Metformin protection against cancer risk in Orientals is uncertain. We examined the possible metformin effect on total, esophageal, gastric, colorectal (CRC), hepatocellular (HCC) and pancreatic ...cancers in a Taiwanese cohort.
A representative sample of 800,000 was drawn from the Taiwanese National Health Insurance data of 2000. A cohort of 480,984 participants 20 years or older, diabetes-cancer-free on 1st January 2000 was formed and categorized as four groups by DM and metformin usage status. Eligible incident cancer events had to occur one year after the index date until the end of 2007. The Cox proportional-hazards model evaluated relative risk of cancer for treated DM patients with or without metformin. The covariates included age, gender, other oral anti-hyperglycemic medication, Charlson comorbidity index (CCI) score and metformin exposure dosage and duration.
With diabetes but no anti-hyperglycemic medication, cancer incidence density increased at least 2-fold for total, CRC and HCC. On metformin, total, CRC and HCC incidences decreased to near non-diabetic levels but to varying degrees depending on gender and cancer type (CRC in women, liver in men). Adjustment for other oral anti-hyperglycemic agents usage and CCI made the benefit of metformin more evident hazard ratios (95% confidence intervals): total 0.12 (0.08-0.19), CRC 0.36 (0.13-0.98), liver 0.06 (0.02-0.16), pancreas 0.15 (0.03-0.79). There was a significant gender interaction with metformin in CRC which favored women. Metformin dosage for a significant decrease in cancer incidence was ≤ 500 mg/day.
Metformin can reduce the incidences of several gastroenterological cancers in treated diabetes.
Neural tube defects (NTDs) are a group of severe congenital malformations, induced by the combined effects of genes and the environment. The most valuable finding so far has been the protective ...effect of folic acid supplementation against NTDs. However, many women do not take folic acid supplements until they are pregnant, which is too late to prevent NTDs effectively. Long-term intake of folic acid-fortified food is a good choice to solve this problem, and mandatory folic acid fortification should be further promoted, especially in Europe, Asia and Africa. Vitamin B2, vitamin B-6, vitamin B-12, choline, betaine and
-3 polyunsaturated fatty acids (PUFAs) can also reduce the NTD risk by interacting with the one-carbon metabolism pathway. This suggest that multivitamin B combined with choline, betaine and
-3 PUFAs supplementation may have a better protective effect against NTDs than folic acid alone. Genetic polymorphisms involved in one-carbon metabolism are associated with NTD risk, and gene screening for women of childbearing age prior to pregnancy may help prevent NTDs induced by the risk allele. In addition, the consumption of alcohol, tea and coffee, and low intakes of fruit and vegetable are also associated with the increased risk of NTDs, and should be avoided by women of childbearing age.
Whether and how it might be possible to imagine a habitable planet through food and health.
Reflection on childhood happenstances, sociodemographic circumstances, educational opportunities, persons ...of influence and lifetime experiences insofar as they might have shaped a view of the past, present and future world as the sole rational home of us all. Confirmation of these notions by personal, kindred, and other contemporary records and publications.
The need to live with uncertainty and an appreciation of connectedness with things animate and inanimate; and for this to be belief, identity, reason and professional imprimatur. That these things have unwittingly informed a near lifetime of interest and enthusiasm for how food and health systems are best served by socioecological approaches.
That we are socioecological beings with a destiny dependent on reconciling ourselves, as earthlings, as to how well we keep our place in the cosmos habitable. To that end we must dream and work.
There is benefit, risk and cost in all that we do, but when it comes to food, we expect that it will benefit our health, be available, safe to eat and affordable. But as climate change and ...demographic shifts through displacement and ageing gather momentum, the emphases on each of benefit, risk and cost will alter. That we are ecological beings whose health and wellbeing are ecosystem-dependent, must now be the underpinning framework for risk management. Loss of natural environment and biodiversity represents reduced nutritional and health resilience, which will need to be factored in to risk assessment and management with climate change. This is proving a problematic risk communication challenge. Previously desirable food and food pattern recommendations will be tempered by substantial sustainability, availability, safety, affordability, equity and ethical considerations. Future workforces will need to ensure basic livelihoods (food, water, shelter, clothing, healthcare, education, communication, essential transport, resource management and effective governance) and with risk minimisation. Cost appraisal will have less to do with monetisation and more to do with resource management in accordance with equity and ethical principles. Communities could adopt Liveability Units (LU) for traceability and community-based transactions, as a currency for a more sustainable future, encouraging and enabling food and health system viability. Open source food and health systems, supported by LU matrix (bar code or QR) scanning with smartphones could be widely available for individual, household and community benefit, risk and cost management. The risk is remoteness from food's origins and megadata commercialisation.
The contributors to and consequences of disordered health are increasingly complex with sociodemographic, ecological, economic and food system change. But there are opportunities for any adversity to ...be mitigated by advances in the understanding of human, especially nutritional, ecobiology and in its more accessible and affordable evaluation and monitoring. Viral pandemics are on the rise with climate change and loss of ecosystems. They threaten human civilisation and planetary habitability. Human security is dependent on sustainable livelihoods of which food and water systems are a vital part. We are socioecological beings and depend for our health on biodiversity and the food diversity that ensures; and on connectedness and communication, made more difficult in pandemics. Rapid and accessible point-of-care (POC) tools are now becoming available to compliment other selfmonitoring network approaches, whether checklist or questionnaire, physical, chemical, or biological, for healthcare and nutritional health. They can provide information as several complimentary and interdependent health indices to facilitate personal, group and community action and management plans. This applies to indices of both communicable and non-communicable disease which problems separately and together are compromising health prospects. These indices include ones of physical and mental activities, dietary patterns, metabolites, blood pressure and now the presence and severity of viruses like Covid-19.Of imminent relevance and promise are optically- readable biosensor based strips for nasal, pharyngeal or salivary samples to check viral presence or finger prick blood for immunoglobulins and interleukins. These should allow less socially prohibitive measures to curb viral transmission and promote personal and societal wellbeing.
