Spatial pattern analysis of the impact of community food environments on foetal macrosomia, preterm births and low birth weight.

Community food environments (CFEs) have a strong impact on child health and nutrition and this impact is currently negative in many areas. In the Republic of Argentina, there is a lack of research evaluating CFEs regionally and comprehensively by tools based on geographic information systems (GIS). This study aimed to characterize the spatial patterns of CFEs, through variables associated with its three dimensions (political, individual and environmental), and their association with the spatial distribution in urban localities in Argentina. CFEs were assessed in 657 localities with ≥5,000 inhabitants. Data on births and CFEs were obtained from nationally available open-source data and through remote sensing. The spatial distribution and presence of clusters were assessed using hotspot analysis, purely spatial analysis (SaTScan), Moran's Index, semivariograms and spatially restrained multivariate clustering. Clusters of low risk for LBW, macrosomia, and preterm births were observed in the central-east part of the country, while high-risk clusters identified in the North, Centre and South. In the central-eastern region, low-risk clusters were found coinciding with hotspots of public policy coverage, high night-time light, social security coverage and complete secondary education of the household head in areas with low risk for negative outcomes of the birth variables studied, with the opposite with regard to households with unsatisfied basic needs and predominant land use classes in peri-urban areas of crops and herbaceous cover. These results show that the exploration of spatial patterns of CFEs is a necessary preliminary step before developing explanatory models and generating novel findings valuable for decision-making.

Maternal dietary components in the development of gestational diabetes mellitus: a systematic review of observational studies to timely promotion of health.

BACKGROUND: There is ample evidence that considers diet as an important factor in the prevention of gestational diabetes mellitus (GDM). The aim of this review is to synthesise the existing evidence on the relationship between GDM and maternal dietary components. METHODS: We performed a systematic bibliographic search in Medline, Latin American and Caribbean Health Sciences Literature (Lilacs) and the Latin American Nutrition Archive (ALAN) of regional and local literature, limiting the searches to observational studies published between 2016 and 2022. Search terms related to nutrients, foods, dietary patterns and the relationship to GDM risk were used. The review included 44 articles, 12 of which were from America. The articles considered different topics about maternal dietary components as follows: 14 are about nutrient intake, 8 about food intake, 4 combined nutrient and food analysis and 18 about dietary patterns. RESULTS: Iron, processed meat and a low carbohydrate diet were positively associated with GDM. Antioxidant nutrients, folic acid, fruits, vegetables, legumes and eggs were negatively associated with GDM. Generally, western dietary patterns increase GDM risk, and prudent dietary patterns or plant-based diets decrease the risk. CONCLUSIONS: Diet is considered one of the causes of GDM. However, there is no homogeneity in how people eat nor in how researchers assess diet in different contextual conditions of the world.

[A population-based study on seroprevalence and factors associated with SARS-CoV-2 infection in Córdoba, Argentina]. / Estudio de base poblacional de seroprevalencia y factores asociados a la infección por SARS-CoV-2 en Córdoba, Argentina.

Seroepidemiological studies help identify the indirect distribution of diseases, detecting serological markers of immunity and demonstrating undiagnosed infections in the general population. The objectives were to estimate the seroprevalence of SARS-CoV-2 antibodies in Córdoba, Argentina, from December 2020 to January 2021 and to identify factors associated with the virus' contagiousness. A population-based cross-sectional observational study was performed in 3,225 individuals over two years of age living in Córdoba city, selected by multiple-stage random sampling proportional to distribution by gender, age group, and socioeconomic status in the city's population. Clinical characteristics, anthropometry, and comorbidities were collected by interview. Qualitative serological testing was performed for detection of SARS-CoV-2 nucleocapsid IgG antibodies (ARCHITECT, Abbott). SARS-CoV-2 seroprevalence was estimated for the total population and by age group, sex, socioeconomic status, and presence of target diseases. Prevalence ratios (PR) were estimated using a log-binomial regression model. SARS-CoV-2 seropositivity was 16.68% (95%CI: 15.41-18.01). Age 2 to 18 years, living in neighborhoods with low socioeconomic status, and obesity increased the odds of seropositivity (PR = 1.50; 95%CI: 1.10-2.04, PR = 1.91; 95%CI: 1.34-2.67 and PR = 1.39; 95%CI: 1.04-1.85). The results indicate that the city of Córdoba displays differential attributes that increase the likelihood of a positive SARS-CoV-2 antibody test. This allows targeting epidemiological surveillance strategies to reduce the spread of the virus.

