USA
| | - Cassandra Evans
- Nova Southeastern University, Department of Health and Human Performance, Davie, FL, USA
| | - Arny A. Ferrando
- University of Arkansas for Medical Sciences, Department of Geriatrics, Little Rock, AR, USA
| | - Jeffrey R. Stout
- University of Central Florida, School of Kinesiology and Rehabilitation Science, Orlando, FL, USA
| | - Brandi Antonio
- University of Central Florida, School of Kinesiology and Rehabilitation Science, Orlando, FL, USA
| | - Harry Cinteo
- Lindenwood University, Exercise and Performance Nutrition Laboratory, St. Charles, MO, USA
| | - Patrick Harty
- Lindenwood University, Exercise and Performance Nutrition Laboratory, St. Charles, MO, USA
| | - Shawn M. Arent
- University of South Carolina, Department of Exercise Science, Arnold School of Public Health, Columbia, SC, USA
| | - Darren G. Candow
- University of Regina, Faculty of Kinesiology and Health Studies, Regina, Canada
| | - Scott C. Forbes
- Brandon University, Department of Physical Education, Faculty of Education, Brandon, MB, Canada
| | - Chad M. Kerksick
- Lindenwood University, Exercise and Performance Nutrition Laboratory, St. Charles, MO, USA
| | - Flavia Pereira
- Keiser University, Exercise and Sport Science, West Palm Beach Flagship Campus, West Palm Beach, FL, USA
| | - Drew Gonzalez
- Texas A&M University, Exercise & Sport Nutrition Lab, Human Clinical Research Facility, Department of Health & Kinesiology, College Station, TX, USA
| | - Richard B. Kreider
- Texas A&M University, Exercise & Sport Nutrition Lab, Human Clinical Research Facility, Department of Health & Kinesiology, College Station, TX, USA
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6
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Do TM, Nguyen QHN, Le NHD, Nguyen HD, Phung AHT, Tran TS, Nguyen TV, Ho-Pham LT. Association between dietary factors and breast cancer risk: a matched case-control study in Vietnam. BMC Cancer 2024; 24:1224. [PMID: 39363187 PMCID: PMC11448273 DOI: 10.1186/s12885-024-12918-y] [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: 05/08/2024] [Accepted: 09/09/2024] [Indexed: 10/05/2024] Open
Abstract
BACKGROUND The role of diet in breast cancer prevention is controversial and limited in low-middle-income countries (LMICs). This study aimed to investigate the association between different dietary factors and breast cancer risk in Vietnamese women. METHODS Three hundred seventy newly histologically confirmed breast cancer cases and 370 controls matched by 5-year age from September 2019 to March 2020 in Ho Chi Minh City were recorded dietary intake using a validated food frequency questionnaire. Odds ratios (OR) and 95% confidence intervals (95% CI) were evaluated using conditional logistic regression and adjusted with potential confounders. RESULTS Compared to the lowest quartile of intake, we found that the highest intake of vegetables, fruit, soybean products, coffee, and egg significantly decreased breast cancer risk, including dark green vegetables (OR 0.46, 95% CI 0.27-0.78, ptrend=0.022), legumes (OR 0.19, 95% CI 0.08-0.44, ptrend <0.001), starchy vegetables (OR 0.37, 95% CI 0.21-0.66, ptrend=0.003), other vegetables (OR 0.46, 95% CI 0.28-0.77, ptrend=0.106), fruits (OR 0.44, 95% CI 0.26-0.74, ptrend <0.001), soybean product (OR 0.45, 95% CI 0.24-0.86, ptrend=0.311), coffee (OR 0.47, 95% CI 0.23-0.95, ptrend 0.004), and egg (OR 0.4, 95% CI 0.23-0.71, ptrend=0.002). CONCLUSION Greater consumption of vegetables, fruit, soybean products, coffee, and eggs is associated with a lower risk of breast cancer. This study provides evidence of breast cancer prevention by increasing the intake of these dietary groups, especially in LMICs.
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Affiliation(s)
- Tam M Do
- BioMedical Research Center, Pham Ngoc Thach University of Medicine, 02 Duong Quang Trung Street, District 10, Ho Chi Minh City, Vietnam
- Saigon Precision Medicine Center, LL2 Ba Vi Street, District 10, Ho Chi Minh City, Vietnam
| | - Quynh H N Nguyen
- Saigon Precision Medicine Center, LL2 Ba Vi Street, District 10, Ho Chi Minh City, Vietnam
| | - Nguyen H D Le
- Medical Oncology of Breast, Gastroenterology, Hepatology and Urology Department, Ho Chi Minh City Oncology Hospital, 03 No Trang Long Street, Binh Thanh District, Ho Chi Minh City, Vietnam
| | - Hien D Nguyen
- BioMedical Research Center, Pham Ngoc Thach University of Medicine, 02 Duong Quang Trung Street, District 10, Ho Chi Minh City, Vietnam
- Saigon Precision Medicine Center, LL2 Ba Vi Street, District 10, Ho Chi Minh City, Vietnam
| | - An H T Phung
- Saigon Precision Medicine Center, LL2 Ba Vi Street, District 10, Ho Chi Minh City, Vietnam
| | - Thach S Tran
- School of Biomedical Engineering, University of Technology Sydney, PO Box 123, Sydney, NSW, 2007, Australia
| | - Tuan V Nguyen
- School of Biomedical Engineering, University of Technology Sydney, PO Box 123, Sydney, NSW, 2007, Australia
- School of Population Health, UNSW Medicine, UNSW Sydney, Sydney, Australia
- Tam Anh Research Institute, Tam Anh General Hospital, Ho Chi Minh City, Vietnam
| | - Lan T Ho-Pham
- BioMedical Research Center, Pham Ngoc Thach University of Medicine, 02 Duong Quang Trung Street, District 10, Ho Chi Minh City, Vietnam.
- Saigon Precision Medicine Center, LL2 Ba Vi Street, District 10, Ho Chi Minh City, Vietnam.
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7
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Stanton AV. Plant-based diets-impacts of consumption of little or no animal-source foods on human health. Front Nutr 2024; 11:1423925. [PMID: 39360272 PMCID: PMC11444979 DOI: 10.3389/fnut.2024.1423925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 09/03/2024] [Indexed: 10/04/2024] Open
Abstract
The world, in 2024, faces both climate and biodiversity crises, and the food system does contribute significantly to these crises. For some, the solution is simple - intakes of animal source foods (ASFs) should be considerably reduced, and consumption of plant-source foods (PSFs) should be greatly increased. Advocates for such a dietary transformation express confidence that plant-based diets will not only benefit planetary health, but will provide nutrient adequacy for all, and will also result in considerable protection from chronic non-communicable diseases (NCDs). However, as described in this perspective, the dramatic reductions in ASFs, entailed by many plant-based diets, will worsen already prevalent micronutrient and protein deficiencies. The protections provided by plant-based diets against NCDs appear to be more strongly associated with reduced intakes of calories and salt, and increased intakes of fruit, vegetables, nuts and whole grains, rather than with reduced intakes of ASFs. Any possible absolute adverse effects of red and processed meat consumption on NCDs are very small and uncertain. Other ASFs either appear to have no impact on NCDs (poultry meat and eggs), or are associated with protections against obesity, cardiovascular events, brain disorders and some cancers (seafood and dairy). Rigorous randomized controlled trials of all newly proposed environmentally-protective plant-based diets are required, so as to provide clear-cut evidence of micronutrient and protein adequacy, with or without, supplementation, fortification and/or biofortification. In the meantime, dietary guidelines should advise moderating excessive consumption, rather than substantially limiting or excluding ASFs from the human diet.
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Affiliation(s)
- Alice V. Stanton
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
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8
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Zeraatkar D, de Souza RJ, Guyatt GH, Bala MM, Alonso-Coello P, Johnston BC. Nutrition users' guides: systematic reviews part 1 -structured guide for methodological assessment, interpretation and application of systematic reviews and meta-analyses of non-randomised nutritional epidemiology studies. BMJ Nutr Prev Health 2024; 7:e000835. [PMID: 39882294 PMCID: PMC11773667 DOI: 10.1136/bmjnph-2023-000835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 05/14/2024] [Indexed: 01/31/2025] Open
Abstract
Due to the challenges of conducting randomised controlled trials (randomised trials) of dietary interventions, evidence in nutrition often comes from non-randomised (observational) studies of nutritional exposures-called nutritional epidemiology studies. When using systematic reviews of such studies to advise patients or populations on optimal dietary habits, users of the evidence (eg, healthcare professionals such as clinicians, health service and policy workers) should first evaluate the rigour (validity) and utility (applicability) of the systematic review. Issues in making this judgement include whether the review addressed a sensible question; included an exhaustive literature search; was scrupulous in the selection of studies and the collection of data; and presented results in a useful manner. For sufficiently rigorous and useful reviews, evidence users must subsequently evaluate the certainty of the findings, which depends on assessments of risk of bias, inconsistency, imprecision, indirectness, effect size, dose-response and the likelihood of publication bias. Given the challenges of nutritional epidemiology, evidence users need to be diligent in assessing whether studies provide evidence of sufficient certainty to allow confident recommendations for patients regarding nutrition and dietary interventions.
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Affiliation(s)
- Dena Zeraatkar
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
| | - Russell J de Souza
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
| | - Gordon H Guyatt
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Malgorzata M Bala
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, Krakow, Poland
| | - Pablo Alonso-Coello
- Iberomerican Cochrane Centre, Clinical Epidemiology and Public Health Department, Institute of Biomedical Research of Barcelona, Barcelona, Spain
- Institut de Recerca Sant Pau (IR SANT PAU), Sant Quintí, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Bradley C Johnston
- Department of Nutrition, College of Agriculture and Life Sciences, Texas A&M University, College Station, Texas, USA
- Department of Epidemiology & Biostatistics, School of Public Health, Texas A&M University, College Station, Texas, USA
- Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
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9
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Sheffield S, Fiorotto ML, Davis TA. Nutritional importance of animal-sourced foods in a healthy diet. Front Nutr 2024; 11:1424912. [PMID: 39119462 PMCID: PMC11306033 DOI: 10.3389/fnut.2024.1424912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Accepted: 07/15/2024] [Indexed: 08/10/2024] Open
Abstract
Animal-sourced foods, such as meats, poultry, eggs, milk, and fish are nutrient-dense foods that are rich sources of protein, essential amino acids, and micronutrients that can be challenging to obtain solely through plant-based foods. Animal-sourced protein foods provide crucial nutrients that support the growth and development in children, maintenance of muscle mass and function in adults, gain in muscle mass and strength in exercising individuals, and mitigation of sarcopenia in the elderly. The 2020-2025 Dietary Guidelines for Americans have identified the important role of animal-sourced foods in the diet at every stage of life. Animal-sourced foods are consumed worldwide and contribute to global food security.
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Affiliation(s)
| | | | - Teresa A. Davis
- Department of Pediatrics, USDA/Agricultural Research Service Children’s Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States
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10
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González A, Odriozola I, Fullaondo A, Odriozola A. Microbiota and detrimental protein derived metabolites in colorectal cancer. ADVANCES IN GENETICS 2024; 112:255-308. [PMID: 39396838 DOI: 10.1016/bs.adgen.2024.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/15/2024]
Abstract
Colorectal cancer (CRC) is the third leading cancer in incidence and the second leading cancer in mortality worldwide. There is growing scientific evidence to support the crucial role of the gut microbiota in the development of CRC. The gut microbiota is the complex community of microorganisms that inhabit the host gut in a symbiotic relationship. Diet plays a crucial role in modulating the risk of CRC, with a high intake of red and processed meat being a risk factor for the development of CRC. The production of metabolites derived from protein fermentation by the gut microbiota is considered a crucial element in the interaction between red and processed meat consumption and the development of CRC. This paper examines several metabolites derived from the bacterial fermentation of proteins associated with an increased risk of CRC. These metabolites include ammonia, polyamines, trimethylamine N-oxide (TMAO), N-nitroso compounds (NOC), hydrogen sulphide (H2S), phenolic compounds (p-cresol) and indole compounds (indolimines). These compounds are depicted and reviewed for their association with CRC risk, possible mechanisms promoting carcinogenesis and their relationship with the gut microbiota. Additionally, this paper analyses the evidence related to the role of red and processed meat intake and CRC risk and the factors and pathways involved in bacterial proteolytic fermentation in the large intestine.
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Affiliation(s)
- Adriana González
- Hologenomics Research Group, Department of Genetics, Physical Anthropology, and Animal Physiology, University of the Basque Country, Spain.
| | - Iñaki Odriozola
- Health Department of Basque Government, Donostia-San Sebastián, Spain
| | - Asier Fullaondo
- Hologenomics Research Group, Department of Genetics, Physical Anthropology, and Animal Physiology, University of the Basque Country, Spain
| | - Adrian Odriozola
- Hologenomics Research Group, Department of Genetics, Physical Anthropology, and Animal Physiology, University of the Basque Country, Spain
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Dinas PC, on behalf of the Students of Module 5104 (Introduction to Systematic Reviews), Karaventza M, Liakou C, Georgakouli K, Bogdanos D, Metsios GS. Combined Effects of Physical Activity and Diet on Cancer Patients: A Systematic Review and Meta-Analysis. Nutrients 2024; 16:1749. [PMID: 38892682 PMCID: PMC11175154 DOI: 10.3390/nu16111749] [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: 05/10/2024] [Revised: 05/29/2024] [Accepted: 05/31/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND The purpose of our systematic review was to examine the effects of any physical activity/exercise intervention combined with any diet/nutrition intervention on any biological/biochemical index, quality of life (QoL), and depression in breast, lung, colon and rectum, prostate, stomach, and liver cancer patients and/or cancer survivors. METHODS A systematic review and meta-analysis were undertaken, using PRISMA guidelines and the Cochrane Handbook. The systematic review protocol can be found in the PROSPERO database; registration number: CRD42023481429. RESULTS We found moderate-quality evidence that a combined intervention of physical activity/exercise and nutrition/diet reduced body mass index, body weight, fat mass, insulin, homeostatic model assessment for insulin resistance, C-reactive protein, triglycerides, and depression, while it increased high-density lipoprotein, the physical component of QoL, and general functional assessment of cancer therapy. CONCLUSIONS We conclude that a combined intervention of physical activity/exercise and diet/nutrition may decrease body weight, fat mass, insulin levels, and inflammation, and improve lipidemic profile, the physical component of QoL, and depression in cancer patients and survivors. These outcomes indicate a lower risk for carcinogenesis; however, their applicability depends on the heterogeneity of the population and interventions, as well as the potential medical treatment of cancer patients and survivors.
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Affiliation(s)
- Petros C. Dinas
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42130 Trikala, Greece; (on behalf of the Students of Module 5104 (Introduction to Systematic Reviews)); (M.K.); (K.G.); (G.S.M.)
