Dietary predictors of serum total carotene in low-income women living in São Paulo, south-east Brazil

Tomita, Luciana Yuki; Almeida, Lana Carneiro; Roteli-Martins, Cecília Maria; D’Almeida, Vânia; Cardoso, Marly Augusto

doi:10.1017/s1368980009005321

Cited by 6 publications

(9 citation statements)

References 35 publications

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“…However, since we found no additive interaction for total vegetables and fruits, it is likely that the effect on CIN3 is associated with specific nutrients found particularly in dark-green and deep-yellow vegetables and fruits rich in b-carotene. These associations were confirmed by serum total carotene, considered a good biomarker for fruit and vegetable intake, and serum vitamin E, a potent antioxidant (30,47,48) .…”

Section: Discussionmentioning

confidence: 95%

“…Sampling strategies, participation rates and initial results from the BRINCA study have been reported elsewhere ( 22 , 30 ) . A total of 1729 women were contacted between 2003 and 2005.…”

Section: Methodsmentioning

confidence: 99%

“…A slightly lower consumption of carotenoids and vitamin C, particularly from fruits, has been observed among smokers compared with among non-smokers ( 25 – 29 ) . Lower serum concentrations of antioxidants, especially carotenoids, have been observed among smokers independently of dietary intake, which further increases the effect of a low intake of fruits ( 25 – 30 ) . Thus, it is unknown whether the smoking effect on the risk of cervical neoplasia is modified by a low intake of fruits and vegetables.…”

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confidence: 99%

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Associations of dietary dark-green and deep-yellow vegetables and fruits with cervical intraepithelial neoplasia: modification by smoking

Tomita

Roteli-Martins

Villa³

et al. 2010

Br J Nutr

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Smoking has been positively and fruit and vegetable intake has been negatively associated with cervical cancer, the second most common cancer among women worldwide. However, a lower consumption of fruits and reduced serum carotenoids have been observed among smokers. It is not known whether the smoking effect on the risk of cervical neoplasia is modified by a low intake of fruits and vegetables. The present study examined the combined effects of tobacco smoking and diet using a validated FFQ and serum carotenoid and tocopherol levels on cervical intraepithelial neoplasia grade 3 (CIN3) risk in a hospital-based case -control study conducted in São Paulo, Brazil, between 2003 and 2005. The sample comprised 231 incident, histologically confirmed cases of CIN3 and 453 controls. A low intake (#39 g) of dark-green and deep-yellow vegetables and fruits without tobacco smoking had a lesser effect on CIN3 (OR 1·14; 95 % CI 0·49, 2·65) than among smokers with higher intake ($40 g; OR 1·83; 95 % CI 0·73, 4·62) after adjusting for confounders. The OR for the joint exposure of tobacco smoking and low intake of vegetables and fruits was greater (3·86; 95 % CI 1·74, 8·57; P for trend, 0·001) compared with non-smokers with higher intake after adjusting for confounding variables and human papillomavirus status. Similar results were observed for total fruit, serum total carotene (including b-, a-and g-carotene) and tocopherols. These findings suggest that the effect of nutritional factors on CIN3 is modified by smoking.

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Section: Discussionmentioning

confidence: 95%

“…Sampling strategies, participation rates and initial results from the BRINCA study have been reported elsewhere ( 22 , 30 ) . A total of 1729 women were contacted between 2003 and 2005.…”

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Associations of dietary dark-green and deep-yellow vegetables and fruits with cervical intraepithelial neoplasia: modification by smoking

Tomita

Roteli-Martins

Villa³

et al. 2010

Br J Nutr

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“…Food consumption was assessed using a food frequency questionnaire (FFQ) previously validated20, 21 and adapted to epidemiological studies on diet and prevention of chronic diseases in São Paulo 22. Women were asked about usual frequency of consumption of 76 foods items and their portion sizes, an open‐ended food section, and vitamin and mineral supplements during the previous year.…”

Section: Methodsmentioning

confidence: 99%

Diet and serum micronutrients in relation to cervical neoplasia and cancer among low‐income Brazilian women

