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Processed meat consumption, dietary nitrosamines and stomach cancer risk in a cohort of Swedish women
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.
... Previous studies on the association between meat consumption and GC risk showed inconsistent results. In agreement with Larsson [23], we did not find a significant association between the intake of red meat and the risk of GC, while others reported a positive association [9,12]. World Cancer Research Fund recommends red meat consumption of 500 g/week or lower [24]. ...
... The results for fish consumption in our study are contradictory to previous results [9,31,32]. Munoz reported a decreased risk of GC by fish intake [33], while others did not find significant associations [11,23]. Based on a meta-analysis, there is no consensus on the role of fish intake in GC [34]. ...
... We also observed a significant association between chicken intake and the risk of GC. Some studies reported that white meat increases the risk of colorectal cancer [38], while others reported no significant association between poultry intake and GC [23,39]. Others reported a protective effect of white meat intake [32,40]. ...
Background
Heme and non-heme irons are two forms of iron in the diet. Few studies have evaluated the association between heme iron intake and the risk of gastric cancer (GC). We aimed to investigate the association between heme, non-heme and total iron intake and risk of GC in Iran.
Methods
In a hospital-based case–control study, nutritionists interviewed 178 pathologically confirmed GC patients and 276 controls using a valid Diet History Questionnaire. Multiple logistic regression model was used to estimate Odds Ratios (OR) and 95% Confidence Intervals (CIs) for iron intake and risk of GC.
Results
Subjects in the highest tertile of total iron intake were 46% less likely to get GC than those in the lowest (OR = 0.54, 95% CI: 0.32–0.92), however, the associations were not significant for intake of heme and non-heme iron. The risk of GC in the highest tertile of total meat intake was 2.51 times higher than the lowest. We found significant associations between GC and chicken (OR = 2.95; 95% CI: 1.66–5.22) and fish intake (OR = 1.89; 95% CI: 1.09–3.27), However, we found no associations between the risk of GC and intake of red meat, salted fish, and liver.
Conclusion
Total iron intake was associated with a lower risk of GC which could be partly due to the high prevalence of anemia in Iran. Although, we could not find any significant association between the risk of GC and the intake of heme and non-hem iron among the Iranian population.
... A total of 40 independent studies were included in the meta-analysis, including 27 case-control studies [23][24][25][26][27][28]31,[33][34][35][36][37][38][39][41][42][43]45,51,52,[54][55][56][57]60,61] and 13 cohort studies [29,30,32,40,[46][47][48][49][50]53,58,59,62]. Details on these studies were provided in Supplementary Tables S1 and S2. ...
... Details on these studies were provided in Supplementary Tables S1 and S2. These studies reported a total of 13 risk estimates for CRC [34,36,42,46,49,51,[53][54][55][56]59,62], 22 for GC [23][24][25][27][28][29][30][31][32][33][34][35][38][39][40][41]44,45,47,49,50,57], seven for EC [26,35,44,47,49,50,60], and five for PC [37,48,52,58,61]. The studies included in the meta-analysis had a minimum score of 7 out of 9 stars in the NOS. ...
... Forest plot (random-effects model) quantifying the relationships between NDMA, nitrite, and nitrate intake and gastric cancer risk stratified by sources. List of references includes:[23][24][25]27,30,[32][33][34][38][39][40][41]44,45,47,50,57]. ...
N-nitroso compounds (NOCs) are a class of chemical carcinogens found in various environmental sources such as food, drinking water, cigarette smoke, the work environment, and the indoor air population. We conducted a systematic review and meta-analysis to investigate the links between nitrate, nitrite, and NOCs in food and water and the risk of gastrointestinal (GI) cancers, including esophageal cancer (EC), gastric cancer (GC), colorectal cancer (CRC), and pancreatic cancer (PC). A systematic search of the literature in Scopus, PubMed, Google Scholar, Web of Science, ScienceDirect, and Embase was performed for studies on the association between NOCs in drinking water and food sources and GI cancers. Forest plots of relative risk (RR) were constructed for all the cancer sites and the intake sources. The random-effects model was used to assess the heterogeneity between studies. Forty articles were included after removing duplicate and irrelevant articles. The meta-analysis indicated that the intake of high dose vs. low dose of these compounds was significantly associated with the overall GI cancer risk and nitrite (RR = 1.18, 95% CI = 1.07–1.29), and N-nitrosodimethylamine (NDMA) (RR = 1.32, 95% CI = 1.06–1.65). We found that dietary nitrite intake increased GC (RR = 1.33, 95% CI = 1.02–1.73), and EC (RR = 1.38, 95% CI = 1.01–1.89). Additionally, dietary NDMA intake increased the risk of CRC (RR = 1.36, 95% CI = 1.18–1.58). This meta-analysis provides some evidence that the intake of dietary and water nitrate, nitrite, and NOCs may be associated with GI cancers. In particular, dietary nitrite is linked to GC and EC risks and dietary NDMA intake is associated with CRC.
... In addition, NDMA acts as an initiator and takes longer from exposure to cancer, which contrasts with the fact that drug exposure mostly serves as a promotor when exerting cancer development 52 . Among the prior nutritional epidemiologic studies, the follow-up periods in cohort studies suggesting significant association ranged from 11.4 to 24 years 41,50,51,53 . Due to the variations in research methodologies, direct comparisons may not be feasible. ...
... Due to the variations in research methodologies, direct comparisons may not be feasible. However, in the two studies with the most extended follow-up periods (18 years and 24 years), the HR for cancer incidence was 2.0 (gastric cancer) and 2.12 (colorectal cancer), respectively 41,50 , which are higher than those reported in other studies. On the other hand, a research with 6.6 years of follow-up did not indicate relevance 54 . ...
N-Nitrosodimethylamine (NDMA) detected above the acceptable level in ranitidine products has been a great global concern. To examine the risk of cancer among people treated with ranitidine, we conducted a cohort study using the National Health Insurance Service-National Sample Cohort data (2002–2015) of South Korea. Patients were aged 40 or above as of January 2004 and began receiving ranitidine or other histamine-2 receptor antagonist (H2RA), active comparator, without a history of H2RAs prescription during the prior 2-years. The lag time was designated up to 6 years. The outcomes were an overall incident cancer risk and the risk of major single cancers during the follow-up. The association between ranitidine use and cancer risk was examined by Cox regression model. After exclusion and propensity score matching, 25,360 patients were available for analysis. The use of ranitidine was not associated with the overall cancer risk and major individual cancers [overall cancer: incidence rate per 1000 person-years, 2.9 vs 3.0 among the ranitidine users and other H2RAs users, respectively; adjusted hazard ratio (HR) and 95% confidence interval (95% CI) for all cancers, 0.98 (0.81–1.20)]. The higher cumulative exposure to ranitidine did not increase the cancer risk. Given the insufficient follow-up period, these findings should be interpreted carefully.
... Acetic acid and its related salts are widely used as acidulants and antimicrobials [8]. Several epidemiologic studies have indicated associations between consumption of raw red and processed meats and increased risk of colorectal, Stomach and Pancreatic cancers [9][10][11], cardiovascular diseases and other causes of death [12]. The association was stronger for high consumption of processed than red meat in these studies. ...
