Nutrition In Cancer Prevention Research Articles

What are we doing concretely for the food prevention of cancer? Nutrition between scientific evidence and myopic policies.

Scientific research has often investigated the role of diet as a risk factor for cancer development. It is well known that cancer has a multifactorial origin in which several factors are involved: genetic predisposition, dietary factors, personal habits, and infectious and environmental factors. In this Commentary, the role of diet in cancer is discussed following the scientific evidence suggesting that excessive consumption of red meat and processed foods is correlated with a greater risk of contracting cancer. Nevertheless, public health strategies on nutrition in cancer prevention are struggling to take off. The decision to pursue a healthier diet, along with a healthier lifestyle, often comes when the cancer diagnosis is made and not before. On the other hand, scientific evidence demonstrates how nutritional support is increasingly important during oncological treatments. This paper highlights how far we are still from the global adoption of a healthy and sustainable food style from a health, economic, social and environmental perspective. Additionally, it highlights the ancient vision of the role of nutrition on cancer development in which diet is seen only as a possible risk factor, underestimating the protective role in terms of cancer prevention and the modulatory one once the oncological diagnosis has been made.

Trends in Diet and Cancer Research: A Bibliometric and Visualization Analysis.

Diet plays a critical role for patients across the cancer continuum. The World Cancer Research Fund International and the American Cancer Society have published evidence supporting the role of nutrition in cancer prevention. We conducted an analysis of the literature on dietary nutrients and cancer to uncover opportunities for future research. The objective of the bibliometric analysis was to describe trends in peer-reviewed publications on dietary components and cancer and to highlight research gaps. PubMed was queried for manuscripts with diet- and cancer-related keywords and Medical Subject Headings (MeSH) terms. Metadata covering 99,784 publications from 6469 journals were analyzed to identify trends since 1970 on diet topics across 19 tumor types. Publications focused largely on breast, colorectal, and liver cancer, with fewer papers linking diet with other cancers such as brain, gallbladder, or ovarian. With respect to "unhealthy" diets, many publications focused on high-fat diets and alcohol consumption. The largest numbers of publications related to "healthy" diets examined the Mediterranean diet and the consumption of fruits and vegetables. These findings highlight the need for additional research focused on under-investigated cancers and dietary components, as well as dietary studies during cancer therapy and post-therapy, which may help to prolong survivorship.

THE ROLE OF NUTRITION AND BIOACTIVE SUBSTANCES OF PLANT ORIGIN IN THE PREVENTION OF CANCER DISEASES

Background. Cancer is one of the leading causes of mortality worldwide. Carcinogenesis is a multistage and complex process that may be partially reversible. In the process of carcinogenesis, numerous metabolic pathways associated with normal cell growth and division are disturbed. An important role in the prevention of cancer is played by a lifestyle characterized by maintaining a healthy weight, an appropriate level of physical activity and increased consumption of food with anti-cancer properties. Results and conclusion. The paper presents the latest literature reports on the pathogenesis of cancer and the impact of diet on the risk of its occurrence. In addition, known models of carcinogenesis and their impact on the development of knowledge in the field of oncology are discussed. Current recommendations on nutrition in cancer prevention, developed by the American Cancer Research Fund, are also presented. The aim of this paper is also to present the role of selected bioactive components of plant origin in cancer prevention. The paper presents basic information on carcinogenesis and the dietary anticancerogen mechanisms . Individual groups of bioactive compounds showing anticancer activity are discussed: dietary fiber, phenolic compounds, flavonoid phytoestrogens (classified as phenolic compounds) and nonflavonoid compounds, betalains, glucosinolates, phytates and carotenoids. An attempt was made to systematize knowledge on the anticancer properties of these compounds. By altering the diet, the supply of plant-derived bioactive components should be increased, which, through various mechanisms, have the ability to inhibit various phases of tumor formation and reduce the supply of potential carcinogens.

The Role of Nutrition in Cancer Prevention - Should You Listen to Your Doctor or Influencer?

