Enhancing knowledge on low-value fishing species: the distinct reproductive strategy of two gurnard species.

The depletion and overexploitation of several fish stock demands for a valorisation of non-target and discarded species. Nonetheless, such species are often poorly studied, and information on their biological parameters must be gathered for effective population management. For 1 year, the reproductive strategy of the piper gurnard Trigla lyra and the red gurnard Chelidonichthys cuculus was studied by monthly samples obtained from commercial boats operating on western Portuguese coast. Both species showed a biased sex ratio towards females, especially for larger length classes. Length at first maturity could be estimated only for red gurnard (22.1 and 19.9 cm for females and males, respectively) because all piper gurnard individuals caught were mature. Piper gurnard showed determinate fecundity and a short spawning season, from November to February with a peak in January, whereas red gurnard showed indeterminate fecundity and a wide spawning season, from late December to May. The relative annual fecundity estimated for red gurnard (1893 ± 728 oocytes × g-1 eviscerated weight [EW]) was higher than the one estimated for piper gurnard (1018 ± 250 oocytes×g-1 EW). Although important information for understanding the species dynamics is presented in this study, additional information on other life-history parameters and of species landings is required.

Height and body fatness and colorectal cancer risk: an update of the WCRF-AICR systematic review of published prospective studies.

PURPOSE: There is no published dose-response meta-analysis on the association between height and colorectal cancer risk (CRC) by sex and anatomical sub-site. We conducted a meta-analysis of prospective studies on the association between height and CRC risk with subgroup analysis and updated evidence on the association between body fatness and CRC risk. METHODS: PubMed and several other databases were searched up to November 2016. A random effects model was used to calculate dose-response summary relative risks (RR's). RESULTS: 47 studies were included in the meta-analyses including 50,936 cases among 7,393,510 participants. The findings support the existing evidence regarding a positive association of height, general and abdominal body fatness and CRC risk. The summary RR were 1.04 [95% (CI)1.02-1.05, I² = 91%] per 5 cm increase in height, 1.02 [95% (CI)1.01-1.02, I² = 0%] per 5 kg increase in weight, 1.06 [95% (CI)1.04-1.07, I² = 83%] per 5 kg/m2 increase in BMI, 1.02 [95% (CI)1.02-1.03, I² = 4%] per 10 cm increase in waist circumference, 1.03 [95% (CI)1.01-1.05, I² = 16%] per 0.1 unit increase in waist to hip ratio. The significant association for height and CRC risk was similar in men and women. The significant association for BMI and CRC risk was stronger in men than in women. CONCLUSION: The positive association between height and risk of CRC suggests that life factors during childhood and early adulthood might play a role in CRC aetiology. Higher general and abdominal body fatness during adulthood are risk factors of CRC and these associations are stronger in men than in women.

Anthropometric factors and ovarian cancer risk: a systematic review and nonlinear dose-response meta-analysis of prospective studies.

In the World Cancer Research Fund/American Institute for Cancer Research report from 2007 the evidence relating body fatness to ovarian cancer risk was considered inconclusive, while the evidence supported a probably causal relationship between adult attained height and increased risk. Several additional cohort studies have since been published, and therefore we conducted an updated meta-analysis of the evidence as part of the Continuous Update Project. We searched PubMed and several other databases up to 20th of August 2014. Summary relative risks (RRs) were calculated using a random effects model. The summary relative risk for a 5-U increment in BMI was 1.07 (95% CI: 1.03-1.11, I(2) = 54%, n = 28 studies). There was evidence of a nonlinear association, pnonlinearity < 0.0001, with risk increasing significantly from BMI∼28 and above. The summary RR per 5 U increase in BMI in early adulthood was 1.12 (95% CI: 1.05-1.20, I(2) = 0%, pheterogeneity = 0.54, n = 6), per 5 kg increase in body weight was 1.03 (95% CI: 1.02-1.05, I(2) = 0%, n = 4) and per 10 cm increase in waist circumference was 1.06 (95% CI: 1.00-1.12, I(2) = 0%, n = 6). No association was found for weight gain, hip circumference or waist-to-hip ratio. The summary RR per 10 cm increase in height was 1.16 (95% CI: 1.11-1.21, I(2) = 32%, n = 16). In conclusion, greater body fatness as measured by body mass index and weight are positively associated risk of ovarian cancer, and in addition, greater height is associated with increased risk. Further studies are needed to clarify whether abdominal fatness and weight gain is associated with risk.