... Consumption of red meat and processed meat has been associated with increased risk of stomach cancer [10], Pancreatic cancer [11] and colorectal cancer [9] besides an increase risk cardiovascular disease and other causes of death [12]. The latter authors have estimated that consumption of more than 20g of processed meat per day increases the mortality rate. ...
Strict application of the international standards requirements for food processing plants is deemed essential for public health and food trade. This is a cross-sectional analytic study that investigates the presence of pathogenies in raw beef (RB) from local slaughterhouses and in beef products (BP) from local meat processing plants (MPPs) in Khartoum state and their conformity to both requirements of national and international standards to ensure their safety. Additionally, determination of nitrite residual levels and nitrosamines content in processed meat products. A total of 140 raw and processed beef samples were examined from four MPPs. The BP samples are; beef burger, hotdog, mortadella, frankfurter, pasterma, sausage, and salami. The results showed frequencies bacterial isolates in RB were belonged to twenty-three genera as follows: Staphylococcus aureus (65%), Aerococcus spp (62.5%), Klebsiella pneumoniae (42.5%), Pasteurella multocida (42.5%), Micrococcus spp (40%), Salmonella spp (40%), E. coli (35%), Proteus vulgaris (32.5%), Acinetobacter spp (30%), Bordetella parapertucis (27.5%), Kurthia spp (22.5%), Streptococcus spp (22.5%), Corynebacterium ovis (17.5%), Listeria monocytogenes (17.5%.), Pseudomonas aeruginosa (15%), Bacillus cereus (12.5%), Sterptobacillus spp (12.5%), Haemophilus spp (7.5%), Rothia spp (7.5%), Nocardia asteroids (7.5%), Aeromonas spp (2.5%) Alcaligenes faecalis (2.5%), and Hafnia.alvei (2.5%). While, the BP samples revealed presence of S. aureus (82.5%), P. vulgaris (45%), E. coli (32.5%), B. cereus (32.5%), L. monocytogenes (7.5%), and P. aeruginosa (2.5%). The levels of residual nitrite ranged (0.00 – 0.99), (1.00 – 1.99), (2.00 – 2.99), (3.00 – 3.99), (4.00– 4.99), (5.00 – 5.99), (6.00 – 6.99), and (7.00->) mg/kg. in 49, 25, 13, 6, 2, 3, 1, and 1% of BP, respectively. Moreover, the detection of nine volatile N-nitrosamine compounds which are classified by IARC as probably carcinogenic to humans in PB samples exhibited concentration levels of N-nitrosodin-butylamine (0.41-91µgkg), N-nitrosodi-ethylamine(9-182µg/kg), N-nitrosodi-methylamine, (1.4-250µg/kg), N-nitrosodi-phenylam-ine (0.7-109µg/kg), N-nitrosodin-propylamine (5-250µg/kg), N-nitroso-methylethylamine (33-191µg/kg), N-nitroso-morpholine (2.4-305µg/kg), N-nitroso-piperidine (25.4-432µg/kg), N-nitroso-pyrrolidine (29-1033µg/kg). The findings revealed that RB has high pathogens load, a situation which necessitates improvement of hygiene in the slaughterhouses as well as, the nitrosamines contents in the BP were in compliance with the regulations of the European Union and FAO/WHO.
... 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). ...
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.
... Here, chronic intoxications are more prominent, but acute risks should not be neglected. Nitrosamines: N-Nitrosamines are known for their carcinogenic properties, meaning they have the potential to cause cancer in living tissue, and they encompass a group of several substances (e.g., N-nitrosodimethylamine, N-nitrosomethylethylamine, N-nitrosodiethylamine, Nnitrosodipropylamine, N-nitrosodibutylamine, N-nitrosomorpholine, N-nitrosopyrrolidine, N-nitrosopiperidine, N-nitrosomethylaniline, N-nitrososarcosine) [32,33]. Pathogenic microorganisms: The consumption of pathogenic microorganisms can result in acute, severe symptoms. ...
Foodborne illnesses and mortalities persist as a significant global health issue. The World Health Organization estimates that one out of every ten individuals becomes ill following the consumption of contaminated food. However, in the age of digitalization and technological progress, more and more data and data evaluation technologies are available to counteract this problem. A specific challenge in this context is the efficient and beneficial utilization of the continuously increasing volume of data. In pursuit of optimal data utilization, the objective of the present study was to develop a Multi-Criteria Decision Analysis (MCDA)-based assessment scheme to be prospectively implemented into an overall artificial intelligence (AI)-supported database for the autonomous risk categorization of food incident reports. Such additional evaluations might help to identify certain novel or emerging risks by allocating a level of risk prioritization. Ideally, such indications are obtained earlier than an official notification, and therefore, this method can be considered preventive, as the risk is already identified. Our results showed that this approach enables the efficient and time-saving preliminary risk categorization of incident reports, allowing for the rapid identification of relevant reports related to predefined subject areas or inquiries that require further examination. The manual test runs demonstrated practicality, enabling the implementation of the evaluation scheme in AI-supported databases for the autonomous assessment of incident reports. Moreover, it has become evident that increasing the amount of information and evaluation criteria provided to AI notably enhances the precision of risk assessments for individual incident notifications. This will remain an ongoing challenge for the utilization and processing of food safety data in the future.
... Nitrosamine N-nitroso compounds or nitrosamines are chemical carcinogens of nitrogen oxides (e.g., nitrites and nitrates). Nitrosamines react with DNA and form adducts with phosphate residues that may stimulate the activation of specific proto-oncogenes (68,69). There is much evidence linking nitrosamines to the incidence of various types of cancer, including colorectal, stomach, esophagus, nasopharynx, bladder, and breast (70)(71)(72)(73). ...
Candida albicans is an “opportunistic fungal agent” in cancer patients that can become colonized in both mucosal and deep tissues and cause severe infections. Most evidence has shown that C. albicans can enhance the progress of different cancers by several mechanisms such as generating virulence factors, participation in endogenous production of pro-inflammatory mediators, and stimulating a wide range of immune cells in the host. The main idea of this review is to describe a range of Candida-used mechanisms that are important in candidiasis-associated malignant processes and cancer development, particularly breast cancer. This review intends to provide a detailed discussion on different regulatory mechanisms of C. albicans that undoubtedly help to open new therapeutic horizons of cancer therapy in patients with fungal infection. The current therapeutic approach is not fully effective in immunocompromised and cancer patients, and further studies are required to find new products with effective antifungal properties and minimal side effects to increase the susceptibility of opportunistic fungal infections to conventional antifungal agents. So, in this situation, a special therapy should be considered to control the infection and simultaneously have the most therapeutic index on tumor patients.
... 20,21 However, its use as a preservative has been shown to have a probable connection between colorectal and stomach cancers in those with a high intake of cured meat. 22 Even those aforementioned trace amounts of nitrite ions are hazardous to human health. Nitrite-contaminated water has even caused shortness of breath and blue baby syndrome in infants once digested. ...
