Consistent Inverse Association Research Articles

Does national expenditure on research and development influence stroke outcomes?

Background Expenditure on research and development is a macroeconomic indicator representative of national investment. International organizations use this indicator to compare international research and development activities. Aim We investigated whether differences in expenditures on research and development at the country level may influence the incidence of stroke and stroke mortality. Methods We compared stroke metrics with absolute amount of gross domestic expenditure on R&D (GERD) per-capita adjusted for purchasing power parity (aGERD) and relative amount of GERD as percent of gross domestic product (rGERD). Sources included official data from the UNESCO, the World Health Organization, the World Bank, and population-based studies. We used correlation analysis and multivariable linear regression modeling. Results Overall, data on stroke mortality rate and GERD were available from 66 countries for two periods (2002 and 2008). Age-standardized stroke mortality rate was associated with aGERD (r = -0.708 in 2002 and r = -0.730 in 2008) or rGERD (r = -0.545 in 2002 and r = -0.657 in 2008) (all p < 0.001). Multivariable analysis showed a lower aGERD and rGERD were independently and inversely associated with higher stroke mortality (all p < 0.05). The estimated prevalence of hypertension, diabetes, or obesity was higher in countries with lower aGERD. The analysis of 27 population-based studies showed consistent inverse associations between aGERD or rGERD and incident risk of stroke and 30-day case fatality. Conclusions There is higher stroke mortality among countries with lower expenditures in research and development. While this study does not prove causality, it suggests a potential area to focus efforts to improve global stroke outcomes.

The landscape of the tumor-infiltrating B cell and its association with T-cell and tumor microenvironment in human cancers.

76 Background: Compared to recent advances in our knowledge of T cell biology with success of immunotherapy, little progress has been made in understanding of the effects of B cells in tumor microenvironment and their interactions with T cells. Preclinical studies reported that B cells may have immune suppressive roles in tumor microenvironment via induction of T cell exhaustion. However, this association has not been shown in human tissues. We explored the landscape of tumor infiltrating B and T cells and their association with tumor microenvironment in various human cancers for which the FDA approved the use of immune checkpoint inhibitors. Methods: Expression patterns for 812 immune related genes from the TCGA database were utilized to define tumor infiltrating cells in 2951 patients with bladder urothelial carcinoma, renal clear cell carcinoma, skin cutaneous melanoma, lung squamous cell carcinoma, lung adenocarcinoma, and head and neck squamous cell carcinoma. Odds ratios (ORs) of the numbers of tumors with versus without activated B cell infiltration by the presence of activated CD8T cell infiltration were calculated. Results: Immune landscape of the six human cancers showed a consistent inverse association between tumor infiltrating activated B and CD8 T cells (OR = 0.18, p &lt; 0.001). B cell infiltration was associated with increased expressions of immune checkpoints PD-L1, PD-1 and CTLA-4 and regulatory cytokines TGF-β, IL-10 and IL-35, which are known to be secreted by regulatory B cells. Angiogenic markers, such as angiopoietins, VEGF, MMP-9, CXCL10, CXCL11 and Tie2, showed differential expression patterns between B cell high and low groups. Conclusions: This is the first study that reports the inverse association between tumor infiltrating B and CD8 T cells in human tissues. The strong associations between B cell infiltration and increased expressions of suppressive cytokines and immune checkpoints suggest regulatory B cells may play a role in the T cell suppression in tumor microenvironment. Our results implicate that depleting B cells, leading to possible disinhibition of T cell activation, may be a future therapeutic option in potentiating T cell mediated immunity.

To assess differential features of marrow adiposity between postmenopausal women with osteoarthritis and osteoporosis using water/fat MRI.

