Nutrients in prevention, treatment, and management of viral infections; special focus on Coronavirus.

BACKGROUND: The coronavirus disease 2019 (COVID-19) is a pandemic caused by coronavirus with mild to severe respiratory symptoms. This paper aimed to investigate the effect of nutrients on the immune system and their possible roles in the prevention, treatment, and management of COVID-19 in adults. METHODS: This Systematic review was designed based on the guideline of the Preferred Reporting for Systematic Reviews (PRISMA). The articles that focussed on nutrition, immune system, viral infection, and coronaviruses were collected by searching databases for both published papers and accepted manuscripts from 1990 to 2020. Irrelevant papers and articles without English abstract were excluded from the review process. RESULTS: Some nutrients are actively involved in the proper functioning and strengthening of the human immune system against viral infections including dietary protein, omega-3 fatty acids, vitamin A, vitamin D, vitamin E, vitamin B1, vitamin B6, vitamin B12, vitamin C, iron, zinc, and selenium. Few studies were done on the effect of dietary components on prevention of COVID-19, but supplementation with these nutrients may be effective in improving the health status of patients with viral infections. CONCLUSION: Following a balanced diet and supplementation with proper nutrients may play a vital role in prevention, treatment, and management of COVID-19. However, further clinical trials are needed to confirm these findings and presenting the strong recommendations against this pandemic.

Association between dietary intake of fatty acids and colorectal cancer, a case-control study.

Background: The association of dietary fat and colorectal cancer (CRC) was frequently reported. However, few studies assessed the effects of different types of dietary fats on CRC. This study aimed to investigate the association between intakes of different types of dietary fatty acids with colorectal cancer risk. Methods: This case-control study was conducted on 480 participants including 160 CRC cases and 320 healthy controls in Firoozgar Hospital, Tehran, Iran. The intake of dietary fatty acids of the participants was assessed using a semi quantitative food frequency questionnaire (FFQ). Results: The mean intake of cholesterol (273.07 ± 53.63 vs. 254.17 ± 61.12, P = 0.001), polyunsaturated fatty acids (PUFA) (16.54 ± 4.20 vs. 15.41 ± 4.44, P = 0.012), and calorie (2,568.76 ± 404.48 vs. 2,493.38 ± 176.03, P = 0.006) was higher and the mean intake of oleic acid (5.59 ± 3.17 vs. 8.21 ± 5.46) and linoleic acid (6.03 ± 3.44 vs. 7.02 ± 4.08, P = 0.01) was lower in the case group compared to the control group. An inverse association was found between colorectal cancer (CRC) and dietary intake of oleic acid (OR: 0.85, CI 95% 0.80-0.90, P = 0.001), linoleic acid (OR: 0.85, CI 95% 0.78-0.93, P = 0.001), and α-linolenic acid (OR: 0.75, CI 95% 0.57-0.98, P = 0.04). The association remained significant after adjusting for age and sex, sleep, smoking, and alcohol consumption, and BMI. Conclusions: The results of this study support a protective effect of oleic acid, linoleic acid, and α-linolenic acid against CRC. Further longitudinal studies are warranted to confirm these results.

Intake of food groups and cervical cancer in women at risk for cervical cancer: A nested case-control study.

Background: The risk of cervical cancer was reported to be influenced by dietary components. This study aimed to illustrate the association between cervical cancer with the intake of food groups in women with a history of cervical neoplasia. Methods: This nested case-control study was conducted in 558 people with a history of cervical intraepithelial neoplasia (CIN), including 279 women with cervical cancers and 279 controls with low-grade squamous intraepithelial lesions (LSIL). A validated food frequency questionnaire (FFQ) was used to assess the intake of food groups. Results: The intake of fruits and vegetables in the case group was significantly lower than the control group (P=0.001). Low intake of dairy products, vegetables, and fruits was associated with cervical cancer risk (OR=4.67; 95% CI 1.2-9.49, P=0.001; OR=9.75, 95% CI 1.36-19. 51, P=0.001; and OR=4.82, 95% CI 1.09-7.25, P=0.001, respectively). After adjusting for age, family history, age at first menstruation, number of children, history of vaginal infection, and age at first sexual intercourse, the results were still significant. Additional adjustments to BMI did not change the results. Conclusion: The results indicate that the risk of cervical cancer can be affected by the intake of certain food groups. Further longitudinal studies are needed to confirm these findings and determine the underlying mechanism of the influence of dietary components on cervical cancer risk.

Associations between the dietary inflammatory index with obesity and body fat in male adolescents.

