Total Diet Approach to Cancer Prevention: A Narrative Review of the Literature Since 2011 Concerning the Association of Colorectal Cancer and Meat Consumption

Diet serves as a primary prevention approach to reduce the global burden of cancer. In 2007, the World Cancer Research Fund and the American Institute for Cancer Research published the Second Expert Report (SER) Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective outlining lifestyle recommendations for primary cancer prevention. Results support a strong link between red and processed meat and colorectal carcinogenesis. Findings from the Colorectal Cancer 2011 Report: Food, Nutrition, Physical Activity, and the Prevention of Colorectal Cancer, a review conducted through the WCRF Continuous Update Project (CUP), strengthened the evidence and supported the conclusions found in the SER. This review explored the available evidence since the publication of the 2011 CUP report and provides an update of the literature, specific to colorectal cancer (CRC) and diet. Furthermore, several proposed mechanisms, including heterocyclic amines (HCAs), polyaromatic hydrocarbons (PAHs), N-nitroso compounds (NOCs), and heme iron, may explain the effects of meat on the cancer process. The studies reviewed continue to support the causal link between red and processed meat consumption and CRC. The most recent literature supports the preventative role of consuming a plant-based diet low in red and processed meat for overall cancer prevention

Underfeeding Patients with Critical Illness: Making Sense of Recent Data

Nutrition support is recognized as an important component of care for patients with critical illness. Providing energy and protein at estimated requirements is thought to prevent or decrease the likelihood of disease-related malnutrition. However, short-term calorie restriction may be advantageous in this setting. Using PubMed, we conducted a search for studies of “permissive underfeeding” or “hypocaloric feeding” for patients with critical illness to evaluate relevant outcomes. Of the initial 137 studies, 32 papers were evaluated, and 16 papers met all eligibility criteria. The results support a benefit or neutral impact on nutrition support-related complications, yet conflicting findings on mortality and infection incidence when compared to patients provided higher energy and protein targets. Across studies, energy and protein needs were calculated using different methods, and the amount of protein administered, and the percentage of estimated calorie needs that constitutes underfeeding remains broad. To become common practice, a consensus on the percentage of calories and amount of protein to define underfeeding must be clarified

Prevalence and Predictors of Low Serum 25-Hydroxyvitamin D among Female African-American Breast Cancer Survivors

Background: African-American breast cancer survivors commonly demonstrate low serum 25-hydroxyvitamin D (25(OH)D). Decreased cutaneous conversion, high levels of adiposity, and even breast cancer treatment may influence vitamin D status. Previous investigations have analyzed African-American women in aggregate with other breast cancer survivors and have not comprehensively addressed these influential factors

Nutrition risk among an ethnically diverse sample of community-dwelling older adults

Objective To assess the prevalence of nutritional risk among an ethnically diverse group of urban community-dwelling older adults and to explore if risk varied by race/ethnicity. Design Demographic characteristics, Katz’s activities of daily living and health-care resource utilization were ascertained cross-sectionally via telephone surveys with trained interviewers. Nutrition risk and nutrition symptomology were assessed via the abridged Patient Generated Subjective Global Assessment (abPG-SGA); scores of ≥6 points delineated ‘high’ nutrition risk. Descriptive statistics and logistic regression analyses were conducted. Setting Urban. Participants White, Black or Hispanic community-dwelling adults, ≥55 years of age, fluent in English or Spanish, residing in the city limits of Chicago, IL, USA. Results A total of 1001 participants (37 % white, 37 % Black, 26 % Hispanic) were surveyed. On average, participants were 66·9 years old, predominantly female and overweight/obese. Twenty-six per cent (n 263) of participants were classified as ‘high’ nutrition risk with 24, 14 and 31 % endorsing decreased oral intake, weight loss and compromised functioning, respectively. Black respondents constituted the greatest proportion of those with high risk scores, yet Hispanic participants displayed the most concerning nutrition risk profiles. Younger age, female sex, Black or Hispanic race/ethnicity, emergency room visits, eating alone and taking three or more different prescribed or over-the-counter drugs daily were significantly associated with high risk scores (P\u3c0·05). Conclusions One in four older adults living in an urban community prone to health disparities was classified as ‘high’ nutrition risk. Targeted interventions to promote healthy ageing are needed, especially for overweight/obese and minority community members

Body Composition, Serum Biomarkers of Inflammation and Quality of Life in Clinically Stable Women with Estrogen Receptor Positive Metastatic Breast Cancer