Los estudios seroepidemiológicos permiten conocer la distribución indirecta de las enfermedades, detectando marcadores séricos de inmunidad y demostrando infecciones no diagnosticadas en la población general. El objetivo fue estimar la seroprevalencia de anticuerpos contra el SARS-CoV-2, en Córdoba, Argentina, entre diciembre de 2020 y enero de 2021, e identificar factores asociados a la contagiosidad del virus. Se realizó un estudio observacional transversal, de base poblacional, con 3.225 individuos mayores de 2 años, residentes en Córdoba Capital, que fueron seleccionados mediante un diseño de muestreo aleatorio en múltiples etapas, proporcional a la distribución por género, franja etaria y nivel socioeconómico de la población de Córdoba. Las características clínicas, antropometría y comorbilidades se recogieron mediante entrevistas. Se realizó un test serológico cualitativo para la detección de anticuerpos IgG antinucleocápside para SARS-CoV-2 (ARCHITECT, Abbott). La seroprevalencia del SARS-CoV-2 se estimó en la población y por franja de edad, sexo, nivel socioeconómico y presencia de las patologías estudiadas. Las razones de prevalencia (RP) se estimaron usando un modelo de regresión log-binomial. La seropositividad para SARS-CoV-2 fue de 16,68% (IC95%: 15,41-18,01). Tener entre 2 y 18 años, residir en barrios con nivel socioeconómico bajo y la presencia de obesidad, aumentaron la oportunidad de seropositividad (RP = 1,50; IC95%: 1,10-2,04, RP = 1,91; IC95%: 1,34-2,67 y RP = 1,39; IC95%: 1,04-1,85). Los resultados indican que en Córdoba Capital existen atributos diferenciales que aumentan la posibilidad de ser seropositivo para SARS-CoV-2. Esto permite dirigir estrategias de vigilancia epidemiológica para reducir la propagación del virus.

Os estudos soroepidemiológicos permitem conhecer a distribuição indireta das doenças, detectando marcadores séricos de imunidade e demonstrando infecções não diagnosticadas na população geral. O objetivo foi estimar a soroprevalência de anticorpos contra o SARS-CoV-2, em Córdoba, Argentina, entre dezembro de 2020 e janeiro de 2021, e identificar fatores associados à contagiosidade do vírus. Um estudo observacional transversal foi realizado, de base populacional, com 3.225 indivíduos maiores de 2 anos, residentes em Córdoba Capital, que foram selecionados por meio de um delineamento de amostragem aleatória em múltiplos estágios, proporcional à distribuição de gênero, a faixa etária e o nível socioeconômico da população de Córdoba. As características clínicas, antropometria e comorbidades foram coletadas por meio de entrevistas. Um teste sorológico qualitativo foi realizado para a detecção de anticorpos IgG anti-nucleocapsídeo para SARS-CoV-2 (ARCHITECT, Abbott). A soroprevalência do SARS-CoV-2 foi estimada na população e por faixa etária, sexo, nível socioeconômico e presença das patologias estudadas. Razões de prevalência (RP) foram estimadas usando um modelo de regressão log-binomial. A soropositividade para SARS-CoV-2 foi de 16,68% (IC95%: 15,41-18,01). Ter entre 2 e 18 años, residir em bairros com nível socioeconômico baixo e a presença de obesidade aumentaram a chance de soropositividade (RP = 1,50; IC95%: 1,10-2,04, RP = 1,91; IC95%: 1,34-2,67 e RP = 1,39; IC95%: 1,04-1,85). Os resultados indicam que em Córdoba Capital existem atributos diferenciais que aumentam a possibilidade de ser soropositivo para SARS-CoV-2. Isso permite direcionar estratégias de vigilância epidemiológica para reduzir a propagação do vírus.

