Article

Processed meat consumption, dietary nitrosamines and stomach cancer risk in a cohort of Swedish women

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Abstract

Processed meat consumption has been associated with an increased risk of stomach cancer in some epidemiological studies (mainly case-control). Nitrosamines may be responsible for this association, but few studies have directly examined nitrosamine intake in relation to stomach cancer risk. We prospectively investigated the associations between intakes of processed meat, other meats and N-nitrosodimethylamine (the most frequently occurring nitrosamine in foods) with risk of stomach cancer among 61,433 women who were enrolled in the population-based Swedish Mammography Cohort. Information on diet was collected at baseline (between 1987 and 1990) and updated in 1997. During 18 years of follow-up, 156 incident cases of stomach cancer were ascertained. High consumption of processed meat, but not of other meats (i.e., red meat, fish and poultry), was associated with a statistically significant increased risk of stomach cancer. After adjustment for potential confounders, the hazard ratios for the highest compared with the lowest category of intake were 1.66 (95% CI = 1.13-2.45) for all processed meats, 1.55 (95% CI = 1.00-2.41) for bacon or side pork, 1.50 (95% CI = 0.93-2.41) for sausage or hotdogs and 1.48 (95% CI= 0.99-2.22) for ham or salami. Stomach cancer risk was 2-fold higher among women in the top quintile of N-nitrosodimethylamine intake when compared with those in the bottom quintile (hazard ratio = 1.96; 95% CI = 1.08-3.58). Our findings suggest that high consumption of processed meat may increase the risk of stomach cancer. Dietary nitrosamines might be responsible for the positive association.

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... The positive associations with meat consumption appeared to be stronger or limited to noncardia gastric cancer, whereas little or no association was found for gastric cardia cancer (González et al., 2006a). No association between red meat consumption and risk of gastric cancer was observed in the Swedish Mammography Cohort (Larsson et al., 2006j) or in a large cohort study in Japan (Tokui et al., 2005). Three other cohort studies also did not reveal any relation between meat consumption and gastric cancer Knekt et al., 1999;Ngoan et al., 2002). ...
... Among prospective cohort studies, NDMA intake was statistically significantly positively associated with risk of gastric cancer in the Swedish Mammography Cohort (Larsson et al., 2006j), while a small Finnish cohort study (Knekt et al., 1999) and the EPIC study (Jakszyn et al., 2006) observed no association (FIGURE 27). Nevertheless, in the EPIC study, an index of endogenous formation of NOCs was statistically significantly positively associated with noncardia gastric cancer risk. ...
... Six cohort studies Galanis et al., 1998;McCullough et al., 2001;Ngoan et al., 2002;González et al., 2006a;Larsson et al., 2006j) and nine case-control studies (Risch et al., 1985;González et al., 1991;Hoshiyama and Sasaba, 1992;Ward et al., 1997;Ward and Lopez-Carrillo, 1999;De Stefani et al., 2001;Ito et al., 2003;Nomura et al., 2003;Lissowska et al., 2004) provided the required data to be included in the dose-response metaanalysis of processed meat consumption. One cohort study and five case-control studies were excluded because processed meat consumption could not be quantified (Boeing et al., 1991b;Knekt et al., 1999;Chen et al., 2002a;De Stefani et al., 2004) or because the range of exposure was very narrow (Lee et al., 1990;Takezaki et al., 2001), leading to exaggerated regression coefficients. ...
... Knowledge and understanding of the public health implications of consuming fried bacon has advanced since the turn of the century. Larsson et al. (2006) published their findings after 18 years of tracking the direct nitrosamine intake and cancer development of 61,433 Swedish women (enrolled in the Swedish Mammography Cohort). The study focused on processed meats, including bacon or side pork, sausages or hotdogs, ham or salami. ...
... This is a very high incidence rate. Larsson et al. (2006) commented on these results, "High consumption of processed meat, but not of other meats (i.e., red meat, fish and poultry), was associated with a statistically significant increased risk of stomach cancer" and that "Stomach cancer risk was two-fold higher among women in the top quintile of N-nitrosodimethylamine intake when compared with those in the bottom quintile. Our findings suggest that high consumption of processed meat may increase the risk of stomach cancer. ...
... Our findings suggest that high consumption of processed meat may increase the risk of stomach cancer. Dietary nitrosamines might be responsible for the positive association [162]". ...
Article
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This review examines the benefits and alleged risks associated with the disinfection of drinking water by chlorination, through critical appraisal of the historical saga of chloroform as the main disinfection by-product (DBP). The author maintains that the provision of clean drinking water is a survival issue for humankind and supports unreservedly the recommendation by the World Health Organization (WHO) of the United Nations to disinfect by chlorination, for the reasons stated herein. The author aims to lead water professionals to a deeper understanding of the public health issues concerning chloroform and how the corpus of knowledge was attained by colossal multi-disciplinary effort on a global scale. Origins of the alleged risks of chlorination are traced and the assumptions behind these allegations are questioned. The author welcomes and encourages innovations for improved methods of water treatment insofar that the standards of potability set out by the WHO are met in the very least, but argues that the commencement point of research into new techniques should be an acknowledgment of the development of disinfection up to contemporary times, on the part of water engineers and policy makers. There must be a clear recognition of the horrific consequences of failure to eliminate pathogens and toxic substances. To this effect, landmark tragedies are described to emphasize the point. Significantly, this work addresses topics which are sine quo non to the debate over chlorination but which are often lacking in public discourse, namely: differences in the way cytochrome P450 enzymes oxidize carbon tetrachloride which is not normally a product of chlorination, and chloroform, which is a disinfection by-product; the role of free radical scavengers in protecting the human body; the difficulties of extrapolating experimental results from rodents to humans; the awareness of the complex relationship between governments, chemical industries, special interest groups and the public. Also introduced are the aetiologies of some cancers (e.g., Hepatitis B and C viruses as the instigators for hepatocellular carcinoma) to juxtapose claims that chloroform in drinking water is the sole culprit responsible for liver, bladder, colorectal cancers and birth defects etc. Other well known human carcinogens and a few inorganic compounds known to cause harm are also depicted. Lastly, a structured approach towards integrating the overarching concepts in the analysis of alleged carcinogenicity is applied to chloroform and the inferences discussed. The literature reviewed spanned the years 1848 – 2017 (235 references).
... A total seven cohort studies and four case-control studies were pooled together to assess the association between NDMA consumption and stomach cancer risk [17,18,20,[26][27][28][29]36]. The pooled RR for high versus low intake was 1.34 (95% CI, 1.02-1.76), ...
... without heterogeneity (p = 0.876). Four papers (seven studies) were included in the dose-response analysis for NDMA [18,20,27,28]. We observed a nonlinear trend toward gastric cancer risk with increasing NDMA intake (p non´linearity < 0.001), following an increase in the risk of NDMA intake up to 0.12 µg/day ( Figure 3C). ...
... without heterogeneity (p = 0.876). Four papers (seven studies) were included in the dose-response analysis for NDMA [18,20,27,28]. We observed a nonlinear trend toward gastric cancer risk with increasing NDMA intake (pnon-linearity < 0.001), following an increase in the risk of NDMA intake up to 0.12 μg/day ( Figure 3C). ...
Article
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The potential associations between dietary consumption of nitrates, nitrites, and nitrosamines and gastric cancer risk have been investigated by several studies, but yielded inconclusive results. We conducted a meta-analysis to provide a quantitative assessment of their relationships. Relevant articles were identified by a systematic literature searching of PubMed and Embase databases prior to August 2015. Random-effects models were employed to pool the relative risks. A total of 22 articles consisting of 49 studies-19 studies for nitrates, 19 studies for nitrites, and 11 studies for N-nitrosodimethylamine (NDMA)-were included. The summary relative risk of stomach cancer for the highest categories, compared with the lowest, was 0.80 (95% confidence interval (CI), 0.69-0.93) for dietary nitrates intake, 1.31 (95% CI, 1.13-1.52) for nitrites, and 1.34 (95% CI, 1.02-1.76) for NDMA (p for heterogeneity was 0.015, 0.013 and <0.001, respectively). The study type was found as the main source of heterogeneity for nitrates and nitrites. The heterogeneity for NDMA could not be eliminated completely through stratified analysis. Although significant associations were all observed in case-control studies, the cohort studies still showed a slight trend. The dose-response analysis indicated similar results as well. High nitrates intake was associated with a weak but statistically significant reduced risk of gastric cancer. Whereas increased consumption of nitrites and NDMA seemed to be risk factors for cancer. Due to the lack of uniformity for exposure assessment across studies, further prospective researches are warranted to verify these findings.
... The positive associations with meat consumption appeared to be stronger or limited to noncardia gastric cancer, whereas little or no association was found for gastric cardia cancer (González et al., 2006a). No association between red meat consumption and risk of gastric cancer was observed in the Swedish Mammography Cohort (Larsson et al., 2006j) or in a large cohort study in Japan (Tokui et al., 2005). Three other cohort studies also did not reveal any relation between meat consumption and gastric cancer Knekt et al., 1999;Ngoan et al., 2002). ...
... Among prospective cohort studies, NDMA intake was statistically significantly positively associated with risk of gastric cancer in the Swedish Mammography Cohort (Larsson et al., 2006j), while a small Finnish cohort study (Knekt et al., 1999) and the EPIC study (Jakszyn et al., 2006) observed no association (FIGURE 27). Nevertheless, in the EPIC study, an index of endogenous formation of NOCs was statistically significantly positively associated with noncardia gastric cancer risk. ...
... Six cohort studies Galanis et al., 1998;McCullough et al., 2001;Ngoan et al., 2002;González et al., 2006a;Larsson et al., 2006j) and nine case-control studies (Risch et al., 1985;González et al., 1991;Hoshiyama and Sasaba, 1992;Ward et al., 1997;Ward and Lopez-Carrillo, 1999;De Stefani et al., 2001;Ito et al., 2003;Nomura et al., 2003;Lissowska et al., 2004) provided the required data to be included in the dose-response metaanalysis of processed meat consumption. One cohort study and five case-control studies were excluded because processed meat consumption could not be quantified (Boeing et al., 1991b;Knekt et al., 1999;Chen et al., 2002a;De Stefani et al., 2004) or because the range of exposure was very narrow (Lee et al., 1990;Takezaki et al., 2001), leading to exaggerated regression coefficients. ...
Thesis
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Diet has been hypothesized to play a major role in the etiology of gastrointestinal cancer, but the specific dietary factors involved remain unclear. The aims of this thesis were: to examine the associations of dietary magnesium and vitamin B6 intakes with risk of colorectal cancer in the Swedish Mammography Cohort (SMC); to evaluate the relation between folate intake and risk of pancreatic cancer in the SMC and the Cohort of Swedish Men (COSM); to use metaanalysis to summarize the evidence from published studies of the associations of folate intake and polymorphisms in the gene encoding 5,10-methylenetetrahydrofolate reductase (MTHFR C677T and A1298C), a central enzyme in one-carbon metabolism, with risk of esophageal, gastric, pancreatic, and colorectal cancer; and to perform a meta-analysis of epidemiologic studies of the relationship between processed meat consumption and risk of gastric cancer. The SMC is a prospective cohort study of 61 433 women in central Sweden who were cancerfree and had completed a dietary questionnaire at enrollment between 1987 and 1990. Participants received a second questionnaire in 1997 that included details on diet and other lifestyle factors. The COSM is a prospective cohort study of 45 306 men in central Sweden who were cancer-free and had completed a questionnaire in 1997. Multivariate rate ratios and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models. We ascertained 805 incident cases of colorectal cancer in the SMC from baseline through June 30, 2004. Dietary intakes of magnesium and vitamin B6 were statistically significantly inversely associated with the risk of colorectal cancer. The multivariate rate ratios comparing the highest with the lowest quintile of intake were 0.59 (95% CI, 0.40-0.87; Ptrend = 0.006) for magnesium and 0.66 (95% Cl, 0.50-0.86; Ptrend = 0.002) for vitamin B6. In the SMC and the COSM, 135 incident cases of pancreatic cancer were diagnosed from 1998 through December 31, 2004. Intake of folate from diet but not from supplements was inversely associated with the risk of pancreatic cancer. The multivariate rate ratios for women and men in the highest category of dietary folate intake (¡Ý350 ¦Ìg/day) compared with those in the lowest category (<200 ¦Ìg/day) was 0.25 (95% CI, 0. 11-0.59; Ptrend = 0.002). For the meta-analyses, epidemiologic studies were identified by searching MEDLINE (1966March 2006) and the reference lists of pertinent articles. Study-specific results were combined using a random-effects model. The summary relative risks (95% CI) for the highest versus the lowest dietary folate intake category were 0.62 (0.53-0.72) for esophageal cancer (7 casecontrol), 0.90 (0.72-1.13) for gastric cancer (9 case-control, 2 cohorts), 0.49 (0.350.67) for pancreatic cancer (1 case-control, 4 cohorts), and 0.75 (0.66-0.87) for colorectal cancer (6 cohorts). Comparing the MTHFR 677TT genotype with the 677CC genotype, the summary odds ratios (95% CI) were 1.59 (0.98-2.58) for esophageal cancer, 1.90 (1.38-2.60) for gastric cardia cancer, 1.68 (1.29-2.19) for gastric cancer, 2.28 (0.91-5.71) for pancreatic cancer, and 0.84 (0.75-0.95) for colorectal cancer. For colorectal cancer, the summary odds ratio for the MTHFR 1298CC versus the 1298AA genotype was 0.82 (95% CI, 0.65-1.03). Six prospective studies and nine case-control studies were included in the dose-response metaanalysis of processed meat consumption and gastric cancer risk. The summary relative risks for an increment in processed meat consumption of 30 g/day were 1.15 (95% CI, 1.041.27) in prospective studies and 1.38 (95% CI, 1.19-1.60) in case-control studies. In conclusion, our findings support a role of diet and one-carbon metabolism related gene polymorphisms in the etiology of gastrointestinal cancer. Specifically, our results suggest that increased consumption of foods rich in magnesium, vitamin B6, and folate as well as reduced consumption of processed meat may lower the risk of gastrointestinal cancer.
... Knowledge and understanding of the public health implications of consuming fried bacon has advanced since the turn of the century. Larsson et al. (2006) published their findings after 18 years of tracking the direct nitrosamine intake and cancer development of 61,433 Swedish women (enrolled in the Swedish Mammography Cohort). The study focused on processed meats, including bacon or side pork, sausages or hotdogs, ham or salami. ...