- FAME Laboratory, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42131 Trikala, Greece
| | | | - Marianthi Karaventza
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42130 Trikala, Greece; (on behalf of the Students of Module 5104 (Introduction to Systematic Reviews)); (M.K.); (K.G.); (G.S.M.)
| | - Christina Liakou
- School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42131 Trikala, Greece;
| | - Kalliopi Georgakouli
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42130 Trikala, Greece; (on behalf of the Students of Module 5104 (Introduction to Systematic Reviews)); (M.K.); (K.G.); (G.S.M.)
| | - Dimitrios Bogdanos
- Department of Internal Medicine, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece;
| | - George S. Metsios
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42130 Trikala, Greece; (on behalf of the Students of Module 5104 (Introduction to Systematic Reviews)); (M.K.); (K.G.); (G.S.M.)
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12
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Pouzou JG, Zagmutt FJ. Guidelines to restrict consumption of red meat to under 350 g/wk based on colorectal cancer risk are not consistent with health evidence. Nutrition 2024; 122:112395. [PMID: 38492553 DOI: 10.1016/j.nut.2024.112395] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/25/2024] [Accepted: 02/10/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND The Nordic Nutrition Recommendations of 2023 (NNR2023) incorporate sustainability, health, and nutrition in their food-based dietary guidelines (FBDGs). NNR2023 recommends a consumption of ≤350 g/wk of unprocessed red meat (RM) based on association with colorectal cancer (CRC). This recommendation is lower than other FBDGs such as the World Cancer Research Fund (WCRF) recommendation it is based on (350-500 g/wk). OBJECTIVE To evaluate the empirical evidence and models cited by the NNR2023 to support the RM guidance. METHODS We fitted least-assumption (LA) dose-response (DR) models to the studies included in two systematic reviews (SRs) selected by NNR2023 on the RM and CRC association. We compared them against six parametric models reported in the two SRs. We evaluated the statistical significance of modeled relative risks (RR) at different consumption levels. RESULTS Twenty-one studies (20,604,188 patient-years) were analyzed. We found no significant association (RR = 1.04, 0.99-1.09) between 350g/wk of RM and CRC using the LA models, in agreement with the least restrictive models reported by Lescinsky et al., 2022 (RR = 1.11[0.89-1.38]) and WCRF (RR= 1.01[0.96-1.07]). The association was significant at 350 g/wk only under restricting assumptions such as monotonicity RR=1.3[1.01-1.64], and linearity RR = 1.06 [1.00-1.12]. No significant empirical association is observed under 567 g/wk based on evidence used by NNR2023. CONCLUSIONS The sources cited by NNR2023 do not support a consumption restriction of ≤350 g/wk of RM due to CRC, and other studies omitted by NNR2023 do not support association between RM and CRC. We show that model assumptions rather than empirical evidence drive this recommendation. Model uncertainty should be explicitly incorporated in FBDGs.
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13
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Liu M, Wang W, Chen Y, Guo M, Wei Y, Yang S, Xiang X. Genetically predicted processed meat, red meat intake, and risk of mental disorders: A multivariable Mendelian randomization analysis. J Affect Disord 2024; 354:603-610. [PMID: 38503356 DOI: 10.1016/j.jad.2024.03.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 03/12/2024] [Accepted: 03/14/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND Previous observational studies have highlighted potential links between the consumption of processed meat and red meat (such as pork, mutton, and beef intake) and the occurrence of mental disorders. However, it is unclear whether a causal association exists. Therefore, we employed the Mendelian randomization (MR) study to investigate the causal effects of genetically predicted processed meat and red meat on mood disorders (MD), anxiety disorders (AD), and major depressive disorder (MDD). METHODS Genetic instruments for processed and red meat were selected from the Genome-Wide Association Study (GWAS) of the UK Biobank Study. Their associations with MD (42,746 cases 254,976), AD (35,385 cases and 254,976 controls), and MDD (38,225 cases and 299,886 controls) were obtained from the FinnGen Consortium. The inverse variance weighted (IVW) method was the primary method for two-sample MR analysis. Additionally, we employed complementary analysis to assess the robustness of our MR findings (eg, MR Egger and weighted median). We also conducted multiple sensitivity analyses to investigate horizontal pleiotropy and heterogeneity. Moreover, we performed a univariate and multivariable MR (MVMR) study to evaluate these associations. RESULTS In our univariate MR analysis, we observed that genetically predicted beef intake was associated with a reduced risk of MD [odds ratio (OR) = 0.403, 95 % confidence interval (CI) = 0.246-0.659; PIVW = 4.428 × 10-5], AD (OR = 0.443, 95 % CI = 0.267-0.734; PIVW = 1.563 × 10-3), and MDD (OR = 0.373, 95 % CI = 0.216-0.643; PIVW = 3.878 × 10-4). After adjusting for processed meat, pork, and mutton intake in the MVMR analysis, the protective association of beef intake against MD and MDD remained. However, there was no substantial evidence indicating a significant causal relationship between processed meat, pork, and mutton intake and the occurrence of mental disorders. Furthermore, our sensitivity analysis revealed no significant evidence of horizontal pleiotropy. CONCLUSION These findings support a causal relationship between genetically predicted beef intake and reducing the risk of MD and MDD.
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Affiliation(s)
- Mingkun Liu
- Department of radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital South Campus, Shanghai 201499, China
| | - Wenwen Wang
- Shanghai Eighth People's Hospital, No.8. Caobao Road, Xuhui District, Shanghai 200235, China
| | - Yi Chen
- Department of PET-CT Imaging Center, Shanghai Jiao Tong University Affiliated Sixth People's Hospital South Campus, No. 6600 Nanfeng Highway, Fengxian District, Shanghai 201499, China
| | - Meixiang Guo
- Department of PET-CT Imaging Center, Shanghai Jiao Tong University Affiliated Sixth People's Hospital South Campus, No. 6600 Nanfeng Highway, Fengxian District, Shanghai 201499, China
| | - Yuanhao Wei
- School of Public Health, Harbin Medical University, Harbin 150076, China
| | - Shaoling Yang
- Shanghai Eighth People's Hospital, No.8. Caobao Road, Xuhui District, Shanghai 200235, China.
| | - Xiqiao Xiang
- Department of PET-CT Imaging Center, Shanghai Jiao Tong University Affiliated Sixth People's Hospital South Campus, No. 6600 Nanfeng Highway, Fengxian District, Shanghai 201499, China.
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14
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Chen Y, Gao Y, Chen Y, Wang Z, Xu H, Hu F, Cai Y. Association between Dietary Patterns and All-Cause Mortality in the Chinese Old: Analysis of the Chinese Longitudinal Healthy Longevity Survey Cohort. Nutrients 2024; 16:1605. [PMID: 38892538 PMCID: PMC11174105 DOI: 10.3390/nu16111605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 05/12/2024] [Accepted: 05/21/2024] [Indexed: 06/21/2024] Open
Abstract
Diet is one of the most important ways to intervene and promote the health of older adults and reduce all-cause mortality. This study aimed to investigate the association between dietary patterns and all-cause mortality in the Chinese old. This study involved 11,958 subjects aged 65-116 years in the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2008 to 2018. Dietary patterns were derived from principal component analysis (PCA) with varimax rotation. Four dietary patterns were derived: the 'milk-egg-sugar pattern', 'carnivorous pattern', 'healthy pattern', and 'northeastern pattern'. Cox proportional hazard models were built for males and females separately to estimate the relationship between different dietary patterns and all-cause mortality. After adjusting for all covariates, the milk-egg-sugar pattern played a reverse role in mortality risk in males and females in different quartiles. In the carnivorous pattern, only males in the fourth quartile were observed to have a significantly reduced mortality risk (HR = 0.84 (95% CI: 0.77-0.93)). Both genders benefited from the healthy pattern, which consistently lowered mortality risk across all quartiles (males: HR = 0.87 (95% CI: 0.84-0.89); females: HR = 0.95 (95% CI: 0.92-0.97)). The northeastern pattern also showed an inverse association with all-cause mortality in males (HR = 0.94 (95% CI: 0.92-0.97)) and females (HR = 0.96 (95% CI: 0.93-0.98)). This study showed the association between dietary patterns and all-cause mortality in the Chinese old, which is significant for further quantitative studies.
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Affiliation(s)
- Yufei Chen
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (Y.C.); (Z.W.); (H.X.)
- Department of Public Health, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200050, China;
| | - Ying Gao
- Department of Public Health, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200050, China;
| | - Yexin Chen
- School of Management, Fudan University, Shanghai 200433, China;
| | - Zuxin Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (Y.C.); (Z.W.); (H.X.)
| | - Huifang Xu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (Y.C.); (Z.W.); (H.X.)
| | - Fan Hu
- Department of Public Health, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200050, China;
| | - Yong Cai
- Department of Public Health, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200050, China;
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15
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van der Vliet N, Stuber JM, Raghoebar S, Roordink E, van der Swaluw K. Nudging plant-based alternatives to meat and dairy in a real-life online supermarket: A randomized controlled trial. Appetite 2024; 196:107278. [PMID: 38373537 DOI: 10.1016/j.appet.2024.107278] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/15/2024] [Accepted: 02/16/2024] [Indexed: 02/21/2024]
Abstract
A shift from predominantly animal-based to plant-based consumption can benefit both planetary and public health. Nudging may help to promote such a shift. This study investigated nudge effects on plant-based alternatives to meat and dairy in an online supermarket. We conducted a two-arm, parallel-group, randomized controlled real-life online supermarket trial. Each customer transaction was randomized to a control arm (regular online supermarket) or an intervention arm (addition of placement, hedonic property and dynamic social norm nudges promoting meat and dairy alternatives). Outcomes were the aggregate of meat and dairy alternative purchases (primary outcome), the number of meat purchases, dairy purchases, meat alternative purchases, and dairy alternative purchases (secondary), and retailer revenue (tertiary). Generalized linear mixed models with a Conway-Maxwell Poisson distribution were used to estimate incidence rate ratios (IRRs). Analyzed data included 8488 transactions by participants (n = 4,266 control arm, n = 4,222 intervention arm), out of which 2,411 (66%) were aged above 45 years, 5,660 (67%) were females, and 1,970 (23%) lived in socially disadvantaged neighborhoods. Intervention arm participants purchased 10% (IRR 1.10 (95% CI 0.99-1.23)) more meat and dairy alternatives and 16% (1.16 (0.99-1.36)) more meat alternatives than control arm participants, although these findings are not statistically significant. There was no difference in dairy alternative purchases (1.00 (0.90-1.10)). Intervention arm participants purchased 3% less meats (0.97 (0.93-1.02)) and 2% less dairy products (0.98 (0.95-1.02)) than control participants. Retailer revenue was not affected (0.98 (0.95-1.01)). Online nudging strategies alone did not lead to a statistically significant higher amount of plant-based purchases, but replication of this work is needed with increased study power. Future studies should also consider nudging strategies as part of a broader set of policies to promote plant-based purchases. TRIAL REGISTRATION: Prospectively registered on 14th of May 2022. ISRCTN16569242 (https://doi.org/10.1186/ISRCTN16569242).
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Affiliation(s)
- Nina van der Vliet
- National Institute of Public Health and the Environment (RIVM), Centre for Sustainability, Environment and Health, 3720 BA, Bilthoven, the Netherlands; Tilburg University Graduate School, Tilburg School of Social and Behavioral Sciences, 5000 LE, Tilburg, the Netherlands
| | - Josine M Stuber
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Public Health, Amsterdam, the Netherlands.
| | - Sanne Raghoebar
- Wageningen University and Research, Consumption and Healthy Lifestyles Group, Education and Learning Sciences Group, 6706 KN, Wageningen, the Netherlands
| | - Eline Roordink
- National Institute of Public Health and the Environment (RIVM), Centre for Nutrition, Prevention and Health Services, 3720 BA, Bilthoven, the Netherlands
| | - Koen van der Swaluw
- National Institute of Public Health and the Environment (RIVM), Centre for Nutrition, Prevention and Health Services, 3720 BA, Bilthoven, the Netherlands; Radboud University, Department of Economics and Business Economics, Nijmegen School of Management, 6500 HK, Nijmegen, the Netherlands
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16
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Wang DD, Li Y, Nguyen XM, Ho YL, Hu FB, Willett WC, Wilson PW, Cho K, Gaziano JM, Djoussé L. Red Meat Intake and the Risk of Cardiovascular Diseases: A Prospective Cohort Study in the Million Veteran Program. J Nutr 2024; 154:886-895. [PMID: 38163586 DOI: 10.1016/j.tjnut.2023.12.051] [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: 09/01/2023] [Revised: 12/22/2023] [Accepted: 12/28/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Red meat consumption was associated with an increased risk of cardiovascular disease (CVD) in prospective cohort studies and a profile of biomarkers favoring high CVD risk in short-term controlled trials. However, several recent systematic reviews and meta-analyses concluded with no or weak evidence for limiting red meat intake. OBJECTIVES To prospectively examine the associations between red meat intake and incident CVD in an ongoing cohort study with diverse socioeconomic and racial or ethnic backgrounds. METHODS Our study included 148,506 participants [17,804 female (12.0%)] who were free of cancer, diabetes, and CVD at baseline from the Million Veteran Program. A food frequency questionnaire measured red meat intakes at baseline. Nonfatal myocardial infarction and acute ischemic stroke were identified through a high-throughput phenotyping algorithm, and fatal CVD events were identified by searching the National Death Index. RESULTS Comparing the extreme categories of intake, the multivariate-adjusted relative risks of CVD was 1.18 (95% CI: 1.01, 1.38; P-trend < 0.0001) for total red meat, 1.14 (95% CI: 0.96, 1.36; P-trend = 0.01) for unprocessed red meat, and 1.29 (95% CI: 1.04, 1.60; P-trend = 0.003) for processed red meat. We observed a more pronounced positive association between red meat intake and CVD in African American participants than in White participants (P-interaction = 0.01). Replacing 0.5 servings/d of red meat with 0.5 servings/d of nuts, whole grains, and skimmed milk was associated with 14% (RR: 0.86; 95% CI: 0.83, 0.90), 7% (RR: 0.93; 95% CI: 0.89, 0.96), and 4% (RR: 0.96; 95% CI: 0.94, 0.99) lower risks of CVD, respectively. CONCLUSIONS Red meat consumption is associated with an increased risk of CVD. Our findings support lowering red meat intake and replacing red meat with plant-based protein sources or low-fat dairy foods as a key dietary recommendation for the prevention of CVD.