With increasing concerns over environmental impact and overall health of both the environment and its people, a need to quantify contaminants is of the utmost importance. Chemosensors with low detection limits and a relative ease of application can address this challenge. Nitrite ions are known to be detrimental to both the environment and human health. A new colorimetric chemodosimeter has been prepared from the homolytic photochemical cleavage of a reaction between pyrrole and pyridine. The product, 4-(pyrrol-1-yl)pyridine, yields a limit of detection of 0.330 (±0.09) ppm for the detection of nitrite in aqueous solution, employing a colorimetric change from yellow to pink. It is also highly selective for nitrite when various competitive anions such as SO32–, NO3–, PO43–, SO4–2, Cl–, F–, I–, Br–, AcO–, and CN– are present in great excess. The molecule’s especially high sensitivity to nitrite is apparently the result of a complex supramolecular mechanism, characterized by both dynamic light scattering of the aggregate and the Tyndall effect. Consequently, this new sensor provides a simple, low-cost way to rapidly detect nitrite anions in aqueous solution.
... Stomach cancer is prevented by vitamin C, onions, garlic, and shallots. [11]. Hightemperature, protein-rich diets produce carcinogenic heterocyclic amines. ...
The Cancer Genome Atlas (TCGA) classified 20% of stomach cancers as genetically stable (GS), aneuploidy, and early-identified, with 73% diffuse subtype enrichment and cadherin-1 (CDH1) somatic mutations. Chromosomally unstable (CIN) stomach malignancies are 50% more prevalent in esophago-gastric junction tumors. Microsatellite instability (MSI) results from DNA mismatch repair errors. The MMR system corrects base mismatches, insertions, and deletions for accurate DNA replication. Lynch syndrome raises young people's risk of colorectal, endometrial, ovarian, and stomach cancer due to autosomal dominant MMR gene mutations. Epstein-Barr virus (EBV) causes breast, lung, stomach, colon, and lung cancers. EBV gene expression and host genome control alter stomach cancer cell cycle pathways and gene expression. EBV-positive gastric tumors (9% of stomach cancers) usually affect men. According to the Asian Cancer Research Group (ACRG), gastric cancer has four molecular classifications: microsatellite stability with epithelial-mesenchymal transition (MSS/EMT), MSS/TP53+ aberrant, which commonly has a higher EBV etiology, and MSS/TP53 normal subgroups; and distal stomach microsatellite instability (MSI).
Aim of the study : We examined the potential of immunohistochemistry to molecularly classify gastric adenocarcinoma according to (TCGA) and (ACRG) algorithms and genetic classification.
Material and methods : From Baghdad, Iraq, we gathered 40 formalin-fixed paraffin-embedded stomach cancer tissue blocks. Primary gastric adenocarcinoma cases were studied using available clinicopathological data and surgical tissues. The immunohistochemical expression assessed by scoring systems and referenced algorithms was used to molecularly classify the gastric adenocarcinoma cases.
Results: IHC staining for P53 was positive in 26 cases (65%) and negative in 14 (35%). EBV- Latent membrane protein (LMP) immunological staining was positive in 27 (67.5%) and negative in 13 (32.5%) cases. A score of 0 (negative) was found in 2 cases (5%), score 1 in 6 (15%), score 2 in 12 (30%), and score 3 in 20 (50%) of E-Cadherin IHC staining. MSI was positive in 39 (97.5%) and negative in 1 (2.5%). The MLH1/PMS2 heterodimeric couple had 13 positive and 27 negative cases. The MSH2/MSH6 heterodimeric couple was positive at 87.5% and negative at 12.5%. Based on the suggested algorithm for TCGA Group A, 67.5% (27 cases) of the forty patients tested positive for the Epstein-Barr virus. Twelve MSI cases (30% of the samples) were found. No genomically stable cases were observed, indicating 0% of the cases, and one case was referred to as chromosomal instability (2.5%). For (ACRG) Group B, 27 MSI cases (67.5% of the sample) were found, one case classified as MSS/EMT (2.5%), and twelve people (30%) had MSS/aberrant P53. MSS/normal P53 cases were not reported.
Conclusion: Immunohistochemical analysis can be used to distinguish immunophenotypic groups in gastric adenocarcinoma, revealing distinct clinicopathological characteristics. This study demonstrates the classification of gastric adenocarcinoma into biologically and clinically distinct subgroups, facilitating clinical diagnosis.
Keywords: gastric adenocarcinoma, molecular classification , immunohistochemistry , P53 , microsatellite instability.
... The consumption of excess meat/water with nitrite contamination poses health risks. Some reports indicate that an increased number of cases associated with stomach/colorectal cancer, intrauterine growth restriction, congenital defects, and methemoglobinemia were due to the consumption of nitrite-preserved meat or nitrite-contaminated water [3]. While the direct link between nitrites and cancer remains unclear, their metabolites, specifically nitrosamines, have been identified as carcinogens in various animal species [4]. ...
Nitrite monitoring serves as a fundamental practice for protecting public health, preserving environmental quality, ensuring food safety, maintaining industrial safety standards, and optimizing agricultural practices. Although many nitrite sensing methods have been recently developed, the quantification of nitrite remains challenging due to sensitivity and selectivity limitations. In this context, we present the fabrication of enzymeless iron oxide nanoparticle-modified zinc oxide nanorod (α-Fe2O3-ZnO NR) hybrid nanostructure-based nitrite sensor fabrication. The α-Fe2O3-ZnO NR hybrid nanostructure was synthesized using a two-step hydrothermal method and characterized in detail utilizing x-ray diffraction (XRD), field emission scanning electron microscopy (FESEM), transmission electron microscopy (TEM), and X-ray photoelectron spectroscopy (XPS). These analyses confirm the successful synthesis of an α-Fe2O3-ZnO NR hybrid nanostructure, highlighting its morphology, purity, crystallinity, and elemental constituents. The α-Fe2O3-ZnO NR hybrid nanostructure was used to modify the SPCE (screen-printed carbon electrode) for enzymeless nitrite sensor fabrication. The voltammetric methods (i.e., cyclic voltammetry (CV) and differential pulse voltammetry (DPV)) were employed to explore the electrochemical characteristics of α-Fe2O3-ZnO NR/SPCE sensors for nitrite. Upon examination of the sensor’s electrochemical behavior across a range of nitrite concentrations (0 to 500 µM), it is evident that the α-Fe2O3-ZnO NR hybrid nanostructure shows an increased response with increasing nitrite concentration. The sensor demonstrates a linear response to nitrite concentrations up to 400 µM, a remarkable sensitivity of 18.10 µA µM⁻¹ cm⁻², and a notably low detection threshold of 0.16 µM. Furthermore, its exceptional selectivity, stability, and reproducibility make it an ideal tool for accurately measuring nitrite levels in serum, yielding reliable outcomes. This advancement heralds a significant step forward in the field of environmental monitoring, offering a potent solution for the precise assessment of nitrite pollution.