... This is a very high incidence rate. Larsson et al. (2006) commented on these results, "High consumption of processed meat, but not of other meats (i.e., red meat, fish and poultry), was associated with a statistically significant increased risk of stomach cancer" and that "Stomach cancer risk was two-fold higher among women in the top quintile of N-nitrosodimethylamine intake when compared with those in the bottom quintile. Our findings suggest that high consumption of processed meat may increase the risk of stomach cancer. ...
... Our findings suggest that high consumption of processed meat may increase the risk of stomach cancer. Dietary nitrosamines might be responsible for the positive association [162]". ...
Article
Full-text available
This review examines the benefits and alleged risks associated with the disinfection of drinking water by chlorination, through critical appraisal of the historical saga of chloroform as the main disinfection by-product (DBP). The author maintains that the provision of clean drinking water is a survival issue for humankind and supports unreservedly the recommendation by the World Health Organization (WHO) of the United Nations to disinfect by chlorination, for the reasons stated herein. The author aims to lead water professionals to a deeper understanding of the public health issues concerning chloroform and how the corpus of knowledge was attained by colossal multidisciplinary effort on a global scale. Origins of the alleged risks of chlorination are traced and the assumptions behind these allegations are questioned. The author welcomes and encourages innovations for improved methods of water treatment insofar that the standards of potability set out by the WHO are met in the very least, but argues that the commencement point of research into new techniques should be an acknowledgment of the development of disinfection up to contemporary times, on the part of water engineers and policy makers. There must be a clear recognition of the horrific consequences of failure to eliminate pathogens and toxic substances. To this effect, landmark tragedies are described to emphasize the point. Significantly, this work addresses topics which are sine quo non to the debate over chlorination but which are often lacking in public discourse, namely: differences in the way cytochrome P450 enzymes oxidize carbon tetrachloride which is not normally a product of chlorination, and chloroform, which is a disinfection by-product; the role of free radical scavengers in protecting the human body; the difficulties of extrapolating experimental results from rodents to humans; the awareness of the complex relationship between governments, chemical industries, special interest groups and the public. Also introduced are the aetiologies of some cancers (e.g., Hepatitis B and C viruses as the instigators for hepatocellular carcinoma) to juxtapose claims that chloroform in drinking water is the sole culprit responsible for liver, bladder, colorectal cancers and birth defects etc. Other well known human carcinogens and a few inorganic compounds known to cause harm are also
... Strengths of the study include the size, follow-up, detailed NDMA and ENOC calculations, and availability of plasma measures. In a prospective study,Larsson et al. (2006)investigated the associations between intake of red meat, poultry and fish, processed meat (bacon or side pork, sausage or hotdogs, and ham or salami), NDMA and risk of stomach cancer. Data was obtained from the Swedish Mammography Cohort composed of a population of women, between the ages of 58 and 92 years, with an 18-year follow-up and repeated assessment of diet. ...
... For GCA and GNCA, no significant associations were found with total nitrite intake (Keszei et al., 2013;total 663 cases), nor with nitrite intake from meat (Cross et al., 2011;total 955cases). NDMA intake was significantly positively associated with overall gastric cancer risk in a Swedish cohort study among women (156 cases), with no effect modification by vitamin C or E (Larsson et al., 2006). The Panel noted that the authors did not provide estimates of the relationship between nitrite intake levels alone (mg/day) and gastric cancer. ...
Article
Full-text available
The Panel on Food Additives and Nutrient Sources added to Food (ANS) provided a scientific opinion re-evaluating the safety of potassium nitrite (E 249) and sodium nitrite (E 250) when used as food additives. The ADIs established by the SCF (1997) and by JECFA (2002) for nitrite were 0–0.06 and 0–0.07 mg/kg bw per day, respectively. The available information did not indicate in vivo genotoxic potential for sodium and potassium nitrite. Overall, an ADI for nitrite per se could be derived from the available repeated dose toxicity studies in animals, also considering the negative carcinogenicity results. The Panel concluded that an increased methaemoglobin level, observed in human and animals, was a relevant effect for the derivation of the ADI. The Panel, using a BMD approach, derived an ADI of 0.07 mg nitrite ion/kg bw per day. The exposure to nitrite resulting from its use as food additive did not exceed this ADI for the general population, except for a slight exceedance in children at the highest percentile. The Panel assessed the endogenous formation of nitrosamines from nitrites based on the theoretical calculation of the NDMA produced upon ingestion of nitrites at the ADI and estimated a MoE > 10,000. The Panel estimated the MoE to exogenous nitrosamines in meat products to be < 10,000 in all age groups at high level exposure. Based on the results of a systematic review, it was not possible to clearly discern nitrosamines produced from the nitrite added at the authorised levels, from those found in the food matrix without addition of external nitrite. In epidemiological studies there was some evidence to link (i) dietary nitrite and gastric cancers and (ii) the combination of nitrite plus nitrate from processed meat and colorectal cancers. There was evidence to link preformed NDMA and colorectal cancers.
... Antioxidants are important to prevent or delay oxidative processes which is one of the main problems observed in meat products, causing changes in sensory parameters, loss of nutritional value and free radicals formation. However, the use of synthetic antioxidants has been questioned since studies have shown that there is an association between the consumption of processed meats and the increased risk of certain types of cancer (Larsson et al., 2006;Larsson and Wolk, 2012). Nitrites and nitrates used as preservatives in processed meat products contribute towards oxidative processes prevention; but throughout the storage period they produce the potentially carcinogenic nitrosamines that may be responsible for the association of processed meats with cancer (Larsson et al., 2006;Pegg and Shahidi, 2006) and the inclusion of processed meats on the list of carcinogenic potential products by the World Health Organization. ...
... However, the use of synthetic antioxidants has been questioned since studies have shown that there is an association between the consumption of processed meats and the increased risk of certain types of cancer (Larsson et al., 2006;Larsson and Wolk, 2012). Nitrites and nitrates used as preservatives in processed meat products contribute towards oxidative processes prevention; but throughout the storage period they produce the potentially carcinogenic nitrosamines that may be responsible for the association of processed meats with cancer (Larsson et al., 2006;Pegg and Shahidi, 2006) and the inclusion of processed meats on the list of carcinogenic potential products by the World Health Organization. Therefore, the use of natural additives to inhibit or delay oxidation processes becomes a viable alternative for meat products (Dimitrios, 2006). ...
Article
Full-text available
The World Health Organization (WHO) recently included processed meats on the carcinogenic potential products list, mainly because of some synthetic additives used on these products. Besides that, consumers have been looking for a healthier and preservative-free diet, worrying about additives that are included in food products. These reports demand urgent development of healthier meat products, with natural additives as the best alternative. Thus, the aim of this work was to develop and study the stability of a new chicken fresh sausage formulation through the use of Jambolão pulp and peel extract (JPPE) instead of the synthetic additives normally used. Two experiments were held: 1) Extracts characterization (color, pH, total soluble solids content, phenolic compounds and antioxidant activity by DPPH• radical capture method); 2) Fresh chicken sausage characterization in the different concentrations (positive control – 0.25% sodium nitrite, negative control - no additives and addition of 2% and 4% of jambolão extract) regarding the centesimal composition and stability evaluation of sausage through color analysis (L * a * b *), pH, water activity and lipid oxidation (TBARS) during 12 days cold storage period. Hydroethanolic extract presented better antioxidant activity (EC50 = 12.15mg.mL-1) than aqueous extract (EC50 = 23.40mg.mL-1); Extract addition did not change the main quality parameters of chicken fresh sausage but on the other hand accelerated its lipids oxidation. Minor amounts of jambolão extract should be tested.
... [9]. This result was supported by conclusions drawn by other studies [4,19,30]. In contrast, statistical significance was not reached in the Iowa Women's Health Study and other studies [21][22][23][24]. ...
Article
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Background: A positive association between a high iron intake and colorectal cancer has been identified; however, the effect of dietary iron on gastric cancer (GC) remains unclear. Here, we investigate whether dietary iron is related to GC risk and whether the transferrin receptor (TFRC) rs9846149 polymorphism modifies this association. Methods: A case-control study was designed to assess this association among 374 GC patients and 754 healthy controls. A self-administered questionnaire was used to collect information on demographics, medical history and lifestyle. Dietary iron intake was assessed using a semi-quantitative food frequency questionnaire. TFRC rs9846149 was genetically analyzed using the Affymetrix Axiom Exom 319 Array platform. Results: A higher total dietary iron was significantly associated with decreased GC risk [OR = 0.65 (0.45-0.94), p for trend = 0.018]. A similar association was observed with nonheme iron [OR = 0.64 (0.44-0.92), p for trend = 0.018]. Individuals with a major allele of TFRC rs9846149 (CC/GC) and higher intake of total iron had a significantly lower GC risk than those with a lower intake [OR = 0.60 (0.41-0.88), p interaction = 0.035]. Conclusion: Our findings show the protective effects of total dietary iron, especially nonheme iron, against GC risk, and this association can be modified by TFRC rs9846149.
... N-nitrosodimethylamine (NDMA) is the most frequently occurring nitrosamine in foods (Chowdhury 2014). Consumption in diet of these nitrosamines as well as other N-nitroso compounds together with endogenous-formed nitrosamines, seems to increase the risk of oral cavity, oesophagus and stomach cancer (Crampton 1980, Bartsch and Montesano 1984, Larsson et al. 2006, Butler 2015. ...
... First, the positive results in the case-control studies may be biologically plausible. When cooked at high temperature for a long time, red and processed meat is a major source of carcinogens, including polycyclic aromatic hydrocarbons, heterocyclic amines and N-nitroso compounds, which may play important roles in the development of GC [13][14][15]. Second, a high iron intake associated with red and processed meat consumption may also play a role in GC by causing oxidative damage and involving the endogenous formation of carcinogenic N-nitroso compounds . Third, positive associations have been reported to be due to genetical differences [18]. ...
Article
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The associations between red and processed meat consumption and gastric cancer risk have remained inconclusive. We performed a systematic review and meta-analysis to analyze these associations. We searched PubMed and EMBASE to identify studies published from inception through October 2016. Subtype analyses of gastric cancer (gastric cardia adenocarcinoma and gastric non-cardiac adenocarcinoma) and dose-response analyses were performed. We finally selected 42 eligible studies. The summary relative risks of highest versus lowest consumption were positive for case-control studies with 1.67 (1.36-2.05) for red meat and 1.76 (1.51-2.05) for processed meat, but negative for cohort studies with 1.14 (0.97-1.34) for red meat and 1.23 (0.98-1.55) for processed meat. Subtype analyses of cohort studies suggested null results for gastric cardia adenocarcinoma (red meat, P = 0.79; processed meat, P = 0.89) and gastric non-cardiac adenocarcinoma (red meat, P = 0.12; processed meat, P = 0.12). In conclusion, the present analysis suggested null results between red and processed meat consumption and gastric cancer risk in cohort studies, although case-control studies yielded positive associations. Further well-designed prospective studies are needed to validate these findings.
... However, there is some evidence that a healthy diet is beneficial; eating sufficient amounts of fruit and vegetables decreases the risk of some cancers, particularly cancers of the mouth, oesophagus and stomach (Benetou et al, 2008;González et al, 2006;IARC 2003); eating sufficient fibre can reduce the risk of colorectal cancer (Nomura et al, 2007). Conversely, excessive consumption of red meat or processed meat can increase the risk of pancreatic cancer, colorectal cancer and stomach cancer (Larsson et al, 2006a;Larsson et al, 2006b;Larsson & Wolk, 2006), and consuming excessive amounts of saturated fat can increase the risk of breast cancer (Thiébaut et al, 2007). Knowledge about the relationship between lifestyle factors and cancer is important since the evidence suggests that health behaviours often 'cluster' together in individuals, and those individuals who are physically active may be more likely to adopt a healthy lifestyle in general. ...
Chapter
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It is widely accepted that physical activity is important for physical functioning and well-being, and as such the promotion of active lifestyles is becoming increasingly significant in public health policy both in the UK and worldwide. Sedentary lifestyles have been associated with increased risk of obesity and preventable disease including diabetes, coronary heart disease and some cancers. With regards cancer specifically, this chapter will provide a brief overview on current opinions on the link between physical activity and cancer prevention. The published evidence focuses both on primary and secondary prevention. More recent evidence has investigated the use of physical activity in secondary prevention for those who have been diagnosed with cancer and proposed a link between physical activity, morbidity and mortality in those with cancer. The evidence-base for secondary prevention is more limited. Nevertheless, studies to date have indicated that physical activity can improve both physical functioning and psychological outcomes in cancer survivors, and significantly improve quality of life. The exact nature of those interventions which confer the most positive effects is less well-established, and there is a current lack of consensus on the most appropriate type, intensity and duration of activity for people with cancer. It has not yet been wellestablished as to which stage of the treatment programme physical activity should be encouraged (during or following treatment) or the most appropriate length of time during which structured physical activity interventions should be delivered to achieve beneficial results. These factors will be discussed in this chapter, and barriers to engaging in physical activity for those with a diagnosis of cancer will be considered. The chapter will conclude with a summary of key findings and the potential for further research.
... Nitrite may react with secondary amines naturally present in the meat to form N-nitrosamines, which are carcinogenic (IARC, 1998). There is an association between consumption of processed meat and increase risk of different cancers (Santarelli et al., 2008;Larsson et al., 2006;Larsson & Wolk, 2012), which cause death (Rohrmann et al., 2013). Unlike synthetic compounds, natural extracts obtained from plants are rich in phenolic compounds which can enhance the overall quality of food by decreasing lipid oxidation and microbial growth (Zhang et al., 2016). ...
Article
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Medicinal plants contain substances can alternate the traditional chemical preservatives which used for preserving meat products that have negative effects on consumer health. Several biological activities have been reported for Artemisia and Portcula as antimicrobial agents, so the current study focused on using Artemisia and Portcula extracts as antimicrobial agents in beef burger. Phytochemical of Artemisia and Portcula extracts were analyzed, and both extracts contain alkaloids, flavonoids, phenols, trepenoids and saponin. The results show that Artemisia extract was inhibited all tested microorganisms (Staphylococcus aureus, Pseudomonas aeruginosa, Salmonella Typhimurium, Listeria monocytogenes and E.coli O157:H7) while, Portulaca extract affect Staphylococcus aureus only. The Minimum Cidal Concentration (MCC) and Minimum Inhibitory Concentration (MIC) were carried out for testing microorganisms, since Artemisia extract was very effective against Staphylococcus aureus followed by E.coli, Pseudomonas aeruginosa, Salmonella Typhimurium and L. monocytogenes. Artemisia and Portcula extracts were separately applied in beef burger as antimicrobials at levels 1% and 1.5%. The sensory evaluation of treated beef burger showed no significant differences between control sample and treatments containing Portcula extract while, the addition of Artmesia extract had a detrimental effect on taste of beef burger since it causes formation of bitter taste.