Estudio de base poblacional de seroprevalencia y factores asociados a la infección por SARS-CoV-2 en Córdoba, Argentina / A population-based study on seroprevalence and factors associated with SARS-CoV-2 infection in Córdoba, Argentina / Estudo populacional de soroprevalência e fatores associados à infecção por SARS-CoV-2 em Córdoba, Argentina

Los estudios seroepidemiológicos permiten conocer la distribución indirecta de las enfermedades, detectando marcadores séricos de inmunidad y demostrando infecciones no diagnosticadas en la población general. El objetivo fue estimar la seroprevalencia de anticuerpos contra el SARS-CoV-2, en Córdoba, Argentina, entre diciembre de 2020 y enero de 2021, e identificar factores asociados a la contagiosidad del virus. Se realizó un estudio observacional transversal, de base poblacional, con 3.225 individuos mayores de 2 años, residentes en Córdoba Capital, que fueron seleccionados mediante un diseño de muestreo aleatorio en múltiples etapas, proporcional a la distribución por género, franja etaria y nivel socioeconómico de la población de Córdoba. Las características clínicas, antropometría y comorbilidades se recogieron mediante entrevistas. Se realizó un test serológico cualitativo para la detección de anticuerpos IgG antinucleocápside para SARS-CoV-2 (ARCHITECT, Abbott). La seroprevalencia del SARS-CoV-2 se estimó en la población y por franja de edad, sexo, nivel socioeconómico y presencia de las patologías estudiadas. Las razones de prevalencia (RP) se estimaron usando un modelo de regresión log-binomial. La seropositividad para SARS-CoV-2 fue de 16,68% (IC95%: 15,41-18,01). Tener entre 2 y 18 años, residir en barrios con nivel socioeconómico bajo y la presencia de obesidad, aumentaron la oportunidad de seropositividad (RP = 1,50; IC95%: 1,10-2,04, RP = 1,91; IC95%: 1,34-2,67 y RP = 1,39; IC95%: 1,04-1,85). Los resultados indican que en Córdoba Capital existen atributos diferenciales que aumentan la posibilidad de ser seropositivo para SARS-CoV-2. Esto permite dirigir estrategias de vigilancia epidemiológica para reducir la propagación del virus.

Seroepidemiological studies help identify the indirect distribution of diseases, detecting serological markers of immunity and demonstrating undiagnosed infections in the general population. The objectives were to estimate the seroprevalence of SARS-CoV-2 antibodies in Córdoba, Argentina, from December 2020 to January 2021 and to identify factors associated with the virus' contagiousness. A population-based cross-sectional observational study was performed in 3,225 individuals over two years of age living in Córdoba city, selected by multiple-stage random sampling proportional to distribution by gender, age group, and socioeconomic status in the city's population. Clinical characteristics, anthropometry, and comorbidities were collected by interview. Qualitative serological testing was performed for detection of SARS-CoV-2 nucleocapsid IgG antibodies (ARCHITECT, Abbott). SARS-CoV-2 seroprevalence was estimated for the total population and by age group, sex, socioeconomic status, and presence of target diseases. Prevalence ratios (PR) were estimated using a log-binomial regression model. SARS-CoV-2 seropositivity was 16.68% (95%CI: 15.41-18.01). Age 2 to 18 years, living in neighborhoods with low socioeconomic status, and obesity increased the odds of seropositivity (PR = 1.50; 95%CI: 1.10-2.04, PR = 1.91; 95%CI: 1.34-2.67 and PR = 1.39; 95%CI: 1.04-1.85). The results indicate that the city of Córdoba displays differential attributes that increase the likelihood of a positive SARS-CoV-2 antibody test. This allows targeting epidemiological surveillance strategies to reduce the spread of the virus.

Os estudos soroepidemiológicos permitem conhecer a distribuição indireta das doenças, detectando marcadores séricos de imunidade e demonstrando infecções não diagnosticadas na população geral. O objetivo foi estimar a soroprevalência de anticorpos contra o SARS-CoV-2, em Córdoba, Argentina, entre dezembro de 2020 e janeiro de 2021, e identificar fatores associados à contagiosidade do vírus. Um estudo observacional transversal foi realizado, de base populacional, com 3.225 indivíduos maiores de 2 anos, residentes em Córdoba Capital, que foram selecionados por meio de um delineamento de amostragem aleatória em múltiplos estágios, proporcional à distribuição de gênero, a faixa etária e o nível socioeconômico da população de Córdoba. As características clínicas, antropometria e comorbidades foram coletadas por meio de entrevistas. Um teste sorológico qualitativo foi realizado para a detecção de anticorpos IgG anti-nucleocapsídeo para SARS-CoV-2 (ARCHITECT, Abbott). A soroprevalência do SARS-CoV-2 foi estimada na população e por faixa etária, sexo, nível socioeconômico e presença das patologias estudadas. Razões de prevalência (RP) foram estimadas usando um modelo de regressão log-binomial. A soropositividade para SARS-CoV-2 foi de 16,68% (IC95%: 15,41-18,01). Ter entre 2 e 18 años, residir em bairros com nível socioeconômico baixo e a presença de obesidade aumentaram a chance de soropositividade (RP = 1,50; IC95%: 1,10-2,04, RP = 1,91; IC95%: 1,34-2,67 e RP = 1,39; IC95%: 1,04-1,85). Os resultados indicam que em Córdoba Capital existem atributos diferenciais que aumentam a possibilidade de ser soropositivo para SARS-CoV-2. Isso permite direcionar estratégias de vigilância epidemiológica para reduzir a propagação do vírus.

