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Associations between Dietary Patterns, Nutrition and Risk of Cancer

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutritional Epidemiology".

Deadline for manuscript submissions: closed (10 February 2022) | Viewed by 39720

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Dr. Adela Castelló Pastor

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1. School of Medicine, University of Alcalá, Av. de Madrid, Km 33,600, 28871 Alcalá de Henares, Madrid, Spain
2. Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Calle de Melchor Fernández, Almagro, 5, 28029 Madrid, Spain
Interests: The efect of diet (specially dietary patterns) on breast, colorectal, stomach and prostate cancer.

Special Issue Information

Dear Colleagues,

As you might know, cancer is the second leading cause of death globally, and it is estimated to be responsible of 9.6 million deaths in 2018. Some recent estimates indicate that around 20% of cancers might be attributable to diet and related factors, percentage that might be even higher for tumors in the digestive tract. However, the association between diet and cancer is still not clear. According to the last report of the World Cancer Research Fund from 2018, the evidence is strong for only a few associations: Protective effect of whole grains and fiber or of dairy and calcium intake against colorectal cancer; detrimental effect of red and processed meat intake on colorectal cancer; increased risk of stomach cancer for high intakes of salt preserved foods; and higher risk of tumors in the gastrointestinal tract, liver and breast for high intakes of alcohol. Other dietary habits such as sugar sweetened beverages or fast foods intake or high adherence to the western type diet have been associated with an increased risk of weight gain, overweight or obesity linked to the increased risk of 12 tumors. Also, a high intake of fruits and vegetables or a high adherence to the Mediterranean type diet has been linked with lower weight and weight gain. Finally, the WCRF points to other associations between diet and nutrition with cancer risk for which the evidence is limited but suggestive and encourage scientist to carry out more research to clarify the role of dietary habits and related factors on cancer risk.

For that reason, we invite you to participate in this special issue focused on deepening in the associations of dietary patterns and nutrition with the risk of cancer.

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Keywords

Dietary Patterns
Mediterranean Diet
Western Diet
Dietary indexes
Nutrition
Cancer

Published Papers (10 papers)

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Research

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16 pages, 1487 KiB

Open AccessArticle

Adherence to the Western, Prudent and Mediterranean Dietary Patterns and Colorectal Cancer Risk: Findings from the Spanish Cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Spain)

by Adela Castelló, Miguel Rodríguez-Barranco, Nerea Fernández de Larrea, Paula Jakszyn, Ane Dorronsoro, Pilar Amiano, María-Dolores Chirlaque, Sandra Colorado-Yohar, Marcela Guevara, Conchi Moreno-Iribas, Marina Pollán and María-José Sánchez

Nutrients 2022, 14(15), 3085; https://doi.org/10.3390/nu14153085 - 27 Jul 2022

Cited by 13 | Viewed by 2473

Abstract

The aim of this study was to explore the association between three previously identified dietary patterns (Western, Prudent, and Mediterranean) and colorectal cancer (CRC) risk by sex and cancer subtype. The Spanish cohort of the European Prospective Investigation into Cancer and Nutrition study provided dietary and epidemiological information from 15,629 men and 25,808 women recruited between 1992 and 1996. Among them, 568 CRC cases and 3289 deaths were identified during a median follow-up of 16.98 years. The associations between adherence to the three dietary patterns and CRC risk (overall, by sex, and by tumour location: proximal and distal colon and rectum) were investigated by fitting multivariate Cox proportional hazards regression models stratified by study centre and age. Possible heterogeneity of the effects by sex and follow-up time (1–10 vs. ≥10 years) was also explored. While no clear effect of the Prudent dietary pattern on CRC risk was found, a suggestive detrimental effect of the Western dietary pattern was observed, especially during the first 10 years of follow-up (HR_1SD-increase (95% CI): 1.17 (0.99–1.37)), among females (HR_1SD-increase (95% CI): 1.31 (1.06–1.61)), and for rectal cancer (HR_1SD-increase (95% CI): 1.38 (1.03–1.84)). In addition, high adherence to the Mediterranean pattern seemed to protect against CRC, especially when restricting the analyses to the first 10 years of follow-up (HR_1SD-increase (95% CI): 0.84 (0.73–0.98)), among males (HR_1SD-increase (95% CI): 0.80 (0.65–0.98)), and specifically against distal colon cancer (HR_1SD-increase (95% CI): 0.81 (0.63–1.03)). In conclusion, low adherence to the Western diet and high adherence to the Mediterranean dietary pattern could prevent CRC, especially distal colon and rectal cancer. Full article

