Mental Health Conditions, Including Depression and Stress, Are Associated with Increased Odds of Gastric Cancer-Insights into the Role of Diet: A Case-Control Study

Several risk factors, including nutritional/lifestyle ones, play a role in gastric cancer etiology. Further interactions with mental health have also been emphasized. We hypothesized that individuals with mental disorders would exhibit compromised nutrient intake, increasing their risk of gastric cancer. The state of mental health was evaluated in 82 patients with gastric cancer and 95 healthy controls using the 21-item Depression-Anxiety-Stress Scale. The participants' dietary intakes were evaluated by a 168-item food frequency questionnaire. Based on fully adjusted logistic regressions, there was a significant association between depression (OR = 1.938, CI 95%: 1.009-3.723) and stress (OR = 2.630, CI 95%: 1.014-6.819) with increased odds of gastric cancer. According to fully adjusted multinomial regressions, vitamins A and B6, beta-carotene, and black tea decreased the odds of depression, based on comparing the control group with cases of depression, while sugar and salt increased its odds. The highest significant association was found for salt intake and anxiety in cases with present anxiety (OR = 4.899, 95% CI: 2.218-10.819), and the highest significant protective effect was found for vitamin B6 and depression in cases with present depression (OR = 0.132, 95% CI: 0.055-0.320). However, considering causal relationships and clarifying the underlying mechanisms is imperative and requires further investigation. Advising healthy dietary patterns, e.g., a Mediterranean diet rich in vitamins, minerals, and phytochemicals such as vitamin A, B6, beta-carotene, and fiber, is expected to reduce the odds of gastric cancer, possibly related to lower levels of anxiety and depression.

The micronutrient content of the diet is correlated with serum glucose biomarkers and lipid profile and is associated with the odds of being overweight/obese-a case-control study

Background

A low micronutrient intake has been reported to contribute to the double-burden of obesity, increasing the risk for chronic diseases such as cardiovascular disease, diabetes, cancer, and mental disorders. This case-control study compared micronutrient intake profiles in overweight/obese vs. normal-weight individuals. We hypothesized that a low intake of certain micronutrients would increase the odds of being overweight/obese.

Methods

The case group (n = 812 adults) consisted of individuals with a BMI of ≥25  kg/m², and the control group (n = 793) had BMIs of 17.9-24.9  kg/m². A validated 124-item food frequency questionnaire was used to determine micronutrient-related dietary-quality, using the index of nutritional quality (INQ), calculated as the fraction of a micronutrient consumed vs. its dietary requirement. In addition, body surface area (BSA) was calculated according to the Mosteller formula.

Results

The control group had significantly higher INQ-scores of vitamin A, vitamin C, calcium, magnesium, and selenium compared to the case group. Furthermore, individuals with normal BSA (≤1.91 m² for men; ≤1.71  m² for women) had significantly higher INQ scores of vitamin C, calcium, magnesium, and zinc compared to participants with high BSA. In multivariable adjustment regression models, INQs of vitamin C (OR_BMI = 0.79, 95%CI: 0.64-0.97; OR_BSA = 0.81, 95%CI, 0.68-0.97) and magnesium (OR_BMI = 0.69, 95%CI: 0.47-0.99; OR_BSA = 0.71, 95%CI: 0.52-0.97) were significantly associated with the odds of obesity/overweight (in both BMI and BSA categories).

Conclusion

The significant association between micronutrient levels of the diet, especially of vitamin C and magnesium, with both obesity criteria, emphasized the importance of certain micronutrients in the obesity/overweight causal network.

Associated between Dietary Antioxidant Index (DAI) and Odds of Breast Cancer and Correlation between DAI with Pathobiological Markers: Hospital-Based Incidence Case-Control Study

Background: The relationship between dietary antioxidants and breast cancer (BrCa) has been investigated in various studies. As a limitation, they generally investigate the relationship between one specific antioxidant and the risk/odds of BrCa, and synergistic or inhibitory effects are less considered. Dietary antioxidant index (DAI) is a reliable nutritional tool that evaluates total nutritional antioxidant capacity and is validated with serum total antioxidant capacity (TAC) and Malondialdehyde (MDA). Our study aimed to investigate the association between the DAI and the odds of BrCa and the correlation between the DAI and pathobiological markers. We hypnotized a correlation between DAI and pathobiological markers, and there is an association between DAI and the odds of BrCa.Methods: Our study included 145 incidence cases of BrCa and 148 hospital-based controls. Controls were randomly selected from patients attending the same center and were frequency-matched on age (±10 years). DAI was calculated based on a valid semi-quantitative 168-item food frequency questionnaire data. DAI standardizes intake of major dietary antioxidants, including vitamins A, E, C, selenium, zinc, and magnesium, and presents them as summarized scores.Results: Modeling with multivariable regressions adjusting for major confounders including age, education, body mass index, occupation, alcohol, smoking, pregnancy, history of cancer, menarche age, metabolic equivalent of task, hormone replacement therapy, and total energy intake, there was a significant association between odds of BrCa and DAI (odds ratio = 0.18; 95% confidence interval:0.09-0.37; p-value= <0.01). After multiple controls, there was a significant and weak reverse correlation between DAI and the number of lymph node(s) (correlation coefficient= -.140; p-value = 0.05).Conclusion: Our study supports the hypothesis that dietary antioxidants intake is associated with a reduced odds of BrCa. Evidently, DAI can reveal these relationships better than a single study of antioxidants. However, further studies are needed to confirm or refute these results.

The association between dietary total antioxidant capacity and quality of nutrients with odds of colorectal cancer: A hospital-based case-control study

BACKGROUND & AIMS

Dietary quality and patterns have been associated with reduced incidence and increased colorectal cancer (CRC) survival. Two validated scores representing the quality of diet defined respectively by their content in micronutrients (nutritional quality index (INQ)) and antioxidant (dietary antioxidant index (DAI)) were used for assessing dietary quality. INQ standardizes all micronutrients using the recommended values and adjusts nutrients intakes based on total energy. Major dietary antioxidants are standardized based on the global mean and then divided by the global standard deviation to calculate the DAI. We hypothesize that a quality diet with higher scores of DAI can reduce CRC odds.

METHODS

In this hospital-based case-control study, 207 definite CRC cases and 220 controls met the inclusion criteria. Cases and controls were frequency-matched for age (±5 years) and sex. A 168-item semi-quantitative food frequency questionnaire was completed. Adjusted and unadjusted odds ratios (OR) and 95% confidence intervals (CI) were reported in logistic and multivariable regression models.

RESULTS

DAI as a continuous (OR = 0.91, 95% CI: 0.85-0.98) and as a categorical (OR = 0.58, 95% CI: 0.37-0.92) variable and the INQs of vitamin A (OR = 0.30, 95% CI: 0.10-0.89), riboflavin (OR = 0.55, 95% CI: 0.32-0.94), magnesium (OR = 0.37, 95% CI: 0.18-0.77) and selenium (OR_{multiple adjusted} = 0.55, 95% CI: 0.36-0.86) in the regression crude models, and multivariable adjustments significantly have a protective association in reducing the odds of CRC (all p-values <0.05).

CONCLUSIONS

It can be concluded that dietary antioxidants, including vitamins A, C, E, zinc, selenium, and manganese from a high-quality diet, including vegetables, whole grains, and fruits, can significantly reduce CRC incidence.