Nutrition and health

Saturated fat increases breast cancer mortality among women

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Objectives:
The influence of dietary fat upon breast cancer mortality remains largely understudied despite extensive investigation into its influence upon breast cancer risk. Therefore, this review article has been conducted.

Does higher total fat or saturated fat dietary intake increase risk of breast-cancer-specific death (breast cancer mortality) among women?

Study design:
This review article included 15 prospective cohort studies investigating total fat and/or saturated fat intake (g/day) and breast cancer mortality.

Results and conclusions:
The investigators found there was no difference in risk of breast-cancer-specific death [HR = 1.14, 95% CI = 0.86 to 1.52, p = 0.34, n = 6] or all-cause death [HR = 1.73, 95% CI = 0.82 to 3.66, p = 0.15, n = 4] for women in the highest versus lowest category of total fat dietary intake.
No difference because HR of 1 was found in the 95% CI of 0.82 to 3.66. HR of 1 means no risk/association.

The investigators found for the highest versus lowest category of saturated fat dietary intake, a significantly increased risk of 51% for breast-cancer-specific death among women [HR = 1.51, 95% CI = 1.09 to 2.09, p 0.01 n = 4].
Significant because HR of 1 was not found in the 95% CI of 1.09 to 2.09. HR of 1 means no risk/association.

The investigators concluded that higher saturated fat dietary intake increases risk of breast-cancer-specific death among women.

Original title:
Dietary fat and breast cancer mortality: A systematic review and meta-analysis by Brennan SF, Woodside JV, […], Cantwell MM.

Link:
https://pubmed.ncbi.nlm.nih.gov/25692500/

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A diet high in saturated fat is a diet with more than 10 En% saturated fat.
The most easy way to follow a diet with more than 10 En% saturated fat is to choose only meals/products with more than 10 En% saturated fat. Check here which products contain more than 10 En% saturated fat.

However, the most practical way to follow a diet with more than 10 En% saturated fat is, all meals/products that you eat on a daily basis should contain on average more than 10 En% saturated fat.

To do this, use the 7-points nutritional profile app to see whether your daily diet contains more than 10 En% saturated fat.

However, a diet with more than 10 En% saturated fat is an unhealthy diet.

A diet low in saturated fat is a diet with maximum 7 En% saturated fat.
 

Dietary fiber intake reduces endometrial cancer

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Objectives:
Does dietary intake of fiber reduce risk of endometrial cancer?

Study design:
This review article included 16 studies, involving 6,563 cases (persons with endometrial cancer).

Results and conclusions:
The investigators found dietary fiber intake significantly reduced risk of endometrial cancer with 14% [RR = 0.86, 95% CI = 0.78 to 0.93].
In stratified analysis, this trend was more pronounced in the case-control studies and in studies conducted in the Americas and Asia.

The investigators found dietary fiber intake significantly reduced risk of endometrial cancer with 26% after adjusting for education level [RR = 0.74, 95% CI = 0.60 to 0.88].

The investigators found dietary fiber intake significantly reduced risk of endometrial cancer with 30% after adjusting for age [RR = 0.70, 95% CI = 0.57 to 0.83].

The investigators found dietary fiber intake significantly reduced risk of endometrial cancer with 19% in studies with NOS scores of 6 (the higher the NOS scores, the more reliable the studies are) [RR = 0.81, 95% CI = 0.67 to 0.95].

The investigators found dietary fiber intake significantly reduced risk of endometrial cancer with 25% in studies with NOS scores of 7 [RR = 0.75, 95% CI = 0.62 to 0.88].

The investigators concluded dietary fiber intake reduces risk of endometrial cancer. Further efforts should be made to confirm these findings.

Original title:
Association between dietary fiber and endometrial cancer: a meta-analysis by Li H, Mao H, [...], Nan Y.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31584301

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High β-carotene concentration reduces bladder cancer

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Objectives:
Some evidence indicates that carotenoids may reduce the risk of bladder cancer (BC), but the association is unclear. Therefore, this review article has been conducted.

Do carotenoids (β-cryptoxanthin, α-carotene, β-carotene and lutein and zeaxanthin) reduce risk of bladder cancer?

Study design:
This review article included a total of 22 studies (case-control and cohort studies) involving 516,740 adults.

Results and conclusions:
The investigators found for the highest compared with the lowest category of carotenoid dietary intake a non-significantly reduced risk of 12% [RR = 0.88, 95% CI = 0.76 to 1.03] for bladder cancer.
Non-significantly because RR of 1 was found in the 95% CI of 0.76 to 1.03. RR of 1 means no risk/association.

The investigators found for the highest compared with the lowest category of circulating carotenoid concentrations a non-significantly reduced risk of 64% [RR = 0.36, 95% CI = 0.12 to 1.07] for bladder cancer.

The investigators found for the highest compared with the lowest category of circulating lutein and zeaxanthin concentrations a significantly reduced risk of 47% [RR = 0.53, 95% CI = 0.33 to 0.84] for bladder cancer.
Significantly because RR of 1 was not found in the 95% CI of 0.33 to 0.84. RR of 1 means no risk/association.

The investigators found dose-response analysis showed that bladder cancer risk significantly decreased by 42% [RR = 0.58, 95% CI = 0.36 to 0.94] for every 1 mg increase in daily dietary β-cryptoxanthin intake.

The investigators found dose-response analysis showed that bladder cancer risk significantly decreased by 76% [RR = 0.24, 95% CI = 0.08 to 0.67] for every 1 μmol/L increase in circulating concentration of α-carotene.

The investigators found dose-response analysis showed that bladder cancer risk significantly decreased by 27% [RR = 0.73, 95% CI = 0.57 to 0.94] for every 1 μmol/L increase in circulating concentration of β-carotene.

The investigators found dose-response analysis showed that bladder cancer risk significantly decreased by 56% [RR = 0.44, 95% CI = 0.28 to 0.67] for every 1 μmol/L increase in circulating concentrations of lutein and zeaxanthin.

The investigators concluded dietary β-cryptoxanthin intake and circulating concentrations of α-carotene, β-carotene and lutein and zeaxanthin reduce risk of bladder cancer.

Original title:
Carotenoid Intake and Circulating Carotenoids Are Inversely Associated with the Risk of Bladder Cancer: A Dose-Response Meta-analysis by Wu S, Liu Y, […], Ramirez AG.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31800007

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High consumption of polyunsaturated fat increases skin cancer

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Objectives:
Is there an association between dietary fat intake and the risk of three major types of skin cancer including basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and cutaneous malignant melanoma (CMM)?