BACKGROUND: Obesity and body composition may be affected by the pro-inflammatory and anti-inflammatory components of diets. The aim of this study was to investigate associations between the dietary inflammatory index (DII) and body fat percentage (BF%) in male adolescents. METHODS: This cross-sectional study was carried out on 535 adolescent boys in Tehran, Iran. Bio-impedance analyzer (BIA) scale was used to measure body mass index (BMI) and body composition. A validated semi-quantitative food frequency questionnaire (FFQ) was used to measure DII. RESULTS: Participants with higher BF% (≥ 19.2%) had higher BMI (P < 0.001), DII, and intake of saturated fatty acids (SFAs), compared with the participants with lower BF%. Participants with a lower DII had significantly higher intakes of fibers (P < 0.001) and lower intakes of fats, SFAs, monounsaturated fatty acids (MUFAs), polyunsaturated fatty acids (PUFAs), oleic acid and linoleic acid (P < 0.05) compared with the participants with higher DII (P < 0.01). High BF% was positively associated to DII (OR = 1.6, CI 95%: 1.1-2.3, P = 0.019). Adjustments for age, BMI, physical activity, mothers' marital status and educational level and the number of siblings did not change the results. CONCLUSIONS: Following a diet with a low inflammatory index score was associated to lower BF% in male adolescents. Thus, a diet rich in anti-inflammatory factors may effectively improve body composition and prevent obesity in adolescents. Further comprehensive studies are necessary to verify these findings and to identify the underlying mechanisms.

FTO genotype was associated with breast cancer in HER2 negative patients.

BACKGROUND: The fat mass and obesity-associated (FTO) gene may influence the risk of breast cancer (BC). The single nucleotide polymorphisms (SNPs) of FTO gene may exert different impacts on different types of BC. In this study, we investigated the association between FTO SNP rs9939609 and the status of estrogen receptor (ER), progesterone receptor (PR), P53, and human epidermal growth factor receptor-2 (HER-2) in BC patients. METHODS: Our case-control study was included 540 Iranian participants aged 35 to 70 (180 women with BC as the case group and 360 healthy controls). After genotyping for risk allele rs9939609 of the FTO gene, a logistic regression was applied to elucidate the association between FTO SNP rs9939609 and BC risk based on the receptor status. RESULTS: The number of HER-2 negative patients was significantly higher in FTO rs9939609 risk allele carrier group (61.5% vs. 41.4%, P < 0.05). A significant association was found between BC and rs9939609 FTO gene polymorphism only in HER2 negative BC patients (OR = 1.79, CI95%: 1.2-3.56, P = 0.03). No association was identified between FTO rs9939609 polymorphism and the status of ER, PR, and P53. CONCLUSION: We indicated that FTO SNP rs9939609 can be a potential therapeutic target particularly in HER-2 negative BC cases. The importance of this risk allele in BC pathogenesis needs to be further highlighted.

The effect of low FODMAP diet with and without gluten on irritable bowel syndrome: A double blind, placebo controlled randomized clinical trial.

BACKGROUND & AIM: Although the effects of low fermentable oligosaccharide, disaccharide, monosaccharide, and polyol (FODMAP) diet on amelioration of irritable bowel syndrome (IBS) symptoms have been reported previously, it has not yet been elucidated whether the gluten of wheat and barley induces the symptoms or only their fructans lead to aggravation of the symptoms. The aim of this study was to assess the effect of low FODMAPs diet with vs. without gluten on clinical symptoms in IBS patients. METHODS: In this double-blind, placebo-controlled randomized trial, forty nine IBS patients were randomly assigned to placebo and/or intervention group. Patients in the intervention group received 5 gr/day of gluten powder with low FODMAP diet, while placebo group received 5 gr of rice flour as placebo, with low FODMAP diet. Quality of life (QoL) and IBS-SSS (symptom severity score) were measured before and after the intervention using a valid QoL questionnaire and a standard visual analog scale, respectively. RESULTS: Significant improvements were observed in total scores of IBS-SSS (-32% vs. - 49%), abdominal pain intensity (-45% vs. -52%), and frequency (-26 vs. -46%), abdominal distension (-29% vs. -63%), Interference with community function (-14% vs. -45%) and quality of life (+23 vs. +32%) in both gluten and placebo groups respectively (P < 0.05). Only 5 patients in the gluten-containing diet reported exacerbation of their symptoms. CONCLUSION: Exacerbation of IBS symptoms after wheat and barley consumption is due to their fructan, and not related to their gluten content in most of the patients. CLINICAL TRIAL REGISTRATION NO: IRCT20100524004010N29.

