Post-diagnosis serum 25-hydroxyvitamin D concentrations in women treated for breast cancer participating in a lifestyle trial in Italy.

OBJECTIVE: To report cross-sectionally serum levels of 25-hydroxyvitamin D [25(OH)D] in women living in Italy within 12 months from breast cancer (BC) diagnosis. METHODS: Baseline data were obtained from 394 women diagnosed with primary BC, enrolled from 2016 to 2019 in a lifestyle trial conducted in Italy. Subjects' characteristics were compared between two 25(OH)D concentrations (hypovitaminosis D<20 and ≥20 ng/mL) with the Chi-squared test or Fisher's exact test for small-expected counts. Using multiple logistic regression-adjusted models, we estimated odds ratios (ORs) of hypovitaminosis D with 95% confidence intervals (CIs) in the total sample and in the unsupplemented subgroup. RESULTS: Hypovitaminosis D was found in 39% of all subjects, 60% in unsupplemented subjects, and 10% in supplemented subjects. Increasing ORs of hypovitaminosis D were found with increasing body mass index, 25-30, >30, and ≥35 versus <25 kg/m2 (ORs: 2.50, 4.64, and 5.81, respectively, in the total cohort and ORs: 2.68, 5.38, and 7.08 in the unsupplemented); living in the most southern Italian region (OR 2.50, 95%CI 1.22-5.13); and with hypertriglyceridemia (OR 2.46; 95%CI 1.16-5.22), chemotherapy history (OR 1.86, 95%CI 1.03-3.38), and inversely with anti-estrogenic therapy (OR 0.43, 95%CI 0.24-0.75) in the total sample. CONCLUSIONS: Hypovitaminosis D in women recently diagnosed with BC and participating in a lifestyle trial in Italy was widespread and highest with obesity, hypertriglyceridemia, and chemotherapy use. Considering that hypovitaminosis D is a risk factor for lower efficacy of bone density treatments and possibly BC mortality, our results suggest the need to promptly address and treat vitamin D deficiency.

Vitamin D and pancreatic cancer: a pooled analysis from the Pancreatic Cancer Case-Control Consortium.

BACKGROUND: The potential role of vitamin D in the aetiology of pancreatic cancer is unclear, with recent studies suggesting both positive and negative associations. PATIENTS AND METHODS: We used data from nine case-control studies from the International Pancreatic Cancer Case-Control Consortium (PanC4) to examine associations between pancreatic cancer risk and dietary vitamin D intake. Study-specific odds ratios (ORs) were estimated using multivariable logistic regression, and ORs were then pooled using a random-effects model. From a subset of four studies, we also calculated pooled estimates of association for supplementary and total vitamin D intake. RESULTS: Risk of pancreatic cancer increased with dietary intake of vitamin D [per 100 international units (IU)/day: OR = 1.13, 95% confidence interval (CI) 1.07-1.19, P = 7.4 × 10(-6), P-heterogeneity = 0.52; ≥230 versus <110 IU/day: OR = 1.31, 95% CI 1.10-1.55, P = 2.4 × 10(-3), P-heterogeneity = 0.81], with the association possibly stronger in people with low retinol/vitamin A intake. CONCLUSION: Increased risk of pancreatic cancer was observed with higher levels of dietary vitamin D intake. Additional studies are required to determine whether or not our finding has a causal basis.

A meta-analysis of coffee consumption and pancreatic cancer.