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Affiliation(s)
- Dong D Wang
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA, United States; The Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States; Broad Institute of MIT and Harvard, Cambridge, MA, United States.
| | - Yanping Li
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA, United States; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Xuan-Mai Nguyen
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA, United States; Department of Medicine, Division of Aging, Brigham and Women's Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Yuk-Lam Ho
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA, United States
| | - Frank B Hu
- The Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States
| | - Walter C Willett
- The Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States
| | - Peter Wf Wilson
- Atlanta VA Medical Center, Atlanta, GA, United States; Emory Clinical Cardiovascular Research Institute, Atlanta, GA, United States
| | - Kelly Cho
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA, United States; Department of Medicine, Division of Aging, Brigham and Women's Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - J Michael Gaziano
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA, United States; Department of Medicine, Division of Aging, Brigham and Women's Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Luc Djoussé
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA, United States; Department of Medicine, Division of Aging, Brigham and Women's Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
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17
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Meinilä J, Virtanen JK. Meat and meat products - a scoping review for Nordic Nutrition Recommendations 2023. Food Nutr Res 2024; 68:10538. [PMID: 38449706 PMCID: PMC10916397 DOI: 10.29219/fnr.v68.10538] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 08/22/2022] [Accepted: 01/23/2024] [Indexed: 03/08/2024] Open
Abstract
Meat is not only a source of several nutrients but also a proposed risk factor for several non-communicable diseases. Here, we describe the totality of evidence for the role of meat intake for chronic disease outcomes, discuss potential mechanistic pathways, knowledge gaps, and limitations of the literature. Use of the scoping review is based on a de novo systematic review (SR) and meta-analysis on the association between poultry intake and cardiovascular disease (CVD) and type 2 diabetes (T2D), qualified SRs (as defined in the Nordic Nutrition Recommendations 2023 project) on meat intake and cancer by the World Cancer Research Fund (WCRF), the International Agency for Research on Cancer (IARC), and a systematic literature search of SRs and meta-analyses. The quality of the SRs was evaluated using a modified AMSTAR 2 tool, and the strength of evidence was evaluated based on a predefined criteria developed by the WCRF. The quality of the SRs was on average critically low. Our findings indicate that the evidence is too limited for conclusions for most of the chronic disease outcomes. However, findings from qualified SRs indicate strong evidence that processed meat increases the risk of colorectal cancer and probable evidence that red meat (unprocessed, processed, or both) increases the risk. The evidence suggests that both unprocessed red meat and processed meat (also including processed poultry meat) are probable risk factors for CVD mortality and stroke, and that total red meat and processed meat are risk factors for CHD. We found no sufficient evidence suggesting that unprocessed red meat, processed red meat, total red meat, or processed meat (including red and white meat) would be protective of any chronic disease. There was also no sufficient evidence to conclude on protective effect of poultry on any chronic diseases; effects on the risk of CVD, stroke, and T2D, to any direction, were regarded as unlikely.
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Affiliation(s)
- Jelena Meinilä
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Jyrki K. Virtanen
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
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18
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Domellöf M, Sjöberg A. Iron - a background article for the Nordic Nutrition Recommendations 2023. Food Nutr Res 2024; 68:10451. [PMID: 38370116 PMCID: PMC10870973 DOI: 10.29219/fnr.v68.10451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 11/14/2023] [Accepted: 12/20/2023] [Indexed: 02/20/2024] Open
Abstract
Iron absorption from foods is generally lower than that of most other nutrients and is highly variable depending on individual iron status and iron bioavailability in the meal. Several large population groups in the Nordic and Baltic countries are at risk of iron deficiency, including infants, young children, menstruating females, pregnant women as well as vegetarians. Iron deficiency leads to anemia, fatigue, and limited capacity for physical activity. Of particular concern is that iron deficiency anemia in young children is associated with impaired neurodevelopment. A comprehensive literature search has been performed and summarized. New factorial calculations have been performed considering iron losses, iron absorption and iron requirements in various population groups. Recent data on iron intakes and the prevalence of iron deficiency in the Nordic countries are presented. Average requirements and tentative recommended intakes are presented for 12 different population groups. Pregnant women and those with high menstrual blood losses should consume iron-rich food and undergo screening for iron deficiency. Infants should consume iron-rich complementary foods and cow's milk should be avoided as a drink before 12 months of age and limited to < 500 mL/day in toddlers. Vegetarians should consume a diet including wholegrains, legumes, seeds, and green vegetables together with iron absorption enhancers. There is no evidence that iron intake per se increases the risk of cancer or diabetes. Iron absorption from foods is generally lower than that of most other nutrients and can vary between <2 and 50% depending on individual iron status and iron bioavailability in the meal.
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Affiliation(s)
- Magnus Domellöf
- Department of Clinical Sciences, Umeå University, Umeå, Sweden
| | - Agneta Sjöberg
- Department of Food and Nutrition and Sport Science, University of Gothenburg, Gothenburg, Sweden
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19
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Liu G, Li CM, Xie F, Li QL, Liao LY, Jiang WJ, Li XP, Lu GM. Colorectal cancer's burden attributable to a diet high in processed meat in the Belt and Road Initiative countries. World J Gastrointest Oncol 2024; 16:182-196. [PMID: 38292848 PMCID: PMC10824120 DOI: 10.4251/wjgo.v16.i1.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 10/20/2023] [Accepted: 12/11/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Colorectal cancer (CRC) plays a significant role in morbidity, mortality, and economic cost in the Belt and Road Initiative ("B and R") countries. In addition, these countries have a substantial consumption of processed meat. However, the burden and trend of CRC in relation to the consumption of a diet high in processed meat (DHPM-CRC) in these "B and R" countries remain unknown. AIM To analyze the burden and trend of DHPM-CRC in the "B and R" countries from 1990 to 2019. METHODS We used the 2019 Global Burden of Disease Study to collate information regarding the burden of DHPM-CRC. Numbers and age-standardized rates (ASRs) of deaths along with the disability-adjusted life years (DALYs) were determined among the "B and R" countries in 1990 and 2019. Using joinpoint regression analysis, the average annual percent change (AAPC) was used to analyze the temporal trends of age-standardized DALYs rate (ASDALR) from 1990 to 2019 and in the final decade (2010-2019). RESULTS We found geographical differences in the burden of DHPM-CRC among "B and R" countries, with the three highest-ranking countries being the Russian Federation, China, and Ukraine in 1990, and China, the Russian Federation, and Poland in 2019. The burden of DHPM-CRC generally increased in most member countries from 1990 to 2019 (all P < 0.05). The absolute number of deaths and DALYs in DHPM-CRC were 3151.15 [95% uncertainty interval (UI) 665.74-5696.64] and 83249.31 (95%UI 15628.64-151956.31) in China in 2019. However, the number of deaths (2627.57-2528.51) and DALYs (65867.39-55378.65) for DHPM-CRC in the Russian Federation has declined. The fastest increase in ASDALR for DHPM-CRC was observed in Vietnam, Southeast Asia, with an AAPC value of 3.90% [95% confidence interval (CI): 3.63%-4.16%], whereas the fastest decline was observed in Kyrgyzstan, Central Asia, with an AAPC value of -2.05% (95% CI: -2.37% to -1.73%). A substantial upward trend in ASR of mortality, years lived with disability, years of life lost, and DALYs from DHPM-CRC changes in 1990-2019 and the final decade (2010-2019) for most Maritime Silk Route members in East Asia, South Asia, Southeast Asia, North Africa, and the Middle East, as well as Central Europe, while those of the most Land Silk Route members in Central Asia and Eastern Europe have decreased markedly (all P < 0.05). The ASDALR for DHPM-CRC increased more in males than in females (all P < 0.05). For those aged 50-74 years, the ASDALR for DHPM-CRC in 40 members exhibited an increasing trend, except for 20 members, including 7 members in Central Asia, Maldives, and 12 high or high-middle social development index (SDI) members in other regions (all P < 0.05). CONCLUSION The burden of DHPM-CRC varies substantially across "B and R" countries and threatens public health. Relevant evidence-based policies and interventions tailored to the different trends of countries in SDIs or Silk Routes should be adopted to reduce the future burden of CRC in "B and R" countries via extensive collaboration.
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Affiliation(s)
- Gu Liu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Jinan University, Guangzhou 510630, Guangdong Province, China
- Department of Gastrointestinal Surgery, Chenzhou Third People’s Hospital, Chenzhou 423000, Hunan Province, China
| | - Chang-Min Li
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Jinan University, Guangzhou 510630, Guangdong Province, China
- Department of Gastrointestinal Surgery, Chenzhou First People’s Hospital and the First Affiliated Hospital of Xiangnan University, Chenzhou, 423000 Hunan Province, China
| | - Fei Xie
- Department of Gastrointestinal Surgery, Chenzhou Third People’s Hospital, Chenzhou 423000, Hunan Province, China
| | - Qi-Lai Li
- Department of Gastrointestinal Surgery, Chenzhou Third People’s Hospital, Chenzhou 423000, Hunan Province, China
| | - Liang-Yan Liao
- Department of Breast and Thyroid Surgery, the Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
| | - Wen-Jun Jiang
- Department of Breast and Thyroid Surgery, the Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
| | - Xiao-Pan Li
- Department of Health Management Center, Zhongshan Hospital, Shanghai Medical College of Fudan University, Shanghai 200032, China
| | - Guan-Ming Lu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Jinan University, Guangzhou 510630, Guangdong Province, China
- Department of Breast and Thyroid Surgery, the Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
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Eshaghian N, Zare MJ, Mohammadian MK, Gozidehkar Z, Ahansaz A, Askari G, Asadi M, Milajerdi A, Sadeghi O. Sugar sweetened beverages, natural fruit juices, and cancer: what we know and what still needs to be assessed. Front Nutr 2023; 10:1301335. [PMID: 38178975 PMCID: PMC10764622 DOI: 10.3389/fnut.2023.1301335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 11/30/2023] [Indexed: 01/06/2024] Open
Abstract
Cancer is known as one of the leading causes of death in the world. In addition to early mortality, cancer is associated with disability in affected patients. Among environmental risk factors, special attention has been paid to the role of dietary factors. In recent decades, the consumption of sugar-sweetened beverages (SSBs) and natural fruit juices has increased. Several studies have assessed the effects of these beverages on human health and found that a higher intake of SSBs is associated with a greater risk of obesity, diabetes, cardiovascular diseases, hypertension, and non-alcoholic fatty liver disease. However, current evidence for cancer incidence and mortality is not conclusive. In the current review, we concluded that SSBs intake might be positively associated with cancer incidence/mortality through their increasing effects on obesity, inflammatory biomarkers, serum levels of insulin-like growth factor-I (IGF-I), and advanced glycation end-products. Such a positive association was also seen for natural fruit juices. However, types of natural fruit juices were not considered in most previous studies. In addition, some types of cancer including brain, lung, and renal cancers were not assessed in relation to SSBs and natural fruit juices. Therefore, further studies are needed in this regard.
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Affiliation(s)
- Niloofar Eshaghian
- Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Javad Zare
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Zohre Gozidehkar
- Department of Public Health, Birjand University of Medical Sciences, Birjand, Iran
| | - Afsaneh Ahansaz
- Department of Food Science and Technology, Faculty of Agriculture, University of Tabriz, Tabriz, Iran
| | - Gholamreza Askari
- Nutrition and Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoomeh Asadi
- Department of Operating Room Nursing, Abadan University of Medical Sciences, Abadan, Iran
| | - Alireza Milajerdi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran
| | - Omid Sadeghi
- Nutrition and Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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Zhang G, Kang J, Jing S, Chen Y, Deng T, Xu H, Wu H, Xu F. Meat, vegetable, and fruit consumption among urban and rural elders aged 60+ years in regional China: a population-level nutritional study. J Nutr Sci 2023; 12:e120. [PMID: 38155810 PMCID: PMC10753460 DOI: 10.1017/jns.2023.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 10/27/2023] [Indexed: 12/30/2023] Open
Abstract
The aim was to assess epidemiological characteristics of the most recent consumption patterns of meat, vegetable, and fruit among representative urban and rural residents aged 60+ years in regional China. In this cross-sectional survey conducted in mid-2018, participants aged 60+ years were randomly chosen from urban and rural communities in Nanjing municipality of China. Meat, vegetable, and fruit intake were assessed with a validated food frequency questionnaire. Multivariate logistic regression models were applied to compute odds ratio (OR) and 95 % confidence interval (CI) to investigate the association of socio-demographic characteristics with a likelihood of meeting intake recommendation. Among the 20 867 participants, 49⋅5 % were men and 45⋅0 % urban elders, and 6⋅5 % aged 80+ years. The mean values of consumption frequency of red meat, white meat, vegetable, and fruit were 2⋅99 ± 2⋅28, 1⋅37 ± 1⋅13, 5⋅24 ± 6⋅43, and 2⋅64 ± 2⋅91 times/week, respectively, among overall participants. Moreover, there were 14⋅9, 23⋅7, and 12⋅1 % of participants meeting intake recommendations of meat, vegetable, and fruit, separately, in this study. After adjustment for potential confounders, age, gender, residence area, and educational attainment each was associated with the likelihood of meeting intake recommendation of meat, vegetable, or fruit. The consumption frequency and proportion of participants meeting intake recommendations of meat, vegetable, or fruit were not high among elders in regional China. Socio-demographic characteristics were associated with intake recommendations of meat, vegetables, and fruit. It has public health implications that participants' socio-demographic attributes shall be considered for precision intervention on meat, vegetable, and fruit consumption in healthy eating campaigns among elders in China.
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Affiliation(s)
- Guilin Zhang
- Geriatric Hospital of Nanjing Medical University, Nanjing, China
| | - Jian Kang
- The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Shibao Jing
- Nanjing Liuhe District Center for Disease Control and Prevention, Nanjing, China
| | - Yinhao Chen
- Wenzhou Center for Disease Control and Prevention, Wenzhou, China
| | - Tianrui Deng
- Nanjing Medical University School of Public Health, Nanjing, China
| | - Huiqing Xu
- Nanjing Medical University School of Public Health, Nanjing, China
| | - Haidi Wu
- Geriatric Hospital of Nanjing Medical University, Nanjing, China
| | - Fei Xu
- Nanjing Municipal Center for Disease Control and Prevention Affiliated to Nanjing Medical University, Nanjing, China
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22
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Ma H, Qi X. Red Meat Consumption and Cancer Risk: A Systematic Analysis of Global Data. Foods 2023; 12:4164. [PMID: 38002221 PMCID: PMC10670314 DOI: 10.3390/foods12224164] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/10/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023] Open
Abstract
The association between red meat consumption and cancer risk remains a controversy. In this study, we systematically collected and analyzed global data (from Our World in Data and Global Cancer Observatory) to investigate this association for the first time. Our results confirmed significant positive associations between red meat consumption (RMC) and overall cancer incidence (0.798, p < 0.001), or colorectal cancer incidence (0.625, p < 0.001). Several previously unreported cancer types linked to RMC were also unveiled. Gross domestic product (GDP) per capita were found to have an impact on this association. However, even after controlling it, RMC remained significantly associated with cancer incidence (0.463, p < 0.001; 0.592, p < 0.001). Meanwhile, after controlling GDP per capita, the correlation coefficients between white meat consumption and overall cancer incidence were found to be much lower and insignificant, at 0.089 (p = 0.288) for poultry consumption and at -0.055 (p = 0.514) for seafood and fish consumption. Notably, an interesting comparison was performed between changes of colorectal cancer incidence and RMC in many countries and regions. A lag of 15-20 years was found, implying causality between RMC and cancer risk. Our findings will contribute to the development of more rational meat consumption concept.
