Green tea has been suggested to improve cardiovascular disease risk factors, including circulating lipid variables. However, current evidence is predominantly based on small, short-term randomized ...controlled trials conducted in diverse populations.
The aim of this study was to examine the efficacy and impact of green tea extract (GTE) supplementation high in epigallocatechin gallate (EGCG) on blood lipids in healthy postmenopausal women.
This was an ancillary study of a double-blind, randomized, placebo-controlled, parallel-arm trial investigating the effects of a GTE supplement containing 1315 mg catechins (843 mg EGCG) on biomarkers of breast cancer risk. Participants were randomly assigned to receive GTE (n = 538) or placebo (n = 537) and were stratified by catechol-O-methyltransferase (COMT) genotype activity (high COMT compared with low or intermediate COMT genotype activity). They consumed either 4 GTE or identical placebo capsules daily for 12 mo. A total of 936 women completed this substudy. Circulating lipid panels including total cholesterol (TC), HDL cholesterol, and triglycerides were measured at baseline and at months 6 and 12.
Compared with placebo, 1-y supplementation with GTE capsules resulted in a significant reduction in circulating TC (-2.1% compared with 0.7%; P = 0.0004), LDL cholesterol (-4.1% compared with 0.9%; P < 0.0001) and non-HDL cholesterol (-3.1% compared with 0.4%; P = 0.0032). There was no change in HDL-cholesterol concentration, but triglyceride concentrations increased by 3.6% in the GTE group, whereas they decreased by 2.5% in the placebo group (P = 0.046). A significant reduction in TC was observed only among women with high (i.e., ≥200 mg/dL) baseline TC concentrations (P-interaction = 0.01) who consumed GTE capsules. The effect of GTE on the increase in triglycerides was mainly observed among obese women and statin users (P-interaction = 0.06).
Supplementation with GTE significantly reduced circulating TC and LDL-cholesterol concentrations, especially in those with elevated baseline TC concentrations. This trial was registered at clinicaltrials.gov as NCT00917735.
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CMK, GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Previous studies have evidenced an association between gastroesophageal reflux and esophageal adenocarcinoma (EA). It is unknown to what extent these associations vary by population, age, sex, body ...mass index, and cigarette smoking, or whether duration and frequency of symptoms interact in predicting risk. The Barrett's and Esophageal Adenocarcinoma Consortium (BEACON) allowed an in-depth assessment of these issues.
Detailed information on heartburn and regurgitation symptoms and covariates were available from five BEACON case-control studies of EA and esophagogastric junction adenocarcinoma (EGJA). We conducted single-study multivariable logistic regressions followed by random-effects meta-analysis. Stratified analyses, meta-regressions, and sensitivity analyses were also conducted.
Five studies provided 1,128 EA cases, 1,229 EGJA cases, and 4,057 controls for analysis. All summary estimates indicated positive, significant associations between heartburn/regurgitation symptoms and EA. Increasing heartburn duration was associated with increasing EA risk; odds ratios were 2.80, 3.85, and 6.24 for symptom durations of <10 years, 10 to <20 years, and ≥20 years. Associations with EGJA were slighter weaker, but still statistically significant for those with the highest exposure. Both frequency and duration of heartburn/regurgitation symptoms were independently associated with higher risk. We observed similar strengths of associations when stratified by age, sex, cigarette smoking, and body mass index.
This analysis indicates that the association between heartburn/regurgitation symptoms and EA is strong, increases with increased duration and/or frequency, and is consistent across major risk factors. Weaker associations for EGJA suggest that this cancer site has a dissimilar pathogenesis or represents a mixed population of patients.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Previous studies suggest an association between obesity and oesophageal (OA) and oesophagogastric junction adenocarcinomas (OGJA). However, these studies have been limited in their ability to assess ...whether the effects of obesity vary by gender or by the presence of gastro-oesophageal reflux (GERD) symptoms.
Individual participant data from 12 epidemiological studies (8 North American, 3 European and 1 Australian) comprising 1997 OA cases, 1900 OGJA cases and 11 159 control subjects were pooled. Logistic regression was used to estimate study-specific odds ratios (ORs) and 95% confidence intervals (CIs) for the association between body mass index (BMI, kg/m(2)) and the risk of OA and OGJA. Random-effects meta-analysis was used to combine these ORs. We also investigated effect modification and synergistic interaction of BMI with GERD symptoms and gender.