Excess weight and thinness over two decades (1996-2015) and spatial distribution in children from Jujuy, Argentina.

BACKGROUND: The increase of excess weight around the world is progressive and sustained in children. This is the most prevalent form of malnutrition in this population and they represent the major public health problem in developed and developing countries. The aim of this study was to analyze the magnitude of change in thinness and excess weight prevalence in 4-7 years-old schoolchildren from Jujuy (Argentina), between 1996 and 2015 and to examine the association according to sex and school location. METHODS: Cross-sectional study. Data was obtained from databases of School Health programs and it is representative of the city school population. For the analysis, 31,014 schoolchildren between 4 and 7 years old were evaluated, 20,224 from the first period (1996-2001) and 10,790 from the second (2010-2015). The city was partitioned in three different areas determined by the rivers that cross it. Nutritional status was determined by BMI for age with the criteria suggested by the International Obesity Task Force. The percentage of malnutrition change between periods was calculated and a binomial regression model was adjusted. RESULTS: Between periods, a significant (p-value< 0.0001) increase in the prevalence of overweight from 15.1% (CI 14.6-15.6%) to 18.1% (CI 17.4-18.8%) and obesity from 5% (CI 4.7-5.3) to 10.7% (CI 10.1-11.3%), and a decrease of thinness prevalence from 6.3% (CI 6.0-6.7%) to 4.7% (CI 4.3-5.1%) were observed. The percentage of change in the prevalence of obesity was very high in all areas and in both sexes (103.5% girls; 125.6% in boys), being higher in the south for girls (122.4%) and in the north for boys (158.8%). Besides, being a boy was inversely associated with the presence of excess weight and, as the age increases, the presence of obesity does it too. By analyzing the effect of the school location, the south and north zones had an inverse association with the presence of obesity. The period has a direct association with the presence of excess weight. CONCLUSION: The study contributes with valuable information on the magnitude of the increase in obesity in schoolchildren and suggests a possible correlation with sex and spatial distribution in the capital city of Jujuy.

Diet Quality, Obesity and Breast Cancer Risk: An Epidemiologic Study in Córdoba, Argentina.

Breast cancer (BC) is a multifactorial disease. Environmental factors, specifically, obesity and diet quality, have been linked with an increased risk of BC in women. This research was aimed at assessing the association of diet quality with BC risk, considering nutritional status, in Córdoba province (Argentina). A case-control study was conducted during the period 2008-2016 (346 cases/566 controls). A diet quality score was calculated for each woman based on fifteen dietary components related to low-grade inflammation. Dietary information was obtained through a validated questionnaire. A score (0, 0.5, or 1) was assigned to each variable depending on compliance with dietary recommendations. The higher the score, the higher the degree of adherence to a poor quality diet, which carries a potential inflammatory effect. A multiple logistic regression analysis was used to assess the association between BC occurrence and diet quality, adjusting by body mass index. The mean score of women was 6.86 (1.83). Of total women studied, 20% were obese. A 39% increase in BC risk was observed for each unit of increase in the score in this group (Odds Ratio: 1.39; 95% Confidence Interval: 1086-1796). Obese women with poorer quality diet have a greater risk of BC occurrence in Córdoba (Argentina).

Do Exposure to Arsenic, Occupation and Diet Have Synergistic Effects on Prostate Cancer Risk?

