Identification of four novel QTL linked to the metabolic syndrome in the Berlin Fat Mouse.

BACKGROUND: The Berlin Fat Mouse Inbred line (BFMI) is a model for obesity and the metabolic syndrome. This study aimed to identify genetic variants associated with impaired glucose metabolism using the obese lines BFMI861-S1 and BFMI861-S2, which are genetically closely related, but differ in several traits. BFMI861-S1 is insulin resistant and stores ectopic fat in the liver, whereas BFMI861-S2 is insulin sensitive. METHODS: In generation 10, 397 males of an advanced intercross line (AIL) BFMI861-S1 × BFMI861-S2 were challenged with a high-fat, high-carbohydrate diet and phenotyped over 25 weeks. QTL-analysis was performed after selective genotyping of 200 mice using the GigaMUGA Genotyping Array. Additional 197 males were genotyped for 7 top SNPs in QTL regions. For the prioritization of positional candidate genes whole genome sequencing and gene expression data of the parental lines were used. RESULTS: Overlapping QTL for gonadal adipose tissue weight and blood glucose concentration were detected on chromosome (Chr) 3 (95.8-100.1 Mb), and for gonadal adipose tissue weight, liver weight, and blood glucose concentration on Chr 17 (9.5-26.1 Mb). Causal modeling suggested for Chr 3-QTL direct effects on adipose tissue weight, but indirect effects on blood glucose concentration. Direct effects on adipose tissue weight, liver weight, and blood glucose concentration were suggested for Chr 17-QTL. Prioritized positional candidate genes for the identified QTL were Notch2 and Fmo5 (Chr 3) and Plg and Acat2 (Chr 17). Two additional QTL were detected for gonadal adipose tissue weight on Chr 15 (67.9-74.6 Mb) and for body weight on Chr 16 (3.9-21.4 Mb). CONCLUSIONS: QTL mapping together with a detailed prioritization approach allowed us to identify candidate genes associated with traits of the metabolic syndrome. In addition, we provided evidence for direct and indirect genetic effects on blood glucose concentration in the insulin-resistant mouse line BFMI861-S1.

Brown adipose tissue prevents glucose intolerance and cardiac remodeling in high-fat-fed mice after a mild myocardial infarction.

BACKGROUND: Obesity increases the risk of developing impaired glucose tolerance (IGT) and type 2 diabetes (T2D) after myocardial infarction (MI). Brown adipose tissue (BAT) is important to combat obesity and T2D, and increasing BAT mass by transplantation improves glucose metabolism and cardiac function. The objective of this study was to determine if BAT had a protective effect on glucose tolerance and cardiac function in high-fat diet (HFD) fed mice subjected to a mild MI. METHODS: Male C57BL/6 mice were fed a HFD for eight weeks and then divided into Sham (Sham-operated) and +BAT (mice receiving 0.1 g BAT into their visceral cavity). Sixteen weeks post-transplantation, mice were further subdivided into ±MI (Sham; Sham-MI; +BAT; +BAT-MI) and maintained on a HFD. Cardiac (echocardiography) and metabolic function (glucose and insulin tolerance tests, body composition and exercise tolerance) were assessed throughout 22 weeks post-MI. Quantitative PCR (qPCR) was performed to determine the expression of genes related to metabolic function of perigonadal adipose tissue (pgWAT), subcutaneous white adipose tissue (scWAT), liver, heart, tibialis anterior skeletal muscle (TA); and BAT. RESULTS: +BAT prevented the increase in left ventricle mass (LVM) and exercise intolerance in response to MI. Similar to what is observed in humans, Sham-MI mice developed IGT post-MI, but this was negated in +BAT-MI mice. IGT was independent of changes in body composition. Genes involved in inflammation, insulin resistance, and metabolism were significantly altered in pgWAT, scWAT, and liver in Sham-MI mice compared to all other groups. CONCLUSIONS: BAT transplantation prevents IGT, the increase in LVM, and exercise intolerance following MI. MI alters the expression of several metabolic-related genes in WAT and liver in Sham-MI mice, suggesting that these tissues may contribute to the impaired metabolic response. Increasing BAT may be an important intervention to prevent the development of IGT or T2D and cardiac remodeling in obese patients post-MI.