(This article belongs to the Special Issue Associations between Dietary Patterns, Nutrition and Risk of Cancer)

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11 pages, 280 KiB

Open AccessArticle

Macronutrients Intake and Risk of Stomach Cancer: Findings from Case-Control Study

by Sabika Allehdan, Maya Bassil, Razan M. Alatrash, Tareq Al-Jaberi, Ahmad Hushki, Yaser Rayyan, Mahammad Dahoud, Khaled Abu-EIteen and Reema F. Tayyem

Nutrients 2022, 14(12), 2373; https://doi.org/10.3390/nu14122373 - 08 Jun 2022

Viewed by 2743

Abstract

Studies on the association between gastric cancer (GC) and the intake of nutrients in Jordan are very limited, while findings from other reports on the intake of energy and macronutrients are controversial. This study aimed to examine the associations between intake of energy and macronutrients and the risk of GC in a Jordanian population. A case-control study was carried out between March 2015 and August 2018 in four major hospitals, including an oncology center in Jordan. Study participants were 173 cases with incident and histologically confirmed GC and 314 frequency-matched controls. Interview-based questionnaires were used to obtain the study’s information. Data on nutrient intake were collected using a validated Arabic food-frequency questionnaire (FFQ). Odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) were calculated through multinomial logistic regression and adjusted for potential confounders, including age, marital status, education, body mass index (BMI), smoking, period of smoking, family history of gastric cancer, history of gastric ulcer, and physical activity. Intakes of total fat, saturated fat, monounsaturated fat, polyunsaturated fat, cholesterol, trans-fat, and omega-6 fatty acids were significantly associated with increased risk of GC. The ORs for the highest versus the lowest tertiles were 6.47 (95% Cl: 3.29–12.77), 2.97 (95% CI: 1.58–5.58), 6.84 (95% CI: 3.46–13.52), 6.19 (95% CI: 3.15–12.17), 3.05 (95% CI: 1.58–5.88), 8.11 (95% CI: 4.20–15.69), and 2.74 (95% CI: 1.47–5.09), respectively. No significant association was found for energy, protein, carbohydrate, sugar, fibers, and omega-3 fatty acids. The findings of this study suggest that high intake of selected types of fats was associated with an increased risk of GC. Full article

(This article belongs to the Special Issue Associations between Dietary Patterns, Nutrition and Risk of Cancer)

12 pages, 299 KiB

Open AccessFeature PaperArticle

Dietary Fat Intake and KRAS Mutations in Colorectal Cancer in a Moroccan Population

by Achraf El Asri, Karim Ouldim, Laila Bouguenouch, Mohammed Sekal, Fatima Zahra Moufid, Ellen Kampman, Inge Huybrechts, Marc J. Gunter, Sanae Abbaoui, Kaoutar Znati, Mehdi Karkouri, Khaoula El Kinany, Zineb Hatime, Meimouna Mint Sidi Deoula, Laila Chbani, Btissame Zarrouq and Karima El Rhazi

Nutrients 2022, 14(2), 318; https://doi.org/10.3390/nu14020318 - 13 Jan 2022

Cited by 6 | Viewed by 2222

Abstract

Epidemiologic data support an association between diet and mutations in the Kirsten-ras (KRAS) gene involved in colorectal cancer (CRC) development. This study aimed to explore the associations between fat intake and KRAS mutations in codons 12 and 13 in cases of CRC in the Moroccan population. A multicenter case-series study nested in a large-scale Moroccan CRC case-control study was conducted. Among all CRC cases recruited, 151 specimens were available for the DNA mutation analysis. Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (Cis) for KRAS mutation status according to the fat intake variables. A KRAS mutation was detected in the CRC tumor of 34.4% of the patients among whom 65.4% had a single mutation at codon 12 and 34.6% had a single mutation at codon 13. Compared to low levels of consumption, a positive association was observed between high polyunsaturated fatty acids (PUFA) consumption (>16.9 g/day) and prevalence of KRAS mutations (OR = 2.15, 95% CI = 1.01–4.59). No statistically significant associations were observed for total fat, monounsaturated fatty acids, saturated fatty acids and KRAS mutations. The results of this study suggest that PUFA may be relevant in the etiology of CRC, possibly through the generation of G > A transitions at the KRAS oncogene. Further studies are needed to verify and explain this finding. Full article

(This article belongs to the Special Issue Associations between Dietary Patterns, Nutrition and Risk of Cancer)