... Nitrite may react with secondary amines naturally present in the meat to form N-nitrosamines, which are carcinogenic (IARC, 1998). There is an association between consumption of processed meat and increase risk of different cancers (Santarelli et al., 2008;Larsson et al., 2006;Larsson & Wolk, 2012), which cause death (Rohrmann et al., 2013). Unlike synthetic compounds, natural extracts obtained from plants are rich in phenolic compounds which can enhance the overall quality of food by decreasing lipid oxidation and microbial growth (Zhang et al., 2016). ...
Article
Full-text available
p> Medicinal plants contain substances can alternate the traditional chemical preservatives which used for preserving meat products that have negative effects on consumer health. Several biological activities have been reported for Artemisia and Portulaca as antimicrobial agents, so the current study focused on using Artemisia and Portulaca extracts as antimicrobial agents in beef burger. Phytochemical of Artemisia and Portulaca extracts were analyzed, and both extracts contain alkaloids, flavonoids, phenols, trepenoids and saponin . The results show that Artemisia extract was inhibited all tested microorganisms (Staphylococcus aureus , Pseudomonas aeruginosa, Salmonella Typhimurium , Listeria monocytogenes and E.coli O157:H7 ) while, Portulaca extract affect Staphylococcus aureus only . The Minimum Cidal Concentration (MCC) and Minimum Inhibitory Concentration (MIC) were carried out for testing microorganisms, since Artemisia extract was very effective against Staphylococcus aureus followed by E.coli, Pseudomonas aeruginosa, Salmonella Typhimurium and L. monocytogenes. Artemisia and Portulaca extracts were separately applied in beef burger as antimicrobials at levels 1 % and 1.5%. The sensory evaluation of treated beef burger showed no significant differences between control sample and treatments containing Portulaca extract while, the addition of Artmesia extract had a detrimental effect on taste of beef burger since it causes formation of bitter taste. </em
... Two additional nitrosamines, N-nitrosodiisopropylamine (NDIPA) and N-nitrosodibutylamine (NDBA), were proposed to be present in certain drug formulations based on process risk. Evidence in some published reports suggests that human exposure to nitrosamine contaminants in food may be associated with stomach cancers, while other publications reported no association (Jakszyn and Gonzalez 2006;Larsson et al. 2006). Occupational exposures to nitrosamines in the American and British rubber industries were associated with cancer in multiple organs (Fajen et al. 1979;Hidajat et al. 2019). ...
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Many nitrosamines are recognized as mutagens and potent rodent carcinogens. Over the past few years, nitrosamine impurities have been detected in various drugs leading to drug recalls. Although nitrosamines are included in a ‘cohort of concern’ because of their potential human health risks, most of this concern is based on rodent cancer and bacterial mutagenicity data, and there are little data on their genotoxicity in human-based systems. In this study, we employed human lymphoblastoid TK6 cells transduced with human cytochrome P450 (CYP) 2A6 to evaluate the genotoxicity of six nitrosamines that have been identified as impurities in drug products: N-nitrosodiethylamine (NDEA), N-nitrosoethylisopropylamine (NEIPA), N-nitroso-N-methyl-4-aminobutanoic acid (NMBA), N-nitrosomethylphenylamine (NMPA), N-nitrosodiisopropylamine (NDIPA), and N-nitrosodibutylamine (NDBA). Using flow cytometry-based assays, we found that 24-h treatment with NDEA, NEIPA, NMBA, and NMPA caused concentration-dependent increases in the phosphorylation of histone H2A.X (γH2A.X) in CYP2A6-expressing TK6 cells. Metabolism of these four nitrosamines by CYP2A6 also caused significant increases in micronucleus frequency as well as G2/M phase cell-cycle arrest. In addition, nuclear P53 activation was found in CYP2A6-expressing TK6 cells exposed to NDEA, NEIPA, and NMPA. Overall, the genotoxic potency of the six nitrosamine impurities in our test system was NMPA > NDEA ≈ NEIPA > NMBA > NDBA ≈ NDIPA. This study provides new information on the genotoxic potential of nitrosamines in human cells, complementing test results generated from traditional assays and partially addressing the issue of the relevance of nitrosamine genotoxicity for humans. The metabolically competent human cell system reported here may be a useful model for risk assessment of nitrosamine impurities found in drugs.
... We identified 148 publications that examined the associations of red meat, processed meat, and total red and processed meat intake and various sites of cancer in prospective studies: 28 publications for breast cancer [22,24,26, (Table S2); 8 publications for ovarian cancer [22,23,59,[68][69][70][71][72] (Table S3); 8 publications for endometrial cancer [22,59,[73][74][75][76][77][78] (Table S4); 20 publications for prostate cancer [27,28,46,59,60,62,[79][80][81][82][83][84][85][86][87][88][89][90][91][92] (Table S5); 38 publications for colorectal, colon, and rectal cancers [21,29,59,60,62,64, (Table S6); 10 publications for stomach cancer [59,64,70,96,[125][126][127][128][129][130] (Table S7); 3 publications for esophageal squamous-cell carcinoma and esophageal adenocarcinoma [130][131][132] (Table S8); 16 publications for pancreatic cancer [30-32, 59, 133-144] (Table S9); 10 publications for lung cancer [33,46,59,60,64,70,[145][146][147][148] (Table S10); 8 publications for bladder cancer [34,59,[149][150][151][152][153][154] (Table S11); 5 publications for renal cell cancer [3,59,[155][156][157] (Table S12); 7 publications for hepatocellular carcinoma [25,35,36,59,[158][159][160] (Table S13), 4 publications for leukemia [59,70,161,162] (Table S14), 5 publications for non-Hodgkin lymphoma [59,[163][164][165][166] (Table S15), 3 publications for melanoma [37,59,70] (Table S16), and 7 publications for glioma [38,59,[167][168][169][170][171] (Table S17). Nine publications reported the findings for more than one cancer [22,46,59,60,62,64,70,96,130]. ...
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Red meat and processed meat consumption has been hypothesized to increase risk of cancer, but the evidence is inconsistent. We performed a systematic review and meta-analysis of prospective studies to summarize the evidence of associations between consumption of red meat (unprocessed), processed meat, and total red and processed meat with the incidence of various cancer types. We searched in MEDLINE and EMBASE databases through December 2020. Using a random-effect meta-analysis, we calculated the pooled relative risk (RR) and 95% confidence intervals (CI) of the highest versus the lowest category of red meat, processed meat, and total red and processed meat consumption in relation to incidence of various cancers. We identified 148 published articles. Red meat consumption was significantly associated with greater risk of breast cancer (RR = 1.09; 95% CI = 1.03–1.15), endometrial cancer (RR = 1.25; 95% CI = 1.01-1.56), colorectal cancer (RR = 1.10; 95% CI = 1.03–1.17), colon cancer (RR = 1.17; 95% CI = 1.09-1.25), rectal cancer (RR = 1.22; 95% CI = 1.01-1.46), lung cancer (RR = 1.26; 95% CI = 1.09–1.44), and hepatocellular carcinoma (RR = 1.22; 95% CI = 1.01-1.46). Processed meat consumption was significantly associated with a 6% greater breast cancer risk, an 18% greater colorectal cancer risk, a 21% greater colon cancer risk, a 22% greater rectal cancer risk, and a 12% greater lung cancer risk. Total red and processed meat consumption was significantly associated with greater risk of colorectal cancer (RR = 1.17; 95% CI = 1.08–1.26), colon cancer (RR = 1.21; 95% CI = 1.09–1.34), rectal cancer (RR = 1.26; 95% CI = 1.09–1.45), lung cancer (RR = 1.20; 95% CI = 1.09-1.33), and renal cell cancer (RR = 1.19; 95% CI = 1.04–1.37). This comprehensive systematic review and meta-analysis study showed that high red meat intake was positively associated with risk of breast cancer, endometrial cancer, colorectal cancer, colon cancer, rectal cancer, lung cancer, and hepatocellular carcinoma, and high processed meat intake was positively associated with risk of breast, colorectal, colon, rectal, and lung cancers. Higher risk of colorectal, colon, rectal, lung, and renal cell cancers were also observed with high total red and processed meat consumption.
... Third, teeth loss is associated with an oral flora which may reduce the process of nitrate to nitrite 40,41 . This nitrite can then spontaneously react with amines and be converted to carcinogenic nitrosamines, some of which be gastrointestinal organ-specific carcinogens 42,43 . ...
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Esophageal carcinoma (EC) is a serious malignancy, and its epidemiologic etiology is not fully explained. We performed this review to investigate the association between teeth loss and teeth brushing and the risk of EC. A systematic search was conducted to identify all relevant studies. The Q test and I 2 statistic were used to examine between-study heterogeneity. Pooled odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were considered by fixed or random effects models. Furthermore, we conducted subgroup analyses based on study design, the studies geographic regions and case type of origin. Modified Egger linear regression test was used to estimate publication bias. Ten articles were included. Pooled analyses indicated that teeth loss was associated with an increased risk of EC for Asians (OR, 1.52; 95% CI: 1.30, 1.78), and high frequency of teeth brushing was associated with a lower incidence of EC (OR, 0.62; 95%CI: 0.43, 0.89). Subgroup analyses showed consistent results and no publication bias existed. Teeth loss and teeth brushing play potential roles in the progressing of EC. People should take care of their oral health in daily life. And large well-designed researches are needed to fully describe the association between teeth health and EC risk.
... It is important to keep residual nitrite at low level to prohibit nitrosamine formation in se'i product, since nitrosamine seems to be associated with gastric cancer (Jakszyn & Gonzales, 2006;Larsson et al., 2006). Nitrosamines are formed when nitrite reacts with secondary amines in food. ...
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The objective of this study was to investigate the effect of Citrus aurantifolia extract (CAE), coconut shell liquid smoke (CSLS) and the combination of CAE and CSLS (CACS) on se’i characteristics. A completely randomized design was assigned in this experiment. Treatments used were: se’i treated with 5% (v/v) CAE, CSLS 5% (v/v), (CAE : CSL 1:1) )/ (CACS) and untreated se’i as a control (C). Parameters measured were: aroma, color, taste, pH, residual nitrite, total bacterial count, Coliform, Staphylococcus aureus, Escherichia coli, and Salmonella. The data of aroma, color, and taste were analyzed by using Kruskal-Wallis test followed by Mann-Whitney test. The pH, residual nitrite, and bacterial data were analyzed with analysis of variance (ANOVA) followed by least significant differences test. Results showed that CAE caused the highest score at both aroma and taste (P
... [5] Gastric carcinogenesis is a complex, multistep and sequential process [6]. Like other malignancies, many factors may contribute to the development of gastric cancer, such as nutrition, dietary habits, salt consumption, excessive alcohol intake, tobacco smoking, Helicobacter pylori (H.pylori) infection, chronic gastritis, atrophyintestinal metaplasia and dysplasia [7][8][9][10][11][12]. Besides these factors, a large number of studies have demonstrated that the development of gastric cancer is partly under genetic control [13][14][15]. ...
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Objectives: The receptor for advanced glycation end products (RAGE) is an oncogenic trans-membranous receptor expressed in many cells. The aim of this study was to clarify the association between RAGE gene 4 single nucleotide polymorphisms (SNPs) and the risk, invasion, metastasis and overall survival of gastric cancer. Methods and Results: We performed a hospital-based case-control study involving 369 gastric cancer patients and 493 cancer free controls. Four widely-studied SNPs, rs1800625 (T-429C), rs1800624 (T-374A), rs2070600 (Gly82Ser) and rs184003 (G1704T) in RAGE gene, were genotyped by the polymerase chain reaction - ligase detection reaction method. The RAGE gene rs1800625 TT genotype and T allele were significantly associated with a reduced risk of gastric cancer (TT vs. CC: adjusted odds ratio [OR]: 0.72, 95% CI: 0.55-0.95, p=0.021; T vs. C: adjusted OR: 0.67, 95% CI: 0.46-0.97, p=0.032). No hints of significance were detected for the other three SNPs in association with gastric cancer risk. Moreover, rs1800625 and rs184003 were significantly associated with tumor clinical stage (p=0.010 and 0.032, respectively). Survival curves differed significantly between the genotypes of rs1800625. Conclusions:RAGE gene SNP rs1800625 was significantly associated with gastric cancer risk, and rs1800625 and rs184003 were related to tumor clinical stage, indicating that RAGE gene may be a gastric cancer-susceptibility gene.
... Several epidemiologic studies show associations between consumption of red and processed meat and increased risk of e.g. colorectal cancer (Santarelli et al., 2008), stomach cancer (Larsson et al., 2006), pancreatic cancer (Larsson and Wolk, 2012) but also with increased risk of cardiovascular diseases and other causes of death (Rohrmann et al., 2013). The association was stronger for high consumption of processed meat than for high consumption of red meat in several of these studies. ...
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Recent epidemiological studies show a positive association between cancer incidence and high intake of processed meat. N-nitrosamines (NA) in these products have been suggested as one potential causative factor. Most volatile NA (VNA) are classified as probable human carcinogens, whereas the carcinogenicity for the majority of the non-volatile NA (NVNA) remains to be elucidated. Danish adults (15-75 years) and children (4-6 years) consume 20 g and 16 g of processed meat per day (95th percentile), respectively. The consumption is primarily accounted for by sausages, salami, pork flank (spiced and boiled) and ham. This consumption results in an exposure to NVNA of 33 and 90 ng kg bw-1 day-1 for adults and children, respectively. The exposure to VNA is significantly lower amounting to 0.34 and 1.1 ng kg bw-1 day-1 for adults and children, respectively. Based on a BMDL10 of 29 µg kg bw-1 day-1 a MOE value ≥17000 was derived for the exposure to NA known to be carcinogenic (VNA including NSAR), indicating an exposure of low concern. The exposure to the NVNA is substantially higher and if found of toxicological significance the exposure may be of concern. Copyright © 2015. Published by Elsevier Ltd.
... This smoked meat has a large amount of Nnitroso compounds in them which in turn result in the production of many potent carcinogenic compounds that are positively co-related to gastric cancer. [59] 2. Type-A blood group: Control studies reported that people of Type -A blood group are more prone to gastric cancer than non-type A and are hence more prone to H-Pylori infection as compare to non A type. [60] 3. Medical history: Heredity diffuse gastric cancer (HDGC) is a rare genetic condition in which the mutated gene (cancer gene) passes from one generation to another thus making the generation inheriting it more prone to gastric cancer as compared to others. [61] Pre-natal genetic diagnosis is the best way to diagnose the probability of the cancer gene in the embryo. ...