Association between total, processed, red and white meat consumption and all-cause, CVD and IHD mortality: a meta-analysis of cohort studies.

An association between processed and red meat consumption and total mortality has been reported by epidemiological studies; however, there are many controversial reports regarding the association between meat consumption and CVD and IHD mortality. The present meta-analysis was carried out to summarise the evidence from prospective cohort studies on the association between consumption of meat (total, red, white and processed) and all-cause, CVD and IHD mortality. Cohort studies were identified by searching the PubMed and ISI Web of Knowledge databases. Risk estimates for the highest v. the lowest consumption category and dose-response meta-analysis were calculated using a random-effects model. Heterogeneity among the studies was also evaluated. A total of thirteen cohort studies were identified (1 674 272 individuals). Subjects in the highest category of processed meat consumption had 22 and 18 % higher risk of mortality from any cause and CVD, respectively. Red meat consumption was found to be associated with a 16 % higher risk of CVD mortality, while no association was found for total and white meat consumption. In the dose-response meta-analysis, an increase of 50 g/d in processed meat intake was found to be positively associated with all-cause and CVD mortality, while an increase of 100 g/d in red meat intake was found to be positively associated with CVD mortality. No significant associations were observed between consumption of any type of meat and IHD mortality. The results of the present meta-analysis indicate that processed meat consumption could increase the risk of mortality from any cause and CVD, while red meat consumption is positively but weakly associated with CVD mortality. These results should be interpreted with caution due to the high heterogeneity observed in most of the analyses as well as the possibility of residual confounding.

Struggling with fish age, a comparison of otolith preparation techniques to unravel age and growth of boarfish, Capros aper (Linnaeus, 1758).

Fish age and growth data are crucial for understanding vital species' traits and their populations. Boarfish is a pelagic species widely distributed in the Northeast Atlantic that is one of the most discarded non-commercial species on the Portuguese coast. Due to its potential valorisation as a new fishery in the Northeast Atlantic, boarfish has become object of interest in several published studies. However, since no age standard protocol has been implemented for boarfish, studies have used a variety of different otolith preparation techniques to estimate age, leading to contradicting and discrepant results. This research aims to consolidate biological insights into boarfish age and growth, lay the foundation for a standardized ageing protocol and serve as a benchmark study for the Portuguese west coast before commercial exploitation. Through the comparison of two otolith ageing methodologies, this study recommends using whole otoliths as the best method, revealing a maximum age of 15 years. The growth pattern estimated, indicated a biphasic growth pattern, with a faster initial growth rate that slows down at 2.4 years, the moment of change, when energy is allocated for sexual maturation. This finding was corroborated by a maturity ogive and analysis of fish size and otolith length relationship.

Red and processed meat intake and risk of colorectal adenomas: a systematic review and meta-analysis of epidemiological studies.

BACKGROUND: Current evidence indicates that red and processed meat intake increases the risk of colorectal cancer; however, the association with colorectal adenomas is unclear. OBJECTIVE: To conduct a systematic review and meta-analysis of epidemiological studies of red and processed meat intake and risk of colorectal adenomas as part of the Continuous Update Project of the World Cancer Research Fund. DESIGN: PubMed and several other databases were searched for relevant studies from their inception up to 31 December 2011. Summary relative risks (RRs) were estimated using a random effects model. RESULTS: Nineteen case-control studies and seven prospective studies were included in the analyses. The summary RR per 100 g/day of red meat was 1.27 (95 % CI 1.16-1.40, I (2) = 5 %, n = 16) for all studies combined, 1.20 (95 % CI 1.06-1.36, I (2) = 0 %, n = 6) for prospective studies, and 1.34 (95 % CI 1.12-1.59, I (2) = 31 %, n = 10) for case-control studies. The summary RR per 50 g/day of processed meat intake was 1.29 (95 % CI 1.10-1.53, I (2) = 27 %, n = 10) for all studies combined, 1.45 (95 % CI 1.10-1.90, I (2) = 0 %, n = 2) for prospective studies, and 1.23 (95 % CI 0.99-1.52, I (2) = 37 %, n = 8) for case-control studies. There was evidence of a nonlinear association between red meat (p nonlinearity < 0.001) and processed meat (p nonlinearity = 0.01) intake and colorectal adenoma risk. CONCLUSION: These results indicate an elevated risk of colorectal adenomas with intake of red and processed meat, but further prospective studies are warranted.

Height and pancreatic cancer risk: a systematic review and meta-analysis of cohort studies.