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Affiliation(s)
- Hongyue Ma
- State Key Laboratory of Marine Food Processing and Safety Control, College of Food Science and Engineering, Ocean University of China, Qingdao 266404, China;
- Haide College, Ocean University of China, Qingdao 266404, China
| | - Xiangming Qi
- State Key Laboratory of Marine Food Processing and Safety Control, College of Food Science and Engineering, Ocean University of China, Qingdao 266404, China;
- Laboratory for Marine Drugs and Bioproducts of Qingdao National Laboratory for Marine Science and Technology, Qingdao 266237, China
- Qingdao Key Laboratory of Food Biotechnology, College of Food Science and Engineering, Ocean University of China, Qingdao 266404, China
- Key Laboratory of Biological Processing of Aquatic Products, China National Light Industry, Qingdao 266404, China
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23
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Wu Z, Wang W, Zhang K, Fan M, Lin R. The Global Burden of Disease Attributable to Diet High in Red Meat in 204 Countries and Territories, 1999-2019: An updated Analysis of the Global Burden of Disease Study. Mol Nutr Food Res 2023; 67:e2300144. [PMID: 37672799 DOI: 10.1002/mnfr.202300144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 07/05/2023] [Indexed: 09/08/2023]
Abstract
SCOPE The study aims to estimates of the deaths and disability-adjusted life year rates (DALYs) of a diet high in red meat from 1999 to 2019. METHODS AND RESULTS The deaths and disability-adjusted life year rates (DALYs) attributable to diet high in red meat were analyzed by sex, age, and geographical location and by Socio-demographic Index (SDI) from 1999 to 2019. RESULTS Globally, deaths and DALYs attributable to diets high in red meat have steadily increased between 1999 and 2019. The global deaths attributable to diet high in red meat have increased from 319,338 (95% UI 190,418 to 441,406) in 1999 to 411,066 (95% UI 250,993 to 573,864) in 2019 for females, and have increased from 335,711 (95% UI 183,491 to 472,091) in 1999 to 484,608 (95% UI 282,347 to 686,919) in 2019 for males. The global DALYs attributable to diet high in red meat have increased from 7,763,803 (95% UI 5,023,428 to 10,370,477) in 1999 to 10,164,451 (95% UI 6,816,205 to 13,348,860) in 2019 for females, and have increased from 9,564,377 (95% UI 5,528,491 to 13,231,311) in 1999 to 13,696,622 (95% UI 8,669,245 to 18,725,223) in 2019 for males. CONCLUSION Globally, since 1999, deaths and DALYs caused by diets high in red meat have steadily increased.
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Affiliation(s)
- Zenghong Wu
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Weijun Wang
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kun Zhang
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mengke Fan
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rong Lin
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Kumar P, Abubakar AA, Verma AK, Umaraw P, Adewale Ahmed M, Mehta N, Nizam Hayat M, Kaka U, Sazili AQ. New insights in improving sustainability in meat production: opportunities and challenges. Crit Rev Food Sci Nutr 2023; 63:11830-11858. [PMID: 35821661 DOI: 10.1080/10408398.2022.2096562] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Treating livestock as senseless production machines has led to rampant depletion of natural resources, enhanced greenhouse gas emissions, gross animal welfare violations, and other ethical issues. It has essentially instigated constant scrutiny of conventional meat production by various experts and scientists. Sustainably in the meat sector is a big challenge which requires a multifaced and holistic approach. Novel tools like digitalization of the farming system and livestock market, precision livestock farming, application of remote sensing and artificial intelligence to manage production and environmental impact/GHG emission, can help in attaining sustainability in this sector. Further, improving nutrient use efficiency and recycling in feed and animal production through integration with agroecology and industrial ecology, improving individual animal and herd health by ensuring proper biosecurity measures and selective breeding, and welfare by mitigating animal stress during production are also key elements in achieving sustainability in meat production. In addition, sustainability bears a direct relationship with various social dimensions of meat production efficiency such as non-market attributes, balance between demand and consumption, market and policy failures. The present review critically examines the various aspects that significantly impact the efficiency and sustainability of meat production.
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Affiliation(s)
- Pavan Kumar
- Laboratory of Sustainable Animal Production and Biodiversity, Institute of Tropical Agriculture and Food Security, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Department of Livestock Products Technology, College of Veterinary Science, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab, India
| | - Abubakar Ahmed Abubakar
- Laboratory of Sustainable Animal Production and Biodiversity, Institute of Tropical Agriculture and Food Security, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Akhilesh Kumar Verma
- Department of Livestock Products Technology, College of Veterinary and Animal Sciences, Sardar Vallabhbhai Patel University of Agriculture and Technology, Meerut, Uttar Pradesh, India
| | - Pramila Umaraw
- Department of Livestock Products Technology, College of Veterinary and Animal Sciences, Sardar Vallabhbhai Patel University of Agriculture and Technology, Meerut, Uttar Pradesh, India
| | - Muideen Adewale Ahmed
- Department of Animal Science, Faculty of Agriculture, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Nitin Mehta
- Department of Livestock Products Technology, College of Veterinary Science, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab, India
| | - Muhammad Nizam Hayat
- Department of Animal Science, Faculty of Agriculture, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Ubedullah Kaka
- Department of Companion Animal Medicine and Surgery, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Awis Qurni Sazili
- Laboratory of Sustainable Animal Production and Biodiversity, Institute of Tropical Agriculture and Food Security, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Department of Animal Science, Faculty of Agriculture, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Halal Products Research Institute, Putra Infoport, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
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25
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Talukdar JR, Steen JP, Goldenberg JZ, Zhang Q, Vernooij RWM, Ge L, Zeraatkar D, Bała MM, Ball GDC, Thabane L, Johnston BC. Saturated fat, the estimated absolute risk and certainty of risk for mortality and major cancer and cardiometabolic outcomes: an overview of systematic reviews. Syst Rev 2023; 12:179. [PMID: 37777760 PMCID: PMC10541715 DOI: 10.1186/s13643-023-02312-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 08/08/2023] [Indexed: 10/02/2023] Open
Abstract
OBJECTIVE To assess the impact of reducing saturated fat or fatty foods, or replacing saturated fat with unsaturated fat, carbohydrate or protein, on the risk of mortality and major cancer and cardiometabolic outcomes in adults. METHODS We searched MEDLINE, EMBASE, CINAHL, and references of included studies for systematic reviews and meta-analyses (SRMAs) of randomized controlled trials (RCTs) and observational studies in adults published in the past 10 years. Eligible reviews investigated reducing saturated fat or fatty foods or replacing saturated fat with unsaturated fat, carbohydrate or protein, on the risk of cancer and cardiometabolic outcomes and assessed the certainty of evidence for each outcome using, for example, the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) approach. We assessed the quality of SRMAs using a modified version of AMSTAR-2. Results were summarized as absolute estimates of effect together with the certainty of effects using a narrative synthesis approach. RESULTS We included 17 SRMAs (13 reviews of observational studies with follow-up 1 to 34 years; 4 reviews of RCTs with follow-up 1 to 17 years). The quality of two-thirds of the SRMAs was critically low to moderate; the main limitations included deficient reporting of study selection, absolute effect estimates, sources of funding, and a priori subgroups to explore heterogeneity. Our included reviews reported > 100 estimates of effect across 11 critically important cancer and cardiometabolic outcomes. High quality SRMAs consistently and predominantly reported low to very low certainty evidence that reducing or replacing saturated fat was associated with a very small risk reduction in cancer and cardiometabolic endpoints. The risk reductions where approximately divided, some being statistically significant and some being not statistically significant. However, based on 2 moderate to high quality reviews, we found moderate certainty evidence for a small but important effect that was statistically significant for two outcomes (total mortality events [20 fewer events per 1000 followed] and combined cardiovascular events [16 fewer per 1000 followed]). Conversely, 4 moderate to high quality reviews showed very small effects on total mortality, with 3 of these reviews showing non-statistically significant mortality effects. CONCLUSION Systematic reviews investigating the impact of SFA on mortality and major cancer and cardiometabolic outcomes almost universally suggest very small absolute changes in risk, and the data is based primarily on low and very low certainty evidence. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020172141.
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Affiliation(s)
- Jhalok Ronjan Talukdar
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Jeremy P Steen
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Joshua Z Goldenberg
- Department of Nutrition, College of Agriculture and Life Sciences, Texas A&M University, College Station, TX, USA
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR, USA
| | - Qian Zhang
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Robin W M Vernooij
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Long Ge
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Evidence Based Social Science Research Centre, School of Public Health, Lanzhou University, Lanzhou, China
| | - Dena Zeraatkar
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | - Małgorzata M Bała
- Department of Hygiene and Dietetics, Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Geoff D C Ball
- Department of Pediatrics, Faculty of Medicine & Dentistry, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
- Biostatistics Unit, St Joseph's Healthcare-Hamilton, Hamilton, ON, Canada
| | - Bradley C Johnston
- Department of Nutrition, College of Agriculture and Life Sciences, Texas A&M University, College Station, TX, USA.
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, TX, USA.
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26
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Sun Y, He X, Sun Y. Red and processed meat and pancreatic cancer risk: a meta-analysis. Front Nutr 2023; 10:1249407. [PMID: 37829734 PMCID: PMC10565855 DOI: 10.3389/fnut.2023.1249407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 09/04/2023] [Indexed: 10/14/2023] Open
Abstract
Background The relationship between red and processed meat consumption and pancreatic cancer risk is controversial and no study has looked specifically at the correlation for 6 years. We conducted a meta-analysis to summarize the evidence about the association between them. Methods We systematically searched PubMed, Embase and Cochrane Library for studies of red or processed meat consumption and pancreatic cancer published from December 2016 to July 2022. We performed random-effects models to pool the relative risks from individual studies. Subgroup analyses were used to figure out heterogeneity. We also performed publication bias analysis. Results Seven cohort studies and one case-control study that contained a total of 7,158 pancreatic cancer cases from 805,177 participants were eligible for inclusion. The combined RRs (95% CI) comparing highest and lowest categories were 1.07 (95% CI: 0.91-1.26; p = 0.064) for red meat and 1.04 (95% CI: 0.81-1.33; p = 0.006) for processed meat with statistically significant heterogeneity. Conclusion This meta-analysis suggested that red and processed meat consumption has no relationship with pancreatic cancer risk.
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Affiliation(s)
| | | | - Yan Sun
- Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
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27
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Shu L, Zhang X, Zhu Q, Lv X, Si C. Association between ultra-processed food consumption and risk of breast cancer: a systematic review and dose-response meta-analysis of observational studies. Front Nutr 2023; 10:1250361. [PMID: 37731393 PMCID: PMC10507475 DOI: 10.3389/fnut.2023.1250361] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 08/21/2023] [Indexed: 09/22/2023] Open
Abstract
Background Some epidemiological studies have examined the association between consumption of ultra-processed food (UPF) and the risk of breast cancer. However, the results were inconsistent. Therefore, we carried out a systematic review and dose-response meta-analysis to examine whether an association exists between high consumption of UPF and breast cancer risk. Methods PubMed/MEDLINE, ISI Web of Science, EBSCO and CNKI databases were systematically searched from inception to May 2023. The summary relative risks (RRs) and 95% confidence intervals (CIs) associated with UPF consumption and breast cancer were calculated using a random-effects model (DerSimonian-Laird method). Heterogeneity between included studies was examined using the Cochran's Q test and I-square (I2) statistics. Publication bias was studied by visual inspection of funnel plot asymmetry and Begg's and Egger's tests. Results Overall, six articles involving 462,292 participants, were eligible to be included in this study. Compared to the lowest consumption, highest consumption of UPF was related to a higher risk of breast cancer (RR = 1.10; 95%CI: 1.00-1.22, p = 0.056). Besides, the linear dose-response analysis showed that each 10% increment in UPF consumption was related to a 5% higher risk of breast cancer (RR = 1.05; 95%CI: 1.00-1.10, p = 0.048). Subgroup analyses suggested that UPF consumption was positively associated with breast cancer risk in case-control studies (RR = 1.13; 95%CI: 1.01-1.26, p = 0.028). Additionally, there was also a significant positive association between UPF consumption and breast cancer risk in the subgroup with sample size<5,000(RR = 1.17; 95%CI: 1.02-1.35, p = 0.028). Conclusion Our results indicate that higher consumption of UPF is slightly related to a higher risk of breast cancer. Further studies in particular of large prospective cohort studies are warranted to confirm these results.
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Affiliation(s)
- Long Shu
- Department of Nutrition, Zhejiang Hospital, Hangzhou, China
| | - Xiaoyan Zhang
- Department of Nutrition, Zhejiang Hospital, Hangzhou, China
| | - Qin Zhu
- Department of Nutrition, Zhejiang Hospital, Hangzhou, China
- Department of Digestion, Zhejiang Hospital, Hangzhou, China
| | - Xiaoling Lv
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, China
- Zhejiang Provincial Key Lab of Geriatrics, Geriatrics Institute of Zhejiang Province, Hangzhou, China
| | - Caijuan Si
- Department of Nutrition, Zhejiang Hospital, Hangzhou, China
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28
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Di Y, Ding L, Gao L, Huang H. Association of meat consumption with the risk of gastrointestinal cancers: a systematic review and meta-analysis. BMC Cancer 2023; 23:782. [PMID: 37612616 PMCID: PMC10463360 DOI: 10.1186/s12885-023-11218-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 07/24/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND The association between gastrointestinal cancer and types of meat consumption, including red meat, processed meat, or a combination of both, remains disputable. Therefore, we performed a systematic review and meta-analysis of prospective cohort studies to estimate the association between meat consumption and gastrointestinal cancer risk. METHODS PubMed, EmBase, and the Cochrane library databases were searched systematically for eligible studies that investigated the relation between meat consumption and the risk of developing gastrointestinal cancers, including esophageal cancer (EC), gastric cancer (GC), colorectal cancer (CRC), colon cancer (CC), rectal cancer (RC), pancreatic cancer (PC), and hepatocellular carcinoma (HCC) throughout February, 2023. The pooled relative risk (RR) with 95% confidence interval (CI) was assigned as an effect estimate and calculated using a random-effects model with inverse variance weighting. RESULTS Forty cohorts comprising 3,780,590 individuals were selected for the final quantitative analysis. The summary results indicated that a higher red meat consumption was associated with an increased risk of CRC (RR: 1.09; 95% CI: 1.02-1.16; P = 0.007) and CC (RR: 1.13; 95% CI: 1.03-1.25; P = 0.011). Moreover, a higher processed meat consumption was associated with an increased risk of CRC (RR: 1.19; 95% CI: 1.13-1.26; P < 0.001), CC (RR: 1.24; 95% CI: 1.13-1.26; P < 0.001), and RC (RR: 1.24; 95% CI: 1.08-1.42; P = 0.002). Furthermore, a higher total consumption of red and processed meat was associated with an increased risk of CRC (RR: 1.13; 95% CI: 1.06-1.20; P < 0.001), CC (RR: 1.17; 95% CI: 1.04-1.33; P = 0.012), and RC (RR: 1.20; 95% CI: 1.04-1.39; P = 0.016). Finally, the strength of higher consumption of total red and processed meat with the risk of GC, and higher consumption of red meat with the risk of RC in subgroup of high adjusted level was lower than subgroup of moderate adjusted level, while the strength of higher consumption of processed meat with the risk of RC and HCC in subgroup of follow-up ≥ 10.0 years was higher than subgroup of follow-up < 10.0 years. CONCLUSIONS This study found that meat consumption was associated with an increased risk of CRC, CC, and RC, and dietary intervention could be considered an effective strategy in preventing CRC.