Does the rs9939609 FTO gene polymorphism affect fat percentage? A meta-analysis.

This meta-analysis aimed to investigate the association of the rs9939609 FTO gene polymorphism and body fat percentage (BF%). To the best of our knowledge, this study is the first meta-analysis to evaluate the relationship between FTO rs9939609 polymorphism and BF%. We searched PubMed, Web of science, Scopus and Embase to identify studies investigating the relations between the rs9939609 FTO gene polymorphism and BF%. Studies that meet inclusion criteria were collected for the final analysis. There was significant differences in the level of BF% between different genotypes of FTO rs9939609 polymorphism, and the carriers of the A allele of FTO rs9939609 polymorphism had higher BF%. The association was significant between carriers of TT genotype compared to carriers of AA (p = .007) and AT genotypes (p = .04), but not between AT and AA genotypes. This study identified that the carriers of the A allele of FTO rs9939609 polymorphism have higher BF%.

Association between different types of dietary carbohydrate and breast cancer.

BACKGROUND: Among modifiable lifestyle factors, unhealthy dietary intake is associated with higher risks of breast cancer (BC). This paper aimed to investigate the association of different types of dietary carbohydrate with BC risk among women 20-75 years old. DESIGN: This case-control study was carried out on 180 women with BC and 360 healthy individuals as the control group. Basic information including anthropometric measurements, medical history, physical activity, alcohol consumption, reproductive histories, smoking, and education level were collected. The amount of intake of carbohydrate, simple sugar, sucrose, maltose, and fructose were assessed using food frequency questionnaire (FFQ). RESULTS: The amounts of intake of total carbohydrate [odds ratio (OR) = 1.76; 95% confidence interval (CI) (1.24-2.14); P = 0.01], simple sugar (OR = 1.95, 95% CI (1.42-3.39); P = 0.01), sucrose (OR = 1.97, 95% CI (1.18-3.12); P = 0.02), maltose (OR = 4.07, 95% CI (1.68-8.14); P = 0.03), and fructose (OR = 1.104, 95% CI (1.06-1.36); P = 0.01) were positively associated with BC after adjustments for age, body mass index (BMI), smoking, using alcohol, physical activity, and dietary intake of calorie, protein, and fat. No significant association was found between the intake of glucose, galactose, and lactose with BC. CONCLUSIONS: The results of this study identified that some types of dietary carbohydrates may play a role in the development of BC. Different monosaccharides and disaccharides may have different effects on the risk of breast cancer. Further longitudinal studies are warranted to identify the effects of carbohydrates on BC and to explore the underlying mechanisms.

The association between FTO rs9939609 polymorphism and serum lipid profile in adult women.

BACKGROUND: FTO gene is considered to play an important role in many metabolic diseases. Evidence from studies indicated the possible association between the FTO rs9939609 polymorphisms with serum lipid profile. Therefore, this study aimed to investigate the association of FTO rs9939609 polymorphism with lipid profile in Iranian women. METHODS: This cross-sectional study was carried out on 380 adult women. Information about age, height, weight, BMI, physical activity, and dietary intake were collected. The serum levels of Low Density Lipoprotein (LDL), High Density Lipoprotein (HDL), Triglyceride (TG), and total cholesterol were measured. The FTO gene was genotyped for rs9939609 polymorphism. The participants were divided into two groups of TT and AT/AA considering dominant model of FTO rs9939609 polymorphism. RESULTS: General characteristics of the participants with different FTO genotypes were not significantly different. The lower levels of HDL were observed in AT/AA genotypes compared to the TT wild type genotype of FTO rs9939609 polymorphism (P = 0.004). Adjustments of age, BMI, and physical activity did not change the results. CONCLUSIONS: However, the significant association between FTO genotype and the HDL level was disappeared after further adjustments for dietary intake. Further studies are warranted to identify the underlying mechanisms of the possible association between FTO gene and serum lipid profile.

Association of serum 25-OH-vitamin D level with FTO and IRX3 genes expression in obese and overweight boys with different FTO rs9930506 genotypes.

