Meat consumption and risk of squamous cell carcinoma of the lung: a case-control study in Uruguayan men.

In the period 1995-2004, a hospital-based case-control study on meat consumption and squamous cell carcinoma of the lung in men was conducted in Montevideo, Uruguay. The study included 300 cases and 600 controls, frequency matched on age and residence. The results showed that total meat [odds ratio (OR) = 1.72, 95% confidence interval (CI): 1.05-2.81, P value for trend = 0.03], red meat (OR = 1.82, 95% CI: 1.13-2.91, P value for trend = 0.01), beef consumption (OR = 2.22, 95% CI: 1.42-3.45, P value for trend = 0.0004), bacon (OR = 1.50, 95% CI: 1.00-2.24, P value for trend = 0.03), saucisson (OR = 1.69, 95% CI: 1.07-2.67, P value for trend = 0.01), and salted meat intake (OR = 2.70, 95% CI: 1.63-4.46, P value for trend = 0.0001) were positively associated with squamous cell lung cancer. These results are discussed and we suggest that meat consumption could be considered as a strong risk factor for squamous cell lung cancer.

Nutrient-based dietary patterns of head and neck squamous cell cancer: a factor analysis in Uruguay.

OBJECTIVE: The aim of this study was to investigate the association between nutrient-based dietary patterns and squamous cell cancers of the head and neck. METHODS: We used a case-control study which included 548 cases and 548 controls. From these participants, we derived 23 nutrients and they were then submitted to a factorability analysis in order to conduct a principal component factor analysis. RESULTS: We were able to identify four nutrient-derived patterns. The first pattern (meat-based pattern) was positively associated with squamous cell cancer of the head and neck (OR 2.85, 95 % CI 1.81-4.15), whereas the third pattern (fruit-based) was strongly protective (OR 0.43, 95 % CI 0.27-0.63). The other nutrient patterns were also significantly associated with head and neck squamous cell carcinoma with minor ORs. CONCLUSION: Both patterns suggest that red meat and fruits are major factors in the etiology of head and neck squamous cell cancer, replicating previous studies in the field.

Meat, milk and risk of lymphoid malignancies: a case-control study in Uruguay.

In the time period 1996-2004, 697 cases with lymphoid neoplasms and 3606 controls with nonneoplastic conditions were included in a case-control study conducted in the Cancer Institute of Uruguay. They were administered a routine questionnaire that included 8 sections and a food frequency questionnaire focused on intakes of total meat, red meat, salted meat, barbecued meat, processed meat, milk, total vegetables and total fruits, and alcoholic beverages. Lymphoid cancers were analyzed by multiple polytomous regression. Red meat, salted meat, and milk were positively associated with risk of lymphoid cancers [odds ratios (OR) for the highest tertile vs. the lowest one of red meat = 1.68, 95% confidence interval (CI) 1.37-2.08, OR for whole milk = 2.92, 95% CI 2.63-3.63). On the other hand, plant foods, particularly total fruits, and alcoholic beverages (mainly red wine) were protective. We could conclude that these foods could play a significant role in the etiology of lymphoid malignancies.

Dietary patterns and risk of cancers of the upper aerodigestive tract: a factor analysis in Uruguay.

In the time period 1996-2004, we conducted a case-control study in Montevideo, Uruguay with the objective of exploring the role of foods and alcoholic beverages in the etiology of cancers of the upper aerodigestive tract (UADT). In brief, 563 male cases and 1099 male controls were frequency matched on age and residence using random sampling. All the participants were drawn from the 4 major public hospitals in Montevideo. We used exploratory factor analysis among controls. Through Scree plot test, the model retained 4 factors, which were labeled as prudent, starchy plants, Western, and drinker. These dietary patterns explained 34.8% of the total variance. Whereas the prudent pattern was inversely associated with UADT cancer [odds ratios (OR) for the upper tertile vs. the lowest one 0.52, 95% confidence intervals 0.32-0.76, P value for trend = 0.0005), the remaining patterns were significantly and positively associated with UADT cancers. We conclude that these patterns were similar among the oral and laryngeal cancers, both in the direction of the ORs and in the magnitude of the associations, suggesting that these cancer sites share the effect of dietary patterns in the etiology of cancer of the upper aerodigestive tract.