To assess the differential features of marrow adiposity between osteoarthritis (OA) and osteoporosis (OP) in postmenopausal women using water/fat MRI. This cross-sectional study included 97 postmenopausal women (OA [n = 25], OA + osteopenia [n = 27], OA + OP [n = 23], and OP groups [n = 22]). Water/fat MRI, dual-energy x-ray absorptiometry and biochemical analysis were performed to assess vertebral marrow fat fraction, bone mineral density, and bone biomarkers, respectively. Harris Hip Score was recorded to evaluate hip function. There were significant differences in marrow fat content among the OA, OA + osteopenia, and OA + OP groups, between OP and OA participants with normal bone mass or osteopenia (all P < 0.05); no significant difference was observed between OA + OP and OP groups. Serum levels of leptin and β-Crosslaps in OA with normal bone mass and osteopenic OA groups were higher than in OP group. Marrow fat fraction was inversely correlated with Harris Hip Score (r = -0.371, P = 0.013), bone mineral density (r = -0.554, P = 0.009) and leptin levels (r = -0.610, P < 0.001). In multivariate regression analysis, marrow fat fraction was found to have a consistent and unchanged inverse association with leptin levels (Sβ = -0.311, P = 0.002) and bone mineral density (Sβ = -0.265, P = 0.006) after adjusting for age, years since menopause, and body mass index. Postmenopausal OA with OP have a phenotype with higher marrow adiposity. OA and OP could coexist, for the presence of a specific subgroup of OA with increased marrow fat accumulation and high risk of developing OP.

A serious misinterpretation of a consistent inverse association of statin use with glioma across 3 case-control studies.

A serious misinterpretation of a consistent inverse association of statin use with glioma across 3 case-control studies.

The association of prenatal metals exposure with children’s growth in Bangladesh

Introduction: Arsenic, lead, and manganese are all known health hazards. However, most information of these metals exposure come from studies on adults. The effects of exposure to metals during fetal life and later growth and development still remain uncertain. This is one area that urgently need exploring with major public health implications. In this study, we seek to characterize the association of prenatal metals exposure with childhood growth parameters. Methods: Study population was taken from 819 women recruited between 2004 and 2011 in Bangladesh. Height and weight measurements were taken at birth, 12 months and again between 24-36 months. Umbilical cord blood measurements were collected at the time of delivery and analyzed via ICP-MS. The association between prenatal metals exposure and child height and weight was investigated using multivariate linear and mixed models. Results: In this study, we showed that, among the three cord blood metals tested, early arsenic (As) exposure had the strongest and most consistent inverse association with infant parameters of birth weight (beta=-0.13 kg +/- 0.05 kg) and birth height (beta=-0.09 cm +/-0.06 cm). Manganese (Mn) also indicated statistically significant inverse relationship with birth height, however only at higher quartile levels compared to the reference. There is inverse association found with child height changes up to 36 months of age due to early exposure to arsenic (beta= =- 0.14 cm +/- 0.08 cm) and at high levels of manganese (Mn: beta=-0.09cm, p=0.05 at highest quartile). No association has been apparent with Lead. Conclusion: Results indicate that prenatal arsenic and manganese exposure adversely affect child height and weight development at birth and up to 36 months of age.

An update of the WCRF/AICR systematic literature review on esophageal and gastric cancers and citrus fruits intake.

PurposeThe 2007 World Cancer Research Fund/American Institute for Cancer Research expert report concluded that foods containing vitamin C probably protect against esophageal cancer and fruits probably protect against gastric cancer. Most of the previous evidence was from case–control studies, which may be affected by recall and selection biases. More recently, several cohort studies have examined these associations. We conducted a systematic literature review of prospective studies on citrus fruits intake and risk of esophageal and gastric cancers.MethodsPubMed was searched for studies published until 1 March 2016. We calculated summary relative risks and 95 % confidence intervals (95 % CI) using random-effects models.ResultsWith each 100 g/day increase of citrus fruits intake, a marginally significant decreased risk of esophageal cancer was observed (summary RR 0.86, 95 % CI 0.74–1.00, 1,057 cases, six studies). The associations were similar for squamous cell carcinoma (RR 0.87, 95 % CI 0.69–1.08, three studies) and esophageal adenocarcinoma (RR 0.93, 95 % CI 0.78–1.11, three studies). For gastric cancer, the nonsignificant inverse association was observed for gastric cardia cancer (RR 0.75, 95 % CI 0.55–1.01, three studies), but not for gastric non-cardia cancer (RR 1.02, 95 % CI 0.90–1.16, four studies). Consistent summary inverse associations were observed when comparing the highest with lowest intake, with statistically significant associations for esophageal (RR 0.77, 95 % CI 0.64–0.91, seven studies) and gastric cardia cancers (RR 0.62, 95 % CI 0.39–0.99, three studies).ConclusionsCitrus fruits may decrease the risk of esophageal and gastric cardia cancers, but further studies are needed.Electronic supplementary materialThe online version of this article (doi:10.1007/s10552-016-0755-0) contains supplementary material, which is available to authorized users.