BACKGROUND: The roles of FTO gene and the level of serum 25-OH-vitamin D in obesity are frequently reported. This study aimed to investigate the interactions of serum 25-OH-vitamin D level, FTO and IRX3 genes expression, and FTO genotype in obese and overweight boys. METHODS: This study was carried out on the 120 male adolescents with overweight in Tehran, Iran. Blood samples were collected from the participants in order to evaluate the serum level of 25-OH-vitamin D, the expression level of FTO and IRX3 genes, and FTO genotype for rs9930506 at baseline and after 18 weeks of the study. RESULTS: In general, no significant association was found between serum 25-OH-vitamin D level and IRX3 and FTO genes expression. The results of linear regression on the relationship between 25-OH-vitamin D serum level and FTO and IRX3 genes expression based on FTO genotypes for rs9930506 indicated that in AA/AG genotype carriers, serum 25-OH-vitamin D level was positively associated with FTO gene expression (B = 0.07, p = 0.02) and inversely associated with IRX3 gene expression (B = - 0.07, p = 0.03). In GG carriers, serum 25-OH-vitamin D level was not associated with expression of IRX3 and FTO genes. CONCLUSION: There are significant interactions between 25-OH-vitamin D and the expression of FTO and IRX3 genes in the subset of obese patients with specific genotypes for FTO rs9930506. There was no association between serum 25-OH-vitamin D levels and the expression of FTO and IRX genes in individuals with a homozygous genotype for the risk allele of the FTO gene polymorphism.

Are the FTO Gene Polymorphisms Associated with Colorectal Cancer? A Meta-analysis.

BACKGROUND: Colorectal cancer (CRC) is reported to be associated with some gene polymorphisms. However, the effect of the fat mass and obesity associated (FTO) gene on colorectal cancer is not yet clear. This meta-analysis aimed to investigate the association of the FTO gene polymorphism and colorectal cancer. METHODS: PubMed, Web of science, Scopus, and Embase were explored to identify the studies investigating the relationship between rs9939609 and rs17817449 polymorphisms of FTO gene and colorectal cancer, and the published papers from 2000 to 2019 were collected. This meta-analysis was conducted by using a random-effects model for the best estimation of the desired outcomes. RESULTS: In this study, 1528 studies were initially included and five eligible case-control studies including 13,460 cases and 22,578 controls were eligible for further analyses. No significant association was found between risk allele of FTO rs9939609 (OR = 0.98, 0.87-1.1) and rs17817449 (OR = 0.9, 0.79-1.03) polymorphisms and colorectal cancer risk. The subgroup analyses considering the source of the control group and race found no significant association between FTO polymorphisms and the risk of colon cancer. CONCLUSIONS: This study indicated that rs9939609 and rs17817449 FTO gene polymorphisms are not associated with colorectal cancer risk. Individual studies involving different FTO polymorphisms are needed to further evaluation of the associations between the FTO gene and colon cancer.

Trends in Serum Vitamin D Levels within 12 Months after One Anastomosis Gastric Bypass (OAGB).

PURPOSE: To assess serum vitamin D trend from baseline to 12 months after one anastomosis gastric bypass (OAGB). MATERIALS AND METHODS: In this observational cohort analysis of longitudinal data, we assessed the trend of serum vitamin D, and its associations with anthropometric, and biochemical measurements in 98 patients undergoing OAGB in a bariatric surgery center. All participants were on >800 IU/day vitamin D supplementation. RESULTS: Vitamin D, lipid profile, creatinine, and albumin levels significantly improved at 12 months post-surgery. Vitamin D concentrations significantly increased from 26.52 ± 12.32 to 54.52 ± 27.90 ng/mL at 12 months. The correlations between vitamin D concentrations and weight, body mass index, lipid profile, ferritin, glycemic indices, and albumin were not significant. In addition, the correlations between vitamin D and parathormone, vitamin D receptor, calcium, phosphorus, body composition, and basal metabolic rate (BMR) did not reach the threshold of statistical significance at 12 months following bariatric surgery. Although there was a significant correlation between body weight and body composition (P < 0.001) and basal metabolic rate (BMR) (r = 0.762, P < 0.001) at 12 months, there were no significant correlations between weight change percent and body composition (P > 0.05), BMR (r = -0.101, P = 0.350), and vitamin D (r = 0.120, P = 0.271) at 12 months. CONCLUSION: Our results showed that supplementation of vitamin D with dosage of >800 IU/day is sufficient for prevention of vitamin D deficiency within 12 months after OAGB surgery. Note: This data is mandatory.

The effect of omega-3 fatty acid supplementation on clinical and biochemical parameters of critically ill patients with COVID-19: a randomized clinical trial.