Study design:
This review article included 3 prospective cohort studies (175,675 participants and 30,915 basal cell carcinoma cases, 4,106 squamous cell carcinoma cases and 1,638 cutaneous malignant melanoma cases) and 9 case-control studies (328 basal cell carcinoma cases, 493 squamous cell carcinoma cases, 1,547 cutaneous malignant melanoma cases and 2,660 controls).

Results and conclusions:
The investigators found pooled results indicated that dietary consumption of total fat and saturated fat were not associated with 3 major types of skin cancer.

The investigators found high consumption of monounsaturated fat was significantly associated with a decreased risk of 10% for basal cell carcinoma [RR = 0.90, 95% CI = 0.85 to 0.96]. 

The investigators found high consumption of polyunsaturated fat was significantly associated with an increased risk of 19% for squamous cell carcinoma [RR = 1.19, 95% CI = 1.06 to 1.33]. 

The investigators concluded high consumption of monounsaturated fat decreases risk of basal cell carcinoma while high consumption of polyunsaturated fat increases risk of squamous cell carcinoma. However, these findings should be confirmed by further evidence from well-designed and large-scale prospective cohort studies.

Original title:
Dietary Fat Intake and the Risk of Skin Cancer: A Systematic Review and Meta-Analysis of Observational Studies by Ruan L, Cheng SP and Zhu QX.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31298947

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100g fruit per day decrease lung cancer in former smokers

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Objectives:
The results of epidemiological studies on the relationship between fruit and vegetable intake and lung cancer risk were inconsistent among participants with different smoking status. Therefore, this review article has been conducted.

Do dietary intakes of fruit and vegetables reduce risk of lung cancer?

Study design:
This review article included a total of 12 prospective cohort studies.
The duration of follow-up ranged from 4 to 12.9 years.
No publication bias was found.

Results and conclusions:
The investigators found for dietary consumption of fruit a significantly reduced risk of 14% [summary RR = 0.86, 95% CI = 0.78 to 0.94, I2 = 0.0%, p = 0.642] for lung cancer among current smokers.

Significant means that there is an association with a 95% confidence.

The investigators found for dietary consumption of fruit a significantly reduced risk of 9% [summary RR = 0.91, 95% CI = 0.84 to 0.99, I2 = 0.0%, p = 0.653] for lung cancer among former smokers.
Significant because RR of 1 was not found in the 95% CI of 0.84 to 0.99. RR of 1 means no risk/association.

The investigators found stratified analysis showed that dietary consumption of fruit significantly reduced risk of lung cancer with 23% [RR = 0.77, 95% CI = 0.62 to 0.96] in current smoking subjects from Europe.

The investigators found in linear dose-response analysis that an increase of 100 grams of fruit intake per day was associated with a 5% reduction [RR = 0.95, 95% CI = 0.93 to 0.97, p for trend 0.001] in current smokers.

The investigators found in linear dose-response analysis that an increase of 100 grams of fruit intake per day was associated with a 5% reduction [RR = 0.95, 95% CI = 0.93 to 0.99, p for trend = 0.001] in former smokers.

The investigators found for dietary consumption of vegetables a significantly reduced risk of 13% [summary RR = 0.87, 95% CI = 0.78 to 0.97, I2 = 25.4%, p = 0.226] for lung cancer among current smokers.

The investigators found in linear dose-response analysis that an increase of 100 grams of vegetable intake per day was associated with a 3% lower risk of lung cancer in current smokers [95% CI = 0.96 to 1.00, p for trend = 0.057]. 

The investigators concluded that fruit consumption, at least 100g per day decreases lung cancer risk among current smokers and former smokers, while vegetables consumption, at least 100g per day decreases lung cancer risk of current smokers. These findings may have considerable public health significance for the prevention of lung cancer through dietary interventions.

Original title:
The Associations of Fruit and Vegetable Intake with Lung Cancer Risk in Participants with Different Smoking Status: A Meta-Analysis of Prospective Cohort Studies by Wang C, Yang T, [...], Li D.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6723574/

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Carrot consumption decreases the lung cancer adenocarcinoma

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Objectives:
Findings of epidemiological studies regarding the association between carrot consumption and lung cancer risk remain inconsistent. Therefore, this review article has been conducted.

Do dietary intakes of carrot reduce risk of lung cancer?

Study design:
This review article included a total of 17 case-control studies and 1 prospective cohort study, involving 202,969 individuals and 5,517 patients with lung cancer.

Results and conclusions:
The investigators found in 18 studies a significantly reduced risk of 42% [pooled OR = 0.58, 95% CI = 0.45 to 0.74] for lung cancer by comparing the highest category with the lowest category of carrot consumption.
Exclusion of any single study did not materially alter the pooled OR.

The investigators found based on subgroup analyses for the types of lung cancer a significantly reduced risk of 66% [pooled OR = 0.34, 95% CI = 0.15 to 0.79] for the lung cancer adenocarcinoma by comparing the highest category with the lowest category of carrot consumption.

The investigators found based on subgroup analyses for the types of lung cancer a significantly reduced risk of 39% [OR = 0.61, 95% CI = 0.46 to 0.81] for mixed types of lung cancer by comparing the highest category with the lowest category of carrot consumption.

The investigators concluded that carrot consumption decreases the risk of lung cancer, especially for adenocarcinoma.

Original title:
Is carrot consumption associated with a decreased risk of lung cancer? A meta-analysis of observational studies by Xu H, Jiang H, […], Lu Z.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31552816

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0.5 g/day dietary trans fat intake increases ovarian cancer

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Objectives:
Observational studies have reported controversial evidence of the association between dietary fat intake and ovarian cancer. Therefore, this review article has been conducted.
Does dietary fat intake increase risk of ovarian cancer among women?

Study design:
This review article included 21 observational studies involved approximately 900,000 women.

Results and conclusions:
The investigators found a significant nonlinear association between dietary total fat intake with the risk of ovarian cancer, with a relatively steep slope at dietary total fat intake higher than 30 g/day [p non-linearity 0.01].

The investigators found, moreover, the risk of ovarian cancer was increased in non-linear form for both saturated and monounsaturated fat from 25 g/day [p non-linearity 0.05].

The investigators found in linear meta-analysis a 2% greater risk of ovarian cancer per 10 g/day increase in total dietary fat intake.

The investigators found in linear meta-analysis a 2% greater risk of ovarian cancer per 0.5 g/day increase in dietary trans fat intake.

The investigators found in linear meta-analysis a 1% greater risk of ovarian cancer per 2.5 g/day increase in dietary monounsaturated fat intake.
However, this association for monounsaturated fat was marginally significant [p = 0.052].