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Affiliation(s)
- Yan Di
- Department of Medical Oncology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Lei Ding
- Department of Oncology Surgery/ Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
| | - Luying Gao
- Department of Ultrasond/Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hongyan Huang
- Department of Medical Oncology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
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Bergengren O, Pekala KR, Matsoukas K, Fainberg J, Mungovan SF, Bratt O, Bray F, Brawley O, Luckenbaugh AN, Mucci L, Morgan TM, Carlsson SV. 2022 Update on Prostate Cancer Epidemiology and Risk Factors-A Systematic Review. Eur Urol 2023; 84:191-206. [PMID: 37202314 PMCID: PMC10851915 DOI: 10.1016/j.eururo.2023.04.021] [Citation(s) in RCA: 293] [Impact Index Per Article: 146.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/29/2023] [Accepted: 04/20/2023] [Indexed: 05/20/2023]
Abstract
CONTEXT Prostate cancer (PCa) is one of the most common cancers worldwide. Understanding the epidemiology and risk factors of the disease is paramount to improve primary and secondary prevention strategies. OBJECTIVE To systematically review and summarize the current evidence on the descriptive epidemiology, large screening studies, diagnostic techniques, and risk factors of PCa. EVIDENCE ACQUISITION PCa incidence and mortality rates for 2020 were obtained from the GLOBOCAN database of the International Agency for Research on Cancer. A systematic search was performed in July 2022 using PubMed/MEDLINE and EMBASE biomedical databases. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines and was registered in PROSPERO (CRD42022359728). EVIDENCE SYNTHESIS Globally, PCa is the second most common cancer, with the highest incidence in North and South America, Europe, Australia, and the Caribbean. Risk factors include age, family history, and genetic predisposition. Additional factors may include smoking, diet, physical activity, specific medications, and occupational factors. As PCa screening has become more accepted, newer approaches such as magnetic resonance imaging (MRI) and biomarkers have been implemented to identify patients who are likely to harbor significant tumors. Limitations of this review include the evidence being derived from meta-analyses of mostly retrospective studies. CONCLUSIONS PCa remains the second most common cancer among men worldwide. PCa screening is gaining acceptance and will likely reduce PCa mortality at the cost of overdiagnosis and overtreatment. Increasing use of MRI and biomarkers for the detection of PCa may mitigate some of the negative consequences of screening. PATIENT SUMMARY Prostate cancer (PCa) remains the second most common cancer among men, and screening for PCa is likely to increase in the future. Improved diagnostic techniques can help reduce the number of men who need to be diagnosed and treated to save one life. Avoidable risk factors for PCa may include factors such as smoking, diet, physical activity, specific medications, and certain occupations.
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Affiliation(s)
- Oskar Bergengren
- Department of Surgery (Urology Service), Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
| | - Kelly R Pekala
- Department of Surgery (Urology Service), Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Jonathan Fainberg
- Department of Surgery (Urology Service), Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sean F Mungovan
- Westmead Private Physiotherapy Services and The Clinical Research Institute, Westmead Private Hospital, Sydney, Australia
| | - Ola Bratt
- Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Freddie Bray
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Otis Brawley
- Department of Oncology, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Lorelei Mucci
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Todd M Morgan
- Department of Urology, University of Michigan, Ann Arbor, MI, USA
| | - Sigrid V Carlsson
- Department of Surgery (Urology Service), Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Dougherty TP, Meyer JE. Comparing Lifestyle Modifications and the Magnitude of Their Associated Benefit on Cancer Mortality. Nutrients 2023; 15:2038. [PMID: 37432170 DOI: 10.3390/nu15092038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/16/2023] [Accepted: 04/20/2023] [Indexed: 07/12/2023] Open
Abstract
Many cancers are associated with poor diet, lack of physical activity, and excess weight. Improving any of these three lifestyle factors would likely reduce cancer deaths. However, modifications to each of these-better nutrition, enhanced activity and fitness, and loss of extra body fat-have different effect sizes on cancer mortality. This review will highlight the relative benefit that each lifestyle change, enacted prior to a diagnosis of cancer, might impart on cancer-related deaths, as well as attempt to quantify the changes required to derive such a benefit. The review relies primarily on epidemiological data, with meta-analyses serving as the backbone for comparisons across interventions and individual studies within the larger meta-analyses providing the data necessary to form more quantitative conclusions. The reader can then use this information to better understand, recommend, and implement behaviors that might ultimately reduce cancer mortality. Of all the interventions, it seems clear that exercise, specifically improving cardiorespiratory fitness, is the best way to decrease the risk of dying from cancer.
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Affiliation(s)
- Timothy P Dougherty
- Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA 19111-2497, USA
| | - Joshua E Meyer
- Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA 19111-2497, USA
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González-Palacios Torres C, Barrios-Rodríguez R, Muñoz-Bravo C, Toledo E, Dierssen T, Jiménez-Moleón JJ. Mediterranean diet and risk of breast cancer: An umbrella review. Clin Nutr 2023; 42:600-608. [PMID: 36893621 DOI: 10.1016/j.clnu.2023.02.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 01/27/2023] [Accepted: 02/15/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND The Mediterranean Diet (MedDiet) is a healthy dietary pattern which has been related to a lower risk of certain chronic diseases, such as some cancers. However, its role in breast cancer development remains unclear. This umbrella review aims to summarize the highest available evidence on MedDiet and breast cancer risk. METHODS Pubmed, Web of Science, and Scopus electronic platforms were searched for relevant systematic reviews and meta-analyses. The selection criteria included systematic reviews with or without meta-analysis including women aged 18 years or older which evaluated the adherence to a MedDiet as the exposure and incidence of breast cancer as the outcome variable. Overlapping and quality of the reviews using AMSTAR-2 tool were independently assessed by two authors. RESULTS Five systematic reviews and six systematic reviews with meta-analysis were included. Overall, 4 systematic reviews - two with and two without meta-analysis - were rated as of high quality. An inverse association was found in 5 of the 9 reviews which evaluated the role of MedDiet on the risk of total breast cancer. The meta-analyses showed moderate-high heterogeneity. The risk reduction seemed to be more consistent among postmenopausal women. No association was found for MedDiet among premenopausal women. CONCLUSIONS The results of this umbrella review suggest that adherence to a MedDiet pattern had a protective effect on the risk of breast cancer, especially for postmenopausal breast cancer. The stratification of breast cancer cases and conducting high-quality reviews are aspects needed to overcome the current results' heterogeneity and to improve knowledge in this field.
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Affiliation(s)
| | - Rocío Barrios-Rodríguez
- Universidad de Granada, Departamento de Medicina Preventiva y Salud Pública, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Spain
| | - Carlos Muñoz-Bravo
- Department of Public Health and Psychiatry, School of Medicine, University of Málaga, Málaga, Spain; Biomedical Research Institute of Malaga (IBIMA), Málaga, Spain.
| | - Estefanía Toledo
- Department of Preventive Medicine and Public Health, University of Navarra-School of Medicine, Pamplona, Navarra, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Navarra, Spain
| | - Trinidad Dierssen
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Spain; Universidad de Cantabria - IDIVAL, Santander, Spain
| | - José Juan Jiménez-Moleón
- Universidad de Granada, Departamento de Medicina Preventiva y Salud Pública, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Spain
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Kastrinos F, Kupfer SS, Gupta S. Colorectal Cancer Risk Assessment and Precision Approaches to Screening: Brave New World or Worlds Apart? Gastroenterology 2023; 164:812-827. [PMID: 36841490 PMCID: PMC10370261 DOI: 10.1053/j.gastro.2023.02.021] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/12/2023] [Accepted: 02/17/2023] [Indexed: 02/27/2023]
Abstract
Current colorectal cancer (CRC) screening recommendations take a "one-size-fits-all" approach using age as the major criterion to initiate screening. Precision screening that incorporates factors beyond age to risk stratify individuals could improve on current approaches and optimally use available resources with benefits for patients, providers, and health care systems. Prediction models could identify high-risk groups who would benefit from more intensive screening, while low-risk groups could be recommended less intensive screening incorporating noninvasive screening modalities. In addition to age, prediction models incorporate well-established risk factors such as genetics (eg, family CRC history, germline, and polygenic risk scores), lifestyle (eg, smoking, alcohol, diet, and physical inactivity), sex, and race and ethnicity among others. Although several risk prediction models have been validated, few have been systematically studied for risk-adapted population CRC screening. In order to envisage clinical implementation of precision screening in the future, it will be critical to develop reliable and accurate prediction models that apply to all individuals in a population; prospectively study risk-adapted CRC screening on the population level; garner acceptance from patients and providers; and assess feasibility, resources, cost, and cost-effectiveness of these new paradigms. This review evaluates the current state of risk prediction modeling and provides a roadmap for future implementation of precision CRC screening.
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Affiliation(s)
- Fay Kastrinos
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York; Division of Digestive and Liver Diseases, Columbia University Medical Center and Vagelos College of Physicians and Surgeons, New York, New York.
| | - Sonia S Kupfer
- University of Chicago, Section of Gastroenterology, Hepatology and Nutrition, Chicago, Illinois
| | - Samir Gupta
- Division of Gastroenterology, Department of Internal Medicine, University of California, San Diego, La Jolla, California; Veterans Affairs San Diego Healthcare System, San Diego, California
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Yuan L, Hu H, Li T, Zhang J, Feng Y, Yang X, Li Y, Wu Y, Li X, Huang H, Hu F, Chen C, Zhang M, Zhao Y, Hu D. Dose-response meta-analysis of ultra-processed food with the risk of cardiovascular events and all-cause mortality: evidence from prospective cohort studies. Food Funct 2023; 14:2586-2596. [PMID: 36866803 DOI: 10.1039/d2fo02628g] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Background: Previous meta-analyses included abundant cross-sectional studies, and/or only assessed high versus low categories of UPF consumption. We conducted this meta-analysis based on prospective cohort studies to estimate the dose-response associations of UPF consumption with the risk of cardiovascular events (CVEs) and all-cause mortality among general adults. Methods: PubMed, Embase, and Web of Science were searched for relevant articles published up to August 17, 2021, and newly published articles between August 17, 2021 and July 21, 2022 were re-searched. Random-effects models were used to estimate the summary relative risks (RRs) and confidence intervals (CIs). Generalized least squares regression was used to estimate the linear dose-response associations of each additional serving of UPF. Restricted cubic splines were used to model the possible nonlinear trends. Results: Eleven eligible papers (17 analyses) were finally identified. The pooled effect size for the highest versus lowest category of UPF consumption showed positive associations with the risk of CVEs (RR = 1.35, 95% CI, 1.18-1.54) and all-cause mortality (RR = 1.21, 95% CI, 1.15-1.27). For each additional daily serving of UPF, the risk increased by 4% (RR = 1.04, 95% CI, 1.02-1.06) for CVEs and 2% (RR = 1.02, 95% CI, 1.01-1.03) for all-cause mortality. With increasing UPF intake, the risk of CVEs reflected a linear upward trend (Pnonlinearity = 0.095), while all-cause mortality reflected a nonlinear upward trend (Pnonlinearity = 0.039). Conclusion: Our findings based on prospective cohorts suggested that any increased level of UPF consumption was linked to higher CVEs and mortality risk. Thus, the recommendation is to control the intake of UPF in daily diet.
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Affiliation(s)
- Lijun Yuan
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China.
| | - Huifang Hu
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China.
| | - Tianze Li
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Jinli Zhang
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Yifei Feng
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Xingjin Yang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yang Li
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Yuying Wu
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China.
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Xi Li
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Hao Huang
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China.
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Fulan Hu
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China.
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Chuanqi Chen
- Department of Endocrinology, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Guangdong, People's Republic of China
| | - Ming Zhang
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China.
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Yang Zhao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Dongsheng Hu
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China.
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Lukic M, Licaj I, Laaksonen MA, Weiderpass E, Borch KB, Rylander C. The burden of colon cancer attributable to modifiable factors-The Norwegian Women and Cancer Study. Int J Cancer 2023; 152:195-202. [PMID: 36054722 PMCID: PMC9804209 DOI: 10.1002/ijc.34237] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/05/2022] [Accepted: 07/25/2022] [Indexed: 01/05/2023]
Abstract
Colon cancer is the second most frequently diagnosed cancer in women in Norway, where incidence rates of colon cancer increased 3-fold between 1955 and 2014, for unknown reasons. We aimed to assess the burden of colon cancer attributable to modifiable risk factors in Norwegian women using the data from the Norwegian Women and Cancer (NOWAC) study. Self-reported information from 35 525 women from the NOWAC study were available. These included the following exposures: smoking status, alcohol consumption, body mass index, physical activity, intake of calcium, fibers, and red and processed meat. Colon cancer cases were identified from the Cancer Registry of Norway. A parametric piecewise constant hazards model was used to estimate the strength of exposure-cancer associations. Population attributable fractions with 95% confidence intervals (CIs) were calculated considering competing risk of death. The fraction of incident colon cancer attributable to ever smoking was 18.7% (95% CI 4.7%-30.6%), low physical activity 10.8% (95% CI -0.7% to 21.0%), alcohol consumption 14.5% (95% CI -2.8% to 28.9%), and low intake of calcium 10.0% (95% CI -7.8% to 24.8%). A small proportion of colon cancer cases was attributable to combined intake of red and processed meat over 500 g/week, overweight/obesity, and low intake of fibers. Jointly, these seven risk factors could explain 46.0% (95% CI 23.0%-62.4%) of the colon cancer incidence burden. Between 23% and 62% of the colon cancer burden among women in Norway was attributable to modifiable risk factors, indicating an important preventive potential of a healthy lifestyle.
