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How to cite this article:Queiroz SA, Sousa IM, Silva FRM, Lyra CO, Fayh APT. Nutritional and environmental risk factors for breast cancer: a case-control study. Sci Med. 2018;28(2):ID28723. http://doi.org/10. 15448/1980-6108.2018.2.28723 Nutritional and environmental risk factors for breast cancer: a case-control study Fatores

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Background The study aims to evaluate the accuracy of isolated nutrition indicators in diagnosing malnutrition in patients with gastric and colorectal cancer and their association with mortality. Methods Prospective cohort study involving patients with cancer (n = 178) attending a reference center of oncology at any point in the disease trajectory or treatment. Nutrition status was evaluated in a unique moment by body mass index (BMI), Patient‐Generated Subjective Global Assessment (PG‐SGA), handgrip strength (HGS), and calf circumference (CC). Kappa coefficient, accuracy, sensitivity, specificity, positive and negative predictive values, and area under the receiver operating characteristic curve (AUC) were calculated for each nutrition indicator (PG‐SGA as the reference method). The Cox proportional hazards model was used to assess hazard ratio (HR) and CI of mortality. Results From the total patients, 11% were underweight, 48% were malnourished (PG‐SGA B or C), 43% had low HGS, and 55% presented low CC. There were 46 deaths (25.8%). BMI, HGS, and CC showed poor and fair agreements (κ < 0.30 for all ) and poor accuracy (AUC < 0.70 for all) in identifying malnutrition by PG‐SGA. After the adjustment for confounders (age, treatment performed, site, and stage of cancer), PG‐SGA (HR, 2.9; 95% CI, 1.5–5.9) and low CC (HR, 2.4; 95% CI, 1.1–5.2) were independent predictors of mortality. Conclusion The nutrition indicators are not accurate in diagnosing malnutrition, whereas PG‐SGA and low CC could predict mortality in gastric and colorectal cancer patients. Thus, CC should be combined with PG‐SGA in nutrition assessments.

The aim of this study was to evaluate whether body composition, muscle function, and their association are predictive factors for short-term postoperative complications in patients with gastric and colorectal cancer. A prospective cohort study was conducted with patients undergoing resection of gastric and colorectal tumors. Nutritional status was assessed using Patient-Generated Subjective Global Assessment (PG-SGA) and anthropometric techniques. Low handgrip strength (HGS) was observed when <16kg for women, and <27kg for men. Computed tomography images were used to measure visceral adipose tissue, skeletal muscle index (SMI), and skeletal muscle radiodensity (SMD). Complications of grade II or above (according to Clavien-Dindo’s classification) were considered in a follow-up period of up to 30 days after surgery. Major complications were defined when they reached grade III or above. A total of 84 patients were analyzed (57.1% female, 59.7 ± 12.6 years) and 19% were diagnosed with low HGS + low SMI or SMD. Postoperative complications occurred in 51.2%, and these patients presented significantly longer duration of surgery and hospital stay. Major complications were observed in 16.7% of the total number of patients. Binary logistic regression adjusted by age, sex, and tumor staging showed that low SMD, low HGS + low SMI or SMD, and obesity were independent risk factors for postoperative complications, but only low SMD was an independent risk factor for major postoperative complications. Low SMD is an independent risk factor for short-term major complications following surgery in patients with gastric and colorectal cancer.

BACKGROUND: The lipid accumulation product (LAP) index is an abdominal adiposity marker. OBJECTIVE: The aim of this study was to describe the cardiovascular risk of primary healthcare users through the LAP index and correlate it with anthropometric and biochemical indicators. DESIGN AND SETTING: Cross-sectional study in primary care units in a city in northeastern Brazil. METHODS: The subjects responded to a structured questionnaire that contained questions about their sociodemographic condition, and then underwent an anthropometric nutritional assessment. The LAP index values were expressed as three degrees of cardiovascular risk intensity: high risk (above the 75 th percentile), moderate risk (between the 25 th and 75 th percentiles) and low risk (below the 25 th percentile). RESULTS: The median LAP index was 52.5 cm.mmol/l (range: 28.2-86.6), and there was no statistically significant difference between the sexes: 57.7 cm.mmol/l (24.5-91.1) and 49.5 cm.mmol/l (29.8-85.2) for females and males, respectively (P = 0.576). Among all the subjects, 67.2% were overweight and there was a statistically significant difference in mean LAP index between those who were and those who were not overweight. Statistically significant differences in anthropometric and biochemical markers for cardiovascular risk were observed among individuals who had higher LAP index values. There were significant correlations between the LAP index and all of the biochemical variables. CONCLUSIONS: These significant correlations between the LAP index and the traditional biochemical risk markers may be useful within conventional clinical practice, for cardiovascular risk screening in primary healthcare.

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RESUMO: Lippia gracilis é uma planta nativa da Caatinga, rica em óleo essencial com atividade antimicrobiana. O trabalho objetivou avaliar o efeito de diferentes tipos de estacas e substratos na propagação vegetativa de L. gracilis . O experimento foi montado em delineamento inteiramente casualizado, em esquema fatorial 3 x 3, sendo 3 tipos de estacas (apical, mediana e basal) e 3 tipos de substratos (areia + húmus, argila + húmus e areia + argila + húmus), com 5 repetições cada. Aos 40 dias foram avaliadas: porcentagem de estacas brotadas e enraizadas, número médio de brotos, comprimento da maior raiz e biomassa seca dos brotos e raízes. Em todas as variáveis as estacas medianas e basais apresentaram melhores resultados do que as apicais. O substrato influenciou apenas na biomassa seca dos brotos, sendo o composto de argila + húmus superior ao areia + argila + húmus e igual, em significância, ao areia+ húmus.