A significant proportion of cancers could be prevented by adopting healthy lifestyle behaviours. In addition, healthy lifestyle factors can have a positive impact on cancer outcomes and survival. Yet, most physicians, including oncologists, do not dedicate a significant amount of time addressing these factors with their patients, who instead look to mainstream media and other non-medical sources for information. This has led to an increase in the number of 'influencers' in the wellness space who can accumulate a large and captive audience. At times, this has caused friction amongst healthcare professionals who feel that 'influencers' may overstate the potential benefits. The reality is that most people, physicians and the public alike, fail to recognise the immense power that lifestyle interventions hold. Rather than shy away from addressing these issues, we should be empowering our patients to take back control over their health. Here, we provide a personal perspective on why addressing lifestyle factors within cancer care is so important and that we can indeed work together with 'influencers' to amplify the message.

Are systematic reviews addressing nutrition for cancer prevention trustworthy? A systematic survey of quality and risk of bias.

ContextThe last 30 years have yielded a vast number of systematic reviews and/or meta-analyses addressing the link between nutrition and cancer risk.ObjectiveThe aim of this survey was to assess overall quality and potential for risk of bias in systematic reviews and meta-analyses (SRMAs) that examined the role of nutrition in cancer prevention.Data SourcesMEDLINE, Embase, and the Cochrane Library databases were searched (last search performed November 2018). Study SelectionStudies identified as SRMAs that investigated a nutritional or dietary intervention or exposure for cancer prevention in the general population or in people at risk of cancer and in which primary studies had a comparison group were eligible for inclusion. Screening, data extraction, and quality assessment were conducted independently by 2 reviewers.Data ExtractionAltogether, 101 studies were randomly selected for analysis. The methodological quality and risk of bias were evaluated using the AMSTAR-2 and ROBIS tools, respectively.ResultsMost SRMAs included observational studies. Less than 10% of SRMAs reported a study protocol, and only 51% of SRMAs assessed the risk of bias in primary studies. Most studies conducted subgroup analyses, but only a few reported tests of interaction or specified subgroups of interest a priori. Overall, according to AMSTAR-2, only 1% of SRMAs were of high quality, while 97% were of critically low quality. Only 3% had a low risk of bias, according to ROBIS.ConclusionsThis systematic survey revealed substantial limitations with respect to quality and risk of bias of SRMAs. SRMAs examining nutrition and cancer prevention cannot be considered trustworthy, and results should be interpreted with caution. Peer reviewers as well as users of SRMAs should be advised to use the AMSTAR-2 and/or ROBIS instruments to help to determine the overall quality and risk of bias of SRMAs.Systematic Review RegistrationPROSPERO registration number CRD42019121116.

Genesis and Mechanism of Some Cancer Types and an Overview on the Role of Diet and Nutrition in Cancer Prevention.

Cancer is a major disease with a high mortality rate worldwide. In many countries, cancer is considered to be the second most common cause of death after cardiovascular disease. The clinical management of cancer continues to be a challenge as conventional treatments, such as chemotherapy and radiation therapy, have limitations due to their toxicity profiles. Unhealthy lifestyle and poor dietary habits are the key risk factors for cancer; having a healthy diet and lifestyle may minimize the risk. Epidemiological studies have shown that a high fruit and vegetable intake in our regular diet can effectively reduce the risk of developing certain types of cancers due to the high contents of antioxidants and phytochemicals. In vitro and in vivo studies have shown that phytochemicals exert significant anticancer effects due to their free radical scavenging capacity potential. There has been extensive research on the protective effects of phytochemicals in different types of cancers. This review attempts to give an overview of the etiology of different types of cancers and assesses the role of phytonutrients in the prevention of cancers, which makes the present review distinct from the others available.

Predictors of Higher Quality of Systematic Reviews Addressing Nutrition and Cancer Prevention.

