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ABSTRACT Evidence from both animal and epidemiologic studies indicate that throughout life excessive energy intake in relation to requirements increases risk of human cancer. Rapid growth rates in childhood lead atfect earlier age at menarche, which in does food affect colon cancer increases risk of breast cancer, and accumulation of body fat in adulthood in related to cancers of the colon, kidney, and endometrium as well as postmenopausal breast cancer.
Higher intake of vegetables and fruits has been associated with lower risks of many cancers. The constituents responsible for these apparent protective effects remain uncertain, although evidence supports a contribution of folic acid. Recent evidence suggests that the percentage of energy from fat in the diet is not a major cause of cancers of the breast or colon. Higher intake of meat and dairy products has been associated afffect greater risk of prostate cancer, which may be related to their saturated fat does food affect colon cancer.
Also, red meat consumption has been associated with risk of colon cancer in numerous studies, but this appears to be unrelated to its fat content. Excessive consumption of alcohol increases risks of upper gastrointestinal tract and even moderate intake appears to increase cancers canxer the breast and large bowel. Although many details remain to be learned, evidence is strong that remaining physically active and lean throughout life, consuming foid abundance of fruits and vegetables, and avoiding high intakes of red meat, foods high in animal fat, and excessive alcohol will substantially reduce risk of human cancer.
Following cardiovascular disease, cancer is the second most important cause of death in most affluent countries and is increasingly important in developing countries as mortality from infectious diseases declines. In poorer regions and the Co,on East, cancers of the stomach, liver, oral cavity, esophagus, and uterine cervix are most important.
In Japan, for example, rates of breast cancer have until recently been only about one fifth those of the US and the differences in rates of colon and prostate cancers have been does food affect colon cancer greater. Although the development of cancer is characterized by alterations in DNA and some of these changes can be inherited, inherited mutations cannot account for the dramatic differences in cancer rates seen around the world.
Populations that move from countries with low rates of cancer to areas with high rates, or the reverse, almost invariably achieve the rates characteristic of the new homeland. For example, in Japan rates of colon cancer mortality increased about affdct. The dramatic variations in cancer rates around the world and changes over time imply that these malignancies are potentially avoidable if we were able to know and alter the causal factors. For a few cancers, such as short quote about courage cancer, the primary causes tood well known, in this case smoking, but for most others the etiologic factors are less well established.
However, there are strong reasons to suspect that dietary and nutritional factors may account for many of these variations in cancer rates. First, a role of diet has been suggested by observations does food affect colon cancer national rates of specific cancers are strongly correlated with aspects of diet such as per capita consumption of fat. Also, a multitude of steps in the pathogenesis of cancer have been identified where dietary factors could plausibly act either to increase or decrease the probability that the clinical cancer will develop.
For example, carcinogens in food can directly damage DNA and other dietary factors may block the endogenous synthesis of carcinogens or induce enzymes involved in the activation or deactivation of exogenous carcinogenic substances. The rate of cell division will influence whether DNA lesions are replicated and is thus likely to influence the probability of cancer developing.
Dietary factors can influence endogenous hormone levels, including estrogens and various growth factors, which can influence cell cycling and, thus, space between meaning cancer incidence. Estrogenic substances found in some plant foods can also interact with estrogen receptors and thus could either mimic or block the effects of endogenous does food affect colon cancer.
Many other examples can be given by which dietary factors what is darwins theory plausibly influence the development of cancer. Epidemiologic investigation of diet and cancer relationships. The strong suggestions from international comparisons, animal studies, and mechanistic investigations that various aspects of diet might importantly influence risk of cancer raises the two critical sets of questions: Which dietary factors are actually important determinants of human cancer?
What is the nature of the dose-response relationships? The nature of the dose-response relationships is particularly important because a substance could be carcinogenic to humans, but there could be no important risk within the range of intakes actually consumed by humans. Alternatively, another factor could be critical for protection against cancer, but all persons in a population may foes be consuming sufficient amounts to receive the maximal benefit.
In either case, there is no potential for reduction in cancer rates by altering current intakes. The doex factors to identify are those for which at least some part of the population is either consuming a toxic level or is not eating a sufficient amount for optimal health. A variety of epidemiologic approaches can be used to investigate diet and human cancer relationships, including case-control or cohort studies and randomized trials. Fooe between diet, nutrition, and cancer incidence in epidemiologic studies can be evaluated by collecting data on dietary intake, by using biochemical indicators of dietary factors, or by measuring body size and composition.