Sleep, circadian rhythm and body weight: parallel developments.

Circadian alignment is crucial for body-weight management, and for metabolic health. In this context, circadian alignment consists of alignment of sleep, meal patterns and physical activity. During puberty a significant reduction in sleep duration occurs, and pubertal status is inversely associated with sleep duration. A consistent inverse association between habitual sleep duration and body-weight development occurs, independent of possible confounders. Research on misalignment reveals that circadian misalignment affects sleep-architecture and subsequently disturbs glucose-insulin metabolism, substrate oxidation, leptin- and ghrelin concentrations, appetite, food reward, hypothalamic-pituitary-adrenal-axis activity and gut-peptide concentrations enhancing positive energy balance and metabolic disturbance. Not only aligning meals and sleep in a circadian way is crucial, also regular physical activity during the day strongly promotes the stability and amplitude of circadian rhythm, and thus may serve as an instrument to restore poor circadian rhythms. Endogenicity may play a role in interaction of these environmental variables with a genetic predisposition. In conclusion, notwithstanding the separate favourable effects of sufficient daily physical activity, regular meal patterns, sufficient sleep duration and quality sleep on energy balance, the overall effect of the amplitude and stability of the circadian rhythm, perhaps including genetic predisposition, may integrate the separate effects in an additive way.

Association between Parkinson's Disease and Cigarette Smoking, Rural Living, Well-Water Consumption, Farming and Pesticide Use: Systematic Review and Meta-Analysis.

ObjectiveBradford Hill’s viewpoints were used to conduct a weight-of-the-evidence assessment of the association between Parkinson’s disease (PD) and rural living, farming and pesticide use. The results were compared with an assessment based upon meta-analysis. For comparison, we also evaluated the association between PD and cigarette smoking as a “positive control” because a strong inverse association has been described consistently in the literature.MethodsPubMed was searched systematically to identify all published epidemiological studies that evaluated associations between Parkinson’s disease (PD) and cigarette smoking, rural living, well-water consumption, farming and the use of pesticides, herbicides, insecticides, fungicides or paraquat. Studies were categorized into two study quality groups (Tier 1 or Tier 2); data were abstracted and a forest plot of relative risks (RRs) was developed for each risk factor. In addition, when available, RRs were tabulated for more highly exposed individuals compared with the unexposed. Summary RRs for each risk factor were calculated by meta-analysis of Tier 1, Tier 2 and all studies combined, with sensitivity analyses stratified by other study characteristics. Indices of between-study heterogeneity and evidence of reporting bias were assessed. Bradford Hill’s viewpoints were used to determine if a causal relationship between PD and each risk factor was supported by the weight of the evidence.FindingsThere was a consistent inverse (negative) association between current cigarette smoking and PD risk. In contrast, associations between PD and rural living, well-water consumption, farming and the use of pesticides, herbicides, insecticides, fungicides or paraquat were less consistent when assessed quantitatively or qualitatively.ConclusionThe weight of the evidence and meta-analysis support the conclusion that there is a causal relationship between PD risk and cigarette smoking, or some unknown factor correlated with cigarette smoking. There may be risk factors associated with rural living, farming, pesticide use or well-water consumption that are causally related to PD, but the studies to date have not identified such factors. To overcome the limitations of research in this area, future studies will have to better characterize the onset of PD and its relationship to rural living, farming and exposure to pesticides.

