ABSTRACT
OBJECTIVE: To analyse the relationship of the risk of breast cancer (BC) to meat intake, preference regarding degree of cooking ('doneness') and cooking methods, using data from a population-based case-control study (MCC-Spain). STUDY DESIGN: 1006 Histologically confirmed incident BC cases and 1370 controls were recruited in 10 Spanish provinces. Participants were 23-85 years old. They answered an epidemiological survey and a food frequency questionnaire. BC risk was assessed overall, by menopausal status and by pathological subtypes, using logistic and multinomial regression mixed models adjusted for known confounding factors and including province as a random effects term. MAIN OUTCOME MEASURES: Breast cancer and pathological subtype. RESULTS: High total intake of meat (ORQ4-Q1 (95% IC)â¯=â¯1.39 (1.03-1.88)) was associated with increased BC risk among post-menopausal women. Similar results were found for processed/cured meat (ORQ4-Q1 (95% IC)â¯=â¯1.47 (1.10-1.97)), and this association was particularly strong for triple-negative tumours (ER-, PR- and HER2-) (ORQ4-Q1 (95% IC)â¯=â¯2.52 (1.15-5.49)). Intakes of well-done (ORwell-donevsrare (95% CI)â¯=â¯1.62 (1.15-2.30)) and stewed (OR (95% CI)â¯=â¯1.49 (1.20-1.84)) red meat were associated with increased BC risk, with a high risk observed for HR+ tumours (ER+/PR+ and HER2-). Pan-fried/bread-coated fried white meat, but not doneness preference, was associated with an increased BC risk for all women (OR (95% CI)â¯=â¯1.38 (1.14-1.65)), with a stronger association for pre-menopausal women (OR (95% CI)â¯=â¯1.78 (1.29-2.46)). CONCLUSION: The risk of developing BC could be reduced by moderating the consumption of well-done or stewed red meat, pan-fried/bread-coated fried white meat and, especially, processed/cured meat.
Subject(s)
Breast Neoplasms/epidemiology , Cooking , Meat , Adult , Aged , Aged, 80 and over , Case-Control Studies , Diet , Female , Humans , Middle Aged , Premenopause , Risk Factors , Spain/epidemiology , Surveys and Questionnaires , Young AdultABSTRACT
Hay gran evidencia sobre los efectos de la pobreza y la exclusión social en la salud infantil. En los últimos años se ha apreciado un interés creciente por el impacto del gradiente social en la salud infantil según la posición social, la educación familiar, el sexo o la etnia. Diversos estudios de cohortes han demostrado la relación entre la posición socioeconómica materna en el período perinatal y la salud en la edad adulta. La comisión de determinantes sociales en salud (CSDH, Commission on Social Determinants of Health) de la Organización Mundial de la Salud propuso eliminar las brechas en la salud en una generación, otorgando un papel destacado al desarrollo temprano (ECD, early child development). El nivel de educación familiar y el rendimiento académico son determinantes fundamentales de las desigualdades. Se dispone de muy poca evidencia empírica sobre la efectividad de las intervenciones dirigidas a disminuir las desigualdades. La mayoría de las intervenciones en la infancia y la adolescencia se encaminan al cambio de conductas individuales, y muy pocas se han evaluado de forma crítica. Se revisan algunas iniciativas e intervenciones recientes dirigidas a reducir las desigualdades sociales en salud infantil, y se presenta un listado a tener en cuenta al evaluar las intervenciones dirigidas a la promoción de la salud y la prevención en las escuelas desde la perspectiva de las desigualdades sociales y de género. Se proponen algunas estrategias para la recogida de información, la investigación y las políticas sanitarias y educativas (AU)
There is considerable evidence of the impact of poverty and social exclusion on child health. In the last few years, interest has grown in the concept of social gradients in health, according to social position, family educational level, gender, and ethnic background. Several cohort studies have demonstrated an association between maternal socioeconomic position during the prenatal period and adult health. The Commission on Social Determinants of Health of the World Health Organization proposed closing the health gap in a generation by giving a major role to early child development. Family educational level and academic achievement are fundamental determinants of health inequalities. There is scarce empirical evidence on the effectiveness of interventions to reduce child health inequalities. Most of the interventions in children and adolescents aim to change individual behavior, and very few have been critically evaluated. The present manuscript provides a review of initiatives and recent interventions aimed at reducing social inequalities, as well as a checklist to be taken into account in interventions on health promotion and disease prevention in schools from the perspective of social and gender inequalities. Strategies for data collection, research and health and educational policies are proposed (AU)