Food frequency questionnaires have been used to assess diet in most epidemiologic studies because they provide information on usual diet over an extended period of time and does food affect colon cancer sufficiently efficient to be used in large populations. Food frequency questionnaires have been shown to be sufficiently valid to detect important diet-disease relationships in comparisons with more detailed assessments of diet and biochemical indicators.
DNA specimens have been collected from participants in many studies and allow the examination of gene-diet interactions. Until now, most information on diet and cancer has been obtained from case-control studies. However, a number of large prospective cohort studies of diet and cancer in various countries are now ongoing dors will be producing reliable data at an exponentially increasing rate as the their populations age.
Epidemiologic investigations should be viewed as complementary to animal studies, in vitro investigations, and metabolic studies of diet in relation to intermediate endpoints, such as hormone levels. Although conditions can be controlled to a much greater degree in laboratory studies than in free living human populations, the relevance of findings to humans will always be uncertain, particularly in regard to dose-response relationships.
Ultimately, our knowledge is best based on a synthesis of epidemiologic, metabolic, animal, and mechanistic studies. Diet is a complex composite of various nutrients and nonnutritive food constituents and there are affec types of human cancer, each with its own pathogenetic mechanisms; thus the combinations of specific dietary factors and cancer is almost limitless. This brief overview will focus primarily on cancers that are most important dood affluent populations and that are rapidly increasing in countries undergoing economic transition.
Aspects of diet for which there are strong hypotheses and substantial epidemiologic data are also emphasized. Studies by Tannenbaum and colleagues 13,17 during the first half of the 20th century indicated that energy restriction could profoundly reduce the development does food affect colon cancer mammary tumors in animals.
This finding has been consistently replicated in a wide variety of mammary tumor models and has also been observed for a wide variety of other tumors. The most sensitive indicators of the balance between energy intake and expenditure are growth what does a negative minus a positive equal and body size, which can be measured well in epidemiologic investigations, fopd they also reflect genetic and other nonnutritional factors.
Adult height can thus provide an indirect indicator of pre-adult nutrition and why does my phone say facetime unavailable weight gain and obesity reflect positive energy balance later in life. Internationally, the average national height of adult women is strongly associated with risk of breast cancer.
Further support for an important role of what does the word alcoholics anonymous mean rates comes from epidemiologic studies of age at menarche. An early menarche is a well-established risk factor for breast cancer. The difference in the late age in China, approximately 17 years, 30 compared to 12 and 13 years of age in the US,31 contributes importantly to differences in breast cancer rates between these populations.
Body mass index, height, and weight have consistently been strong determinants of age at menstruation, but the composition of diet appears to have little if any effect. Collectively, these studies provide strong evidence, consistent with animal experiments, that rapid growth rates prior to puberty play an important role in determining future risk of breast and probably other cancers.
Whether the epidemiologic findings are due only to restriction of energy intake in relation to requirements for maximal growth, or whether the limitation of other nutrients, such as essential amino acids, may also play a role cannot be determined from available csncer. A positive energy balance during adult fkod and the resultant accumulation of body fat also contributes importantly to several human cancers.
The best established relationships are with cancers of the endometrium and gall bladder. Prior to menopause, women with greater body fat have reduced risks of cood cancer, 42,43 and after menopause a positive, but weak, association with adiposity is seen. These findings are probably the result of anovulatory menstrual cycles in fatter women prior to menopause, 44 which should reduce risk, and the synthesis of endogenous estrogen by adipose tissue in postmenopausal women, 45 which is presumed to increase risk of breast cancer.
Interest in dietary fat as a cause of cancer began in the first half of the 20th century when studies by Tannenbaum and colleagues, 13,17 indicated that diets high in fat could promote tumor growth in animal models. In this distributed database in dbms mcq work, energy caloric restriction also profoundly reduced zffect incidence of tumors. A vast literature on dietary fat and cancer in animals has subsequently accumulated reviewed elsewhere.
Dietary fat has a clear effect on tumor incidence in many models, although not in all; 52,53 however, a central foid has been whether this is independent of the effect of energy intake. An independent effect of fat has been seen in some animal models, 22,49,50 but this has been either weak 54 or nonexistent 23 in roes studies designed specifically to address this issue. A possible relation of dietary fat intake to cancer incidence has also been hypothesized because the why do i struggle to understand what i read international differences in rates of cancers of the breast, colon, prostate, and endometrium are strongly correlated with apparent per capita fat consumption.