Health-related quality of life and its related factors in coronary heart disease patients: results from the Henan Rural Cohort study.

The aims were to identify the possible influencing factors of health-related quality of life (HRQoL) and its domain-specific scores in patients with coronary heart disease (CHD). A total of 1247 patients with CHD from the Henan Rural Cohort Study (n = 39,259) were included in this study. The Chinese version of the European Quality of Life Five Dimension Five level scale (EQ-5D-5L) and Visual Analogue Scale (VAS) were used to evaluate HRQoL in patients with CHD. Tobit regression, generalized linear models and binary logistic regression were applied to determine the potential factors influencing the EQ-5D utility, as well as each domain, and the VAS. CHD patients had lower per capita monthly actual income, and higher rates of diabetes mellitus, stroke, anxiety and poor sleep quality, which significantly decreased EQ-5D index and VAS scores. In addition, sex, older age, education, not having a spouse, ever drinking alcohol, a high-fat diet, physical activity, hypertension and depression affected the various domain-specific EQ-5D scores in CHD patients. CHD patients in rural areas have a lower HRQoL. Factors associated with the EQ-5D index, including each domain, and the VAS need attention. CHD patients in rural areas need to be managed systematically.

Common variants in the CD36 gene are associated with dietary fat intake, high-fat food consumption and serum triglycerides in a cohort of Quebec adults.

BACKGROUND: The CD36 gene is a candidate for sensory detection of fatty acids and has been associated with individual differences in fat preferences and consumption. Excess adiposity may compromise sensory detection, but few studies have examined whether associations between CD36 variants and fat consumption differ between underweight/normal weight (UW/NW) and overweight/obese (OW/OB) individuals. METHODS: Diet (assessed by food frequency questionnaire), genetic (nine variants), body mass index (BMI), lifestyle and biomarker data were obtained from the CARTaGENE biobank (n = 12,065), a Quebec cohort of middle-aged adults. Primary outcome variables included intakes (%kcal/day) of total, saturated (SFA), monounsaturated (MUFA) and polyunsaturated (PUFA) fatty acids. Secondary outcome variables included consumption (servings/day) of four food categories with high-fat content (added fats and oils, high-fat foods, desserts and MUFA- and PUFA-rich foods) and biomarkers of chronic disease. Multivariable regression models stratified by BMI category were used to assess associations between CD36 variants and outcome variables. RESULTS: Among UW/NW, rs1049654 and rs10499859 were associated with higher intakes of total fat, MUFA and PUFA (all P < 0.05), while rs1527483 and rs3211956 were associated with higher SFA (P = 0.0278) and lower PUFA (P = 0.0466) intake, respectively. Rs1527483 and rs3211956 were also associated with higher consumption of high-fat foods and desserts (all P < 0.05). Among OW, rs1054516 and rs3173798 were associated with higher SFA intake (both P < 0.05), and rs1054516 was also associated with higher serum triglycerides (P = 0.0065). CONCLUSIONS: CD36 variants are associated with habitual fat consumption, which may play a role in subsequent associations with chronic-disease biomarkers. Associations differ by BMI status and dietary fat type.

Low-Intensity Exercise Training Additionally Increases Mitochondrial Dynamics Caused by High-Fat Diet (HFD) but Has No Additional Effect on Mitochondrial Biogenesis in Fast-Twitch Muscle by HFD.

