Elzbieta Sochacka-Tatara

Case-control study on beneficial effect of regular consumption of apples on colorectal cancer risk in a population with relatively low intake of fruits and vegetables.

Laboratory in-vitro studies and animal experiments showing the potential health benefits from apples raises the question to what extent the regular consumption of apples in humans may have a beneficial effect on colorectal cancer risk. A total of 592 incident cases of colorectal cancer have been enrolled in a hospital-based case–control study. The comparison group included 765 controls chosen from the patients of the same hospital without history of cancer and admitted for treatment of nonneoplastic conditions. Interviews of both cases and controls were conducted in the hospital setting by trained interviewers. The median intake of fruits among cases was lower than in controls (9.5 vs. 11 servings/week) and the difference was statistically significant. Apples were the most frequent fruit consumed by the study participants and about 80% of variability in the total fruit consumption resulted from the intake of apples. We did not observe any significant statistical differences in consumption of berries, citrus, or stone fruits and other kinds of fruits across cases and controls. The adjusted estimates of colorectal cancer risk related to the daily consumption of apples (in quintiles) were based on the unconditional multivariate logistic model, which considered the set of potential confounding variables such as demographic characteristics of participants (age, gender, place of residency, marital status, tobacco smoking), total energy intake, intake of vegetables and fruits without apples. The results of the logistic analysis showed that the adjusted risk of colorectal cancer inversely correlated with daily number of apple servings. The reduced risk of colorectal cancer of border significance level was already observed at the consumption of at least one apple a day (odds ratio=0.65, 95% CI: 0.39–1.09), but at the intake of more than one apple a day the risk was reduced by about 50% (odds ratio=0.53, 95% CI: 0.35–0.79). Neither the consumption of vegetables nor other fruits have shown beneficial effects on the risk of colorectal cancer. The observed protective effect of apple consumption on colorectal risk may result from their rich content of flavonoid and other polyphenols, which can inhibit cancer onset and cell proliferation.

Higher fish consumption in pregnancy may confer protection against the harmful effect of prenatal exposure to fine particulate matter.

Background/Aim: The objective of this study was to assess a hypothesized beneficial effect of fish consumption during the last trimester of pregnancy on adverse birth outcomes resulting from prenatal exposure to fine air particulate matter. Methods: The cohort consisted of 481 nonsmoking women with singleton pregnancies, of 18–35 years of age, who gave birth at term. All recruited women were asked about their usual diet over the period of pregnancy. Measurements of particulate matter less than 2.5 µm in size (PM2.5) were carried out by personal air monitoring over 48 h during the second trimester of pregnancy. The effect of PM2.5 and fish intake during gestation on the birth weight of the babies was estimated from multivariable linear regression models, which beside the main independent variables considered a set of potential confounding factors such as the size of the mother (height, prepregnancy weight), maternal education, parity, the gender of the child, gestational age and the season of birth. Results: The study showed that the adjusted birth weight was significantly lower in newborns whose mothers were exposed to particulate matter greater than 46.3 µg/m3 (β coefficient = –97.02, p = 0.032). Regression analysis stratified by the level of maternal fish consumption (in tertiles) showed that the deficit in birth weight amounted to 133.26 g (p = 0.052) in newborns whose mothers reported low fish intake (<91 g/week). The birth weight deficit in newborns whose mothers reported medium (91–205 g/week) or higher fish intake (>205 g/week) was insignificant. The interaction term between PM2.5 and fish intake levels was also insignificant (β = –107,35, p = 0.215). Neither gestational age nor birth weight correlated with maternal fish consumption. Conclusions: The results suggest that a higher consumption of fish by women during pregnancy may reduce the risk of adverse effects of prenatal exposure to toxicants and highlight the fact that a full assessment of adverse birth outcomes resulting from prenatal exposure to ambient hazards should consider maternal nutrition during pregnancy.