... 18 According to a study by , the risk of stomach cancer is increased by 1.66 times for all processed meats, 1.55 times for bacon, 1.50 times for sausages or hot dogs, and 1.48 times for ham or salami. 19 Meat and meat-based products are common sources of dietary nitrosamines. NDMA is the type of nitrosamine most frequently found in meat and processed meat products. ...
Nitrite, nitrate, and their salts are added to processed meat products to improve color, flavor, and shelf life and to lower the microbial burden. N‐Nitrosamine compounds are formed when nitrosing agents (such as secondary nitrosamines) in meat products interact with nitrites and nitrates that have been added to the meat. With the consumption of such meat products, nitrosation reactions occur in the human body and N‐nitrosamine formation occurs in the gastrointestinal tract. Despite the benefits nitrites and nitrates have on food, their tendency to create nitrosamines and an increase in the body's nitrous amine load presents health risks. The inclusion of nitrosamine compounds in possible and probable carcinogen classes according to the International Agency for Research on Cancer requires a re‐examination of the literature review on processed meat products. This article evaluates the connections between various cancer types and nitrosamines found in processed meat products. © 2023 Society of Chemical Industry.
... It is interesting how nitrosamines in cigarettes have been identified as carcinogenic to the human race in terms of lung cancer, for example [16], nitrosamines in food have been identified as carcinogenic in terms of the development of gastrointestinal or urogenital forms of cancer [17,18], but nitrosamines in medicines were not dangerous and should not be feared within their intake ? Although this intake is indicative of the development of melanomas and keratinocytic forms of cancer [2,3,4], but not only. ...
The purposeful oblivion of the objective truth, the disregard of
scientific reality, the denial of the contributions and successes of
surrounding researchers, the substitution of priorities in clinical
routine and the unwillingness to reason in the right direction
often lead to disastrous consequences in the field of public
health.
Controlled projects almost never lead to a significant
contribution or breakthrough in medicine that will be
remembered by future generations.
Another illustrative example in this regard is the link
shared above to the saga of the worldwide cancer pandemic
and its possible real cause: the contamination of drugs with
nitrosamines/NDSRIs.
The carcinogenic action of nitrosamines in rats under
experimental conditions was demonstrated as early as the early
1960s (1954) by Barnes and Magee.
The series of subsequent experiments in their numerous
research studies was strongly indicative of a pathogenetic role
of nitrosamines / dimethylnitrosamine / in the development of
liver cancer and kidney cancer. Starting from the fact that contact
with nitrosamines is of primary importance for the development
of tumours in animals, there is practically no circumstance that
would lead us to believe that the intake of the same mutagens in
man would have a different carcinogenic effect from that already
known to us (as was found under experimental conditions as
early as 1954, but in animals).
On the contrary, to this day the incidence of cancer is
increasing every year and, according to global statistics, it is
projected to increase by nearly 50% or 18 million new cases
by 2040. The intake of (un)identified nitrosamines found in
drugs as contaminants is increasing analogously to the shared
breakneck cancer incidence.
In addition to the number of identified carcinogens or NDSRIs
, the number of affected drug classes is also progressively
growing and in mid-2023 this number amounts to over 250 drugs
according to the official data of the FDA bulletin of 08.04.2023.
In practice, the population/patients have been in a continuous,
still ongoing, multicentric prospective study since 1954.
The parameters of the ˝experiment˝ are probably pre-set,
crystallizing gradually over time and imposed forcefully in
the form of hypnotic suggestions and directives by regulators.
Encouragingly , the results of the prospective study are also
available, are not one-sided and have been published in dozens
of international journals as well as in part in the well-known
Cancer Journal of the clinicians / Impact factor 254,7.
The bad news is that in most of these observations and
results, there is no correlation of what is shared between, say, 1) mandatory alternative-free intake of mutagen-contaminated
drugs and 2) the breakneck development of heterogeneous
cancers/including melanomas, and the scientific vision of the
studies is currently rather one-sided.
Cancer incidence is skyrocketing (according to Globocan/
Cancer Journal for the Clinicians), and not a single worldwide
study has commented on its potential link to actual contamination
of the most commonly used drugs worldwide with nitrosamines/
NDSRIs. For the past 5 years, the team of the Bulgarian Society of
Dermatological Surgery has been committed to formalizing
the final results of these prospective nationwide observational
studies and providing full transparency on the relationship
between the intake of actual/potential nitrosamine-contaminated
drugs and the development of skin cancer. Over 95% of newly
reported skin cancers during this period (2016-2023) were
associated with prior intake of drugs listed in the 2023 FDA as
potentially nitrosamine/NDSRIs contaminated or carcinogens.
Melanoma is one of the most significant patterns of tumor
arising after contact of the human body with nitrosamines.
Whether the drugs affected by the contamination are from the
group of sartans, beta blockers, hydrochlorothiazide, calcium
antagonists, ACE inhibitors or antidepressants- the ultimate
side effect remains the same and is known to the scientific
community as or by the frightening and loud name : melanoma.
We report the occurrence of another case of nevus associated
cutaneous melanoma and multiple dysplastic nevi after taking
the antidepressant Sertraline. A drug declared according to the
official FDA bulletin of 08.04.2023 as potentially contaminated
with class 2 nitrosamines/ NDSRIs: having similar to completely
identical carcinogenic potency as that of NDMA and NNK. Or
reciprocal to that in valsartan, irbesartan, olmesartan, repeatedly
described already as possible melanoma inducers.
According to the literature search, this is also the first case
in the world of Sertraline-induced nevus associated cutaneous
melanoma, and we share the view/ thesis that the real inducer of
the tumor is in fact the impurities in the medication in the form
of contaminants or nitrosamines: the so-called NDSRIs.
The nitrosogenesis of skin cancer is a more than significant
concept that has been cleverly concealed by the scientific
community until recently. The reason for this concealment
could be sought in the paramount importance or central role
that the nitrosogenesis occupies at the base of the ʺpyramidʺ
guaranteeing billions of dollars of monthly revenue to the
regulators of globalism.
... In a Swedish cohort study (61,433 women), NDMA intake was significantly associated with overall gastric cancer risk (Q5 vs. Q1, HR: 1.96; 95% CI: 1.08-3.58; p-trend = 0.02) (Larsson et al., 2006). In a cohort study conducted in the UK (23,363), an increased risk (per 1 SD increase of NDMA, HR: 1.13; 95% CI: 1.00-1.28) ...