BACKGROUND: Omega-3 polyunsaturated fatty acids (n3-PUFAs) may exert beneficial effects on the immune system of patients with viral infections. This paper aimed to examine the effect of n3-PUFA supplementation on inflammatory and biochemical markers in critically ill patients with COVID-19. METHODS: A double-blind, randomized clinical trial study was conducted on 128 critically ill patients infected with COVID-19 who were randomly assigned to the intervention (fortified formula with n3-PUFA) (n = 42) and control (n = 86) groups. Data on 1 month survival rate, blood glucose, sodium (Na), potassium (K), blood urea nitrogen (BUN), creatinine (Cr), albumin, hematocrit (HCT), calcium (Ca), phosphorus (P), mean arterial pressure (MAP), O2 saturation (O2sat), arterial pH, partial pressure of oxygen (PO2), partial pressure of carbon dioxide (PCO2), bicarbonate (HCO3), base excess (Be), white blood cells (WBCs), Glasgow Coma Scale (GCS), hemoglobin (Hb), platelet (Plt), and the partial thromboplastin time (PTT) were collected at baseline and after 14 days of the intervention. RESULTS: The intervention group had significantly higher 1-month survival rate and higher levels of arterial pH, HCO3, and Be and lower levels of BUN, Cr, and K compared with the control group after intervention (all P < 0.05). There were no significant differences between blood glucose, Na, HCT, Ca, P, MAP, O2sat, PO2, PCO2, WBCs, GCS, Hb, Plt, PTT, and albumin between two groups. CONCLUSION: Omega-3 supplementation improved the levels of several parameters of respiratory and renal function in critically ill patients with COVID-19. Further clinical studies are warranted. Trial registry Name of the registry: This study was registered in the Iranian Registry of Clinical Trials (IRCT); Trial registration number: IRCT20151226025699N3; Date of registration: 2020.5.20; URL of trial registry record: https://en.irct.ir/trial/48213.

The effect of omega-3 fatty acids supplementation on social and behavioral disorders of children with autism: a randomized clinical trial.

INTRODUCTION: Some studies reported that essential fatty acids deficiencies can be related to autism spectrum disorders (ASD) in children. This study aimed to investigate the effect of omega-3 on social, verbal, and behavioral activities in ASD children. MATERIAL AND METHODS: A double-blind, randomized clinical trial study was conducted on 54 children with autism, who were assigned to the case (n = 28) and control (n = 26) groups. The cases received one capsule of 1000 mg omega-3 daily and the controls received one capsule of 1000 mg medium chain triglyceride daily as placebo for eight weeks. The Gilliam Autism Rating Scale-second edition (GARS-2) was used to assess the severity of autism and food frequency questionnaire (FFQ) was used to assess their dietary intake. All measurements were done at baseline and after the intervention. RESULTS: After adjusting for age, gender, birth weight, BMI, dietary intake, mother's age, and mother's BMI, the intervention group had significantly improved stereotyped behaviors (p = 0.02), social communication (p = 0.02), and the GARS score (p = 0.001) after the intervention compared to the control group. No significant change was found in the score of social interaction subscale. CONCLUSIONS: The findings indicate that omega-3 treatment improved autism characteristics including stereotyped behaviors and social communication. Further studies are needed to confirm these findings and to determine the underlying mechanisms.

Interactions of anthropometric indices, rs9939609 FTO gene polymorphism and breast cancer: A case-control study.

Contradictory results were reported on the effect of fat mass- and obesity-associated (FTO) gene and anthropometric measurements on breast cancer (BC). This study aimed to assess the interactions between rs9939609 polymorphism of FTO gene, anthropometric indices and BC risk in Iranian women. This case-control study was performed on 540 women including 180 women with BC and 360 healthy women in Tehran, Iran. Physical activity and dietary intakes were assessed by validated questionnaires. Data on sociodemographic and pathologic factors of the participants as well as their blood samples were collected. The rs9939609 FTO gene polymorphism was genotyped using the tetra-primer amplification refractory mutation system-polymerase chain reaction (T-ARMS-PCR). No significant association was found between BC and risk allele of FTO rs9939609 polymorphism after adjustments for the confounders. However, there was a significant association between rs9939609 polymorphism risk allele and BC risk in females with overweight, even after adjusting for age, family history of BC, abortion, BMI and the number of pregnancies (P < .05). The association was disappeared after further adjustments for lifestyle factors including smoking, alcohol consumption, calorie and macronutrients intake, and physical activity. The FTO gene polymorphism was associated with the risk of BC in overweight individuals. This association was influenced by environmental factors including diet, alcohol consumption and smoking. Future studies are required to confirm the association between the FTO gene and BC in overweight females and to identify the underlying mechanisms.