Systematic reviews/meta-analyses (SR/MAs) are considered a reliable source of information in healthcare. We aimed to explore the association of several characteristics of SR/MAs addressing nutrition in cancer prevention and their quality/risk of bias (using assessments from AMSTAR-2 and ROBIS tools). The analysis included 101 SR/MAs identified in a systematic survey. Associations of each specified characteristic (e.g., information about the protocol, publication year, reported use of GRADE, or other methods for assessing overall certainty of evidence) with the number of AMSTAR-2 not met (‘No’ responses) and the number of ROBIS items met (‘Probably Yes’ or “Yes’ responses) were examined. Poisson regression was used to identify predictors of the number of ‘No’ answers (indicating lower quality) for all AMSTAR-2 items and the number of ‘Yes’ or ‘Probably Yes’ answers (indicating higher quality/lower concern for bias) for all ROBIS items. Logistic regression was used to identify variables associated with at least one domain assessed as ‘low concern for bias’ in the ROBIS tool. In multivariable analysis, SR/MAs not reporting use of any quality/risk of bias assessment instrument for primary studies were associated with a higher number of ‘No’ answers for all AMSTAR-2 items (incidence rate ratio (IRR) 1.26, 95% confidence interval (CI) 1.09–1.45), and a lower number of ‘Yes’ or ‘Probably Yes’ answers for all ROBIS items (IRR 0.76, 95% CI 0.66–0.87). Providing information about the protocol and search for unpublished studies was associated with a lower number of ‘No’ answers (IRR 0.73, 95% CI 0.56–0.97 and IRR 0.75, 95% CI 0.59–0.95, respectively) and a higher number of ‘Yes’ or ‘Probably Yes’ answers (IRR 1.43, 95% CI 1.17–1.74 and IRR 1.28, 95% CI 1.07–1.52, respectively). Not using at least one quality/risk of bias assessment tool for primary studies within an SR/MA was associated with lower odds that a study would be assessed as ‘low concern for bias’ in at least one ROBIS domain (odds ratio 0.061, 95% CI 0.007–0.527). Adherence to methodological standards in the development of SR/MAs was associated with a higher overall quality of SR/MAs addressing nutrition for cancer prevention.

Predictors of higher quality of systematic reviews on nutrition in cancer prevention

Predictors of higher quality of systematic reviews on nutrition in cancer prevention

Reliability of studies published as SR/MA on nutrition in cancer prevention - a systematic survey

Abstract Background In several fields of medicine, the quality of studies published as systematic reviews/meta-analyses (SR/MAs) is low. Similar problems may exist for SR/MA on nutrition in cancer prevention. We aimed to assess overall quality and risk of bias (RoB) of studies published as SR/MA on nutritional interventions in cancer prevention with two instruments: AMSTAR 2 ('a measurement tool to assess systematic review 2') and ROBIS ('Risk of Bias in Systematic Reviews') respectively. Methods Following a systematic search in 3 databases we included studies identified as SR/MA published between 2010 and 2018 assessing any nutritional interventions in cancer prevention in the general population or among people with cancer risk (Protocol in PROSPERO CRD42019121116). All the steps of study selection and data extraction were done by two independent reviewers with conflicts solved by discussion or by the third reviewer. Results We focused on a subsample of 101 SR/MA randomly selected from 737 included SR/MA. Included SR/MA on average searched 2 databases with Medline in 98% and included cohort studies (93%). They focused on specific food (36%), specific nutrients (27%) or beverages (24%, mostly tea and coffee). The assessment using AMSTAR 2 tool indicated that 93% of SR/MA had no pre-specified methodology, in 77% - research questions and inclusion criteria did not include the components of PICO, RoB assessment of primary studies was not used or did not contain all elements (87%) and RoB was not accounted for in the interpretation of the results (75%). Overall, the quality of 97% of studies was assessed as critically low. In the ROBIS tool for 97% of included studies, the overall high risk of bias was detected. The most important methodological flaws in ROBIS were similar to identified in AMSTAR tool. Conclusions Poor quality of SR/MA due to flawed methodology may lead to many concerns and mislead public media and consumers. Key messages Poor quality of SR/MA due to flawed methodology may lead to many concerns and mislead public media and consumers. The studies published as SR/MAs addressing nutrition for cancer prevention have major flaws, which limit the reliability of their conclusions.