Food groups and risk of prostate cancer: a case-control study in Uruguay.

OBJECTIVE: The role of foods and beverages has been studied in detail in order to establish probable risk factors for prostate cancer. METHODS: Data were derived from 326 cases with incident and microscopically confirmed adenocarcinomas of the prostate and 652 controls. Odds ratios and 95 % confidence intervals of prostate cancer were estimated by unconditional multiple logistic regression. RESULTS: We identified the following food items as risk factors: lamb meat, salted meat, whole milk, total eggs, and maté consumption. The highest OR was associated with total eggs (OR, 2.43; 95 % CI, 1.70-3.48), followed by salted meat (OR, 2.65; 95 % CI, 1.36-3.76), maté consumption (OR, 1.96; 95 % CI, 1.17-3.31), and whole milk (OR, 2.01; 95 % CI, 1.26-2.51). CONCLUSIONS: The final model, fitted by stepwise forward method, included total eggs, salted meat, whole milk, and maté consumption, whereas fruits were protective.

Meat consumption, cooking methods, mutagens, and risk of squamous cell carcinoma of the esophagus: a case-control study in Uruguay.

The role of meat in squamous cell carcinoma of the esophagus (ESCC) has been considered conflictive. For this reason, we decided to conduct a case-control study on meat consumption and ESCC. Data included 234 newly diagnosed and microscopically examined ESCC and 2,020 controls with conditions not related to tobacco smoking nor alcohol drinking and without changes in their diets. We studied total meat, red meat, beef, lamb, processed meat, poultry, fish, total white meat, liver, fried meat, barbecued meat, boiled meat, heterocyclic amines, nitrosodimethylamine, and benzo[a]pyrene in relation with the risk of ESCC. Red meat, lamb, and boiled meat were directly associated with the risk of ESCC, whereas total white meat, poultry, fish, and liver were mainly protective against this malignancy.

Observational and clinical evidence that plant-based nutrition reduces dietary acid load.

Contemporary diets in Western countries are largely acid-inducing and deficient in potassium alkali salts, resulting in low-grade metabolic acidosis. The chronic consumption of acidogenic diets abundant in animal-based foods (meats, dairy, cheese and eggs) poses a substantial challenge to the human body's buffering capacities and chronic retention of acid wherein the progressive loss of bicarbonate stores can cause cellular and tissue damage. An elevated dietary acid load (DAL) has been associated with systemic inflammation and other adverse metabolic conditions. In this narrative review, we examine DAL quantification methods and index observational and clinical evidence on the role of plant-based diets, chiefly vegetarian and vegan, in reducing DAL. Quantitation of protein and amino acid composition and of intake of alkalising organic potassium salts and magnesium show that plant-based diets are most effective at reducing DAL. Results from clinical studies and recommendations in the form of expert committee opinions suggest that for a number of common illnesses, wherein metabolic acidosis is a contributing factor, the regular inclusion of plant-based foods offers measurable benefits for disease prevention and management. Based on available evidence, dietary shifts toward plant-based nutrition effectively reduces dietary-induced, low-grade metabolic acidosis.

Dietary patterns and risk of adenocarcinoma of the lung in males: a factor analysis in Uruguay.

