Laura Rosana Aballay

Overweight and obesity: a review of their relationship to metabolic syndrome, cardiovascular disease, and cancer in South America

Socioeconomic and demographic transformations are occurring very rapidly in some areas of the world, especially in South America, and are accompanied by changes in lifestyle, dietary patterns, and the epidemiological profile of prevalent diseases. This review examines whether obesity and overweight are related to metabolic syndrome, cardiovascular disease, and cancer in South America. Research carried out in more than 6,000 cases and controls was evaluated, along with most of the available publications related to South America. In South America, obesity and risk factors for cardiovascular disease are related mainly to aging, ethnicity effects, and preventable risky lifestyle conditions. Most of the studies that found an association between cancer and obesity are from the Southern Cone, the geographic area most affected by this pathology. Overall, the prevalence of metabolic syndrome was highest in Chile, followed in decreasing order by Colombia, Peru, Argentina, and Ecuador, with differences noted between urban and rural areas or between urban and periurban areas. Obesity and cancer may be preventable, at least in part, by healthy behavior; hence, exercise, weight control, and healthy dietary habits are important to reduce the risk of these major chronic diseases.

Cancer incidence and pattern of arsenic concentration in drinking water wells in Córdoba, Argentina

Cancer occurrence is associated with Arsenic (As) in drinking water. In Argentina, there are high As concentrations in groundwater but there is no published evidence yet of an association between geographic patterns of cancer incidence and the distribution of As in groundwater supplies. The purpose of this study is to assess the association between cancer incidence patterns and As in Córdoba provinces aquifers. Age standardized incidence rates (ASIRs) were obtained from Córdoba Cancer Registry (CCR), and As data from official reports of monitoring wells. A multilevel model was applied. Total ASIRs by aquifers for males/females were 191.01/249.22 (Rioja plain); 215.03/225.37 (Pampa hills); and 239.42/188.93 (Chaco-Pampa plain). As was associated with increased risk of colon cancer in women, and lung and bladder cancers in both sexes. It had no association with breast cancer. ASIRs were related to As, controlling for unobserved heterogeneity. An overlapping pattern of higher As and higher risks was evident for lung, bladder and female colon cancers.

Cancer incidence pattern in Cordoba, Argentina.

Cancer is the second cause of death in Argentina; nevertheless the distribution of the cancer incidence rates throughout the country is unknown. This study was conducted to describe cancer incidence patterns in Córdoba Province. Incidence data were supplied by the Government Córdoba Cancer Registry. Demographic information (age, sex, and place of residence) and diagnosis, certified by a pathologist, about all incident cases from June 2003 to May 2005 by type and 5-year age groups were obtained. Comparison of the incidence rate of cancer in various counties was performed by using standardized incidence rates (SIR) per 100 000 inhabitants using the world standard population. Estimated SIRs were used to build up incidence maps. Two indicators were created: sex ratio and site-specific ratio. Mixed Poisson models were fitted. Taken as a whole for all counties, SIR was 121.42 and 141.57 for men and women, respectively. The most common sites in men were prostate (13.62), lung (10.12), colon (7.53), and bladder (7.03); in women were breast (22.51) and colon (3.31). The highest and lowest rates were in urban and rural areas, respectively. Cancer registry has a pivotal role in cancer control. Such information is the primary resource of information not only for epidemiological research on cancer determinants but also for planning and evaluating health services for the policies of prevention, diagnosis and treatment of the disease.

Overweight and obesity: Prevalence and their association with some social characteristics in a random sample population-based study in Córdoba city, Argentina

SUMMARY BACKGROUND Obesity has become a threat to public health, as the epidemic is not confined to developed countries but is affecting many developing countries. Because obesity is known to vary according to socio-cultural factors, including socio-economic position and social roles, a multi-stage random sample population-based study was conducted in Córdoba, Argentina, from January 2005 to December 2006, to explore the effect of selected social factors on the prevalence of obesity. METHODS Information was obtained about demographic, anthropometric, lifestyle, dietary and physical activity characteristics. Logistic regression (LR) and proportional odds models (POM) were used in data analysis. RESULTS The prevalence of overweight and obesity was 52 and 17%, respectively. LR models revealed that overweight was positively associated with gender (men), decreasing socio-economic status (SES), married and divorced status and negatively with increasing levels of physical activity whereas obesity was positively associated with decreasing SES levels, married status and negatively associated with physical activity levels. POM revealed strong associations between variables and the outcomes and an effect modification among women aged 30 years or older with a low SES. CONCLUSIONS Our data indicate a high prevalence of overweight and obesity in this population; several social factors and lifestyle characteristics are associated with both overweight and obesity. However, a prospective cohort study would be needed to investigate causality.