This study examines how the high-fat diet (HFD) affects mitochondrial dynamics and biogenesis, and also whether combining it with low-intensity endurance exercise adds to these effects. Six 8-week-old male Sprague-Dawley (SD) rats were put on control (CON; standard chow diet), HF (HFD intake), and HFEx (HFD + low-intensity treadmill exercise) for 6 weeks. As a result, no change in body weight was observed among the groups. However, epididymal fat mass increased significantly in the two groups that had been given HFD. Blood free fatty acid (FFA) also increased significantly in the HF group. While HFD increased insulin resistance (IR), this was improved significantly in the HFEx group. HFD also significantly increased mitochondrial biogenesis-related factors (PPARδ, PGC-1α, and mtTFA) and mitochondrial electron transport chain proteins; however, no additional effect from exercise was observed. Mitochondrial dynamic-related factors were also affected: Mfn2 increased significantly in the HFEx group, while Drp1 and Fis-1 increased significantly in both the HF and HFEx groups. The number of mitochondria in the subsarcolemmal region, and their size in the subsarcolemmal and intermyofibrillar regions, also increased significantly in the HFEx group. Taken overall, these results show that HFD in combination with low-intensity endurance exercise has no additive effect on mitochondrial biogenesis, although it does have such an effect on mitochondrial dynamics by improving IR.

Short-Term Diet Induced Changes in the Central and Circulating IGF Systems Are Sex Specific.

Insulin-like growth factor (IGF) 1 exerts a wide range of functions in mammalians participating not only in the control of growth and metabolism, but also in other actions such as neuroprotection. Nutritional status modifies the IGF system, although little is known regarding how diet affects the newest members of this system including pregnancy-associated plasma protein-A (PAPP-A) and PAPP-A2, proteases that liberate IGF from the IGF-binding proteins (IGFBPs), and stanniocalcins (STCs) that inhibit PAPP-A and PAPP-A2 activity. Here we explored if a 1-week dietary change to either a high-fat diet (HFD) or a low-fat diet (LFD) modifies the central and peripheral IGF systems in both male and female Wistar rats. The circulating IGF system showed sex differences in most of its members at baseline. Males had higher levels of both free (p < 0.001) and total IGF1 (p < 0.001), as well as IGFBP3 (p < 0.001), IGFBP5 (p < 0.001), and insulin (p < 0.01). In contrast, females had higher serum levels of PAPP-A2 (p < 0.05) and IGFBP2 (p < 0.001). The responses to a short-term dietary change were both diet and sex specific. Circulating levels of IGF2 increased in response to LFD intake in females (p < 0.001) and decreased in response to HFD intake in males (p < 0.001). In females, LFD intake also decreased circulating IGFBP2 levels (p < 0.001). In the hypothalamus LFD intake increased IGF2 (p < 0.01) and IGFBP2 mRNA (p < 0.001) levels, as well as the expression of NPY (p < 0.001) and AgRP (p < 0.01), but only in males. In conclusion, short-term LFD intake induced more changes in the peripheral and central IGF system than did short-term HFD intake. Moreover, these changes were sex-specific, with IGF2 and IGFBP2 being more highly affected than the other members of the IGF system. One of the main differences between the commercial LFD employed and the HFD or normal rodent chow is that the LFD has a significantly higher sucrose content, suggesting that this nutrient could be involved in the observed responses.

Withdrawal of High-Carbohydrate, High-Fat Diet Alters Status of Trace Elements to Ameliorate Metabolic Syndrome in Rats With Type 2 Diabetes Mellitus.

OBJECTIVES: Inadequate nutrient supply and insulin resistance contribute to the pathogenesis of metabolic syndrome (MetS) and increase the risk of developing cardiovascular disease. MetS can be induced by prolonged feeding of a high-carbohydrate, high-fat (HCHF) diet. The present study was designed using Wistar albino rats as an experimental model to investigate the effect of subchronic withdrawal of an HCHF diet during MetS on distribution of copper (Cu), iron (Fe), magnesium (Mg), manganese (Mn), zinc (Zn) and chromium (Cr) in different biological media. METHODS: The experimental animals were fed an HCHF diet for up to 16 weeks for induction of MetS. After inducing MetS, some animals were shifted to a basal diet for the next 4 weeks. Distribution of trace elements (TE) in serum, liver and faeces at the different time intervals and their relationship with dietary TE were analyzed. RESULTS: On withdrawal of the HCHF diet, concentrations of Zn, Mg, Mn (serum, p<0.05; liver, p<0.001) and Cr were increased, and Cu and Fe were decreased in serum and liver at week 16. Furthermore, levels of Cu and Fe were reduced significantly (p<0.05) in faeces on feeding the HCHF diet and increased on withdrawal of the diet, which also reflects the metabolic fate of TE during MetS. CONCLUSIONS: Consumption of an HCHF diet over a long time period leads to alteration of the TE profile in serum, liver and feces during MetS, which is reversed upon dietary intervention. This can be correlated with their concentrations in HCHF and basal diets, and hence can contribute to proper dietary control of this global issue.