In the period 1996-2004, a hospital-based case-control study on diet and adenocarcinoma of the lung in men was conducted in Montevideo, Uruguay. The study included 200 cases and 800 controls, frequency matched on age, residence, and interviewers. Factor analysis (principal components) was used to identify the major food patterns associated with adenocarcinoma. The analysis of food groups led to the identification of 4 patterns, arbitrarily labeled as Western, starchy vegetables, prudent, and milk/coffee. Whereas the Western pattern (OR 1.94, 95% CI 1.08-3.45) and the milk/coffee pattern (OR 2.30, 95% CI 1.35-3.90) were positively associated with risk of adenocarcinoma of the lung, the starchy vegetables (OR 0.49, 95% 0.28-0.86) and prudent patterns (OR 0.54, 95% CI 0.32-0.92) were significantly protective against this malignancy. The results suggests that adenocarcinoma of the lung could be considered a different nosologic entity, compared with the other histologies of lung cancer.

Dietary acid load and lung cancer risk: A case-control study in men.

BACKGROUND: Dysregulation of the endogenous acid-base balance can contribute to inflammation and cancer development if metabolic acidosis is sustained. The epidemiologic evidence on the association between diet-dependent acid load and cancer risk is scarce and inconsistent. We aim to explore the possible role of dietary acid load in lung cancer (LC) risk. METHODS: A case-control study was performed on 843 LC cases and 1466 controls by using a multi-topic questionnaire, including a food frequency questionnaire. Controls were matched to cases by age-frequency, urban/rural residence, and region. Food-derived nutrients were calculated from available databases. The dietary acid load was calculated using validated measures as potential renal acid load (PRAL) score and net endogenous acid production (NEAP) score. Odds ratios (ORs) were estimated by logistic regression. RESULTS: We found direct associations between dietary acid load and LC risk. The highest quartile of the NEAP score was significantly associated (OR=2.22, ptrend<0.001). The PRAL score displayed similar associations in simpler regression models, but there was no association when a more complex one was used (OR=0.99, ptrend =0.94). The NEAP score was associated with a significant risk increase in all cell types, except for small cell cancers, but the PRAL score did not show any association. CONCLUSIONS: The NEAP scores, directly associated with meat intake and inversely associated with plant-based foods intake, suggest that a high acid load dietary style may increase LC risk. Studies focused on food groups, and nutritional patterns are in line with our findings. Although the data shown here represent the first one to be published on this issue, further studies are needed to confirm these findings.

Dietary patterns and risk of advanced prostate cancer: a principal component analysis in Uruguay.

OBJECTIVE: In order to explore the role of broader eating patterns in the etiology of prostate cancer, we conducted a principal components analysis among Uruguayan men. METHODS: The study included 345 newly diagnosed cases of advanced prostate cancer and 690 hospitalized controls. The factor analysis was performed using the control population. RESULTS: Factor analysis allowed the extraction of five patterns, labeled as prudent, traditional, substituter, drinker, and Western. Whereas the traditional and Western patterns were directly associated with risk of prostate cancer (OR for high quartile versus the low quartile of the Western diet was 2.35, 95% CI 1.44-3.85, p-value for trend < 0.0001), the prudent, drinker, and substituter patterns were not associated with risk of the disease. After adjustment of each pattern for the foods with high loadings, these three patterns did not modify substantially their original ORs. CONCLUSION: The Western and traditional patterns could partially explain the high incidence of advanced prostate cancer in Uruguay, a main producer of beef in the World.

Dietary patterns and risk of cancer: a factor analysis in Uruguay.

A multisite case-control study on factor analysis and several cancer sites (mouth and pharynx, esophagus, stomach, colon, rectum, larynx, lung, breast, prostate, bladder, kidney) was conducted in Uruguay. The study included 3,528 cases and 2,532 controls. Factor analysis (principal components) was modeled among controls. This patterning method retained 4 factors per sex, labeled as prudent, drinker, traditional and Western. Odds ratios for these cancer sites, stratified by sex, were estimated using polytomous regression. Whereas the prudent pattern was mainly negatively associated with cancers of the upper aerodigestive tract, the Western pattern showed a strong increase in breast, lung and colon cancers. The study allowed for the reproducibility of the prudent, drinker and Western patterns, whereas the traditional pattern appears to be country specific.

Meat intake, meat mutagens and risk of lung cancer in Uruguayan men.

