Retinol, Antioxidant Vitamins, and Cancers of the Upper Digestive Tract in a Prospective Cohort Study of Postmenopausal Women

Zheng, Wei; Sellers, Thomas A.; Doyle, Timothy J.; Kushi, Lawrence H.; Potter, John D.; Folsom, Aaron R.

doi:10.1093/oxfordjournals.aje.a117743

Cited by 90 publications

(79 citation statements)

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“…Despite this potential, results from previous reports on dietary intake of carotenoids assessed from dietary questionnaires have been mixed and many have not shown strong associations with GC risk (Chyou et al, 1990;Zheng et al, 1995;Botterweck et al, 2000b). To date, only a few studies have considered prediagnostic blood levels of carotenoids in association with GC risk.…”

Section: Discussionmentioning

confidence: 99%

“…Several case -control studies have shown strong inverse associations between GC risk and higher consumption of some of these nutrients (Buiatti et al, 1990(Buiatti et al, , 1991Gonzalez et al, 1994;Hansson et al, 1994;Ekstrom et al, 2000). Results from prospective dietary studies are conflicting and show either a strong protection (Zheng et al, 1995) or no clear inverse associations between the dietary intake of carotenoids and GC risk (Ocke et al, 1995;Botterweck et al, 2000b).…”

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confidence: 99%

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Plasma and dietary carotenoid, retinol and tocopherol levels and the risk of gastric adenocarcinomas in the European prospective investigation into cancer and nutrition

Jenab¹,

Riboli²,

Ferrari³

et al. 2006

Br J Cancer

111

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Despite declining incidence rates, gastric cancer (GC) is a major cause of death worldwide. Its aetiology may involve dietary antioxidant micronutrients such as carotenoids and tocopherols. The objective of this study was to determine the association of plasma levels of seven common carotenoids, their total plasma concentration, retinol and a-and g-tocopherol, with the risk of gastric adenocarcinoma in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC), a large cohort involving 10 countries. A secondary objective was to determine the association of total sum of carotenoids, retinol and a-tocopherol on GCs by anatomical subsite (cardia/noncardia) and histological subtype (diffuse/intestinal). Analytes were measured by high-performance liquid chromatography in prediagnostic plasma from 244 GC cases and 645 controls matched by age, gender, study centre and date of blood donation. Conditional logistic regression models adjusted by body mass index, total energy intake, smoking and Helicobacter pylori infection status were used to estimate relative cancer risks. After an average 3.2 years of follow-up, a negative association with GC risk was observed in the highest vs the lowest quartiles of plasma b-cryptoxanthin (odds ratio (OR) ¼ 0.53, 95% confidence intervals (CI) ¼ 0.30-0.94, P trend ¼ 0.006), zeaxanthin (OR ¼ 0.39, 95% CI ¼ 0.22-0.69, P trend ¼ 0.005), retinol (OR ¼ 0.55, 95% CI ¼ 0.33-0.93, P trend ¼ 0.005) and lipid-unadjusted a-tocopherol (OR ¼ 0.59, 95% CI ¼ 0.37-0.94, P trend ¼ 0.022). For all analytes, no heterogeneity of risk estimates or significant associations were observed by anatomical subsite. In the diffuse histological subtype, an inverse association was observed with the highest vs lowest quartile of lipid-unadjusted a-tocopherol (OR ¼ 0.26, 95% CI ¼ 0.11-0.65, P trend ¼ 0.003). These results show that higher plasma concentrations of some carotenoids, retinol and a-tocopherol are associated with reduced risk of GC.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Plasma and dietary carotenoid, retinol and tocopherol levels and the risk of gastric adenocarcinomas in the European prospective investigation into cancer and nutrition

Jenab¹,

Riboli²,

Ferrari³

et al. 2006

Br J Cancer

111

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“…Clarification of the protective mechanisms of fruits, vegetables and whole grains is important to our understanding of cancers of the upper aerodigestive tract. In an analysis of the Iowa Women's Health Study (IWHS), a prospective cohort study of initially 55-to 69-year old women living in Iowa, Zheng et al 13 reported lower dietary intake of yellow/orange vegetables and of carotene, vitamins C and E and retinol in the 59 women who developed upper digestive tract cancers between 1986 and 1992.Our primary focus was to study whether, after 14 years of follow-up in the IWHS, whole-grain intake is related to reduced risk of upper aerodigestive tract cancers. At the same time, we reviewed evidence for the established lifestyle risk factors: low fruit and vegetable intake, smoking and alcohol intake.…”

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confidence: 99%

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confidence: 99%

Dietary risk factors for upper aerodigestive tract cancers

Kasum

Jacobs

Nicodemus

et al. 2002

Intl Journal of Cancer

Self Cite

112

103

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We examined the association between whole-grain intake and incident upper aerodigestive tract cancer in a cohort of 34,651 postmenopausal, initially cancer-free women. We also studied established risk factors for upper aerodigestive cancers, including fruit and vegetable intake, smoking and alcohol intake. A mailed questionnaire at baseline in 1986 included a food-frequency questionnaire and assessment of other cancer risk factors. During the 14-year follow-up period, 169 Studies that have considered the role of dietary factors with regard to cancers of the upper aerodigestive tract have generally reported inverse associations with intake of fruit and vegetables, 1-7 and whole grains. 8,9 Several studies support the idea that wholegrain intake is associated with reduced risk of gastric cancers. 10 Studies that included grain fiber as a predictor 11,12 further bolster the idea that whole grain may protect against upper aerodigestive tract cancers. Previous studies of upper aerodigestive cancers have been case-control in design and, therefore, potentially subject to recall bias.The mechanism of the apparent protective effect of fruits, vegetables and whole grains against upper aerodigestive cancers remains unclear. It may be a result of their fiber content, antioxidant content or some other phytochemicals. Clarification of the protective mechanisms of fruits, vegetables and whole grains is important to our understanding of cancers of the upper aerodigestive tract. In an analysis of the Iowa Women's Health Study (IWHS), a prospective cohort study of initially 55-to 69-year old women living in Iowa, Zheng et al. 13 reported lower dietary intake of yellow/orange vegetables and of carotene, vitamins C and E and retinol in the 59 women who developed upper digestive tract cancers between 1986 and 1992.Our primary focus was to study whether, after 14 years of follow-up in the IWHS, whole-grain intake is related to reduced risk of upper aerodigestive tract cancers. At the same time, we reviewed evidence for the established lifestyle risk factors: low fruit and vegetable intake, smoking and alcohol intake. To address potential mechanisms, we considered the roles of fiber and specific micronutrients in the risk of upper digestive tract neoplasms. MATERIAL AND METHODSA detailed description of the methodology of the IWHS has been published elsewhere. 14 Briefly, participants in the IWHS were a random sample of women aged 55-69 years from the 1985 Iowa driver's license list. A total of 41,836 women responded to a mail survey in January 1986 (42.7% response rate). Using information from the driver's license list and the 1980 U.S. census, it was determined that responders were about 3 months older than nonresponders, 0.4 kg/m 2 lighter and slightly more likely to live in rural, less affluent counties. Nonresponders had somewhat higher rates of smoking-related diseases. 14 Women were excluded from the analysis if they left 30 or more items blank on the foodfrequency questionnaire or reported implausibly high or low energy intak...

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“…The association between other components of fruit and vegetables (e.g., folate, dietary fiber, and carotenoids) 19 -22 and the use of vitamin-containing supplements 11,21 and the risk of gastric carcinoma have been investigated only in a few studies.…”

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confidence: 99%