RESUMEN
Intake of heterocyclic amines (HCAs) and other mutagenic compounds formed during cooking has been hypothesized to be responsible for the positive association observed between red meat and colorectal cancer. We evaluated whether well-done/very well-done preferences for various meat and fish items, higher intakes of meat and fish, and meat-derived and fish-derived HCA are associated with the risk of colorectal adenoma (CRA) in a Japanese-Brazilian population. We selected 302 patients with adenoma and 403 control individuals who underwent total colonoscopy between 2007 and 2013, and collected information on aspects of meat intake using a detailed questionnaire. We also estimated HCA intake of the study participants using an HCA database that matched the cooking methods of this population. Latent class analysis on the basis of response to doneness preferences for different cooking methods of commonly consumed meat and fish items identified four distinct subgroups. Compared with the subgroup characterized by a preference for rare/medium well-done cooking for most meat and fish items, the odds ratio of CRA for the well-done/very well-done preference subgroup was 1.19 (95% confidence interval: 0.51-2.75). High intake of mixed-meat dishes was suggestively associated inversely with CRA, whereas a high intake of poultry was associated positively with CRA. No clear association with intake of total or specific HCAs and no effect modification by N-acetyltransferase 2 acetylation genotype were observed. We found no statistically significant associations between meat and HCA intake and CRA. These findings do not support a positive association between meat and meat-derived HCA intake and the risk of CRA.
Asunto(s)
Adenoma/epidemiología , Aminas/administración & dosificación , Arilamina N-Acetiltransferasa/genética , Carcinógenos/administración & dosificación , Neoplasias Colorrectales/epidemiología , Culinaria/estadística & datos numéricos , Adenoma/genética , Adulto , Anciano , Aminas/efectos adversos , Aminas/metabolismo , Pueblo Asiatico/estadística & datos numéricos , Brasil/epidemiología , Carcinógenos/metabolismo , Estudios de Casos y Controles , Colonoscopía/estadística & datos numéricos , Neoplasias Colorrectales/genética , Comportamiento del Consumidor/estadística & datos numéricos , Culinaria/métodos , Conducta Alimentaria , Femenino , Productos Pesqueros/efectos adversos , Predisposición Genética a la Enfermedad , Calor/efectos adversos , Humanos , Masculino , Persona de Mediana Edad , Polimorfismo de Nucleótido Simple , Carne Roja/efectos adversos , Factores de RiesgoRESUMEN
BACKGROUND: Cardiometabolic diseases and depression are public health problems that are often related. The benefits of behavioral interventions on lifestyle are well documented. However, the influence of depression in these interventions is unclear. OBJECTIVE: To evaluate whether depression affects the impact of a lifestyle intervention on cardiometabolic response in an at-risk sample. METHODS: 129 individuals identified by the public health system to be at risk for cardiometabolic disease were allocated to 18-month interventions on diet and physical activity. Socio-demographic and clinical data were obtained. Depressive symptoms were assessed by the Beck Depression Inventory. Changes by at least 10% in each of 6 cardiometabolic risk factors were used to define responses to intervention. Logistic regression models were employed for each gender. RESULTS: Approximately 42% of individuals had depressive symptoms. They had higher adiposity, cholesterol, and blood pressure levels and lower quality of life and physical activity levels than non-depressed individuals. In adjusted models, only women with depression at baseline had lower chance of improving plasma glucose (OR: 0.32) and lower chance of improving mean blood pressure (OR: 0.29) after the follow-up, compared with non-depressed women. LIMITATIONS: The small sample size may have diminished the power of the results and the instrument used to measure depression does not provide clinical diagnosis according to DSM criteria. CONCLUSION: Depression at baseline of lifestyle interventions predicted a lower chance of improving long-term cardiometabolic risk, particularly in women, suggesting that screening and management of depression as part of lifestyle interventions can potentially improve cardiometabolic risk profile.