Metabolomic Profile of Serum 25‐Hydroxy‐Vitamin D

The role of vitamin D in human health has been studied using a variety of approaches. In laboratory studies, the active form of vitamin D, 1,25(OH)2D3 has been shown to play a significant role in reducing autoimmune diseases, such as diabetes. In epidemiological studies, vitamin D has been associated with risk for some cancers but not others. For example, fairly consistent inverse (i.e., protective) associations with circulating 25‐hydroxy‐vitamin D (25(OH)D) have been observed for colorectal cancers, while direct (i.e., adverse) associations have been seen in prostate cancer studies. In order to gain a more comprehensive biological understanding of vitamin D associations with cancers and other health outcomes, we utilized a metabolomics approach to identify metabolites associated with serum 25(OH)D. Over 900 metabolites were measured from fasting blood samples collected at study entry between 1985 and 1988 in the Alpha‐Tocopherol, Beta‐Carotene Cancer Prevention (ATBC) Study, a cohort of Finnish male smokers ages 50–69 years. Baseline serum 25(OH)D was measured in 392 men using radioimmunoassay, chemiluminescence assays, and OCTEIA direct enzyme‐linked immunosorbent assay kits. Metabolites were profiled using ultrahigh performance liquid chromatography/mass spectroscopy and gas chromatography/mass spectroscopy (Metabolon, Inc., N.C.). Metabolite‐vitamin D associations were modeled using linear regression. A statistically significant (p&lt;0.05) change in beta‐estimates per 1 standard deviation (SD) increment was seen for 117 metabolites, the majority of which were lipids, along with 26 amino acids, 10 xenobiotics, seven peptides, six cofactors or vitamins, and four carbohydrate metabolites. Six lipid metabolites were significant at the Bonferroni corrected threshold of p &lt; 0.000053, including 3‐carboxy‐4‐methyl‐5‐propyl‐2‐furanpropanoic acid (CMPF) (beta=0.42/1 SD increment), stearoyl‐arachidonoyl‐glycerophosphoethanolamine (GPPE) (beta =−0.36/1 SD), stearoyl‐linoleoyl‐GPPE (beta = −0.35/1 SD), erucoyl sphingomyelin (beta = 0.32/1 SD), eicosapentaenoate (beta=0.24/1 SD) and docosahexaenoate (beta=0.21/1 SD). The identification of these metabolites may provide insights into the role of vitamin D in human health.Support or Funding InformationResearch support: Intramural Research Program of the National Cancer Institute, NIH.

Maternal phthalate exposure during pregnancy is associated with DNA methylation of LINE-1 and Alu repetitive elements in Mexican-American children

Phthalates are frequently used in personal care products and plasticizers and phthalate exposure is ubiquitous in the US population. Exposure to phthalates during critical periods in utero has been associated with a variety of adverse health outcomes but the biological mechanisms linking these exposures with disease are not well characterized. In this study, we examined the relationship of in utero phthalate exposure with repetitive element DNA methylation, an epigenetic marker of genome instability, in children from the longitudinal birth cohort CHAMACOS. Methylation of Alu and long interspersed nucleotide elements (LINE-1) was determined using pyrosequencing of bisulfite-treated DNA isolated from whole blood samples collected from newborns and 9 year old children (n=355). Concentrations of eleven phthalate metabolites were measured in urine collected from pregnant mothers at 13 and 26 weeks gestation. We found a consistent inverse association between prenatal concentrations of monoethyl phthalate, the most frequently detected urinary metabolite, with cord blood methylation of Alu repeats (β(95%CI): −0.14 (−0.28,0.00) and −0.16 (−0.31, −0.02)) for early and late pregnancy, respectively, and a similar but weaker association with LINE-1 methylation. Additionally, increases in urinary concentrations of di-(2-ethylhexyl) phthalate metabolites during late pregnancy were associated with lower levels of methylation of Alu repeats in 9 year old blood (significant p-values ranged from 0.003 to 0.03). Our findings suggest that prenatal exposure to some phthalates may influence differences in repetitive element methylation, highlighting epigenetics as a plausible biological mechanism through which phthalates may affect health.

The economic status of older people's households in urban and rural settings in Peru, Mexico and China: a 10/66 INDEP study cross-sectional survey.

Few data are available from middle income countries regarding economic circumstances of households in which older people live. Many such settings have experienced rapid demographic, social and economic change, alongside increasing pension coverage. Population-based household surveys in rural and urban catchment areas in Peru, Mexico and China. Participating households were selected from all households with older residents. Descriptive analyses were weighted back for sampling fractions and non-response. Household income and consumption were estimated from a household key informant interview. 877 Household interviews (3177 residents). Response rate 68 %. Household income and consumption correlated plausibly with other economic wellbeing indicators. Household Incomes varied considerably within and between sites. While multigenerational households were the norm, older resident’s incomes accounted for a high proportion of household income, and older people were particularly likely to pool income. Differences in the coverage and value of pensions were a major source of variation in household income among sites. There was a small, consistent inverse association between household pension income and labour force participation of younger adult co-residents. The effect of pension income on older adults’ labour force participation was less clear-cut. Historical linkage of social protection to formal employment may have contributed to profound late-life socioeconomic inequalities. Strategies to formalise the informal economy, alongside increases in the coverage and value of non-contributory pensions and transfers would help to address this problem.

