Sugary drink consumption and the subsequent risk of gastric cancer: The Japan Public Health Center-based Prospective Study.

BACKGROUND/OBJECTIVES: Evidence on the association between sugary drink consumption and gastric cancer (GC) risk is limited, especially in Asian populations. This study aimed to investigate the association between consumption of sugary drinks (sugar-sweetened beverages and 100% fruit juices) and GC risk in a Japanese population. SUBJECTS/METHODS: This study included 74,455 Japanese individuals aged 45-74 years (35,102 males and 39,353 females) who participated in a population-based cohort study (Japan Public Health Center-based Prospective Study). Sugary drinks were assessed using a food frequency questionnaire. Cox proportional hazard regression was used to obtain hazard ratios (HRs) and 95% confidence intervals (CIs) of GC incidence according to the quintile of sugary drink consumption. RESULTS: We identified 2141 patients with GC cases during 16.7 years of follow-up. Sugary drink consumption was not associated with GC risk. The multivariate HR of total, cardia, and non-cardia GC in the highest vs. lowest quintile of sugary drinks consumption in males was 0.98 (95% CI: 0.82-1.17; p-trend 0.48), 0.48 (95% CI: 0.23-0.99; p-trend 0.03), and 1.03 (95% CI: 0.86-1.24; p-trend 0.88), respectively. In females, the respective multivariate HRs were 1.03 (95% CI: 0.79-1.33; p-trend 0.47), 1.28 (95% CI: 0.32-5.12; p-trend 0.53), and 1.01 (95% CI: 0.78-1.32; p-trend 0.56). The results did not change significantly after adjusting for Helicobacter pylori infection and atrophic gastritis status in the subgroup analysis. CONCLUSIONS: In this Japanese prospective cohort study, sugary drink consumption was not associated with GC risk.

Pneumonia and subsequent risk of dementia: Evidence from the Japan Gerontological evaluation study.

BACKGROUND: Recently, several studies reported that pneumonia might increase the risk of cognitive decline and dementia due to increased frailty. OBJECTIVES: This study aims to examine the association between a history of pneumonia and subsequent dementia risk. METHODS: Participants were 9952 aged 65 years or older Japanese men and women from the Japan Gerontological Evaluation Study prospective cohort study, followed up from 2013 to 2019. Dementia was identified by public long-term care insurance registration. A history of pneumonia contracted 1 year before the baseline questionnaire in 2013. A cox regression model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for dementia risk, adjusted for potential confounding variables. We conducted competing risk analyses using a cause-specific hazard model. RESULTS: During the follow-up period of 6 years, 939 persons developed dementia. There was no association between having a prior history of pneumonia with dementia risk (HR 1.20, 95% CI:0.81-1.78). However, we observed an increased risk of dementia in persons with pre-frailty and frailty; the multivariable HR (95% CI) was 1.75 (1.48-2.07) and 2.42 (2.00-2.93) for pre-frailty and frailty, respectively. When pneumonia and frailty were combined, the risk of dementia was the highest for the persons with a history of pneumonia and frailty; the multivariable HR (95% CI) was 2.30 (1.47-3.62). The multivariable HR (95% CI) for those without pneumonia with frailty was 1.95 (1.66-2.28). Meanwhile, the multivariable HR (95% CI) for those with pneumonia without frailty was 1.64 (0.68-3.99). CONCLUSION: Our findings imply that a prior history of pre-frailty and frailty with or without pneumonia, but not a history of pneumonia per se, was associated with an increased risk of dementia among population-based-cohort of older Japanese people.

Association of B Vitamins and Methionine Intake with the Risk of Gastric Cancer: The Japan Public Health Center-based Prospective Study.