Protective Effect of Fish Consumption on Colorectal Cancer Risk

Background/Aims: Current epidemiologic studies investigating the effect of fish intake on colorectal cancer (CRC) risk are scarce. Therefore, the aim of this study was to elucidate the relationship between fish consumption and CRC risk. Methods: This hospital-based case-control study was performed in 548 CRC patients (Surgery Clinic, University Hospital in Krakow, Poland) between November 2000 and May 2008. Histological findings, information on anatomic location and stage of cancer were available for all the patients enrolled in this study. The control group consisted of 745 patients of the same hospital with no history of cancer admitted for treatment of non-neoplastic conditions. During the 5-year study period, the food frequency questionnaire used focused on the reference period that was defined as 1–5 years prior to CRC diagnosis for the CRC cases and the date of hospital admission for the controls. Results: Thecrude odds ratio (OR) was inversely related to fish consumption (z for trend in quartiles of intake = –2.31, p = 0.021; OR = 0.89; 95% confidence interval, CI: 0.81–0.98). The risk of CRC increased with intake of stewed or cooked meat (z for trend in quartiles of intake = 2.14; p = 0.032; OR = 1.11; 95% CI: 1.01–1.23). The adjusted OR showed a significant reduction in CRC already at the moderate fish intake of one or two servings per week (OR = 0.70; 95% CI: 0.51–0.94), but it was even lower at higher fish intake (OR = 0.56; 95% CI: 0.39–0.86). All multivariate statistical models employed in the analysis considered potential confounders, such as demographic characteristics of subjects, body mass index, smoking status, leisure time physical activity, energy consumption and intake of meat products. Conclusions: The study results indicate that increased fish intake may have a preventive effect on CRC and modulate the effect of meat consumption. To our knowledge, this is the first large epidemiologic study on dietary habits and CRC incidence in Eastern Europe.

Relative validity of a semi-quantitative FFQ in 3-year-old Polish children

OBJECTIVES The aim of the study was to assess the relative validity of a semi-quantitative FFQ (SFFQ) which measures the usual dietary intake of 3-year-old children. DESIGN The childrens daily dietary intake was measured using the SFFQ. The average intake of three 24 h dietary recalls (24hDR) was calculated as a reference method. Wilcoxons rank test and Spearmans rank-correlation coefficient were used to compare nutrient intakes assessed by both methods. The level of agreement between the SFFQ and the repeated 24hDR was determined by the Bland-Altman method. To assess the agreement in quartile distribution, the weighted kappa coefficient (κ w) was used. SETTING Krakow, Poland. SUBJECTS One hundred and forty-three 3-year-old children and their mothers, participants of a prospective cohort study. RESULTS Overall, the SFFQ overestimated energy and nutrient intakes compared with the repeated 24hDR. The median correlation coefficient for energy and nutrient intakes was 0·456, with higher results for Ca, P and riboflavin. Although the κ w value showed only slight to fair agreement between the two methods, about 75 % of the children were classified into the same or adjacent quartile and the level of agreement assessed by the Bland-Altman method for most of the nutrients investigated was good. CONCLUSIONS The study indicated that the SFFQ might be a useful tool to assess dietary intakes of nutrients by small children, especially for ranking them according their nutrient intake.

Reduced risk of colorectal cancer and regular consumption of apples: Hospital based case-control study in Poland

Experimental studies in animals and epidemiological evidence supporting the health benefits from apples encouraged the authors to assess the potential protective impact of apples on the risk of colorectal cancer in the course of the hospital based case-control study. A total of 186 incident cases of colorectal cancer — for which the information on histology, anatomic location, and stage of cancer were available — have been enrolled to the study. The comparison group included 211 controls chosen from the patients of the same hospital with no history of cancer and admitted for treatment of non-neoplastic conditions. Interviews of both cases and controls were conducted in hospital settings by trained interviewers. The results showed that the risk of colorectal cancer inversely correlated with daily number of apple servings, but the significant reduction of OR estimates were observed for an intake of one or more apple servings daily (OR = 0.37, 95%CI: 0.15 − 0.91). The risk of colorectal cancer was estimated from the multivariate logistic model including a set of potential confounding variables, such as, demographic characteristics of subjects (age, gender, place of residency, marital status and occupational activity), total energy intake (in tertiles) and intake of vegetables (number of servings per day). No fruits except for apples were significantly associated with the reduced risk of colorectal cancer. The reduction of colorectal risk associated with apple consumption may result from their rich content of flavonoid and other polyphenols, which can inhibit cancer onset and cell proliferation.

Modulating effects of maternal fish consumption on the occurrence of respiratory symptoms in early infancy attributed to prenatal exposure to fine particles.

