Adipose tissue fatty acids in breast cancer patients versus healthy control women from Crete.

BACKGROUND: Few studies have implemented biomarkers of fatty acid intake in relation to breast cancer. AIMS: To examine possible differences in adipose tissue fatty acid composition between breast cancer patients and healthy control women. The relationship between tumor promotion and adipose tissue fatty acid synthesis was also investigated. METHODS: The study was conducted at the University of Crete. Subjects included 94 women with clinically diagnosed cancer of the breast and 131 healthy control women. Histological tumor grading and breast cancer staging were assessed. Fatty acids were determined by gas chromatography in gluteal adipose tissue. RESULTS: Conditional logistic regression analysis controlling for potential confounders indicated that elevated adipose monounsaturated fatty acids and oleic acid are associated with reduced odds of breast cancer [OR (T2 vs. T1) 0.15; 95% CI 0.03-0.64, and OR (T2 vs. T1) 0.18; 95% CI 0.04-0.71, respectively]. Adipose myristic acid was associated with an increase in breast cancer risk [OR (T3 vs. T1) 5.66; 95% CI 1.3-23.9]. CONCLUSIONS: Adipose oleic acid is inversely related, whereas adipose myristic acid is positively related to breast cancer risk. These relations could be mediated by Her-2/neu and FAS oncogenes.

Depression and adipose and serum cholesteryl ester polyunsaturated fatty acids in the survivors of the seven countries study population of Crete.

BACKGROUND: Studies have shown that depression relates to biomarkers of both short- and long-term polyunsaturated fatty acid (PUFA) intake. However, it is not known which of these two biomarkers has the closest relationship to depression. OBJECTIVE: To examine the relationship of depression with both adipose tissue and serum cholesteryl ester PUFA and to assess the importance of each of these two biomarkers in relating to depression. DESIGN: Cross-sectional study of healthy elderly men from the island of Crete. SETTING: The Preventive Medicine and Nutrition Clinic, University of Crete, Greece. SUBJECTS: A total of 150 males, aged 80-96 years. The subjects were survivors of the Greek Seven Countries Study group. METHODS: Fatty acids were determined by gas chromatography in adipose tissue and serum cholesteryl esters. Information about depression was obtained through the use of the short form of the Geriatric Depression Scale (GDS-15). RESULTS: Regression analysis showed that depression related positively to age and serum cholesteryl ester arachidonic/docosahexaenoic fatty acid ratio. The only significant unadjusted correlation between depression and serum cholesteryl ester and adipose fatty acids was with adipose alpha-linolenic acid (ALA) (r = -0.31, P < 0.01). Depressed males (GDS-15 > 5) had lower adipose ALA and sum n-3 fatty acids than non-depressed ones. There were no significant differences between depressed and non-depressed males in serum cholesteryl ester fatty acids. When adipose tissue ALA was included as one of the independent measures in the regression model, the observed positive relation between GDS-15 depression and cholesteryl ester arachidonic/docosahexaenoic ratio failed to persist. Instead, there was a negative relationship between GDS-15 depression and adipose tissue ALA. CONCLUSIONS: It appears that the fatty acids of the adipose tissue are better predictors of depression than those of serum cholesteryl esters. This indicates that depression relates more strongly to long-term than to short-term fatty acid intake. The reason for this may be the reported slow rate of deposition of dietary PUFA to the brain.

Depression and long chain n-3 fatty acids in adipose tissue in adults from Crete.

BACKGROUND: Only one study has investigated the relationship of essential fatty acids in the adipose tissue with depression in adults and suggested an inverse relationship between docosahexaenoic acid (22:6 n-3) (DHA) and depression. OBJECTIVE: To examine the relation between adipose tissue polyunsaturated fatty acids especially n-3 and n-6 fatty acids, an index of long-term or habitual fatty acid intake, and depression in adults. DESIGN: Cross-sectional study of healthy adults from the island of Crete. SETTING: The Preventive Medicine and Nutrition Clinic, University of Crete, Greece. SUBJECTS: A total of 130 healthy adults (59 males, 71 females) aged 22-58 years. The sample was a sub-sample of the Greek ApoEurope study group. METHODS: Fatty acids were determined by gas chromatography in adipose tissue. Information about depression was obtained through the Zung Self-rating Depression Scale. RESULTS: Adipose tissue DHA was inversely related with depression. Multiple linear regression analysis taking into account the possible confounding effect of age, gender, body mass index, smoking and educational level confirmed this association. CONCLUSIONS: The inverse relationship between adipose DHA and depression in adults, replicates findings of a previous study. This relationship indicates that a low long-term dietary intake of DHA is associated with an increased risk for depression in adults.