The investigators found in linear meta-analysis a 1% greater risk of ovarian cancer per 50 mg/day increase in dietary cholesterol intake.

The investigators concluded that dietary total, trans, saturated and partially monounsaturated fat as well as cholesterol intake increase risk of ovarian cancer among women.

Original title:
Dietary Fat Intake and Risk of Ovarian Cancer: A Systematic Review and Dose-Response Meta-Analysis of Observational Studies by Sadeghi A, Shab-Bidar S, […], Djafarian K.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31058552

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High serum iron levels increase breast cancer risk

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Objectives:
Iron has been shown to promote breast carcinogenesis in animal models through generation of oxidative stress and interaction with estrogen. Heme iron, which is found exclusively in animal-sourced foods, is suggested to have a more detrimental effect. Epidemiological evidence of the association between iron and breast cancer risk remains inconclusive and has not been comprehensively summarized. Therefore, this review article has been conducted.

Does dietary iron consumption increase breast cancer risk?

Study design:
This review article included 15 case-control studies and 12 prospective cohort studies.

Of the 17 studies assessing iron intake, 7 were cohort studies with study size ranging from 4,646 to 193,742 participants, follow-up ranging from 5.5 to 20 years and number of breast cancer cases ranging from 188 to 9,305. The remaining 10 studies were case-control studies, of which 4 were hospital-based, 3 were population-based and 3 were nested within existing cohorts, with case numbers ranging from 220 to 3,452.

Of the 11 studies assessing body iron status, 5 were cohort studies with study size ranging from 1,795 to 164,355 participants, follow-up ranging from 7.1 to 17.6 years and number of cases ranging from 80 to 3,238. The remaining 6 studies used a nested case-control or case-cohort design, with follow-up (where reported) ranging from 4 to 15.7 years and case numbers ranging from 107 to 795.

Overall, NOS scores ranged from 4 to 9 (mean = 7.0).

No publication bias was found.

Results and conclusions:
The investigators found compared to lowest category, highest dietary heme iron intake significantly increased risk of breast cancer with 12% [pooled RR = 1.12, 95% CI = 1.04-1.22, I2 = 39%, p heterogeneity = 0.15].

The investigators found each 1 mg/day increase in dietary heme iron intake, was associated with a statistically significant 8% increase in breast cancer risk [pooled RR = 1.08, 95% CI = 1.002–1.17].

The investigators found compared to lowest levels, highest serum iron levels significantly increased risk of breast cancer with 22% [pooled RR = 1.22, 95% CI = 1.01-1.47, I2 = 61%, p heterogeneity = 0.04].

The investigators found serum iron levels exhibited a J-shaped dose-response relationship with breast cancer risk, with strong evidence of a nonlinear effect [p nonlinearity  0.001].

Specifically, a steady increase in risk was noted for serum iron levels above ~ 100 μg/dL, with the association becoming statistically significant at just beyond ~ 125 μg/dL.

The investigators concluded that higher dietary heme iron intake and higher serum iron levels increase breast cancer risk. Further research is needed to better elucidate the association between iron intake/status and risk of breast cancer.

Original title:
Iron intake, body iron status, and risk of breast cancer: a systematic review and meta-analysis by Chang VC, Cotterchio M and Khoo E.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6555759/

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Egg consumption is not associated with brain cancer risk

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Objectives:
Is there an association between poultry and egg consumption and brain cancer risk?

Study design:
This review article included a total of 10 articles (6 articles for poultry consumption and 5 articles for egg consumption).

Results and conclusions:
The investigators found no association between poultry consumption and reduced risk of brain cancer [summarized relative risk = 0.901, 95% CI = 0.703-1.154, I2 = 60.7%, p = 0.018].
No association because RR of 1 was found in the 95% CI of 0.703 to 1.154. RR of 1 means no risk/association.

The investigators found in 4 studies no association between poultry consumption and reduced risk of brain cancer glioma [summarized relative risk = 0.873, 95% CI = 0.737-1.034, I2 = 0.0%, p = 0.838].

The investigators found no association between egg consumption and reduced risk of brain cancer [summarized relative risk = 0.998, 95% CI = 0.552-1.805, I2 = 82.6%, p = 0.001].

The investigators found no association between egg consumption and increased risk of brain cancer glioma [summarized relative risk = 1.472, 95% CI = 0.935-2.316].

The investigators concluded that poultry and egg consumption are not associated with the risk of brain cancer. Due to the limited quality of evidence currently available, more studies related to poultry and egg consumption for brain cancer is necessary.

Original title:
A meta-analysis of the association between poultry and egg consumption and the risk of brain cancer by Luo H, Sun P, [...], Guo Y.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30782302

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Tea reduces brain cancer in American population

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Objectives:
Previous studies had demonstrated some associations between coffee and tea consumption and brain cancer risk resulted in an inconsistent relationship. Therefore, this review article has been conducted.

Does coffee or tea consumption reduce brain cancer risk?

Study design:
This review article included 8 cohort studies and 3 case-control studies, involving 2,583 cases (persons with brain cancer) among 1,684,262 participants.

Based on Egger’s test and funnel plot, there existed no publication bias.

Results and conclusions:
The investigators found highest category of coffee consumption significantly reduced risk of brain cancer with 21.5% [RR = 0.785, 95% CI = 0.580-0.984, I2 = 65.6%, p for heterogeneity = 0.001], when compared with the lowest category.

The investigators found in supgroup analysis highest category of coffee consumption significantly reduced risk of glioma with 24% [RR = 0.760, 95% CI = 0.548-0.972], when compared with the lowest category.

The investigators found in cohort studies highest category of coffee consumption significantly reduced risk of brain cancer with 14.2% [RR = 0.858, 95% CI = 0.700-0.992], when compared with the lowest category. However, this reduced risk was not significant in case-control studies.

The investigators found highest category of coffee consumption significantly reduced risk of brain cancer with 88.3% in Asian populations [RR = 0.217, 95% CI = 0.042-0.896], when compared with the lowest category. However, this reduced risk was not significant in other populations.

The investigators found sensitivity analysis showed pooled RR of coffee consumption ranged from 0.738 [95% CI = 0.542-0.961) to 0.905 [95% CI = 0.754-1.088].

The investigators found highest category of tea consumption significantly reduced risk of brain cancer with 20.2% in American populations [RR = 0.798, 95% CI = 0.646-0.986], when compared with the lowest category.

The investigators found sensitivity analysis showed pooled RR of tea consumption ranged from 0.863 [95% CI = 0.699-1.067] to 0.947 [95% CI = 0.763-1.176].

The investigators found highest category of coffee plus tea consumption significantly reduced risk of brain cancer with 31.6% [RR = 0.684, 95% CI = 0.481-0.975], when compared with the lowest category.