The purpose of the study was to test the hypothesis whether infants with higher prenatal exposure to fine particles (PM2.5) are at greater risk of developing respiratory symptoms and whether fish consumption in pregnancy may modulate the effect. The study was carried out in a cohort of 465 newborns in Krakow (Poland) who have been followed over the first 2 years of life and for whom data on the occurrence of respiratory symptoms and measurements of personal air monitoring in the second trimester of pregnancy were available. The incidence risk ratio (IRR) of respiratory symptoms due to prenatal PM2.5 exposure were adjusted for potential confounders (gender of child, breastfeeding, parity, maternal atopy, maternal education as a proxy for the socio-economic status, exposure to postnatal environmental tobacco smoke (ETS), and moulds in households) in the generalized estimating equations (GEE) statistical models. The adjusted risk of coughing was associated significantly with PM2.5 level (IRR = 2.51; 95% CI: 1.77–3.58), moulds in the household, parity, maternal atopy and postnatal ETS, but was lower in girls, and in infants whose mothers consumed more fish in pregnancy (IRR = 0.85; 95% CI: 0.79–0.91). The risk of wheezing was also correlated significantly with the prenatal exposure to PM2.5 (IRR = 1.36; 95% CI: 1.29–1.43) but also with the presence of moulds in homes, parity, maternal atopy and postnatal ETS. The occurrence of wheezing was associated inversely with the gender of child, gestational age, and fish consumption in pregnancy (IRR = 0.97; 95% CI: 0.95–0.99). Similarly, the risk of difficult (puffy) breathing increased with prenatal exposure to PM2.5 (IRR = 1.18; 95% CI: 1.12–1.25) moulds, maternal atopy, and parity. The symptom occurrence was lower in girls and associated inversely with the gestational age, and fish consumption in pregnancy (IRR = 0.94; 95% CI: 0.92–0.97). The results of the study support the hypothesis that fish consumption in pregnancy may mitigate the harmful effect of prenatal or perinatal exposure to components of PM2.5 resulting in an increased burden of respiratory infections among infants.

Urinary polycyclic aromatic hydrocarbon metabolites among 3-year-old children from Krakow, Poland

&NA; Polycyclic aromatic hydrocarbons (PAHs) are widespread in the environment and can adversely affect human health. The aim of the present study is to describe the level of PAHs exposure in children living in Kraków, one of the most polluted cities in Poland, and to determine the relationship of urinary biomarkers with environmental PAHsexposure. Urinary monohydroxy metabolites (OH‐PAHs) of 20 PAHs were assessed in 218 three‐year old children, of which only 10 were present in nearly all the samples: monohydroxy metabolites of naphthalene, fluorene, phenantrene and pyrene. Of the metabolites analyzed, hydroxynaphthalenes were predominant and constituted almost 73% of total excreted OH‐PAHs, while 1‐OH‐PYRene was the least abundant (2.3% of total OH‐PAHs). All measured urinary OH‐PAHs were statistically significantly correlated with each other (R = 0.165–0.880) but the highest correlation coefficients with other individual OH‐PAHs and with total OH‐PAHs were observed for 2‐OH‐FLUOR. Children exposed at home to environmental tobacco smoke (ETS) had higher concentrations of fluorene and pyrene urinary metabolites compared to those without ETS exposure; and those exposed to gas‐based appliances used for cooking or heating water had higher levels of fluorene and phenanthrene metabolites than children not exposed. The use of coal, wood or oil for heating was associated with elevated levels of 1‐OH‐PYRene. Urinary PAHs metabolites only modestly reflect high molecular weight carcinogenic PAHs exposures such as those monitored in air in the present study. None of the measured PAHs metabolites was correlated with airborne PM2.5 and only two were slightly correlated with measured higher molecular mass airborne PAHs. The average concentrations of these specific metabolites in Polish children were much higher than observed in other pediatric populations living in developed countries. Our findings suggest that to capture various sources of PAHs, in addition to 1‐OH‐PYRene, biomonitoring of PAHs exposure should include 2‐OH‐NAP and 2‐OH‐FLUOR. Graphical abstract Figure. No Caption available. HighlightsETS, combustion of gas, coal or wood indoors were associated with OH‐PAH levels.The predominant metabolites in urine were OH‐napthalenes and OH‐fluorenes.In biomonitoring of PAHs exposure, measuring only 1‐OH‐pyrene is insufficient.Urinary OH‐PAHs only modestly reflect high molecular weight PAHs exposures.