Tomita

Longatto‐Filho

Costa

et al. 2009

Intl Journal of Cancer

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Cervical cancer is a leading cancer among women in developing countries. Infection with oncogenic human papillomavirus (HPV) types has been recognized as a necessary cause of this disease. Serum carotenoids and tocopherols have also been associated with risk for cervical neoplasia, but results from previous studies were not consistent. We evaluated the association of serum total carotene and tocopherols, and dietary intakes with the risk of newly diagnosed, histologically confirmed cervical intraepithelial neoplasia (CIN) grades 1, 2, 3 and invasive cancer in a hospital-based case-control study in São Paulo, Brazil. The investigation included 453 controls and 4 groups of cases (CIN1, n 5 140; CIN2, n 5 126; CIN3, n 5 231; invasive cancer, n 5108) recruited from two major public clinics between 2003 and 2005. Increasing concentrations of serum lycopene were negatively associated with CIN1, CIN3 and cancer, with odds ratios (OR) (95% CI) for the highest compared to the lowest tertile of 0.53 (0.27-1.00, p for trend 5 0.05), 0.48 (0.22-1.04, p for trend 5 0.05) and 0.18 (0.06-0.52, p for trend 5 0.002), respectively, after adjusting for confounding variables and HPV status. Increasing concentrations of serum a-and c-tocopherols, and higher dietary intakes of dark green and deep yellow vegetables/fruit were associated with nearly 50% decreased risk of CIN3. These results support the evidence that a healthy and balanced diet leading to provide high serum levels of antioxidants may reduce cervical neoplasia risk in low-income women.Cervical cancer is the second most common cancer among women worldwide. Disease occurrence varies widely by geographic region, with the highest rates in Latin American countries and the Caribbean, sub-Sahara Africa and parts of Asia. 1 Infection with oncogenic human papillomavirus (HPV) types is considered a necessary cause in the development of cervical cancer, and cofactors are tobacco smoking, long-term oral contraceptive use and high parity. [2][3][4][5][6][7] The aforementioned associations notwithstanding, the results on the relationship of nutritional factors to cervical neoplasia have not been consistent across different studies. Only a few investigations have used large numbers of subjects but were conducted mostly in developed countries. An important limitation is the absence of valid information on HPV status and distribution of types, which varies by country. 8 Thus, it has been suggested that most of the observations to date must be accepted only tentatively. 9 The study of the relationship of nutritional factors with cervical neoplasia is complicated by its multifactorial etiology, with many of the identified risk factors being correlated with nutritional and socioeconomic status. 10 Dietary components may be involved in the etiology of this disease since socioeconomic differences in risk persist after adjustment for known factors which suggests that dietary inadequacy consequent to poverty may help explain the high incidence rates in developing countries. 11 Previous case-con...

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“…This method was used to measure habitual dietary intake in the month prior to the interview. The questionnaire was developed based on the data from the first 24HR and on other FFQs previously developed for use with Brazilian adults 17 and adapted for use with Brazilian children aged between 9 and 12 years 13 . It is important to note that these FFQs were targeted at the population of the Southeast Region of Brazil, and thus were not specific to the dietary components of the population of the Brazilian Amazonian.…”

Section: Ffqmentioning

confidence: 99%

Relative validity of a food-frequency questionnaire developed to assess food intake of schoolchildren living in the Brazilian Western Amazon

et al. 2011

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This study aimed to assess the relative validity of a food frequency questionnaire (FFQ) developed to assess food intake of schoolchildren from the Brazilian Western Amazon. The dietary intakes of 61 schoolchildren, aged between six and nine 9 years, were measured using two 24-hour dietary recalls and one FFQ, conducted with the children's, mother or guardians. Validity of the FFQ compared to the mean of the two dietary recalls was assessed using Pearson's correlation coefficient adjusted for attenuation and energy intake, Bland & Altman plots and evaluation of agreement levels between the two assessment methods. Energy-adjusted and deattenuated correlation coefficients ranged from -0.03 for vitamin C, to 0.93 for calcium. The mean coefficient was 0.46. The mean proportion of subjects classified within one quintile by the two methods was 66%. The Bland & Altman plots indicated good agreement for almost all nutrients, with a mean limit of agreement of 108%. These results indicate that, although there was a lack of accuracy for certain nutrients, such as vitamins A and C, the FFQ ensures reliable estimates of intake of most nutrients.

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Dietary predictors of serum total carotene in low-income women living in São Paulo, south-east Brazil

Cited by 6 publications

References 35 publications

Associations of dietary dark-green and deep-yellow vegetables and fruits with cervical intraepithelial neoplasia: modification by smoking

Associations of dietary dark-green and deep-yellow vegetables and fruits with cervical intraepithelial neoplasia: modification by smoking

Diet and serum micronutrients in relation to cervical neoplasia and cancer among low‐income Brazilian women

Relative validity of a food-frequency questionnaire developed to assess food intake of schoolchildren living in the Brazilian Western Amazon

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