Calorie-providing nutrients and risk of breast cancer.

A case-control study was conducted in Italy to investigate the role of diet in breast cancer. Cases were 250 women with breast cancer, and controls were a stratified random sample of 499 women from the general population. A dietary history questionnaire was used to measure the intake of total fat, saturated fat, animal proteins, and other macronutrients. In multivariate analyses, the relative risks of breast cancer for women in the highest quintile of consumption of saturated fat and animal proteins were 3.0 (95% confidence interval, 1.9-4.7) and 2.9 (1.8-4.6), respectively. A reduced risk was found for women who derived less than 28% of calories from fat versus greater than 36%. A similarly reduced risk was found for women who derived less than 9.6% of calories from saturated fat or less than 5.9% from animal proteins. These data suggest that during adult life, a reduction in dietary intake of fat and proteins of animal origin may contribute to a substantial reduction in the incidence of breast cancer in population subgroups with high intake of animal products.

Breast cancer and alcohol consumption: a case-control study in northern Italy.

From 1983 to 1986, a population-based case-control study of alcohol and breast cancer (250 cases and 499 controls) was conducted in a grape-farming area of northern Italy, where wine consumption is widespread. In the study population, 30% of women were abstainers and 15% reported alcohol intakes of 30 g/day or more. After adjustment for potential confounders, no appreciable association was evident for alcohol consumptions as high as 40 g/day. Women reporting intakes of more than 40 g/day showed approximately a 2-fold increase in the risk of breast cancer (relative risk, 1.9; 95% confidence interval, 1.1-3.3). A 2-fold increase in risk was observed for consumptions of more than 40 g/day of alcohol from wine, the most common alcoholic beverage in this population. These findings suggest that an association between alcohol intake and breast cancer may exist. However, the moderate risk observed seems to be limited to the relatively small group of women consuming daily amounts of alcohol in excess of 40 g, the equivalent of about half a bottle of wine or more.

Risk of breast cancer, diet and internal migrations in northern Italy.

The protective effect of birth in southern Italy as opposed to other regions was evaluated in a population-based case-control study of diet and breast cancer among residents in the province of Vercelli. Cases were 250 women with breast cancer diagnosed during 1983-1984 and controls 499 women randomly selected from the general population. The crude relative risk of breast cancer for women born in the south was 0.76 (95% confidence interval, 0.43-1.3). After adjustment for dietary and other potential confounders in multivariate analyses, the protective effect of place of birth disappeared (RR 1.0; 95% CI, 0.57-1.9). The study indicates that north-south differences in the incidence of breast cancer in Italy may in large part be attributed to different dietary habits.

[Trace nutrients in total enteral nutrition: the basal status and longitudinal course]. / Oligonutrienti in nutrizione enterale totale: stato basale e andamento longitudinale.

INTRODUCTION: Previous studies demonstrated deficiencies of selenium and other micronutrients in patients receiving total enteral nutrition (TEN). The content and bioavailability of trace elements in enteral formulas can be suboptimal. MATERIAL AND METHODS: Basal blood levels of some trace elements (copper, iron, selenium, zinc) and vitamins (B12, folic acid) were determined in twenty patients at the beginning of TEN. Vitamin E was measured in 7 patients. Primary diagnosis was cancer (no. = 13) and organic brain syndromes (no. = 7). Commercially available polymeric and oligomeric enteral formulas were used, containing respectively, as a percent of RDA in 1500 kcal, 65-39% of copper, 180-135% of iron, 80-100% of zinc. Selenium was not indicated; determinations in our laboratory gave a content of 78-63% of the minimum recommended intake. Blood levels of copper and zinc (no. = 6), selenium (no. = 5), iron, transferrin and ferritin (no. = 13) were measured after two months of TEN (mean intake of 30 +/- 3 kcal/kg/day). Copper, selenium and zinc were measured with atomic absorption; iron with the complessometric method: vitamin B12 and folic acid with RIA; vitamin E with HPLC. RESULTS: Mean values, expressed as mean +/- SD (range) were: copper: 129 +/- 23 (82-300) micrograms/dl; iron: 37 +/- 18 (16-89) mg/dl; selenium: 53 +/- 20 (22-93) micrograms/dl; zinc: 85 +/- 34 (44-185) micrograms/dl; vitamin B12: 632 +/- 450 (140-1575) pg/ml); vitamin E: 5.4 +/- 1.5 (3.3-7.8) mg/dl; folic acid: 11 +/- 8 (2-20) ng/ml. Values below the lower normal limit were found in 100% (vitamin E), 89% (selenium), 60% (iron), 35% (zinc), 24% (vitamin B12) and 14% (folic acid) of the patients studied. Copper was higher than the upper normal limit in 31% of cases; no data below normal range was found. Mean blood levels of depleted subjects were at the 28%, 43%, 54% and 63% of the mean normal value respectively for iron, selenium, vitamin E and zinc. Blood iron (p < 0.05) and selenium (p < 0.001) were significantly lower in more malnourished patients (weight loss > 20% vs < 20% on usual body weight). After two months of TEN, a reduction of 33% of mean blood selenium was observed in 4 of 5 patients studied. Blood copper and zinc remained stable in 6 subjects with initial normal or higher than normal values. Blood iron increased nonsignificantly, ferritin remained stable, transferrin increased significantly (p < 0.05). No clinical deficiency syndromes were observed. CONCLUSIONS: A careful monitoring of micronutrients during TEN is recommended. Selenium content of enteral formulas, unless supplemented by the producers, seems to be insufficient to maintain the initial blood level in two months of TEN.