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Kashmiri population has distinct dietary habits owing to the long winter spells prevalent in the valley which has accustomed the population to preserve the food in the form of smoked, pickled and dried foods. These peculiar dietary habits contribute to the intake of many N-nitroso compounds (NOCs) which are responsible for DNA damage, Cytotoxicity, gene mutation, DNA methylation, and unscheduled DNA synthesis. At the molecular level, these changes are responsible for the pathogenesis of cancer. This paper presents a review of the relation between the Kashmiri diet and gastric carcinomas, highly prevalent in the valley. This study creates an initial study base and enlists the number of potential factors responsible for the alarming rate of gastric carcinoma in the valley.
... This smoked meat has a large amount of Nnitroso compounds in them which in turn result in the production of many potent carcinogenic compounds that are positively co-related to gastric cancer. [59] 2. Type-A blood group: Control studies reported that people of Type -A blood group are more prone to gastric cancer than non-type A and are hence more prone to H-Pylori infection as compare to non A type. [60] 3. Medical history: Heredity diffuse gastric cancer (HDGC) is a rare genetic condition in which the mutated gene (cancer gene) passes from one generation to another thus making the generation inheriting it more prone to gastric cancer as compared to others. [61] Pre-natal genetic diagnosis is the best way to diagnose the probability of the cancer gene in the embryo. ...
Article
Full-text available
Kashmiri population has distinct dietary habits owing to the long winter spells prevalent in the valley which has accustomed the population to preserve the food in the form of smoked, pickled and dried foods. These peculiar dietary habits contribute to the intake of many N-nitroso compounds (NOCs) which are responsible for DNA damage, Cytotoxicity, gene mutation, DNA methylation, and unscheduled DNA synthesis. At the molecular level, these changes are responsible for the pathogenesis of cancer. This paper presents a review of the relation between the Kashmiri diet and gastric carcinomas, highly prevalent in the valley. This study creates an initial study base and enlists the number of potential factors responsible for the alarming rate of gastric carcinoma in the valley.
... Finally, a total of 43 studies which were published between 1990 and 2017 were included in this meta-analysis. All studies consisted of 11 cohort studies (5 for red meat, 8 for processed meat, and 5 for white meat) [4,[21][22][23][24][25][26][27][28][29][30] and 32 casecontrol studies (19 for red meat, 20 for processed meat, and 14 for white meat) Table 1 illustrates the general characteristics of the studies in this meta-analysis. A total of 1,764,894 subjects and 4314 stomach cancer patients in 11 cohort studies were included in this study. ...
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: Whether the risk of gastric cancer varies by the types of meat consumption still remains disputable. The purpose of this meta-analysis was to identify the exact associations that red, processed, and white meat have with gastric cancer. We searched relevant studies in Medline, EMBASE, and the Cochrane Library before November 2018, including cohort and case-control studies. We used random-effect models to estimate the adjusted relative risk (RR), and Egger’s tests to evaluate publication bias. Through stepwise screening, 43 studies were included in this analysis (11 cohort studies and 32 case-control studies with 16,572 cases). In a meta-analysis for the highest versus lowest categories of meat consumption, both red (RR: 1.41, 95% confidence interval (CI): 1.21–1.66) and processed (RR: 1.57, 95% CI: 1.37–1.81) meat consumption were positively associated with gastric cancer risk, while white meat consumption was negatively associated with gastric cancer risk (RR: 0.80, 95% CI: 0.69–0.92). In a dose–response meta-analysis, the RRs of gastric cancer were 1.26 (95% CI: 1.11–1.42) for every 100 g/day increment in red meat consumption, 1.72 (95% CI: 1.36–2.18) for every 50 g/day increment in processed meat consumption, and 0.86 (95% CI: 0.64–1.15) for every 100 g/day increment in white meat consumption. The increase of white meat consumption may reduce the risk of gastric cancer, while red or processed meat may increase the risk of gastric cancer. Further studies are required to identify these associations, especially between white meat and gastric cancer.
... They also found a positive correlation between increased NDMA intake and gastric non-cardia adenocarcinoma [27]. One cohort study showed a positive relation between NDMA intake and gastric cancer risk in women [28]. While another study did not find an association between NDMA and gastric cancer, they did find an association between NDMA intake and colorectal cancer [29]. ...
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Consumption of nitrate-rich beetroot juice (BRJ) by athletes induces a number of beneficial physiological health effects, which are linked to the formation of nitric oxide (NO) from nitrate. However, following a secondary pathway, NO may also lead to the formation of N-nitroso compounds (NOCs), which are known to be carcinogenic in 39 animal species. The extent of the formation of NOCs is modulated by various other dietary factors, such as vitamin C. The present study investigates the endogenous formation of NOCs after BRJ intake and the impact of vitamin C on urinary NOC excretion. In a randomized, controlled trial, 29 healthy recreationally active volunteers ingested BRJ with or without additional vitamin C supplements for one week. A significant increase of urinary apparent total N-nitroso Compounds (ATNC) was found after one dose (5 to 47 nmol/mmol: p < 0.0001) and a further increase was found after seven consecutive doses of BRJ (104 nmol/mmol: p < 0.0001). Vitamin C supplementation inhibited ATNC increase after one dose (16 compared to 72 nmol/mmol, p < 0.01), but not after seven daily doses. This is the first study that shows that BRJ supplementation leads to an increase in formation of potentially carcinogenic NOCs. In order to protect athlete’s health, it is therefore important to be cautious with chronic use of BRJ to enhance sports performances.
... Authorities have postulated that diet-in particular, consumption of red meat and processed meat-may be a determinant of cancer risk (2). Many primary studies have reported an association between red and processed meat consumption and cancer mortality and incidence (3)(4)(5)(6)(7)(8)(9)(10)(11)(12). In response, the International Agency for Research on Cancer classified consumption of processed meat as carcinogenic to humans on the basis of evidence about colorectal cancer (group 1) and classified that of red meat as probably carcinogenic on the basis of evidence about colorectal, pancreatic, and prostate cancer (group 2A) (13). ...
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This article has been corrected. The original version (PDF) is appended to this article as a Supplement. Background: Cancer incidence has continuously increased over the past few centuries and represents a major health burden worldwide. Purpose: To evaluate the possible causal relationship between intake of red and processed meat and cancer mortality and incidence. Data sources: Embase, Cochrane Central Register of Controlled Trials, Web of Science, CINAHL, and ProQuest from inception until July 2018 and MEDLINE from inception until April 2019 without language restrictions. Study selection: Cohort studies that included more than 1000 adults and reported the association between consumption of unprocessed red and processed meat and cancer mortality and incidence. Data extraction: Teams of 2 reviewers independently extracted data and assessed risk of bias; 1 reviewer evaluated the certainty of evidence, which was confirmed or revised by the senior reviewer. Data synthesis: Of 118 articles (56 cohorts) with more than 6 million participants, 73 articles were eligible for the dose-response meta-analyses, 30 addressed cancer mortality, and 80 reported cancer incidence. Low-certainty evidence suggested that an intake reduction of 3 servings of unprocessed meat per week was associated with a very small reduction in overall cancer mortality over a lifetime. Evidence of low to very low certainty suggested that each intake reduction of 3 servings of processed meat per week was associated with very small decreases in overall cancer mortality over a lifetime; prostate cancer mortality; and incidence of esophageal, colorectal, and breast cancer. Limitation: Limited causal inferences due to residual confounding in observational studies, risk of bias due to limitations in diet assessment and adjustment for confounders, recall bias in dietary assessment, and insufficient data for planned subgroup analyses. Conclusion: The possible absolute effects of red and processed meat consumption on cancer mortality and incidence are very small, and the certainty of evidence is low to very low. Primary funding source: None. (PROSPERO: CRD42017074074).
... Higher frequency of G:C.A:T transitions at non-CpG sites can be attributed to alkylating agents in food and environment [48]. Of note, nitrosamines in alcoholic beverages [49] and processed meat [50] are known to increase the risk of esophageal and stomach cancer, respectively. ESCC studies from Iran [51] as well as southern Brazil [52] reported an association of habit of drinking hot tea with G:C.A:T transitions. ...
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The tumor suppressor p53 is known to be inactivated frequently in various cancers. In addition, germline polymorphisms in TP53 are known to affect protein function and influence risk of developing different types of cancers. In this study, we analyzed the association of TP53 Pro72Arg polymorphism with squamous cell carcinoma of oral tongue (SCCOT) and esophagus (ESCC) in India. We assessed the distribution of TP53 Pro72Arg polymorphism in one hundred and fifteen and eighty two SCCOT and ESCC patients, respectively, with respect to one hundred and ten healthy controls from the same population. In addition, we analyzed association of the polymorphism with several clinico-pathological and molecular parameters. Pro72 allele was significantly enriched in SCCOT patients compared to the healthy control group but neither allele was enriched in ESCC. Interestingly, Pro72 allele was preferentially mutated in ESCC which was confirmed by analysis of samples heterozygous for Pro72Arg. Our study revealed the association of Pro72 allele with SCCOT suggesting the effect of this polymorphism on SCCOT risk. Preferential mutation of Pro72 allele exclusively in ESCC indicates the need for further studies to understand the tissue specific effect of p53 polymorphism.
... Many studies suggest that consumption of smoked or processed meats and other nitrite-related foods is associated with increased risk of gastrointestinal (especially colorectal), nasopharyngeal, and pancreatic tumors [1][2][3][4]. ...
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Volatile N-nitrosamines (VNAs) are class 2 carcinogens (by International Agency for Research on Cancer (IARC), and they have been detected in various food samples, including meat products. Chinese style sausages are produced with some unique procedures, however, the conditions of contamination of Chinese sausages with VNAs are poorly known. In the present study, nine VNAs were analyzed in 94 sampled Chinese sausages from six provinces of China, using QuEChERS-based gas chromatography-tandem mass spectrometry. The most frequently detected VNAs included N-nitrosodimethylamine, N-nitrosodibutylamine, N-nitrosopyrrolidine (NPYR), N-nitrosomorpholine (NMOR), and N-nitrosodiphenylamine. The sum of concentrations of the nine VNAs detected in each sample ranged from 0.5 to 100.7 (median of 7.5) μg/kg. The levels of either total VNAs or particular components (including N-nitrosomethylethylamine, NPYR, and NMOR) in home-made sausages were statistically higher than those in commercial sausages, and this may be attributive to the varied ingredients and modes of package applied at home and commercial sausage production. ABBREVIATIONS
... La carne de esta especie fue utilizada para elaborar nuggets de pescado con adición de bioconsevantes como opción al uso de nitratos y nitritos, reconocidos como cancerígenos, además de benzoatos y parabenos con reconocidas efectos toxicológicas (Yurchenko y Mölder, 2007, Larsson et al., 2006. En este sentido han sido realizadas diversas investigaciones para desarrollar nuevas alternativas de conservación utilizando conservantes naturales que inhiban la presencia de microorganismos como Escherichia coli , Listeria monocytogenes , Salmonella spp., Campylobacter spp., Clostridium perfringens, staphylococcus aureus que podrían presentar riesgos notables para los seres humanos (Yong et al., 2015;Devatkal et al., 2004). ...
Article
Los nuggets de pescado cachama (Piaractus Brachypomus) son un producto cárnico creado para todo consumidor, de fácil preparación, del cual se aprovecha el contenido nutricional del pescado y satisface el estilo de vida nutricional que se impone con el ritmo de vida actual. Sabiendo que uno de los ingredientes en la elaboración de nuggets son los conservantes químicos, este estudio implementó la utilización de conservantes naturales obtenidos de extractos etanólicos de propóleos (EPP), aceite esencial de laurel y quitosano que presentan propiedades con actividad antibacteriana. Fueron analizados cuatro tratamientos de recubrimientos comestibles (RCs) en los cuales se evaluó la capacidad antimicrobiana in vitro utilizando el método de difusión en disco en agar Mueller – Hinton con cultivos de Salmonella enteritidis ATCC 25923, Listeria monocytogenes ATCC 13076, E.coli ATCC 25922, Vibrio sp, Staphilococcus aureus ATCC 25923. Posteriormente fueron evaluados nuggets tratados con RC, sin RC y nuggets prefritos con y sin RC, fueron realizados análisis para microorganismos aerobios mesófilos, psicrófilos y coliformes de origen fecal, determinación de Salmonella sp, L. monocytogenes, Vibrio cholerae, S. aureus coagulasa positiva, cada 25 días por 100 días de almacenamiento bajo congelación a -18 °C. Los resultados indican que en los nuggets sin RC incrementaron los valores para microorganismos aerobios mesófilos durante el periodo de almacenamiento y en los nuggets con RC estos microorganismos disminuyeron, sin embargo, los nuggets sometidos a prefritura no presentaron carga microbiológica. Por lo tanto, los recubrimientos comestibles a base de propóleos pueden ser una alternativa para la conservación de alimentos cárnicos.
... Endogenous synthesis of nitrosamines (ENOCs) accounts for the majority (45-75%) of overall exposure. Consumption of a diet high in pre-formed nitrosamines such as nitrosodimethylamine (NDMA) was shown to increase the risk of gastric cancer (in Swedish women) [165]. However, exogenous NDMA was not shown to be a risk factor (HR, 1.00; 95% CI, 0.7-1.43) in the EPIC-EURGAST study. ...
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Helicobacter pylori is a class one carcinogen which causes chronic atrophic gastritis, gastric intestinal metaplasia, dysplasia and adenocarcinoma. The mechanisms by which H. pylori interacts with other risk and protective factors, particularly vitamin C in gastric carcinogenesis are complex. Gastric carcinogenesis includes metabolic, environmental, epigenetic, genomic, infective, inflammatory and oncogenic pathways. The molecular classification of gastric cancer subtypes has revolutionized the understanding of gastric carcinogenesis. This includes the tumour microenvironment, germline mutations, and the role of Helicobacter pylori bacteria, Epstein Barr virus and epigenetics in somatic mutations. There is evidence that ascorbic acid, phytochemicals and endogenous antioxidant systems can modify the risk of gastric cancer. Gastric juice ascorbate levels depend on dietary intake of ascorbic acid but can also be decreased by H. pylori infection, H. pylori CagA secretion, tobacco smoking, achlorhydria and chronic atrophic gastritis. Ascorbic acid may be protective against gastric cancer by its antioxidant effect in gastric cytoprotection, regenerating active vitamin E and glutathione, inhibiting endogenous N-nitrosation, reducing toxic effects of ingested nitrosodimethylamines and heterocyclic amines, and preventing H. pylori infection. The effectiveness of such cytoprotection is related to H. pylori strain virulence, particularly CagA expression. The role of vitamin C in epigenetic reprogramming in gastric cancer is still evolving. Other factors in conjunction with vitamin C also play a role in gastric carcinogenesis. Eradication of H. pylori may lead to recovery of vitamin C secretion by gastric epithelium and enable regression of premalignant gastric lesions, thereby interrupting the Correa cascade of gastric carcinogenesis.