BACKGROUND: Since when in 1981 a case-control study showed a positive association between coffee and pancreatic cancer, several studies reported inconsistent results on this issue. MATERIALS AND METHODS: We conducted a systematic bibliography search updated March 2011 to identify observational studies providing quantitative estimates for pancreatic cancer risk in relation to coffee consumption. We used a meta-analytic approach to estimate overall relative risk (RR) and 95% confidence interval (CI) for the highest versus the lowest coffee consumption categories, using random-effects models. RESULTS: Based on 37 case-control and 17 cohort studies (10,594 cases), the pooled RR for the highest versus lowest intake was 1.13 (95% CI 0.99-1.29). Considering only the smoking-adjusting studies, the pooled RRs were 1.10 (95% CI 0.92-1.31) for the 22 case-control, 1.04 (95% CI 0.80-1.36) for the 15 cohort, and 1.08 (95% CI 0.94-1.25) for all studies. The pooled RR for the increment of one cup of coffee per day was 1.03 (95% CI 0.99-1.06) for the 28 smoking-adjusting studies reporting three or more coffee consumption categories. No significant heterogeneity was observed across strata of study design, sex, geographic region, and other selected characteristics. CONCLUSIONS: This meta-analysis provides quantitative evidence that coffee consumption is not appreciably related to pancreatic cancer risk, even at high intakes.

Long chain omega 3 polyunsaturated fatty acids supplementation in the treatment of elderly depression: effects on depressive symptoms, on phospholipids fatty acids profile and on health-related quality of life.

OBJECTIVE: Recent observations showed that long chain omega 3 polyunsaturated fatty acids (n-3 LCPUFA) could represent a potential treatment for elderly depression. To determine if a n-3 LCPUFA containing supplement improves depressive symptoms, changes phospholipids acids profile and ameliorates Health related quality of life (HRQoL) in depressed elderly patients. DESIGN: Two-months, randomized, double-blind, placebo-controlled trial. SETTING: Nursing home in Pavia, Italy. SUBJECTS: Forty-six depressed females, aged 66-95 years. INTERVENTION: 22 depressed females were included in the intervention group (n-3 group, that received 2.5 g/day of n-3 LCPUFA, with 1.67 grams of EPA and 0.83 grams of DHA), and 24 patients in the placebo group. The primary endpoint was the improvement of depressive symptoms as evaluated by Geriatric Depression Scale (GDS). Secondary endpoints were the evaluation of modifications of erythrocyte membrane phospholipids fatty acid profile and of of HRQoL, by using the Short-Form 36-Item Health Survey (SF-36). All parameters were assessed before and after the treatment period of 8 weeks. RESULTS: The mean GDS at 2 months was significantly lowered only for the n-3 group. SF-36 physical and mental components were significantly increased in the intervention group. Compliance was good, as confirmed by erythrocyte membrane phospholipid FA concentrations, with significant increase of EPA and DHA in the intervention group. CONCLUSION: The supplementation of n-3 LCPUFA in elderly female patients reduces the occurrence of depressive symptoms, improves phospholipids fatty acids profile and health-related quality of life.

Coffee and cancers of the upper digestive and respiratory tracts: meta-analyses of observational studies.

BACKGROUND: Data of epidemiological studies on the relation between coffee drinking and upper aerodigestive tract cancer risk are scattered and inconclusive. We therefore conducted systematic meta-analyses of observational studies published before October 2009. MATERIALS AND METHODS: We combined relative risks (RR) with 95% confidence intervals (CI) for cancers of the oral cavity/pharynx (OP) and larynx, esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC), comparing the highest versus the lowest categories of coffee consumption, using random-effects models. RESULTS: For OP cancer, the pooled RR was 0.64 (95% CI 0.51-0.80) for highest versus lowest coffee drinking, based on a total of 2633 cases from one cohort and eight case-control studies, with no significant heterogeneity across studies. The RRs were 0.61 (95% CI 0.41-0.89) for European, 0.58 (95% CI 0.36-0.94) for American and 0.74 (95% CI 0.48-1.15) for Asian studies, where coffee consumption is lower. The corresponding RRs were 1.56 (95% CI 0.60-4.02) for laryngeal cancer (732 cases from three case-control studies), 0.87 (95% CI 0.65-1.17) for ESCC (2115 cases from one cohort and six case-control studies) and 1.18 (95% CI 0.81-1.71) for EAC (415 cases from three case-control studies). CONCLUSION: Coffee drinking is inversely related to OP cancer risk, while there is no relation with laryngeal cancer, ESCC and EAC.