Depression and adipose essential polyunsaturated fatty acids.

The objective of the present study was to investigate the relation between adipose tissue polyunsaturated fatty acids, an index of long-term or habitual fatty acid dietary intake, and depression. The sample consisted of 247 healthy adults (146 males, 101 females) from the island of Crete. The number of subjects with complete data on all variables studied was 139. Subjects were examined at the Preventive Medicine and Nutrition Clinic of the University of Crete. Depression was assessed through the use of the Zung Self-rating Depression Scale. Mildly depressed subjects had significantly reduced (-34.6%) adipose tissue docosahexaenoic acid (DHA) levels than non-depressed subjects. Multiple linear regression analysis indicated that depression related negatively to adipose tissue DHA levels. In line with the findings of other studies, the observed negative relation between adipose tissue DHA and depression, in the present study, appears to indicate increasing long-term dietary DHA intakes with decreasing depression. This is the first literature report of a relation between adipose tissue DHA and depression. Depression has been reported to be associated with increased cytokine production, such as IL-1, IL-2, IL-6, INF-gamma and INF-alpha. On the other hand, fish oil and omega-3 fatty acids have been reported to inhibit cytokine synthesis. The observed negative relation between adipose DHA and depression, therefore, may stem from the inhibiting effect of DHA on cytokine synthesis.

Abdominal vs buttock adipose fat: relationships with children's serum lipid levels.

OBJECTIVE: To explore the extent to which the reported unfavorable fatty acid content of abdominal depots in adults is also true for children. In addition, the present study aims to assess the relative importance of abdominal vs buttock adipose tissue fat in the prediction of serum lipid levels in children. DESIGN: A cross-sectional study of children from the island of Crete. SETTING: The study was conducted between October 1999 and January 2000 in the Municipality of St Nikolas, Crete. SUBJECTS: A total of 475 children (aged 11-18) participated in the study. Data were obtained on children's anthropometry, serum lipids, physical activity and abdominal and buttock adipose tissue fatty acids. In total 138 children (aged 11-16) had complete data in all of the variables studied. RESULTS: Abdominal depots have elevated proportions of saturated fatty acids (P<0.001) and trans fatty acids (P<0.001), and reduced proportions of monounsaturated (P<0.001) and polyunsaturated fatty acids (P<0.001) in comparison to buttock depots. Buttock adipose tissue monounsaturated fat correlated negatively to serum LDL-C (P<0.05). Abdominal adipose tissue polyunsaturated fat had negative correlations with serum total cholesterol (P<0.05) and LDL-C (P<0.05). Regression analyses indicated that children's serum total cholesterol (P<0.05) and LDL-C (P<0.05) were inversely related to abdominal adipose tissue polyunsaturated fat. Body mass index was positively related to serum triglycerides (P<0.01) and LDL-C (P<0.01), and negatively to serum HDL-C (P<0.05). Age was negatively related to serum HDL-C (P<0.05). CONCLUSIONS: It appears that, similar to adults, children's fatty acid composition of abdominal adipose tissue is less favorable than that of the buttock. Abdominal depots have elevated proportions of saturated fatty acids and reduced proportions of monounsaturated and polyunsaturated fat in comparison to buttock depots. Moreover, children's abdominal depots appear to have higher trans fatty acid contents than buttock depots. Children's adipose polyunsaturated fat, a biomarker of long-term polyunsaturated fatty acid intake, is inversely related to serum total cholesterol and LDL-C. It appears that abdominal adipose tissue fatty acids are more strongly related to serum lipids than buttock adipose tissue fatty acids. This may be attributed to the reported higher lipolysis rates in abdominal as opposed to buttock depots. SPONSORSHIP: Funding was provided by the Municipality of St Nikolas, Crete, Greece.

Prostate cancer vs hyperplasia: relationships with prostatic and adipose tissue fatty acid composition.