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Affiliation(s)
- Marko Lukic
- Department of Community Medicine, Faculty of Health SciencesUiT The Arctic University of NorwayTromsøNorway
| | - Idlir Licaj
- Department of Community Medicine, Faculty of Health SciencesUiT The Arctic University of NorwayTromsøNorway
| | - Maarit A. Laaksonen
- Department of Statistics, School of Mathematics and StatisticsFaculty of Science, UNSWSydneyAustralia
| | | | - Kristin B. Borch
- Department of Community Medicine, Faculty of Health SciencesUiT The Arctic University of NorwayTromsøNorway
| | - Charlotta Rylander
- Department of Community Medicine, Faculty of Health SciencesUiT The Arctic University of NorwayTromsøNorway
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Du X, Yang R, Ma M, Ke S, Zheng J, Tan X. The association of energy and macronutrient intake at breakfast and cardiovascular disease in Chinese adults: From a 14-year follow-up cohort study. Front Nutr 2023; 10:1093561. [PMID: 37020811 PMCID: PMC10069285 DOI: 10.3389/fnut.2023.1093561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 02/13/2023] [Indexed: 04/07/2023] Open
Abstract
Background We aimed to examine the associations between energy and macronutrient intakes at breakfast and the incidence of cardiovascular events among Chinese adults. Methods There were 12,937 participants from the China Health and Nutrition Survey who met the study criteria and completed six rounds of questionnaires in 1997, 2000, 2004, 2006, 2009, and 2011. Combined weighing methods with 24-h dietary recall were used to measure dietary intake throughout the day. Intakes of macronutrients at breakfast were calculated using energy provided by nutrients as a percentage of breakfast energy. We calculated hazard ratios using a multivariable Cox frailty model with random intercepts to account for household clustering. Results During follow-up, we documented 453 (3.6 per 1,000 person-years) major cardiovascular events, 195 (1.5 per 1,000 person-years) myocardial infarctions, and 293 (2.3 per 1,000 person-years) strokes. In Chinese adults, more breakfast carbohydrates or less proteins intake was associated with the reduced risk of cardiovascular diseases. Especially for women, higher intake of breakfast carbohydrates was associated with a lower risk of major cardiovascular events (quintile 5 vs. quintile 1, HR 0.47 [95%CI 0.30-0.74]; p trend = 0.0008) and stroke (quintile 5 vs. quintile 1, HR 0.48 [95%CI 0.26-0.88]; p trend = 0.0006). Higher intake of breakfast proteins was associated with a higher risk of major cardiovascular events (quintile 5 vs. quintile 1, HR 1.77 [95%CI 1.12-2.79]; p trend = 0.1162), myocardial infarction (quintile 5 vs. quintile 1, HR 2.49 [95%CI 1.21-5.11]; p trend = 0.2641). There was a significant association between breakfast fat intake and cardiovascular diseases in the adult population, but less significant correlation was found in Chinese men or women. Breakfast fat intake was positively associated with the risk of major cardiovascular events (quintile 5 vs. quintile 1, HR 1.74 [95%CI 1.27-2.36]; p trend = 0.0070), myocardial infarction (quintile 5 vs. quintile 1, HR 2.03 [95%CI 1.23-3.37]; p trend = 0.0168), and stroke (quintile 5 vs. quintile 1, HR 1.64 [95%CI 1.12-2.41]; p trend = 0.0732). There was a significant reduction in major cardiovascular events and stroke when breakfast energy intake was moderated, even if the independence of skipping breakfast. Conclusion High carbohydrate intake and low protein and fat intake at breakfast may contribute to cardiovascular health while maintaining a moderate energy intake.
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Affiliation(s)
- Xiaoan Du
- Wuhan Blood Center, Institute of Blood Transfusion of Hubei Province, Wuhan, China
| | - Ru Yang
- Wuhan Blood Center, Institute of Blood Transfusion of Hubei Province, Wuhan, China
| | - Mengdi Ma
- Wuhan Blood Center, Institute of Blood Transfusion of Hubei Province, Wuhan, China
| | - Songqing Ke
- Wuhan Blood Center, Institute of Blood Transfusion of Hubei Province, Wuhan, China
| | - Jie Zheng
- Wuhan Blood Center, Institute of Blood Transfusion of Hubei Province, Wuhan, China
- *Correspondence: Jie Zheng,
| | - Xiaodong Tan
- School of Public Health, Wuhan University, Wuhan, China
- School of Health and Nursing, Wuchang University of Technology, Wuhan, China
- Xiaodong Tan,
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Qin X, Xu X, Hou X, Liang R, Chen L, Hao Y, Gao A, Du X, Zhao L, Shi Y, Li Q. The pharmacological properties and corresponding mechanisms of farrerol: a comprehensive review. PHARMACEUTICAL BIOLOGY 2022; 60:9-16. [PMID: 34846222 PMCID: PMC8635655 DOI: 10.1080/13880209.2021.2006723] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
CONTEXT Farrerol, a typical natural flavanone isolated from the traditional Chinese herb 'Man-shan-hong' [Rhododendron dauricum L. (Ericaceae)] with phlegm-reducing and cough-relieving properties, is widely used in China for treating bronchitis and asthma. OBJECTIVE To present the anti-inflammatory, antioxidant, vasoactive, antitumor, and antimicrobial effects of farrerol and its underlying molecular mechanisms. METHODS The literature was reviewed by searching PubMed, Medline, Web of Knowledge, Scopus, and Google Scholar databases between 2011 and May 2021. The following key words were used: 'farrerol,' 'flavanone,' 'anti-inflammatory,' 'antioxidant,' 'vasoactive,' 'antitumor,' 'antimicrobial,' and 'molecular mechanisms'. RESULTS Farrerol showed anti-inflammatory effects mainly mediated via the inhibition of interleukin (IL)-6/8, IL-1β, tumour necrosis factor(TNF)-α, NF-κB, NO, COX-2, JNK1/2, AKT, PI3K, ERK1/2, p38, Keap-1, and TGF-1β. Farrerol exhibited antioxidant effects by decreasing JNK, MDA, ROS, NOX4, Bax/Bcl-2, caspase-3, p-p38 MAPK, and GSK-3β levels and enhancing Nrf2, GSH, SOD, GSH-Px, HO-1, NQO1, and p-ERK levels. The vasoactive effects of farrerol were also shown by the reduced α-SMA, NAD(P)H, p-ERK, p-Akt, mTOR, Jak2, Stat3, Bcl-2, and p38 levels, but increased OPN, occludin, ZO-1, eNOS, CaM, IP3R, and PLC levels. The antitumor effects of farrerol were evident from the reduced Bcl-2, Slug, Zeb-1, and vimentin levels but increased p27, ERK1/2, p38, caspase-9, Bax, and E-cadherin levels. Farrerol reduced α-toxin levels and increased NO production and NF-κB activity to impart antibacterial activity. CONCLUSIONS This review article provides a theoretical basis for further studies on farrerol, with a view to develop and utilise farrerol for treating of vascular-related diseases in the future.
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Affiliation(s)
- Xiaojiang Qin
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
- CONTACT Xiaojiang Qin School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Xinrong Xu
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Xiaomin Hou
- Department of Pharmacology, Shanxi Medical University, Shanxi, China
| | - Ruifeng Liang
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Liangjing Chen
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yuxuan Hao
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Anqi Gao
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Xufeng Du
- Department of Exercise Rehabilitation, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Liangyuan Zhao
- Department of Exercise Rehabilitation, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yiwei Shi
- Department of Respiratory and Critical Care Medicine, Shanxi Medical University Affiliated First Hospital, Taiyuan, Shanxi, China
| | - Qingshan Li
- School of Pharmaceutical Science, Shanxi Medical University, Taiyuan, Shanxi, China
- Shanxi Key Laboratory of Chronic Inflammatory Targeted Drugs, School of Materia Medica, Shanxi University of Traditional Chinese Medicine, Taiyuan, Shanxi, China
- Qingshan Li School of Pharmaceutical Science, Shanxi Medical University, Taiyuan, Shanxi, China
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Promote Community Engagement in Participatory Research for Improving Breast Cancer Prevention: The P.I.N.K. Study Framework. Cancers (Basel) 2022; 14:cancers14235801. [PMID: 36497282 PMCID: PMC9736257 DOI: 10.3390/cancers14235801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/15/2022] [Accepted: 11/21/2022] [Indexed: 11/27/2022] Open
Abstract
Breast cancer (BC) has overtaken lung cancer as the most common cancer in the world and the projected incidence rates show a further increase. Early detection through population screening remains the cornerstone of BC control, but a progressive change from early diagnosis only-based to a personalized preventive and risk-reducing approach is widely debated. Risk-stratification models, which also include personal lifestyle risk factors, are under evaluation, although the documentation burden to gather population-based data is relevant and traditional data collection methods show some limitations. This paper provides the preliminary results from the analysis of clinical data provided by radiologists and lifestyle data collected using self-administered questionnaires from 5601 post-menopausal women. The weight of the combinations of women's personal features and lifestyle habits on the BC risk were estimated by combining a model-driven and a data-driven approach to analysis. The weight of each factor on cancer occurrence was assessed using a logistic model. Additionally, communities of women sharing common features were identified and combined in risk profiles using social network analysis techniques. Our results suggest that preventive programs focused on increasing physical activity should be widely promoted, in particular among the oldest women. Additionally, current findings suggest that pregnancy, breast-feeding, salt limitation, and oral contraception use could have different effects on cancer risk, based on the overall woman's risk profile. To overcome the limitations of our data, this work also introduces a mobile health tool, the Dress-PINK, designed to collect real patients' data in an innovative way for improving women's response rate, data accuracy, and completeness as well as the timeliness of data availability. Finally, the tool provides tailored prevention messages to promote critical consciousness, critical thinking, and increased health literacy among the general population.
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Tsai CY, Jiesisibieke ZL, Tung TH. Association between dry eye disease and depression: An umbrella review. Front Public Health 2022; 10:910608. [PMID: 36466469 PMCID: PMC9713230 DOI: 10.3389/fpubh.2022.910608] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 10/26/2022] [Indexed: 11/18/2022] Open
Abstract
PURPOSE This umbrella review aimed to summarize the available evidence on the association between dry eye disease and depression. METHODS We searched the Pubmed, Embase, and Cochrane databases using the search string "(Dry eye syndrome OR Keratoconjunctivitis sicca OR KCS OR Aqueous tear deficiency OR Sjogren syndrome) AND (depression OR depressive symptoms) AND (meta-analysis OR systematic review)" from inception to 20 July 2022. We considered all meta-analyses investigating the association between dry eye disease and depression. RESULTS After summarizing the included meta-analyses, it was concluded that dry eye disease is associated with depression. The symptoms of dry eye disease affect the daily lives of patients, thus affecting their mood. However, further evidence is required to confirm this association. CONCLUSION This finding highlights the importance of psychological support for patients with dry eye disease. Future clinical studies should investigate the mechanism underlying the association between dry eye disease and depression. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022320619.
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Affiliation(s)
- Ching-Yao Tsai
- Department of Ophthalmology, Taipei City Hospital, Taipei, Taiwan
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Business Administration, Fu Jen Catholic University, Taipei, Taiwan
- General Education Center, University of Taipei, Taipei, Taiwan
| | - Zhu Liduzi Jiesisibieke
- Li Ka Shing Faculty of Medicine, School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Tao-Hsin Tung
- Taiwan Association of Health Industry Management and Development, Taipei, Taiwan
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Gianfredi V, Ferrara P, Dinu M, Nardi M, Nucci D. Diets, Dietary Patterns, Single Foods and Pancreatic Cancer Risk: An Umbrella Review of Meta-Analyses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14787. [PMID: 36429506 PMCID: PMC9691178 DOI: 10.3390/ijerph192214787] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/06/2022] [Accepted: 11/08/2022] [Indexed: 06/16/2023]
Abstract
Pancreatic cancer (PC) represents the third leading cause of cancer death in 2020. Despite the fact that, in 2018, the World Cancer Research Fund report concluded that there is still a lack of evidence on the role of foods or diets and risk for PC, a flourishing body of evidence has been published and needs to be analyzed. For this reason, we conducted an umbrella review on the association between different dietary patterns/food components and PC. Data sources PubMed/MEDLINE, Scopus, Web of Science, EMBASE, and the Cochrane Collaboration were searched. The Joanna Briggs Institute Umbrella Review Methodology was used. The protocol was registered in PROSPERO. A total of 23 articles were included, covering a wide range of dietary patterns/food components: healthy/prudent dietary patterns (n = 4), Mediterranean diets (MedDiet) (n = 1), plant-based diets (n = 2), the Dietary Inflammatory Index (DII) (n = 2), western diets (n = 2), and, lastly, unhealthy diets (n = 2). Regarding dietary components, the following were assessed: total fruit (n = 2), citrus fruit (n = 1), total vegetables (n = 2), cruciferous vegetables (n = 1), red meat (n = 6), processed meat (n = 4), poultry (n = 2), eggs (n = 1), fish (n = 5), whole grain (n = 2), potato (n = 1), and nuts (n = 2). The methodological quality of the included meta-analyses was generally low or critically low. Although the strength of evidence was generally weak, convincing or suggestive evidence was found for a healthy/prudent, plant-based diet, fruit and vegetables, and lower risk of PC, whereas a high intake of red meat was associated with a higher risk of PC at a convincing level of evidence. Further studies are needed to confirm the role of the other dietary patterns/food components and the risk of PC.
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Affiliation(s)
- Vincenza Gianfredi
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133 Milan, Italy
- CAPHRI Care and Public Health Research Institute, Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Pietro Ferrara
- Center for Public Health Research, University of Milan-Bicocca, 20900 Monza, Italy
- IRCCS Istituto Auxologico Italiano, 20145 Milan, Italy
| | - Monica Dinu
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Mariateresa Nardi
- Nutritional Support Unit, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata, 64, 35128 Padua, Italy
| | - Daniele Nucci
- Nutritional Support Unit, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata, 64, 35128 Padua, Italy
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Wolska A, Stasiewicz B, Kaźmierczak-Siedlecka K, Ziętek M, Solek-Pastuszka J, Drozd A, Palma J, Stachowska E. Unhealthy Food Choices among Healthcare Shift Workers: A Cross-Sectional Study. Nutrients 2022; 14:nu14204327. [PMID: 36297011 PMCID: PMC9611829 DOI: 10.3390/nu14204327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 10/09/2022] [Accepted: 10/12/2022] [Indexed: 11/07/2022] Open
Abstract
Shift healthcare workers are a group particularly exposed to an increased risk of poor eating habits and are affected by many diseases. The aim of the study was to evaluate the dietary patterns (DPs), including the Polish-adapted Mediterranean Diet (Polish-aMED®) score, and dietary fat intake in association with the shift work of healthcare workers. This cross-sectional study involved 445 healthcare workers from the West Pomeranian in Poland. Dietary data were collected using an FFQ-6®. A posteriori DPs were derived with a Principal Component Analysis (PCA). The Polish-aMED® score and the individual’s percentage of energy from dietary fat (Pfat) were calculated. Healthcare shift work compared to the daily work was associated with approximately 2-times higher odds of adherence to the ‘Meat/fats/alcohol/fish’ DP in the upper tertile (OR: 2.38; 95% Cl: 1.27−4.47; p < 0.01) and higher Pfat >35% of total energy intake (OR: 1.73; 95% Cl: 1.06−2.83; p < 0.05). Healthcare shift work compared to the daily work was associated with approximately 50% lower odds of adherence to the ‘Pro-healthy’ DP in the middle tertile (OR: 0.48; 95% Cl: 0.26−0.89; p < 0.05) and a higher level of the Polish-aMED® score (OR: 0.57; 95% Cl: 0.33−0.98; p < 0.05), as well as lower odds of the constants of mealtime (OR: 0.54; 95% Cl: 0.33−0.89; p < 0.05). The obtained findings highlight the unhealthy food choices among shift healthcare workers. Thus, to avoid the negative health consequences, there is a need for nutritional education for healthcare workers, especially those working shifts.