EFSA was asked for a scientific opinion on the risks to public health related to the presence of N-nitrosamines (N-NAs) in food. The risk assessment was confined to those 10 carcinogenic N-NAs occurring in food (TCNAs), i.e. NDMA, NMEA, NDEA, NDPA, NDBA, NMA, NSAR, NMOR, NPIP and NPYR. N-NAs are genotoxic and induce liver tumours in rodents. The in vivo data available to derive potency factors are limited, and therefore, equal potency of TCNAs was assumed. The lower confidence limit of the benchmark dose at 10% (BMDL10) was 10 μg/kg body weight (bw) per day, derived from the incidence of rat liver tumours (benign and malignant) induced by NDEA and used in a margin of exposure (MOE) approach. Analytical results on the occurrence of N-NAs were extracted from the EFSA occurrence database (n = 2,817) and the literature (n = 4,003). Occurrence data were available for five food categories across TCNAs. Dietary exposure was assessed for two scenarios, excluding (scenario 1) and including (scenario 2) cooked unprocessed meat and fish. TCNAs exposure ranged from 0 to 208.9 ng/kg bw per day across surveys, age groups and scenarios. 'Meat and meat products' is the main food category contributing to TCNA exposure. MOEs ranged from 3,337 to 48 at the P95 exposure excluding some infant surveys with P95 exposure equal to zero. Two major uncertainties were (i) the high number of left censored data and (ii) the lack of data on important food categories. The CONTAM Panel concluded that the MOE for TCNAs at the P95 exposure is highly likely (98-100% certain) to be less than 10,000 for all age groups, which raises a health concern.
... A case-control study showed that high consumption of vegetables and fruits has been suggested to decrease gastric cancer risk [8]. Additionally, several prospective cohort studies reported that high intake of salt and salted foods [9,10] and high intake of processed meats were associated with the risk of gastric cancer [11]. ...
Background
Epidemiological findings on the association between soybean product consumption and gastric cancer risk remain inconsistent. We evaluated the relationship between soybean product consumption and the risk of gastric cancer in a prospective cohort study in Korea.
Methods
This prospective cohort study included a total of 139,267 participants aged 40–69 years from the Health Examinees-Gem (HEXA-G) study between 2004 and 2013. Information on cancer diagnosis was retrieved from the Korea Central Cancer Registry until 31 December 2018. Multivariate hazard ratios (HRs) and 95% of confidence intervals (CIs) for the risk of gastric cancer according to the consumption of soybean products were estimated using Cox proportional hazards models.
Results
A total of 767 incident cases of gastric cancer occurred over an average follow-up period of 9.21 years. We found that men who consumed two servings per week had 37% lower risk of gastric cancer compared with who consume those who almost never consumed (HR for tofu consumption of more than two servings/week vs. almost never consumed was 0.63 (95% CI 0.45, 0.89); p for trend = 0.04). Among men with a BMI of less than 25 kg/m², increased consumption of soybean paste (p for trend = 0.02) and tofu (HR 0.51 (95% CI 0.32, 0.82 for more than two servings/week vs. almost never consumed); p for trend = 0.01) was associated with decreased risk of gastric cancer.
Conclusion
Our results suggest that a high consumption of soybean products has a protective effect against gastric cancer.
... Studies indicating a probable connection between increased cases of colorectal/ stomach cancer and dietary intake of processed meat have led to further studies to probe the role of such preservatives. 5 Although the direct role of nitrites in causing such cancers is inconclusive, metabolites of nitrites such as nitrosamines are known to be carcinogenic in animal species. 6 Intake of excess nitrites, however, can lead to pathological functions such as intrauterine growth restriction, defects at birth, and methemoglobinemia. ...
Nitrite (NO2-) is a physiologically significant anion having implications for cellular signaling. Here we report our serendipitous discovery of highly selective fluorescence-based nitrite sensing using a benzimidazole which stems from hitherto-unknown direct nitration of a benzimidazole using sodium nitrite. Using one- and two-dimensional NMR techniques, we elucidate the chemical structures of the new nitrated benzimidazoles and show differences in the nitration products using conventional nitration with nitric acid. We also show its utility in robust sensing of nitrite-containing samples.
... The US Environmental Protection Agency has also included five nitrosamines on its latest two candidate lists of pollutants (CCL3 and CCL4). Studies have shown that nitrosamines induce tumorigenesis in the liver, lung, esophagus, nasal mucosa, bladder, tongue, front stomach and pancreas regardless of the administration route [20][21][22]. The carcinogenic risk of certain nitrosamines (especially NDMA) reportedly exceeds that of many known potent carcinogens (such as asbestos, benzo[a]pyrene and polychlorinated biphenyls). ...
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.
... 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). ...
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]. ...
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.
... [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]. ...
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.
... 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. ...
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.
... 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. ...
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.
... NDPA, NMEA and NPYR are known to cause oesophageal cancer. Among these derivatives, NDPA also causes lung cancer (Larsson et al. 2006). ...
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).
... 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]. ...
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.
... 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. ...
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.
... 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. ...
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.
... 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). ...
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.
... 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]. ...
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
... 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). ...
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).
... 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]. ...
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.
... 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 case-control 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. ...
: 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.
... 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. ...
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. ...
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.
... [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]. ...
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.
Recently, 4-(pyrrol-1-yl)pyridine has been found to act as a supramolecular chemodosimeter, sensing nitrite ions in an aqueous solution with naked eye detection and a low limit of detection of 0.330 ppm. This work explores the anion-sensing properties of related derivatives, 4-(2,5-dimethyl-pyrrol-1-yl)pyridine and 4-(2,4-dimethyl-pyrrol-1-yl)pyridine, and provides a comparison with the parent compound. These molecules are determined to be effective sensors for nitrite ions with limits of detection of 1.06 ppm and 1.05 ppm, respectively. The high sensitivity and selectivity to nitrite remain even in the presence of competing anions such as SO3²⁻, NO3²⁻, PO4³⁻, SO4²⁻, Cl⁻, F⁻, I⁻, Br⁻, AcO⁻, and CN⁻. Analogous to the 4-(pyrrol-1-yl)pyridine system, the sensing mechanism appears to be the result of changes in the supramolecular aggregate system upon the interaction of an anion; this is further explored through dynamic light scattering, the Tyndall effect, and NMR spectroscopy. The two methylated derivative systems reported herein, 4-(2,5-dimethyl-pyrrol-1-yl)pyridine and 4-(2,4-dimethyl-pyrrol-1-yl)pyridine, are shown to affect the size of the supramolecular system and provide further insight into the unique mechanism of action.
Meat processing has a long history and involves a wide and ever-increasing range of chemical and physical processes, resulting in a heterogeneous food category with a wide variability in nutritional value. Despite the known benefits of meat consumption, observational epidemiological studies have shown associations between consumption of red and processed meat - but not white meat - and several non-communicable diseases, with higher relative risks for processed meat compared to unprocessed red meat. This has led global and regional nutrition and health organisations to recommend reducing consumption of unprocessed red meat and avoiding processed meat. A plethora of potentially implicated hazardous compounds present in meat or formed during processing or gastrointestinal digestion have been reported in the literature. However, our mechanistic understanding of the impact of meat consumption on human health is still very incomplete and is complicated by the simultaneous occurrence of multiple hazards and interactions with other food compounds and host factors. This narrative review briefly discusses hazards, risks and their assessment in the context of dietary guidelines. It is argued that more mechanistic studies of the interactive effects of meat products with other foods and food compounds in different dietary contexts are needed to refine and increase the evidence base for dietary guidelines. Importantly, the great diversity in the composition and degree of processing of processed meats should be better understood in terms of their impact on human health in order to develop a more nuanced approach to dietary guidelines for this food category.