The objective of the present study was to study whether adipose tissue and prostatic tissue fatty acid composition differentiates between prostate cancer and benign hyperplasia patients. In addition, the present investigation aimed at exploring the extent to which prostatic tissue fatty acid composition differentiates between prostate-confined cancer and extraprostatic disease including possible metastasis. The subjects were 71 male patients from the island of Crete. Half the patients (n=35) had been diagnosed with benign hyperplasia of the prostate, half with prostatic malignancy (n=36). Patients were examined at the outpatient clinic of the urology unit, University Hospital, Medical School, University of Crete. Relative to benign hyperplasia patients, cancer patients had elevated adipose tissue saturated and reduced monounsaturated fatty acid levels. Cancer patients had reduced prostate tissue stearic to oleic acid ratios and stearic acid levels as opposed to hyperplasia patients. The most pronounced difference between cancer patients and hyperplasia patients was a 3-fold elevated prostatic palmitoleic acid in the former group. Relative to benign hyperplasia patients, cancer patients had reduced prostate tissue arachidonic and docosahexaenoic acid levels. Finally, there was a significantly reduced omega-3/omega-6 polyunsaturated fatty acid ratio in the prostate cancer patient as opposed to the benign hyperplasia group. The pronounced elevations in prostatic tissue palmitoleic acid in cancer patients highlight a possible role of this fatty acid in neoplastic processes. The decreased arachidonic acid levels in cancer patients possibly stem from enhanced metabolism of arachidonic acid via lipoxygenase and cyclooxygenase pathways, and the formation of derivatives such as 5-HETE, 15-HETE, 12(S)-HETE and PGE(2).

Adipose fat quality vs. quantity: relationships with children's serum lipid levels.

BACKGROUND: There is a controversy as to the relative importance of obesity vs quality of dietary fat in the prediction of serum lipoproteins in children. A reason for this is an apparent lack of studies implementing biomarkers of long-term dietary fat intake among children. The objective of the present study was to assess the relative contribution of degree of obesity, fat centrality, and quality of adipose tissue fat in the prediction of serum lipids in 12-year-old children. METHODS: Pupils came from 40 schools randomly selected among 541 primary schools in three different provinces of the island of Crete. One thousand forty-six pupils were examined at age 6. At age 9, a representative sample from the original cohort (n = 579) was randomly selected for reevaluation. At the age of 12, a representative sample of 831 pupils was reexamined. At ages 6, 9, and 12, serum lipid measures were obtained from 941, 458, and 791 children, respectively. At age 12, data were obtained on pupils' anthropometry, serum lipids, dietary intake, physical fitness, and physical activity. Adipose tissue fatty acid data were obtained from a subsample of 194 children at age 12. RESULTS: Regression analyses indicated that children's serum triglycerides related positively to body mass index and waist-hip ratio (WHR). Serum HDL-C related negatively to WHR and positively to endurance run test, an index of physical fitness. Dietary fatty acids, assessed by a single administration of 3-day weighed-food records, did not relate to serum lipids. However, serum HDL-C related negatively to sum of adipose polyunsaturated fatty acids, a measure of long-term polyunsaturated fat intake. CONCLUSIONS: It appears that obesity and fat centrality are stronger predictors of children's serum lipids than the quality of long-term dietary fat intake or adipose tissue fatty acid composition. It is possible that this finding may relate to the particular subcutaneous depot studied. It is suggested that future studies study abdominal rather than buttock adipose tissue fatty acid composition in relation to children's serum lipid levels.

Obesity indices in a cohort of primary school children in Crete: a six year prospective study.