BACKGROUND: Greater height has been associated with increased risk of several cancers, but epidemiological data on height and pancreatic cancer are inconclusive. We conducted a systematic review and meta-analysis of prospective studies to clarify these results. METHODS: PubMed and several other databases were searched up to September 2011. Prospective studies of height and pancreatic cancer were included. Summary relative risks were estimated by the use of a random effects model. RESULTS: We identified twelve cohort studies that were included in the meta-analysis. The summary RR per 5-cm increase in height was 1.07 (95 % CI: 1.03-1.12, I (2) = 57 %). The results were similar among men and women. The summary estimate was attenuated when we included results from two pooled analyses together with these studies, summary RR = 1.03 (95 % CI: 1.00-1.07, I (2) = 44 %). CONCLUSIONS: This meta-analysis of cohort studies provides further evidence that greater adult attained height is associated with increased pancreatic cancer risk. However, given the unexplained heterogeneity, further studies are needed before a conclusion can be drawn.

Seasonal study of the nutritional composition of unexploited and low commercial value fish species from the Portuguese coast.

Target species diversification is essential for fisheries sustainability and fish market revitalization. Fish discards are a widely recognized problem resulting from fisheries worldwide, and are of major concern for all sector players, from administrations, to fishermen, and scientists. However, non-target species are seldom studied, and information on nutritional profiles and seasonal changes in nutritional properties is generally lacking. This study assessed the seasonal nutritional composition of two unexploited (Serranus cabrilla, Capros aper) and three low commercial value fish species (Trachurus picturatus, Spondyliosoma cantharus, and Trigla lyra), captured on the Portuguese coast over 1 year. Significant seasonal variations were observed in the nutritional composition of all the species studied. Moisture and ash contents varied from 70% to 81% and from 5% to 13%, respectively. The maximum fat contents were 5% for C. aper and 4% for T. picturatus, allowing to classify all studied fishes as lean. The highest protein contents were recorded for C. aper (25%) and S. cantharus (20%). The unexploited and low commercial value fish species studied were shown to be good fat and protein sources, comparable to commonly consumed species, such as cod and salmon, having a great potential to become commonly consumed fish in Portugal.

Reproduction of the Blue Jack Mackerel, Trachurus picturatus, in Western Portugal: Microscopic Gonad Analysis Reveals Indeterminate Fecundity and Skipped Spawning Patterns.

Blue jack mackerel, Trachurus picturatus, is the fifth most landed fish species in mainland Portugal, but information on its reproductive biology is scarce. From September 2018 to August 2019, 626 specimens were collected from commercial vessels to clarify the reproductive strategy of the T. picturatus population off the west coast of Portugal. The proportion and length range of males and females were similar. Only three of the specimens collected were categorized as immature, indicating that the fish caught in the fishery are primarily mature. The spawning season lasted from late January until the end of March, with gonadosomatic indices being similar for males and females. Fecundity was indeterminate, and estimated batch fecundity ranged between 6,798 (at 25.4 cm TL) and 302,358 oocytes (at 33.8 cm TL). The low number of females showing direct evidence of imminent or recent spawning suggests a low number of spawning events. In addition, 12.7% of females were considered non-reproductive due to ovary abnormalities including parasitic infection by Kudoa species, atretic structures and skipped spawning events. This study highlights the importance of accounting for skipped spawning events and ovary abnormalities in the management of species fisheries.

Annual variations in the mineral element content of five fish species from the Portuguese coast.

The most consumed fish species in Portugal do not correspond to the most caught fish species on the Portuguese coast. From the point of view of ocean sustainability and economics, it is important to study unexploited or underexploited fish species that have the potential to be introduced into the food market. This potential can be reflected by their nutritional value, where mineral elements are often overlooked despite their importance in human health. Therefore, it is important to study the elemental concentration of those fish species, which should also include seasonal variations of essential mineral elements such as Ca, P, Mg, Na, K, Fe, Cu, Mn, Zn, and I, and non-essential elements such as As, Ni, Cd, and Pb. This work is part of a project that studied five fish species with the potential to be brought to the market: three species with low commercial value (Trachurus picturatus, Spondyliosoma cantharus and Trigla lyra) and two species with no commercial value (Serranus cabrilla and Capros aper), caught over a year in the coast of Portugal. Mineral elements were quantified by ICP-OES (ICP-MS for I). The results showed that the studied fish species present significant elemental concentrations, similar to those found in the most caught fish species in Portugal. Trachurus picturatus was found to be a source of Fe, and all species are sources of I. Overall, Spondyliosoma cantharus proved to be the most element-rich species. Sensorially, Cu was related to "metallic odour" and Fe to "metallic flavour", and I was related to "seaweed odour" and "seawater flavour". Additionally, toxic elements such as Cd, Pb, Ni and As were not detected. The corresponding Hazard Quotients (HQ) show the safety of the consumption of these fish species concerning the content of potentially toxic elements.