... GC risk factors include SES as well as gender, age, ethnicity, geography, Helicobacter pylori (H. pylori) infection, gastric lymphoma, and diet (smoked meats and salted foods) [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25]. The measurement of SES is generally a combination of income, education, and occupation. ...
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IntroductionSocioeconomic status (SES) is a known risk factor for gastric cancer (GC). This study seeks to examine education, income, and occupation variables separately to identify the single variable that can be best used to assess SES risk for GC.Methods Data from a case-control survey study were used. Logistic regression models were created for education, income, and occupation adjusted for age, sex, and race. Models were compared using AIC, c-statistics, and pseudo-R square to determine the model that had the highest risk predictive ability.ResultsGC cases had lower education levels and more commonly held jobs in unskilled labor. Annual household income was lower in cases compared to controls. Age, gender, race, education, and occupation were associated with increased risk of GC. The education model adjusted for age, gender, and race found < high school (HS) education to have an OR of 3.18 (95% CI 1.09–9.25) for GC compared to > HS education. The occupation model demonstrated that employment in unskilled labor had OR of 4.32 (95% CI 1.05–17.76) for GC compared to professional occupation. Model fit was best for the education model (AIC: 113.583, lower AIC is better) compared to income (117.562) or occupation (117.032). Education contributed the most to model variability (% delta pseudo-R square (4.7%)) compared to occupation (4.0%) or income (3.8%).Conclusion Education level was the single most reliable measure of GC risk among 3 SES variables and can be employed as an ideal single indicator of SES-related GC risk when multiple SES factors cannot be obtained.
... Studies revealed that these preserved and peculiar foods have a significant amount of N-Nitroso compounds, which have great potential to cause cancers [76]. Kashmiri population enjoys a large variety of smoked foods like mutton and beef barbecues popularly called as 'Tujji' , which contains large amount cancer causing of N-Nitroso compounds [77]. Heredity diffuse gastric cancer (HDGC) is a rare genetic condition in which the mutated gene (cancer gene) passes from one generation to another, thus making the generation inheriting it more this class of cancer [78]. ...
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Enduring health complications are part of older human populations, which are grossly elevated by common food habits and higher use of chemicals or chemical based products. Cancer, a deadliest disease is reason for higher mortality and morbidity on global scale. All types of cancers have been reported in Kashmir valley including the cancers of skin (Kangri cancer), lungs, breast, rectum, stomach, prostate, liver, cervix, esophagus, bladder, blood etc. The causes of such high incidence rates of cancers may be both internal (genetic, mutations, hormonal, poor immune conditions) and external or environmental factors (food habits, industrialization, over growth of population, social etc.). The incidence and mortality of diverse cancers among various geographical regions is important to initiate therapies against the wide range of cancers. The incidence and mortality of various cancers varies among the geographically heterogeneous countries worldwide, some represent the frequent type in geographically heterogeneous regions. This review provides in-depth status of cancers with reference to distribution pattern, incidence and causes in Kashmir valley, a cancer belt of India, having a peculiar cancer profile.
... NDPA, NMEA and NPYR are known to cause oesophageal cancer. Among these derivatives, NDPA also causes lung cancer (Larsson et al. 2006). ...
Article
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N-nitrosamines are harmful components that can be formed in processed meat products. Due to its production technique, salami is an important meat product in terms of volatile N-nitrosamines. In this regard, the presence of volatile N-nitrosamines, which may pose a risk for human health, was investigated in salami. N-nitrosamines were extracted from the salami and determined with a validated GC-MS method. Accordingly, the analysed samples of salami contained 7.86–29.11 ppb total volatile N-nitrosamines. The salami brand affected the type and level of N-nitrosamines (P <,005).
... ES (95%CI) % weight Nomura 1990 1. 40 between fish consumption and colon or rectal cancer. In 12 studies involving colon cancer, fish intake slightly reduced the risk of colon cancer (summary RR = 0.95; 95%CI: 0.91-0.98). ...
Article
Aim: To assess quantitatively the relationship between fish intake and the incidence of gastrointestinal cancers in a meta-analysis of cohort studies. Methods: We searched MEDLINE, Embase, Science Citation Index Expanded, and the bibliographies of retrieved articles. Prospective cohort studies were included if they reported relative risks (RRs) and corresponding 95% confidence intervals (CIs) of various cancers with respect to fish intake. When RRs were not available in the published article, they were computed from the exposure distributions. Two investigators extracted the data independently and discrepancies were resolved by discussion with a third investigator. We performed random-effect meta-analyses and meta-regressions of study-specific incremental estimates to determine the risk of cancer associated with a 20-g/d increment of fish consumption. Results: Forty-two studies, comprising 27 independent cohorts, met our inclusion criteria. The studies included 2325040 participants and 24115 incident cases of gastrointestinal cancer, with an average follow-up of 13.6 years. Compared with individuals who did not eat, or seldom ate, fish, the pooled RR of gastrointestinal cancers was 0.93 (95%CI: 0.88-0.98) for regular fish consumers, 0.94 (0.89-0.99) for low to moderate fish consumers, and 0.91 (0.84-0.97) for high fish consumers. Overall, a 20-g increase in fish consumption per day was associated with a 2% reduced risk of gastrointestinal cancers (RR = 0.98; 95%CI: 0.96-1.01). In subgroup analyses, we noted that fish consumption was associated with reduced risk of colorectal (RR = 0.93; 95%CI: 0.87-0.99; P < 0.01), esophageal (RR = 0.91; 95%CI: 0.83-0.99; P < 0.05) and hepatocellular cancers (RR = 0.71; 95%CI: 0.48-0.95; P < 0.01). Conclusion: This meta-analysis suggested that fish consumption may reduce total gastrointestinal cancer incidence. Inverse relationships were also detected between fish consumption and specific types of cancers.
... Diet directly influences intestinal microbiota composition and metabolic activity, contributing to growing chronic diseases in the developed world, including obesity, cardiovascular disease, IBD, and cancer (173,174). The high fat and high sugar (HF/HS) western diet have crucial implications on CRC; with a higher risk associated with red meat intake, opposed to high dietary fiber intake decreasing CRC risk (175,176). Additionally, diet-induced intestinal inflammation (based on high plasma IL6, CRP, and TNFRSF1B levels) is associated with F. nucleatum-containing colorectal carcinoma in patients (177), indicating that diet alters microbiota balance. ...
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Colorectal cancer (CRC) is one of the most common cancers worldwide. As with other cancers, CRC is a multifactorial disease due to the combined effect of genetic and environmental factors. Most cases are sporadic, but a small proportion is hereditary, estimated at around 5-10%. In both, the tumor interacts with heterogeneous cell populations, such as endothelial, stromal, and immune cells, secreting different signals (cytokines, chemokines or growth factors) to generate a favorable tumor microenvironment for cancer cell invasion and metastasis. There is ample evidence that inflammatory processes have a role in carcinogenesis and tumor progression in CCR. Different profiles of cell activation of the tumor microenvironment can promote pro or anti-tumor pathways; hence they are studied as a key target for the control of cancer progression. Additionally, the intestinal mucosa is in close contact with a microorganism community, including bacteria, bacteriophages, viruses, archaea, and fungi composing the gut microbiota. Aberrant composition of this microbiota, together with alteration in the diet‐derived microbial metabolites content (such as butyrate and polyamines) and environmental compounds has been related to CRC. Some bacteria, such as pks+ Escherichia coli or Fusobacterium nucleatum , are involved in colorectal carcinogenesis through different pathomechanisms including the induction of genetic mutations in epithelial cells and modulation of tumor microenvironment. Epithelial and immune cells from intestinal mucosa have Pattern-recognition receptors and G-protein coupled receptors (receptor of butyrate), suggesting that their activation can be regulated by intestinal microbiota and metabolites. In this review, we discuss how dynamics in the gut microbiota, their metabolites, and tumor microenvironment interplays in sporadic and hereditary CRC, modulating tumor progression.
... Indeed, salt also limits juice loss during cooking (Pietrasik and Gaudette, 2015) whereas nitrite is also used for keeping a pink coloration of meat (Eakes and Blumer, 1975;Froehlich et al., 1983). However, over the past few years, reducing their incorporation in meat products has become a great matter of concerns for cooked ham producers, considering that sodium overconsumption can cause hypertension (Sanders, 1996;Cappuccio et al., 2000;Caudarella et al., 2009;Ha 2014;Ma Yuan et al., 2015) and that excessive nitrite intake increases the risk of digestive cancer (Larsson et al., 2006;Cross et al., 2010;Chan et al., 2011;Bryan et al., 2012). Because this reduction is likely to modify the microbial ecology of meat products during storage, it is necessary to anticipate to what extent the content of these preservatives could be reduced and to assess the following consequences in terms of meat quality and preservation. ...
Thesis
Réduire le sel et le nitrite utilisés pour la conservation du jambon est un enjeu de santé publique, mais cette réduction est susceptible de modifier les écosystèmes microbiens et de favoriser le développement de l’altération des produits. L’objectif de ces travaux était de caractériser i) les communautés microbiennes de jambons issus d’une usine de fabrication ii) leurs productions de métabolites d’altération et de prévoir l’évolution de ces deux facteurs dans le cadre d’une réduction de sel et de nitrite.Parmi les paramètres de production étudiés, nous avons montré que la ligne de tranchage était un facteur capital. Deux grands profils de communautés ont été observés à la date limite de conservation en fonction de la ligne de tranchage, composés de neuf espèces représentant 95% d’abondance relative dans les échantillons. La présence de ces espèces était corrélée à différents profils de production de métabolites issus de la fermentation du pyruvate.Sur la base des espèces identifiées, nous avons élaboré une communauté synthétique que nous avons inoculée sur un milieu de jambon synthétique à différentes concentrations en sel et en nitrite. Cette approche d’écologie synthétique a permis de montrer qu’une réduction en deçà du seuil de 12 g/kg de sel et de 25-30 mg/kg de nitrite entraînait un déséquilibre d’abondances lié à une croissance exponentielle des Leuconostoc et à une diminution de la croissance des Carnobacterium. Ce déséquilibre s’accompagnait d’une augmentation de la production d’éthanol et d’acide D-lactique de 30%, suggérant un risque d’altération des jambons plus élevé à ces concentrations. Nous avons ensuite testé l’effet de ces concentrations à l’échelle pilote de production. Les comportements microbiens étaient très différents selon les profils de communautés de jambons issus des deux lignes de tranchage. Pour le premier profil, un comportement similaire à celui de l’écosystème synthétique a été observé, avec un déséquilibre d’abondances en dessous du seuil de 12 g/kg de sel et de 25-30 mg/kg de nitrite et une diminution de l’abondance de Carnobacterium divergens. Pour le deuxième profil, dominé par Serratia proteamaculans, la structure de la communauté était très peu impactée par une réduction de sel et de nitrite. Enfin, sur tous les jambons, nous avons observé qu’une réduction de sel et de nitrite favorisait la croissance de levures.Ces travaux mettent en lumière l’importance du procédé sur la structuration des communautés microbiennes. Ce facteur est à prendre en compte pour comprendre l’impact de tout autre changement environnemental sur les comportements microbiens.
... Nitrosamines are well-known carcinogenic agents [1,2]. Humans are exposed to nitrosamines through various routes, the most important of which is the diet. ...
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This study was carried out to investigate the effects of ethanolic leaf extract Annona muricata (soursop) on N,N-dimethylnitrosamine (DMN)-induced liver fibrosis in rats. Four groups of Wistar albino rats (12 rats/group) were used for the study. One group received intra-peritoneal injection of 10mg of DMN/kg body wt. thrice a week (on the first three days) for 14 days, in addition to the extract at a dose of 200mg/kg body wt. given by gavage. A second group received the same dose of DMN but without extract, while rats in the third group were administered the same dose of extract without DMN. Members of the fourth group were given physiological saline (vehicle), and served as controls. After 14 days, the rats were sacrificed by cardiac puncture. Blood samples were collected from the ocular vein, and the sera were analysed for aspartate transaminase, AST; alanine transaminase, ALT and alkaline phosphatase, ALP; while collagen, malondialdehyde, MDA; reduced glutathione, GSH, superoxide dismutase, SOD and catalase, CAT levels were assayed in liver tissue. All assays were done using standard methods. Liver sections were also fixed in formol-saline and subjected to histological analysis. DMN administration resulted in significant increases in serum AST, ALT and ALP; and in liver MDA and total collagen content (P 0.05). On the other hand, liver SOD and CAT activities were significantly reduced by the DMN treatment. Histological examination of liver sections from the DMN rats showed severe degenerative changes such as congestion, haemorrhagic necrosis and deposition of thick collagen fibers. These biochemical and histological changes were reversed significantly by the Annona muricata leaf extract.These results suggest that Annona muricata leaves may reverse hepatic fibrosis probably through maintenance/restoration of liver antioxidant status.
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Gastric cancer is the most frequent digestive system cancer in Turkey. The purpose of this study was to investigate the effect of sociodemographic, environmental, dietary and reproductive factors on the development of this malignancy. 150 patients diagnosed with gastric cancer and 300 healthy controls were included in the present study. Sociodemographic, environmental, dietary and reproductive factors that might affect the risk of gastric cancer were retrospectively investigated. Examination of the dietary menus revealed that consumption of animal fats, pickled and salted foods were considerably higher (p<0.001) in gastric cancer compared to controls. Consumption of meat and eggs were significantly different (p=0.048) between gastric cancer patients and the control group. Consumption of bread and cereal products (p<0.001), milk and milk products (p<0.001), orange juice (p=0.022), tea and coffee (p=0.004 and p=0.002) was markedly lower in the gastric cancer patients. Consumption of pickles was an independent risk factor for development of gastric cancer. Eating too hot foods and barbecued meat was also shown to increase the risk of gastric cancer (p<0.001). In addition, the educational level of the patients was also lower compared to those of the control group (p=0.033). Women with onset of menarche at 15 years and above also possessed a higher risk for gastric cancer (p<0.001). Environmental and dietary factors play a significant role in the development of gastric cancer.