The association of OA and OGJA increased directly with increasing BMI (P for trend <0.001). Compared with individuals with a BMI <25, BMI ≥40 was associated with both OA (OR 4.76, 95% CI 2.96-7.66) and OGJA (OR 3.07, 95% CI 1.89-4.99). These associations were similar when stratified by gender and GERD symptoms. There was evidence for synergistic interaction between BMI and GERD symptoms in relation to OA/OGJA risk.
These data indicate that BMI is directly associated with OA and OGJA risk in both men and women and in those with and without GERD symptoms. Disentangling the relationship between BMI and GERD will be important for understanding preventive efforts for OA and OGJA.
Objective
To investigate the association between gut microbiome with breast tumor characteristics (receptor status, stage and grade) and known breast cancer risk factors.
Methods
In a pilot ...cross-sectional study of 37 incident breast cancer patients, fecal samples collected prior to chemotherapy were analyzed by 16S ribosomal RNA (rRNA) gene-based sequencing protocol. Alpha diversity and specific taxa by tumor characteristics and breast cancer risk factors were tested by Wilcoxon rank sum test, and by differential abundance analysis, using a zero-inflated negative binomial regression model with adjustment for total counts, age and race/ethnicity.
Results
There were no significant alpha diversity or phyla differences by estrogen/progesterone receptor status, tumor grade, stage, parity and body mass index. However, women with human epidermal growth factor receptor 2 positive (HER2+) (
n
= 12) compared to HER2− (
n
= 25) breast cancer showed 12–23% lower alpha diversity number of species (OTU)
p
= 0.033, Shannon index
p
= 0.034, lower abundance of
Firmicutes
(
p
= 0.005) and higher abundance of
Bacteroidetes
(
p
= 0.089
).
Early menarche (ages ≤ 11) (
n
= 11) compared with later menarche (ages ≥ 12) (
n
= 26) was associated with lower OTU (
p
= 0.036), Chao1 index (
p
= 0.020) and lower abundance of
Firmicutes
(
p
= 0.048). High total body fat (TBF) (> 46%) (
n
= 12) compared to lower (≤ 46%) TBF was also associated with lower Chao 1 index (
p
= 0.011). There were other significant taxa abundance differences by HER2 status, menarche age, as well as other tumor and breast cancer risk factors.
Conclusions and relevance
Further studies are needed to identify characteristics of the human microbiome and the interrelationships between breast cancer hormone receptor status and established breast cancer risk factors.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Previous studies using different exposure methods to assess air pollution and breast cancer risk among primarily whites have been inconclusive. Air pollutant exposures of particulate matter and ...oxides of nitrogen were estimated by kriging (NOx, NO2, PM10, PM2.5), land use regression (LUR, NOx, NO2) and California Line Source Dispersion model (CALINE4, NOx, PM2.5) for 57,589 females from the Multiethnic Cohort, residing largely in Los Angeles County from recruitment (1993–1996) through 2010. Cox proportional hazards models were used to examine the associations between time‐varying air pollution and breast cancer incidence adjusting for confounding factors. Stratified analyses were conducted by race/ethnicity and distance to major roads. Among all women, breast cancer risk was positively but not significantly associated with NOx (per 50 parts per billion ppb) and NO2 (per 20 ppb) determined by kriging and LUR and with PM2.5 and PM10 (per 10 μg/m3) determined by kriging. However, among women who lived within 500 m of major roads, significantly increased risks were observed with NOx (hazard ratio HR = 1.35, 95% confidence interval 95% CI: 1.02–1.79), NO2 (HR = 1.44, 95% CI: 1.04–1.99), PM10 (HR = 1.29, 95% CI: 1.07–1.55) and PM2.5 (HR = 1.85, 95% CI: 1.15–2.99) determined by kriging and NOx (HR = 1.21, 95% CI:1.01–1.45) and NO2 (HR = 1.26, 95% CI: 1.00–1.59) determined by LUR. No overall associations were observed with exposures assessed by CALINE4. Subgroup analyses suggested stronger associations of NOx and NO2 among African Americans and Japanese Americans. Further studies of multiethnic populations to confirm the effects of air pollution, particularly near‐roadway exposures, on the risk of breast cancer is warranted.