Limited data exist regarding body composition and associated patient-reported outcomes for women with metastatic BC. Demographic, clinical, blood, and questionnaire data were collected to quantify body composition and explore associations with symptoms, inflammation, and quality of life (QOL) in 41 women with ER + metastatic BC. Diagnostic/surveillance computed tomography (CT) images including the third lumbar region (L3) were obtained to evaluate skeletal muscle (SM) quantity and quality, and abdominal adipose tissue. Frequencies, medians and interquartile ranges are presented, stratified by sarcopenia and obesity (Body mass index (BMI) ≥ 30.0 kg/m2). Overall, 34% (n = 14/41), 49% (n = 20/41), and 34% (n = 14) of women had sarcopenia, myosteatosis, and obesity, respectively. Handgrip strength was compromised in 24% of subjects (n = 10/41). Women with sarcopenia had significantly lower body weight (P = 0.01), BMI (P ≤ 0.001), and whole body SM (P \u3c 0.001), yet reported greater engagement in leisure time exercises (P = 0.05) vs. nonsarcopenic women. Women with obesity had significantly higher levels of abdominal obesity (all values P \u3c 0.0001) and serum biomarkers of inflammation (P values \u3c0.06), yet lower QOL (P = 0.02) vs. women without obesity. The abPGSGA did not differentiate women with sarcopenia. Future interventions should test if improvements in body composition are associated with better outcomes for this vulnerable, emerging population

Vitamin D Supplementation for the Treatment of Depressive Symptoms in Women with Type 2 Diabetes: A Randomized Clinical Trial

Aim. To determine the efficacy and safety of vitamin D3 supplementation in reducing depressive symptoms in women with type 2 diabetes (T2D), depression, and low vitamin D. Methods. In this double-blind randomized active comparator-controlled trial, women with significant depressive symptoms as assessed by the Center for Epidemiologic Studies Depression (CES-D) scale received weekly oral vitamin D3 supplementation (50,000 IU) or an active comparator (5,000 IU) for 6 months. Assessments of vitamin D, 25-hydroxyvitamin D [25 (OH) D], and depression were measured at baseline, 3 months, and 6 months. Results. A total of 129 women were randomized, from which 119 completed the study (57 in lower dose and 62 in higher dose). Participants had an average 25 (OH) D and HbA1c of 20.8 ng/mL and 7.8%, respectively, at baseline. They were diverse (48% Black) and had a mean age of 50 and T2D for about 8 years. Upon completion of vitamin D3 supplementation, serum 25 (OH) D levels increased with 50,000 IU (+34 ng/mL) and 5,000 IU (+10 ng/mL). There was no difference in CES-D scores by treatment dose. Overall, depressive symptoms significantly improved over time with an average CES-D decline of 12.98 points (95% CI: −15.04 to −10.93; ). Among women with moderate baseline depressive symptoms, those receiving the lower dose had nominally lower depression scores at follow-up than those in the higher dose cohort. Among women with severe baseline depressive symptoms, the improvement in follow-up depression scores was the same regardless of dose. Conclusions. There was no difference in the dosing effect of vitamin D3 supplementation for the treatment of depressive symptoms in women with T2D who present with significant symptoms and low vitamin D. Regardless of the dose, participants’ mood improved over time. Further study of vitamin D to target depressive symptoms in comorbid populations is needed

Efficacy of a Weight Loss Intervention for African American Breast Cancer Survivors

African American women with breast cancer have higher cancer-specific and overall mortality rates. Obesity is common among African American women and contributes to breast cancer progression and numerous chronic conditions. Weight loss interventions among breast cancer survivors positively affect weight, behavior, biomarkers, and psychosocial outcomes, yet few target African Americans. This article examines the effects of Moving Forward, a weight loss intervention for African American breast cancer survivors (AABCS) on weight, body composition, and behavior

Serum 25(OH)D and Cognition: A Narrative Review of Current Evidence

The effect of low serum 25(OH)D on cognitive function is difficult to determine owing to the many factors that can influence these relationships (e.g., measurements, study design, and obesity). The primary purpose of this review was to synthesize the current evidence on the association between serum 25(OH)D and cognition giving special consideration to specific influential factors. A search was conducted in PubMed for studies published between 2010 and 2018 using terms related to serum 25(OH)D and cognition. Only studies that used liquid chromatography tandem-mass spectrometry (LC-MS) were included, since this is considered the ‘gold standard method’, to measure serum 25(OH)D. Of the 70 articles evaluated, 13 met all inclusion criteria for this review. The majority of the observational and longitudinal studies demonstrate a significant association between low serum 25(OH)D and compromised cognition. However, two randomized controlled trials showed inconsistent results on the impact of vitamin D supplementation on cognitive function. The varied methodologies for ascertaining cognition and the inclusion or exclusion of confounding variables (e.g., obesity, sunlight exposure) in the statistical analyses make drawing conclusions on the association between serum 25(OH)D and cognitive functioning inherently difficult. Despite the known higher occurrence of serum 25(OH) deficiency among minority populations, the majority of studies were conducted in with White participants. In order to more clearly discern the relationship between serum 25(OH)D and cognitive functioning, future studies should target more diverse study populations and utilize comprehensive measures to reliably capture cognition, as well as important known determinants of serum 25(OH)D