Highly regional population structure of Spondyliosoma cantharus depicted by nuclear and mitochondrial DNA data.

Resolution of population structure represents an effective way to define biological stocks and inform efficient fisheries management. In the present study, the phylogeography of the protogynous sparid Spondyliosoma cantharus, in the East Atlantic and Mediterranean Sea, was investigated with nuclear (S7) and mitochondrial (cytochrome b) DNA markers. Significant divergence of four regional genetic groups was observed: North Eastern Atlantic, Mediterranean Sea, Western African Transition (Cape Verde) and Gulf of Guinea (Angola). The two southern populations (Cape Verde and Angola) each comprised reciprocally monophyletic mtDNA lineages, revealed low levels of diversity in Cape Verde and high diversity for Angola despite being represented by only 14 individuals. A complete divergence between North Atlantic and Mediterranean populations was depicted by the mitochondrial marker, but a highly shared nuclear haplotype revealed an incomplete lineage sorting between these regions. Bayesian skyline plots and associated statistics revealed different dynamics among the four regions. Cape Verde showed no expansion and the expansion time estimated for Angola was much older than for the other regions. Mediterranean region seems to have experienced an early population growth but has remained with a stable population size for the last 30000 years while the North Atlantic population has been steadily growing. The lack of genetic structuring within these regions should not be taken as evidence of demographic panmixia in light of potential resolution thresholds and previous evidence of intra-regional phenotypic heterogeneity.

Seasonal Sensory Evaluation of Low Commercial Value or Unexploited Fish Species from the Portuguese Coast.

Overfishing is increasing over time, and according to FAO (Food and Agriculture Organization), about one third of the world's fish stocks are now overfished. Thus, diversifying the target species is essential for fisheries sustainability contributing to improve resource-efficient processes. Non-target species can be valuable resources for the development of new food products. However, those species are scarcely studied, and it is of high importance to trace their seasonal sensory profile as a first step towards their valorisation. Therefore, in this study, seasonal influence on sensory properties of five low commercial value or unexploited fish species, namely Trachurus picturatus (blue jack mackerel), Spondyliosoma cantharus (black seabream), Trigla lyra (piper gurnard), Serranus cabrilla (comber) and Capros aper (boarfish), was assessed in order to identify the most favourable season for catching each species. Fish samples were assessed by a panel of 16 semi-trained assessors for sensory attributes previously identified. The evaluation takes place every 2 months. Statistical differences were reported between attributes and seasons for all species, except for T. lyra, which did not present any difference in its sensory attributes throughout the year.

Adding Value to Bycatch Fish Species Captured in the Portuguese Coast-Development of New Food Products.

We live in a world of limited biological resources and ecosystems, which are essential to feed people. Consequently, diversifying target species and considering full exploitation are essential for fishery sustainability. The present study focuses on the valorization of three low commercial value fish species (blue jack mackerel, Trachurus picturatus; black seabream, Spondyliosoma cantharus; and piper gurnard, Trigla lyra) and of two unexploited species (comber, Serranus cabrilla and boarfish, Capros aper) through the development of marine-based food products with added value. A preliminary inquiry with 155 consumers from Região de Lisboa e Vale do Tejo (Center of Portugal) was conducted to assess fish consumption, the applicability of fish product innovation, and the importance of valorizing discarded fish. Five products (black seabream ceviche, smoked blue jack mackerel pâté, dehydrated piper gurnard, fried boarfish, and comber pastries) were developed and investigated for their sensory characteristics and consumer liking by hedonic tests to 90 consumers. The most important descriptors were identified for each product (texture, flavor, color, and appearance). Comber pastries had the highest purchase intention (88%), followed by black seabream ceviche (85%) and blue jack mackerel pâté (76%). Sensory evaluations showed a clear tendency of consumers to accept reformulated products, with the introduction of the low-value and unexploited species under study.

Otolith shape and isotopic ratio analyses as a tool to study Spondyliosoma cantharus population structure.