Volatile N-nitrosamines (VNAs) are probably and possibly carcinogenic compounds to humans and widely found in processed meat products. In this study, the dietary exposure distribution and probabilistic cancer risk for main VNAs (N-nitrosodimethylamine, N-nitrosodiethylamine, N-nitrosomethylethylamine, N-nitrosopiperidine, N-nitrosodibutylamine, and N-nitrosodi-n-propylamine) were calculated by Monte Carlo simulation (MCS). The lowest and highest mean concentrations of these six NAs were related to NDBA and NDEA as 0.350 and 2.655 μg/kg, respectively. In the 95th percentile, chronic daily intake of total VNAs for children (3-14 years) and adults (15-70 years) were calculated to be 2.83 × 10-4 and 5.90 × 10-5 mg/kg bw/day, respectively. The cancer risk caused by the consumption of chicken sausages was less than 10-4, indicating low concern for the Iranian population. According to principal component analysis and heat map results, NDEA, NPIP and frying showed a positive correlation, highlighting that the variables follow a similar trend.
Several epidemiological studies have reported a positive association between the consumption of processed
meats containing N-nitrosamines (NAs) and the incidence of hepatocellular and colon cancer. The health risk
assessment in this investigation was based on the concentration of six volatile N-nitrosamines (VNAs) (Nnitrosodimethylamine,
N-nitrosodiethylamine, N-nitrosomethylethylamine, N-nitrosopiperidine, N-nitrosodibutylamine,
and N-nitrosodi-n-propylamine) found in processed meat products (sausage and kielbasa) in the
Iranian market. Direct supported liquid membrane two-phase hollow fiber electromembrane extraction coupled
to gas chromatography/mass spectrometry was used to analyse six VNAs. The mean concentration of the six
VNAs in sausages and kielbasa was 38.677 ± 27.56 and 48.383 ± 35.76 μg/kg, respectively. The 95th percentile
for the chronic daily intake of total VNAs for children (3–14 years) and adults (15–70 years) were calculated to
be 5.06 × 10 4 and 1.09 × 10 4 mg/kg bw/day, respectively. The cancer risk assessment showed that the risk
associated with NDEA was the highest among the other VNAs studied in Iranian processed meat, with a 95th
percentile for the child and adult groups. Based on an incremental lifetime cancer risk (ILCR) value of ≤10 4 for
the carcinogenic effects of exposure to a total of six VNAs, it indicates low concern for all age groups.
Nitrosamines (Nams) have been demonstrated to possess carcinogenic properties in certain animal species, suggesting a potential link between the consumption of this compound and the development of cancer in humans. Multiple reports have highlighted the presence of nitrosamine contamination in various food groups, particularly meat and meat products. Consequently, the presence of nitrosamines in meat products has raised significant concerns. This study aims to examine the levels of nitrosamines in meat and meat products, explore the mechanisms underlying their formation in these foods, and identify potential strategies for reducing this compound in food. To achieve this objective, scholarly articles about the keywords Nitrosamine, Exposure, Meat and Meat Products, and Mechanism of Formation were retrieved from academic databases such as PubMed, Web of Science, and Scopus, among others. The formation of nitrosamines (Nams) can be influenced by several factors including nitrosating agents, pH levels, the presence or accessibility of nitrite and nitrosable amines, and oxidative status. Moreover, the rate at which Nams form can be impacted by reducing these factors. Additionally, processed meat products may contain natural components and additives that interact with these factors to either hinder or facilitate the formation of Nams. Given the increasing consumption of sausages in daily diets, evaluating the levels of nitrosamines in meat products can serve as a quality measure for assessing nutritional value and the effectiveness of processing and thermal treatments.
Ensuring an appropriate nitrite level in food is essential to keep the body healthy. However, it still remains a huge challenge to offer a portable and low‐cost on‐site food nitrite analysis without any expensive equipment. Herein, a portable integrated electrochemical sensing system (IESS) is developed to achieve rapid on‐site nitrite detection in food, which is composed of a low‐cost disposable microfluidic electrochemical patch for few‐shot nitrite detection, and a reusable smartphone‐assisted electronic device based on self‐designed circuit board for signal processing and wireless transmission. The electrochemical patch based on MXene‐Ti3C2Tx/multiwalled carbon nanotubes‐cyanocobalamin (MXene/MWCNTs‐VB12)‐modified working electrode achieves high sensitivity of 10.533 µA mm⁻¹ and low nitrite detection limit of 4.22 µm owing to strong electron transfer ability of hybrid MXene/MWCNTs conductive matrix and high nitrite selectivity of VB12 bionic enzyme‐based ion‐selective layer. Moreover, the portable IESS can rapidly collect pending testing samples through a microfluidic electrochemical patch within 1.0 s to conduct immediate nitrite analysis, and then wirelessly transmit data from a signal‐processing electronic device to a smartphone via Bluetooth module. Consequently, this proposed portable IESS demonstrates rapid on‐site nitrite analysis and wireless data transmission within one palm‐sized electronic device, which would pave a new avenue in food safety and personal bespoke therapy.
Background
The association between gastrointestinal cancer and types of meat consumption, including red meat, processed meat, or a combination of both, remains disputable. Therefore, we performed a systematic review and meta-analysis of prospective cohort studies to estimate the association between meat consumption and gastrointestinal cancer risk.
Methods
PubMed, EmBase, and the Cochrane library databases were searched systematically for eligible studies that investigated the relation between meat consumption and the risk of developing gastrointestinal cancers, including esophageal cancer (EC), gastric cancer (GC), colorectal cancer (CRC), colon cancer (CC), rectal cancer (RC), pancreatic cancer (PC), and hepatocellular carcinoma (HCC) throughout February, 2023. The pooled relative risk (RR) with 95% confidence interval (CI) was assigned as an effect estimate and calculated using a random-effects model with inverse variance weighting.
Results
Forty cohorts comprising 3,780,590 individuals were selected for the final quantitative analysis. The summary results indicated that a higher red meat consumption was associated with an increased risk of CRC (RR: 1.09; 95% CI: 1.02–1.16; P = 0.007) and CC (RR: 1.13; 95% CI: 1.03–1.25; P = 0.011). Moreover, a higher processed meat consumption was associated with an increased risk of CRC (RR: 1.19; 95% CI: 1.13–1.26; P < 0.001), CC (RR: 1.24; 95% CI: 1.13–1.26; P < 0.001), and RC (RR: 1.24; 95% CI: 1.08–1.42; P = 0.002). Furthermore, a higher total consumption of red and processed meat was associated with an increased risk of CRC (RR: 1.13; 95% CI: 1.06–1.20; P < 0.001), CC (RR: 1.17; 95% CI: 1.04–1.33; P = 0.012), and RC (RR: 1.20; 95% CI: 1.04–1.39; P = 0.016). Finally, the strength of higher consumption of total red and processed meat with the risk of GC, and higher consumption of red meat with the risk of RC in subgroup of high adjusted level was lower than subgroup of moderate adjusted level, while the strength of higher consumption of processed meat with the risk of RC and HCC in subgroup of follow-up ≥ 10.0 years was higher than subgroup of follow-up < 10.0 years.
