Association Between Interleukin 6 and C-Reactive Protein Serum Levels and Body Composition Compartments and Components in Breast Cancer Survivors

Obesity is highly prevalent in breast cancer (BC) survivors. Adipose tissue promotes inflammation, affecting recurrence, morbidity, and quality of life. This study aimed to determine the relationship of body composition parameters with the levels of C-reactive protein (CRP) and interleukin 6 (IL-6) in female BC survivors. Additionally, we evaluated the association of log-transformed serum concentrations of CRP and IL-6 with the appendicular skeletal lean mass index (ASMI). The results showed that CRP was positively associated with body fat percentage (BFP; β adjusted = .08, 95% CI: .02-.14) in all participants, and with fat mass index (FMI; β = .24, 95% CI: .08-.40) only in premenopausal women. IL-6 was positively associated with FMI (β adjusted = .16, 95% CI: .03-.29), while ASMI decreased as CRP levels increased (β adjusted = -.30, 95% CI: -.53 to -.06). Interventions to improve body composition in BC survivors should also consider the role of inflammatory markers in changes in body composition to avoid sarcopenic obesity (SO) and the risk of BC recurrence.

Changes in Diet, Physical Activity, Alcohol Consumption, and Tobacco Use in Adults During the COVID-19 Pandemic: A Systematic Review

The COVID-19 pandemic changed various lifestyle habits worldwide due to the prevention measures implemented in each country, these changes may affect or benefit people's health. We aimed to systematically review changes in diet, physical activity (PA), alcohol consumption, and tobacco use habits during the COVID-19 pandemic in adults. Two databases: PubMed and ScienceDirect, were used for this systematic review. The research was limited to open-access, peer-reviewed original articles published in English, French, or Spanish from January 2020 to December 2022 and investigated diet, PA, alcohol consumption, and tobacco use habits before and during the COVID-19 pandemic in adults. Excluded studies were review studies, intervention studies with a sample size of fewer than 30 participants, and poor-quality articles. This review followed PRISMA 2020 guidelines (PROSPERO: CRD42023406524), whereas to assess the quality of the studies, we used the quality assessment tools developed by the BSA Medical Sociology Group for cross-sectional studies and the QATSO for the longitudinal studies. Thirty-two studies were included. Some studies reported changes to promote healthy lifestyles; 13 out of 15 articles reported an increase in healthy diet consumption habits, 5 out of 7 studies reported a decrease in alcohol consumption, and 2 out of 3 studies reported a decrease in tobacco use. On the other hand, the other studies reported changes to promote unhealthy lifestyles: 9 out of 15, and 2 out of 7 studies reported an increase in unhealthy diet and alcohol consumption habits respectively, 25 out of 25 reported a decrease in physical activity, and 13 out of 13 reported an increase in sedentary behavior. During the COVID-19 pandemic, there have been changes to promote a healthy and unhealthy lifestyle; the latter can affect people's health. Therefore, effective responses are needed to mitigate the consequences.

Dietary patterns, cooking methods and breast cancer risk in Mexico: An exploratory case-control study

Background: Nutrition has an important influence on the risk of developing breast cancer (BC). Dietary patterns can capture the complex interplay of nutrients and cooking methods can contribute to the presence of heterocyclic amines, which are potent mammary carcinogens. Research on dietary patterns, cooking methods, and their association with BC in Mexican women is scarce. Aim: To evaluate the association of dietary patterns and cooking methods with BC risk among women from the Northwest region of Mexico. Methods: This case-control study included 120 women. Eligible cases (n = 60) were diagnosed and biopsy-confirmed in the past 2 years. Control subjects (n = 60) were hospital and population-based. Dietary intake and cooking methods were respectively assessed through a food frequency questionnaire (FFQ) and the National Cancer Institute survey. We obtained dietary patterns from a K-means cluster analysis (CA), and multivariate logistic regression tested the association of dietary patterns and cooking methods with BC risk. Results: Prudent and caloric dietary patterns were identified. The caloric pattern was associated with BC risk (Model 1: ORadj: 5.07, 95%CI:1.44-17.84, p = 0.011; Model 2: ORadj: 4.99 (95%CI:1.39-17.92, p = 0.014). Intense frying, meat grilling and poultry resulted in a significant BC risk (Model 1: ORadj: 5.54,95%CI: 2.13-14.41), p < 0.001; Model 2: ORadj: 5.12, 95%CI: 1.83-14.31, p = 0.002). At Oestrogen exposure of <32 years, there was an association between dietary patterns and BC risk (ORadj: 4.69, 95%CI: 1.01-21.92, p = 0.049). The relationship between BC risk and cooking intensity was found in both strata of exposure to oestrogens: <32 years (ORadj: 3.72, 95%CI:1.04-13.33, p = 0.044), and ≥32 years (ORadj: 6.06, 95%CI:1.34-27.42, p = 0.019). Conclusions: A caloric dietary pattern rich in refined carbohydrates and saturated fat, and intense meat product cooking may increase the risk of BC in Mexican women.