Associations of unhealthy lifestyles with metabolic syndrome in Chinese rural aged females.

The purpose of this study is to update the prevalence of metabolic syndrome (MetS) and explore to identify the susceptible populations. A total of 38208 subjects aged 18 to 79 years were obtained from the Henan Rural Cohort Study (n = 39259). Five criteria (ATP ß, IDF, JIS, CDS, EGIR) were used to estimate the prevalence of MetS. Multivariate logistic regression analysis was used to assess odds ratios (ORs) and 95% confidence interval (CI) of potential risk factors with MetS. The age-standardized prevalence of MetS were 27.87%, 24.63%, 27.40%, 18.00% and 8.91% according to the standard of ATP ß, IDF, JIS, CDS, and EGIR, respectively. After adjusted for the potential confounding factors, aging, females, physical activity and the state of drinking were independent risk factors of MetS. MetS is positively associated with stroke and coronary heart disease in all five criteria (P < 0.01). The current data identify a high prevalence of MetS among Chinese rural adults. Especially for aged females with unhealthy lifestyle had a higher risk for MetS.

Physical frailty in older men: prospective associations with diet quality and patterns.

BACKGROUND: increasing numbers of older adults are living with frailty and its adverse consequences. We investigated relationships between diet quality or patterns and incident physical frailty in older British men and whether any associations were influenced by inflammation. METHODS: prospective study of 945 men from the British Regional Heart Study aged 70-92 years with no prevalent frailty. Incident frailty was assessed by questionnaire after 3 years of follow-up. Frailty was defined as having at least three of: low grip strength, low physical activity, slow walking speed, unintentional weight loss and feeling of low energy, all based on self-report. The Healthy Diet Indicator (HDI) based on WHO dietary guidelines and the Elderly Dietary Index (EDI) based on a Mediterranean-style dietary intake were computed from questionnaire data and three dietary patterns were identified using principal components analysis: prudent, high fat/low fibre and high sugar. RESULTS: men in the highest EDI category and those who followed a prudent diet were less likely to become frail [top vs bottom category odds ratio (OR) (95% CI) 0.49 (0.30, 0.82) and 0.53 (0.30, 0.92) respectively] after adjustment for potential confounders including BMI and prevalent cardiovascular disease. No significant association was seen for the HDI. By contrast those who had a high fat low fibre diet pattern were more likely to become frail [OR (95% CI) 2.54 (1.46, 4.40)]. These associations were not mediated by C-reactive protein (marker of inflammation). CONCLUSIONS: the findings suggest adherence to a Mediterranean-style diet is associated with reduced risk of developing frailty in older people.

Association between dietary patterns and metabolic syndrome in Chinese adults: a propensity score-matched case-control study.

Previous studies indicated that dietary patterns were associated with metabolic syndrome (MS), but little is known in Chinese. We design this case-control study to evaluate the associations between dietary patterns and MS in Chinese adults. In this study, 1492 participants with MS were matched with 1492 controls using the 1:1 ratio propensity score matching methods. Dietary intake was assessed using a valid self-administered food frequency questionnaire, and MS was defined in accordance with the criteria of the American Heart Association scientific statement of 2009. Higher scores for the high-protein/cholesterol pattern were associated with higher prevalence of MS. Compared with the participants in the lowest quartile, the odds ratio (OR) for the extreme quartile was 1.36 (95% confidence interval (CI), 1.10-1.68) and the P for trend <0.01 after adjusted for the other two dietary pattern scores. We also found a moderate consumption of the balanced pattern was associated with the lowest prevalence of MS. The ORs across quartiles of the balanced pattern were 1 (reference), 0.83 (95% CI, 0.68-1.02), 0.69 (95% CI, 0.56-0.85), and 0.84 (95% CI, 0.68-1.04) after adjustment. Our study demonstrates that there is a strong association between a diet rich in animal offal, animal blood, meat, and sausage and a higher prevalence of MS.