Olive oil and health: summary of the II international conference on olive oil and health consensus report, Jaén and Córdoba (Spain) 2008.

Olive oil (OO) is the most representative food of the traditional Mediterranean Diet (MedDiet). Increasing evidence suggests that monounsaturated fatty acids (MUFA) as a nutrient, OO as a food, and the MedDiet as a food pattern are associated with a decreased risk of cardiovascular disease, obesity, metabolic syndrome, type 2 diabetes and hypertension. A MedDiet rich in OO and OO per se has been shown to improve cardiovascular risk factors, such as lipid profiles, blood pressure, postprandial hyperlipidemia, endothelial dysfunction, oxidative stress, and antithrombotic profiles. Some of these beneficial effects can be attributed to the OO minor components. Therefore, the definition of the MedDiet should include OO. Phenolic compounds in OO have shown antioxidant and anti-inflammatory properties, prevent lipoperoxidation, induce favorable changes of lipid profile, improve endothelial function, and disclose antithrombotic properties. Observational studies from Mediterranean cohorts have suggested that dietary MUFA may be protective against age-related cognitive decline and Alzheimer's disease. Recent studies consistently support the concept that the OO-rich MedDiet is compatible with healthier aging and increased longevity. In countries where the population adheres to the MedDiet, such as Spain, Greece and Italy, and OO is the principal source of fat, rates of cancer incidence are lower than in northern European countries. Experimental and human cellular studies have provided new evidence on the potential protective effect of OO on cancer. Furthermore, results of case-control and cohort studies suggest that MUFA intake including OO is associated with a reduction in cancer risk (mainly breast, colorectal and prostate cancers).

Fried foods, olive oil and colorectal cancer.

BACKGROUND: The epidemiologic evidence for an etiologic role of fried foods and heterocyclic amines in colorectal carcinogenesis is inconsistent. PATIENTS AND METHODS: We have investigated the relation between fried foods and colorectal cancer risk using data from a large, multicentric case-control study conducted in Italy and Switzerland between 1992 and 2000, with 1394 cases of colon cancer, 886 cases of rectal cancer and 4765 controls. RESULTS: After allowing for major relevant covariates, the multivariate odds ratios (ORs) for an increment of one portion per week of fried foods were 0.97 [95% confidence interval (CI)=0.93-1.01] for colon cancer and 1.04 (95% CI=1.00-1.09) for rectal cancer. When we analyzed the type of fats mainly used for frying, we found that olive oil, but not other types of oils, appeared to protect from colon cancer risk (OR=0.89, 95% CI=0.82-0.98). CONCLUSIONS: Our results do not indicate a relevant role of fried foods on colorectal cancer risk. We found a possible favorable effect of (fried) olive oil on colon cancer risk but not on rectal cancer risk.

Folate intake and squamous-cell carcinoma of the oesophagus in Italian and Swiss men.

BACKGROUND: Dietary folate has been inversely related to the risk of several cancers. However, studies on the role of dietary folate in oesophageal cancer are scanty. PATIENTS AND METHODS: Using data from a multicentric case-control study conducted in Italy and Switzerland between 1992 and 1999, we investigated the association between dietary folate intake and oesophageal squamous-cell carcinoma (OSCC) among 351 men with incident, histologically confirmed OSCC and 875 hospital controls admitted for acute, non-neoplastic conditions, unrelated to alcohol and smoking consumption. Intake of folate and other nutrients was computed from a validated food frequency questionnaire. RESULTS: The multivariate odds ratios (ORs) of OSCC were 0.68 (95% confidence intervals, CI: 0.46-1.00) for the highest versus the lowest tertile of folate intake, and 0.84 (95% CI: 0.72-0.99) for an increment of folate intake equal to a standard deviation (98 microg/day). The inverse relation was somewhat stronger in strata of high methionine, vitamin B6 and alcohol intake, and did not vary substantially according to age and smoking habits. CONCLUSION: Dietary folate was inversely related to OSCC risk in this population with high alcohol consumption and infrequent use of supplements and multivitamins.