The Role of the Representativeness Heuristic in Probability Judgments of Heart Attack and Coronary Heart Disease

Abstract. Background: Diabetes continues to be a major health problem around the globe, and low treatment adherence continues to hinder clinical outcomes. Risk perception has been considered to guide the decision-making processes, and in recent years, the bounded rationality theory and cognitive heuristics have proved to be a useful lens to gain insight into informal and irrational reasoning. In particular, heuristics for the estimation of event frequencies and probabilities are considered to be relevant to the field of health behaviors. It is possible that the risk perceptions that determine patients’ adherence could be generated by these heuristics. Aims: The purpose of this study is to analyze the role of the representativeness heuristic in risk perceptions related to heart attacks and coronary heart disease (CHD) in a sample of patients with type 2 diabetes (T2D). Method: Cross-sectional study with 342 patients attending a public hospital in an urban setting to treat their diabetes. Results: The heuristic was correlated through both its mechanisms with CHD and heart attack. Evidence suggests that the representativeness heuristic might play a role in probability judgments related to heart complications in patients with T2D. Limitations: Only CHD and heart attack were included in the study, and the heuristic could correlate with the risk perception of other complications as well as the perceived risks and benefits of the diabetes treatment. Conclusion: We call for researchers to further study these heuristics in the context of treatment adherence of T2D patients.

Interventions to Improve Bone Mineral Density, Muscle Mass and Fat Mass among Breast Cancer Survivors

Survivors of breast cancer (BC) are at increased risk of chronic diseases due to factors such as low bone mineral density (BMD) and loss of muscle mass (MM) coupled with increased fat mass (FM). It is important to know that healthy behaviors can mitigate the risk of these complications. A narrative review was performed using PubMed and ScienceDirect to identify diet and physical activity (PA) interventions aimed at improving BMD, MM, and/or FM in female BC survivors. Data from 2000 to 2018 were used and 17 diet and/or PA interventions were identified. The duration of interventions was from 3 weeks until 24 months, the smallest sample was 26 women, and the largest was 223. The ranging age of participants was from 46 to 64 years. Studies with a longer duration, in-person modality and/or that used behavioral models showed better results. In BMD, the best results in spine were observed at 24 months in a face-to-face intervention (increase of 3.08%). Regarding MM, the greatest increase was at 26 weeks under Cognitive Behavioral Therapy (CBT) in person (43.8 ± 8.7 to 44.7 ± 8.4 kg, p = 0.04). This approach also showed the greatest decrease in FM from 36.7 to 31.2 kg in 4 months (p ≤ 0.01). Improving BMD and MM and preventing the increase of FM is a challenge for public health. More studies are needed to improve BMD among BC survivors and consider strategies that have yielded better results to promote healthy changes.Key teaching pointsBreast cancer survivors are at increased risk for low bone mineral density, loss of muscle mass, and increased fat mass due to the treatments received; the adoption of a healthy diet and physical activity can mitigate these complications.Of the 17 studies included, 8 used the face-to-face modality, 7 combined face-to-face with phone calls and two studies used only phone calls and email; studies that used the face-to-face modality showed better results.For bone mineral density, the best results were observed in spine at 24 months (increase of 3.08%) in a face-to-face intervention.The greatest increase in muscle mass (43.8 to 44.7 kg) was at 26 weeks in a physical activity intervention; the larger amount of fat mass loss was 5.5 kg in a diet and physical activity intervention. Both results were obtained using the Cognitive Behavioral Therapy (CBT) in person.Lifestyle interventions to maintain or improve bone mineral density, muscle mass and fat mass are effective at least for one of these three variables.

