Josep M. Ramon

Dietary fat intake and prostate cancer risk: a case–control study in Spain

AbstractObjectives: Epidemiological evidence suggests that dietary factors can play a role in the etiology of prostate cancer. Results from several case–control and cohort studies on nutrient intake and prostate cancer have been unclear. The authors examined the effect of lipid intake on the risk of prostate cancer. Methods: In order to assess associations between lipid intake and prostate cancer risk, a case–control study was conducted between May 1994 and March 1998 in the Barcelona metropolitan area, Spain. Two hundred seventeen incident cases with histologically confirmed diagnosis of prostate cancer were matched to 434 hospital and community controls by age and residence. Information about food intake was gathered by a semiquantitative food-frequency questionnaire. Unconditional logistic regression was used for the analysis. Results and conclusions: Animal fat intake was associated with prostate cancer with an estimated OR for highest quartile of 2.0 (95% CI 1.2–3.2). Vitamin C intake was inversely associated with prostate cancer (OR = 0.6; 95% CI 0.3–0.9). The prostate cancer risk increased in proportion to α-linolenic acid intake. In the analysis adjusting for energy and major covariables the estimated OR for upper quartile of α-linolenic acid was 3.1 (95% CI 1.1–3.8). In conclusion, the association between fat intake and prostate cancer may be correlated with α-linolenic acid, although the specific mechanism has to be determined.

Genetic polymorphism of glutathione S-transferase P1 gene and lung cancer risk.

Objectives: The human GSTTP1 gene is polymorphic with an A → G transition in exon 5 causing a replacement 105 Ile→Val in the GSTP1 protein. The two isoforms, encoded by the alleles GSTP1*A and GSTP1*B, respectively, show different catalytic efficiencies towards some carcinogenic epoxides. In this study we have addressed the possible role of the Ile105Val GSTP1 polymorphism in lung cancer susceptibility.Methods: The polymorphic site was genotyped by RFLP in a group of lung cancer patients (n=164) and in two control groups (healthy smokers, n=132; general population, n=200). All patients and controls were Northwestern Mediterranean Caucasians of the same ethnic origin.Results and Conclusions: The cancer patients showed frequencies of GSTP1*A/A; GSTP1*A/B and GSTP1*B/B (50%, 38%, 11%, respectively) very similar to those of both control groups (healthy smokers: 48%, 41%, 11%). After adjusting for age, sex and smoking status, no association was found between the GSTP1*B allele and lung cancer risk (OR: 1.18; 95% CI: 0.67–2.07). The Ile105val GSTP1 polymorphism was also analysed in combination with the GSTM1 and GSTT1 genes. The results showed that allelism at GSTP1 did not increase the risk associated with the GSTM1 or GSTT1 deletions.

Comparative Cost of Selective Screening To Prevent Transmission of Methicillin‐Resistant Staphylococcus aureus (MRSA), Compared With the Attributable Costs of MRSA Infection

The annual cost of a screening program to detect methicillin-resistant Staphylococcus aureus (MRSA) in a teaching hospital in Spain was 10,261 Euro. The average cost per MRSA infection was 2,730 Euro; therefore, the cost of the program would be covered if it only prevented 4 infections per year (11% of the total number of MRSA infections at our hospital).

Prevalencia de malnutrición en la población anciana española

>Fundamento La malnutricion en la poblacion anciana es un problema de salud frecuente, que incide de forma importante en la morbimortalidad de este grupo de poblacion. El objetivo del estudio fue determinar su prevalencia en la poblacion anciana espanola, tanto en sujetos institucionalizados como no institucionalizados. Sujetos Y Metodo Se estudio de forma transversal una muestra de 3.460 sujetos de 65 o mas anos de edad representativos de la poblacion espanola (tasa de respuesta del 96%). El estado nutricional se determino a partir del Mini Nutritional Assessment. Resultados La prevalencia de malnutricion fue del 3,3% entre la poblacion anciana que vivia en su domicilio y del 7,7% en los sujetos institucionalizados. Se observo una mayor prevalencia de malnutricion entre las mujeres y en los grupos con menores ingresos. Asi mismo se constato un incremento lineal con la edad. Conclusiones La prevalencia observada en la poblacion anciana espanola no institucionalizada es similar a la obtenida en otras poblaciones. El sexo, la edad y los ingresos constituyen los principales factores asociados a la malnutricion.