The investigators concluded higher consumption of coffee reduces risk of brain cancer in Asian populations and higher consumption of tea reduces risk of brain cancer in American population. However, future studies with detailed information about sex, lifestyle and some other related factors are warranted to further explore the association between coffee or tea consumption and risk of brain cancer.

Original title:
Association between tea and coffee consumption and brain cancer risk: an updated meta-analysis by Song Y, Wang Z, [....], Guo J.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6419842/

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Decaffeinated coffee consumption could reduce ovarian cancer

Afbeelding

Objectives:
Results from earlier publications on the association of coffee and caffeine and risk of ovarian cancer are inconsistent. Therefore, this review article has been conducted.

Is there an association between coffee and caffeine consumption and risk of ovarian cancer among women?

Study design:
This review article included 22 case-control studies with a total of 40,140 participants, of which 8,568 patients with ovarian cancer. The participants were ≥ 17 years.

Results and conclusions:
The investigators found combining 21 effect sizes from 18 studies, no significant association was observed between total coffee consumption and risk of ovarian cancer [OR = 1.09, 95% CI = 0.94 to 1.26].

The investigators found no significant association between total caffeine intake and ovarian cancer risk [OR = 0.89, 95% CI = 0.55 to 1.45].

The investigators found, in addition, caffeinated coffee intake was not significantly associated with ovarian cancer risk [OR = 1.05, 95% CI = 0.87 to 1.28].

The investigators found, however, combining effect sizes from 5 studies, an inverse significant association between decaffeinated coffee intake and risk of ovarian cancer [OR = 0.72, 95% CI = 0.58 to 0.90].

The investigators concluded decaffeinated coffee consumption could reduce risk of ovarian cancer among women. Could reduce because this review article only included case-control studies and no cohort studies.

Original title:
Coffee and caffeine intake and risk of ovarian cancer: a systematic review and meta-analysis by Shafiei F, Salari-Moghaddam A , […], Esmaillzadeh A.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30833443

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Omega-3 fatty acids in fish consumption reduce breast cancer in Asian patients

Afbeelding

Objectives:
Do omega-3 fatty acids in fish consumption reduce risk of breast cancer in Asian patients?

Study design:
This review article included 4 cohort studies and 7 case-control studies with a total of 130,365 Asian patients.

There was not any study with significant publication bias included.

Results and conclusions:
The investigators found omega-3 fatty acids in fish consumption significantly reduced risk of  breast cancer in Asian patients with 20% [OR = 0.80, 95% CI = 0.73-0.87, p 0.00001].
Significant because OR of 1 was not found in the 95% CI of 0.73 to 0.87. OR of 1 means no risk/association.

The investigators concluded omega-3 fatty acids in fish consumption reduce breast cancer risk in Asian patients.

Original title:
Protective Effect of Omega-3 Fatty Acids in Fish Consumption Against Breast Cancer in Asian Patients: A Meta-Analysis by Nindrea RD, Aryandono T, […], Dwiprahasto I.

Link:
http://journal.waocp.org/?sid=Entrez:PubMed&id=pmid:30803190&key=2019.20.2.327

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Fish containing omega-3 fatty acids are salmon, mackerel, herring, lake trout, bluefin tuna, sturgeon, sablefish, anchovy, albacore tuna, whitefish, arctic char, sardines, bluefish, mullet, halibut, striped bass, mahi mahi, pollock, rockfish, rainbow trout, shark, catfish, carp, cod, flounder, grouper, haddock, ocean perch, red snapper, swordfish, pike, sole and tilapia.

Trans fatty acids are not associated with risk of breast cancer

Afbeelding

Objectives:
Although the relationship between dietary intake and serum levels of trans fatty acids and risk of breast cancer has been investigated extensively, findings are inconsistent. Therefore, this review article has been conducted.

Do dietary intake and serum levels of trans fatty acids increase risk of breast cancer?

Study design:
This review article included 6 cohort studies and 1 nested case-control study on total dietary trans fat intake and 1 cohort study and 4 nested case-control studies on serum trans fatty acids.

Participants were apparently healthy aged 26 years or older.

Results and conclusions:
The investigators found no significant relationship between dietary intake of total trans fatty acids and risk of breast cancer [pooled effect size = 1.02, 95% CI = 0.95-1.10, p = 0.403].

The investigators found in 3 effect sizes from 2 cohort studies and 1 nested case-control study, no significant relation between dietary intake of conjugated linoleic acid (CLA) and risk of breast cancer [pooled effect size = 1.05, 95% CI = 0.95-1.17, p = 0.513].

The investigators found based on 5 effect sizes, each additional 1 g/day dietary intake of total trans fats was not significantly associated with risk of breast cancer [RR = 1.00, 95% CI = 0.99-1.01].

The investigators found high serum levels of trans fats were associated with an increased risk of 37% of breast cancer among postmenopausal women [pooled effect size = 1.37, 95% CI = 1.04-1.81, p = 0.02].

The investigators concluded dietary intake of trans fatty acids (also called trans fats) is not associated with risk of breast cancer. However, a significant positive association is seen between serum trans fats and risk of breast cancer in postmenopausal women.

Original title:
Dietary intake and serum levels of trans fatty acids and risk of breast cancer: A systematic review and dose-response meta-analysis of prospective studies by Anjom-Shoae J, Sadeghi O, […], Esmaillzadeh A.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30954361

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Daily 100 μg dietary folate intake reduce oestrogen-receptor-negative breast cancer

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Objectives:
Epidemiological studies focusing on the association between folate and breast cancer risk reported inconsistent findings. Therefore, this review article has been conducted.

Does dietary folate intake reduce breast cancer risk?

Study design:
This review article included a total of 23 prospective cohort studies involving 41,516 cases (=women with breast cancer) among 1,171,048 individuals.

Results and conclusions:
The investigators found dietary folate intake significantly reduced risk of oestrogen-receptor-negative breast cancer with 12% [pooled risk ratio = 0.88, 95% CI = 0.78-1.00].

The investigators found dietary folate intake significantly reduced risk of oestrogen-receptor-negative/progesterone-receptor-negative breast cancer with 18% [pooled risk ratio = 0.82, 95% CI = 0.68-0.97].

The investigators found an increment of dietary folate intake of 100 μg per day was associated with a deceased risk of oestrogen-receptor-negative breast cancer with 6% [RR = 0.94, 95% CI = 0.88-0.99].

The investigators found an increment of dietary folate intake of 100 μg per day was associated with a deceased risk of oestrogen-receptor-negative/progesterone-receptor-negative breast cancer with 10% [RR = 0.90, 95% CI = 0.85-0.97].