Knowledge on population units is critical for understanding population dynamics and providing an adequate fisheries management. Despite its vast distribution and commercial importance, there is no information on black seabream population structure. Different approaches to otolith analysis were used to elucidate on the stock structure of this species. Otoliths from seven areas along the eastern Atlantic: English Channel, Bay of Biscay, Galicia (Spain), Peniche (west coast of Portugal), Algarve (south coast of Portugal), the Canary Islands and Angola were compared through elliptical Fourier analysis and oxygen and carbon stable isotopes ratio. Otolith shape analysis data achieved 80% of correct assigned specimens in discriminant analysis while poor correct assignment levels were achieved with the stable isotopes ratio. However, the PERMANOVA conducted on δ13C and δ18O values revealed significant differences between all areas, with exception of the two Portuguese areas. The results of this study indicate that black seabream spends most of its life in the same area and that the studied populations should probably be considered as different stock units. However, some mixture was detected in the European region pointing for the usefulness of life history parameters and genetic studies to enlighten the stock structure of the species.

[Learning needs of parents in transition to parenthood: review of the literature]. / Necessidades de aprendizagem dos pais na transição para a parentalidade: uma revisão da literatura.

This article is a review of the literature published in an international context between 1999 and 2008, on the subject of parenthood adaptation. From a query to the database EBSCO and B-ON, using terms related to the subject, there have been studies on motherhood and parenthood in general and in specific groups. After this an identification of abstracts that referred directly to the learning needs in the transition to parenthood was made. The results of the literature review suggest a more specific knowledge about the needs for information of the parents and for a constant adaptation to the changes of society priorities. The transmission and clarification of doubts should meet learning needs, in order to adjust to the parental education and to foment processes ofempowerment of the parents. It is basic that the parenthood education be sensitive to the factors that condition the learning needs. Evidence demonstrates that people learn when and how they want. There is a lack of studies on the topic and, furthermore, the need of a deeper investigation. The aims of this review article is to formulate new knowledge, to ponder new attitudes and to stimulate the interest in investigation and new findings.

Genetic and Morphological Variation of the Forkbeard, Phycis phycis (Pisces, Phycidae): Evidence of Panmixia and Recent Population Expansion along Its Distribution Area.

The knowledge of population structure of a species is essential to effectively assess and manage fisheries. In the present study, genetics, by mitochondrial DNA cytochrome b sequence analysis, and body geometric morphometrics were used to evaluate the existence of distinct populations of the forkbeard (Phycis phycis), an important commercial species in several European countries, especially Portugal and Spain. For geometric morphometric analysis, specimens were collected in the Northeast Atlantic Ocean-Azores, Madeira and mainland Portugal, and for genetic analysis, these samples were complemented with samples collected in the Mediterranean Sea-Spain, Italy and Croatia, in order to cover the entire distribution area of the species. Body shape of the forkbeard from the Northeast Atlantic was found to be highly variable. This variation was probably associated with different environmental factors between the study areas. Despite morphological variation, a low genetic differentiation between samples from different areas was found, most likely due to gene flow that occurred in the past or with the demographic history of the species. Moreover, the presence of unique haplotypes in the Northeast Atlantic and in the Mediterranean suggests that recent gene flow between populations from these areas should be limited. Altogether, a high haplotype diversity, a low nucleotide diversity, a "star-like" network and the results of the mismatch distribution, indicate a possible signature of recent population expansions, which probably started during the end of the Last Glacial Maximum and led to the colonization of the Northeast Atlantic and the Mediterranean.

Blood concentrations of carotenoids and retinol and lung cancer risk: an update of the WCRF-AICR systematic review of published prospective studies.

Carotenoids and retinol are considered biomarkers of fruits and vegetables intake, and are of much interest because of their anti-inflammatory and antioxidant properties; however, there is inconsistent evidence regarding their protective effects against lung cancer. We conducted a meta-analysis of prospective studies of blood concentrations of carotenoids and retinol, and lung cancer risk. We identified relevant prospective studies published up to December 2014 by searching the PubMed and several other databases. We calculated summary estimates of lung cancer risk for the highest compared with lowest carotenoid and retinol concentrations and dose-response meta-analyses using random effects models. We used fractional polynomial models to assess potential nonlinear relationships. Seventeen prospective studies (18 publications) including 3603 cases and 458,434 participants were included in the meta-analysis. Blood concentrations of α-carotene, ß-carotene, total carotenoids, and retinol were significantly inversely associated with lung cancer risk or mortality. The summary relative risk were 0.66 (95% confidence interval [CI]: 0.55-0.80) per 5 µg/100 mL of α-carotene (studies [n] = 5), 0.84 (95% CI: 0.76-0.94) per 20 µg/100 mL of ß-carotene (n = 9), 0.66 (95% CI: 0.54-0.81) per 100 µg/100 mL of total carotenoids (n = 4), and 0.81 (95% CI: 0.73-0.90) per 70 µg/100 mL of retinol (n = 8). In stratified analysis by sex, the significant inverse associations for ß-carotene and retinol were observed only in men and not in women. Nonlinear associations were observed for ß-carotene, ß-cryptoxanthin, and lycopene, with stronger associations observed at lower concentrations. There were not enough data to conduct stratified analyses by smoking. In conclusion, higher blood concentrations of several carotenoids and retinol are associated with reduced lung cancer risk. Further studies in never and former smokers are needed to rule out confounding by smoking.