Much nutrition policy is nutrient-based, supported by extensive nutrient science and food nutrient composition tables and recommendations for dietary evaluation. There are no comparable instruments ...for food structure. This constitutes a policy and practice gap since food is valued for its textural properties and not simply its chemistry. The structurally-important 'dietary fibre' at first proved of greater interest for its chemistry than its physico-chemistry even to health scientists and workers. As food chemistry became evidently complex, especially for phytonutrients, food-based dietary guidelines became an imperative and were launched by FAO and WHO in Cyprus in 1995. Food-health relationships, after weaning, are best articulated in terms of the achievement of dietary diversity, predicated partly on how intact foods are or in what way they are prepared. Cooking itself has health-promoting characteristics. Even with identical chemistry, food structure makes a major difference to biological and health outcomes. With evidence that food structure contributes to the matrix that food provides for nutrient delivery, and also to gut microbiomic profile and integrity, concern has grown about overly-processed food and health outcomes. The definition and categorisation of 'ultra-processed foods' is now a work-in-progress. Future public health nutritional and clinical nutrition developments will take account of food structure. To these ends, food composition tables will need to provide information like particle size and viscosity. Dietary recommendations will need to take account of food structure, as is the case for Brazil whose first step is "Make natural or minimally processed foods the basis of your diet".
To determine incidence of dementia in type 2 diabetic (T2DM) patients, and whether there are adverse or favorable effects of oral agents (OA) in DM, we obtained a representative cohort of 800,000 ...from Taiwan’s National Health Insurance database. Those who, as of on January 1, 2000, were 50 years or older and dementia free (n = 127,209) were followed until December 31, 2007, in relation to absence (n = 101,816) or presence (n = 25,393) of T2DM, and whether any OA was used. Dementia was ascertained by ICD9-CM or A-code. Dementia incidence densities (DID) and fully adjusted Cox proportional hazard models were used to estimate association between dementia, DM, and OA. Notably, DID (per 10,000 person-years)was markedly increased with DM (without medication), compared to DM free subjects (119 versus 46). Using non-DM as reference, the adjusted hazard ratios (HRs) (95% confidence interval) for DM without and with OA were 2.41 (2.17–2.66) and 1.62 (1.49–1.77), respectively. For T2DM, compared with no medication, sulfonylureas alone reduced the HR from 1 to 0.85 (0.71–1.01), metformin alone to 0.76 (0.58–0.98), while with combined oral therapy the HR was 0.65 (0.56–0.74). Adjustments included cerebrovascular diseases so that non-stroke related dementias were found to be decreased in DM with sulfonylurea and metformin therapy. T2DM increases the risk of dementia more than 2-fold. On the other hand, sulfonylureas may decrease the risk of dementia, as does metformin; together, these 2 OAs decrease the risk of dementia in T2DM patients by 35% over 8 years.
Background: Prospective cohort studies have examined mortality and overall cancer incidence among vegetarians, but the results have been inconclusive. Aims: The objective of the present meta-analysis ...was to investigate cardiovascular disease mortality and cancer incidence among vegetarians and nonvegetarians. Methods: Medline, EMBASE and Web Of Science databases were searched for cohort studies published from inception to September 2011. Studies were included if they contained the relative risk (RR) and corresponding 95% CI. Participants were from the UK, Germany, California, USA, the Netherlands and Japan. Results: Seven studies with a total of 124,706 participants were included in this analysis. All-cause mortality in vegetarians was 9% lower than in nonvegetarians (RR = 0.91; 95% CI, 0.66–1.16). The mortality from ischemic heart disease was significantly lower in vegetarians than in nonvegetarians (RR = 0.71; 95% CI, 0.56–0.87). We observed a 16% lower mortality from circulatory diseases (RR = 0.84; 95% CI, 0.54–1.14) and a 12% lower mortality from cerebrovascular disease (RR = 0.88; 95% CI, 0.70–1.06) in vegetarians compared with nonvegetarians. Vegetarians had a significantly lower cancer incidence than nonvegetarians (RR = 0.82; 95% CI, 0.67–0.97). Conclusions: Our results suggest that vegetarians have a significantly lower ischemic heart disease mortality (29%) and overall cancer incidence (18%) than nonvegetarians.
Pandemics have shaped humanity over and over again, but the coronavirus outbreak of 2019-2020 is in a world at the tipping point of catastrophic climate change. Its origins and distinction derive ...from over-population with inequity and an industrial revolution since the 17th century which has exploited fossil fuels as a globalised energy source, a period now described as the anthropocene. Asymptotic ecosystem loss and dysfunction, for people whose being is socioecological, makes ultimate survival tenuous. Microbial forms of life jump species when habitats are destroyed, or their host misused. Our innate immunity depends on our general health and fitness- social, mental, physical, and nutritional, in step with nature and its rhythms through walking in it, enjoying sunlight and sleep. Biodiversity and the associated benefit of food variety, after being breast-fed, is the key descriptor of a healthful, sustainable, accessible, and acceptable way of eating. How this pattern might contribute to our resilience in the face of a highly transmissible and biologically evasive virus is becoming clear. It may also be possible to compliment usefully preventive vaccination and therapeutic healthcare and rehabilitation through a greater understanding of our nutritional biology.
PDF
