Abstract
Background: Prior research suggests that vitamin D protects against lung cancer with evidence only among subgroups including women and non-smokers. We investigated whether vitamin D intake ...was associated with lung cancer and explored whether vitamin A intake modified the association.
Methods: Data from 128,779 postmenopausal women including 1,771 incident lung cancers in the Women's Health Initiative, 1993-2010, were analyzed. Twelve percent of women received active intervention (1 g calcium+400 IU vitamin D3 daily) in the Calcium/Vitamin D Trial. Baseline total intake was assessed by a food frequency questionnaire and supplement bottle labels. Hazard ratios (HR) were estimated by Cox proportional hazard models.
Results: No association was observed overall. Among never smokers, vitamin D intake was inversely associated with total lung cancer (HR=0.37, 95% confidence interval CI=0.18-0.77, ≥800 vs. <100 IU/d; P-trend=0.01). The Calcium/Vitamin D Trial active intervention was not associated with a lower lung cancer risk among women with vitamin A intake ≥1,000 μg/d Retinol Activity Equivalent (RAE), but among those with vitamin A intake <1,000 μg/d RAE (HR=0.69, 95% CI=0.50-0.96; P-interaction=0.09). Among current smokers with excess vitamin A intake (≥3,000 μg/d RAE), the intervention was associated with a higher lung cancer risk (HR=2.26, 95% CI=1.02-5.01), as no association was observed among current smokers with vitamin A intake <3,000 μg/d RAE (P-interaction=0.01).
Conclusion: Vitamin D intake was associated with a lower lung cancer risk in never-smoking, postmenopausal women. Lower vitamin A intake may be important for a beneficial association of 1 g calcium+400 IU vitamin D3 supplementation with lung cancer.
Citation Format: Ting-Yuan David Cheng, Andrea Z. LaCroix, Shirley A.A. Beresford, Gary E. Goodman, Mark D. Thornquist, Yingye Zheng, Rowan T. Chlebowski, Gloria Y.F. Ho, Marian L. Neuhouser. Vitamin D intake and lung cancer risk in the Women's Health Initiative (WHI). abstract. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 2572. doi:10.1158/1538-7445.AM2013-2572
Abstract Snacking may play a role in weight control. The associations of timing and frequency of snacking with observed weight change and nutrient intake were assessed in an ancillary study to a ...12-month randomized controlled trial in Seattle, WA. Overweight-to-obese postmenopausal women (n=123) enrolled in the two dietary weight-loss arms from 2007 to 2008 with complete data at 12 months were included in these analyses. Generalized linear models were used to test the associations between snacking and weight loss (percent) and nutrient intake at the 12-month time point. Participants were, on average, 58 years old and mainly non-Hispanic white (84%). Ninety-seven percent reported one or more snacks per day. Weight loss (percent) was significantly lower among mid-morning (10:30 am to 11:29 am ) snackers (7.0%, 95% confidence interval: 4.3 to 9.7) compared to non–mid-morning snackers (11.4%, 95% confidence interval: 10.2 to 12.6; P =0.005). A higher proportion of mid-morning snackers reported more than one snack per day (95.7%), compared to afternoon (82.8%) and evening (80.6%) snackers, although differences were not statistically significant ( P >0.05). Women who reported two or more snacks per day vs one or no snacks per day had higher fiber intake ( P =0.027). Afternoon snackers had higher fruit and vegetable intake compared to non–afternoon-snackers ( P =0.035). These results suggest that snack meals can be a source for additional fruits, vegetables, and fiber-rich foods; however, snacking patterns might also reflect unhealthy eating habits and impede weight-loss progress. Future dietary weight-loss interventions should evaluate the effects of timing, frequency, and quality of snacks on weight loss.
The Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets are characterized by higher intake of fruit, vegetables, whole grains, and unsaturated fatty acids. All of these foods and ...nutrients may affect cholesterol, inflammation, the development of atherosclerosis, and, therefore, risk of cardiac death.
Our objective was to examine the association between the Mediterranean and DASH dietary patterns and risk of sudden cardiac death (SCD) in women.
We used a prospective cohort of 93,122 postmenopausal women enrolled in the Women’s Health Initiative study between 1993 and 1998 and followed for an average of 10.5 y. Women completed a food-frequency questionnaire (FFQ) twice during follow-up. We scored their diets according to how closely the reported diet resembled each dietary pattern. SCD was defined as death that occurred within 1 h of symptom onset.
A higher Mediterranean diet score was associated with lower risk of SCD (HR: 0.64; 95% CI: 0.43, 0.94) when women in the highest quintile were compared with women in the lowest quintile after adjustment for age, total energy, race, income, smoking, and physical activity. After adjustment for potential mediators, the association was similar (HR: 0.67; 95% CI: 0.46, 0.99). A higher DASH diet score was not associated with risk of SCD. However, sodium intake, which is a crucial component of the DASH dietary pattern, was not well characterized by the FFQ.