Abstract 1189: Association between female breast cancer period prevalence and residential exposure to environmental hazards at Hermosillo municipality, Sonora, Mexico: A retrospective observational study based on clinical databases from years 2013 to 2019 and INEGI census 2010

Background: Breast cancer is the leading cause of female cancer-related deaths in Mexico. Breast cancer risk may increase given residential exposure to environmental hazards, such as industrial-produced air pollutants (HAPs), and residual water sites (RWS). Hermosillo is one municipality with high breast cancer prevalence in Sonora, Mexico. However, the association of environmental hazards with breast cancer remains a matter of debate for this community.

Objectives: This retrospective observational study aims to evaluate associations between breast cancer period prevalence (years 2013 - 2019) and residential exposure to potentially hazardous sites (PHS) in Hermosillo.

Methods: The study collected the data from 912 female breast cancer cases from 6-year old hospital files (2013 to 2019) in Hermosillo. INEGI Census 2010 provided the PHS coordinates, and ArcGIS software (version 10.7.1) projected the data onto a map by conversion to UTM 12 N. Cluster analysis identified regions of high breast cancer period prevalence. Additionally, PHS-proximity is used as a criterion to define subpopulations of interest. The odds ratio (OR) estimated breast cancer risk among the Hermosillo subpopulations to find a difference between them. Age distribution analysis assessed putative residential exposure between PHS-exposed and non-PHS-exposed breast cancer cases.

Results: Findings indicate high-high clusters in six neighborhoods across Hermosillo, and from those, three are contiguous. Significant associations with breast cancer risk were the following: residence in highly-industrialized (≥ 7 industries) vs low-industrialized neighborhoods (≤ 6 industries) with an OR = 1.69 (1.41, 2.02) (p-value &lt; 0.0001); residence within ≤ 4 km to gas power plants (GPP) vs those ≥ 4 km (OR = 1.55, (1.36, 1.77)) (p -value &lt; 0.0001); residence within ≤ 3 km to RWS vs residences ≥ 3 km (OR = 1.45, (1.26, 1.66)) (p-value &lt; 0.0001). In comparison to non-PHS-exposed locations, cumulative residential exposure to highly-industrialized neighborhoods within ≤ 4 km to GPP and RWS (PHS-exposed) had an OR = 2.29 (1.80, 2.91) (p-value &lt; 0.0001). Moreover, older breast cancer patients (≥ 58 years old) are in PHS-exposed subpopulation.

Conclusions: This study shows a difference in breast cancer prevalence for highly industrialized neighborhoods closer to HAPs' sources (GPP) and RWS. Age distribution showed an older population in the PHS-exposed group. Further studies with larger cohorts are needed to confirm or reject these findings.

Citation Format: Diana E. Villa-Guillen, Enrique Avila-Monteverde, Jose H. Gonzalez-Zepeda, Luis F. Munguia-Ibarra, Baldemar Corral-Villegas, Karla Aguilar-Gutierrez, Cynthia Rojas-Camarena, Luis C. Durazo-Cons, Carlos D. Luque-Morales, Wendy B. Aguilar-Peraza, Jorge A. Cordon-Guillen, Leticia Garcia-Rico, Martin Jara-Marini, Ana I. Valenzuela-Quintanar, Graciela Caire-Juvera, Ivan Anduro-Corona, Eduardo Ruiz-Bustos, Jorge A. Villa-Carrillo. Association between female breast cancer period prevalence and residential exposure to environmental hazards at Hermosillo municipality, Sonora, Mexico: A retrospective observational study based on clinical databases from years 2013 to 2019 and INEGI census 2010 [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 1189.