Background: Diverse environmental exposures, as well as dietary and lifestyle factors, are associated with prostate cancer (PC) etiology; however little is known about joint interactive influences. The aim of this study was to analyse effects of diet combined with arsenic in drinking water and agricultural occupation on PC risk. Methods: A case-control study was conducted in Córdoba, Argentina (period 2008-2015) including 147 cases of PC and 300 controls. All subjects were interviewed about food consumption, socio-demographic and lifestyle characteristics. A sample of drinking water was taken to determine arsenic concentrations. Adherence scores to the Traditional Dietary Pattern were estimated, based on a principal component factor analysis. A two-level logistic regression model was fitted in order to assess effects of the Traditional Pattern, occupation and arsenic exposure on the occurrence of PC (outcome). Family history of PC was considered as a clustering variable. Results: PC risk was greatest in subjects with high adherence to the Traditional Pattern (OR 2.18; 95%IC 1.097­4.344). Subjects exposed to arsenic in drinking water above 0.01mg/l who simultaneously performed agricultural activities showed a markedly elevated PC risk (OR 5.07; 95%IC 2.074-12.404). Variance of the random effect of family history of PC was significant. conclusion: Diet, arsenic and occupation in agriculture exert significant effects on PC risk. Further efforts are necessary to analyse risk factors integrally, in order to achieve a better understanding of the complex causal network for PC in this multiple-exposure population.

Burden of cancer mortality and differences attributable to demographic aging and risk factors in Argentina, 1986-2011.

The world faces an aging population that implies a large number of people affected with chronic diseases. Argentina has reached an advanced stage of demographic transition and presents a comparatively high rate of cancer mortality within Latin America. The objectives of this study were to examine cancer mortality trends in the province of Córdoba, Argentina, between 1986 and 2011, and to analyze the differences attributable to risk variations and demographic changes. Longitudinal series of age-standardized mortality rates for overall, breast and prostate cancers were modeled by Joinpoint regression to estimate the annual percent change. The Bashir & Estève method was used to split crude mortality rate variation into three components: mortality risk, population age structure and population size. A decreasing cancer age-standardized mortality rates trend was observed (1986-2011 annual percent change: -1.4, 95%CI: -1.6, -1.2 in men; -0.8, 95%CI: -1.0, -0.6 in women), with a significant shift in 1996. There were positive crude mortality rate net changes for overall female cancer, breast and prostate cancers, which were primarily attributable to demographic changes. Inversely, overall male cancer crude mortality rate showed a 9.15% decrease, mostly due to mortality risk. Despite favorable age-standardized mortality rates trends, the influence of population aging reinforces the challenge to control cancer in populations with an increasingly aged demographic structure.

Burden of cancer mortality and differences attributable to demographic aging and risk factors in Argentina, 1986-2011 / Carga de mortalidad por cáncer y diferencias atribuibles al envejecimiento poblacional y factores de riesgo en Argentina, 1986-2011 / Carga de mortalidade por câncer e diferenças atribuíveis ao envelhecimento populacional e fatores de risco na Argentina, 1986-2011

Abstract: The world faces an aging population that implies a large number of people affected with chronic diseases. Argentina has reached an advanced stage of demographic transition and presents a comparatively high rate of cancer mortality within Latin America. The objectives of this study were to examine cancer mortality trends in the province of Córdoba, Argentina, between 1986 and 2011, and to analyze the differences attributable to risk variations and demographic changes. Longitudinal series of age-standardized mortality rates for overall, breast and prostate cancers were modeled by Joinpoint regression to estimate the annual percent change. The Bashir & Estève method was used to split crude mortality rate variation into three components: mortality risk, population age structure and population size. A decreasing cancer age-standardized mortality rates trend was observed (1986-2011 annual percent change: -1.4, 95%CI: -1.6, -1.2 in men; -0.8, 95%CI: -1.0, -0.6 in women), with a significant shift in 1996. There were positive crude mortality rate net changes for overall female cancer, breast and prostate cancers, which were primarily attributable to demographic changes. Inversely, overall male cancer crude mortality rate showed a 9.15% decrease, mostly due to mortality risk. Despite favorable age-standardized mortality rates trends, the influence of population aging reinforces the challenge to control cancer in populations with an increasingly aged demographic structure.