The Mediterranean dietary pattern may be associated with lower risk of SCD in women. This trial was registered at clinicaltrials.gov as NCT00000611.
Diets high in fruits and vegetables are associated primarily with a reduced risk of human cancers of the gastrointestinal tract, as well as some other common cancers including those of the lung, ...breast, and prostate. Plants contain hundreds of bioactive substances, including flavonoids, which are a large group of compounds consisting of two phenolic benzene rings linked to a heterocyclic pyran or pyrone. This report reviews published epidemiologic studies that have examined associations of flavonoid intake with cancer risk in humans. Findings to date are extremely limited, but there is relatively consistent evidence from these studies that flavonoids, especially quercetin, reduce risk of lung cancer. Evidence is modest for other epithelial cancers. Further research is needed to confirm these findings before public health recommendations about flavonoids can be offered to consumers.
Our objective was to investigate whether associations of obesity with chronic disease risk biomarkers are mediated by dietary patterns that cause unfavorable metabolic profiles. Our randomized, ...cross‐over, controlled feeding study tested the effect of low‐ and high‐glycemic load (GL) experimental diets on disease risk biomarkers glucose, insulin, IGF1, IGFBP3, leptin, adiponectin, interleukin‐6 and C‐reactive protein (CRP). Normal weight (n=40) and overweight/obese (n=42) men and women completed two 28‐day feeding periods – low GL and high GL. All meals were prepared in a metabolic kitchen and were isocaloric; both arms had identical macronutrients but differed in GL. Fasting blood was drawn before and after each feeding period. Linear mixed models tested the intervention effect on the biomarkers; models were adjusted for baseline biomarker concentrations, diet sequence, feeding period, age, sex and body fat mass. Compared to the high‐GL diet, the low‐GL diet significantly reduced IGF1 (p=0.04) and the IGF1:IGFBP3 ratio (p=0.01). Results were more pronounced among overweight/obese participants. When stratified by body fat mass, CRP was significantly lower for the low‐ vs. the high GL diet for those with high body fat (p=0.01). A dietary change emphasizing low GL foods may improve the metabolic and inflammatory profile of overweight and obese persons. Supported by NIH U54 CA116847, NIH R03 CA132158.
Abstract Previous studies have shown that sociodemographic characteristics can be determinants of healthful eating. However, health characteristics such as smoking status have not been well studied. ...The objective of this research, therefore, was to determine predictors of diet quality in postmenopausal women. We included 164 overweight or obese postmenopausal women aged 50 to 75 years living in and around Seattle, WA, and intake, measured by food frequency questionnaire, was used to calculate scores for the Diet Quality Index and Healthy Eating Index. Information on sociodemographic factors and health behaviors was collected by self-administered questionnaire. Body mass index was computed using duplicate measures of height and weight. Percent body fat was measured by dual-energy x-ray absorptiometry. Following data collection, one-way analysis of variance, χ2 , and Pearson correlations were used to compare means of diet quality scores across participant characteristics. We found that predictors of better diet quality in this study population were higher education and former smoking history (compared to never-smokers); there was no evidence for a relationship with income level. Individuals with higher-quality diets were more likely to have lower body mass index or percent body fat. Based on the results of this study, education level and smoking history are predictors of diet quality among overweight and obese postmenopausal women. These findings add to the increasing evidence for targeting public health interventions to individuals with lower education because this group stands to benefit from improved dietary intake. In addition, these results suggest that the timing of smoking cessation is a possible teachable moment for food and nutrition professionals.
It remains unclear whether estrogenic botanical supplement (EBS) use influences breast cancer survivors' health-related outcomes.
We examined the associations of EBS use with health-related quality ...of life (HRQOL), with fatigue, and with 15 hormone-related symptoms such as hot flashes and night sweats among 767 breast cancer survivors participating in the Health, Eating, Activity, and Lifestyle (HEAL) Study. HRQOL was measured by the Medical Outcomes Study short form-36 physical and mental component scale summary score. Fatigue was measured by the Revised-Piper Fatigue Scale score.
Neither overall EBS use nor the number of EBS types used was associated with HRQOL, fatigue, or hormone-related symptoms. However, comparisons of those using each specific type of EBS with non-EBS users revealed the following associations. Soy supplements users were more likely to have a better physical health summary score (odds ratio OR = 1.66, 95% confidence interval CI = 1.02-2.70). Flaxseed oil users were more likely to have a better mental health summary score (OR = 1.76, 95% CI = 1.05-2.94). Ginseng users were more likely to report severe fatigue and several hormone-related symptoms (all ORs ≥ 1.7 and all 95% CIs exclude 1). Red clover users were less likely to report weight gain, night sweats, and difficulty concentrating (all OR approximately 0.4 and all 95% CIs exclude 1). Alfalfa users were less likely to experience sleep interruption (OR = 0.28, 95% CI = 0.12-0.68). Dehydroepiandrosterone users were less likely to have hot flashes (OR = 0.33, 95% CI = 0.14-0.82).