The investigators found high dietary folate intake significantly reduced breast cancer risk in premenopausal women with 6% [RR = 0.94, 95% CI = 0.88-1.00].

The investigators found high dietary folate intake significantly reduced breast cancer risk in women with moderate or high levels of alcohol consumption with 18% [RR = 0.82, 95% CI = 0.72-0.94].

The investigators concluded that at least 100 μg per day dietary folate intake, reduce both oestrogen-receptor-negative and oestrogen-receptor-negative/progesterone-receptor-negative breast cancer, particularly among premenopausal women and women with moderate or high levels of alcohol consumption.

Original title:
Folate intake and the risk of breast cancer: an up-to-date meta-analysis of prospective studies by Zeng J, Wang K, [...], Chang H.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30647438

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100-300 g/day fruit or vegetables reduce all-cause mortality

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Objectives:
Low fruit and vegetable intakes are recognized risk factors for noncommunicable diseases. Therefore, this review article has been conducted.

Do fruit or vegetables intakes reduce noncommunicable diseases, likes cancer, coronary heart disease and all-cause mortality?

Study design:
This review article included 64 reports investigating 98 risk-disease pairs. 56 pairs from 39 reports were assessed as statistically significant, involving 29 burden of diseases.

Results and conclusions:
The investigators found in linear dose analysis for each 100 g/day increase in fruit intakes a significantly reduced risk of 44% [RR = 0.56, 95% CI = 0.42 to 0.74] for esophageal cancer.
Significant means that there is an association with a 95% confidence.

The investigators found in linear dose analysis for each 100 g/day increase in fruit intakes a significantly reduced risk of 28% [RR = 0.72, 95% CI = 0.59 to 0.87] for mouth, pharynx and larynx cancer.

The investigators found in nonlinear dose analysis for the first 100 g/day increase in fruit intakes a significantly reduced risk of 14% [RR = 0.86, 95% CI = 0.84 to 0.88] for stroke.

The investigators found in nonlinear dose analysis for the first 100 g/day increase in fruit intakes a significantly reduced risk of 11% [RR = 0.89, 95% CI = 0.88 to 0.90] for all-cause mortality.

The investigators found in linear dose analysis for each 100 g/day increase in vegetable intakes a significantly reduced risk of 12% [RR = 0.88, 95% CI = 0.80 to 0.95] for renal cell cancer.

The investigators found in linear dose analysis for each 100 g/day increase in vegetable intakes a significantly reduced risk of 11% [RR = 0.89, 95% CI = 0.84 to 0.95] for non-Hodgkin lymphoma.

The investigators found in nonlinear dose analysis for the first 100 g/day increase in vegetable intakes a significantly reduced risk of 14% [RR = 0.86, 95% CI = 0.84 to 0.89] for coronary heart disease.

The investigators found in nonlinear dose analysis for the first 100 g/day increase in vegetable intakes a significantly reduced risk of 13% [RR = 0.87, 95% CI = 0.84 to 0.90] for all-cause mortality.

The investigators found in nonlinear dose analysis clear increases in protective associations were observed with the first 200 g/day of fruit or vegetable intakes, whereas little further increase or even decrease in protective associations were reported beyond 300 g/day intakes.

The investigators found canned fruit intakes were positively associated with all-cause and cardiovascular disease mortality.

The investigators found pickled vegetable intakes were positively associated with stomach cancer.

The investigators concluded that 100-300 g/day of fruit or vegetables intakes reduce certain cancers, coronary heart disease and all-cause mortality. These findings support existing recommendations for fruit and vegetable intakes. Current comparative risk assessments might significantly underestimate the protective associations of fruit and vegetable intakes.

Original title:
The Associations of Fruit and Vegetable Intakes with Burden of Diseases: A Systematic Review of Meta-Analyses by Yip CSC, Chan W and Fielding R.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30639206

Additional information of El Mondo:
Find more information/studies on fruit and vegetable consumption, coronary heart disease and cancer right here.

Daily dietary intake of 100g red meat and 50g processed meat increase risk of colorectal cancer

Afbeelding

Objectives:
What is the relationship between dietary intake of 12 major food groups, including whole grains, refined grains, vegetables, fruit, nuts, legumes, eggs, dairy, fish, red meat, processed meat and sugar-sweetened beverages and colorectal cancer (CRC) risk?

Study design:
This review article included cohort studies.

Results and conclusions:
The investigators found in the linear dose-response meta-analysis, that every 30 g/d whole grains significantly reduced risk of colorectal cancer with 5% [RR = 0.95, 95% CI = 0.93 to 0.97, n = 9 cohort studies].

The investigators found in the linear dose-response meta-analysis, that every 100 g/d vegetables significantly reduced risk of colorectal cancer with 3% [RR = 0.97, 95% CI = 0.96 to 0.98, n = 15 cohort studies].

The investigators found in the linear dose-response meta-analysis, that every 100 g/d fruit significantly reduced risk of colorectal cancer with 3% [RR = 0.97, 95% CI = 0.95 to 0.99, n = 16 cohort studies]. 

The investigators found in the linear dose-response meta-analysis, that every 200 g/d dairy products significantly reduced risk of colorectal cancer with 7% [RR = 0.93, 95% CI = 0.91 to 0.94, n = 15 cohort studies]. 

The investigators found in the linear dose-response meta-analysis, that every 100 g/d red meat significantly increased risk of colorectal cancer with 12% [RR = 1.12, 95% CI = 1.06 to 1.19, n = 21 cohort studies].

The investigators found in the linear dose-response meta-analysis, that every 50 g/d processed meat significantly increased risk of colorectal cancer with 17% [RR = 1.17, 95% CI = 1.10 to 1.23, n = 16 cohort studies].

The investigators found some evidence for a nonlinear relationship between dietary intake of vegetables, fruit and dairy products and risk of colorectal cancer.

The investigators concluded that daily dietary intake of 30g whole grains, 100g vegetables,100g fruit and 200g dairy products reduce risk of colorectal cancer, while daily dietary intake of 100g red meat and 50g processed meat increase risk of colorectal cancer.

Original title:
Food groups and risk of colorectal cancer by Schwingshackl L, Schwedhelm C, [...], Schlesinger S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29210053

Additional information of El Mondo:
Find more information/studies on different food groups and colorectal cancer right here.

 

Daily 2-4 g carnitine does not reduce cancer-related fatigue

Afbeelding

Objectives:
Carnitine deficiency has been implicated as a potential pathway for cancer-related fatigue that could be treated with carnitine supplementation. Therefore, this review article (meta-analysis) has been conducted.