Resumen: El mundo enfrenta el fenómeno del envejecimiento poblacional, con grandes contingentes de individuos afectados por enfermedades crónicas. Entre los países de América Latina, Argentina ya alcanzó un nivel avanzado en la transición demográfica y presenta una tasa relativamente alta de mortalidad por cáncer. El estudio tuvo como objetivos: examinar las tendencias en la mortalidad por cáncer en la provincia de Córdoba, Argentina, entre 1986 y 2011, y analizar las diferencias atribuibles a variaciones de riesgo y cambios demográficos. Para estimar la variación porcentual anual, se elaboraron modelos de series longitudinales de la tasa de mortalidad estandarizada por edad para todos los cánceres y, específicamente, para mama y próstata utilizando regresión Joinpoint. Se utilizó el método de Bashir & Estève para dividir la variación de la tasa bruta de mortalidad en tres componentes: riesgo de mortalidad, estructura etaria poblacional y tamaño de la población. Se observó una tendencia decreciente en la tasa de mortalidad estandarizada por edad por cáncer (variación porcentual annual 1986-2011: -1,4; IC95%: -1,6; -1,2 en hombres; -0,8; IC95%: -1,0; -0,6 en mujeres), con un cambio significativo en 1996. Las tasas brutas de mortalidad aumentaron para todos los cánceres en mujeres, y de mama y próstata, lo cual fue atribuible principalmente a cambios demográficos. Inversamente, la tasa bruta de mortalidad para todos los cánceres en hombres mostró una caída de 9,15%, influenciada básicamente por el riesgo de mortalidad. A pesar de las tendencias favorables en la tasa de mortalidad estandarizada por edad, la influencia del envejecimiento poblacional refuerza el desafío del control de cáncer en poblaciones con una estructura etaria cada vez más envejecida.

Resumo: O mundo enfrenta o fenômeno do envelhecimento populacional, com grandes contingentes de indivíduos afetados por doenças crônicas. Entre os países da América Latina, a Argentina já atingiu um patamar avançado na transição demográfica e apresenta uma taxa relativamente alta de mortalidade por câncer. O estudo teve como objetivos, examinar as tendências na mortalidade por câncer na província de Córdoba, Argentina, entre 1986 e 2011, e analisar as diferenças atribuíveis a variações de risco e mudanças demográficas. Para estimar a variação percentual anual, a regressão Joinpoint foi utilizada para elaborar modelos de séries longitudinais da taxa de mortalidade padronizada por idade para todos os cânceres e especificamente para mama e próstata. Foi utilizado o método de Bashir & Estève para dividir a variação da taxa bruta de mortalidade em três componentes: risco de mortalidade, estrutura etária populacional e tamanho da população. Observou-se uma tendência decrescente na taxa de mortalidade padronizada por idade por câncer (variação percentual annual 1986-2011: -1,4; IC95%: -1,6; -1,2 em homens; -0.8, IC95%: -1,0; -0.6 em mulheres), com um deslocamento significativo em 1996. As taxas brutas de mortalidade aumentaram para todos os cânceres em mulheres, e de mama e próstata, atribuíveis principalmente a mudanças demográficas. Inversamente, a taxa bruta de mortalidade para todos os cânceres em homens mostrou uma queda de 9,15%, influenciada basicamente pelo risco de mortalidade. Apesar de tendências favoráveis na taxa de mortalidade padronizada por idade, a influência do envelhecimento populacional reforça o desafio do controle de câncer em populações com estrutura etária cada vez mais envelhecida.

[Cancer and its association with dietary patterns in Córdoba (Argentina)]. / Cáncer y su asociación con patrones alimentarios en Córdoba (Argentina).

INTRODUCTION: Feeding habits play a prominent role in carcinogenesis. The dietary patterns approach applied to the study of chronic diseases is of increasing interest in nutritional epidemiology. Nevertheless, it has been seldom used in Latin America. OBJECTIVE: To identify dietary patterns in adult population in Córdoba (Argentina) and to estimate their effects on the risk of colon-rectal (CRC), urothelial (UC), breast (BC) and prostate (PC) cancers. METHODS: Four case control studies were conducted, 2006-2012 for CRC, PC, BC and UC. To identify the dietary patterns, a Principal Components Factor Analysis was conducted. A multilevel logistic regression was adjusted for the risk analyses. RESULTS: Characteristic dietary patterns in the whole population, and in women and men independently, were identified. In the whole population South Cone and Sweet Beverages patterns behaved as promoters for CRC and UC while the Prudent Pattern had a protective effect. Female South Cone, Rural and Starchy patterns were associated to a higher BC risk. Prudent Pattern lowered BC risk. In men, South Cone, Sweet Beverages and Typical Measured patterns promoted PC. CONCLUSION: It is necessary to promote a regular intake of vegetables, fruits and diary products (although a moderate intake for men), and to reduce red meat (especially fat meat), processed meat, starchy vegetables, wine and sweet beverages intakes, to prevent the occurrence of cancer. In men, it is recommended a moderate intake of egg. In women, it is advised a moderate intake of refined grains, bakery products, oils and mayonnaise intake.