What's new?
Prior studies of air pollution and breast cancer generally have employed one method of exposure assessment and have focused on white women, with inconsistent results. Here, three exposure assessment methods, kriging interpolation, land use regression (LUR), and California Line Source Dispersion model (CALINE4), were used to investigate associations between long‐term air pollutant exposure and breast cancer risk in the Southern California Multiethnic Cohort. Breast cancer risk was increased in association with air pollution exposure among women residing near major roads according to kriging and LUR measures.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
There is substantial interest in the possible anticancer effects of soy foods. In part, this is because of the historically low incidence rates of breast and prostate cancer in Asia. Of the several ...putative soybean chemopreventive agents, isoflavones have received the most attention. Awareness of this research has led increasing numbers of consumers to use soy foods, isoflavone-fortified foods, and isoflavone supplements. Therefore, there is a need for guidance regarding appropriate isoflavone intake levels. To this end, this article analyzed soy protein (as a surrogate for isoflavones) and isoflavone intake of the major soy food-consuming countries using individual dietary surveys for the bulk of the information. In total, 24 surveys from 4 countries that met the inclusion criteria were identified: Japan (n = 11), China (n = 7), Hong Kong (n = 4), and Singapore (n = 2). The results indicate that older Japanese adults consume approximately 6-11 g of soy protein and 25-50 mg of isoflavones (expressed as aglycone equivalents) per day. Intake in Hong Kong and Singapore is lower than in Japan, whereas significant regional intake differences exist for China. Evidence suggests that < or =10% of the Asian population consumes as much as 25 g of soy protein or 100 mg of isoflavones per day. The applicability of these findings for making soy intake recommendations for non-Asians is discussed.
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DOBA, IJS, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Abstract
The climate-violence relationship has been debated for decades, and yet most of the supportive evidence has come from ecological or cross-sectional analyses with very limited long-term ...exposure data. We conducted an individual-level, longitudinal study to investigate the association between ambient temperature and externalizing behaviors of urban-dwelling adolescents. Participants (n = 1,287) in the Risk Factors for Antisocial Behavior Study, in California, were examined during 2000–2012 (aged 9–18 years) with repeated assessments of their externalizing behaviors (e.g., aggression, delinquency). Ambient temperature data were obtained from the local meteorological information system. In adjusted multilevel models, aggressive behaviors significantly increased with rising average temperatures (per 1°C increment) in the preceding 1, 2, or 3 years (respectively, β = 0.23, 95% confidence interval (CI): 0.00, 0.46; β = 0.35, 95% CI: 0.06, 0.63; or β = 0.41, 95% CI: 0.08, 0.74), equivalent to 1.5–3.0 years of delay in age-related behavioral maturation. These associations were slightly stronger among girls and families of lower socioeconomic status but greatly diminished in neighborhoods with more green space. No significant associations were found with delinquency. Our study provides the first individual-level epidemiologic evidence supporting the adverse association of long-term ambient temperature and aggression. Similar approaches to studying meteorology and violent crime might further inform scientific debates on climate change and collective violence.