Dietary patterns and food groups are linked to the risk of urinary tract tumors in Argentina.

Epidemiological and laboratory research has shown that dietary components are associated with the risk of developing urinary tract tumors (UTT). The purpose of this case–control study, carried out between 2004 and 2008 in Córdoba, a Mediterranean city in Argentina, was to describe the role of dietary patterns and to investigate any association with the risk of developing UTT. One hundred and sixty-eight patients with histologically confirmed transitional UTT and 334 controls with acute, nonneoplastic, and nonurinary tract diseases from the same hospitals were studied. All patients were interviewed about their food habits and their exposure to a number of known or suspected risk factors for UTT. Multiple correspondence analysis was used to explore dietary patterns and data analyses were carried out by calculating odds ratios and their 95% confidence intervals by using multiple logistic regression. Two main dietary patterns identified were a ‘prudent’ pattern that was linked to controls and a ‘western’ pattern that was associated with cases. A frequent intake of vegetable oils, lean meats, grains, and fruits, the moderate use of alcohol (mainly red wine) together with potato and sweet consumption, and the habit of taking at least four meals per day, were associated with a reduced risk for UTT. In contrast, frequent consumption of infusions (mainly maté), potatoes, alcohol, sweets, and processed meat resulted in a high risk for UTT. The dietary patterns of our population have a role in the development of UTT, thus implying that appropriate nutritional education may decrease this risk.

Cáncer y su asociación con patrones alimentarios en Córdoba (Argentina)

Introduccion: La alimentacion es un importante factor vinculado a la ocurrencia del cancer. Su abordaje en terminos de patrones alimentarios es de creciente interes en epidemiologia nutricional, no obstante ha sido pocas veces empleado en Latinoamerica. Objetivos: Identificar patrones alimentarios en la poblacion adulta de Cordoba (Argentina) y estimar sus efectos sobre el riesgo de ocurrencia de cancer colorrectal (CCR), cancer de mama (CM), cancer de prostata (CP) y urotelial (CU). Metodos: Se condujeron estudios caso-control, 2006-2012, correspondientes a CCR, CM, CP y CU. Empleando un analisis factorial de componentes principales se identificaron patrones alimentarios. Se estimaron ORs mediante regresion logistica multinivel. Resultados: Se identificaron patrones caracteristicos en la poblacion general, y en hombres y mujeres independientemente. En poblacion total, los patrones Cono Sur y Bebidas Azucaradas evidenciaron un efecto promotor para CCR y CU, y el Patron Prudente mostro efecto protector. En mujeres, el CM se asocio de manera directa con los patrones Cono Sur Femenino, Rural y Amilaceo, e inversa con el Patron Prudente. En hombres, los Patrones Cono Sur Masculino, Bebidas Azucaradas y Tipico Mesurado mostraron un efecto promotor para CP. Conclusion: Resulta necesario promover una ingesta habitual de vegetales, frutas y lacteos (estos ultimos de manera moderada en hombres), y disminuir el consumo de carnes rojas (fundamentalmente grasas), carnes procesadas, vegetales amilaceos, vino y bebidas azucaradas, a fin de prevenir la ocurrencia de cancer. En hombres se sugiere moderar la ingesta de huevos, y en mujeres la de granos refinados, productos de pasteleria, aceites y mayonesa.

Cancer and its association with dietary patterns in Cordoba (Argentina)

INTRODUCTION Feeding habits play a prominent role in carcinogenesis. The dietary patterns approach applied to the study of chronic diseases is of increasing interest in nutritional epidemiology. Nevertheless, it has been seldom used in Latin America. OBJECTIVE To identify dietary patterns in adult population in Córdoba (Argentina) and to estimate their effects on the risk of colon-rectal (CRC), urothelial (UC), breast (BC) and prostate (PC) cancers. METHODS Four case control studies were conducted, 2006-2012 for CRC, PC, BC and UC. To identify the dietary patterns, a Principal Components Factor Analysis was conducted. A multilevel logistic regression was adjusted for the risk analyses. RESULTS Characteristic dietary patterns in the whole population, and in women and men independently, were identified. In the whole population South Cone and Sweet Beverages patterns behaved as promoters for CRC and UC while the Prudent Pattern had a protective effect. Female South Cone, Rural and Starchy patterns were associated to a higher BC risk. Prudent Pattern lowered BC risk. In men, South Cone, Sweet Beverages and Typical Measured patterns promoted PC. CONCLUSION It is necessary to promote a regular intake of vegetables, fruits and diary products (although a moderate intake for men), and to reduce red meat (especially fat meat), processed meat, starchy vegetables, wine and sweet beverages intakes, to prevent the occurrence of cancer. In men, it is recommended a moderate intake of egg. In women, it is advised a moderate intake of refined grains, bakery products, oils and mayonnaise intake.