Does carnitine supplementation reduce cancer-related fatigue?

Study design:
This review article included 3 RCTs involving a total of 659 participants.

There were not enough studies to conduct sensitivity analyses to isolate potential sources of heterogeneity and test the robustness of findings.

Results and conclusions:
The investigators found in 3 RCTs involving a total of 659 participants that carnitine supplementation did not significantly reduce cancer-related fatigue [SMD = 0.06 points, 95% CI = -0.09 to 0.21, p = 0.45, I2 = 0%].
Clinical heterogeneity was evident from these studies in regards to the dose (2-4 g of carnitine per day), patient demographics (40-100% females included) and carnitine status.

The investigators concluded there is no evidence to support the use of carnitine supplementation (2-4 g of carnitine per day) for cancer-related fatigue.

Original title:
Efficacy and Effectiveness of Carnitine Supplementation for Cancer-Related Fatigue: A Systematic Literature Review and Meta-Analysis by Marx W, Teleni L, [...], Isenring E.

Link:
http://www.mdpi.com/2072-6643/9/11/1224/htm

Additional information of El Mondo:
Find more information/studies on carnitine, randomized controlled trials/cohort studies/subgroup analysis and cancer right here.

High intake of cooked carrot might be associated with a low incidence of urothelial cancer

Afbeelding

Objectives:
Previous studies regarding the relationship between carrot intake and risk of urothelial cancer have reported conflicting results. Therefore, this review article (meta-analysis) has been conducted.

Does a high consumption of carrot reduce urothelial cancer risk?

Study design:
This review article included a total of 6 epidemiological studies (4 case-control and 2 cohort studies) with 1,523 urothelial cancer cases.

There was no significant publication bias by Begg's test (p = 0.348) or Egger's test (p = 0.130).

Results and conclusions:
The investigators found overall analysis indicated a significantly reduced risk of 37% for urothelial cancer for high intake of carrot [OR = 0.63, 95% CI = 0.44-0.90, I2 = 79.6%, p 0.001].

The investigators found in the subgroup analysis by study design, a significantly reduced risk of 55% for urothelial cancer in case-control studies [OR = 0.45, 95% CI = 0.25-0.81]. However, this reduced risk was not significant in cohort studies [OR = 0.91, 95% CI = 0.67-1.24].
Not significant because OR of 1 was found in the 95% CI of 0.67 to 1.24. OR of 1 means no risk/association.

The investigators found, when separately analyzed by carrot type, a significantly reduced risk of 31% for cooked carrot [OR = 0.69, 95% CI 0.51-0.94], but the reduced risk was not significant for raw carrot [OR = 0.84, 95% CI = 0.37-1.93].

The investigators found in the stratified analysis by geographical region, a non-significantly reduced risk of 38% [OR = 0.62, 95% CI = 0.37-1.06], a non-significantly reduced risk of 30% [OR = 0.70, 95% CI = 0.29-1.67] and a non-significantly reduced risk of 47% [OR = 0.53, 95% CI = 0.22-1.26] for Europe, Asia and USA, respectively.

The investigators also found a non-significantly reduced risk of 44% [OR = 0.56, 95% CI = 0.27-1.17] and a non-significantly reduced risk of 27% [OR = 0.73, 95% CI = 0.12-4.60] for male and female, respectively.

The investigators concluded that a high intake of carrot might be associated with a low incidence of urothelial cancer. Might be associated because the reduced risk was not significant in cohort studies. Considering the limited included studies and huge heterogeneity, further large well-designed prospective cohort studies are warranted to confirm these findings.

Original title:
Carrot intake and incidence of urothelial cancer: a systematic review and meta-analysis by Luo X, Lu H, [...], Wang S.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5652827/

Additional information of El Mondo:
Find more information/studies on carrot consumption, randomized controlled trials/cohort studies/subgroup analysis and cancer right here.

 

N-3 PUFA supplementation improves immune function and reduces the level of inflammation in gastrointestinal cancer patients postoperatively

Afbeelding

Objectives:
Surgical resection remains the primary treatment for gastrointestinal (GI) malignancy including early-stage cancer. Omega-3 polyunsaturated fatty acids (n-3 PUFAs) have been reported to have beneficial clinical and immune-modulating effects in the prognosis of gastrointestinal cancer patients undergoing surgery. Therefore, this review article (meta-analysis) has been conducted.

What is the impact of n-3 PUFA supplementation on postoperative inflammation status and immune function of gastrointestinal cancer patients?

Study design:
This review article included a total of 9 RCTs with 623 participants.

The homogeneous test detected no statistical heterogeneity between studies.

There was no evidence of publication bias following assessment by funnel plot, Egger’s test [p > 0.05] and Begg’s test [p > 0.05].

Results and conclusions:
The investigators found the n-3 PUFAs regime significantly resulted in lower levels of C-reactive protein [p 0.05], interleukin-6 [p 0.01] and higher levels of albumin, CD3+ T cells, CD4+ T cells and CD4+/CD8+ ratio [p 0.05] compared with the isocaloric nutrition regime.

The investigators found, however, no significant difference in the level of tumor necrosis factor-α between the n-3 PUFAs regime and the isocaloric nutrition regime [p = 0.17].

The investigators found that the level of CD8 + T cells significantly decreased compared with the isocaloric nutrition regime [p 0.0001].

The investigators concluded that n-3 PUFAs are effective in improving the nutritional status and immune function of gastrointestinal cancer patients undergoing surgery as they effectively enhance immunity and attenuate the inflammatory response. Although further larger trials are needed, these fatty acids should be widely used in the clinic.

Original title:
Effects of omega-3 fatty acids on patients undergoing surgery for gastrointestinal malignancy: a systematic review and meta-analysis by Yu J, Liu L, [...], Yang F.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5391568/

Additional information of El Mondo:
Find more information/studies on n-3 PUFA consumption and cancer right here.
 

Plant-based dietary patterns decrease cancer risk

Afbeelding

Objectives:
The aim of this review article (meta-analysis) is to compare empirically derived dietary patterns in relation to cancer risk.

Study design:
This review article included observational studies, which evaluated the association with cancer risk between a posteriori derived dietary patterns.

Results and conclusions:
The investigators found a significantly 64% increased risk of cancer for the adoption of high-meat compared to plant-based dietary patterns [RR = 1.64, 95% CI = 1.02-2.63].

The investigators found a significantly 12% lower risk of cancer for individuals adopting a plant-based dietary pattern over a mixed one [RR = 0.88, 95% BI = 0.82-0.95].

The investigators concluded that plant-based dietary patterns decrease cancer risk; meanwhile meat-based dietary patterns increase cancer risk.