Abstract P5-08-21: Breast cancer risk and residential exposure to environmental hazards in Hermosillo, Sonora, Mexico

Introduction: Breast cancer is the leading cause of female cancer-related deaths in Mexico. Residential exposure to environmental hazards, like air pollutants produced by industrial activities (HAPs), and contaminated sources of drinking water (CSW) may increase breast cancer risk. There is an interest in assessing environmental pollutants as risk factors, but there is no consensus on such an association. Hermosillo municipality is one of the regions with high breast cancer incidence at Sonora, Mexico. The role of environmental hazards on breast cancer risk in Hermosillo; however, has not been fully explored. This study aims at evaluating associations between breast cancer incidence rates and residential exposure to potentially hazardous sites (PHS). Objective: The aim is to determine breast cancer incidence rates in neighborhoods in the municipality of Hermosillo exposed to HAPs and/or CSW. Methods: Data (744 cases) is being collected from 5-year old clinical files of breast cancer patients residing in Hermosillo, and who were patients in private and public hospitals. Coordinates of PHS were obtained through government databases (INEGI, CONAGUA, SAGARPA) and projected onto a map by conversion to UTM zone 12 N. Cluster analysis was conducted to identify geographic regions of high breast cancer incidence. Neighborhoods were classified by their proximity to PHS, then calculated odds ratio (OR) and 95% confidence interval for breast cancer risk among residentially exposed inhabitants with that for non-exposed tenants. Results: Preliminary findings include high-high breast cancer clusters in five neighborhoods across Hermosillo, and from those, three are contiguous. In order to evaluate the association between neighborhoods with breast cancer cases, and the number of industries, an OR = 1.55 was obtained ((1.26 - 1.90), 95% CI, p-value = 0.00002). The previous comparison involved the location of 6 or more factories and those with less than 6 facilities (gas power industries excluded). We also examined an association between neighborhoods with breast cancer cases and their proximity (radio distance in km) to gas power industries-only. A comparison was made between neighborhoods within a radio of ≤ 2 km with those between a radio 2 - 4 km resulting in an OR = 0.68 ((0.56 - 0.83) CI, p-value = 0.00001). An additional comparison was carried out between residential locations within a radio of ≤ 2 km to those beyond 4 km, estimating an OR = 0.53 ((0.44 - 0.64), 95% CI, p-value &lt; 0.00001). Furthermore, we evaluated associations for neighborhoods potentially exposed to CSW; particularly to residual waters within a radio of &lt;1, between 1 - 2 km, and between 2 - 3 km. OR did not show significant differences for those comparisons. Conclusions: At this point in the study, a difference in breast cancer incidence rates has been observed in more industrialized neighborhoods or which are closer to potential sources of HAPs (gas power facilities). Residential proximity to CSW shows no association with incidence rates. Further studies with larger cohorts are needed to confirm findings.

Citation Format: Diana Evelyn Villa-Guillen, Enrique Avila-Monteverde, Jose H Gonzalez-Zepeda, Luis F Munguia-Ibarra, Baldemar Corral-Villegas, Leticia Garcia-Rico, Martin Jara-Marini, Ana I Valenzuela-Quintanar, Graciela Caire-Juvera, Ivan Anduro-Corona, Eduardo Ruiz-Bustos, Jorge A Villa-Carrillo. Breast cancer risk and residential exposure to environmental hazards in Hermosillo, Sonora, Mexico [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P5-08-21.

Adherence to a Diet, Physical Activity and Body Weight Program Using Motivational Interviewing Among Breast Cancer Survivors (P05-025-19)

Objectives

This study aims to evaluate the adherence to a dietary, physical activity, and body weight intervention using the principles of Motivational Interviewing (MI) in female breast cancer survivors who participated in a trial for 4 months.

Methods

Premenopausal and postmenopausal female cancer survivors (n = 47) were randomized to the intervention group (IG, n = 22) that received the MI strategy, or the comparison group (CG, n = 25) that received nutritional counseling. Adherence to the program was evaluated based on compliance with dietary and physical activity goals, changes in body weight and changes in serum levels of α-carotene and β-carotene. We applied two non-consecutive 24-hour recalls to estimate dietary intake, and used a pedometer to measure number of steps. Blood samples were taken at time 0 (basal) and at 4 months of the study, and the serum concentrations of α-carotene and β-carotene were evaluated by high-performance liquid chromatography.

Results

Among participants in the IG, percentages of compliance with goals for fruit and vegetable intakes were 93% and 90% respectively. The consumption of red, green and yellow vegetables increased (135.3 to 148.6 g/day, 192.1 to 227.7 g/day and 49.1 to 58.9 g/day, respectively) in the IG. There were no differences in fiber or total sugar intakes between groups. Women in the IG significantly increased their serum β-carotene levels (median 10.7 to 21.2 μg/dL) compared to the CG (median 13.1 to 19.9 μg/dL) (P < 0.05). The number of steps increased in the IG compared to the CG (1865 vs. 189, P < 0.05), although participants in the two groups continued to be classified as sedentary (physical activity level <1 at 0 and 4 months). Women in the IG lost 1.75 kg of body weight compared to 0.70 kg in the CG (P = 0.08).