Conclusions
This study found that meat consumption was associated with an increased risk of CRC, CC, and RC, and dietary intervention could be considered an effective strategy in preventing CRC.
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).
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.
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
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.
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.
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.
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.
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.
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
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.
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.
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.
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.
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.†
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
WE reported1 that the subcutaneous injection of a potent mutagen2, N-methyl-N′-nitro-N-nitrosoguanidine (NG), into rats induced many transplantable sarcomas at the injected loci. Schoental3 reported the occurrence of squamous cell carcinoma in the fore-stomach of rats to which NG was administered by stomach tube. Druckrey et al.4 also described the production of sarcoma in rats by the subcutaneous injection of NG. The careinogenicity of this mutagen seemed to be well documented.
Of the death certificates issued in Sweden in 1978 and stating cancer as the underlying or contributory cause of death, 1634 cases were unrecorded in the national cancer register. In 62 per cent of the cases the criteria for cancer registration were fulfilled. The non-reported cases represented a total deficit of 4.5 per cent calculated on cancer deaths in 1978. The factors responsible for the deficit were investigated. When the diagnosis had been histologically/cytologically confirmed the deficit was less than 2 per cent but was about 30 per cent when the diagnostic basis was only clinical. More than half of the non-notified cancer patients were older than 75 years. Exclusion of this age group and of myeloma and leukaemia cases gave a cancer-register deficit of 2.3 per cent. Non-notification to the Swedish cancer registry can be diminished by supplementation with data from death certificates, as practised in other Nordic countries. On regional basis these death certificates will now be collected and used as a supplement to the cancer notification in Sweden.
The influence of sodium chloride on chemical carcinogenesis of the gastroduodenal tract was examined in male outbred Wistar rats exposed to N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) in the drinking water (100 mg/liter) for 20 weeks. Sodium chloride given concomitantly with MNNG during the first 20 weeks of the experiment increased both the incidence and the size of tumors at 40 weeks. However, sodium chloride given after MNNG during the second 20 weeks of the experiment did not enhance tumor development. This study indicates that, although sodium chloride given with MNNG enhances tumor development, sodium chloride does not promote gastric carcinogenesis.
A case-control study on gastric cancer and diet was conducted in Marseille (France). Ninety-two patients with histologically confirmed adenocarcinoma and 128 controls undergoing functional reeducation for injuries or trauma were interviewed by a trained dietician using a dietary history questionnaire on their usual diet during the year preceding the first symptoms for cases, or preceding interview for controls. Intake of nitrite, nitrate and pre-formed N-nitrosodimethylamine (NDMA) from food was estimated using a food composition table compiled ad hoc. Odds ratios (ORs) were calculated after adjustment for age, sex, occupation and calorie intake. The results indicated that high intake of NDMA was associated with increased risk for gastric cancer. The ORs for the second and third tertile of NDMA intake were: OR2 = 4.13 (95% CI = 0.93 18.27) and OR3 = 7.00 (95% CI = 1.85 to 26.46). Intake of nitrate and nitrite was not associated with increased risk of stomach cancer. Consumption of vegetables was protective in general and independent of their estimated nitrate content.
The influence of different doses of sodium chloride (NaCl) on glandular stomach carcinogenesis was examined in male outbred
Wistar rats after initiation with N-methyl-N'-nitro-N-nitrosoguanidine (MNNG). Rats were given 100 p.p.m. MNNG in their drinking water for 8 weeks and then fed a diet supplemented
with NaCl at doses of 10, 5, 2.5 or 0% for the next 82 weeks. The administration of 10% and 5% NaCl significantly enhanced
the development of gastric adenocarcinomas and adenomas in a dose-dependent manner. Similar but non-significant tendencies
for increase were also seen in the group given 2.5% NaCl compared to the MNNG-alone group values. Clear linear correlations
between incidences of adenocarcinomas and/or adenomas and the concentration of supplemented NaCl were found. Mesenchymal tumors
were also induced in the stomach of rats given MNNG, although the incidence was not statistically different between groups.
Independent of the MNNG treatment, urinary lipid peroxidation levels were significantly increased in the NaCl-treated groups
as compared to the control values. Thus, the results in the present studyindicate that NaCl exerts dose-dependent tumor promoting
activity on gastric carcinogenesis in rats, even at doses as lowas 2.5%, when given after MNNG initiation.
A case-control study on diet and gastric cancer, carried out in selected areas of four regions of Spain (Aragon, Castile, Catalonia, and Galicia) in 1988 and 1989, included 354 cases of histologically confirmed gastric adenocarcinoma and 354 controls matched by age, sex, and area of residence. Cases and controls were selected from 15 hospitals, representing most of the hospital facilities in the study areas. Usual diet was estimated by means of a dietary history questionnaire administered by interview. An increased risk of gastric cancer was observed for high consumption of exogenous nitrosamines (odds ratio = 2.1 for the highest quartile of consumption versus the lowest; p for linear trend = 0.007), nitrites, fat, and cholesterol. However, in a multivariate regression model, the effect of fat and cholesterol disappeared. An inverse association with the risk for gastric cancer was seen for high intake of fiber, vitamin C, folate, carotene, and nitrates. High consumption of vitamin C seemed to neutralize the increased risk related to simultaneous consumption of nitrosamines. For histologic type, the authors found no meaningful differences in the effect of most of the nutrients between intestinal and diffuse cancers. Their findings are consistent with previously reported results about the protective effect of fruit and vegetables and the increased risk associated with foods that are important sources of nitrites and preformed nitrosamines.
A total of 136 incident intestinal type gastric cancer cases and 151 age-comparable population controls were interviewed in Puerto Rico about their dietary habits with special emphasis on dietary salt consumption. All interviews were conducted at home using a quantitative dietary frequency instrument. The weekly intake of foods was estimated from the reported frequency of consumption and portion size according to a food model. The dietary salt exposure was estimated from the intake of nine selected food items which are highly salted food items commonly consumed in Puerto Rico. A strong (odds ratio [OR] = 3.34) and statistically significant (P < 0.001) unadjusted difference was found between cases and controls regarding dietary salt exposure. A statistically significant dose response for the index of salt exposure and gastric cancer was also found. The association remained positive and statistically significant after simultaneously adjusting for the confounding effects of sex, education and cigarette smoking.
The association between intake of N-nitrosodimethylamine (NDMA), the most commonly occurring of the volatile nitrosamines derived from foods, and gastric cancer risk has been investigated using data from a case-control study conducted in Northern Italy between 1985 and 1993, including 746 incident cases of gastric cancer and 2,053 controls admitted to hospital for acute, non-neoplastic and non-digestive tract diseases, not related to long-term modifications of diet. Information was collected on frequency of consumption of 29 food items, including selected sources of NDMA. Compared with subjects in the lowest tertile of NDMA intake, the odds ratios (ORs) were 1.1 in the intermediate and 1.6 in the highest tertile of intake. These estimates were not appreciably modified after allowance for total energy intake, other major dietary and non-dietary correlates of gastric cancer, and estimated intake of nitrite and nitrate: the multivariate OR for the highest NDMA intake tertile was 1.4 (95% CI 1.1-1.7). The association was consistent across strata of sex and age, but somewhat stronger in males and in subjects below age 60 (OR in the highest tertile, 1.8). Limitations of exposure assessment and absence of information on other N-nitrosamines preclude, however, any definite assessment of the possible role of exogenous N-nitrosamines in gastric carcinogenesis.