Nutritional “hot topics” in studies published as SR/MA in cancer prevention between 2010 and 2018

Abstract Background The number of systematic reviews and meta analysis (SR/MA) is increasing, also in the field of nutrition. Objectives The aim of this work was to analyse the frequency of exploring the effects of specific nutritional interventions in studies published as SR/MA focused on cancer prevention. Methods The main study was a systematic survey of SR/MA on nutrition in cancer prevention published between 2010 and 2018 identified through search in 3 databases. The protocol of the study was registered (CRD42019121116 in PROSPERO). All steps of the survey were done by two reviewers independently with any conflicts resolved by discussion or by the third reviewer. The quality and risk of bias were assessed using AMSTAR 2 and ROBIS tools amid subsample of 101 SR/MA. We grouped all dietetic interventions by year and analysed frequency. Results Among 737 SR/MA meeting the inclusion criteria, an average number of publications was 83/year ranging from 38 (in 2010) to 118 (in 2015). The most commonly studied food categories were: non-alcoholic beverages (127 publications in total; on average 14/year) and vitamins and/or minerals (157 publications in total; on average 17/ year) with coffee as one of the most popular (on average 7 SR/MA per year). The most commonly analysed vitamins were vitamin D, C, and E, while amid minerals calcium and selenium. Red meat and processed meat were comparably popular with about 4 dedicated publications every year. SR/MA about fruits and vegetables and alcohol appeared on average about 8 times every year. The overall quality of SR/MA assessed in a subsample of randomly selected 101 of included articles was poor (97% were classified as having a low quality). Conclusions In SR/MA published between 2010 and 2018, each food category appears many times, while for example coffee - many times every year. Detailed analysis per food item may help identify potential research waste in the field of nutrition in cancer prevention. Key messages Currently, coffee is the ‘hottest’ nutritional topic in cancer prevention. The general quality of SR/MA published in the field of cancer prevention is low.

The role of plant-based nutrition in cancer prevention

The role of plant-based nutrition in cancer prevention

The Under appreciated Role of Lifestyle and Nutrition in Cancer Prevention, Genesis, and Treatment

This article presents a review of the impact of nutrition and lifestyle on the most frequently occurring cancers, including blood, bone, brain, breast, gastric, lung, oral, pancreatic and skin cancers. Heart disease and cancer are the leading causes of morbidity and mortality and the first and second leading causes of death in the United States. Risk of death declined more steeply for heart disease than cancer, offsetting the increase in heart disease deaths, which partially offsets the increase in cancer deaths resulting from demographic changes over the past four decades. Lung cancer is by far the most common cause of cancer-related mortality worldwide in many countries. The incidence rates of lung, colorectal and prostate cancers will continue to rise in the future decades due to the rise of ageing population. Pancreatic cancer is an aggressive malignancy with a poor long-term survival and there has been only slight improvement in outcomes over the past 30 years. Some of the most common contributing factors to various cancers include: genetics, tobacco use, infections, obesity, poor diet, physical inactivity, environmental pollution and hazards, ionizing and ultra-violet radiation (UVR), sunlight, cancer causing substances, chronic inflammation and immunosuppression. This article summarizes recent and tangible cancer control measures which include early detection, weight control, Mediterranean type diet, phytochemicals such as flavonoids, regular physical activity, therapeutic agents, chemotherapy, nano-medicine, medicinal plants and education through mass media awareness.

Customized Text Messaging to Assist Cancer Patients with Diet, Nutrition and Activity: a Pilot Study