Chapter
Noncommunicable chronic diseases such as inflammatory bowel diseases, cancer, diabetes, obesity, and pulmonary, cardiovascular, and neurodegenerative diseases are becoming the leading cause of death throughout the world. Unhealthy diet, smoking, lack of exercise, stress, radiation exposure, and environmental pollution are among the common causes of chronic diseases. Most of these risk factors are closely linked to chronic inflammation, which leads to the development of various chronic diseases. Diets high in fruits, vegetables, legumes, fiber, and certain spices have been shown to suppress chronic inflammation and prevent the development of chronic diseases. In this review we discuss the evidence for the molecular basis of inflammation and how inflammation mediates most chronic diseases. We also present clinical and experimental models showing the molecular effects of selected spices and spice-derived nutraceuticals such as cardamonin, curcumin, capsaicin, gingerol, thymoquinone, and piperine on these inflammatory pathways and the potential role of nutraceuticals in preventing chronic diseases.
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The aim of this study was to perform a meta-analysis to test the association between red, processed, and total meat, as well as fruit and vegetable consumption, and selected health risk factors, including body weight status, smoking habit, physical activity level, level of education, and alcohol drinking in cohort studies on non-communicable disease. A systematic search of electronic databases was performed to identify relevant articles published up to March 2017. In a two-stage approach, frequency-weighted linear regression coefficients were first calculated for each variable, and then combined across studies through meta-regression. Ninety-eight studies including 20 on red meat, 6 on processed meat, 12 on total meat, 37 on fruit and vegetable combined, 21 on fruit and 24 on vegetable consumption were analyzed. Intake of red meat was positively associated with BMI, percentage of overweight and obese, low physical activity, and current and ever smoking and inversely associated with percentage of non-smokers and high physically active individuals. Similar associations were found for red meat were found, although based on fewer data. Intake of fruits and vegetables was positively associated with prevalence of non-smokers, high education and high physical activity, and similar results were found when examining fruit and vegetable consumption separately. Stratification by geographical area revealed that some associations were stronger in US rather than European or Asian cohorts. In conclusions, the distribution of health risk factors associated with high meat and fruit/vegetable consumption may differ from those of low-consumers. Some of these differences may mediate, confound, or modify the relation between diet and non-communicable disease risk.
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Meat is one of the staples of the human diet, which provides high-quality nutrients, but that also constitutes a relevant source of cholesterol and saturated fatty acids. Epidemiologic studies have linked consumption of red or processed meat with obesity, type 2 diabetes, cardiovascular diseases, and cancers. Most epidemiological studies suggest that a high intake of meat, especially processed meat, is associated with increased colorectal cancer risk. Potential reasons for the association between high meat intake and colorectal cancer risk include some chemicals naturally contained in meat, or generated by the processing and cooking. From the literature it can be concluded that there is enough epidemiological evidence linking processed meat intake and colorectal cancer risk, but there is limited evidence regarding unprocessed red meat intake and the disease. On the contrary, there is only limited evidence linking meat intake with other diseases such as cardiovascular disease, type 2 diabetes or other cancers. Nevertheless, the literature suggest that dietary intervention may be a promising approach for prevention of cancers of the colon, esophagus, liver, stomach and bladder, and type 2 diabetes and cardiovascular disease which still need to be confirmed by further well designed prospective studies and experimental research.
Chapter
The adult years from 19 to 65 represent the stage of life at which most of the adverse consequences of poor nutrition and acquisition of unhealthy lifestyle behaviours at earlier life stages begin to manifest as major disease states. This chapter focuses on these nutrition-related diseases of adulthood and explains how diet and lifestyle change might offset risk of ill health and mortality. Most of the major disease states diabetes, cardiovascular disease (CVD) and cancer, reviewed in this chapter, are the consequence of this overnutrition. Obesity-related insulin resistance is the main feature of diabetes. The metabolic syndrome represents a complex cluster of disorders including hypertension, renal dysfunction and disordered lipid and glucose metabolism. All these disorders are driven by insulin resistance. The major dietary risk factors for CVD are high intakes of saturated fats, trans-fatty acids and sodium. Cancer risk is strongly related to the overall quality of the diet.
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The results of prospective cohort studies regarding the role of salt intake and subsequent gastric cancer risk are inconsistent. Thus, we performed a systematic review and meta-analysis to summarize the strength of the association of salt intake with gastric cancer morbidity and mortality. PubMed, EmBase, and Cochrane Library were systematically searched to identify eligible studies published throughout September 2021. The effect estimates with 95% confidence intervals (CIs) for gastric cancer morbidity or mortality in each study were applied to calculate the pooled results; these analyses were performed using the random-effects model. Twenty-six prospective cohort studies involving 4,956,350 individuals were selected; these studies reported 19,301 cases of gastric cancer and 2,871 cases of gastric cancer-associated mortality. High (RR: 1.25; 95%CI: 1.10–1.41; P = 0.001) or moderate (RR: 1.20; 95%CI: 1.04–1.38; P = 0.012) salt intake was associated with a greater risk of gastric cancer. High pickled food intake was associated with an increased gastric cancer risk (RR: 1.28; 95%CI: 1.05–1.57; P = 0.017), while moderate pickled foods intake had no significant effect on gastric cancer risk (RR: 1.10; 95%CI: 0.88–1.37; P = 0.390). Neither high (RR: 1.14; 95%CI: 0.95–1.36; P = 0.161) nor moderate (RR: 1.10; 95%CI: 0.87–1.40; P = 0.436) salted fish intake were associated with gastric cancer risk. A high intake of processed meat was significantly associated with a higher risk of gastric cancer (RR: 1.24; 95%CI: 1.03–1.49; P = 0.023), while moderate processed meat intake had no significant effect on the gastric cancer risk (RR: 1.01; 95%CI: 0.92–1.11; P = 0.844). High (RR: 1.04; 95%CI: 0.90–1.19; P = 0.626) and moderate (RR: 1.02; 95%CI: 0.94–1.11; P = 0.594) miso-soup intake had no effects on the gastric cancer risk. High intakes of salt, pickled food, and processed meat are associated with significantly increased risks of gastric cancer; these increased risks are also seen when participants consumed moderate amounts of salt.
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Gastric cancer is the fourth most common cancer and is the second cause of death from cancer. Although the Helicobacter pylori infection is a very important factor in gastric cancer, it is not the only risk factor. The role of nutrition has been studied as the most important environmental risk factors in incidence, control and prevention of gastric cancer. This study aimed to review past researches on the association between several dietary factors and gastric cancer. A literature search in PubMed was done with the use of "Gastric cancer", "Helicobacter pylori", "Fruit and vegetables", "Meat and processed meat", "Salt and salted food", "Green tea", "Black tea" and "Coffee" as keywords. Findings from 36 cross-sectional, ecologic, case-control, cohort, and meta-analysis studies, until 2011, have been taken into account in this review. Findings from the current evidence suggest that the risk of gastric cancer decreases with high intake of fruits and fresh vegetables and possibly with green tea consumption, and increases with the intake of various processed meats, salt and salted foods. There is no clear evidence about the relationship between gastric cancer and various meats, fish, black tea and coffee. Dietary modification to increase intake of fruits and fresh vegetables and to reduce intake of salt and salted foods, represent an effective strategy in control and prevention of gastric cancer. Keywords: Gastric Cancer, Helicobacter Pylori, Fruits and Vegetables, Meat and Processed Meats, Salt and Salted Foods, Green Tea, Black Tea, Coffee
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Advanced glycosylation end products (AGEs) and N-nitrosamines (NAs) are common hazards in the processing of meat products. AGEs are produced by Maillard reaction and fat oxidation during processing and storage, whereas NAs are produced by nitrosation after the addition of nitrite during meat processing. They may have some relevance to human diseases, such as diabetes and cancer. Literature revealed that the contents of fat and protein in meat products and processing methods have a remarkable influence on the formation of AGEs and NAs. These two hazardous substances can be detected in a variety of meat products, and adding antioxidants can effectively inhibit the production of AGEs and NAs. This paper reviews the formation mechanism, influencing factors, detection methods, and inhibition methods of AGEs and NAs in meat products and discusses their exposure values in meat products to provide reference for people's healthy diet and understand and control the levels of AGEs and NAs in meat products.
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La información presentada en este capítulo corresponde al diagnóstico de la situación alimentaria y nutricional del país desde varias aristas: 1) el contexto socioeconómico, 2) el perfil epidemiológico nutricional de la población, 3) la soberanía alimentaria y patrimonio alimentario; y, finalmente, 4) el estado de la seguridad alimentaria y sus componentes. En síntesis, este diagnóstico recoge los principales aspectos de los sistemas alimentarios del Ecuador que resultan en la construcción de las Guías Alimentarias Basadas en Alimentos (GABA), como un instrumento edu-comunicacional, sencillo y útil, que guie el comportamiento alimentario, individual, familiar y comunitario.
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Meat percent and frying process are two major factors affected on the formation of heterocyclic aromatic amines (HAAs) in heated sausage samples. High consumption of heated sausage, as famous tasty‐food, enhances the interest to monitor the status of toxic level of this fast‐food. In this work, three percent of meat content and two types of frying processes have been investigated to determine the concentration of HAAs in 18 types of heated sausage samples. Three‐phase electromembrane extraction coupled with high‐performance liquid chromatography has been applied for the extraction step and “one variable at a time (OVAT)” methodology was used for the optimization of extraction parameters. The found concentration for HAAs was determined in the range 50.66‐327.94 ng g‐1 for IQ, 12.64‐532.85 ng g‐1 for MeIQ and 18.2‐877.97 ng g‐1 for MeIQx. The limits of detection (LODs) of HAAs in sausage samples were obtained between 1.5 and 1.6 ng g‐1. The recoveries of proposed method were in the range 93‐97% and the enrichment factor was determined from 108‐112 for 3 HAAs. The results showed that the meat percentage and the frying processes have significant effects on the formation of HAAs in sausage samples (p<0.05).
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Background: Alcohol consumption is a potential risk factor for gastric cancer. However, findings from cohort studies that examined the relationship between alcohol consumption and gastric cancer risk among Japanese population are not conclusive. Methods: A total of 54,682 Japanese men and women participating in the Japan Collaborative Cohort study completed a questionnaire including alcohol consumption information. The Cox proportional hazard model was used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs). Results: After a median 13.4-year follow-up, we documented 801 men and 466 women incident cases of gastric cancer. Alcohol consumption was associated with increased risk of gastric cancer among men (HRs in ex-drinkers and current alcohol consumption of <23g, 23-<46g, 46-<69g and ≥69g/d categories versus never drinkers were 1.82; 95% CI, 1.38-2.42, 1.41; 95% CI, 1.10-1.80, 1.47; 95% CI, 1.17-1.85, 1.88; 95% CI, 1.48-2.38 and 1.85; 95% CI, 1.35-2.53, respectively, and that for 10g increment of alcohol consumption after excluding ex-drinkers was 1.07; 95% CI, 1.04-1.10). The association in men were observed for cardia and non-cardia gastric cancer (HRs in the highest alcohol consumption category versus never drinkers were 9.96; 95% CI, 2.22-44.67 for cardia cancer, and 2.40; 95% CI, 1.64-3.52 for non-cardia cancer). However, no such trend was observed in women. Conclusions: Alcohol consumption is associated with increased risk of gastric cancer among Japanese men, regardless of anatomical subsite of the cancer.
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Upper gastrointestinal (UGI) cancers are among the most common cancers in the world, four of them being among the top eight causes of cancer related mortality. Included among UGI cancers are oesophageal, gastric, liver, biliary, pancreatic and small intestinal cancers. Despite more than half a century of well designed epidemiological (large cohort and case-control studies) and a limited number of experimental studies into the role of nutrition on UGI cancer, there is much inconsistency in the findings. Studies have reported significant associations of various food types and UGI cancers, but there are issues with reproducibility. Over the years, numerous meta-analyses have been conducted in an attempt to harmonize available data. On the whole, it is well accepted that fruit and vegetables reduce UGI cancer risk, while processed foods increase the risk. The role of antioxidants in protecting against UGI carcinogenesis is of great interest, but controversial. There is evidence that specific diets, such the Mediterranean or Okinawa, are associated with reduced cancer risk at a population level, but it is less clear if adopting them reduces risk in otherwise high-risk locations. In this review, I will discuss some of the available literature from selected original publications, systematic reviews and meta-analyses on the influence of diet on UGI cancers. I will also provide a brief overview of future directions that have the potential to provide specific evidence on how diet could be modified to reduce the growing global burden of UGI cancers.
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N-Nitrosamines (nitrosamines) are attracting increased attention because of their high toxicity and wide distribution. They have been strictly restricted by regulations in many fields. Researchers around the world have conducted substantial work on nitrosamine detection. This paper reviews the progress of research on nitrosamine detection methods with emphasis on biological-matrix samples. After introducing the category, toxicity, regulatory limit and source of nitrosamines, the paper discusses the most commonly used sample-preparation techniques and instrumental-detection techniques for nitrosamine detection, including some typical application cases.
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We report on the associations between the intake of certain foods and beverages and the incidence of gastric cancer in a cohort of 11,907 randomly selected Japanese residents of Hawaii (6297 women and 5610 men). The daily intake of six beverages, cigarettes and alcohol and the weekly frequency of intake of 13 foods and food groups was estimated with a short food frequency questionnaire. Over an average follow-up period of 14.8 years, 108 cases of gastric cancer (44 women, 64 men) were identified via linkage to the Hawaii Tumor Registry. In gender-combined proportional hazards analyses, the consumption of fresh fruit seven or more times per week was associated with a significantly reduced risk of gastric cancer, compared to lower levels of consumption (relative hazard (RH): 0.6, 95% confidence interval (CI): 0.4-1.0, P = 0.03). The combined intake of fresh fruit and raw vegetables was inversely associated with the risk of gastric cancer in the total cohort, and among the men (P < 0.05). No significant relationships were found between gastric cancer incidence and the intake of pickled vegetables, miso soup, dried or salted fish, or processed meats among either gender. Compared to non-drinkers, men who drank one cup of coffee per day had a significantly elevated risk of gastric cancer (RH: 2.5, 95% CI: 1.0-6.1, P = 0.05), but there was no evidence of a dose-response relationship. Cigarette smoking and consumption of alcohol were not related to gastric cancer, in analyses restricted to the men. The results related to fruit and vegetable intake are consistent with an anti-nitrosating effect of these foods, while the unexpected association between coffee consumption and gastric cancer is difficult to explain and may represent a chance finding.