Subject(s)
Humans , Male , Female , Child , Adolescent , Health Status Disparities , Child Welfare , Spain , Socioeconomic FactorsABSTRACT
There is considerable evidence of the impact of poverty and social exclusion on child health. In the last few years, interest has grown in the concept of social gradients in health, according to social position, family educational level, gender, and ethnic background. Several cohort studies have demonstrated an association between maternal socioeconomic position during the prenatal period and adult health. The Commission on Social Determinants of Health of the World Health Organization proposed closing the health gap in a generation by giving a major role to early child development. Family educational level and academic achievement are fundamental determinants of health inequalities. There is scarce empirical evidence on the effectiveness of interventions to reduce child health inequalities. Most of the interventions in children and adolescents aim to change individual behavior, and very few have been critically evaluated. The present manuscript provides a review of initiatives and recent interventions aimed at reducing social inequalities, as well as a checklist to be taken into account in interventions on health promotion and disease prevention in schools from the perspective of social and gender inequalities. Strategies for data collection, research and health and educational policies are proposed.
Subject(s)
Child Welfare , Health Status Disparities , Adolescent , Child , Female , Humans , Male , Socioeconomic Factors , SpainABSTRACT
Motor road transport has increased exponentially in the last few years. To a large extent, mobility is an essential element in the organization of society, but, until recently, the implications of chosen forms of transport for health and the environment have not been considered. In this chapter we review the negative impact of current forms of transport on health in terms of traffic injuries, climate change, atmospheric contamination, noise, and interference with daily activities and exercise, such as impediments to walking or cycling. Some possible interventions related to the instruments available in public health and other fields are proposed. Issues deserving further research are highlighted. Some examples in Spain and other countries are described. Recommendations are made on the need to reduce the use of private cars and to develop segmented routes and areas of quiet traffic connected in the cities and among nearby towns to promote walking are cycling. One major goal in current public policies should be to develop and maintain a public transport system that is safe, cheap and faster and less polluting than private transport. These interventions would help to achieve a change in current modes of transport and would lead to a healthier population and a more sustainable environment.
Subject(s)
Environment , Health , Transportation , Humans , SpainABSTRACT
El transporte a motor se ha incrementado de manera exponencialen los últimos años. La organización de la sociedadrequiere en gran medida la movilidad como un elemento esencial,pero, hasta hace poco tiempo, no se habían consideradolas implicaciones para la salud y el medio ambiente de lasformas de desplazamiento elegidas. En este capítulo se revisael impacto negativo en salud que el tipo de transporte actualtiene en términos de lesiones de tráfico, el cambio climático,la contaminación atmosférica, el ruido, y las interferenciaspara las actividades cotidianas y la actividad física, como ladificultad para andar o ir en bicicleta. Se proponen algunas intervencionesposibles relacionadas con los instrumentos disponiblesen salud pública y otras áreas, y se destacan aspectosdonde se necesita más investigación. Se describen algunosejemplos en España y en otros países. Se hacen recomendacionesacerca de la necesidad de reducir el uso del cocheprivado, desarrollar vías segmentadas y espacios de tráfico tranquiloconectados en las ciudades y entre pueblos cercanos parapromocionar el desplazamiento andando o en bicicleta. Se planteaque el desarrollo y el mantenimiento de un sistema de transportepúblico que sea más rápido, seguro, barato y menos contaminanteque el transporte privado debería ser una metaimportante en las políticas públicas actuales. Estas accionesayudarán a conseguir un cambio en los modos de transportede la sociedad y, consecuentemente, una población más sanay un ambiente más sostenible(AU)