Retracted: Effect of a high-fat Mediterranean diet on bodyweight and waist circumference: a prespecified secondary outcomes analysis of the PREDIMED randomised controlled trial.

BACKGROUND: Because of the high density of fat, high-fat diets are perceived as likely to lead to increased bodyweight, hence health-care providers are reluctant to recommend them to overweight or obese individuals. We assessed the long-term effects of ad libitum, high-fat, high-vegetable-fat Mediterranean diets on bodyweight and waist circumference in older people at risk of cardiovascular disease, most of whom were overweight or obese. METHODS: PREDIMED was a 5 year parallel-group, multicentre, randomised, controlled clinical trial done in primary care centres affiliated to 11 hospitals in Spain. 7447 asymptomatic men (aged 55-80 years) and women (aged 60-80 years) who had type 2 diabetes or three or more cardiovascular risk factors were randomly assigned (1:1:1) with a computer-generated number sequence to one of three interventions: Mediterranean diet supplemented with extra-virgin olive oil (n=2543); Mediterranean diet supplemented with nuts (n=2454); or a control diet (advice to reduce dietary fat; n=2450). Energy restriction was not advised, nor was physical activity promoted. In this analysis of the trial, we measured bodyweight and waist circumference at baseline and yearly for 5 years in the intention-to-treat population. The PREDIMED trial is registered with ISRCTN.com, number ISRCTN35739639. FINDINGS: After a median 4·8 years (IQR 2·8-5·8) of follow-up, participants in all three groups had marginally reduced bodyweight and increased waist circumference. The adjusted difference in 5 year changes in bodyweight in the Mediterranean diet with olive oil group was -0·43 kg (95% CI -0·86 to -0·01; p=0·044) and in the nut group was -0·08 kg (-0·50 to 0·35; p=0·730), compared with the control group. The adjusted difference in 5 year changes in waist circumference was -0·55 cm (-1·16 to -0·06; p=0·048) in the Mediterranean diet with olive oil group and -0·94 cm (-1·60 to -0·27; p=0·006) in the nut group, compared with the control group. INTERPRETATION: A long-term intervention with an unrestricted-calorie, high-vegetable-fat Mediterranean diet was associated with decreases in bodyweight and less gain in central adiposity compared with a control diet. These results lend support to advice not restricting intake of healthy fats for bodyweight maintenance. FUNDING: Spanish Government, CIBERobn, Instituto de Salud Carlos III, Hojiblanca, Patrimonio Comunal Olivarero, California Walnut Commission, Borges SA, and Morella Nuts.

Unhealthy food consumption in adolescence: role of sedentary behaviours and modifiers in 11-, 13- and 15-year-old Italians.

BACKGROUNDS AND AIM: Unhealthy eating behaviours increase with age and have been associated with adverse health consequences in adulthood. We examined the influence of screen-based sedentary behaviours (SBs) on unhealthy food consumption, such as energy-dense foods and sweetened drinks, among a representative sample of nearly 60 000 adolescents and assessed the role of possible modifiers. METHODS: Data come from the Italian 2009-10 Health Behaviour in School-aged Children (HBSC) survey. Data on Eating patterns, SBs, physical activity, peers network, BMI and socio-economic status (SES) were collected following the HBSC study protocol. Hierarchical logistic regression models were used. RESULTS: Unhealthy food consumption was significantly associated with a lower intake of fruit and vegetables and with the increase of SBs in both sexes and in all ages. The risk was interestingly higher in normal weight adolescents, in those with wider relationships with peers and in low SES children. CONCLUSIONS: This study adds evidence to support the importance of investing more resources in educational initiatives both to increase parents' awareness to support adolescents on dietary choices and on time spent in screen-based behaviours, independently of their adiposity status; and to develop youth's ability to access and appropriately use media and technologies. Policy makers should also increase their attention on introducing regulatory policies on television food advertising to which youth are exposed.