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Reports of dramatic increases in gastric cardia cancer incidence warrant concern. However, the recent introduction of a separate diagnostic code, the lack of a consensus definition of the cardia area, and the accelerating interest in cardia cancer may affect classification practices. Little is known about the magnitude of cardia cancer misclassification in large cancer registries. In a well-defined Swedish population (1.3 million), we uniformly classified all patients with newly diagnosed gastric adenocarcinoma (from 1989 through 1994) with respect to gastric subsite, and we used this patient group as our gold standard. We then evaluated the completeness of the Swedish Cancer Registry in registering gastric adenocarcinomas against this gold standard and, further, assessed the completeness of cardia cancer registration and the rate of falsely included cases to estimate the potential impact on observed incidence trends. Our gold standard contained 1337 case subjects with gastric adenocarcinoma. Overall, the Swedish Cancer Registry was 98% complete with regard to gastric adenocarcinomas and had a 4% rate of falsely included cases. The completeness of coding cardia cancer was only 69%, and the positive predictive value for cardia cancer was 82%, with no improvement over time. Although overall completeness of gastric cancer registration by the Swedish Cancer Registry was excellent, accuracy in registering cardia tumors was surprisingly low. Our estimates suggest that true cardia cancer incidence could be up to 45% higher or 15% lower than that reported in the Cancer Registry. This margin of error could accommodate the observed increase in cardia cancer in Sweden. Therefore, secular trends in cardia cancer incidence should be interpreted cautiously.
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The effects were studied of NaCl on the production of gastric carcinomas by N-methyl-N′-nitro-N-nitrosoguanidine (MNNG) and by 4-nitroquinoline-1-oxide (NQO) in male Wistar rats. Nine groups of rats were treated as follows: Group 1 was given 50 mg MNNG/liter and 6 g NaCl solution/liter to drink and was fed a stock diet supplemented with 10% NaCl. Group 2 received 1 ml saturated NaCl once a week and 50 mg MNNG/liter to drink. Group 3 was treated with MNNG alone. Group 4 was given a solution of 1 mg NQO once a week and fed a stock diet supplemented with 10% NaCl. Group 5 received a solution of 1 mg NQO saturated with NaCl. Group 6 was given NQO alone. Groups 7 and 8 were given NaCl alone. Group 9 was untreated. Adenocarcinomas developed in the glandular stomach in group 2 at a significantly higher incidence than in group 3. Poorly differentiated adenocarcinomas of the glandular stomach were detected in only groups 1 and 2. One poorly differentiated adenocarcinoma metastasized to the lymph nodes. A high incidence of squamous cell carcinomas of the forestomach was found in groups 4 and 5. No malignant tumors were seen in groups 6-9. NaCl given alone had no apparent carcinogenicity in rats but, when administered with MNNG or NQO, it enhanced the carcinogenic effects of MNNG and NQO in the stomach
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Comparative epidemiological studies with ecological and case-control approaches in high- and low-epidemic areas of China have provided us with much evidence with regard to risk and benefit in the environment. To clarify how dietary factors are involved in esophageal and stomach cancer development, we performed a case-control study in a low-epidemic area, and compared the findings with those obtained earlier for a high-epidemic area for stomach cancer in the same Jiangsu Province, China. We recruited 199 and 187 cases with esophageal and stomach cancers, respectively, and 333 population-based common controls. Odds ratios (ORs) for esophageal and stomach cancers were calculated with adjustment for potential confounding factors, using an unconditional logistic model. Current and former smoking elevated the OR for esophageal cancer, along with high intake of pickled vegetables and broiled meat, while decreased ORs were observed for frequently consumed raw vegetables and garlic. With regard to stomach cancer, ORs were increased with frequent consumption of salty fish, leftover gruel, and broiled meat, and lowered by snap bean consumption. The present risk factors were common to the previously obtained results in the high-epidemic area, and similarly distributed in each general population. While more protective factors were observed in the high-epidemic area, their penetrance was much greater in the low-epidemic area. The present study thus suggests that frequent vegetable and garlic consumption contributes to low mortality rates for esophageal and stomach cancers in a low-epidemic area, counteracting similar exposure levels for risk factors as in the high-epidemic area.
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Introduction. Survival distributions. Single sample nonparametric methods. Dependence on explanatory variables. Model formulation. The multiplicative log-linear hazards model. Partial likelihood. Several types of failure. Further problems. Exercises. Bibliography. Index.
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N-nitroso compounds are potent carcinogens detected in foodstuffs. The importance of dietary nitrosamines in relation to human cancer development is, however, uncertain. We studied the relationship between intake of nitrates, nitrites and N-nitrosodimethylamine (NDMA) and risk of cancers of the gastro-intestinal tract in a cohort of 9,985 adult Finnish men and women. During a follow-up period of up to 24 years, 189 gastro-intestinal cancer cases were diagnosed in the cohort, initially free from cancer. Intake of nitrate, nitrite and NDMA were estimated, based on food-consumption data from a 1-year dietary history interview covering the total diet of the participants. A significant positive association was observed between intake of NDMA and subsequent occurrence of colorectal cancer with a relative risk (RR) between the highest and lowest quartiles of intake of 2.12 [95% confidence interval (CI) 1.04–4.33]. Of various sources of N-nitroso compounds, intake of smoked and salted fish was significantly (RR = 2.58, 95% CI 1.21 − 5.51) and intake of cured meat was non-significantly (RR = 1.84, 95% CI 0.98– 3.47) associated with risk of colorectal cancer. No similar association was observed for intake of other fish or other meat. No significant associations were observed between NDMA intake and cancers of the head and neck combined or of the stomach or between nitrate or nitrite intake and risk of cancers of the gastro-intestinal tract. Our results are in line with the idea that N-nitroso compounds can induce colorectal cancer in humans. Int. J. Cancer 80:852–856, 1999.
Article
Dietary factors in the aetiology of stomach cancer were investigated using data from a case-control study conducted in Northern Italy on 206 histologically confirmed carcinomas and 474 control subjects in hospital for acute, non-digestive conditions, unrelated to any of the potential risk factors for giistric cancer. Dietary histories concerned the frequency of consumption per week of 29 selected food Items (including ttie major sources of starches, proteins, fats, fibres, vitamins A and C, nitrates and nitrites in the Italian diet) and subjective stores for condiments and salt intake. Pasta and rice (the rajor sources of starch), polenta (a porridge made of maize) and ham were positively related with gastric cancer risk, whereas green vegetables and fresh fruit as a whole (and specifically citrus fruit) and selected fibre-rich aliments (such aii whole-grain bread or pasta) showed protective effects on giistric cancer risk. Allowance for major identified potential distorting factors (chiefly indicators of socio-economic status) reduced the positive association with pasta or rice consumption, but did not appreciably modify any of the other risk estimates. When a single logistic model was fitted including all food items significant in univariate analysis, the 3 items remaining statistically significant were green vegetables (rel-acive risk, RR = 0.27 for upper vs. lower tertile), polenta (f;R = 2.32) and ham (RR = 1.60). Indices of beta-carotene and ascorbate intake were negatively and strongly related with giistric cancer risk, but the association with these micronu-trients was no longer evident after simultaneous allowance for various food items. An approximately 7-fold difference in risk was found between extreme quintiles of a scale measuring major positive and negative associations.
Article
Stomach cancer remains the second leading cancer in incidence in Shanghai, China, despite its decline over the past 2 decades. To clarify risk factors for this common malignancy, we conducted a population-based case-control study in Shanghai, China. Included in the study were 1,124 stomach cancer patients (age 20–69) newly diagnosed in 1988–1989 and 1,451 controls randomly selected among Shanghai residents. Usual adult dietary intake was assessed using a comprehensive food frequency questionnaire. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression models. Risks of stomach cancer were inversely associated with high consumption of several food groups, including fresh vegetables and fruits, poultry, eggs, plant oil, and some nutrients, such as protein, fat, fiber and antioxidant vitamins. By contrast, risks increased with increasing consumption of dietary carbohydrates, with odds ratios (ORs) of 1.5 (95% confidence interval [CI] 1.1–2.1) and 1.9 (95% CI 1.3–2.9) in the highest quartile of intake among men (p for trend = 0.02) and women (p = 0.0007), respectively. Similar increases in risk were associated with frequent intake of noodles and bread in both men (p = 0.07) and women (p = 0.05) after further adjustment for fiber consumption. In addition, elevated risks were associated with frequent consumption of preserved, salty or fried foods, and hot soup/porridge, and with irregular meals, speed eating and binge eating. No major differences in risk were seen according to subsite (cardia vs. non-cardia). Our findings add to the evidence that diet plays a major role in stomach cancer risk and suggest the need for further evaluation of risks associated with carbohydrates and starchy foods as well as the mechanisms involved. Int. J. Cancer 76:659–664, 1998. Published 1998 Wiley-Liss, Inc.†
Article
A case-control study to evaluate risk factors of gastric cancer was carried out in areas with contrasting incidence rates in Sweden. Face-to-face interviews were conducted with 338 of 456 eligible histologically confirmed gastric-cancer cases and 669 of 880 eligible control subjects, sampled from population registers and frequency-matched by age and gender. We focused on 2 periods, adolescence and 20 years prior to interview. The association of gastric-cancer risk with dietary habits during adolescence were similar to that found for the period 20 years before interview; high consumption of wholemeal bread, fruit and vegetables was associated with reduced gastric-cancer risk. In addition, cheese, fish and tea had a protective effect during adolescence. Increased gastric-cancer risk was related to whole-milk consumption, but this association decreased substantially in a multivariate analysis including vegetables. There was a positive relationship between gastric-cancer risk and the age at which the interviewees started using refrigerators. This population-based study confirmed the protective effect of a high consumption of vegetables and fruit in the development of gastric cancer, but failed to find any association between intake of meat, sausage, cold cuts, liver, salt, coffee, the habit of frying, smoking or grilling foods, and risk of gastric cancer.
Article
A multicentric hospital-based case-control study was simultaneously performed in a high-risk and a low-risk area for stomach cancer in Germany, 143 patients with incident stomach cancer and 579 controls completing a retrospective interview about life style aspects. Periods of non-centralized water supply or well water as the only source compared to life-long central water supply, and preservation of meat by smoking it with spruce compared to no home smoking of meat, were significantly associated with an increased stomach cancer risk. Use of a refrigerator at home for 30 and more years compared to 24 years or less showed an inverse relationship, whereas salt intake estimated by questionnaire showed no relationship to stomach cancer risk. Tobacco smoking was negatively associated with risk for current smokers of cigarettes compared to non-smokers but was presumably not causally related. After adjustment for other food constituents, only increased vitamin C consumption showed an inverse relation to risk. For food groups, increased consumption of fruit, citrus fruit, cheese and whole-meal bread were associated with decreased risk. A similar effect was also seen for increased consumption of raw vegetables. Total vegetable consumption was not particularly associated with risk. Increased consumption of processed meat and of beer showed a positive association with risk whereas increased wine and liquor consumption showed a significant negative association. The association of alcoholic beverages with stomach cancer risk may reflect a particular life style rather than being causally related to risk.
Article
A multi-centre case-control study of diet and gastric cancer was carried out in 4 regions of Spain (Aragon, Castile, Catalonia and Galicia). We selected 354 cases of pathologically confirmed gastric adenocarcinoma from 15 hospitals, representative of nearly all those in the study areas. A control for each case, matched by age, sex and area of residence, was selected from the same hospital as the case. Habitual diet was investigated by the dietary history method, and past diet by means of frequency questionnaire. The results regarding consumption of food items are presented here. With respect to habitual diet, an increase in risk was associated with consumption of preserved fish, cold cuts and oleaginous fruits. A high intake of cooked green vegetables, fresh noncitrus fruit and dried fruit showed an inverse association with the risk of gastric cancer. Simultaneous intake of 2 groups of food which increase or decrease the risk of cancer strengthens the respective individual effect. The intake of protective food items seems to neutralize the effects of food items which increase risk. With reference to past diet, possible a protective effect was observed for daily consumption of fresh fruit and green vegetables.
Article
Demographic, smoking and dietary information was obtained from a cohort of 17,633 white American men, largely of Scandinavian and German descent, who responded to a mailed questionnaire in 1966. After 20 years of follow-up, 50% to 90% increases in mortality from stomach cancer (75 deaths) were found among foreign-born, their children, and among residents of the North Central states. An association was seen with low educational attainment and laboring or semiskilled occupations, primarily among immigrants and their children. Risk was elevated in subjects who regularly smoked cigarettes (RR = 2.6, 95% CI = 1.1 to 5.8). A significant dose-response trend was observed, with subjects who smoked 30 or more cigarettes per day having more than a five-fold increased risk compared with those who never smoked. Elevated risks were also found for pipe smoking and smokeless tobacco use, but not for alcohol consumption. Analysis of dietary consumption of nine food groups revealed no significant associations with stomach cancer. However, total carbohydrate intake and a few individual food items (salted fish, bacon, cooked cereal, milk, and apples) were associated with increased risk. The findings of this prospective study of a high-risk population add to the limited evidence relating tobacco consumption to stomach cancer risk and suggest clues to ethnic, geographic, and dietary risk factors.
Article
Meats cooked at high temperatures (frying, grilling) and for a long duration contain heterocyclic amines (HCAs), which are both mutagens and animal carcinogens. Additionally, barbecuing/grilling of meats produces polycyclic aromatic hydrocarbons (PAHs). Consumption of well-done meat has been associated with an increased risk of colon cancer but has not been evaluated as a risk factor for stomach or esophageal cancers. We conducted a population-based case-control study in 66 counties of eastern Nebraska. Telephone interviews were conducted with white men and women diagnosed with adenocarcinoma of the stomach (n = 176) and esophagus (n = 143) between July 1988 and June 1993 and 502 controls. The dietary assessment included several questions about usual cooking methods for meats and doneness preference for beef. High intake of red meat was associated with increased risks for both stomach and esophageal cancers. Overall, broiling or frying of beef, chicken or pork was not associated with the risk of these tumors. Barbecuing/grilling, reported as the usual cooking method for a small number of study participants, was associated with an elevated risk of stomach and esophageal cancers. after excluding those who reported usually barbecuing/grilling, a source of both PAHc and HCAs, we evaluated doneness level as a surrogate for HCA exposure. Compared to a preference for rare/medium rare beef, odds ratios were 2.4 for medium, 2.4 for medium well and 3.2 for well done, a significant positive trend. Doneness level was not associated with a significant trend in risk of esophageal cancer. Int. J. Cancer, 71:14–19, 1997. © 1997 Wiley-Liss. Inc.
