This population-based case-control study examined the association between selected nutrients, foods, and diet behaviors and bladder cancer. Bladder cancer cases (n = 262) were identified from the Surveillance, Epidemiology, and End Results Program cancer registry for western Washington, and controls (n = 405) were identified through random digit dialing. Cases were diagnosed between January 1987 and June 1990, and eligible subjects were Caucasian, aged 45-65 years, and residents of King, Pierce, or Snohomish counties. Subjects completed a self-administered, 71-item food frequency questionnaire and a structured telephone interview. Analyses were conducted by logistic regression analysis and included adjustment for age, sex, smoking (current, former, never), and county. Odds ratios and their 95% confidence intervals for highest versus lowest level of intake were examined. An inverse association was found between the risk of bladder cancer and dietary retinol (odds ratio (OR) across quartiles: 1.00, 1.09, 0.97, and 0.52; 95% CI 0.29-0.97; trend p value = 0.03) and dietary vitamin C (OR across quartiles: 1.00, 0.96, 0.67, and 0.50; 95% CI 0.28-0.88; trend p value = 0.009), adjusted for calories. The use of multivitamin supplements daily over the 10-year period ending 2 years before diagnosis versus no use was associated with a decreased risk of bladder cancer (OR = 0.39; 95% CI 0.24-0.63) as was use of supplemental vitamin C (OR for > 502 mg/day over the 10 years vs. none = 0.40; 95% CI 0.21-0.76). Increased intake of fruit was associated with a decreased risk of bladder cancer (OR across quartiles: 1.00, 1.24, 0.72, and 0.53; 95% CI 0.30-0.93; trend p value = 0.01, adjusted for calories), while increased use of fried foods was associated with an increased risk of bladder cancer (OR across quartiles: 1.00, 1.51, 1.81, and 2.24; 95% CI 1.25-4.03; trend p value = 0.006). This study provides modest evidence that certain nutrients, foods, and supplementation may affect the incidence of bladder cancer.

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Skeletal muscle protein loss occurs during marrow transplantation despite total parenteral nutrition. To determine if muscle atrophy could be minimized with exercise therapy, 30 patients undergoing marrow transplantation for acute leukemia completed a prospective randomized trial to receive: (1) no therapy (controls), (2) physical therapy thrice weekly (PT3), or (3) physical therapy five times weekly (PT5). Patients were studied through 35 days posttransplant. Muscle protein status and turnover was assessed by weekly nitrogen balance, and creatinine and 3-methylhistidine excretion. Results favored a muscle protein-sparing effect of exercise, as a significant decrease in creatinine excretion in controls only suggested muscle protein loss associated with inactivity. Changes in arm muscle area correlated with energy, but not protein intake. Large individual variation, inadequate nutritional support and differences in admission arm muscle area may have clouded these results.