OBJECTIVE: To report on the body mass index (BMI), waist-to-hip ratio (WHR) and sum of skinfolds in a cohort of Cretan children and identify the factors associated with these indices. DESIGN: The present study was a follow-up study. Children were measured prospectively at ages 6, 9 and 12. SUBJECTS: Pupils came from 40 schools randomly selected from the 541 primary schools in three different provinces of Crete. 1046 pupils were examined at age 6. At age 9, a representative sample from the original cohort (n=579) was randomly selected for re-evaluation. At the age of 12, a sample of 831 pupils was re-examined, following similar procedures. MEASUREMENTS: Both during baseline and each subsequent follow-up, data were obtained on pupils' anthropometry, serum lipids, dietary intake, physical fitness and physical activity as well as their dietary and their health knowledge. Data on parents' anthropometry, age, occupation, educational level, and issues relating to health habits, attitudes and knowledge were also collected. RESULTS: Half of the obese children at age 6 were also obese at age 12. Cretan children had higher mean BMI than similar American cohorts. Compared to their American counterparts, Cretans had higher proportions of overweight in both genders across all ages tested. The endurance run test (ERT), an index of physical fitness, was positively associated with obesity indices. Sum of skinfolds related positively to serum LDL-C. Children from urban areas had higher skinfold sums than children from rural areas. Parental health-related hedonism related positively to children's BMI. CONCLUSION: It appears that these findings offer some support to the reported increasing prevalence of obesity among Greek children. Higher ERT, presumably reflecting higher physical activity, is associated with lower obesity. The relationship between degree of fatness and LDL-C appears to be evidenced at an early age in life. This relationship may relate to the reported VLDL and cholesteryl ester transfer protein elevations in obesity. The parental attitude of health-related hedonism appears to be linked with children's adiposity.

Anxiety and adipose essential fatty acid precursors for prostaglandin E1 and E2.

OBJECTIVE: The purpose of the present study was to investigate the relation state and trait anxiety and adipose tissue essential fatty acid precursors for prostaglandins E1 and E2. METHODS: The sample consisted of 144 male and female Cretan adults, 23 to 69 years of age. Anthropometric and arterial blood pressure measurements were taken, and adipose tissue samples as well as data concerning general health habits were collected. Dietary data were collected using the weekly food frequency questionnaire and the 24-hour dietary recall method, while state and trait anxiety was assessed through the use of the Spielberger State-Trait Anxiety Inventory (STAI) and the Zung anxiety scale. RESULTS: State anxiety (STAI) related positively with sex (p < 0.0003) and negatively with adipose fat myristic acid (C14:0) (p < 0.004). Similarly, Zung trait anxiety related positively with sex (p < 0.0001) and negatively with adipose tissue myristic acid (C14:0) (p < 0.04). Spielberger trait anxiety related positively with adipose (LA + ALA)/(AA + EPA) ratio (p < 0.0002) and negatively with (C14:0) (p < 0.02) and dietary monounsaturated fat (p < 0.03). CONCLUSION: It appears that the positive relation between trait anxiety and adipose (LA + ALA)/(AA + EPA) ratio may stem from the inhibiting role of catecholamines on delta 6 and delta 5 desaturases.

The effects of a health education intervention initiated at first grade over a 3 year period: physical activity and fitness indices.

A health education intervention was carried out for three consecutive years on primary school Cretan children. Baseline measures were obtained from 962 pupils (509 boys and 453 girls) registered in first grade in 1992. The health education intervention programme was directed at both the children of the intervention group and their parents, and has a projected duration of 6 years. After the completion of the 3 years of intervention and while pupils were in fourth grade, measures were obtained for evaluation purposes on a random subsample of 393 pupils of the original cohort. Statistically greater improvements in the intervention, as opposed to the control group, were observed for both children's and parents' health knowledge, and children's standing broad jump, sit-ups (SUP), sit-and-reach, handgrip and endurance run test (ERT). Furthermore, time spent on moderate to vigorous physical activities out of school significantly increased for intervention group children compared to the control group. Statistically smaller increases in the intervention as opposed to the control group were observed in suprailiac skinfold and body mass index. The degree of improvement in both SUP and ERT related positively to parent's baseline physical activity score. Finally, the parental attitude of health-related hedonism related negatively to SUP improvement.

Heart disease risk-factor status and dietary changes in the Cretan population over the past 30 y: the Seven Countries Study.

A follow-up study was conducted to identify the heart disease risk-factor status and dietary changes of surviving elderly subjects in Crete who took part in the Seven Countries Study in 1960. In 1991, data were obtained from 245 of the 686 original male participants (169 of the original 40-49-y age group and 76 men 50-59 y age group). In 1991, the men were 70-79 and 80-89 y old. There was a significant (11.5%) increase in serum total cholesterol concentrations between 1960 and 1991. Body mass index and systolic and diastolic blood pressures also increased significantly, and all age groups were characterized by central obesity. A representative subsample of 21 men took part in a 3-d weighed food record study. Dietary data indicated increases in the intake of saturated fat and decreases in monounsaturated fat over the 30-y period. Comparison with a 1962 representative Cretan sample indicated a significantly increased concentration of adipose palmitic acid (16:0) in our surviving sample. The observed changes occurred during a period when many developed countries were observing a decline in most heart disease risk factors.