Conclusions

Findings indicate that adherence to the recommendation on fruit and vegetable intakes is relatively high and that adherence to the recommendation on fiber intake, sugar intake, body weight and physical activity should be promoted. The MI strategy is promising to motivate changes in lifestyle changes.

Funding Sources

Consejo Nacional de Ciencia y Tecnología (CONACYT-México) (English: National Council for Science and Technology).

Comparison of Measurements of Bone Mineral Density in Young and Middle-Aged Adult Women in Relation to Dietary, Anthropometric and Reproductive Variables

The objective of this study was to compare current measurements of bone mineral density (BMD) of the lumbar spine (LS), femoral neck (FN), and total femur (TF) regions with initial values recorded 12 years ago in women from Northwest Mexico, and evaluate their correlation with dietary, anthropometric, and reproductive variables. BMD was assessed by Dual-energy X-ray absorptiometry. Participants were grouped as follows: Nulliparous (G1); women who were mothers 12 years ago (G2); and women who were nulliparous 12 years ago, but are now mothers (G3). In all three groups, current LS BMD was higher than initial (p ≤ 0.05) and current TF BMD in G2 was higher than initial values (p ≤ 0.05). When comparing current FN and TF BMD among the three groups, G2 had higher values than G3 (p ≤ 0.05). G2 also showed higher LS BMD than G1 and G3 (p = 0.006). Age at menarche was inversely-correlated with FN and TF BMD in G1 (p < 0.01), while the body mass index (BMI) correlated positively with all three bone regions in G2 (p < 0.05). This study shows that in women without and with children, age at menarche, BMI, and age were factors associated to BMD in healthy subjects in reproductive age.

Body shape, adiposity index, and mortality in postmenopausal women: Findings from the Women's Health Initiative

OBJECTIVE

Studies evaluating the relationship between body mass index (BMI) and mortality demonstrate a U-shaped association. To expand, this study evaluated the relationship between adiposity indices, a body shape index (ABSI) and body adiposity index (BAI), and mortality in 77,505 postmenopausal women.

METHODS

A prospective cohort analysis was conducted in the Women's Health Initiative to ascertain the independent relationships between adiposity indices and mortality in order to inform on the clinical usefulness of alternate measures of mortality risk. ABSI (waist circumference (cm)/[BMI(2/3) × height (cm)(1/2) ]), BAI (hip circumference (cm)/[height (m)(1.5) ] - 18), weight, BMI, and waist circumference (WC) were evaluated in relation to mortality risk using adjusted Cox proportional hazards regression models.

RESULTS

ABSI showed a linear association with mortality (HR, 1.37; 95% CI, 1.28-1.47 for quintile 5 vs. 1) while BMI and BAI had U-shaped relationships with HR of 1.30; 95% CI, 1.20-1.40 for obesity II/III BMI and 1.06, 95% CI, 0.99-1.13 for BAI. Higher WC (HR, 1.21; 95% CI, 1.13-1.29 for quintile 5 vs. 1) showed relationships similar to BMI.

CONCLUSIONS

ABSI appears to be a clinically useful measure for estimating mortality risk, perhaps more so than BAI and BMI in postmenopausal women.

[INFLUENCE OF REPRODUCTIVE FACTORS, BREASTFEEDING AND OBESITY ON THE RISK OF BREAST CANCER IN MEXICAN WOMEN]