Our findings indicate that several specific types of EBS might have important influences on a woman's various aspects of quality of life, but further verification is necessary.
Reading nutrition labels on food packages may improve food choices and enable healthful dietary practices. This report describes the prevalence of nutrition label use and its association with ...demographic, behavioral, and psychological factors and diet among African-American adults.
Self-reported data from a population-based cross-sectional survey of 658 African Americans, aged 20 to 70 years, in North Carolina. An 11-page questionnaire assessed nutrition label use, fruit and vegetable consumption, total and saturated fat intakes, fat-related dietary behaviors, diet-related psychosocial factors, and demographic and behavioral characteristics.
χ
2 tests and logistic regression analyses examined associations of demographic, psychosocial, and behavioral factors with nutrition label use. Linear regression was used to estimate the variation in diet explained by label use.
The mean age of participants was 43.9±11.6 years, 41% were men, 37% were college graduates, and 75% were overweight/obese. Seventy-eight percent of respondents read nutrition labels when they purchased packaged foods. Nutrition label use was significantly higher among participants who were women, older, educated beyond high school, and obese (
P<.05). After adjusting for demographic characteristics, the strongest psychosocial predictors of nutrition label use were healthful eating self-efficacy, strong belief in a diet-cancer relationship, and trying to lose weight. Usual/often label users had higher fruit and vegetable consumption and lower fat intakes (
P<.001), and nutrition labels explained 2% to 17% of the variance in dietary intake.
Nutrition information on packaged foods appears to be a useful way to conduct point-of-purchase nutrition education among African Americans in North Carolina. Most respondents used food labels at least sometimes, but only about half usually or often did so. Efforts should be made to determine how all consumers could use nutrition labels effectively.
To develop and validate a new dietary assessment tool, the focused recall, and to use this to measure co-consumption of carotenoid-containing fruits and vegetables with savory snacks.
Participants ...completed a telephone-administered focused recall and a 24-hour recall on the same day. We compared mean estimates of fruit, vegetable, savory snack and carotenoid consumption from both instruments. We also assessed the ability of each method to measure co-consumption of carotenoids with full-fat, reduced/non-fat and olestra-containing savory snacks.
Data are from 245 male and 244 female adult participants in the Olestra Post-Marketing Surveillance Study (OPMSS).
The mean (=/- SD) intake of fruit was 1.8(1.1) servings day(-1) from the focused recall and 1.6 (1.4) servings day(-1) from the 24-hour recall (r=0.56). The mean vegetable intake was 2.1 (1.3) and 2.2 (1.7) servings day(-1) (r=0.42), respectively, from each instrument. Estimates of total carotenoid and beta-carotene intake were within 5% of each other (r= 0.63 for total carotenoids and r= 0.70 for beta-carotene). Both instruments estimated that approximately 14% of total daily carotenoids were co-consumed with savory snacks (r= 0.63).
The focused recall provides valid information about fruit, vegetable and savory snack consumption and allows researchers to examine associated eating patterns more easily.
Prior research suggests that vitamin D protects against lung cancer only among certain subgroups.
We investigated whether vitamin D intake was associated with lung cancer and explored whether vitamin ...A intake modified the association.
Prospective cohort data from 128,779 postmenopausal women, including 1771 incident lung cancers in the Women’s Health Initiative (Clinical Trials and Observational Study) 1993–2010, were analyzed. Twelve percent of women received active intervention (1 g Ca + 400 IU vitamin D3/d) in the Calcium/Vitamin D Trial. Baseline total intake included both dietary intake (from food-frequency questionnaires) and supplement intake (from bottle labels). HRs were estimated by Cox proportional hazard models.
No significant association was observed overall. Among never smokers, a total vitamin D intake ≥400 IU/d was significantly associated with lower risks of lung cancer (HR: 0.37; 95% CI: 0.18, 0.77 for ≥800 compared with <100 IU/d; P-trend = 0.01). No significant effect modification of total vitamin A intake on the association between total vitamin D intake and lung cancer was found. However, the Calcium/Vitamin D Trial active intervention was significantly associated with a lower lung cancer risk only among women with a vitamin A intake <1000 μg/d retinol activity equivalents (HR: 0.69; 95% CI: 0.50, 0.96; P-interaction = 0.09).
Vitamin D intake was associated with a lower lung cancer risk in never-smoking, postmenopausal women. Lower vitamin A intake may be important for a beneficial association of 1 g Ca + 400 IU vitamin D3 supplementation with lung cancer. This trial was registered at clinicaltrials.gov as NCT00000611.
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