The Effect of Vitamin C on Pathological Parameters and Survival Duration of Critically Ill Coronavirus Disease 2019 Patients: A Randomized Clinical Trial.

Introduction: Vitamin C has been reported to have beneficial effects on patients with coronavirus disease 2019 (COVID-19). This study aimed to investigate the effect of vitamin C supplementation on pathological parameters and survival duration of critically ill patients with COVID-19. Methods: This clinical trial was conducted on 120 hospitalized critically ill patients infected with COVID-19. The intervention group (n = 31) received one capsule of 500 mg of vitamin C daily for 14 days. The control group (n = 69) received the same nutrition except for vitamin C supplements. Measurement of pathological and biochemical parameters was performed at baseline and after 2 weeks of the intervention. Results: Following 2 weeks of vitamin C supplementation, the level of serum K was significantly lower in the patients compared with the control group (3.93 vs. 4.21 mEq/L, p < 0.01). Vitamin C supplementation resulted in a higher mean survival duration compared with that of the control group (8 vs. 4 days, p < 0.01). There was a linear association between the number of days of vitamin C intake and survival duration (B = 1.66, p < 0.001). The vitamin C supplementation had no effect on blood glucose, mean arterial pressure, arterial blood gas (ABG) parameters, Glasgow Coma Scale (GCS), kidney function, cell blood count (CBC), hemoglobin (Hb), platelet (Plt), partial thromboplastin time (PTT), albumin, hematocrit (Hct), and other serum electrolytes including sodium (Na), calcium, and phosphorus (P). Conclusion: The present study demonstrated the potential of vitamin C supplementation in enhancing the survival duration of critically ill patients with COVID-19. Clinical Trial Registration: https://www.irct.ir/trial/55074, identifier IRCT20151226025699N5.

A pro-inflammatory diet increases the likelihood of obesity and overweight in adolescent boys: a case-control study.

BACKGROUND: Obesity and Overweight at an early age can contribute with many chronic diseases such as cancers, diabetes and cardiovascular diseases. Diet-related inflammation is one of the most important underlying mechanisms that may has a key role in obesity and overweight. This paper aimed to compare the dietary inflammatory index (DII®) in normal weight and overweight adolescent boys. METHODS: A total of 535 adolescent boys (214 cases were overweight and obese and 321 controls with normal weight) participated in this study from two schools in Tehran, Iran. The student's weight and body composition were measured using a Bio-Impedance Analyzer (BIA) scale. A validated semi-quantitative Food Frequency Questionnaire (FFQ) was used to assess dietary inflammatory index. RESULTS: Results obtained from modeling DII® as a continuous variable identified a positive association between DII® and obesity (OR = 1.08, CI 1.01-1.16). After multivariable adjustment, subjects with DII® > 0.02 had at 1.5 times higher odds of obesity and overweight compared to subjects with DII® ≤ 0.02 (OR = 1.52; CI 1.04-2.22). CONCLUSION: Our study indicated the importance of dietary-induced inflammation in the obesity and overweight during adolescence. Therefore, advising adolescent to consume diet with lower DII® with more fruits and vegetables, rich sources of fiber, flavonoids, zinc, magnesium and selenium and avoiding the consumption of saturated fatty acids (SFA), trans-fatty acids, and cholesterol may support a healthy weight.

Association between FTO gene polymorphisms and breast cancer: the role of estrogen.

Introduction: The fat mass and obesity-associated (FTO) gene may be associated with breast cancer risk. This study aimed to systematically investigate the association between FTO gene polymorphisms and breast cancer and the possible role of estrogen in this association.Areas covered: We performed an extensive search of electronic databases such as PubMed, Science Direct, Scopus, and Cochran for published original studies on the association of FTO gene polymorphisms with breast cancer risk. Keywords such as breast cancer and/or FTO gene and/or polymorphism were used in order to identify the related articles. We excluded studies unrelated to the FTO genotype and the outcome of breast cancer.Expert opinion: FTO gene may have a significant association with the risk of breast cancer. The association between FTO gene polymorphisms and breast cancer was influenced by the status of estrogen receptors. Estrogen may promote breast cancer cell proliferation through up-regulation of FTO gene expression and activation of the PI3 K/Akt signaling pathway in estrogen receptor positive patients. Further studies are warranted to identify the underlying mechanisms and signaling pathways involved in the interactions between FTO gene, estrogen, and the risk of breast cancer.