OBJECTIVE: To determine the role of meat consumption and related mutagens in the etiology of lung cancer, we conducted a case-control study among Uruguayan males in the time period 1996-2004. METHODS: The study included 846 cases and 846 controls, frequency matched on age and residence. Both series were drawn from the four major public hospitals in Montevideo, Uruguay. Unconditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) of lung cancer by quartiles of meat intake and mutagens. RESULTS: The highest vs. the lowest quartile of intake of total meat (OR = 2.04, 95% CI 1.42-2.92), red meat (OR = 2.33, 95% CI 1.63-3.32), and processed meat (OR = 1.79, 95% CI 1.22-2.65) was associated with increased risk of lung cancer, while intake of total white meat, poultry and fish was not. Heterocyclic amines (IQ, MeIQx, PhIP), nitrosamines and benzo[a]pyrene were directly associated with the risk of lung cancer (OR for PhIP 2.16, 95% CI 1.48-3.15). Moreover, both red meat and meat mutagens displayed higher risks among former smokers compared with current smokers. CONCLUSIONS: This study suggests that red and processed meat and meat mutagens may play a role in the etiology of lung cancer.

A case-control study on fat-to-muscle ratio and risk of breast cancer.

Our objective was to analyze detailed anthropometric characterization for risk of breast cancer in Uruguayan women. The design was a case-control study. The setting was Pereira Rossell Women's Hospital, Montevideo, Uruguay. Subjects were 343 incident breast cancer cases and 1,042 frequency-matched healthy controls who were interviewed on menstrual and reproductive story; and a series of skin folds, circumferences, and diameters were measured to calculate fat and muscle fractions and the derived fat-to-muscle ratio (FMR). Odds ratio (ORs) coefficients were taken as estimates of relative risk derived from unconditional logistic regression. Muscle fraction was negatively associated with risk [OR for highest quartile = 0.23, 95% confidence interval (CI) = 0.15-0.34], fat fraction was positively associated (OR = 3.90, 95% CI = 2.62-5.80), and FMR was positively associated (OR = 4.45, 95% CI = 2.99-6.62). Stratified analyses by body mass index levels also showed risk increases for the highest tertiles of FMR, always displaying significant linear trends. Since increases of risk were found in overweight and in normal weight women, results suggest that fractions and amount of muscle and fat components might be risk factors for breast cancer on the basis of currently existing metabolic and immune interrelationships between adipose and muscular tissue given by glutamine, exercise-derived myokines, and other cytokines produced by these tissues.

Dietary patterns and risk of bladder cancer: a factor analysis in Uruguay.

OBJECTIVE: To determine the major dietary patterns associated with bladder cancer risk, we conducted a principal components analysis (PCA) in a case-control study from Uruguay. METHODS: A total of 255 newly diagnosed and microscopically confirmed cases of transitional cell carcinoma of the bladder and 501 hospitalized controls were included in the study. Both series were drawn from the four major public hospitals in Montevideo, Uruguay. Cases and controls were frequency matched on age and sex. Controls were submitted to factor (principal components) analysis. RESULTS: We retained three factors that explained 25.1% of the total variance (including error variance). The first factor was labeled as the sweet beverages pattern. This factor was characterized by high loadings of coffee, tea, and added sugar and was strongly associated with risk of bladder cancer (OR 3.27, 95% CI 1.96-5.45). The second factor was labeled as the Western pattern and displayed high loadings of red meat, fried eggs, potatoes, and red wine. This pattern was directly associated with risk of bladder cancer (OR 2.35, 95% CI 1.42-3.89). Finally, the third factor was labeled as the prudent pattern and showed high loadings of fresh vegetables, cooked vegetables, and fruits. This pattern was not associated with risk of bladder cancer. CONCLUSIONS: According to our study, non-alcoholic beverages were the strongest risk factor for bladder cancer, whereas the Western pattern was also associated with a significant increase in risk of bladder cancer.

Nutrient patterns and risk of lung cancer: a factor analysis in Uruguayan men.