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Affiliation(s)
- Anna Wolska
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University, 70-204 Szczecin, Poland
| | - Beata Stasiewicz
- Department of Human Nutrition, Faculty of Food Sciences, University of Warmia and Mazury in Olsztyn, Sloneczna 45F, 10-718 Olsztyn, Poland
| | - Karolina Kaźmierczak-Siedlecka
- Department of Surgical Oncology, Faculty of Medicine, Medical University of Gdańsk, Smoluchowskiego 18, 80-214 Gdańsk, Poland
| | - Maciej Ziętek
- Department of Perinatology, Obstetrics and Gynecology, Pomeranian Medical University, 70-204 Szczecin, Poland
| | - Joanna Solek-Pastuszka
- Department of Anesthesiology and Intensive Therapy, Pomeranian Medical University, 70-204 Szczecin, Poland
| | - Arleta Drozd
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University, 70-204 Szczecin, Poland
| | - Joanna Palma
- Department of Biochemical Science, Pomeranian Medical University in Szczecin, 71-460 Szczecin, Poland
- Correspondence: (J.P.); (E.S.)
| | - Ewa Stachowska
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University, 70-204 Szczecin, Poland
- Correspondence: (J.P.); (E.S.)
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Zhao Y, Qiu P, Yan L, Li S, Yang Z, Zhang H, He J, Zhou C. Epidemiological trends of female breast and gynecologic cancers in adolescents and young adults in China from 1990 to 2019: Results from the Global Burden of Disease Study 2019. Front Oncol 2022; 12:1003710. [PMID: 36313685 PMCID: PMC9606349 DOI: 10.3389/fonc.2022.1003710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 09/23/2022] [Indexed: 12/03/2022] Open
Abstract
Background Research on the incidence, mortality, and disability-adjusted life years (DALYs) of female breast and gynecologic cancers (FeBGCs) and the relevant risk factors for adolescents and young adults (AYAs) are valuable for policy-making in China. We aimed to estimate the incidence, deaths, and DALYs and predict epidemiological trends of FeBGCs among AYAs in China between 1990 and 2019. Methods Data from the 2019 Global Burden of Disease (GBD) study between 1990 and 2019 in 195 countries and territories were retrieved. Data about the number of FeBGC incident cases, deaths, DALYs, age-standardized rates (ASRs), and estimated annual percentage changes (EAPCs) were extracted. A comparative risk assessment framework was performed to estimate the risk factors attributable to breast cancer deaths and DALYs, and autoregressive integrated moving average (ARIMA) models were fitted for time-series analysis to predict female cancer morbidity and mortality among Chinese AYAs until 2030. Results In 2019, there are 61,038 incidence cases, 8,944 deaths, and 529,380 DALYs of FeBGCs among the AYAs in China, respectively. The estimated annual percentage change (EAPC) values were positive scores (>0) in ASIRs and negative scores (<0) in ASMR and ASDR. Furthermore, in 2030, the incidence rate of FeBGCs would grow to 30.49 per 100,000 in China, while the mortality rate would maintain a steady state. Of the deaths and DALYs, diet high in red meat was the greatest contributor to breast cancer, while a high body mass index (BMI) was the greatest contributor to cervical, ovarian, and uterine cancers. Conclusion The increasing Chinese FeBGC burden is mainly observed in AYAs and non-red meat diet, and the control of body weight could reduce FeBGC burden in China.
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Affiliation(s)
- Yuting Zhao
- Department of Breast Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- School of Medicine, Xi’an Jiaotong University, Xi’an, China
| | - Pei Qiu
- Department of Breast Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- School of Medicine, Xi’an Jiaotong University, Xi’an, China
| | - Lutong Yan
- Department of Breast Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- School of Medicine, Xi’an Jiaotong University, Xi’an, China
| | - Shouyu Li
- Department of Breast Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- School of Medicine, Xi’an Jiaotong University, Xi’an, China
| | - Zejian Yang
- Department of Breast Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- School of Medicine, Xi’an Jiaotong University, Xi’an, China
| | - Huimin Zhang
- Department of Breast Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Jianjun He
- Department of Breast Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Can Zhou
- Department of Breast Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
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Collatuzzo G, Etemadi A, Sotoudeh M, Nikmanesh A, Poustchi H, Khoshnia M, Pourshams A, Hashemian M, Roshandel G, Dawsey SM, Abnet CC, Kamangar F, Brennan P, Boffetta P, Malekzadeh R. Meat consumption and risk of esophageal and gastric cancer in the Golestan Cohort Study, Iran. Int J Cancer 2022; 151:1005-1012. [PMID: 35489023 PMCID: PMC9543688 DOI: 10.1002/ijc.34056] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/25/2022] [Accepted: 03/29/2022] [Indexed: 11/12/2022]
Abstract
Red meat and processed meat are associated with some gastrointestinal cancers. Our study aims to investigate the association of different meat types with esophageal and gastric cancer (EC, GC) in a high-risk population. The Golestan Cohort Study (GCS) is a population-based cohort of 50 045 individuals aged 40 to 75 from northeast Iran. Detailed data on different exposures were collected using validated questionnaires. We considered quintiles of meat consumption, using grams and density (g/1000 kcal/day). We calculated intake of red, processed, organ and white meat, as well as total red meat, including the first three. We used proportional hazards regression models to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) for the association between meat types and cancer. During 12 years of follow-up, out of 49 585 participants (57.4% women), 369 developed EC (48.2% women) and 368 developed GC (27.5% women), including 309 esophageal squamous cell, 20 esophageal adenocarcinomas, 216 cardia and 95 non-cardia GC. No association was found for EC except for red meat among females (HR for one quintile increase 1.13, 95% CI = 1.00-1.27). The risk of GC increased for intake of total red meat (HR 1.08, 95% CI = 1.00-1.17) and red meat separately (HR 1.09, 95% CI = 1.00-1.18). The HR for red meat and non-cardia GC was 1.23 (95% CI = 1.02-1.48). No associations were observed for other types of meat. In conclusion, in this high-risk population red meat intake is associated with GC, but not EC, suggesting a substantial role of this modifiable factor in determining the burden of GC.
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Affiliation(s)
- Giulia Collatuzzo
- Department of Medical and Surgical SciencesUniversity of BolognaBolognaItaly
| | - Arash Etemadi
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and GeneticsNational Cancer InstituteBethesdaMarylandUSA
- Digestive Oncology Research Center, Digestive Diseases Research InstituteTehran University of Medical Sciences, Shariati HospitalTehranIran
| | - Masoud Sotoudeh
- Digestive Oncology Research Center, Digestive Diseases Research InstituteTehran University of Medical Sciences, Shariati HospitalTehranIran
| | - Arash Nikmanesh
- Digestive Oncology Research Center, Digestive Diseases Research InstituteTehran University of Medical Sciences, Shariati HospitalTehranIran
| | - Hossein Poustchi
- Digestive Oncology Research Center, Digestive Diseases Research InstituteTehran University of Medical Sciences, Shariati HospitalTehranIran
| | - Masoud Khoshnia
- Digestive Oncology Research Center, Digestive Diseases Research InstituteTehran University of Medical Sciences, Shariati HospitalTehranIran
- Golestan Research Center of Gastroenterology and HepatologyGolestan University of Medical SciencesGorganIran
| | - Akram Pourshams
- Digestive Oncology Research Center, Digestive Diseases Research InstituteTehran University of Medical Sciences, Shariati HospitalTehranIran
| | - Maryam Hashemian
- Digestive Oncology Research Center, Digestive Diseases Research InstituteTehran University of Medical Sciences, Shariati HospitalTehranIran
- Department of Biology, School of Art and SciencesUtica CollegeUticaNew YorkUSA
| | - Gholamreza Roshandel
- Digestive Oncology Research Center, Digestive Diseases Research InstituteTehran University of Medical Sciences, Shariati HospitalTehranIran
- Golestan Research Center of Gastroenterology and HepatologyGolestan University of Medical SciencesGorganIran
| | - Sanford M. Dawsey
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and GeneticsNational Cancer InstituteBethesdaMarylandUSA
| | - Christian C. Abnet
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and GeneticsNational Cancer InstituteBethesdaMarylandUSA
| | - Farin Kamangar
- Department of Biology, School of Computer, Mathematical, and Natural SciencesMorgan State UniversityBaltimoreMarylandUSA
| | - Paul Brennan
- Section of GeneticsInternational Agency for Research on CancerLyonFrance
| | - Paolo Boffetta
- Department of Medical and Surgical SciencesUniversity of BolognaBolognaItaly
- Stony Brook Cancer CenterStony Brook UniversityStony BrookNew YorkUSA
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research InstituteTehran University of Medical Sciences, Shariati HospitalTehranIran
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De Pretis F, Jukola S, Landes J. E-synthesis for carcinogenicity assessments: A case study of processed meat. J Eval Clin Pract 2022; 28:752-772. [PMID: 35754297 DOI: 10.1111/jep.13697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 04/09/2022] [Accepted: 04/28/2022] [Indexed: 11/27/2022]
Abstract
RATIONALE, AIMS AND OBJECTIVES Recent controversies about dietary advice concerning meat demonstrate that aggregating the available evidence to assess a putative causal link between food and cancer is a challenging enterprise. METHODS We show how a tool developed for assessing putative causal links between drugs and adverse drug reactions, E-Synthesis, can be applied for food carcinogenicity assessments. The application is demonstrated on the putative causal relationship between processed meat consumption and cancer. RESULTS The output of the assessment is a Bayesian probability that processed meat consumption causes cancer. This Bayesian probability is calculated from a Bayesian network model, which incorporates a representation of Bradford Hill's Guidelines as probabilistic indicators of causality. We show how to determine probabilities of indicators of causality for food carcinogenicity assessments based on assessments of the International Agency for Research on Cancer. CONCLUSIONS We find that E-Synthesis is a tool well-suited for food carcinogenicity assessments, as it enables a graphical representation of lines and weights of evidence, offers the possibility to make a great number of judgements explicit and transparent, outputs a probability of causality suitable for decision making and is flexible to aggregate different kinds of evidence.
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Affiliation(s)
- Francesco De Pretis
- Department of Communication and Economics, University of Modena and Reggio Emilia, Reggio, Emilia, Italy
| | - Saana Jukola
- Department of Philosophy I, Ruhr-University Bochum, Bochum, Germany.,Institute for Medical Humanities, University Clinic Bonn, University of Bonn, Bonn, Germany
| | - Jürgen Landes
- Munich Center for Mathematical Philosophy, Faculty of Philosophy, Philosophy of Science and Study of Religion, Ludwig-Maximilians-Universität München, München, Germany.,Open Science Center, Ludwig-Maximilians-Universität München, München, Germany
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44
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Lescinsky H, Afshin A, Ashbaugh C, Bisignano C, Brauer M, Ferrara G, Hay SI, He J, Iannucci V, Marczak LB, McLaughlin SA, Mullany EC, Parent MC, Serfes AL, Sorensen RJD, Aravkin AY, Zheng P, Murray CJL. Health effects associated with consumption of unprocessed red meat: a Burden of Proof study. Nat Med 2022; 28:2075-2082. [PMID: 36216940 PMCID: PMC9556326 DOI: 10.1038/s41591-022-01968-z] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 07/26/2022] [Indexed: 12/19/2022]
Abstract
Characterizing the potential health effects of exposure to risk factors such as red meat consumption is essential to inform health policy and practice. Previous meta-analyses evaluating the effects of red meat intake have generated mixed findings and do not formally assess evidence strength. Here, we conducted a systematic review and implemented a meta-regression-relaxing conventional log-linearity assumptions and incorporating between-study heterogeneity-to evaluate the relationships between unprocessed red meat consumption and six potential health outcomes. We found weak evidence of association between unprocessed red meat consumption and colorectal cancer, breast cancer, type 2 diabetes and ischemic heart disease. Moreover, we found no evidence of an association between unprocessed red meat and ischemic stroke or hemorrhagic stroke. We also found that while risk for the six outcomes in our analysis combined was minimized at 0 g unprocessed red meat intake per day, the 95% uncertainty interval that incorporated between-study heterogeneity was very wide: from 0-200 g d-1. While there is some evidence that eating unprocessed red meat is associated with increased risk of disease incidence and mortality, it is weak and insufficient to make stronger or more conclusive recommendations. More rigorous, well-powered research is needed to better understand and quantify the relationship between consumption of unprocessed red meat and chronic disease.
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Affiliation(s)
- Haley Lescinsky
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Ashkan Afshin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Charlie Ashbaugh
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Catherine Bisignano
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Michael Brauer
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Giannina Ferrara
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Jiawei He
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Vincent Iannucci
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Laurie B Marczak
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Susan A McLaughlin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Erin C Mullany
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Marie C Parent
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Audrey L Serfes
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Reed J D Sorensen
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Aleksandr Y Aravkin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
- Department of Applied Mathematics, University of Washington, Seattle, WA, USA
| | - Peng Zheng
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Christopher J L Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA.
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The role of nutrition in harnessing the immune system: a potential approach to prevent cancer. MEDICAL ONCOLOGY (NORTHWOOD, LONDON, ENGLAND) 2022; 39:245. [PMID: 36180759 DOI: 10.1007/s12032-022-01850-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 09/08/2022] [Indexed: 10/14/2022]
Abstract
Cancer is a vital barrier to increase the life expectancy and the foremost cause of death globally. The initial diagnosis and proper management of cancer can expand the survival rate of individuals. This review provides an in-depth investigation of cancer causes symptoms, types of cancer, and worldwide distribution of cancer. The relation between nutrition (i.e., various food items) and cancer is also emphasized to offer a framework of nutrition management in different cancer types. The microbiota is closely associated with the occurrence of cancer. Thus, genomics of intestinal microbes and nutrigenomics have been discussed based on the reported meta-analysis studies. A dramatic increase in cancer rates has been observed due to intake of alcohol, microbial infections, and deficiency of nutrition. Malnutrition is a substantial problem in cancer patients linked with improper treatment and increased morbidity. The detail studies of cancer and nutrigenomics are an eminent approach to comprehend the relation between microbes and the consumption of certain food types which can further reduce the cancer risk. The incorporation of specific nutrients and probiotics improved the gut microbial health, increased life expectancy, and also decreased the incidence of tumorigenesis in individuals.