13 pages, 277 KiB

Open AccessArticle

Prospective Association of the Portfolio Diet with All-Cause and Cause-Specific Mortality Risk in the Mr. OS and Ms. OS Study

by Kenneth Lo, Andrea J. Glenn, Suey Yeung, Cyril W. C. Kendall, John L. Sievenpiper, David J. A. Jenkins and Jean Woo

Nutrients 2021, 13(12), 4360; https://doi.org/10.3390/nu13124360 - 03 Dec 2021

Cited by 4 | Viewed by 3843

Abstract

The Portfolio Diet has demonstrated its cardiovascular benefit from interventions, but the association between Portfolio Diet adherence and the risk of all-cause and cause-specific mortality has not been examined in Chinese population. The present study has collected Portfolio Diet adherence (assessed by food frequency questionnaire), lifestyle factors and mortality status of 3991 participants in the Mr. Osteoporosis (OS) and Ms. OS Study. Cox regression models were used to examine the association between the Portfolio Diet adherence and mortality risk (all-cause, cardiovascular disease or cancer). The highest quartile of the Portfolio Diet score was associated with a 28% lower risk of all-cause (hazard ratio, HR: 0.72) and cancer (HR: 0.72) mortality, respectively. The association between Portfolio Diet adherence and cardiovascular disease mortality did not reach statistical significance (HR: 0.90, 95% CI = 0.64, 1.26). Among male participants, the highest adherence to the Portfolio Diet was also associated with a lower risk of all-cause (HR: 0.63) and cancer mortality (HR: 0.59), and there was an inverse association between food sources of plant protein and the risk of cardiovascular mortality (HR: 0.50). However, most associations between the Portfolio Diet and mortality were not significant among females. The protection for cancer mortality risk might reach the plateau at the highest adherence to the Portfolio Diet for females. To conclude, greater adherence to the Portfolio Diet was significantly associated with a lower risk of mortality in Hong Kong older adults, and the associations appeared stronger among males. Full article

(This article belongs to the Special Issue Associations between Dietary Patterns, Nutrition and Risk of Cancer)

14 pages, 608 KiB

Open AccessArticle

Effect on an Oral Nutritional Supplement with β-Hydroxy-β-methylbutyrate and Vitamin D on Morphofunctional Aspects, Body Composition, and Phase Angle in Malnourished Patients

by Isabel Cornejo-Pareja, Maria Ramirez, Maria Camprubi-Robles, Ricardo Rueda, Isabel Maria Vegas-Aguilar and Jose Manuel Garcia-Almeida

Nutrients 2021, 13(12), 4355; https://doi.org/10.3390/nu13124355 - 03 Dec 2021

Cited by 11 | Viewed by 3794

Abstract

This is a retrospective study of data from clinical practice to observe the effect of a high-calorie, high-protein oral nutritional supplement (ONS) with β-hydroxy-β-methylbutyrate (HMB) on nutritional status, body weight, and muscle-related parameters in 283 adult patients with or at risk of malnutrition under standard of care, 63% being cancer patients. They were recommended to increase physical activity and energy and protein intake from regular diet plus two servings per day of a specialized ONS enriched with HMB or standard ONS for up to 6 months. Dietary records, adherence and tolerance to ONS, nutritional status, body composition, handgrip strength, and blood analysis at the beginning and the end of the intervention were recorded. This program improved nutritional status from 100% malnourished or at risk of malnutrition at baseline to 80% well-nourished at final visit. It also increased body weight by 3.6–3.8 kg, fat-free mass by 0.9 to 1.3 kg, and handgrip strength by 4.7 to 6.2 kg. In a subgroup of patients (n = 43), phase angle (PhA), and body cell mass (BCM) increased only in the patients receiving the ONS enriched with HMB (0.95 (0.13) vs. −0.36 (0.4), and 2.98 (0.5) vs. −0.6 (1.5) kg, mean difference (SE) from baseline for PhA and BCM, respectively), suggesting the potential efficacy of this supplement on muscle health. Full article

(This article belongs to the Special Issue Associations between Dietary Patterns, Nutrition and Risk of Cancer)

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12 pages, 1835 KiB

Open AccessArticle

Per- and Polyfluoroalkyl Substance Exposure Combined with High-Fat Diet Supports Prostate Cancer Progression

by Ozan Berk Imir, Alanna Zoe Kaminsky, Qian-Ying Zuo, Yu-Jeh Liu, Ratnakar Singh, Michael J. Spinella, Joseph Irudayaraj, Wen-Yang Hu, Gail S. Prins and Zeynep Madak Erdogan