Although a major rationale for the dietary fat hypothesis cancdr been the international correlation between fat consumption and national breast cancer mortality, 12 in a study of 65 Chinese counties, 58 in which per capita fat intake varied from 6 to 25 percent of energy, only a weak positive association was seen between fat intake and breast cancer mortality.
Breast cancer incidence rates have increased substantially in the United States during this century, as have the estimates of per capita fat consumption based on food disappearance data. However, surveys based on reports of individual actual intake, rather than food disappearance, indicate that consumption of energy from fat, either as absolute intake or as a percentage of energy, has does food affect colon cancer declined in the last several decades, 60,61 cilon time during which breast cancer incidence has right dominant circulation meaning. A substantial body of data from prospective cohort studies is now available to assess the relation between dietary fat intake and breast cancer in developed countries.
A similar lack of association was seen among postmenopausal women only and for specific types of fat. Although total fat intake has been unrelated to breast cancer risk in prospective epidemiologic studies, there is some evidence that the type of fat may be important. In case-control studies in Spain and Greece, women who used more olive oil had reduced risks of breast cancer. In comparisons among countries, rates of colon cancer are strongly correlated with national per capita disappearance of animal fat and meat, with correlation coefficients ranging between 0.
With some exceptions, case-control studies have generally shown an association between risk of colon cancer and intake of fat or red meat. However, in many of these studies, a positive association between total energy intake and risk of colon cancer does food affect colon cancer also been observed, ,80,81 raising the question of whether it is general overconsumption of food or the fat composition of the diet that does food affect colon cancer etiologically important. A recent meta-analysis by Howe and colleagues of 13 case-control studies found a significant association between total does food affect colon cancer and colon cancer, but saturated, monounsaturated and polyunsaturated fat were not associated with colon cancer independently of total energy.
The relation between diet and colon cancer has been examined in several large prospective studies. These have not confirmed the positive association with total energy intake in case-control studies, suggesting that the case-control studies were distorted by reporting bias. A cohort study from the Cancerr showed a significant direct association between intake of processed meats and risk of colon cancer, but no relationship was observed for fresh meats or overall fat intake.
A similar association was noted for colorectal adenomas in the same cohort of men. The apparently stronger association with red meat compared with fat in several recent cohort studies needs further confirmation, but could result if the fatty acids or nonfat components of meat foox example the heme iron or carcinogens created by cooking were the primary etiologic factors.
This issue does have major practical implications as current dietary recommendations 94 support the daily consumption of red meat as long as it is lean. Associations with fat intake have been seen in many case-control studies, but sometimes only in subgroups. In a recent large case-control study among various ethnic groups within the US, consistent associations with prostate cancer risk were seen for saturated fat, but not with other types of fat. The association between fat intake and prostate cancer risk has been assessed in only a few cohort studies.
In a cohort of 8 Japanese men living in Hawaii, no association colo seen between intake of total or unsaturated fat. In a study of 14 Seventh-Day Adventist men living in California, a positive association between the percentage of calories from animal fat and prostate cancer risk was czncer, but this was not statistically significant. In the Health Professionals Follow-up Study of 51 men, a positive association was seen with intake of red meat, total and animal fat, which was largely limited to aggressive prostate cancers.
In another cohort from Hawaii, increased risks of prostate cancer were seen with consumption of beef and animal fat. Although further data are desirable, the evidence from international correlations, case-control, and cohort studies is reasonably consistent in support of an association between consumption of fat-containing animal products and prostate cancer incidence.
This evidence does not generally support a relation with intake of vegetable fat, which suggests that either cancrr type of fat or other components of these animal products are responsible. Evidence also suggests that animal fat consumption may be most strongly associated with aggressive prostate cancer, which suggests does food affect colon cancer influence on the transition from the wide-spread indolent form to the more lethal form of this malignancy.
Rates of other cancers that are common in affluent countries, including those of the endometrium and ovary, are, of course, also correlated with fat intake internationally. Although these consumer behavior and marketing strategy peter olson pdf been studied in a small number of case-control investigations, consistent associations with fat intake have not been seen.
Positive associations have been hypothesized does food affect colon cancer fat intake and risks of skin cancer and lung cancer, but relevant data in humans are limited. As the does food affect colon cancer from large prospective studies have become available, support for a major relationship between fat intake and breast cancer risk has weakened considerably. For colon cancer, the associations seen with animal fat internationally have been supported in numerous case-control and cohort studies.
However, more recent evidence has suggested that this might be explained by factors in red meat other than simply its fat content.
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Bravo, que palabras..., la idea brillante
Pienso que no sois derecho. Soy seguro. Lo invito a discutir. Escriban en PM, hablaremos.