Article
The effects were studied of NaCl on the production of gastric carcinomas by N-methyl-N-nitro-N-nitrosoguanidine (MNNG) and by 4-nitroquinoline-1-oxide (NQO) in male Wistar rats. Nine groups of rats were treated as follows: Group 1 was given 50 mg MNNG/liter and 6 g NaCl solution/liter to drink and was fed a stock diet supplemented with 10% NaCl. Group 2 received 1 ml saturated NaCl once a week and 50 mg MNNG/liter to drink. Group 3 was treated with MNNG alone. Group 4 was given a solution of 1 mg NQO once a week and fed a stock diet supplemented with 10% NaCl. Group 5 received a solution of 1 mg NQO saturated with NaCl. Group 6 was given NQO alone. Groups 7 and 8 were given NaCl alone. Group 9 was untreated. Adenocarcinomas developed in the glandular stomach in group 2 at a significantly higher incidence than in group 3. Poorly differentiated adenocarcinomas of the glandular stomach were detected in only groups 1 and 2. One poorly differentiated adenocarcinoma metastasized to the lymph nodes. A high incidence of squamous cell carcinomas of the forestomach was found in groups 4 and 5. No malignant tumors were seen in groups 6-9. NaCl given alone had no apparent carcinogenicity in rats but, when administered with MNNG or NQO, it enhanced the carcinogenic effects of MNNG and NQO in the stomach.
Article
Studies were made on the effect of mucin on the induction of gastric carcinomas by N-methyl-N'-nitro-N-nitrosoguanidine (MNNG), with or without sodium chloride, in male Wistar rats. Seven groups of rats were treated as follows: Group 4 was given continuously 50 mg MNNG/liter solution to drink and 1 ml of saturated sodium chloride once a week and fed on stock diet supplemented with 4% mucin. Group 2 was given 50 mg MNNG/liter solution and fed on stock diet supplemented with 4% mucin. Group 3 received 1 ml of saturated sodium chloride once a week and 50 mg MNNG/liter solution to drink. Group 1 was treated with MNNG only. Group 5 was fed on stock diet supplemented with 4% mucin. Group 6 was given sodium chloride only. Group 7 was untreated. The incidence of gastric cancer in Group 3 was significantly higher than that in Group 4 (P less than 0.05) or in Group 1 (P less than 0.05). The difference in the incidence of gastric cancer in Groups 2 and 4, and of intestinal tumors in Groups 1 to 4 were not statistically significant. No malignant tumors were seen in Groups 5, 6, and 7. Thus mucin reduced the high incidence of gastric cancer induced by MNNG and sodium chloride to the level induced by MNNG alone, but it had no effect on the incidence of intestinal tumors. The effect of mucin in preventing destruction of the gastric mucosal barrier by sodium chloride and so reducing the induction of gastric cancer is discussed.
Article
A case-control study of stomach cancer in relation to dietary, smoking, and drinking habits was undertaken in Saitama Prefecture, Japan. The study was based on 294 cases of newly diagnosed adenocarcinoma of the stomach at a single institution, 294 general population controls (matched by sex, age, and administrative division), and 202 hospital controls. Dietary habits were investigated based on the intake of 12 separate foods and 12 food groups in a food frequency questionnaire, together with individual food preferences. The consumption of raw vegetables was inversely related to the risk of stomach cancer, with a dose-response relation observed consistently in the comparisons with both sets of controls. Current cigarette smokers (1-29/day) had an increased risk (relative risk = 1.8, 95 percent confidence interval = 1.1-3.0) compared with nonsmokers in the general population controls, but no dose-response effect with heavier cigarette smoking. Alcohol use did not affect the risk of stomach cancer. In the multiple logistic regression, the consumption of raw vegetables showed a protective effect on stomach cancer while cigarette smoking had no significant association, in both sets of controls.
Article
A case-control study was carried out in 2 Belgian provinces with contrasting gastric-cancer mortality. The results were analyzed for the total study group and also separately in each of the 4 sub-groups: men and women in each province. Only risks which appeared consistently in at least 3 of these 4 sub-groups were retained in the discussion. Consumption of most vegetables, either cooked or raw, and of fresh fruit was found to be protective. There was an increased risk associated with meal and flour products, including white bread. Added sugar also increased the risk of gastric cancer. Consumption of lean meat was associated with a decreased risk. There was no clear effect for most sources of fat, but for oils with a high P/S ratio there was a decreased risk. Together with our earlier finding on salt, these results are to a large extent similar to those of other recent studies on gastric cancer.
Article
We studied the relationship between diet and gastric cancer in a case-control study. One hundred and nine (109) cases were taken from pathology reports of the regional hospitals, and the 123 controls were obtained from the municipal census of the municipalities of the study. The data were analysed using the Mantel-Haenszel chi-square test. The non-consumption of fresh fruits appeared as a statistically significant risk factor, as well as the consumption of home-made sausages and home-cured meats in general, the risk of which was enhanced when they were eaten smoked. It appears that the less frequent the consumption of fresh fruit and the more frequent the consumption of sausages were the higher the risk was. The non-consumption of fresh vegetables also appeared to be a risk factor, but it was not statistically significant.
Article
A hospital-based, multicenter, case-control study has been performed in Poland covering 741 incident stomach-cancer cases (520 males and 221 females) and the same number of controls. All stomach-cancer diagnoses were evaluated for histologic type according to the Lauren criteria. Fifty-one percent were of the intestinal type, 35 percent of the diffuse type, and 8.5 percent of the mixed type. The frequency of consumption of individual food items and several food groups was analyzed and the association of various foods with stomach cancer risk was evaluated after controlling for sex, age, occupation, education, and residency. Increased consumption of sausages was related significantly to gastric cancer risk, whereas increased consumption of cheese products, nonwhite bread, vegetables, and fruit was associated with decreased risk. A particularly strong decrease in risk was associated with consumption of radishes and onions. When consumption of fruits and vegetables, sausages, nonwhite bread, and cheese were introduced simultaneously in a multivariate model, independent effects were found only for fruit and vegetables, sausages, and nonwhite bread. The use of table salt, the frequency of eating hot meals, and an irregular eating pattern were also associated with increased risk, while additional consumption of fruit between meals showed reduced risk. If a reduction in vegetable and fruit consumption took place after marriage, an increased risk for stomach cancer was found, whereas augmented consumption of these food items after marriage decreased the risk. Separate risk models were calculated for stomach cancer of the intestinal and diffuse types, but both histologic varieties showed the same pattern of associations with dietary risk factors.
Article
Nitrosamines form a large group of genotoxic chemical carcinogens which occur in the human diet and other environmental media, and can be formed endogenously in the human body. N-Nitroso compounds can induce cancer in experimental animals. Some representative compounds of this class induce cancer in at least 40 different animal species including higher primates. Tumours induced in experimental animals resemble their human counterparts with respect to both morphological and biochemical properties. Extensive experimental, and some epidemiological data suggest that humans are susceptible to carcinogenesis by N-nitroso compounds and that the presence of these compounds in some foods may be regarded as an aetiological risk factor for certain human cancers including cancers of the oesophagus, stomach and nasopharynx.
Article
A clarification of the mechanism of carcinogenesis is developing at a rapid rate. This new understanding undermines many assumptions of current regulatory policy toward rodent carcinogens and necessitates rethinking the utility and meaning of routine animal cancer tests. At a recent watershed meeting on carcinogenesis, much evidence was presented suggesting that mitogenesis plays a dominant role in carcinogenesis. Our own rethinking of mechanism was prompted by our findings that: spontaneous DNA damage caused by endogenous oxidants is remarkably frequent and in chronic testing at the maximum tolerated dose (MTD), more than half of all chemicals tested (both natural and synthetic) are carcinogens in rodents, and a high percentage of these carcinogens are not mutagens.
Article
From 1965 to 1968 in Hawaii, 7990 American men of Japanese ancestry were interviewed and examined in a cohort study. The intake of 20 separate foods in a food frequency questionnaire and the intake of carbohydrate and other nutrients, based on a 24-h diet recall history, were recorded. Since then, 150 incident cases of stomach cancer have been identified. Although men with stomach cancer (cases) consumed pickles and ham/bacon/sausages more often and fruits and fried vegetables less often than men without cancer (noncases), none of the differences was statistically significant. Current cigarette smokers had an increased risk (relative risk = 2.7; 95% confidence interval = 1.8 to 4.1) compared with nonsmokers, but there was no dose-response effect with heavier cigarette smoking. The consumption of alcohol, either from beer, spirits, or wine, did not affect the incidence of stomach cancer. The failure to detect an association with dietary foods in this study may be due to the omission of many oriental foods in the questionnaire and the limitations of the 24-h diet recall history.
Article
Both descriptive and analytical studies were carried out to examine epidemiologic characteristics and multiple risk factors of stomach cancer in Taiwan. The age-adjusted mortality rate of stomach cancer has been decreasing since the early 1970s for both males and females. The male-to-female ratio of the disease has remained around 2:1 in the past three decades. Comparison of the incidence of stomach cancer among Chinese in different countries showed a much lower incidence among Chinese in the USA than those in southeastern Asia. A hospital-based matched case-control study carried out in Taipei metropolitan areas showed a positive association of stomach cancer with blood type A, chronic gastric diseases, cigarette smoking, alcohol drinking, green tea drinking as well as consumption of salted meat, cured meat, smoked food, fried food and fermented beans. There was also a significant negative association between the disease and the consumption of milk.
Article
Most western-style foods have been analysed for the presence of volatile N-nitrosamines. Relatively few foods consistently contain detectable (greater than 0.1 microgram/kg) amounts of volatile N-nitrosamines. The major known contributors to dietary volatile N-nitrosamines are nitrite-cured meats, particularly fried bacon, and beer. The amount of volatile N-nitrosamines in these foods has declined in recent years. Average dietary intakes of preformed volatile N-nitrosamines have been calculated from these data and indicate that dietary exposure for consumers of western-style foods amounts to 0.5 to 1.0 microgram/day/person. Asian foods have not been surveyed to the same extent but preliminary data indicate a somewhat higher and more frequent volatile N-nitrosamine content, in part due to differences in fish intake and preparation. Indirect evidence suggests that the non-volatile content of some foods may be one to three orders of magnitude higher than volatile N-nitrosamine content.
Article
A case-control study of diet and stomach cancer was conducted during 1979-1982 in Toronto, Winnipeg, and St. John's Canada. Two hundred forty-six histologically verified cancer cases were individually matched by age, sex, and area of residence to 246 randomly selected population controls. Daily nutrient consumption values were calculated from quantitative diet history questionnaire data through use of the US Department of Agriculture Food Composition Data Bank, which was extended and modified for Canadian items. For the analysis, continuous conditional logistic regression methods were used. It was found that consumption of dietary fiber was associated with decreased risk of gastric cancer; the odds ratio estimate of trend was 0.40/10 g average daily intake of fiber (i.e., 0.40(1.5)/15 g, etc.) (p less than 10(-8)). Also, average daily consumption of nitrite, chocolate, and carbohydrate was associated with increasing trends in risk, with odds ratio estimates, respectively, 2.6/mg (p less than 10(-4)), 1.8/10 g (p less than 10(-4)), and 1.5/100 g (p = 0.015). While citrus fruit intake appeared to be somewhat protective (odds ratio = 0.75/100 g daily average, p = 0.0056), vitamin C intake was less so, and vitamin E not at all. Thus, a number of dietary components seem to be implicated in the pathogenesis of stomach cancer.
Article
Although the proof that N-nitroso compounds (NOC), a versatile class of carcinogens in animals, are also carcinogenic in man is lacking, humans are exposed through ingestion or inhalation to preformed NOC in the environment and through the endogenous nitrosation of amino precursors in the body. Activated macrophages can synthesize nitrate, nitrite and nitrosating agents that can form NOC. A number of bacterial strains isolated from human infections can produce NOC enzymatically from precursors at neutral pH. As a consequence endogenous nitrosation may occur at various sites of the body such as the oral cavity, stomach, urinary bladder, lungs, and at other sites of infection or inflammation. Since the demonstration by Mirvish et al. (1972) showing that ascorbate can reduce tumor formation in animals following feeding of nitrite plus amine, numerous substances to which humans are exposed have been identified and shown to inhibit formation of NOC in vitro, in animal models and in humans. Such inhibitors of nitrosation include vitamins C and E, phenolic compounds, and complex mixtures such as fruit and vegetable juices or other plant extracts. Nitrosation inhibitors normally destroy the nitrosating agents and thus act as competitors for the amino compound that serves as substrate for the nitrosating species. Independently, epidemiological studies have already established that fresh fruits and vegetables that are sources of vitamin C, other vitamins and polyphenols have a protective effect against cancers at various sites and in particular gastric cancer. Although the evidence that endogenously formed NOC are involved in human cancers is far from conclusive, it is suggestive and justifies preventive measures for reducing exposure to NOC. This article briefly reviews (i) the chemistry of NOC formation and inhibition, (ii) the studies in experimental animals which showed that inhibition of endogenous NOC synthesis leads to a reduction of toxic, mutagenic and carcinogenic effects, (iii) recent studies in humans where the degree of inhibition of endogenous NOC synthesis was directly quantified and lastly (iv) the contribution of nitrosation inhibitors to human cancer prevention.
Article
Foods on the Swedish market in 1980-1986 were analysed for volatile N-nitrosamines using gas chromatography-thermal energy analysis. Detectable levels were found in 474 of the 764 samples analysed. The average daily intake of volatile N-nitrosamines was estimated to be 0.29 microgram per person. Over 93% of the intake comes from meat and malt products.
Article
Dietary sodium chloride has been identified, both experimentally and epidemiologically, as a risk factor for gastric cancer. In order to elucidate the manner in which salt increases gastric tumor incidence in N-methyl-N'-nitro-N-nitrosoguanidine-treated animals, flow cytometric cell cycle analyses were performed on rats which had been treated with 1 ml of a solution of saturated NaCl by gavage and sacrificed 0, 1, 6, 12, 24, or 48 h after treatment. The gastric antra were excised, disaggregated, and stained with propidium iodide for cell cycle analysis. Results showed that there is a reduction in cell yield at early time points due to the toxicity of NaCl, followed by a net increase in the number of cells in the S phase of the cell cycle at 24 h. Treatment of rats with NaCl 24 h prior to a dose of 10 micrograms of 3H-labeled N-methyl-N'-nitro-N-nitrosoguanidine did not lead to an increase in alkylation of DNA isolated from mucosal cells. Therefore, the hypothesis that salt enhances gastric cancer risk from N-methyl-N'-nitro-N-nitrosoguanidine by disruption of the "mucosal barrier" leading to an increased effective dose to target cells is not supported by the results of these experiments. Several studies have shown that cells in S phase are the most susceptible to mutagenesis and that increasing the number of cycling cells in a target organ will increase tumor incidence (e.g., partial hepatectomy). Thus it is possible that NaCl increases gastric cancer risk through the mitogenesis which results from the damage caused to the mucosa by this agent.