Natalia Tumas

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.

Breast Cancer and Modifiable Lifestyle Factors in Argentinean Women: Addressing Missing Data in a Case-Control Study

A number of studies have evidenced the effect of modifiable lifestyle factors such as diet, breastfeeding and nutritional status on breast cancer risk. However, none have addressed the missing data problem in nutritional epidemiologic research in South America. Missing data is a frequent problem in breast cancer studies and epidemiological settings in general. Estimates of effect obtained from these studies may be biased, if no appropriate method for handling missing data is applied. We performed Multiple Imputation for missing values on covariates in a breast cancer case-control study of Córdoba (Argentina) to optimize risk estimates. Data was obtained from a breast cancer case control study from 2008 to 2015 (318 cases, 526 controls). Complete case analysis and multiple imputation using chained equations were the methods applied to estimate the effects of a Traditional dietary pattern and other recognized factors associated with breast cancer. Physical activity and socioeconomic status were imputed. Logistic regression models were performed. When complete case analysis was performed only 31% of women were considered. Although a positive association of Traditional dietary pattern and breast cancer was observed from both approaches (complete case analysis OR=1.3, 95%CI=1.0-1.7; multiple imputation OR=1.4, 95%CI=1.2-1.7), effects of other covariates, like BMI and breastfeeding, were only identified when multiple imputation was considered. A Traditional dietary pattern, BMI and breastfeeding are associated with the occurrence of breast cancer in this Argentinean population when multiple imputation is appropriately performed. Multiple Imputation is suggested in Latin America’s epidemiologic studies to optimize effect estimates in the future.