Nutrients 2021, 13(11), 3902; https://doi.org/10.3390/nu13113902 - 30 Oct 2021

Cited by 15 | Viewed by 8234

Abstract

Per- and polyfluoroalkyl substances (PFAS) are synthetic chemicals utilized in various industrial settings and include products such as flame retardants, artificial film-forming foams, cosmetics, and non-stick cookware, among others. Epidemiological studies suggest a link between increased blood PFAS levels and prostate cancer incidence, but the mechanism through which PFAS impact cancer development is unclear. To investigate the link between PFAS and prostate cancer, we evaluated the impact of metabolic alterations resulting from a high-fat diet combined with PFAS exposure on prostate tumor progression. We evaluated in vivo prostate cancer xenograft models exposed to perfluorooctane sulfonate (PFOS), a type of PFAS compound, and different diets to study the effects of PFAS on prostate cancer progression and metabolic activity. Metabolomics and transcriptomics were used to understand the metabolic landscape shifts upon PFAS exposure. We evaluated metabolic changes in benign or tumor cells that lead to epigenomic reprogramming and altered signaling, which ultimately increase tumorigenic risk and tumor aggressiveness. Our studies are the first in the field to provide new and clinically relevant insights regarding novel metabolic and epigenetic states as well as to support the future development of effective preventative and therapeutic strategies for PFAS-induced prostate cancers. Our findings enhance understanding of how PFAS synergize with high-fat diets to contribute to prostate cancer development and establish an important basis to mitigate PFAS exposure. Full article

(This article belongs to the Special Issue Associations between Dietary Patterns, Nutrition and Risk of Cancer)

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14 pages, 3085 KiB

Open AccessFeature PaperArticle

Impact of a Geriatric Intervention to Improve Screening and Management of Undernutrition in Older Patients Undergoing Surgery for Colorectal Cancer: Results of the ANC Stepped-Wedge Trial

by Thomas Gilbert, Lorraine Bernard, Marine Alexandre, Sylvie Bin-Dorel, Laurent Villeneuve, Evelyne Decullier, Marc Bonnefoy and ANC Working Group

Nutrients 2021, 13(7), 2347; https://doi.org/10.3390/nu13072347 - 09 Jul 2021

Cited by 6 | Viewed by 2864

Abstract

Almost two in three patients who are aged 75 years and older and scheduled for surgery for colorectal cancer (CRC) are undernourished. Despite evidence that perioperative nutritional management can improve patients outcomes, international guidelines are still insufficiently applied in current practice. In this stepped-wedge cluster-randomized study of five surgical hospitals, we included 147 patients aged 70 years or older with scheduled abdominal surgery for CRC between October 2013 and December 2016. In the intervention condition, an outreach team comprising a geriatrician and a dietician visited patients and staff in surgical wards to assist with the correct application of guidelines. Evaluation, diagnosis, and prescription (according to nutritional status) were considered appropriate and strictly consistent with guidelines in 39.2% of patients in the intervention group compared to only 1.4% in the control group (p = 0.0002). Prescription of oral nutritional supplements during the perioperative period was significantly improved (41.9% vs. 4.1%; p < 0.0001). However, there were no benefits of the intervention on surgical complications or adverse events. A possible benefit of hospital stay reduction will need to be confirmed in further studies. This study highlights the importance of the implementation of quality improvement interventions into current practice for the perioperative nutritional management of older patients with CRC. Full article

(This article belongs to the Special Issue Associations between Dietary Patterns, Nutrition and Risk of Cancer)

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18 pages, 973 KiB

Open AccessArticle

Dairy Consumption and Incidence of Breast Cancer in the ‘Seguimiento Universidad de Navarra’ (SUN) Project

by Inmaculada Aguilera-Buenosvinos, Cesar Ignacio Fernandez-Lazaro, Andrea Romanos-Nanclares, Alfredo Gea, Rodrigo Sánchez-Bayona, Jose M. Martín-Moreno, Miguel Ángel Martínez-González and Estefanía Toledo