There is ample evidence supporting the significance of diet and nutrition in cancer prevention and management. Yet providing comprehensive nutritional support presents with challenges. In this study, we tested the feasibility of providing patients with a cost-effective, hands-on text-messaging platform, in order to implement nutritional support and increase patient engagement throughout the course of radiation therapy cancer treatment. Patients to receive curative radiation treatment for head and neck (H&N), breast or prostate cancers were screened for eligibility. Those consented were enrolled onto a HIPPA compliant texting platform, and set to receive 3-5 text messages a day. Messages sent were specific to diagnosis and treatment time point. Patient responses triggered automated texts from the platform, and notifications were sent to providers when there was a more personalized patient need. Weekly quality of life and post-treatment feedback surveys were collected. Patient engagement was measured by number of text responses and end of treatment feedback score. Of the 25 patients enrolled, 22 completed the program and 3 were screen fails. Breakdown by diagnosis included 7 H&N, 9 breast and 6 prostate. Prostate cancer patients showed the highest engagement, at a mean 59.3 (IQR 60-8.25) total responses throughout treatment. Of the breast and prostate patients, only 1 was referred to a nutritional specialist during the study. Overall feedback scores averaged at 81.3% (IQR 91.7-71.9). On a categorical level, “ease of use” scored the highest rating at 94% (IQR 100-87.5). Impact of the recommendations on changing eating habits scored 59.5% (IQR 75-37.5). Ninety-five percent of patients said they would recommend the program to others. There were no significant weight changes for the breast or prostate patients. Weight expectedly dropped for H&N patients, but returned to baseline by month 3 post treatment and study intervention. There are many challenges to providing comprehensive nutritional support for cancer patients. While most H&N patients receive dietary guidance per standard of care, the same is not always true for breast and prostate patients. A simple texting program can provide the nutritional education and motivation needed for these patients, with minimal costs or time required. Feedback from patients supported a comfortable, appropriate, and easy to use platform. Use increased patient engagement with their clinical care. A future program can tie in activity monitoring and be more tailored to specific needs of each patient, controlling for treatment course or concurrent therapies. Such could offer all types of oncology patients the nutritional and dietary support needed to tolerate treatment and maintain long-term, healthy habits throughout recovery.

Nutrition in Cancer Prevention and Treatment

Nutrition in Cancer Prevention and Treatment

Diet, nutrition, and cancer: past, present and future.

Despite the potentially important roles of diet and nutrition in cancer prevention, the evidence to support these roles is widely perceived by the public and health professionals as being inconsistent. In this Review, we present the issues and challenges in conducting and interpreting diet-cancer research, including those relating to the design of epidemiological studies, dietary data collection methods, and factors that affect the outcome of intervention trials. Approaches to improve effect estimates, such as the use of biomarkers to improve the accuracy of characterizing dietary exposures, are also discussed. Nutritional and dietary patterns are complex; therefore, the use of a reductionist approach to investigations, by focusing on specific nutrients, can produce misleading information. The effects of tumour heterogeneity and the failure to appreciate the nonlinear, U-shaped relationship between micronutrients and cancer in both observational studies and clinical trials are discussed. New technologies and investigational approaches are enabling the exploration of complex interactions between genetic, epigenetic, metabolic, and gut-microbial processes that will inform our knowledge of the diet-cancer relationship. Communicating the status of the evolving science in the context of the overall scientific evidence base, and evidence-based dietary recommendations for cancer prevention, should be emphasized in guidance for the public and for individual patients.

Olive oil compounds inhibit vascular endothelial growth factor receptor-2 phosphorylation

Vascular endothelial growth factor (VEGF) triggers crucial signaling processes that regulate tumor angiogenesis and, therefore, represents an attractive target for the development of novel anticancer therapeutics. Several epidemiological studies have confirmed that abundant consumption of foods from plant origin is associated with reduced risk of developing cancers. In the Mediterranean basin, the consumption of extra virgin olive oil is an important constituent of the diet. Compared to other vegetable oils, the presence of several phenolic antioxidants in olive oil is believed to prevent the occurrence of a variety of pathological processes, such as cancer. While the strong antioxidant potential of these molecules is well characterized, their antiangiogenic activities remain unknown. The aim of this study is to investigate whether tyrosol (Tyr), hydroxytyrosol (HT), taxifolin (Tax), oleuropein (OL) and oleic acid (OA), five compounds contained in extra virgin olive oil, can affect in vitro angiogenesis. We found that HT, Tax and OA were the most potent angiogenesis inhibitors through their inhibitory effect on specific autophosphorylation sites of VEGFR-2 (Tyr951, Tyr1059, Tyr1175 and Tyr1214) leading to the inhibition of endothelial cell (EC) signaling. Inhibition of VEGFR-2 by these olive oil compounds significantly reduced VEGF-induced EC proliferation and migration as well as their morphogenic differentiation into capillary-like tubular structures in Matrigel. Our study demonstrates that HT, Tax and OA are novel and potent inhibitors of the VEGFR-2 signaling pathway. These findings emphasize the chemopreventive properties of olive oil and highlight the importance of nutrition in cancer prevention.