Original title:
Differences in the association between empirically derived dietary patterns and cancer: a meta-analysis by Bella F, Godos J, […], Sciacca S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/27894200

Additional information of El Mondo:
Find more information/studies on veganism and cancer right here.
 

A high intake of red meat increases risk of lung cancer among never and non-smokers

Afbeelding

Objectives:
Increasing evidence suggests that high consumption of meat is linked to lung cancer but the previous meta-analyses did not properly address the role of tobacco smoking as a potential confounder. Therefore, this review article (meta-analysis) has been conducted.

Does high consumption of meat increase lung cancer risk among never and non-smokers?

Study design:
This review article included 14 independent observational studies and a total of 5,368 subjects with lung cancer.
There was no indication of publication bias.

Results and conclusions:
The investigators found in 11 studies, a statistically significant 24% increased risk of lung cancer for high consumption of red meat [Summary Relative Risk = 1.24, 95% CI = 1.01-1.51, I2 = 31%].

The investigators found no significant associations between high consumption of other types of meat, fish or for heterocyclic amines and lung cancer risk.

The investigators found no significant risk estimates for the increase of one serving per week of any type of meat or fish.

The investigators concluded a high intake of red meat increases the risk of lung cancer among never and non-smokers.

Original title:
Carcinogenicity of High Consumption of Meat and Lung Cancer Risk Among Non-Smokers: A Comprehensive Meta-Analysis by Gnagnarella P, Caini S, […], Gandini S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29016198

Additional information of El Mondo:
Find more information/studies on meat consumption, randomized controlled trials/cohort studies/subgroup analysis and cancer right here.

According to international recommendations, adults should aim to have a maximum of 70g red meat per day or 500g per week (cooked weight).
 

High serum selenium levels reduce risk of cervical cancer among women

Afbeelding

Objectives:
Several studies have investigated the relationship between serum selenium concentration and cervical cancer, but the results were inconsistent. Therefore, this review article (meta-analysis) has been conducted.

Do high serum selenium levels reduce risk of cervical cancer among women?

Study design:
This review article included 12 studies investigating the association by univariate analysis and 5 studies by multivariate analysis.

Results and conclusions:
The investigators found in univariate analysis, that serum selenium levels in women with cervical cancer were significantly lower than in women without cervical cancer [SMD = -4.86, 95% CI = -6.03 to -3.69]. Subgroup analysis showed consistent results.

The investigators found in multivariate analysis, that serum selenium levels in women with cervical cancer were significantly lower than in women without cervical cancer [OR = 0.55, 95% CI = 0.42-0.73].

The investigators found after treatment, the serum selenium levels increased significantly [SMD = 2.59, 95% CI = 0.50-4.69].

The investigators concluded high serum selenium levels reduce risk of cervical cancer among women.

Original title:
Serum Selenium Levels and Cervical Cancer: Systematic Review and Meta-Analysis by He D, Wang Z, […], Chen D.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28255860

Additional information of El Mondo:
Find more information/studies on selenium, randomized controlled trials/cohort studies/subgroup analysis and cancer right here.

Univariate analysis is the simplest form of analyzing data. "Uni" means "one", thus in other words your data has only one variable.

High serum selenium levels can be obtained by consuming selenium-rich food items and/or taking selenium supplements.
 

Both high vitamin E intake and circulating vitamin E levels could reduce cervical neoplasia risk

Afbeelding

Objectives:
Several epidemiological studies have suggested that vitamin E could reduce the risk of uterine cervical neoplasm. However, controversial data were presented by different reports. Therefore, this review article (meta-analysis) has been conducted.

Do both high vitamin E intake and circulating vitamin E levels reduce risk of uterine cervical neoplasm?

Study design:
This review article included 15 case-control studies, involving 3,741 cases (those with uterine cervical neoplasm) and 6,328 controls (those without uterine cervical neoplasm).

There was no obvious publication bias.

Results and conclusions:
The investigators found in pooled analysis that the highest intake of vitamin E significantly reduced risk of cervical neoplasia with 42% [OR = 0.58, 95% CI = 0.47-0.72, I2 = 83%]. In addition, both vitamin E intake and blood levels of vitamin E were negatively correlated with cervical neoplasia risk.

The investigators found in subgroup analysis that the highest intake of dietary vitamin E significantly reduced risk of cervical neoplasia with 32% [OR = 0.68, 95% CI = 0.49-0.94, I2 = 70%].

The investigators found in subgroup analysis that the highest vitamin E blood levels significantly reduced risk of cervical neoplasia with 48% [OR = 0.52, 95% CI = 0.40-0.69, I2 = 86%].

The investigators found in subgroup analysis that vitamin E significantly reduced risk of cervical neoplasia with 40% [OR = 0.60, 95% CI = 0.45-0.78, I2 = 84%] in studies conducted in America and Europe.

The investigators found in subgroup analysis that the highest intake of vitamin E significantly reduced risk of cervical neoplasia with 46% [OR = 0.54, 95% CI = 0.39-0.76, I2 = 75%] in studies conducted in Asia.

The investigators found subgroup analysis stratified by different types of cervical neoplasm indicated that the highest intake (or serum level) of vitamin E significantly decreased risk of cervical cancer with 47% [OR = 0.53, 95% CI = 0.390.73, I2 = 77%] and cervical intraepithelial neoplasia (CIN) with 46% [OR = 0.54, 95% CI = 0.43-0.70, I2 = 79%]. Meanwhile, sensitivity analysis to assess the influence of each single study on the pooled ORs by omitting a research in each turn, showed combined ORs were not substantially different, indicating that the results of this meta-analysis were stable and reliable.

The investigators concluded that both vitamin E intake and circulating vitamin E levels could reduce cervical neoplasia risk, including cervical cancer and cervical intraepithelial neoplasia. In other words, sufficient supplementation of vitamin E might reduce the risk of cervical neoplasia. However, more randomized controlled trials and cohort studies with high quality are required to further validate this inverse relationship.

Original title:
Effect of vitamin E supplementation on uterine cervical neoplasm: A meta-analysis of case-control studies by Hu X, Li S, [...], Zhu X.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5567498/

Additional information of El Mondo:
Find more information/studies on vitamin E, randomized controlled trials/cohort studies/subgroup analysis and cancer right here.

Higher intake of vitamin E is an intake which covers the recommended daily allowance of vitamin E of at least 1 day.

High intakes of saturated fat increase risk of lung cancer

Afbeelding

Objectives:
Dietary fat may play a role in lung carcinogenesis. Findings from epidemiologic studies, however, remain inconsistent. Therefore, this review article (meta-analysis) has been conducted.