Association of high dietary saturated fat intake and uncontrolled diabetes with constipation: evidence from the National Health and Nutrition Examination Survey.

BACKGROUND: Constipation is highly prevalent in the United States. The association of dietary fat intake with constipation has not been well studied. We recently reported that mice fed a high-fat diet had higher incidence of constipation than regular diet fed mice. The aim of this study was to assess if increased intake of dietary saturated fat in humans is also associated with higher risk of constipation and reduced stool frequency. METHODS: Analyses were based on data from 6207 adults (≥20 years) from the 2005-2006 and 2007-2008 cycles of the National Health and Nutrition Examination Surveys who had completed the bowel health questionnaire. Constipation was defined as a stool frequency of less than three times per week. Multivariable logistic regression analysis was used to calculate adjusted prevalence odds ratio (OR) estimates. Statistical analyses were performed using R and RStudio softwares. KEY RESULTS: The prevalence of constipation in this sample was 3.1%. After multivariable adjustment high saturated fat remained associated with constipation. The OR for high saturated fat intake associated with constipation was much higher in diabetics above 65 years, especially in non-Hispanic blacks, females, and those with poor glycemic control, compared to the control group. CONCLUSIONS & INFERENCES: To the best of our knowledge, this is the first report to investigate the association of high saturated fat diet, bowel frequency, and diabetes. This study demonstrates that a high dietary saturated fat intake is associated with significant increase in the prevalence of constipation, especially in the uncontrolled diabetic, non-Hispanic black, female patients.

Fat, fibre and cancer risk in African Americans and rural Africans.

Rates of colon cancer are much higher in African Americans (65:100,000) than in rural South Africans (<5:100,000). The higher rates are associated with higher animal protein and fat, and lower fibre consumption, higher colonic secondary bile acids, lower colonic short-chain fatty acid quantities and higher mucosal proliferative biomarkers of cancer risk in otherwise healthy middle-aged volunteers. Here we investigate further the role of fat and fibre in this association. We performed 2-week food exchanges in subjects from the same populations, where African Americans were fed a high-fibre, low-fat African-style diet and rural Africans a high-fat, low-fibre western-style diet, under close supervision. In comparison with their usual diets, the food changes resulted in remarkable reciprocal changes in mucosal biomarkers of cancer risk and in aspects of the microbiota and metabolome known to affect cancer risk, best illustrated by increased saccharolytic fermentation and butyrogenesis, and suppressed secondary bile acid synthesis in the African Americans.

Association between dietary fat intake and bone mineral density in Korean adults: data from Korea National Health and Nutrition Examination Survey IV (2008 ∼ 2009).

UNLABELLED: We determined the relation between dietary fat intake and bone mineral density, and our study showed that low- as well as high-fat diet was associated with the risk of osteoporosis. Our study provides significant evidence of the specific dietary components that may be important modifiable factors for the prevention of osteoporosis. INTRODUCTION: Osteoporosis and osteoporosis-related fractures have become major public health problems. It is important to understand the various factors that influence bone health and to prevent osteoporosis by correcting modifiable risk factors for the disease. Previous studies suggested that dietary habits and body composition were potent factors associated with bone mineral density. The aim of this study was to determine the independent effect of dietary fat intake on bone mineral density while controlling for other possible confounders, including fat mass and lean body mass. METHODS: This study was based on data obtained in the Fourth Korea National Health and Nutrition Examination Survey. After serial exclusion of subjects according to the selection criteria, 7,192 subjects were included in our analysis. We divided the study population into quintiles according to dietary fat calorie/total calorie intake and compared the adjusted means of bone mineral density between quintiles. RESULTS: The bone mineral density was higher in men and women with a medium fat energy intake compared to those with a low- and high-fat energy intake, but the finding was statistically significant only in women. The results were valid after controlling for body fat percentage and lean body mass. CONCLUSIONS: We found that dietary fat intake is an independent modifiable risk factor for osteoporosis, regardless of body fat or lean body mass, especially in women. However, further investigations with accurate analyses of food intake and nutritional consumption, in addition to long-term follow-up data, are necessary to recommend an osteoporosis-preventive diet in Koreans.