Motor road transport has increased exponentially in the lastfew years. To a large extent, mobility is an essential elementin the organization of society, but, until recently, the implicationsof chosen forms of transport for health and the environmenthave not been considered.In this chapter we review the negative impact of current formsof transport on health in terms of traffic injuries, climate change,atmospheric contamination, noise, and interference withdaily activities and exercise, such as impediments to walkingor cycling. Some possible interventions related to the instrumentsavailable in public health and other fields are proposed.Issues deserving further research are highlighted.Some examples in Spain and other countries are described.Recommendations are made on the need to reduce the useof private cars and to develop segmented routes and areasof quiet traffic connected in the cities and among nearby townsto promote walking are cycling. One major goal in currentpublic policies should be to develop and maintain a publictransport system that is safe, cheap and faster and less pollutingthan private transport. These interventions would helpto achieve a change in current modes of transport and wouldlead to a healthier population and a more sustainable environment(AU)
Subject(s)
Humans , Male , Female , Environmental Health/education , Environmental Health/methods , Accidents, Traffic/legislation & jurisprudence , Accidents, Traffic/prevention & control , Noise/adverse effects , Noise, Transportation/legislation & jurisprudence , Noise, Transportation/prevention & control , Noise/prevention & control , Air Pollution/prevention & control , Public Policy , Transportation/standards , Noise/legislation & jurisprudence , Air Pollution/legislation & jurisprudence , Transportation/methods , Environmental Health/organization & administration , Environmental Health/standards , Environmental Health/trends , Ecosystem , Accidents, Traffic/trendsABSTRACT
El transporte a motor se ha incrementado de manera exponencial en los últimos años. La organización de la sociedad requiere en gran medida la movilidad como un elemento esencial, pero, hasta hace poco tiempo, no se habían considerado las implicaciones para la salud y el medio ambiente de las formas de desplazamiento elegidas. En este capítulo se revisa el impacto negativo en salud que el tipo de transporte actual tiene en términos de lesiones de tráfico, el cambio climático, la contaminación atmosférica, el ruido, y las interferencias para las actividades cotidianas y la actividad física, como la dificultad para andar o ir en bicicleta. Se proponen algunas intervenciones posibles relacionadas con los instrumentos disponibles en salud pública y otras áreas, y se destacan aspectos donde se necesita más investigación. Se describen algunos ejemplos en España y en otros países. Se hacen recomendaciones acerca de la necesidad de reducir el uso del coche privado, desarrollar vías segmentadas y espacios de tráfico tranquilo conectados en las ciudades y entre pueblos cercanos para promocionar el desplazamiento andando o en bicicleta. Se plantea que el desarrollo y el mantenimiento de un sistema de transporte público que sea más rápido, seguro, barato y menos contaminante que el transporte privado debería ser una meta importante en las políticas públicas actuales. Estas acciones ayudarán a conseguir un cambio en los modos de transporte de la sociedad y, consecuentemente, una población más sana y un ambiente más sostenible
Motor road transport has increased exponentially in the last few years. To a large extent, mobility is an essential element in the organization of society, but, until recently, the implications of chosen forms of transport for health and the environment have not been considered. In this chapter we review the negative impact of current forms of transport on health in terms of traffic injuries, climate change, atmospheric contamination, noise, and interference with daily activities and exercise, such as impediments to walking or cycling. Some possible interventions related to the instruments available in public health and other fields are proposed. Issues deserving further research are highlighted. Some examples in Spain and other countries are described. Recommendations are made on the need to reduce the use of private cars and to develop segmented routes and areas of quiet traffic connected in the cities and among nearby towns to promote walking are cycling. One major goal in current public policies should be to develop and maintain a public transport system that is safe, cheap and faster and less polluting than private transport. These interventions would help to achieve a change in current modes of transport and would lead to a healthier population and a more sustainable environment