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Kong Y, Zhuo L, Dong D, Zhuo L, Lou P, Cai T, Chen S, Pan J, Gao Y, Lu H, Ma Y, Dong Z, Luo X, Zhao H. Validation of the Asia-Pacific colorectal screening score and its modified versions in predicting colorectal advanced neoplasia in Chinese population. BMC Cancer 2022; 22:961. [PMID: 36071414 PMCID: PMC9450334 DOI: 10.1186/s12885-022-10047-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 08/30/2022] [Indexed: 12/09/2022] Open
Abstract
BACKGROUND Colorectal cancer is one of the most common cancers in the world. Several studies suggest using the Asia-Pacific colorectal screening (APCS) score and its modified versions to select high-risk populations for early colonoscopy, but external validation remains rare, and which score should be selected for CRC screening in China is unclear. Validation of multiple scores in the same population might help to choose the best performing score. METHODS We conducted a cross-sectional study under the framework of Cancer Screening Program in Urban China, data from asymptomatic colorectal cancer screening in Xuzhou was used to validate the APCS score, the colorectal neoplasia predict (CNP) score, the Korean colorectal screening (KCS) score, the Modified APCS score and the 8-point risk score in predicting colorectal advanced neoplasia (CAN). RESULTS 1804 subjects were included in the analysis and 112 CAN (6.21%) was detected. In each score, the detection rate of CAN was higher in the high-risk group than in the non-high-risk group (P < 0.05), and the RR (95%C.I.) ranged 2.20 (1.50-3.22) [8-point risk] to 4.00 (2.41-6.65) [Modified APCS]. The c-statistics (95%C.I.) of the scoring systems ranged from 0.58 (0.53-0.62) [8-point risk] to 0.65 (0.61-0.69) [KCS]. The sensitivity (95%C.I.) of these systems ranged from 31.25 (22.83-40.70) [8-point risk] to 84.82 (76.81-90.90) [Modified APCS], while the specificity (95%C.I.) ranged from 43.50 (41.12-45.90) [Modified APCS] to 83.81 (81.96-85.53) [8-point risk]. Using the APCS scoring system as a comparator, the net reclassification improvement (NRI) of each modified version ranged from - 10.34% (95%C.I.: - 22.63 to 1.95%) [8-point risk] to 4.79% (95%C.I.: - 1.50% to 11.08) [KCS]. The colonoscopy resource load (95%C.I.) ranged from 9 [1-3] [8-point risk] to 11 [3-5] [APCS and Modified APCS]. CONCLUSIONS The APCS score and its modified versions have certain ability to predict the risk of advanced neoplasia and reduce the resource load. The modified APCS score and the KCS score seemed the preferable systems to classify high risk subjects based on its high RR, sensitivity and predictive ability in the selected population. Future research could focus on adding risk factors or combining with laboratory test results to improve the predictive power of the scoring system.
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Affiliation(s)
- Yunxin Kong
- Cancer Prevention office, Xuzhou Cancer Hospital, Huancheng Road 131, Gulou District, Xuzhou, 221000 Jiangsu China
| | - Lin Zhuo
- Endocrinology and metabolism, Tianjin Medical University General Hospital, Tianjin, 300000 China
| | - Dong Dong
- Cancer Prevention office, Xuzhou Cancer Hospital, Huancheng Road 131, Gulou District, Xuzhou, 221000 Jiangsu China
| | - Lang Zhuo
- School of Public Health, Xuzhou Medical University, Tong Shan Road 209, Yunlong District, Xuzhou, 221004 Jiangsu China
| | - Peian Lou
- Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou, 221004 China
| | - Ting Cai
- School of Management, Xuzhou Medical University, Xuzhou, Jiangsu Province, 221004 China
| | - Siting Chen
- School of Management, Xuzhou Medical University, Xuzhou, Jiangsu Province, 221004 China
| | - Jianqiang Pan
- School of Management, Xuzhou Medical University, Xuzhou, Jiangsu Province, 221004 China
| | - Yihuan Gao
- School of Public Health, Xuzhou Medical University, Tong Shan Road 209, Yunlong District, Xuzhou, 221004 Jiangsu China
| | - Hang Lu
- School of Management, Xuzhou Medical University, Xuzhou, Jiangsu Province, 221004 China
| | - Yue Ma
- Cancer Prevention office, Xuzhou Cancer Hospital, Huancheng Road 131, Gulou District, Xuzhou, 221000 Jiangsu China
| | - Zongmei Dong
- Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou, 221004 China
| | - Xiaohu Luo
- Toxicology Lab, Xuzhou Cancer Hospital, Xuzhou, 221000 China
| | - Hongying Zhao
- Department of Medical Oncology, Xuzhou Cancer Hospital, Xuzhou, 221000 China
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Alexandropoulou I, Goulis DG, Merou T, Vassilakou T, Bogdanos DP, Grammatikopoulou MG. Basics of Sustainable Diets and Tools for Assessing Dietary Sustainability: A Primer for Researchers and Policy Actors. Healthcare (Basel) 2022; 10:healthcare10091668. [PMID: 36141280 PMCID: PMC9498311 DOI: 10.3390/healthcare10091668] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/26/2022] [Accepted: 08/30/2022] [Indexed: 11/16/2022] Open
Abstract
Climate change can have economic consequences, affecting the nutritional intake of populations and increasing food insecurity, as it negatively affects diet quality parameters. One way to mitigate these consequences is to change the way we produce and consume our food. A healthy and sustainable diet aims to promote and achieve the physical, mental, and social well-being of the populations at all life stages, while protecting and safeguarding the resources of the planet and preserving biodiversity. Over the past few years, several indexes have been developed to evaluate dietary sustainability, most of them based on the EAT-Lancet reference diet. The present review explains the problems that arise in human nutrition as a result of climate change and presents currently available diet sustainability indexes and their applications and limitations, in an effort to aid researchers and policy actors in identifying aspects that need improvement in the development of relevant indexes. Overall, great heterogeneity exists among the indicators included in the available indexes and their methodology. Furthermore, many indexes do not adequately account for the diets’ environmental impact, whereas others fall short in the economic impact domain, or the ethical aspects of sustainability. The present review reveals that the design of one environmentally friendly diet that is appropriate for all cultures, populations, patients, and geographic locations is a difficult task. For this, the development of sustainable and healthy diet recommendations that are region-specific and culturally specific, and simultaneously encompass all aspects of sustainability, is required.
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Affiliation(s)
- Ioanna Alexandropoulou
- Department of Nutritional Sciences & Dietetics, Faculty of Health Sciences, International Hellenic University, Alexander Campus, GR-57400 Thessaloniki, Greece
- Correspondence: (I.A.); (M.G.G.)
| | - Dimitrios G. Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, 76 Agiou Pavlou Street, GR-56429 Thessaloniki, Greece
| | - Theodora Merou
- Department of Forest and Natural Environment Sciences, International Hellenic University, GR-66100 Drama, Greece
| | - Tonia Vassilakou
- Department of Public Health Policy, School of Public Health, University of West Attica, 196 Alexandras Avenue, GR-11521 Athens, Greece
| | - Dimitrios P. Bogdanos
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, GR-41110 Larissa, Greece
| | - Maria G. Grammatikopoulou
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, GR-41110 Larissa, Greece
- Correspondence: (I.A.); (M.G.G.)
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Prokop-Dorner A, Piłat-Kobla A, Zając J, Luśtyk M, Valli C, Łapczuk A, Brzyska M, Johnston B, Zera D, Guyatt G, Alonso-Coello P, Bala MM. Values and preferences influencing willingness to change red and processed meat consumption in response to evidence-based information: a mixed methods study. Public Health Nutr 2022; 25:2084-2098. [PMID: 35392999 PMCID: PMC9991620 DOI: 10.1017/s1368980022000866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 03/09/2022] [Accepted: 04/01/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES The aim of the study is (1) to assess the extent to which omnivores are willing to stop or reduce their consumption of red and processed meat in response to evidence-based information regarding the possible reduction of cancer mortality and incidence achieved by dietary modification; (2) to identify socio-demographic categories associated with higher willingness to change meat consumption and (3) to understand the motives facilitating and hindering such a change. DESIGN During an initial computer-assisted web interview, respondents were presented with scenarios containing the estimates of the absolute risk reduction in overall cancer incidence and mortality tailored to their declared level of red and processed meat consumption. Respondents were asked whether they would stop or reduce their average meat consumption based on the information provided. Their dietary choices were assessed at 6-month follow-up. Additionally, we conducted semi-structured interviews to better understand the rationale for dietary practices and the perception of health information. PARTICIPANTS The study was conducted among students and staff of three universities in Krakow, Poland. RESULTS Most of the 513 respondents were unwilling to change their consumption habits. We found gender to be a significant predictor of the willingness. Finally, we identified four themes reflecting key motives that determined meat consumption preferences: the importance of taste and texture, health consciousness, the habitual nature of cooking and persistence of omnivorous habits. CONCLUSIONS When faced with health information about the uncertain reduction in the risk of cancer mortality and incidence, the vast majority of study participants were unwilling to introduce changes in their consumption habits.
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Affiliation(s)
- Anna Prokop-Dorner
- Department of Medical Sociology, Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, 31-034Krakow, Poland
| | - Aleksandra Piłat-Kobla
- Department of Medical Sociology, Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, 31-034Krakow, Poland
| | - Joanna Zając
- Department of Hygiene and Dietetics, Jagiellonian University Medical College, Krakow, Poland
| | - Michalina Luśtyk
- Department of Medical Sociology, Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, 31-034Krakow, Poland
| | - Claudia Valli
- Department of Paediatrics, Obstetrics, Gynaecology and Preventive Medicine, Universidad Autónoma de Barcelona, Barcelona, Spain
- Iberoamerican Cochrane Centre, Biomedical Research Institute San Pau (IIB Sant Pau), Barcelona, Spain
| | - Aneta Łapczuk
- Department of Medical Sociology, Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, 31-034Krakow, Poland
| | - Monika Brzyska
- Department of Medical Sociology, Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, 31-034Krakow, Poland
| | - Bradley Johnston
- College of Agriculture and Life Scinces, Texas A&M University, College Station, TX, USA
- Department of Epidemiology & Biostatistics, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Dena Zera
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Gordon Guyatt
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Pablo Alonso-Coello
- Iberoamerican Cochrane Centre, Biomedical Research Institute San Pau (IIB Sant Pau), Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Malgorzata M Bala
- Department of Hygiene and Dietetics, Jagiellonian University Medical College, Krakow, Poland
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Bruns A, Mueller M, Schneider I, Hahn A. Application of a Modified Healthy Eating Index (HEI-Flex) to Compare the Diet Quality of Flexitarians, Vegans and Omnivores in Germany. Nutrients 2022; 14:nu14153038. [PMID: 35893892 PMCID: PMC9330316 DOI: 10.3390/nu14153038] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/21/2022] [Accepted: 07/21/2022] [Indexed: 12/10/2022] Open
Abstract
Interest in plant-based nutrition has steadily increased in the western world in the recent years. The number of people following a meat-reduced, flexitarian diet is growing continuously. However, little is known about the diet quality of flexitarians compared to vegans or omnivores. Therefore, in this cross-sectional study, the food intake of 94 participants aged between 25–45 years was recorded via a validated food frequency questionnaire and 28 self-designed questions about the consumption of plant-based alternatives. An adapted Healthy Eating Index, HEI-flex, was developed to evaluate the diet quality of flexitarians, vegans and omnivores. Higher score points (SP) of the HEI-flex are associated with higher compliance with the official diet recommendations (Vmax = 100 SP). Finally, flexitarians scored significantly more highly when compared to omnivores (54 ± 8 vs. 47 ± 9 SP; p = 0.008) but lower than vegans (54 ± 8 vs. 61 ± 10 SP; p = 0.010). The results showed that the HEI-flex is a useful tool for assessing and comparing the diet quality of flexitarians, vegans and omnivores. Despite the consumption of highly processed plant-based alternatives, reduction in meat and meat products seems to be accompanied by increased overall diet quality.
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50
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Zhao D, Shan K, Xie Y, Zhang G, An Q, Yu X, Zhou G, Li C. Body weight index indicates the responses of the fecal microbiota, metabolome and proteome to beef/chicken-based diet alterations in Chinese volunteers. NPJ Biofilms Microbiomes 2022; 8:56. [PMID: 35821237 PMCID: PMC9276758 DOI: 10.1038/s41522-022-00319-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 06/13/2022] [Indexed: 12/15/2022] Open
Abstract
Relationships between meat consumption and gut diseases have been debated for decades, and the gut microbiota plays an important role in this interplay. It was speculated that the gut microbiota and relevant indicators of hosts with different body weight indexes (BMIs) might respond differentially to meat-based diet alterations, since lean and obese hosts have different gut microbiota composition. Forty-five young Chinese volunteers were recruited and assigned to high-, middle- and low-BMI groups. All of the volunteers were given a beef-based diet for 2 weeks and subsequently with a chicken-based diet for another 2 weeks. Body weight and blood indexes were measured, and fecal samples were obtained for 16S rRNA sequencing, metabolome and proteome analyses. The fecal metabolites of the low-BMI volunteers showed greater sensitivity to meat-based diet alterations. In contrast, the fecal proteome profiles and blood indexes of the high- and middle-BMI volunteers indicated greater sensitivity to meat-based diet alterations. Replacing the beef-based diet with the chicken-based diet largely changed operational taxonomic units of Bacteroides genus, and thus probably induced downregulation of immunoglobulins in feces. Compared with the beef-based diet, the chicken-based diet decreased inflammation-related blood indexes, especially in high- and middle-BMI volunteers. This work highlighted the role of BMI as an important factor predicting changes in gut homeostasis in response to meat consumption. Compared with the chicken-based diet, the beef-based diet may induce more allergic and inflammation-related responses in high- and middle- BMI Chinese at the current level.
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Affiliation(s)
- Di Zhao
- Key Laboratory of Meat Processing, MOA, Key Laboratory of Meat Processing and Quality Control, MOE, Jiang Synergetic Innovation Center of Meat Production, Processing and Quality Control, College of Food Science and Technology, Nanjing Agricultural University, 210095, Nanjing, P. R. China
| | - Kai Shan
- Key Laboratory of Meat Processing, MOA, Key Laboratory of Meat Processing and Quality Control, MOE, Jiang Synergetic Innovation Center of Meat Production, Processing and Quality Control, College of Food Science and Technology, Nanjing Agricultural University, 210095, Nanjing, P. R. China
| | - Yunting Xie
- Key Laboratory of Meat Processing, MOA, Key Laboratory of Meat Processing and Quality Control, MOE, Jiang Synergetic Innovation Center of Meat Production, Processing and Quality Control, College of Food Science and Technology, Nanjing Agricultural University, 210095, Nanjing, P. R. China
| | - Guanghong Zhang
- Key Laboratory of Meat Processing, MOA, Key Laboratory of Meat Processing and Quality Control, MOE, Jiang Synergetic Innovation Center of Meat Production, Processing and Quality Control, College of Food Science and Technology, Nanjing Agricultural University, 210095, Nanjing, P. R. China
| | - Qi An
- Key Laboratory of Meat Processing, MOA, Key Laboratory of Meat Processing and Quality Control, MOE, Jiang Synergetic Innovation Center of Meat Production, Processing and Quality Control, College of Food Science and Technology, Nanjing Agricultural University, 210095, Nanjing, P. R. China
| | - Xiaobo Yu
- Key Laboratory of Meat Processing, MOA, Key Laboratory of Meat Processing and Quality Control, MOE, Jiang Synergetic Innovation Center of Meat Production, Processing and Quality Control, College of Food Science and Technology, Nanjing Agricultural University, 210095, Nanjing, P. R. China
| | - Guanghong Zhou
- Key Laboratory of Meat Processing, MOA, Key Laboratory of Meat Processing and Quality Control, MOE, Jiang Synergetic Innovation Center of Meat Production, Processing and Quality Control, College of Food Science and Technology, Nanjing Agricultural University, 210095, Nanjing, P. R. China
| | - Chunbao Li
- Key Laboratory of Meat Processing, MOA, Key Laboratory of Meat Processing and Quality Control, MOE, Jiang Synergetic Innovation Center of Meat Production, Processing and Quality Control, College of Food Science and Technology, Nanjing Agricultural University, 210095, Nanjing, P. R. China.
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