Dietary guideline adherence for gastroesophageal reflux disease.

BACKGROUND: Gastroesophageal reflux disease (GERD) is the most common gastrointestinal disease, and the cost of health care and lost productivity due to GERD is extremely high. Recently described side effects of long-term acid suppression have increased the interest in nonpharmacologic methods for alleviating GERD symptoms. We aimed to examine whether GERD patients follow recommended dietary guidelines, and if adherence is associated with the severity and frequency of reflux symptoms. METHODS: We conducted a population-based cross-sectional study within the Kaiser Permanente Northern California population, comparing 317 GERD patients to 182 asymptomatic population controls. All analyses adjusted for smoking and education. RESULTS: GERD patients, even those with moderate to severe symptoms or frequent symptoms, were as likely to consume tomato products and large portion meals as GERD-free controls and were even more likely to consume soft drinks and tea [odds ratio (OR) = 2.01 95% confidence interval (CI) 1.12-3.61; OR = 2.63 95% CI 1.24-5.59, respectively] and eat fried foods and high fat diet. The only reflux-triggering foods GERD patients were less likely to consume were citrus and alcohol [OR = 0.59; 95% CI: 0.35-0.97 for citrus; OR = 0.41 95% CI 0.19-0.87 for 1 + drink/day of alcohol]. The associations were similar when we excluded users of proton pump inhibitors. CONCLUSIONS: GERD patients consume many putative GERD causing foods as frequently or even more frequently than asymptomatic patients despite reporting symptoms. These findings suggest that, if dietary modification is effective in reducing GERD, substantial opportunities for nonpharmacologic interventions exist for many GERD patients.

Tobacco smoking patterns and differential food effects on prostate and breast cancers among smokers and nonsmokers in Córdoba, Argentina.

The aim of this study was to estimate the effect of diet on prostate and breast cancer (PC and BC) risks in smokers and nonsmokers and to explore the effect modification between smoking and dietary patterns. PC or BC incidence rates were assessed spatially according to tobacco exposure, age-adjusted standardization using lung cancer mortality as a proxy. Two case-control studies were carried out in Argentina (2008-2012). Participants were interviewed about their diet, smoking habits, and other lifestyle factors. Multilevel models were fitted including family history of cancer as the random intercept for the second level, and diet and lifestyle variables as covariates. Tobacco exposure was aggregated spatially. Family history of cancer significantly accounts for PC and BC. In smokers, high intake of fat meat increased PC and BC risks [odds ratio (OR) 1.56, 95% confidence interval (CI) 0.81-3.05 and OR 6.01, 95% CI 1.99-8.19, respectively]. PC and BC risks were also greater in smokers with high intakes of fatty foods (OR 1.95, 95% CI 1.09-3.50 and OR 24.2, 95% CI 0.82-7.21, respectively). Moderate intake of nonstarchy vegetables and risk of PC were inversely associated in nonsmokers (OR 0.55, 95% CI 0.20-1.48). In smoker women, BC risk was associated with sweet drink consumption (OR 2.96, 95% CI 1.10-7.92) and ethanol intake (OR 5.15, 95% CI 1.88-14.16). Spatial distributions of cancer incidence rates match those of tobacco exposure. Differential effects of diet on PC and BC risks were found in smokers and nonsmokers.

Dietary fat intake and development of specific breast cancer subtypes.

We prospectively evaluated fat intake as predictor of developing breast cancer (BC) subtypes defined by estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor 2 receptor (HER2), in a large (n = 337327) heterogeneous cohort of women, with 10062 BC case patients after 11.5 years, estimating BC hazard ratios (HRs) by Cox proportional hazard modeling. High total and saturated fat were associated with greater risk of ER(+)PR(+) disease (HR = 1.20, 95% confidence interval [CI] = 1.00 to 1.45; HR = 1.28, 95% CI = 1.09 to 1.52; highest vs lowest quintiles) but not ER(-)PR(-) disease. High saturated fat was statistically significantly associated with greater risk of HER2(-) disease. High saturated fat intake particularly increases risk of receptor-positive disease, suggesting saturated fat involvement in the etiology of this BC subtype.