Dietary intake of B vitamins and methionine might associate with carcinogenesis due to their role in DNA synthesis and methylation. Owing to the previous inconsistent findings on gastric cancer risk, we aimed to examine the associations between dietary intakes of B vitamins and methionine and the risk of gastric cancer, according to sodium intake.We included 86,820 Japanese individuals who completed a validated food frequency questionnaire with 138 food items in the Japan Public Health Center-based Prospective Study. Cox proportional hazards regression was used to obtain HRs and 95% confidence intervals (CI) of gastric cancer according to separate intakes of folate, vitamin B6, vitamin B12, and methionine after adjusting for confounding factors, including Helicobacter pylori and atrophic gastritis in the subgroup analysis.We identified 2,269 gastric cancer cases within a median of 15.4 years of follow-up. We found no association between any of the dietary intakes of folate, vitamin B6, vitamin B12, or methionine with the risk of gastric cancer. In the stratified analysis by sodium intake, we observed a positive association between folate intake and risk of gastric cancer among participants with a high sodium intake (≥4.5 g/day) [HR = 1.28 (95% CI, 1.06-1.56), P trend = 0.001; P interaction = 0.02]. Meanwhile, there was no association between folate intake and risk of gastric cancer among participants with low sodium intake (<4.5 g/day) [HR = 0.94 (95% CI, 0.73-1.21), P trend = 0.49].In conclusion, we found no association between any dietary intakes of folate, vitamin B6, vitamin B12, and methionine with the risk of gastric cancer. PREVENTION RELEVANCE: The increased intake of B vitamins and methionine in populations with adequate dietary intake of these nutrients showed no association with the risk of gastric cancer.

Association of dietary intakes of vitamin B12, vitamin B6, folate, and methionine with the risk of esophageal cancer: the Japan Public Health Center-based (JPHC) prospective study.

BACKGROUND: B vitamins and methionine are essential substrates in the one-carbon metabolism pathway involved in DNA synthesis and methylation. They may have essential roles in cancer development. We aimed to evaluate the associations of dietary intakes of vitamin B12, vitamin B6, folate, and methionine with the risk of esophageal cancer (EC) using data from the Japan Public Health Center-based Prospective Study. METHODS: We included 87,053 Japanese individuals who completed a food frequency questionnaire and were followed up from 1995-1998 to 2013 and 2015. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated by Cox proportional-hazard regression across quintiles of dietary intakes of B vitamins and methionine. RESULTS: After 1,456,678 person-years of follow-up, 427 EC cases were documented. The multivariable HR (95% CI) of incident EC in the highest versus lowest quintile of dietary intake of vitamin B12 was 1.75 (1.13-2.71; p-trend=0.01). Stratification analysis based on alcohol consumption showed that higher dietary intakes of vitamin B12 and methionine were associated with an increased risk of EC among never-drinkers; HRs (95% CIs) were 2.82 (1.18-6.74; p-trend=0.009; p-interaction=0.18) and 3.45 (1.32-9.06; p-trend=0.003; p-interaction 0.02) for vitamin B12 and methionine, respectively. Meanwhile, there was no association between vitamin B12 and methionine intake with the risk of EC among drinkers. There were no associations between dietary intake of folate or vitamin B6 and the risk of EC. CONCLUSION: Dietary intake of vitamin B12 was positively associated with the risk of EC in the Japanese population.

Colloids Versus Albumin in Large Volume Paracentesis to Prevent Circulatory Dysfunction: Evidence-based Case Report.

Large volume paracentesis may cause paracentesis induced circulatory dysfunction (PICD). Albumin is recommended to prevent this abnormality. Meanwhile, the price of albumin is too expensive and there should be another alternative that may prevent PICD. This report aimed to compare albumin to colloids in preventing PICD. Search strategy was done using PubMed, Scopus, Proquest, dan Academic Health Complete from EBSCO with keywords of "ascites", "albumin", "colloid", "dextran", "hydroxyethyl starch", "gelatin", and "paracentesis induced circulatory dysfunction". Articles was limited to randomized clinical trial and meta-analysis with clinical question of "In hepatic cirrhotic patient undergone large volume paracentesis, whether colloids were similar to albumin to prevent PICD". We found one meta-analysis and four randomized clinical trials (RCT). A meta analysis showed that albumin was still superior of which odds ratio 0.34 (0.23-0.51). Three RCTs showed the same results and one RCT showed albumin was not superior than colloids. We conclude that colloids could not constitute albumin to prevent PICD, but colloids still have a role in patient who undergone paracentesis less than five liters.