Is there an association between dietary fat intake and the risk of lung cancer?

Study design:
This review article included 10 prospective cohort studies with a total of 1,445,850 participants, of which 18,822 incident cases (subjects with lung cancer).

The mean follow-up was 9.4 years. 

Results and conclusions:
The investigators found high intakes of total fat were associated with a 7% significant increased risk of lung cancer [for highest v lowest quintile: HR = 1.07, 95% CI = 1.00 to 1.15].

The investigators found high intakes of saturated fat were associated with a 14% significant increased risk of lung cancer [for highest v lowest quintile: HR = 1.14, 95% CI = 1.07 to 1.22].

The investigators found high intakes of saturated fat were associated with a 23% significant increased risk of lung cancer among current smokers [for highest v lowest quintile: HR = 1.23, 95% CI = 1.13 to 1.35, p for trend 0.001].

The investigators found high intakes of saturated fat were associated with a 61% significant increased risk of squamous cell lung cancer [for highest v lowest quintile: HR = 1.61, 95% CI = 1.38 to 1.88].

The investigators found high intakes of saturated fat were associated with a 40% significant increased risk of small cell carcinoma lung cancer [for highest v lowest quintile: HR = 1.40, 95% CI = 1.17 to 1.67].

The investigators found a high intake of polyunsaturated fat was associated with a 8% significant decreased risk of lung cancer [for highest v lowest quintile: HR = 0.92, 95% CI = 0.87 to 0.98, p for trend = 0.02].

The investigators found a 5% energy substitution of saturated fat with polyunsaturated fat was associated with a 16% and 17% lower risk of small cell and squamous cell carcinoma, respectively.

The investigators found no associations for monounsaturated fat.

The investigators concluded that high intakes of polyunsaturated fat decrease risk of lung cancer, while high intakes of saturated fat increase risk of lung cancer, particularly among smokers and for squamous cell and small cell carcinoma.

Original title:
Dietary Fat Intake and Lung Cancer Risk: A Pooled Analysis by Yang JJ, Yu D1, […], Shu XO.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28742456

Additional information of El Mondo:
Find more information/studies on fat and cancer right here.

A daily diet with high intakes of saturated fat is a diet that is largely made up of meals/products with more than 10 En% saturated fat, with a small part of meals/products with less than 10 En% saturated fat. Practically, this means that all meals/products that you eat on a daily basis should contain on average more than 10 En% saturated fat.
Check here which products contain more than 10% En% saturated fat.

A daily diet with low intakes of saturated fat is a diet that is largely made up of meals/products with less than 7 En% saturated fat, with a small part of meals/products with more than 7 En% saturated fat. Practically, this means that all meals/products that you eat on a daily basis should contain on average less than 7 En% saturated fat.
Check here which products contain less than 7% En% saturated fat.

Vitamin and antioxidant supplements have no overall preventive effect against bladder cancer

Afbeelding

Objectives:
Recently, several randomized controlled trials (RCTs) reported the association between the use of vitamin or antioxidant supplements and the risk of bladder cancer. However, those findings remain inconsistent and some studies even reported that vitamin and antioxidant supplements increased the risk of bladder cancer. Therefore, this review article (meta-analysis) has been conducted.

Is there an association between the use of vitamin or antioxidant supplements and the risk of bladder cancer?

Study design:
This review article included 14 RCTs with a total of 147,383 participants, which involved 89,972 in the supplement group and 57,411 in the control group.

The supplementation and follow-up periods ranged between 1 and 13 years.

The types of vitamin and antioxidant supplements were as follows: vitamin A, vitamin B6, vitamin C, vitamin D, vitamin E, beta-carotene, folic acid and selenium.
The dosage regimens in individual trials were as follows: vitamin A (200 mg or 25,000, 36,000 or 40,000 IU daily), vitamin B6 (25 or 100 mg daily), vitamin C (2,000 mg daily), vitamin D (1,600 IU daily), vitamin E (50 mg or 400 IU daily), beta-carotene (20 or 30 mg daily; 50 mg alternate day; 75 mg daily for 3-month cycles), folic acid (1.6 mg daily) and selenium (200 μg daily).

Publication bias was not observed [Begg's funnel plot, symmetrical and Egger's test, p for bias = 0.378].

Results and conclusions:
The investigators found in fixed-effect meta-analysis of all 14 trials that vitamin or antioxidant supplementation was not associated with the risk of bladder cancer [RR = 1.04, 95% CI = 0.92-1.17, I2 = 39.7%].

The investigators found regarding types of supplements, any type of vitamin and antioxidant supplements had no beneficial effect on the risk of bladder cancer:
-vitamin A [RR = 0.86, 95% CI = 0.65-1.13, I2 = 61.7%, n = 5];
-vitamin B6 [RR = 0.77, 95% CI = 0.49-1.20, I2 = 78.8%, n = 3];
-vitamin C [RR = 0.74, 95% CI = 0.36-1.54, I2 = 88.8%, n = 2];
-vitamin D [RR = 1.05, 95% CI = 0.85-1.29, n = 1];
-vitamin E [RR = 0.91, 95% CI = 0.69-1.19, I2 = 60.9%, n = 6];
-beta-carotene [RR = 1.19, 95% CI = 0.96-1.46, I2 = 0.0%, n = 6];
-folate [RR = 1.05, 95% CI = 0.85-1.29, n = 1] and
-selenium [RR = 1.09, 95% CI = 0.81-1.46, I2 = 0.0%, n = 2].

The investigators found overall, there was no significant effect of vitamin and antioxidant supplements in the subgroup meta-analyses by various factors such as dose of supplements, type of cancer prevention, methodological quality, duration of treatment, provider of supplements, type of control and number of participants.
However, the risk of bladder cancer was marginally increased in trials with the use of beta-carotene alone [RR = 1.44, 95% CI = 1.00-2.09, I2 = 0.0%, n = 3].

The investigators concluded that vitamin and antioxidant supplements have no overall preventive effect against bladder cancer. Instead, subgroup meta-analyses showed that beta-carotene supplementation marginally increased the risk of bladder cancer. Even though further large, high-quality trials are required to confirm these associations, the effects (either beneficial or harmful) of vitamin or antioxidant supplements on bladder cancer should not be overemphasized.

Original title:
Effects of Vitamin and Antioxidant Supplements in Prevention of Bladder Cancer: a Meta-Analysis of Randomized Controlled Trials by Park SJ, Myung SK, […], Lee YJ.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5334161/

Additional information of El Mondo:
Find more information/studies on vitamins, selenium, beta-carotene, antioxidants and cancer right here.