Dairy products, calcium, and prostate cancer risk: a systematic review and meta-analysis of cohort studies.

BACKGROUND: Dairy product and calcium intakes have been associated with increased prostate cancer risk, but whether specific dairy products or calcium sources are associated with risk is unclear. OBJECTIVE: In the Continuous Update Project, we conducted a meta-analysis of prospective studies on intakes of dairy products and calcium and prostate cancer risk. DESIGN: PubMed and several other databases were searched up to April 2013. Summary RRs were estimated by using a random-effects model. RESULTS: Thirty-two studies were included. Intakes of total dairy products [summary RR: 1.07 (95% CI: 1.02, 1.12; n = 15) per 400 g/d], total milk [summary RR: 1.03 (95% CI: 1.00, 1.07; n = 14) per 200 g/d], low-fat milk [summary RR: 1.06 (95% CI: 1.01, 1.11; n = 6) per 200 g/d], cheese [summary RR: 1.09 (95% CI: 1.02, 1.18; n = 11) per 50 g/d], and dietary calcium [summary RR: 1.05 (95% CI: 1.02, 1.09; n = 15) per 400 mg/d] were associated with increased total prostate cancer risk. Total calcium and dairy calcium intakes, but not nondairy calcium or supplemental calcium intakes, were also positively associated with total prostate cancer risk. Supplemental calcium was associated with increased risk of fatal prostate cancer. CONCLUSIONS: High intakes of dairy products, milk, low-fat milk, cheese, and total, dietary, and dairy calcium, but not supplemental or nondairy calcium, may increase total prostate cancer risk. The diverging results for types of dairy products and sources of calcium suggest that other components of dairy rather than fat and calcium may increase prostate cancer risk. Any additional studies should report detailed results for subtypes of prostate cancer.

Dietary compared with blood concentrations of carotenoids and breast cancer risk: a systematic review and meta-analysis of prospective studies.

BACKGROUND: Measurement errors in the dietary assessment of fruit and vegetable intake may attenuate associations with breast cancer risk and might explain the weak associations observed in epidemiologic studies. Carotenoid concentrations in blood are biomarkers of fruit and vegetable intake; however, no systematic assessment has compared dietary intake with blood concentrations of carotenoids and breast cancer risk. OBJECTIVE: We conducted a systematic review and meta-analysis of prospective studies of dietary intake and blood concentrations of carotenoids and breast cancer risk. DESIGN: We searched PubMed and several other databases for relevant studies up to 31 August 2011. Random-effects models were used to estimate summary estimates. RESULTS: Of the 6 dietary carotenoids assessed, only intake of ß-carotene was significantly associated with a reduced breast cancer risk (summary RR: 0.95; 95% CI: 0.91, 0.99; I(2): 0%) per 5000 µg/d (n = 10). In contrast, the summary RR for blood concentrations of carotenoids was 0.78 (95% CI: 0.61, 0.99; I(2): 53%) per 100 µg total carotenoids/dL (n = 7), 0.74 (95% CI: 0.57, 0.97; I(2): 43%) per 50 µg ß-carotene/dL (n = 13), 0.82 (95% CI: 0.73, 0.92, I(2): 3%) per 10 µg α-carotene/dL (n = 12), and 0.68 (95% CI: 0.52, 0.89; I(2): 0%) per 25 µg lutein/dL (n = 6). CONCLUSIONS: Blood concentrations of carotenoids are more strongly associated with reduced breast cancer risk than are carotenoids assessed by dietary questionnaires. Our results suggest that the use of certain biomarkers may clarify inconsistent and weak results between dietary intake and breast cancer risk.