Does an apple a day keep the oncologist away?

BACKGROUND: Apples have commonly been described as a healthy food. To understand better their role on risk of cancer at several sites, we analyzed data from multicenter case-control studies conducted between 1991 and 2002 in Italy. PATIENTS AND METHODS: The studies included 598 patients with incident cancers of the oral cavity and pharynx, 304 of the oesophagus, 460 of the larynx, 1953 of the colorectum, 2569 of the breast, 1031 of the ovary and 1294 of the prostate. The comparison group included a total of 6629 patients admitted to the same network of hospitals as cases for acute, non-neoplastic diseases. Multivariate odds ratios (OR) were obtained with allowance for age, sex, study center, education, body mass index, tobacco smoking, alcohol drinking, total energy intake, vegetable consumption and physical activity. RESULTS: Compared with subjects reporting consumption of <1 apple/day, the ORs for > or =1 apple/day were 0.79 [95% confidence interval (CI) 0.62-1.00] for cancers of the oral cavity and pharynx, 0.75 (95% CI 0.54-1.03) for oesophagus, 0.80 (95% CI 0.71-0.90) for colorectum, 0.58 (95% CI 0.44-0.76) for larynx, 0.82 (95% CI 0.73-0.92) for breast, 0.85 (95% CI 0.72-1.00) for ovary and 0.91 (95% CI 0.77-1.07) for prostate. CONCLUSION: This investigation found a consistent inverse association between apples and risk of various cancers.

Risk of melanoma and vitamin A, coffee and alcohol: a case-control study from Italy.

Limited information is available on the association between the risk of cutaneous malignant melanoma (CMM) and dietary factors. The issue was investigated using data from a case-control study conducted in Italy between 1992 and 1994, including 542 patients with incident, histologically confirmed CMM and 538 controls, admitted to the same hospitals as cases for non-dermatologic and non-neoplastic diseases. We found a significant inverse association between vitamin A intake and CMM risk. The multivariate odds ratio, after allowance for phenotypic characteristics and history of sunburns, for the highest, compared with the lowest, quartile of intake was 0.71 (95% confidence interval (CI) 0.50-1.02) for beta-carotene, 0.57 (95% CI 0.39-0.83) for retinol, and 0.51 (95% CI 0.35-0.74) for total vitamin A. We found no appreciable association of CMM risk with selected food items, including fish, meat, vegetables, fruit, dairy products, wholemeal bread, alcohol, coffee and tea drinking. Consumption of tea appeared to have a protective effect on CMM risk. The relations with measures of dietary vitamin A are, however, moderate compared with the associations between phenotypic characteristics, sun exposure and number of naevi and CMM risk.

Mediterranean diet and cancer risk.

Various aspects of the Mediterranean diet are considered favourable with regard to cancer risk. These aspects were analysed using data from a series of case-control studies conducted in northern Italy between 1983 and 2001 on over 12,000 cases of 20 cancer sites and 10,000 controls. For most epithelial cancers, the risk decreased with increasing vegetable and fruit consumption, with odds ratios (OR) between 0.3 and 0.7 for the highest versus the lowest tertile. Subjects reporting frequent red meat intake showed ORs above unity for several common neoplasms. Conversely, fish (and consequently, n-3 fatty acids) tended to be another favourable dietary indicator. Wholegrain food intake was related to reduced risk of several types of cancer, particularly of the upper digestive tract, probably on account of its high fibre content. Fibres were in fact found to be protective with regard to colorectal and other selected cancers. In contrast to wholegrain, refined grain intake, and consequently glycaemic load, was associated with an increased risk of different types of cancer, including those of the upper digestive tract, colorectum, breast and endometrium. These results thus suggest that a low-risk diet for cancer entails increasing vegetables and fruit, reducing meat, but also refined carbohydrate consumption. Furthermore, olive oil and other unsaturated fats, which may be a unique common characteristic of the Mediterranean diet, should be preferred to animal and saturated fats. A score summarizing the major characteristics of the Mediterranean diet was inversely and consistently related to the risk of selected cancer sites. Regular consumption of pizza, one of the most typical Italian foods, showed a reduced risk of digestive tract cancers. Pizza could however simply be an indicator of a typical Italian diet.