Background Previous studies that showed an association between smoking and adenocarcinomas of the esophagus and esophagogastric junction were limited in their ability to assess differences by tumor ...site, sex, dose–response, and duration of cigarette smoking cessation. Methods We used primary data from 10 population-based case–control studies and two cohort studies from the Barrett’s Esophagus and Esophageal Adenocarcinoma Consortium. Analyses were restricted to white non-Hispanic men and women. Patients were classified as having esophageal adenocarcinoma (n = 1540), esophagogastric junctional adenocarcinoma (n = 1450), or a combination of both (all adenocarcinoma; n = 2990). Control subjects (n = 9453) were population based. Associations between pack-years of cigarette smoking and risks of adenocarcinomas were assessed, as well as their potential modification by sex and duration of smoking cessation. Study-specific odds ratios (ORs) estimated using multivariable logistic regression models, adjusted for age, sex, body mass index, education, and gastroesophageal reflux, were pooled using a meta-analytic methodology to generate summary odds ratios. All statistical tests were two-sided. Results The summary odds ratios demonstrated strong associations between cigarette smoking and esophageal adenocarcinoma (OR = 1.96, 95% confidence interval CI = 1.64 to 2.34), esophagogastric junctional adenocarcinoma (OR = 2.18, 95% CI = 1.84 to 2.58), and all adenocarcinoma (OR = 2.08, 95% CI = 1.83 to 2.37). In addition, there was a strong dose–response association between pack-years of cigarette smoking and each outcome (P < .001). Compared with current smokers, longer smoking cessation was associated with a decreased risk of all adenocarcinoma after adjusting for pack-years (<10 years of smoking cessation: OR = 0.82, 95% CI = 0.60 to 1.13; and ≥10 years of smoking cessation: OR = 0.71, 95% CI = 0.56 to 0.89). Sex-specific summary odds ratios were similar. Conclusions Cigarette smoking is associated with increased risks of adenocarcinomas of the esophagus and esophagogastric junction in white men and women; compared with current smoking, smoking cessation was associated with reduced risks.
Perspectives on the soy-breast cancer relation Messina, Mark; Wu, Anna H
The American journal of clinical nutrition,
05/2009, Volume:
89, Issue:
5S
Journal Article, Conference Proceeding
Peer reviewed
Open access
There has been considerable investigation of the potential for soy foods to reduce risk of breast cancer. Initial enthusiasm for this research was partially based on the historically low incidence ...rates of breast cancer and high soy food intake in Japan. There are several putative soybean chemopreventive agents, but most cancer research has focused on isoflavones. Isoflavones possess both hormonal and nonhormonal properties relevant to carcinogenesis. Recent epidemiologic analyses indicate that among Asians high soy intake is associated with an approximate one-third reduction in the risk of both pre- and postmenopausal breast cancer. However, several lines of evidence suggest that to derive maximum protection against breast cancer, soy must be consumed early in life. This evidence is consistent with the lack of significant effects noted in clinical studies that have evaluated the effects of isoflavone-containing products on breast cancer risk markers. Isoflavones may exert their putative protective effects by stimulating breast cell differentiation in a manner similar to that which is thought to occur during early pregnancy. Finally, the ability of the isoflavone genistein to stimulate the growth of mammary tumors in ovariectomized athymic nude mice implanted with estrogen-sensitive breast cancer cells has raised concern that soy foods, and especially isoflavone supplements, are contraindicated for patients with breast cancer and women at high risk of breast cancer. However, findings from clinical studies, in which breast biopsies have been taken or breast tissue density measured after isoflavone exposure, are reassuring and contrast with the proliferative effects of conventional combined hormone therapy, although understanding of the effect of soy and isoflavones on breast tissues remains imprecise.
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CMK, GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Medicare claims record linkage has been used to identify diagnosed dementia cases in order to estimate dementia prevalence and cost of care. Claims records in the 1990 s and early 2000 s have been ...found to provide 85% - ∼90% sensitivity and specificity.
Considering that dementia awareness has improved over time, we sought to examine sensitivity and specificity of more recent Medicare claims records against a standard criterion, clinical diagnosis of dementia.
For a sample of patients evaluated at the University of Southern California Alzheimer Disease Research Center (ADRC), we performed database linkage with Medicare claims files for a six-year period, 2007-2012. We used clinical diagnosis at the ADRC as the criterion diagnosis in order to calculate sensitivity and specificity.
Medicare claims correctly identified 85% of dementia patients and 77% of individuals with normal cognition. About half of patients clinically diagnosed with mild cognitive impairment had dementia diagnoses in Medicare claims. Misclassified dementia patients (i.e., missed diagnosis by Medicare claims) had more favorable Mini-Mental State Examination and Clinical Dementia Rating scores and were less likely to present behavioral symptoms than correctly-classified dementia patients.
Database linkage to Medicare claims records is an efficient and reasonably accurate tool to identify dementia cases in a population-based cohort. However, possibilities of obtaining biased results due to misclassification of dementia status need to be carefully considered to use Medicare claims diagnosis for etiologic research studies. Additional confirmation of dementia diagnosis may also be considered. A larger study is warranted to confirm our findings.
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