RED MEAT, MICRONUTRIENTS AND ORAL SQUAMOUS CELL CARCINOMA OF ARGENTINE ADULT PATIENTS.

INTRODUCTION the identification of risk group of oral cancer allows reducing the typical morbidity and mortality rates of this pathology. OBJETIVE it was analyzed the role of red meat, macronutrients and micronutrients on Oral Squamous Cell carcinoma (OSCC) in a case-control study carried out in Cordoba, Argentina. METHODS case-control study 3:1, both genders, aged 24-80 years. Dietary information was collected using a quali-quantitative food frequency questionnaire. The logistic regression was applied for assessing the association among case/control status and daily red meat/macronutrient/ micronutrients/energy intake. RESULTS micronutrients and minerals in the diet that showed high significant median values of common consumption in cases relative to controls were iron, phosphorus, vitamins B1, B5, B6, E and K and selenium. The association measurement estimated by logistic regression was showed that a significant association between red meat, fat, daily energy, phosphorous, vitamin B5, vitamin E, and selenium intake and OSCC presence. CONCLUSIONS a high intake of fats, phosphorus, vitamin B5, vitamin E, and selenium intake and red meat appears to be related to the presence OSCC in Cordoba, Argentina. In relation to red meat consumption and risk of OSCC, the future research should center of attention on reducing the complexity of diet and disease relationships and reducing variability in intake data by standardizing of criteria in order to implement simple strategies in public health for recognizing risk groups of OSCC.

Do Exposure to Arsenic, Occupation and Diet have Synergistic Effects on Prostate Cancer Risk?

Background: Diverse environmental exposures, as well as dietary and lifestyle factors, are associated with prostate cancer (PC) etiology; however little is known about joint interactive influences. The aim of this study was to analyse effects of diet combined with arsenic in drinking water and agricultural occupation on PC risk. Methods: A case-control study was conducted in Córdoba, Argentina (period 2008-2015) including 147 cases of PC and 300 controls. All subjects were interviewed about food consumption, socio-demographic and lifestyle characteristics. A sample of drinking water was taken to determine arsenic concentrations. Adherence scores to the Traditional Dietary Pattern were estimated, based on a principal component factor analysis. A two-level logistic regression model was fitted in order to assess effects of the Traditional Pattern, occupation and arsenic exposure on the occurrence of PC (outcome). Family history of PC was considered as a clustering variable. Results: PC risk was greatest in subjects with high adherence to the Traditional Pattern (OR 2.18; 95%IC 1.097–4.344). Subjects exposed to arsenic in drinking water above 0.01mg/l who simultaneously performed agricultural activities showed a markedly elevated PC risk (OR 5.07; 95%IC 2.074-12.404). Variance of the random effect of family history of PC was significant. conclusion: Diet, arsenic and occupation in agriculture exert significant effects on PC risk. Further efforts are necessary to analyse risk factors integrally, in order to achieve a better understanding of the complex causal network for PC in this multiple-exposure population.

Modificaciones en el nivel de anión superóxido en leche materna, según la ingesta de flavonoides y carotenoides

Resumen: Objetivo: Asociar la ingesta de flavonoides y carotenoides con el nivel en leche materna del anion superoxido, como marcador de estres oxidativo. Material y metodos: Durante el periodo 2013-2015 se estudio a 100 mujeres lactantes de Cordoba (Argentina), dentro los primeros seis meses posparto; se evaluaron sus datos sanitarios, ingesta alimentaria y nivel lacteo del anion con regresion logistica multiple. Resultados: La ingesta de flavonoides, carotenoides provitaminicos y carotenoides no provitaminas fue de 72 (61) mg/dia, 1 813 (1657) µg/dia y 5 427 (3664) µg/dia, respectivamente. El anion se asocio con la ingesta de flavanoles (RM=1.081; IC95 1.001-1.167) y flavanonas (RM=1.025; IC95 1.001-1.048). No se observo este efecto con otros flavonoides ni con los carotenoides. Conclusiones: La ingesta de flavanoles y flavanonas aumenta el riesgo de oxidacion lactea, lo cual es relevante para realizar recomendaciones dieteticas.