Sonia Edith Muñoz

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.

DIET DIVERSITY AND GASTRIC CANCER

It has long been suggested that a varied diet may protect against gastric cancer, in the absence, however, of definition and quantification of the issue. Thus, we considered the relationship between diet diversity (i.e., variety of food intake computed as the total number of foods consumed at least once per week) and the risk of gastric cancer using data of a case‐control study conducted between 1985 and 1993 in northern Italy on 746 gastric‐cancer cases below age 75 years and 2,053 controls admitted to hospital for acute, non‐neoplastic, non‐digestive‐tract diseases. A significant inverse association was observed between various measures of food diversity and gastric cancer risk. Compared with subjects in the lowest quartile of total diversity, the multivariate odds ratios (ORs) were 0.9 for the second, 0.9 for the third and 0.7 for the highest quartiles. The inverse association was even stronger for vegetable (OR = 0.5 for the highest level) and fruit (OR = 0.6) diversity. Our findings were not explained by allowance for total calorie intake and total number of servings, besides education as an indicator of social class, and support, therefore, the concept that a more diversified and richer diet is a relevant underlying correlate of the decline in gastric cancer rates. Int. J. Cancer 72:255–257, 1997.

Alcohol, methylxanthine-containing beverages, and colorectal cancer in Córdoba, Argentina.

The relationship between social class indicators, body mass index (BMI), selected life-style habits (alcohol, coffee, maté and tea drinking) and colorectal cancer was investigated in a case-control study conducted between 1993 and 1997 in Córdoba, Argentina, a relatively high mortality area for colorectal cancer. Cases were 190 patients below age 80 years with incident, histologically confirmed colorectal adenocarcinomas, and controls were 393 patients admitted to hospital for a wide spectrum of acute, non-neoplastic disorders. Higher social class, based on occupation of the head of the household, was significantly associated with colorectal cancer risk: the odds ratios (OR) and 95% confidence intervals (95% CI) were 1.9 (1.2-2.9) for intermediate and 2.0 (1.2-3.4) for the highest as compared to the lowest social class individuals. When compared with subjects whose BMI was<25 kg/m2, the OR was 1.1 (0.7-1.6) for those with BMI 25 to 29 kg/m2, and 1.3 (0.7-2.3) for those ≥ 30. In comparison with alcohol abstainers, the OR was 2.8 (1.6-5.1) for drinkers, and there was a significant trend in risk with dose. The association was observed with wine (the most common alcoholic beverage in Argentina), as well as for beer and spirits. The consumption of coffee, mate and tea was not significantly related to colorectal cancer, but the ORs were below unity (0.9 (0.7-1.3) for coffee, 0.9 (0.6-1.5) for mate and 0.8 (0.6-1.2) for tea drinkers). The relationship between social class, alcohol drinking and colorectal cancer were consistent across strata of sex and age. This study confirms that colorectal cancer has positive social class correlates. The association with alcohol drinking is apparently stronger than previously reported, and may be due to the role of chance and/or peculiar correlates of alcohol drinking in this Argentinean population

Artificial sweetener consumption and urinary tract tumors in Cordoba, Argentina

OBJECTIVE To determine the role of the habitual use of the most common artificial sweeteners (AS) in the development of urinary tract tumors (UTT) in Argentina. METHODS Case-control study of 197 patients with histologically confirmed UTT of transitional varieties, and 397 controls with acute, non-neoplastic, and non-urinary tract diseases, admitted to the same hospitals in Córdoba (Argentina) between 1999 and 2006. All subjects were interviewed about their use of AS and their exposure to other known or suspected risk factors for UTT. RESULTS Fifty-one UTT patients (26%) and 87 controls (22%) used AS. The risk of UTT was significantly increased in long-term (> or =10 years) AS users compared with none-AS users. The OR (95% CI) for long-term consumers was 2.18 (1.22-3.89) and for short-term users was 1.10 (0.61-2.00) after adjustment for age, gender, BMI, social status. and years of tobacco use. CONCLUSION Regular use of AS for 10 years or more was positively associated with UTT.

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.

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.

Delayed-type hypersensitivity and humoral immunity modulation by dietary lipids in a murine model of pulmonary tumorigenesisinduced by urethan

Mice fed on semisynthetic formulas containing 15% of corn oil (CO), cod fish liver oil (FO), oleic acid (O) or a mixture of 46% of palmitic and 50% of stearic acids (PS) were treated with urethan during 18 weeks for lung tumor induction. Delayed-type hypersensitivity (DTH) assay, hemagglutination assay and the amount of lung nodes (alveolar adenocarcinomas) were recorded. Results showed significantly greater DTH in CO and FO with respect to O and PS feeding mice; the two last ones induced an essential fatty acid (EFA) deficiency (EFAD). In the O lot there was a non-significant diminution of the humoral response. EFAD animals exhibited a tendency to increase number of lung nodes in relation to CO and FO lots. Splenomegalia was recorded in FO lot. Confront between spleen weight and DTH showed a 72% correlation, suggesting an increase in cellular immunity as increasing unsaturation. It may be concluded that in this suitable model of tumorigenesis the manipulation of dietary lipids may be a strategy to modify the immune system response.

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.

Proaggregatory and procoagulant properties of three murine mammary gland tumor cell lines with different metastatic capabilities

We have investigated the in vitro proaggregatory and procoagulant properties of three murine tumor cell lines having different metastatic potentials. The characterization was carried out with appropriate procoagulant inhibitors and plasma deficient in factors VII and X. The proaggregatory properties of M2, M3 and MM3 cell lines increased according to their metastatic potentials. Their procoagulant activity were dependent on factor X. The prothrombotic abilities exhibited by neoplastic cells (NC), acting synergistically, might play a role in cancer dissemination.

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.