María Dolores Román

Dietary habits and prostate cancer prevention: a review of observational studies by focusing on South America.

There exist several works considering the association between diet and prostate cancer (PC) risk, but the issue is largely unsettled. This article systematically reviews the epidemiological studies on diet and risk of PC focusing on those carried out in countries of South America. There is some suggestion that dairy products, red meat, processed meat, α-linolenic fatty acids, as well as dietary patterns characterized by higher intakes of red and processed meat, eggs, and grains may play some role in the development of PC. There is no clear association with the intake of vegetables and fruits, lycopene, fats, and different types of fatty acids. The evidence on diet and PC is therefore inconclusive in general and specifically in South America. Particular attention must be paid to the study of cancer risk in some countries of South America because of the singularly risky dietary pattern consumed by its population.

Traditional Dietary Pattern Increases Risk of Prostate Cancer in Argentina: Results of a Multilevel Modeling and Bias Analysis from a Case-Control Study.

There is increasing evidence that dietary habits play a role in prostate cancer (PC) occurrence. Argentinean cancer risk studies require additional attention because of the singular dietary pattern of this population. A case-control study (147 PC cases, 300 controls) was conducted in Córdoba (Argentina) throughout 2008–2013. A principal component factor analysis was performed to identify dietary patterns. A mixed logistic regression model was applied, taking into account family history of cancer. Possible bias was evaluated by probabilistic bias analysis. Four dietary patterns were identified: Traditional (fatty red meats, offal, processed meat, starchy vegetables, added sugars and sweets, candies, fats, and vegetable oils), Prudent (nonstarchy vegetables, whole grains), Carbohydrate (sodas/juices and bakery products), and Cheese (cheeses). High adherence to the Traditional (OR 2.82, 95%CI: 1.569–5.099) and Carbohydrate Patterns (OR 2.14, 95%CI: 1.470–3.128) showed a promoting effect for PC, whereas the Prudent and Cheese Patterns were independent factors. PC occurrence was also associated with family history of PC. Bias adjusted ORs indicate that the validity of the present study is acceptable. High adherence to characteristic Argentinean dietary patterns was associated with increased PC risk. Our results incorporate original contributions to knowledge about scenarios in South American dietary patterns and PC occurrence.

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.

Consumo de micronutrientes y tumores de vías urinarias en Córdoba, Argentina.

INTRODUCTION Micronutrients content of habitually consumed foods comprise a causal network model of cancer, but the evaluation of their effect on this pathology represents a great challenge because of the interdependence in their usual consumption. Several studies reported that nutrients can modify the urinary tract tumors (UTT) risk, although such evidence is still limited. OBJECTIVE To identify associations between dietary vitamins A, E, B6, C, phosphorus, selenium and zinc intakes and the presence of UTT in Córdoba, Argentina, considering the multicollinearity caused by the interdependence of their consumption. METHODS A case control study was carried out including 129 cases with incident histopathologically confirmed UTT and 257 controls. A food frequency questionnaire previously validated was administrated to each subject. Dietary intakes of vitamins A, E, B6, C, phosphorus, selenium and zinc were the variables of interest, each showing high correlation with each other and thus, causing collinearity. So, multiple logistic regression models were adjusted and their adaptation to the presence of correlation, Ridge regression, to obtain the odds ratio (OR). The models included terms of sex, age, body mass index (BMI), socioeconomic status, occupational exposure to carcinogens, tobacco consumption and caloric intake as covariates. RESULTS Vitamin E and vitamin B6 showed a slight protective effect (OR: 0.943, CI 95% 0.897-0.998 and OR: 0.730 CI 95% 0.457-1.167). Selenium was slightly promoter (OR: 1.012 CI 95% 1.001-1.023). CONCLUSION When multicollinearity is considered in the model, it is possible to obtain more accurate estimates of the modulation that some micronutrients have on the risk of UTT more precisely.

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.

P1-13 Meat intake and urinary tract tumours risk assessment through promoting latent variables models

Introduction Generalize Linear Latent and Mixed Models are scarcely used in cancer epidemiology, having been basically used multilevel and generalised linear and mixed models. Using flexible models allow including random effects, common factors coupled to a multilevel structure for unobserved heterogeneity. Cancer is the main cause of death worldwide. In Córdoba, (Argentina) bladder cancer is the fourth most incident cancer among men and ninth in the overall population. Previous studies have suggested that fruits, lean meats, some cereals and cereal products, and vegetable oils would prevent against these tumours, while some fatty meats and use of sweeteners, may increase the risk. In the present work new methodological strategies are used in order to explore the dietary influence on the disease outcome. Objective To define some possible promoting dimensions related to meat intake and combine with a disease model including some bio-socio-cultural characteristics. Methods A case-control study, conducted in Córdoba, including 221/472 cases/controls is used. Subjects were interviewed using a validated FFQ containing biological, educational and lifestyle characteristics, and 127 food items. A two steps model was proposed: common factor modelling as confirmatory factor analysis to explore the dimensionality of constructs from the diet information; and a disease model, which arises from the composition of exposure and measurement models. Results and Conclusion Two constructs were identified, a promoting and a protective one. The direct and indirect covariates effects were also estimated as risk. This work improves the understanding about the diet-cancer relationship.