SUMMARY: In the time period 1996-2004, a case-control study on environmental factor risks and lung cancer was conducted in Montevideo, Uruguay. The study included 846 cases and 846 controls and was restricted to men. Forty nutrients and bioactive substances were submitted to exploratory (principal components) factor analysis. We retained three factors which were labeled as high-meat, antioxidants and carbohydrates. After that, score patterns (obtained from the retained factors) were correlated with sociodemographic variables, tobacco use, alcohol drinking and food groups. Finally, scored patterns were used as explanatory variables through multiple logistic regression analysis. The so-called antioxidants pattern was inversely associated with lung cancer risk (OR 0.69, 0.51-0.96) whereas the high-meat pattern was associated with a strong increase in risk (OR 2.90, 95% CI 1.91-4.40). The carbohydrates pattern was not associated with risk of lung cancer. Although nutrients could be important determinants in the etiology of lung cancer, stop smoking continue to be the major preventive measure for this disease.

Nutrient patterns and risk of squamous cell carcinoma of the esophagus: a factor analysis in uruguay.

BACKGROUND: Squamous cell carcinoma of the esophagus is a common disease, with an age-standardized incidence rate of 55 cases per 100,000 persons in the northern counties of Uruguay. These rates are comparable to those observed in Iran and China. MATERIALS AND METHODS: In order to contribute to the clarification of the etiology of this lethal disease, a case-control study which included 234 cases and 936 controls, frequency matched for age, sex and residence, was conducted. Factor analysis (principal components) was conducted on the controls and three factors were retained, high-fat, carbohydrates and antioxidants. These nutrient patterns were submitted to multiple logistic unconditional regression in order to estimate the odds ratios of esophageal cancer. RESULTS: The nutrient patterns (labeled as high-fat, carbohydrates and antioxidants) were significantly associated with the risk of esophageal squamous cell cancer. Whereas the high-fat and carbohydrates patterns were directly associated with an increased risk of esophageal cancer, the antioxidants pattern was strongly protective (OR 0.39, 95% CI 0.23-0.66). CONCLUSION: In squamous cell carcinoma of the esophagus an antioxidant dietary pattern is protective, probably due to its action against oxidative stress while high-fat and carbohydrates patterns are associated with an increased risk which may be due to the meat and sodium content, respectively.

The effect of smoking and drinking in oral and pharyngeal cancers: a case-control study in Uruguay.

In the time period 1988-2000, a case-control study on oral and pharyngeal cancers was conducted among men in Montevideo, Uruguay. The study included 776 cases and 1501 controls. The cases were distributed by site in oral cancers (335 patients) and pharyngeal cancers (441 patients). Odds ratios for smoking were higher among participants with pharyngeal cancers compared with those with oral carcinomas, but there was no significant heterogeneity. On the contrary, alcohol drinking displayed statistically higher risks among those with pharyngeal carcinomas compared with patients with oral cancer (P-value for heterogeneity=0.01). The effect of alcohol was particularly strong for cancers of the hypopharynx. Our results raise the possibility that oral and pharyngeal carcinomas are in fact different entities. Further studies are needed in order to clarify this important point.

Non-alcoholic beverages and risk of bladder cancer in Uruguay.

BACKGROUND: Bladder cancer is the fourth most frequent malignancy among Uruguayan men. A previous study from Uruguay suggested a high risk of bladder cancer associated with maté drinking. We conducted an additional case-control study in order to further explore the role of non-alcoholic beverages in bladder carcinogenesis. METHODS: In the time period 1996-2000, 255 incident cases with transitional cell carcinoma of the bladder and 501 patients treated in the same hospitals and in the same time period were frequency matched on age, sex, and residence. Both cases and controls were face-to-face interviewed on occupation, tobacco smoking, alcohol drinking and intake of maté, coffee, tea, and soft drinks. Statistical analysis was carried out by unconditional multiple logistic regression. RESULTS: Ever maté drinking was positively associated with bladder cancer (odds ratio [OR] 2.2, 95% confidence interval [CI] 1.2-3.9) and the risk increased for increasing duration and amount of maté drinking. Both coffee and tea were strongly associated with bladder cancer risk (OR for coffee drinking 1.6, 95% CI 1.2-2.3; OR for tea drinking 2.3, 95% CI 1.5-3.4). These results were confirmed in a separate analysis of never-smokers. CONCLUSION: Our results suggest that drinking of maté, coffee and tea may be risk factors for bladder carcinoma in Uruguay.