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 PAHs 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.
To study the effects of dietary chemicals like nitrosodimethylamine and 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine, resulting from the cooking method of red meat, on gastric carcinogenesis, a case-control study was conducted in Uruguay, a country with areas of high rates of gastric cancer. The study involved 340 cases and 698 controls, who were interviewed between January 1993 and December 1996. Dietary nitrosodimethylamine was associated with an increased risk of gastric cancer [odds ratio (OR) = 3.6, 95% confidence interval (CI) = 2.4-5.5], whereas dietary 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (a potent mutagen derived from the frying and broiling of red meat) showed an OR of 3.9 (95% CI = 2.3-6.4). Both chemicals displayed independent effects, and its interaction followed a multiplicative model with an elevated OR of 12.7 (95% CI = 7.7-21.2). These results suggest that salted and barbecued meat, frequent items in the Uruguayan diet, and the resulting chemicals from the cooking methods of both types of meat are significantly associated with a high risk of stomach cancer.
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.
Epidemiologic studies have linked the consumption of red meat and the consumption of highly browned meats containing high levels of heterocyclic aromatic amines (HCAs) to increased risk of colorectal cancer or polyps. The present study determined the effects of long-term feeding of beef-containing diets with low and high levels of HCAs (in the context of a low or high beef tallow diet) on a standard 1,2-dimethylhydrazine (DMH)-induced colon tumorigenesis protocol. Very lean beef was cooked by a variety of methods at different temperatures, and the levels of the major HCAs (2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline, 2-amino-3,4,8-trimethylimidazo[4,5-f]quinoxaline, and 2-amino-1-methyl-6-phenylimidazo[4,5-f]pyridine) were measured by high-performance liquid chromatography. Diets incorporating beef containing low or high levels of HCAs were fed for 12 weeks, during which DMH was administered to induce colon tumors, followed by various dietary regimens as promotional stimuli. Feeding of a beef diet high in HCAs resulted in more DMH-induced colon adenocarcinomas, but only in the context of a low-fat diet. The high-HCA diets increased stomach tumors in all DMH-treated rats. An apparent interaction of high HCA with a high fat level reduced the colon tumor incidence and tumor numbers in those diets containing both factors. These results support the epidemiologic data linking well-cooked meat to increased risk for colon and stomach cancer, but the role of dietary fat level remains puzzling.
Heterocyclic amines (HCAs) are known mutagens and animal carcinogens produced in meats cooked at high temperature. As pork is the second most frequently consumed meat in the United States, five predominant HCAs [2-amino-3-methylimidazo[4,5-f]quinoline (IQ), 2-amino-3,4-dimethylimidazo[4,5-f]quinoline (MeIQ), 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline (MeIQx), 2-amino-3,4,8-trimethylimidazo[4.5-f]quinoxaline (DiMeIQx) and 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP)] were measured in various pork products, cooked by different techniques and to varying doneness levels. Pork chops and ham slices were pan-fried and oven-broiled; bacon was pan-fried, oven-broiled or microwaved; hot dogs were pan-fried, oven-broiled, grilled/barbecued or boiled; sausage links and patties were pan-fried. All the products were cooked to three levels of doneness: just until done, well done or very well done. HCA type and level varied substantially by pork product, cooking method and doneness level. The highest PhIP levels were found in well done and very well done oven-broiled bacon; for very well done 30.3 and 4.0 ng per gram of meat of PhIP and MeIQx, respectively. Pan-fried very well done sausage patties contained 5.4 ng of MeIQx per gram of meat, while sausage links contained 1.3 ng per gram of meat. MeIQx was formed in well done and very well done pan-fried but not broiled pork chops. Hot dogs or ham slices had low or undetectable levels of HCAs. These results demonstrate that epidemiological studies investigating the relationship between HCA intake and cancer risk need to incorporate type of meat, cooking method and degree of doneness/surface browning into questions to assess adequately an individual's HCA exposure.
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.
The proceedings of the UICC 17th International Cancer Congress, held in Rio de Janeiro in August, are now available on videotape. The following videos are available: Highlights of the Congress, Interviews with the Panels, Prostate Diseases (ICUD/UICC/WHO), Global Cancer Facts and Figures (Dr. Max Parkin), The Fatal Combination in Cancer Development: Self-Stimulation and Self-Renewal (Dr. Donald Metcalf), Viral Oncology: The HPV Story (Dr. Harald zur Hausen), Nature and Nurture (Sir Richard Doll), Metastases (Dr. Max Burger), Pain Management in Cancer (Dr. Charles Cleeland), Behavioral Science (Dr. David Hill), Eurotrial 40 (Dr. Marco Rosselli del Turco), History and Development of Intravenous Feeding and Use in Cancer Therapy (Dr. Jonathan Rhoads), Cytopathology (Dr. William Frable), Laparoscopic Surgery (Dr. Bruce Ramshaw), Radiology for the Year 2000 (Dr. Carl d'Orsi), Breast Cancer (Dr. Kirby Bland), Rectal Cancer (Dr. Glen Steele), Prostate Cancer (Dr. Michael Brawer), Cervical Cancer (Dr. Hervy Averette), Lymphoma (Dr. Charles Coltman), Chronic Leukemias (Dr. Heinz Ludwig), and Soft Tissue Sarcoma (Dr. Murray Brennan).
Dietary factors play an important role in gastric cancer risk but have not been investigated extensively in Mexico. The authors conducted a population-based case-control study of gastric cancer in the Mexico City, Mexico, metropolitan area in 1989-1990. A total of 220 patients with histologically confirmed gastric adenocarcinomas were interviewed. Controls were an age-stratified random sample of residents of the Mexico City metropolitan area. The dietary questionnaire was a 70-item semiquantitative food frequency adapted for the Mexican diet. Odds ratios were calculated for quartiles of consumption of food groups and were adjusted for age, gender, calories, chili pepper intake, cigarette smoking, socioeconomic status, added salt, and history of peptic ulcer disease. There was approximately a threefold increased risk of gastric cancer for frequent consumption (highest quartile) of both fresh meat (odds ratio (OR) = 3.1) and processed meat (OR = 3.2). Odds ratios were also significantly elevated for frequent consumption of dairy products (OR = 2.7) and fish (OR = 2.2). The authors observed a decreasing gradient of risk with increasing frequency of vegetable consumption due to a significant inverse trend for the yellow and orange vegetables. High intake of citrus fruits showed a slight inverse association. Consumption of salty snacks more than twice per month was associated with an 80 percent increased risk, and there was a significant positive trend. These findings are consistent with many studies around the world that indicate important roles for salt, processed meats, and vegetable consumption in gastric cancer risk.