Introducción: La alimentación es un importante factor vinculado a la ocurrencia del cáncer. Su abordaje en términos de patrones alimentarios es de creciente interés en epidemiología nutricional, no obstante ha sido pocas veces empleado en Latinoamérica. Objetivos: Identificar patrones alimentarios en la población adulta de Córdoba (Argentina) y estimar sus efectos sobre el riesgo de ocurrencia de cáncer colorrectal (CCR), cáncer de mama (CM), cáncer de próstata (CP) y urotelial (CU). Métodos: Se condujeron estudios caso-control, 2006-2012, correspondientes a CCR, CM, CP y CU. Empleando un análisis factorial de componentes principales se identificaron patrones alimentarios. Se estimaron ORs mediante regresión logística multinivel. Resultados: Se identificaron patrones característicos en la población general, y en hombres y mujeres independientemente. En población total, los patrones Cono Sur y Bebidas Azucaradas evidenciaron un efecto promotor para CCR y CU, y el Patrón Prudente mostró efecto protector. En mujeres, el CM se asoció de manera directa con los patrones Cono Sur Femenino, Rural y Amiláceo, e inversa con el Patrón Prudente. En hombres, los Patrones Cono Sur Masculino, Bebidas Azucaradas y Típico Mesurado mostraron un efecto promotor para CP. Conclusión: Resulta necesario promover una ingesta habitual de vegetales, frutas y lácteos (éstos últimos de manera moderada en hombres), y disminuir el consumo de carnes rojas (fundamentalmente grasas), carnes procesadas, vegetales amiláceos, vino y bebidas azucaradas, a fin de prevenir la ocurrencia de cáncer. En hombres se sugiere moderar la ingesta de huevos, y en mujeres la de granos refinados, productos de pastelería, aceites y mayonesa.

Patrones alimentarios y contaminantes ambientales asociados al cáncer de próstata en Córdoba / Food and environmental contaminants patterns associated with prostate cancer in Córdoba

La creciente incidencia del cáncer ha motivado el desarrollo de investigaciones tendientes a analizar la red causal que determina su ocurrencia. En la etiología del cáncer de próstata (CP), la neoplasia maligna más incidente en la población masculina de la Provincia de Córdoba, se reconocen factores biológicos, ambientales y otros relacionados al estilo de vida, por lo que su estudio requiere un abordaje que considere las múltiples dimensiones del fenómeno tanto a nivel individual como contextual. La evidencia sugiere que algunos contaminantes ambientales como el arsénico y los plaguicidas pueden incidir en el riesgo de desarrollar CP. Asimismo hábitos alimentarios, tóxicos, ocupacionales, entre otros, resultan importantes factores moduladores de la enfermedad. La presente Tesis propuso analizar el efecto de la presencia de arsénico y plaguicidas, en la distribución de CP en la Provincia de Córdoba, considerando las características bio-socio-culturales y alimentarias de las poblaciones de regiones con diferentes niveles de exposición. En primer lugar se realizó estudio ecológico para analizar la distribución espacial de la incidencia de CP y su asociación con la exposición a arsénico y a plaguicidas, empleando mediciones de arsénico de aguas subterráneas y construyendo índices de exposición a los plaguicidas más utilizados en la provincia (glifosato, cipermetrina y "Ópera"), respectivamente...

The increasing incidence of cancer has motivated the development of studies analyzing the causal network that determines its occurrence. Prostate cancer (PC) is the most incident malignant neoplasm in male population of the Province of Córdoba. Due to the etiology of PC, including biological, environmental, and other lifestyle-related factors, its study requires an approach considering the multiple dimensions of the phenomenon both at individual and contextual levels. Evidence suggests that some environmental contaminantssuch as arsenic and pesticides can affect the risk of developing CP. Moreover diet, cigarette smoking, occupation, among other factors are important modulators of the disease. The main objective of this research was to analyze the effect of arsenic and pesticides on the distribution of CP in the Province of Córdoba, considering bio-sociocultural and nutritional characteristics of the populations in regions with different exposure levels. In a first step, an ecological study was carried out to analyze the association between spatial distribution of PC incidence and exposure to arsenic content in groudwater andpesticides...