'Mate' Intake, Hormone-Based Risk Factors and Breast Cancer: a Case-Control Study

Previous reports on the inverse association between 'mate' intake (infusion of Ilex Paraguariensis herb) and breast cancer (BC) risk led us to consider two main roles for the infusion: as a substantial antioxidant contributor and as a hormone regulator, particularly through anti-aromatase capacities. Since menstrual-reproductive risk factors for BC reflect women's estrogenic exposure during the reproductive lifespan, and considering that 'mate' intake exerts putative stronger protection among high antioxidant contributors, we attempted to analyze interactions among the infusion, hormon-linked reproductive factors and BC risk, which have hitherto remained unexplored. We analyzed a database of 572 BC incident cases and 889 controls. Women were interviewed with a specific questionnaire featuring socio-demographic, lifestyle and reproductive variables (age at menarche, 1st live birth and menopause; number of live births; breastfeeding months), and a food frequency questionnaire, focusing on 'mate' intake (consumer status, daily intake, age at start, age at quit, duration of habit). Odds ratios (OR) and their 95% confidence Intervals were calculated through unconditional logistic regression, adjusting for relevant potential confounders. 'Mate' intake showed strong inverse associations with some high-risk hormone-related factors: early menarche, nulliparity, low breastfeeding, long reproductive years and high number of ovulatory cycles. Moreover, all subsets of high dietary energy demonstrated even stronger associations. In conclusion, regarding exposure to known hormone risk factors, we found strong inverse associations between high 'mate' intake and BC, which were greater among those consuming higher calorific diets. Our analyses support possible combined antioxidant and antiestrogenic effects for 'mate' infusions.

Mate and Tea Intake, Dietary Antioxidants and Risk of Breast Cancer: a Case-Control Study.

Recently, we reported an inverse association between high 'mate' intake (infusion of Ilex paraguariensis herb, a staple beverage in temperate South America) and breast cancer (BC) risk. Stronger inverse associations were found in high strata of tea, vegetable, fruit and energy intakes, and in overweight/obese women, suggesting possible roles for 'mate' mainly from its antioxidant contribution. The present study attempted to thoroughly explore possible associations among 'mate' and tea intake, dietary antioxidants and BC risk. Combining two databases of previous studies, 572 BC incident cases and 889 controls were interviewed with a specific questionnaire featuring socio-demographic, reproductive and lifestyle variables, and a food frequency questionnaire (64 items), focusing on 'mate' intake (consumer status, daily intake, age at start, age at quit, duration of habit). Food-derived nutrients were calculated from available databases. Odds ratios (OR) and their 95% confidence intervals were calculated through unconditional logistic regression, adjusting for relevant potential confounders. The highest 'mate' intake was significantly inversely associated with BC risk for both low and high carotenoids (OR=0.40 vs. 0.41), vitamin C (OR=0.33 vs. 0.50), vitamin E (OR=0.37 vs. 0.45), flavonols (OR=0.38 vs. 0.48) and reduced glutathione (OR=0.48 vs. 0.46) strata. High tea intake showed significant inverse risk associations only with high carotenoids (OR=0.41), vitamin E (OR=0.48) and reduced glutathione (OR=0.43) strata. In conclusion, a strong and inverse association for 'mate' intake and BC was found, independent of dietary antioxidant levels. Also strong inverse associations with tea intake were more evident only at high levels of certain dietary antioxidants.