Dietary Habits and Dental Caries in a Population of Spanish Schoolchildren with Low Levels of Caries Experience

The aim of this study was to analyze the relationship between current dietary habits and dental caries in schoolchildren from an area of Spain on which the prevalence of caries was low. The results of an epidemiological study conducted on a random sample of 893 children from the cities of Girona and Figueres are presented. The method of dietary interview consisted of a food-frequency questionnaire. This showed a positive relationship between dental caries and consumption of ice cream, pastries, cakes, sliced bread, on the one hand, and sugar-free chewing gum and sugar-free candies, on the other. A protective effect of skimmed milk and artificial sweeteners was also observed. Results reflect the role of certain foods in caries development, but also the outcome of selective dietary counseling to high-risk children.

Compliance with dietary guidelines in the Spanish population. Results from the Catalan Nutrition Survey

The aim of the present study was to analyse the different food and nutrition profiles of the section of the Spanish population having either a low or a high intake of energy, fat, saturated fatty acids (SFA) and fibre in order to analyse the compliance with dietary guidelines. Analyses were made from the Catalan Nutrition Survey, comprising a random sample of 1600 people aged 18 to 60. Dietary information was obtained by means of two 24 h recall, and food and energy intake was categorized according to the quartiles of fat, SFA and fibre intake. The results show the food consumption patterns that distinguish low versus high fat, SFA and fibre eaters in the Spanish population, and facilitate the establishment of food-based dietary guidelines in Spain and other Mediterranean countries.

Determinants of the nutritional status of vitamin E in a non-smoking Mediterranean population. Analysis of the effect of vitamin E intake, alcohol consumption and body mass index on the serum alpha-tocopherol concentration

Objectives: Study was conducted in order to investigate the association of vitamin E intake and other factors with plasma α-tocopherol concentration in a non-smoking Mediterranean population.Design: A cross-sectional study was conducted in a subsample of a representative sample of the Catalan population.Subjects: Sample size was 143 men and women, aged between 18 and 75 y, and final response rate reached 61.9% of the initial sample.Interventions: Serum alpha-tocopherol concentration standardized by serum total lipids was used as a proxy of the nutritional status of vitamin E. Vitamin E intake and alcohol consumption were estimated by a replicated 24 h recall method. Dietary data were collected in two different periods, winter and summer, in order to account for seasonal variation in nutrient intake, and were corrected for random within-person variability in order to account for day-to-day variation in nutrient intake. Multivariate linear regression models were fitted in order to estimate the determinants of serum α-tocopherol concentration.Results: In this population study, for each one mg increase in vitamin E intake, serum α-tocopherol concentration increased, on average, 0.66 micromol/L, after adjusting for age, gender, Body Mass Index (BMI), alcohol consumption and energy intake. BMI also influenced significantly serum α-tocopherol concentration, whereas alcohol intake, age and gender did not show significant associations with serum α-tocopherol.Conclusions: The study showed that vitamin E nutritional status was associated to vitamin E intake and BMI in non-smokers.Sponsorship: This study was supported by a research agreement between the Department of Health of the Autonomous Government of Catalonia and the Bosch Gimpera Foundation of the University of Barcelona (Contract 2415/95).

Efectividad de una intervención de deshabituación tabáquica en pacientes con patología cardiovascular