[Micronutrients intake and urinary tract tumors in Córdoba, Argentina]. / Consumo de micronutrientes y tumores de vías urinarias en Córdoba, Argentina.

INTRODUCTION: Micronutrients content of habitually consumed foods comprise a causal network model of cancer, but the evaluation of their effect on this pathology represents a great challenge because of the interdependence in their usual consumption. Several studies reported that nutrients can modify the urinary tract tumors (UTT) risk, although such evidence is still limited. OBJECTIVE: To identify associations between dietary vitamins A, E, B6, C, phosphorus, selenium and zinc intakes and the presence of UTT in Córdoba, Argentina, considering the multicollinearity caused by the interdependence of their consumption. METHODS: A case control study was carried out including 129 cases with incident histopathologically confirmed UTT and 257 controls. A food frequency questionnaire previously validated was administrated to each subject. Dietary intakes of vitamins A, E, B6, C, phosphorus, selenium and zinc were the variables of interest, each showing high correlation with each other and thus, causing collinearity. So, multiple logistic regression models were adjusted and their adaptation to the presence of correlation, Ridge regression, to obtain the odds ratio (OR). The models included terms of sex, age, body mass index (BMI), socioeconomic status, occupational exposure to carcinogens, tobacco consumption and caloric intake as covariates. RESULTS: Vitamin E and vitamin B6 showed a slight protective effect (OR: 0.943, CI 95% 0.897-0.998 and OR: 0.730 CI 95% 0.457-1.167). Selenium was slightly promoter (OR: 1.012 CI 95% 1.001-1.023). CONCLUSION: When multicollinearity is considered in the model, it is possible to obtain more accurate estimates of the modulation that some micronutrients have on the risk of UTT more precisely.

Introducción: Los micronutrientes contenidos en los alimentos de consumo habitual integran el modelo de red causal del cáncer aunque su evaluación conjunta es compleja debido a la interdependencia en el consumo habitual. Diversos estudios reportaron que ciertos nutrientes pueden modificar el riesgo de desarrollar tumores de vías urinarias (TVU), aunque dicha evidencia es aún limitada. Objetivo: Identificar asociaciones entre el consumo de vitaminas A, E, B6, C, fósforo, selenio y zinc procedentes de la dieta, y la presencia TVU en Córdoba, Argentina, entre 1999 y 2008, considerando la multicolinealidad entre sus consumos. Métodos: Se realizó un estudio caso-control que incluyó 129 casos con TVU confirmados histopatológicamente y 257 controles. Se administró a cada sujeto un formulario de frecuencia alimentaria previamente validado. La ingesta de vitaminas A, E, B6 y C, fósforo, selenio y zinc fueron las variables de interés, presentando alta correlación entre sí y provocando colinealidad. Por ello, fueron ajustados modelos de regresión logística múltiple y su adaptación ante la presencia de correlación vía estimación Ridge, para la obtención de los odds ratio (OR), previa inclusión de las covariables sexo, edad, índice de masa corporal (IMC), estrato socioeconómico, exposición ocupacional a carcinógenos, consumo de tabaco y consumo calórico. Resultados: Las vitaminas E y B6 evidenciaron un leve efecto protector (OR: 0,943, IC 95% 0,897-0,998 y OR: 0,730, IC 95% 0,457-1,167). El selenio resultó ligeramente promotor (OR: 1,012, IC 95% 1,001-1,023). Conclusión: Considerando la multicolinealidad es posible detectar de manera más precisa la modulación que algunos micronutrientes ejercen sobre el riesgo de TVU.

Dietary habits and prostate cancer prevention: a review of observational studies by focusing on South America.

There exist several works considering the association between diet and prostate cancer (PC) risk, but the issue is largely unsettled. This article systematically reviews the epidemiological studies on diet and risk of PC focusing on those carried out in countries of South America. There is some suggestion that dairy products, red meat, processed meat, α-linolenic fatty acids, as well as dietary patterns characterized by higher intakes of red and processed meat, eggs, and grains may play some role in the development of PC. There is no clear association with the intake of vegetables and fruits, lycopene, fats, and different types of fatty acids. The evidence on diet and PC is therefore inconclusive in general and specifically in South America. Particular attention must be paid to the study of cancer risk in some countries of South America because of the singularly risky dietary pattern consumed by its population.