Prevalence of obesity in Greece.

The purpose of the present study is the presentation of the available literature on obesity in Greece. The heterogeneity of design, small sample size and limited number of studies conducted, complicates the delineation of definite trends. Nevertheless, the existing literature appears to point at a high prevalence of obesity among Greek children. Childhood obesity, may partly be accounted for by the over-protection and forced feeding by Greek parents. With regard to the incidence of obesity among Greek adolescents, studies have yielded controversial results. On the other hand, the existing evidence appears to indicate a high prevalence of obesity among Greek adults and the elderly, particularly those above 30 years of age. In contrast to the females, males appear to be characterised by central obesity. These observations highlight a need for primary prevention measures.

Type A behavior and adipose tissue linoleic acid: implications for stress management.

OBJECTIVE: The purpose of the present study was to investigate the relation between Type A behavior and adipose tissue linoleic acid composition. METHODS: The sample consisted of 73 male and female Cretan adults, 23-64 years of age. Anthropometric and arterial blood pressure measurements were taken. Adipose tissue samples were collected by aspiration and data concerning general health habits were obtained. Food intake was estimated by a 24-hour dietary recall, while Type A profile was assessed with a Greek translation of the Bortner scale. RESULTS: Factors associated with Type A profile are adipose tissue linoleic acid (p < 0.0004), annual income (p < 0.001), total serum cholesterol (p < 0.009), and adipose fat myristoleic acid (p < 0.02). Negative correlations were observed between adipose linoleic and myristoleic acids and the dependent variable. CONCLUSION: It appears that adipose tissue linoleic acid may be one of the etiological factors for Type A behavior in adults.

Nutrition status of the elderly in Anogia, Crete, Greece.

General health and nutritional status of 167 free-living elderly Greek (aged 65-91 years) were assessed. The most prevalent diseases/symptoms encountered were related to respiratory, gastrointestinal, musculoskeletal and vascular systems (hypertension). Most subjects were socially active. Body mass index was < 20 and > 25 Kg/m2 in 7 and 57% of the subjects, respectively. Systolic blood pressure was significantly higher in women than in men, and as a group, 18 and 42%, respectively, had diastolic blood pressures > 90 and systolic blood pressures > 160 mmHg. Anemia and hypoalbuminemia were detected in < 5% of the population. Total fat intake was 40-45% of total energy intake and most of it came from monounsaturated fat. Hypercholesterolemia (> 6 mmol/L) was present in 32% of subjects. The percentages of men who smoked (66%) or drank (68%) were significantly higher than those of women (2 and 1%, respectively). Dietary intake data were compared with US recommended dietary allowances (RDA) for elderly. Daily energy and protein intakes were lower than the US RDA levels; calcium intake was > 50% of the US RDA, while magnesium and vitamin B6 levels were < 50% of the US RDA. Vitamin C intake was much higher than that of the US RDA. Mean thiamin, vitamin A, riboflavin and iron intakes were below the US RDA, while fiber intake was < 50% of the corresponding US estimate. Phosphorus was higher than the US RDA in men, while lower for women. Sodium intakes exceeded those recommended, while potassium levels were higher than those recommended in males, and lower in females.(ABSTRACT TRUNCATED AT 250 WORDS)

Alcohol, tobacco, and father's aggressive behavior in relation to socioeconomic variables in Cretan low versus medium income families.

In order to identify socioeconomic factors affecting parents' alcohol and cigarette consumption and father's aggressiveness toward other family members, 87 low-income and 92 medium-income Greek families were tested. Father's alcohol consumption correlated positively with his smoking (p < .0008) and aggressive behavior (p < .00005), while mother's alcohol correlated positively with her smoking (p < .0001) and number of marriages (p < .01), and negatively with the family's overcrowding index (p < .006). Furthermore, father's smoking correlated positively with his alcohol (p < .01), and mother's smoking with her alcohol (p < .0004) and tenancy (p < .01). Finally, father's aggressiveness was found to be positively related to his alcohol consumption and negatively to his work and level of education.