Breast cancer (BC) is considered a global public health problem, and is the most frequently type diagnosed in Mexican women. Therefore, it is important to study the risk factors associated to this neoplasia in order to establish prevention strategies. The aim of this study was to evaluate the effect of hormonal contraceptives and hormone therapy (HT) use and period of use, breastfeeding practice, abdominal obesity and weight gain in adulthood, on the risk of BC in adult women from Northwest Mexico. This was a case-control study that included 162 women (81 cases and 81 controls). A sociodemographic and health questionnaire, and a survey history of body weight were applied to participants. Measurements of body weight, height and waist circumference were performed. To assess the association between BC risk and exposing factors, a multivariate logistic regression model was used. Average age of cases and controls were 51.8 ± 11.7 and 51.4 ± 11.3 years, respectively. No significant association was found between the use and period of use of hormonal contraceptives and HT with the risk of BC. The practice of breastfeeding (OR=0.34, 95%CI: 0.12- 0.92) and the time of exclusive breastfeeding (OR=0.64, 95%CI: 0.42-0.97; crude) were protective against the risk of BC. Abdominal obesity (OR=0.93, 95%CI: 0.90-0.97) and weight gain in early adulthood (OR=0.90, 95%CI: 0.85-0.95) were inversely associated to the risk of BC. In conclusion, the practice of breastfeeding may help prevent BC in Mexican women.

Depression and quality of life before and after breast cancer diagnosis in older women from the Women's Health Initiative

PURPOSE

Distress and reduced quality of life (QOL) are common among people with cancer. No study has compared these variables after breast cancer diagnosis to pre-cancer diagnosis levels.

METHODS

Data on women with breast cancer 50 years of age or older (n = 6949) were analyzed from the Women's Health Initiative (1993-2013). Health-related QOL (physical function, mental health) was measured using Rand-36. Depressive symptoms were measured with the six-item Center for Epidemiologic Studies Depression scale. Assessments occurred before and after the cancer diagnosis. Hierarchical linear modeling compared pre-cancer QOL and depressive symptoms to levels post-diagnosis and tested whether pre-cancer physical activity, stressful life events, sleep disturbance, and pain predicted post-diagnosis outcomes.

RESULTS

Compared with pre-cancer levels, depressive symptoms increased (20.0% increase at 0-6 months, 12.9% increase at 6-12 months), while physical function (-3.882 points at 0-6 months, -3.545 at 6-12 months) and mental health decreased (-2.899 points at 0-6 months, -1.672 at 6-12 months) in the first year after diagnosis (all p < .01). Depressive symptoms returned to pre-cancer levels after 10 years, but QOL remained significantly lower. At more than 10 years post-diagnosis, physical function was 2.379 points lower than pre-cancer levels (p < 0.01) while mental health was 1.922 points lower (p < 0.01). All pre-cancer predictors were associated with all outcomes. Pain predicted uniquely greater decreases in physical function post-diagnosis.

CONCLUSIONS

Depressive symptoms increased and QOL decreased following breast cancer diagnosis compared with pre-cancer levels, particularly in the first year.

IMPLICATIONS FOR CANCER SURVIVORS

QOL may remain lower for years after breast cancer diagnosis, although decreases are small.

Amino acid composition, score and in vitro protein digestibility of foods commonly consumed in northwest Mexico

A better knowledge of the amino acid composition of foods commonly consumed in different regions is essential to calculate their scores and, therefore, to predict their protein quality. This paper presents the amino acid composition, amino acid score and in vitro protein digestibility of fifteen foods that are commonly consumed in Northwest Mexico. The foods were prepared by the traditional methods and were analyzed by reverse-phase HPLC. The chemical score for each food was determined using the recommendations for children of 1-2 years of age, and the digestibility was evaluated using a multienzyme technique. Lysine was the limiting amino acid in cereal-based products (scores 15 to 54), and methionine and cysteine were limiting in legume products (scores 41 to 47), boiled beef (score = 75) and hamburger (score = 82). The method of preparation had an effect on the content of certain amino acids, some of them increased and others decreased their content. Meat products and regional cheese provided a high amino acid score (scores 67 to 91) and digestibility (80.7 to 87.8%). Bologna, a processed meat product, had a lower digestibility (75.4%). Data on the amino acid composition of foods commonly consumed in Mexico can be used to provide valuable information on food analysis and protein quality, and to contribute to nutrition and health research and health programs.