Pizza and risk of acute myocardial infarction.

OBJECTIVES: Pizza eating has been favourably related to the risk of cardiovascular disease, but the data are limited. To evaluate the potential role of pizza consumption on the risk of acute myocardial infarction (AMI), we considered data from an Italian study. DESIGN: We conducted a hospital-based case-control study on 507 cases of nonfatal AMI and 478 controls in Milan, Italy, between 1995 and 1999. RESULTS: The multivariate odds ratios were 0.78 for occasional, 0.62 for regular and 0.44 for frequent eaters. The estimates were similar across strata of age, sex, smoking and other major covariates. CONCLUSIONS: Some of the ingredients of pizza have been shown to have a favourable influence on the risk of cardiovascular disease. However, there is no single explanation for the present findings. Pizza may in fact represent a general indicator of Italian diet, that has been shown to have potential cardiovascular benefits.

Reproducibility and validity of coffee and tea consumption in Italy.

OBJECTIVE: The reproducibility and validity of coffee, decaffeinated coffee and tea intake has not been adequately studied, particularly in Italy, where coffee drinking is peculiar in terms of type and amount of coffee consumed. DESIGN: We compared coffee and tea consumption, measured by two interviewer-administered food frequency questionnaires (FFQ), with average intake derived from two 7-day dietary (DD) records (the reference method) on 395 volunteers. The Pearson correlation coefficients (r) were used to assess both reproducibility and validity of information on coffee intake. RESULTS: A satisfactory level of reproducibility and validity of the pattern consumption was observed for coffee, decaffeinated coffee and tea. The reproducibility for both sex combined showed r of 0.74-0.78 for coffee, 0.57-0.65 for decaffeinated coffee and 0.61-0.67 for tea. The validity was about 0.70 for coffee, around 0.58 for decaffeinated coffee and 0.56-0.60 for tea intake. CONCLUSIONS: The FFQ is a satisfactorily reliable and valid instrument for collecting information on coffee, decaffeinated coffee and tea intake.

Does coffee protect against hepatocellular carcinoma?

We analysed the relation between coffee consumption and hepatocellular carcinoma in two case-control studies conducted between 1984 and 1998 in Italy and Greece, including 834 cases and 1912 controls. Compared to non coffee drinkers, the multivariate odds ratio was 0.7 for drinkers of three or more cups per day.

Fried foods: a risk factor for laryngeal cancer?

The role of fried foods on laryngeal cancer risk was investigated in a case-control study from Italy and Switzerland on 527 cases and 1,297 hospital controls. A significant increased risk was found for high consumption of fried meat, fish, eggs and potatoes, with odds ratios of 1.6, 3.1, 1.9 and 1.9, respectively.

n-3 Polyunsaturated fatty acids, fish, and nonfatal acute myocardial infarction.

BACKGROUND: The relation between n-3 polyunsaturated fatty acids (PUFAs), fish intake, and risk of coronary heart disease is controversial. METHODS AND RESULTS: An Italian case-control study including 507 patients with nonfatal acute myocardial infarction (AMI) and 478 hospital controls found a multivariate odds ratio (OR) of 0.67 (95% CI, 0.47 to 0.95) for the highest n-3 PUFA intake and 0.68 (95% CI, 0.47 to 0.98) for an intake of >1 portion of fish per week compared with >/=2 portions per week. CONCLUSIONS: Small amounts of n-3 PUFAs may be inversely related to AMI risk in this low-risk population.

