Archana Jaiswal McEligot

Dietary Fat, Fiber, Vegetable, and Micronutrients Are Associated With Overall Survival in Postmenopausal Women Diagnosed With Breast Cancer

Abstract: Relatively few studies have assessed the relationship between dietary intakes and survival after breast cancer diagnosis. We investigated the influence of diet, including dietary fat (percentage energy), fiber, vegetable, and fruit intakes, and micronutrients (folate, carotenoids, and vitamin C) on overall survival in women diagnosed with breast cancer. Subjects were postmenopausal women diagnosed with breast cancer (N = 516) between 1994 and 1995 with a mean survival time of 80 mo (SD: 18). Subjects completed a food frequency questionnaire for the year prior to diagnosis. Cox proportional hazards models were used to measure the relationship between dietary intakes and death due to any cause after breast cancer diagnosis. In the multivariate analysis, we found that the hazard ratio [HR and 95% confidence interval (CI)] of dying in the highest tertile compared to the lowest tertile of total fat, fiber, vegetable, and fruit was 3.12 (95% CI = 1.79–5.44), 0.48 (95% CI = 0.27–0.86), 0.57 (95% CI = 0.35–0.94), and 0.63 (95% CI = 0.38–1.05), respectively (P ≤ 0.05 for trend, except for fruit intake). Other nutrients including folate, vitamin C, and carotenoid intakes were also significantly associated with reduced mortality (P ≤ 0.05 for trend). These results suggest that in postmenopausal women diagnosed with breast cancer, reduced dietary fat and increased fiber, vegetable, fruit, and other nutrient intakes associated with a plant-based, high-fiber diet improves overall survival after breast cancer diagnosis.

Hypertension, diuretics and breast cancer risk

It is unclear whether hypertension and antihypertensive medication use are associated with breast cancer. In order to examine these associations, we conducted a case–control study among women aged 50–75 years. Breast cancer cases were ascertained via a population-based cancer registry (n=523) and controls were ascertained via random-digit-dialing (n=131). Participants completed a self-administered questionnaire which queried history of hypertension, antihypertensive medication use and risk factors. Unconditional logistic regression was used to estimate the odds ratio (OR) and 95% confidence intervals (CI), adjusted for age, body mass index (BMI), diabetes, smoking, alcohol use, menopausal status, family history of breast or ovarian cancer, age at first full-term pregnancy and education. History of treated hypertension was associated with significant increased risk of breast cancer (OR, 1.77; 95% CI, 1.04–3.03) and this association appeared only in women with BMI ⩾25 kg/m2 (OR, 2.30; 95% CI, 1.12–4.71). Diuretic use was also associated with elevated breast cancer risk (OR, 1.79; 95% CI, 1.07–3.01). The risk associated with diuretic use increased with duration of use (P for trend, <0.01). Use of other blood pressure medications was not found to be associated with breast cancer risk. These results support a positive association between treated hypertension, diuretic use and breast cancer risk among women aged 50–75 years.

Differential effects of wine consumption on colorectal cancer outcomes based on family history of the disease.

Abstract Potentially favorable effects of wine consumption on colorectal cancer (CRC) incidence have been reported, but effects on clinical outcomes are unknown. This case-only analysis was designed to investigate outcomes among familial (n = 141) and sporadic (n = 358) CRC patients enrolled in the University of California Irvine CRC gene-environment study during 1994–1996 based on their reported frequency of wine consumption in the year prior to diagnosis. Cases were categorized as either regular or infrequent wine consumers. Univariate survival rate analyses were estimated using the Kaplan and Meier method and log-rank test. Multivariate survival analyses were performed using Cox proportionalhazards ratios (HRs). Earlier stage at presentation (P = 0.034) was noted for familial (but not sporadic) CRC cases reporting regular wine consumption. An overall survival (OS) benefit was observed for familial (but not sporadic) CRC cases that were regular (10-yr OS = 75%) versus infrequent wine consumers (10-yr OS = 47%; P = 0.002). This survival improvement for familial CRC cases remained after adjustment for age, stage, treatment, and other clinically relevant factors (HR = 0.50, 95% confidence interval = 0.25–0.99). Our findings implicate favorable effects of wine consumption on stage at presentation and survival in CRC, selectively among familial CRC cases. * Dr. Anton-Culver and Dr. Holcombe contributed equally as co-senior investigators for this research.

Sex differences in the association of cutaneous melanoma incidence rates and geographic ultraviolet light exposure

Background: Cutaneous melanoma (CM) incidence rates continue to increase, and the reasons are unknown. Previously, we reported a unique age‐specific sex difference in melanoma that suggested additional causes other than solar ultraviolet (UV) radiation. Objective: This study attempted to understand whether and how UV radiation differentially impacts the CM incidence in men and women. Methods: CM data and daily UV index (UVI) from 31 cancer registries were collected for association analysis. A second dataset from 42 US states was used for validation. Results: There was no association between log‐transformed female CM rates and levels of UVI, but there was a significant association between male rates and UVI and a significant association between overall rates and UVI. The 5‐year age‐specific rate–UVI association levels (represented by Pearsons coefficient &rgr;) increased with age in men, but age‐specific &rgr; levels remained low and unchanged in women. The significant rate–UVI association in men and nonassociation in women was validated in a population of white residents of the United States. Limitations: Confounders, including temperature and latitude, are difficult to separate from UVI. Conclusions: Ambient UVI appears to be associated with melanoma incidence in males but not in females.