Introduction and objectives. The incidence of coronary events descends in patients with cardiac disease who quit smoking. Only around 50% of the patients who quit smoking after an acute event remain abstinent three months after hospital discharge. The objective of this study was to evaluate the effectiveness of a tobacco dishabituation program in patients with cardiovascular disease. Methods. We studied a cohort of smokers who started a smoking cessation program between September 1993 and June 1999. We compared 348 patients with cardiovascular disease with 1.107 smokers without disease. A twelve-month protocolized follow-up was performed, measuring carbon monoxide for evaluating relapse on every control. We calculated the abstinence in each period and estimated the odds ratio for relapse at twelve months. Results. We observed a global continued abstinence at twelve months of 37.1% (129/348) in the patients with cardiovascular disease and of 39.6% (438/1.107) in the patients without disease. The consonant smokers (precontemplatives) showed a greater number of relapses, with an adjusted Odds ratio of 1.36. Conclusions. Exhaustive treatment and follow-up achieved a percentage of great abstinence in the cardiovascular patients of our study who were unable to quit smoking during hospitalisation or after diagnosis. We therefore suggest that these patients may benefit from inclusion in smoking cessation units.

Combining varenicline and nicotine patches: a randomized controlled trial study in smoking cessation

BackgroundSome smokers may benefit from a therapy that combines different nicotine replacement therapies (NRT) or drugs with different mechanisms of action.The aim of this study was to determine the efficacy of the combined therapy of varenicline and nicotine patches versus varenicline monotherapy.MethodsThree hundred forty-one smokers who smoked 20 or more cigarettes per day were recruited from a smoking cessation clinic between February 2012 and June 2013. The participants were randomized to receive a varenicline plus nicotine patch of 21 mg every 24 hours (170) or varenicline plus a placebo patch (171). All of the smokers received a standard 12-week course of varenicline and an 11-week course of either the placebo patch or the active patch after the target quit day. Both groups received behavioral support. The primary outcome was continuous abstinence for weeks 2 through 12 confirmed by exhaled levels of carbon monoxide. Post hoc subgroup analyses were performed to evaluate the treatment effects for a specific endpoint in subgroups of smokers.ResultsThe combination of the nicotine patch with varenicline was not associated with higher rates of continuous abstinence at 12 weeks (39.1% versus 31.8%; odds ratio (OR) 1.24; 95% confidence interval (CI) 0.8 to 2.6) and 24 weeks (32.8% versus 28.2%; OR 1.17; 95% CI 0.4 to 1.9). When participants were analyzed by subgroups according to cigarette consumption, the abstinence rates among smokers who smoked more than 29 cigarettes per day at 12 weeks (OR 1.39; 95% CI 1.2 to 2.5) and 24 weeks (OR 1.46; 95% CI 1.2 to 2.8) were significantly higher in the combination group. Other post hoc analyses based on level of dependence and previous quit attempts did not show subgroup differences. No differences between the groups for the reported adverse events were observed (χ2 value 0.07; P 0.79).ConclusionsThe combination of varenicline with the nicotine patch does not improve abstinence rates at 12 and 24 weeks compared with varenicline used as monotherapy when all smokers were analyzed as a whole, independent of consumption level.Trial registrationThis study is registered at clinicaltrial.gov (NCT01538394).

Food Groups and Nutrient Intake and Risk of Colorectal Cancer: A Hospital-Based Case-Control Study in Spain

Although evidence supports that colorectal cancer (CRC) has an environmental etiology, the potential influence of diet appears to be one of the most important components. We studied the relation between food groups and nutrient intake and the risk of CRC. A hospital-based case-control study was conducted in Spain between 2007 and 2009. The authors matched 245 patients with incident histologically confirmed CRC by age, gender, and date of admission with 490 controls. Information about nutrient intake was gathered by using a semiquantitative frequency food questionnaire. Univariate analysis was done with individual food items. Odds ratios (ORs) for consecutive tertiles of nutrient intake were computed after allowance for sociodemographic variables and consumption of food groups. Vitamin B6 (OR: 0.26), vitamin D (OR: 0.45), vitamin E (OR: 0.42), polyunsaturated fatty acids (OR: 0.57), and fiber (OR: 0.40) were inversely associated with CRC, whereas carbohydrates (OR: 1.82) were significantly associated with CRC risk for the upper tertile. In multivariate analysis adjusting for major covariables (energy, age, and gender), vitamin D (OR:0.45), vitamin E (OR:0.36), and fiber (OR:0.46) remained associated with CRC. Data suggest that the etiology of colorectal cancer is not due to lifestyle and dietary patterns being important the effect of single nutrients.