Coffee and alcohol intake and risk of ovarian cancer: an Italian case-control study.

The relation between coffee and alcohol intake and ovarian cancer risk was analyzed in a case-control study conducted in Italy between 1992 and 1999. Cases were 1,031 women, aged 18-79 years, with incident, histologically confirmed invasive epithelial ovarian cancer, and controls were 2,411 women, aged 17-79 years, admitted to the hospital for acute nonneoplastic non-hormone-related diseases. Coffee intake (mostly espresso and mocha) was not associated with ovarian cancer risk, with an odds ratio (OR) of 0.93 [95% confidence interval (CI) = 0.69-1.27] in drinkers of > or = 4 cups/day compared with drinkers of < 1 cup/day. No meaningful relation was observed with cappuccino (OR = 1.06, 95% CI = 0.85-1.32 for drinkers compared with nondrinkers), decaffeinated coffee (OR = 0.64, 95% CI 0.42-0.96), and tea intake (OR = 0.90, 95% CI = 0.75-1.08). Total alcohol intake was not associated with ovarian cancer risk (OR = 1.09, 95% CI = 0.76-1.57 in drinkers of > or = 36 g/day compared with never drinkers). No relationship was found with wine (OR = 1.03, 95% CI = 0.70-1.50 for > 39 g/day compared with never drinkers), beer, amari, grappa, and spirits. No significant heterogeneity was found for coffee or total alcohol intake across strata of age, education, parity, oral contraceptive use, family history of ovarian/breast cancer, body mass index, and calorie intake. This study, based on a large data set; provides no support for a causal association between invasive epithelial ovarian cancer risk and coffee and alcohol intake.

Alcohol, smoking, coffee and risk of non-fatal acute myocardial infarction in Italy.

OBJECTIVES: To assess the relation between cigarette smoking, alcohol, coffee, decaffeinated coffee and tea consumption, and the risk of non-fatal acute myocardial infarction (AMI). DESIGN AND SETTING: Hospital-based case-control study conducted in 1995-1999 in Milan, Italy. PATIENTS: 507 cases with a first episode of non-fatal AMI, and 478 controls admitted to hospital for acute diseases. METHODS: Information was collected by interviewer-administered questionnaires. Odds ratios (OR) and 95% confidence intervals (CI) were calculated by multiple logistic regression. RESULTS: Compared to alcohol non-drinkers the OR was 0.6 (95% CI: 0.4-0.9) in drinkers, and 0.5 in drinkers of > 3 drinks/day. The OR for > 1 drink/day of wine was 0.5, and those for beer, amari, grappa and spirits ranged between 0.4 and 0.6. Compared to never smokers, the OR was 2.2 (95% CI: 1.5-3.1) among current smokers, and 4.6 among current smokers of > or = 25 cigarettes/day. The risk was similar to that of never smokers > or = 5 years after cessation (OR: 1.1 after 5-9 years, 0.7 after > or = 10 years). The OR was 2.3 for low tar cigarettes and 2.0 for high tar ones. The OR for coffee intake (expresso and mocha) was around unity up to 3 cups/ day, but rose to 1.9 (95% CI: 1.1-3.3) for > or = 6 cups/ day. Moderate decaffeinated coffee and tea intake was not associated with AMI risk. Compared to non-smokers drinking < or = 3 cups of coffee/day, the OR was 1.6 among non-smokers drinking > 3 cups of coffee/ day and 3.3 (95% CI: 2.1-5.0) among current smokers drinking < or = 3 cups of coffee/day. Compared to alcohol drinkers with a coffee intake of < or = 3 cups/ day, alcohol non-drinkers with higher coffee intake had an OR of 2.2, and compared to non-smokers alcohol drinkers, the OR was 3.3 in current smokers alcohol non-drinkers. CONCLUSIONS: In this Italian population alcohol intake was inversely associated to AMI risk, while smoking and heavy (but not moderate) coffee drinking increased the risk.