School Racial Composition and Parental Choice

Racial segregation remains a persistent problem in U.S. schools. In this article, we examine how social psychological factors—in particular, individuals’ perceptions of schools with varying demographic characteristics—may contribute to the ongoing structural problem of school segregation. We investigate the effects of school racial composition and several nonracial school characteristics on white parents’ school enrollment decisions for their children as well as how racial stereotypes shape the school choice process. We use data from a survey-based experiment we designed to test ‘‘pure race’’ and ‘‘racial proxy’’ hypotheses regarding parents’ enrollment preferences. We also use a measure of pro-white stereotype bias, both alone and in combination with school racial composition (percentage black). Using logistic regression analysis, we find support for the ‘‘pure race’’ hypothesis. The proportion of black students in a hypothetical school has a consistent and significant inverse association with the likelihood of white parents enrolling their children in that school net of the effects of the included racial proxy measures. In addition, higher levels of pro-white stereotype bias further inhibit enrollment, particularly in schools with higher proportions of black students. We discuss the implications of this research for policies aimed at mitigating racial segregation in U.S. schools.

The Associations of C-Reactive Protein with Serum Levels of Polyunsaturated Fatty Acids and Trans Fatty Acids Among Middle-Aged Men from Three Populations.

C-reactive protein (CRP) and many fatty acids (FAs) have been linked to cardiovascular disease. Associations of serum CRP with FAs in different populations have not been established. Participants were 926 men aged 40-49 (2002-2006) from a population-based sample; 310 Whites from Pennsylvania, U.S., 313 Japanese from Shiga, Japan, and 303 Japanese Americans from Hawaii, U.S. Serum CRP (mg/L) was measured using immunosorbent assay while serum FAs (%) were measured using capillary-gas-liquid chromatography. Whites had CRP (mg/L) levels higher than Japanese with Japanese Americans in-between (age-adjusted geometric mean "GM" 0.96, 0.38, 0.66, respectively). Whites had also higher levels of total n-6 FAs (%) and trans fatty acids (TFAs) but lower levels of marine-derived n-3 FAs compared to Japanese (41.78 vs. 35.05, 1.04 vs. 0.58, and 3.85 vs. 9.29, respectively). Japanese Americans had FAs levels in-between the other two populations. Whites had significant inverse trends between CRP and tertiles of total n-6 FAs (GM 1.20, 0.91 and 0.80; p=0.002) and marine-derived n-3 FAs (GM 1.22, 1.00 and 0.72; p<0.001) but a significant positive trend with TFAs (GM 0.80, 0.95 and 1.15; p=0.007). Japanese had a significant inverse trend between CRP and only total n-6 FAs (GM 0.50, 0.35 and 0.31; p<0.001). Japanese Americans had CRP associations with n-3 FAs, n-6 FAs, and TFAs similar to but weaker than Whites. With the exception of consistent inverse association of CRP with total n-6 FAs, there are considerable variations across the three populations in the associations of CRP with different FAs.

Vitamin D and Colorectal, Breast, and Prostate Cancers: A Review of the Epidemiological Evidence.

