Serum concentrations of fatty acids and colorectal adenoma risk: a case-control study in Japan.

BACKGROUND: Epidemiologic studies of n-3 fatty acids (FAs) and risk of colorectal cancer have generated inconsistent results, and relations with precursor colorectal adenomas (CRA) have not been evaluated in detail. We here focused on possible associations of serum FAs with CRA in the Japanese population. METHODS: We conducted a case-control study of 203 asymptomatic CRA cases (148 men, 55 women) and 179 healthy controls (67 men, 112 women) during 1997-2003 in Nagoya, Japan. Baseline information was obtained using a lifestyle questionnaire and serum FA levels were measured by gas chromatography. RESULTS: A non-significant inverse association with CRA was observed for eicosapentaenoic acid (EPA) among women. Moreover, the concentrations of docosahexaenoeic acid (DHA), a major component of n-3 highly-unsaturated FAs (HUFAs), were significantly lower in cases in both sexes. In addition, serum concentrations of total FAs, saturated FAs (SFAs) and mono-unsaturated FAs (MUFAs) had strong positive links with CRA risk. In contrast, arachidonic acid (AA) and DHA were inversely related, with 66% and 59% risk reduction, respectively. Ratios of SFAs/n-3 PUFAs and SFAs/n-3 HUFAs exhibited significant positive relations with CRA risk but there was no clear link with n-6 PUFAs/n-3 PUFAs. CONCLUSIONS: Our findings suggest a promoting influence of SFAs and MUFAs along with a protective effect of DHA on CRA risk. However, further research is needed to investigate the observed discrepancy with the generally accepted roles of the AA cascade in carcinogenesis.

[Utility of cycle ergometer stress testing as a measure to assess health status and physical functioning for elderly people].

PURPOSE: This study was carried out to determine the prevalence of abnormal cardiovascular findings for elderly persons on exercise stress testing, and examine the relationship between exercise capacity estimated by the test and other physical functions or self-rated functional capacity cross-sectionally. METHODS: Participants of this study were 83 elderly persons (24 males and 59 females, mean age, 80 years old) who were planning to undergo a falls prevention program. A questionnaire asking about functional capacity, physical functional testing (maximum stride length, maximum speed walking for 10 meters, one leg standing time, and grip strength), and cycle ergometer exercise stress testing were applied. The initial work load of exercise testing was 15 watts, and this was progressively increased by 15 watts every 3 minutes. Exercise capacity was estimated with reference to working time and subjects were divided into tertiles for each gender. Comparisons of physical functional testing and self-rated functional capacity among the groups were then performed. RESULTS: Of 83 participants, 65 subjects (78.3%) could complete the exercise stress testing. Next to leg fatigue (46%), blood pressure elevation (26.2%) was the most common reason for termination of the test. No evidence of ischemia was found in any subject during exercise stress testing. The values for walking speed and walking pitch were highest among male participants in the third (uppermost) tertile group with statistical significance. In addition, the value for one foot standing time was highest among female participants in the third tertile group, again with statistical significance. Regarding self-rated functional capacity, the rates for subjects who reported being able to rise from a seat in a vehicle, jump over a puddle, and step on an escalator were highest among female participants in the third tertile group, with statistical significance, whereas no significant differences were seen among male participants. No one suffered falls in the previous one year in either gender in the third tertile group. CONCLUSION: As the major finding, higher exercise capacity mainly for lower-extremity work, was associated with better physical functions and self-rated functional capacity.

Prevalence of hyperesthesia detected by current perception threshold test in subjects with glucose metabolic impairments in a community.

OBJECTIVE: Recent studies reported that hyperesthesia may be an indicator of early diabetic polyneuropathy. Using the current perception threshold (CPT) test, which stimulates peripheral sensory nerve fibers by three different frequencies (2,000, 250, and 5 Hz), we investigated the relationship between hyperesthesia and glucose metabolic impairment in a community. METHODS: The number of subjects, aged 40 to 79 years, was 2,074. The CPT values at each frequency were classified into three categories (hyperesthesia, normal, and hypoesthesia). Subjects were also subgrouped into three groups (normal, insulin resistance, and diabetes) according to glucose metabolic status, and those with hypoesthesia at each frequency were excluded in the analyses. RESULTS: The prevalence of hyperesthesia at 2,000, 250, and 5 Hz in male diabetic subjects were 14.1, 15.6, and 7.7%, respectively, and 22.2, 24.5, and 16.4% respectively in female diabetic subjects. In logistic regression analysis adjusted for age, females with diabetes showed a significantly high odds ratio (OR) for hyperesthesia at 2,000 Hz (OR, 2.42; 95% confidence interval (95%CI), 1.18 to 4.97) and 250 Hz (OR, 2.65; 95%CI, 1.31 to 5.37). In male diabetic subjects, a significantly high odds ratio for hyperesthesia was seen at 250 Hz (OR, 2.09; 95%CI, 1.07 to 4.05). CONCLUSION: Our results suggested that hyperesthesia may emerge coupled with developing diabetes, supporting the precedent hypothesis.

Japanese versus Mediterranean Diets and Cancer.

Morbidity and mortality statistics, including incidences of fat-related cancers (FRCs), and dietary intake and sources of fats and oils were compared for Japanese, Mediterranean and American people. Incidences of FRCs, except for steeply increasing colon cancer, have remained low in Japan. Similarly, Mediterranean people enjoy relatively low risks of FRCs compared with American people. The low risks of FRCs in Japanese may be explained by limited intake of fats and oils as a whole, and a low ratio of n-6 polyunsaturated fatty acids (PUFAs) versus n-3 PUFAs through consumption of the latter from marine foods. They also frequently consume vegetables and fruit, and dietary fiber. Mediterranean people moderately consume fats and oils from a large amount of olive oil, containing not only oleic acid but also polyphenols (including flavonoids), &mgr;-tocopherol and carotenoids (including &mgr;-carotene), which are antioxidants and anti-carcinogenic as in red wine, vegetables (including herbs) and fruit. The diet also features medium intake of fish and shellfish along with cereals/pasta/bread. From the standpoint of intake of total fat, the low risks of FRCs in Japanese seem "plausible," while the low risks in Mediterranean people may be termed "paradoxical." In summary, limited consumption of fats and oils, moderate intakes of marine foods, and vegetables and fruit, in line with a modest intake of energy may be advocated for promoting health, prolonging life and prevention of lifestyle-related diseases including FRCs.