Asunto(s)
Terapia Conductista , Depresión/terapia , Diabetes Mellitus Tipo 2/terapia , Estilo de Vida , Adulto , Anciano , Biomarcadores/sangre , Depresión/sangre , Depresión/complicaciones , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/prevención & control , Femenino , Humanos , Masculino , Persona de Mediana Edad , Educación del Paciente como Asunto , Psicoterapia de Grupo , Adulto JovenRESUMEN
OBJECTIVE: To assess the validity of a 161-item quantitative FFQ (QFFQ) that was developed to evaluate dietary risk factors for a colorectal adenoma casecontrol study. DESIGN: A cross-sectional validation study of the QFFQ against 4 d food diary using Pearson correlation coefficients, cross-classification, weighted k statistics and BlandAltman plotting. SETTING: Two hospitals in SaËo Paulo, Brazil. SUBJECTS: Ninety-seven healthy Japanese-Brazilian adults (4075 years) were recruited. One participant was excluded from the analysis due to unusual energy intake report. RESULTS: Mean daily nutrient intakes from the QFFQ were higher than from the food diary. The mean Pearson correlation coefficient for nutrient intakes between the QFFQ and the average of the 4 d food diary was 0?43, and increased to 0?45 after correcting correlations for attenuation due to residual day-to-day variation in the food diary measurements. Adjustment for total energy and further adjustment for age and gender decreased the correlation; however, 77% of observations remained in the same or adjacent quartiles with a mean weighted k of 0?22. BlandAltman plots on loge-transformed data showed no linear trend between the differences and means for energy, fat, protein, total folate and vitamin C. Compared with the food diary, the QFFQ showed consistently reasonable performance for dietary fibre, total folate, retinol, riboflavin and vitamin C. CONCLUSIONS: This investigation supports the relative validity of the QFFQ as a method for assessing long-term dietary intake. The instrument will be a useful tool in the analysis of dietadenoma associations in the casecontrol study.
Asunto(s)
Neoplasias Colorrectales/prevención & control , Conducta Alimentaria , Encuestas y Cuestionarios , Adulto , Anciano , Ácido Ascórbico/administración & dosificación , Pueblo Asiatico , Brasil , Estudios de Casos y Controles , Neoplasias Colorrectales/patología , Estudios Transversales , Registros de Dieta , Grasas de la Dieta/administración & dosificación , Fibras de la Dieta/administración & dosificación , Femenino , Ácido Fólico/administración & dosificación , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Evaluación Nutricional , Riboflavina/administración & dosificación , Factores de Riesgo , Vitamina A/administración & dosificaciónRESUMEN
OBJECTIVE: To assess the validity of a 148-item quantitative FFQ (QFFQ) that was developed for the Barbados National Cancer Study (BNCS) to determine dietary intake over 12 months and examine the dietary risk factors. DESIGN: A cross-sectional validation study of the QFFQ against 4 d food diaries. Spearman's rank correlations (ρ), intra-class correlation coefficients (ICC) and weighted κ were computed as measures of concordance, adjusting for daily variations in the food diaries. Cross-classification tables and Bland-Altman plots were created for further assessment. SETTING: BNCS is a case-control study of environmental risk factors for breast and prostate cancer in a predominantly African-origin population in Barbados. SUBJECTS: Fifty-four individuals (21 years and older) were recruited among controls in the BNCS who were frequency-matched on sex and age group to breast and prostate cancer cases. RESULTS: Similar mean daily energy intake was derived from the food diary (8201 kJ (1960 kcal)) and QFFQ (7774 kJ (1858 kcal)). Rho for energy and macronutrients ranged from 0·66 (energy) to 0·17 (dietary fibre). The percentage of energy from carbohydrates and protein showed the highest and lowest ICC among macronutrients (0·63 and 0·27, respectively). The highest weighted κ was observed for energy (0·45). When the nutrient intake was divided into quartiles, approximately 34 % of the observations were in the same quartile. CONCLUSIONS: This investigation supports the validity of the QFFQ as a method for assessing long-term dietary intake except for dietary fibre, folate, vitamins A, E and B12. The instrument will be a useful tool in the analysis of diet-cancer associations in the BNCS.