Over the past two decades, the question of whether vitamin D has a role in cancer incidence, progression, and mortality has been studied in detail. Colorectal, breast, and prostate cancers have been a particular area of focus; together, these three malignancies account for approximately 35% of cancer cases and 20% of cancer deaths in the United States, and as such are a major public health concern. Herein, we review and synthesize the epidemiological research regarding vitamin D, as measured by the biomarker 25-hydroxycholecalciferol [25(OH)D], and the incidence, progression, and mortality of these cancers. Overall, the results of observational studies of the relationship between 25(OH)D and colorectal cancer have revealed a consistent inverse association for incidence and mortality; while for breast cancer, results have generally demonstrated a relationship between higher 25(OH)D and lower risk for progression and mortality. In contrast, randomized, double-blind clinical trials conducted to date have generally failed to support these findings. For prostate cancer, there is no convincing evidence of an association between 25(OH)D and incidence, and inconsistent data for progression and mortality, though results of one open label clinical trial suggest that supplementation with 4000 IU/d of vitamin D3 may inhibit progression of the disease. Nonetheless, until the results of additional ongoing randomized, double-blind clinical trials are reported, it will be difficult to ascertain if vitamin D itself is related to a reduction in risk for some cancer endpoints, or whether high concentrations of the vitamin D biomarker 25(OH)D may instead serve as a marker for an overall beneficial risk factor profile.

Reduced risk of pancreatic cancer associated with asthma and nasal allergies

ObjectiveStudies indicate an inverse association between ductal adenocarcinoma of the pancreas (PDAC) and nasal allergies. However, controversial findings are reported for the association with asthma. Understanding PDAC risk factors will...

From a cardio-vascular reserve hypothesis to a proposed measurable index: A pilot empirical validation

BackgroundCardiovascular reserve index (CVRI) was previously proposed as an estimate of the assumed (momentary) cardiovascular reserve as a function of stroke volume (SV), systemic vascular resistance (SVR), respiratory rate (RR) and body surface area (BSA). Conversion through conventional hemodynamic equations reveals an equivalent, simpler, vital signs based function. We evaluated the association between CVRI and diverse conditions along the hemodynamic spectrum. MethodsCVRI was retrospectively computed for each subject of 3 existing patient databases. 1) Acute severe hospital admissions [N=333] classified by disease course to: “shock on arrival”, “developing shock” and “non-shock”. 2) Heart failure (HF) patients [N=71] classified by HF severity to: mild, moderate and severe HF. 3) Cardio-pulmonary exercise testing (CPX) [n=387] classified by exercise capacity (EC) to: normal, mildly decrease, moderately decrease and severely decreased EC. CVRI association with these hemodynamic conditions was evaluated through ANOVA. Results‘Normal EC’ has the highest CVRI of 0.97 (0.88, 1.06), and in decreasing CVRI order ‘mildly decrease EC’, ‘moderately decrease EC’, ‘mild HF’ which was similar to ‘severely decrease EC’, ‘moderate HF’ which was similar to acute severe admission of ‘non-shock’, ‘severe heart failure’ which was similar to ‘developing shock’ and the lowest CVRI was observed in ‘shock on arrival’ with mean CVRI of 0.20 (0.19, 0.22), ANOVA p<0.001. ConclusionsMean CVRI exhibited consistent inverse association with the severity of the hemodynamic condition. However, CVRI clinical utility of an individual patient requires further studies.

Adherence to Mediterranean diet and risk of cancer: an updated systematic review and meta-analysis of observational studies.

The aim of the present systematic review and meta‐analysis of observational studies was to gain further insight into the effects of adherence to Mediterranean Diet (MD) on overall cancer mortality, incidence of different types of cancer, and cancer mortality risk in cancer survivors. Literature search was performed using the electronic databases PubMed, and EMBASE until 2 July 2015. We included either cohort (for specific tumors only incidence cases were used) or case–control studies. Study specific risk ratios, hazard ratios, and odds ratios (RR/HR/OR) were pooled using a random effect model. The updated review process showed 23 observational studies that were not included in the previous meta‐analysis (total number of studies evaluated: 56 observational studies). An overall population of 1,784,404 subjects was included in the present update. The highest adherence score to an MD was significantly associated with a lower risk of all‐cause cancer mortality (RR: 0.87, 95% CI 0.81–0.93, I 2 = 84%), colorectal cancer (RR: 0.83, 95% CI 0.76–0.89, I 2 = 56%), breast cancer (RR: 0.93, 95% CI 0.87–0.99, I 2=15%), gastric cancer (RR: 0.73, 95% CI 0.55–0.97, I 2 = 66%), prostate cancer (RR: 0.96, 95% CI 0.92–1.00, I 2 = 0%), liver cancer (RR: 0.58, 95% CI 0.46–0.73, I 2 = 0%), head and neck cancer (RR: 0.40, 95% CI 0.24–0.66, I 2 = 90%), pancreatic cancer (RR: 0.48, 95% CI 0.35–0.66), and respiratory cancer (RR: 0.10, 95% CI 0.01–0.70). No significant association could be observed for esophageal/ovarian/endometrial/and bladder cancer, respectively. Among cancer survivors, the association between the adherence to the highest MD category and risk of cancer mortality, and cancer recurrence was not statistically significant. The updated meta‐analyses confirm a prominent and consistent inverse association provided by adherence to an MD in relation to cancer mortality and risk of several cancer types.