Nutrition-related cancer prevention attitudes in low-income women

Objective. To investigate the nutrition-related cancer prevention attitudes of low-income African American women, determine whether a nutrition education program can alter these attitudes, and determine whether these attitudes are related to diet and dietary changes. Method. One-hundred and fifty-seven African American women from Washington, D.C. public housing communities participated in a nutrition education program from 2001 to 2003. They completed questionnaires assessing their attitudes about the role of nutrition in cancer prevention at baseline, post-intervention, and 4 months later. They also completed 24-hour food recalls at baseline, post-intervention, and 4 months later. Results. Women agreed that good nutrition prevents cancer, especially women with higher literacy, women with fewer children living at home, women who had not had experience with cancer, and women who were worried about their health. Participation in the program increased agreement that good nutrition prevents cancer over 4 months. Women whose agreement increased over the intervention were able to maintain dietary changes they made over 4 months. Conclusion. Nutrition-related cancer prevention attitudes were strong and were strengthened by a nutrition education program. These attitudes may contribute to people's ability to maintain dietary changes.

Nutrition-Related Cancer Prevention Cognitions and Behavioral Intentions: Testing the Risk Perception Attitude Framework

This study tested whether the risk perception attitude framework predicted nutrition-related cancer prevention cognitions and behavioral intentions. Data from the 2003 Health Information National Trends Survey were analyzed to assess respondents' reported likelihood of developing cancer (risk) and perceptions of whether they could lower their chances of getting cancer (efficacy). Respondents with higher efficacy were more likely to report that good nutrition can prevent cancer, and they reported more preventive dietary changes, as compared to respondents with lower efficacy. Respondents with higher efficacy were more likely to report intentions to change their diets to prevent cancer, and they reported more preventive dietary changes to their own diets but only at higher levels of risk. Results suggest that to improve cognitions about the role of nutrition in cancer prevention, interventions should target cancer prevention efficacy; however, to increase intentions to change nutrition behaviors, interventions should target efficacy and risk perceptions.

Role of Diet in Prostate Cancer Development and Progression

Increasing evidence supports the important role of nutrition in cancer prevention, including prevention of prostate cancer. In this review, we summarize data for some of the most consistently observed dietary associations for prostate cancer incidence, briefly consider possible postdiagnostic effects of nutrition on prostate cancer progression/survival, discuss new but limited data on diet-gene interactions, and comment on current areas of controversy for future research focus. Potential protective dietary elements include tomatoes/lycopene, other carotenoids, cruciferous vegetables, vitamin E, selenium, fish/marine omega-3 fatty acids, soy, isoflavones and polyphenols; whereas milk, dairy, calcium, zinc at high doses, saturated fat, grilled meats, and heterocyclic amines may increase risk. It is important to note that randomized clinical trial data exist only for vitamin E, calcium, beta-carotene, and selenium (all of which suggest inverse or no association). Several genes, such as MnSOD, XRCC1, and GST, may modify the association of specific nutrients and foods with prostate cancer risk; and further research is warranted to confirm these initial observed relationships. Until further clinical trial data are available on specific supplements and prostate cancer prevention, it would be prudent to emphasize a diet consisting of a wide variety of plant-based foods and fish; this is similar to what is recommended (and what is more well established) for the primary prevention of heart disease.

Nutrition in cancer prevention.

Although variation in diet may account for approximately one third of the variation in cancer incidence worldwide, epidemiologic studies have proven to be a blunt instrument for identifying causal relationships between intakes of specific food constituents and cancer risk at specific sites. Diets rich in fruits and vegetables seem to be protective, but the adverse effects of beta carotene supplementation trials on lung cancer incidence in smokers caution against the attribution of benefit to single substances. Important diet-gene interactions may exist, as illustrated by differential responses to variation in folate status in those with methylenetetrahydrofolate reductase polymorphisms. Targeting initial intervention studies in those with explicit genetic predisposition to cancer may have both greater cost-effectiveness and fewer ethical difficulties than do similar studies in the general public.