Nutrients 2021, 13(2), 687; https://doi.org/10.3390/nu13020687 - 21 Feb 2021

Cited by 8 | Viewed by 3731

Abstract

Dairy products might influence breast cancer (BC) risk. However, evidence is inconsistent. We sought to examine the association between dairy product consumption—and their subtypes—and incident BC in a Mediterranean cohort. The SUN (“Seguimiento Universidad de Navarra”) Project is a Spanish dynamic ongoing cohort of university graduates. Dairy product consumption was estimated through a previously validated 136-item food frequency questionnaire (FFQ). Incident BC was reported in biennial follow-up questionnaires and confirmed with revision of medical records and consultation of the National Death Index. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated with Cox regression models. Among 123,297 women-years of follow-up (10,930 women, median follow-up 12.1 years), we confirmed 119 incident BC cases. We found a nonlinear association between total dairy product consumption and BC incidence (p_nonlinear = 0.048) and a significant inverse association for women with moderate total dairy product consumption (HR_Q2vs.Q1 = 0.49 (95% CI 0.28–0.84); HR_Q3vs.Q1 = 0.49 (95% CI 0.29–0.84) p_trend = 0.623) and with moderate low-fat dairy product consumption (HR_Q2vs.Q1 = 0.58 (95% CI 0.35–0.97); HR_Q3vs.Q1 = 0.55 (95% CI 0.32–0.92), p_trend = 0.136). In stratified analyses, we found a significant inverse association between intermediate low-fat dairy product consumption and premenopausal BC and between medium total dairy product consumption and postmenopausal BC. Thus, dairy products, especially low-fat dairy products, may be considered within overall prudent dietary patterns. Full article

(This article belongs to the Special Issue Associations between Dietary Patterns, Nutrition and Risk of Cancer)

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Review

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13 pages, 678 KiB

Open AccessReview

Liver Metastatic Breast Cancer: Epidemiology, Dietary Interventions, and Related Metabolism

by Qianying Zuo, Nicole Hwajin Park, Jenna Kathryn Lee and Zeynep Madak Erdogan

Nutrients 2022, 14(12), 2376; https://doi.org/10.3390/nu14122376 - 08 Jun 2022

Cited by 7 | Viewed by 4641

Abstract

The median overall survival of patients with metastatic breast cancer is only 2–3 years, and for patients with untreated liver metastasis, it is as short as 4–8 months. Improving the survival of women with breast cancer requires more effective anti-cancer strategies, especially for metastatic disease. Nutrients can influence tumor microenvironments, and cancer metabolism can be manipulated via a dietary modification to enhance anti-cancer strategies. Yet, there are no standard evidence-based recommendations for diet therapies before or during cancer treatment, and few studies provide definitive data that certain diets can mediate tumor progression or therapeutic effectiveness in human cancer. This review focuses on metastatic breast cancer, in particular liver metastatic forms, and recent studies on the impact of diets on disease progression and treatment. Full article

(This article belongs to the Special Issue Associations between Dietary Patterns, Nutrition and Risk of Cancer)

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17 pages, 697 KiB

Open AccessReview

Vitamin D Supplementation and Cancer Mortality: Narrative Review of Observational Studies and Clinical Trials

by Patrizia Gnagnarella, Valeria Muzio, Saverio Caini, Sara Raimondi, Chiara Martinoli, Susanna Chiocca, Claudia Miccolo, Paolo Bossi, Diego Cortinovis, Ferdinando Chiaradonna, Roberta Palorini, Federica Facciotti, Federica Bellerba, Stefania Canova and Sara Gandini

Nutrients 2021, 13(9), 3285; https://doi.org/10.3390/nu13093285 - 21 Sep 2021

Cited by 21 | Viewed by 3823

Abstract

Several studies have investigated the beneficial effects of vitamin D on survival of cancer patients. Overall evidence has been accumulating with contrasting results. This paper aims at narratively reviewing the existing articles examining the link between vitamin D supplementation and cancer mortality. We performed two distinct searches to identify observational (ObS) studies and randomized clinical trials (RCTs) of vitamin D supplementation (VDS) in cancer patients and cohorts of general population, which included cancer mortality as an outcome. Published reports were gathered until March 2021. We identified 25 papers published between 2003 and 2020, including n. 8 RCTs on cancer patients, n. 8 population RCTs and n. 9 ObS studies. There was some evidence that the use of VDS in cancer patients could improve cancer survival, but no significant effect was found in population RCTs. Some ObS studies reported evidence that VDS was associated with a longer survival among cancer patients, and only one study found an opposite effect. The findings do not allow conclusive answers. VDS may have the potential as treatment to improve survival in cancer patients, but further investigations are warranted. We strongly support investment in well-designed and sufficiently powered RCTs to fully evaluate this association. Full article

(This article belongs to the Special Issue Associations between Dietary Patterns, Nutrition and Risk of Cancer)

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