Polyunsaturated fatty acid interactions and breast cancer incidence: a population-based case-control study on Long Island, New York

PurposeExperimental studies demonstrate that ω-3 polyunsaturated fatty acids (PUFAs) inhibit inflammatory eicosanoids generated by ω-6 PUFAs. Epidemiologic studies on dietary ω-3 PUFA intake show consistent inverse associations with breast cancer incidence among Asian populations, where ω-3, relative to ω-6, intake is high. In contrast, associations are inconsistent among Western populations, where intake of ω-3, relative to ω-6, is low. We hypothesized that examining interactions between ω-3 and ω-6 would help elucidate the PUFA-breast cancer association in the United States. MethodsIn a Long Island, New York, population-based study of 1463 breast cancer cases and 1500 controls, we estimated multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) using unconditional logistic regression to examine interactions between ω-3 and ω-6 intake. ResultsWe observed a super-additive interaction (relative excess risk due to interaction = 0.41; 95% confidence interval = 0.06–0.76) between ω-3 and ω-6 intake in association with breast cancer incidence, although the CIs for the joint exposure of low ω-3/high ω-6 compared to high ω-3/low ω-6 intake were wide (odds ratio = 1.20; 95% confidence interval = 0.85–1.69). ConclusionsBreast cancer risk reduction may be possible for U.S. women with dietary consumption of higher ω-3, which has anti-inflammatory properties, in concert with lower ω-6, which induces inflammation. Replication from future U.S.-based investigations is needed.

Impact Of Air Pollution And PM2.5 Composition On Lung Function And Airway Inflammation In Asthmatic And None-Asthmatic Children In Santiago, Chile: Preliminary Results

Background: The association between PM2.5 and airway inflammation and lung function has been extensively-studied. However, few studies have evaluated the effects of PM2.5 components. Objective: To evaluate the association between PM2.5 composition and airway inflammation and lung function in asthmatics and none-asthmatics children from Santiago, Chile. Methods: A panel study was performed in the winter months of 2010-2011 on children 6-14 years-old in Santiago, Chile. Spirometry and exhaled Nitric Oxide (eNO) was assessed every 2 weeks on 104 asthmatics and 108 none-asthmatics children. PM2.5 samples were collected on a central site and analyzed for mass and composition. To estimate the association between air pollutants and respiratory outcomes crude generalized linear mixed with random intercepts models were used, considering lags and means of exposure of 0 to 7 days. Results: PM2.5 mass and component concentrations were rather large, exceeding national and international standards, with high variability between days. Major contributions to PM2.5 were EC, OC, Ca, Cl, Fe, K, S, and Si. For lung function, strong and consistent inverse associations were found between FEV1, PEF, FVC and for short and medium term (lag 0-7 and mean 1-7) exposures to PM2.5 and components associated with industrial emissions (S, Se, Sn, V, Si and Mo), with stronger impacts found for asthmatics compared to none-asthmatics. Also, none-asthmatics showed inverse associations between PEF and the carbonaceous fractions (EC, OC, TC). For eNO, all children showed strong associations with the carbonaceous fractions and criteria pollutants associated with traffic (PM2.5, CO, NO2), while the rest of PM2.5 components showed rather weak associations. Conclusion: Strong association were found between air pollutants and PM2.5 components and the studied outcomes in all children. Larger impacts were found for PM2.5 components and air pollutants associated with industrial pollution and traffic emissions.

Consumption of spicy foods and total and cause specific mortality: population based cohort study

Objective To examine the associations between the regular consumption of spicy foods and total and cause specific mortality.Design Population based prospective cohort study.Setting China Kadoorie Biobank in which participants from...