Diet and predictors of dietary intakes in women with family history of breast and/or ovarian cancer.

BACKGROUND Dietary intakes of vegetable, fruit, fiber, folate, and B vitamins have been associated with reduced breast and/or ovarian cancer risk. However, few studies have assessed dietary intakes and factors associated with diet in women with family history of breast and/or ovarian cancer (FHBOC). We examined dietary intakes and predictors of diet in women with FHBOC (n=211) enrolled in a population-based cancer family registry. METHODS We assessed diet via a food frequency questionnaire, family history by telephone and demographic variables by questionnaire. Descriptive statistics were performed, and multivariate linear regression analyses were conducted to examine variables [body mass index (BMI), age, parity, energy intake, alcohol use, smoking and education] associated with dietary intakes. RESULTS Mean daily intakes were: 2.57 vegetable servings [+/-standard deviation (SD) 1.22], 1.56 fruit servings (+/-0.9), 11.21g fiber (+/-5.32) and 33.85% energy from fat (+/-9.05), 241.98microg folate (+/-120.80) and 1.33mg vitamin B6 (+/-0.62). Regression analyses showed that younger age, smoking, lower education and higher BMI had a significant association with decreasing vegetable, fruit and/or fiber intakes. BMI had a significant positive association with % energy from fat. Similar results were observed when assessing independent variables with micronutrient intakes studied. CONCLUSIONS These data suggest that women with FHBOC should be encouraged to meet dietary guidelines for cancer prevention. Specifically, public health dietary interventions should target women with FHBOC who are smokers, less educated, have a higher BMI and are younger. Such interventions may potentially reduce breast and/or ovarian cancer risk in this population.

Health Behaviors of Native Hawaiian and Pacific Islander Adults in California

Smoking, diet and physical activity are associated with chronic diseases, but representative prevalence data on these behaviors for Native Hawaiian and Pacific Islander (NHPI) adults are scarce. Data from the 2005 California Health Interview Survey were analyzed for self-identified NHPI and non-Hispanic white (NHW) adults. Ethnic and NHPI gender differences were examined for socio-demographic variables, obesity and health behaviors. Compared to NHW, NHPI displayed higher prevalence of obesity (p<0.001), smoking (p<0.05) and consumption of unhealthy foods and beverages (p<0.05). NHPI males were more likely than females to smoke (p<0.001). NHPI adults appear to be at higher risk for chronic disease than NHW due to obesity, smoking and intake of unhealthy foods and beverages. Culturally-specific health promotion interventions are needed to reduce risks among the underrepresented NHPI population.

The Association Between Circulating Total Folate and Folate Vitamers With Overall Survival After Postmenopausal Breast Cancer Diagnosis

We studied the relationship between plasma total folate and folate vitamer concentrations [5-methyltetrahydrofolic acid, pteroylglutamic acid (folic acid) and tetrahydrofolic acid] with overall survival after breast cancer diagnosis. A secondary aim was to assess the relationship between folic acid supplement use with circulating total folate and folate vitamer concentrations. Participants were postmenopausal women diagnosed with breast cancer (n = 498) with an average follow-up of 6.7 yr. Plasma total folate and folate vitamers were measured by isotope-dilution LC-MS/MS in samples collected at or postdiagnosis. Cox proportional multivariate hazards models (controlled for stage, age at diagnosis, body mass index, parity, hormone replacement therapy use, treatment, alcohol use, folic acid use, and energy intake), were used to assess overall survival after breast cancer diagnosis. We found that the relative risk of dying for women with plasma total folate concentrations in the highest quartile was 59% lower (hazard ratio: 0.41, 95% confidence interval: 0.19–0.90) compared with the lowest quartile. Data on supplement use showed that women taking folic acid supplements had significantly higher circulating total folate and folate vitamer concentrations (P < 0.0001), suggesting that increased folate consumption through diet and/or supplementation may improve prognosis after breast cancer diagnosis.

Enhancing Diversity in Biomedical Data Science

The gap in educational attainment separating underrepresented minorities from Whites and Asians remains wide. Such a gap has significant impact on workforce diversity and inclusion among cross-cutting Biomedical Data Science (BDS) research, which presents great opportunities as well as major challenges for addressing health disparities. This article provides a brief description of the newly established National Institutes of Health Big Data to Knowledge (BD2K) diversity initiatives at four universities: California State University, Monterey Bay; Fisk University; University of Puerto Rico, Río Piedras Campus; and California State University, Fullerton. We emphasize three main barriers to BDS careers (ie, preparation, exposure, and access to resources) experienced among those pioneer programs and recommendations for possible solutions (ie, early and proactive mentoring, enriched research experience, and data science curriculum development). The diversity disparities in BDS demonstrate the need for educators, researchers, and funding agencies to support evidence-based practices that will lead to the diversification of the BDS workforce.