Production of interferon α and β, pro-inflammatory cytokines and the expression of suppressor of cytokine signaling (SOCS) in obese subjects infected with influenza A/H1N1

BACKGROUND & AIMS

Obesity was recognized as an independent risk factor for morbidity and mortality during last influenza A/H1N1 pandemic. Mechanisms involved in the high mortality risk from obesity during influenza A virus include reduced type I interferon production and delayed pro-inflammatory response, which lead to a higher rate of morbidity and mortality in murine models. In this study, we evaluated the production of type I interferons, pro-inflammatory and anti-inflammatory cytokines in peripheral blood mononuclear cells (PBMCs) from obese and lean subjects with and without confirmed infection of influenza A/H1N1. The expression levels of the suppressor of cytokine signaling-1 (SOCS1), SOCS3 and nuclear factor-kB were also evaluated.

METHODS

Cytokines were measured by real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) and/or by ELISA in PBMCs stimulated with toll like receptor-3 (TLR-3) and TLR-7 ligands. The mRNA expression of SOCS1 and SOCS3 were evaluated by qRT-PCR.

RESULTS

The obese volunteers infected with influenza A/H1N1 showed a diminished ability to produce type I interferon in response to TLR-3 ligand. Interestingly, the pro-inflammatory response was also affected in TLR-3 stimulated PBMCs. Obese influenza-free volunteers showed an increased basal expression of SOCS3, but not SOCS1. During influenza infection, SOCS1 and SOCS3 expression was higher in the lean infected volunteers in contrast to those who were obese infected.

CONCLUSIONS

These data suggest that obesity is related to TLR-3 impairment and explain, at least in part, the inadequate immune response of obese individuals during infection with influenza A/H1N1 virus.

Vitamin A and retinol intakes and the risk of fractures among participants of the Women's Health Initiative Observational Study

BACKGROUND

Excessive intakes of vitamin A have been shown to have adverse skeletal effects in animals. High vitamin A intake may lead to an increased risk of fracture in humans.

OBJECTIVE

The objective was to evaluate the relation between total vitamin A and retinol intakes and the risk of incident total and hip fracture in postmenopausal women.

DESIGN

A total of 75,747 women from the Women's Health Initiative Observational Study participated. The risk of hip and total fractures was determined using Cox proportional hazards models according to different intakes of vitamin A and retinol.

RESULTS

In the analysis adjusted for some covariates (age; protein, vitamin D, vitamin K, calcium, caffeine, and alcohol intakes; body mass index; hormone therapy use; smoking; metabolic equivalents hours per week; ethnicity; and region of clinical center), the association between vitamin A intake and the risk of fracture was not statistically significant. Analyses for retinol showed similar trends. When the interaction term was analyzed as categorical, the highest intake of retinol with vitamin D was significant (P = 0.033). Women with lower vitamin D intake (< or =11 microg/d) in the highest quintile of intake of both vitamin A (hazard ratio: 1.19; 95% CI: 1.04, 1.37; P for trend: 0.022) and retinol (hazard ratio: 1.15; 95% CI: 1.03, 1.29; P for trend: 0.056) had a modest increased risk of total fracture.

CONCLUSIONS

No association between vitamin A or retinol intake and the risk of hip or total fractures was observed in postmenopausal women. Only a modest increase in total fracture risk with high vitamin A and retinol intakes was observed in the low vitamin D-intake group.

Food components and dietary patterns of two different groups of Mexican lactating women

OBJECTIVE

To evaluate the energy, nutrient intakes and dietary patterns of Mexican lactating women at one month postpartum, and the associations of maternal age and region on their intakes.

METHODS

A total of 60 women were studied: 41 from Northwest and 19 from Central Mexico, 33 adolescent and 27 adult women. Data were collected through two quantitative 24 h recalls. Two more recalls were used in a sub sample to calculate the coefficient of variation of intakes. Menus were based on the consumption frequency of foods.

RESULTS

The mean energy intake of the adolescent women (2354 +/- 1199 kcal) and those of Central Mexico (1690 +/- 981 kcal) was lower than the recommendations. Zinc, calcium, vitamin E, C and folate were inadequate (55 to 85% prevalence of inadequacy). Energy, dietary fiber, sodium, potassium, iron and folate intakes were higher (P < 0.05) in Northwest Mexico. Northwestern women consumed less variety of vegetables or fruits compared to Mexico City region women. Wheat tortillas and beans were from Northwestern but not from the Mexico City region diet.

CONCLUSIONS

The energy and nutrient intakes of women were different by regional hospital and not by age. Education about the importance of the maternal diet during lactation should be directed toward increasing consumption of foods rich in micronutrients.