The Association of Dietary Patterns with High-Risk Human Papillomavirus Infection and Cervical Cancer: A Cross-Sectional Study in Italy

Barchitta, Martina; Maugeri, Andrea; Quattrocchi, Annalisa; Agrifoglio, O; Scalisi, Aurora; Agodi, Antonella

doi:10.20944/preprints201803.0109.v1

Cited by 41 publications

(29 citation statements)

References 32 publications

(42 reference statements)

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“…In fact, the FFQ used for dietary assessment was prone to a degree of misreporting 43 . However, this tool has been developed and validated among women from Southern Italy 44 , and current findings were consistent with previous studies conducted on similar cohorts [45][46][47][48][49] . Moreover, we cannot evaluate the potential effect of additional social factors (e.g.…”

Section: Discussionsupporting

confidence: 90%

Adherence to the Mediterranean diet partially mediates socioeconomic differences in leukocyte LINE-1 methylation: evidence from a cross-sectional study in Italian women

Maugeri

Barchitta

Lio

et al. 2020

Sci Rep

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Although previous research demonstrated that socioeconomic status (SES) might affect DNA methylation, social inequalities alone do not completely explain this relationship. We conducted a cross-sectional study on 349 women (Catania, Italy) to investigate whether behaviors might mediate the association between SES and long interspersed nuclear elements (LINE-1) methylation, a surrogate marker of global DNA methylation. Educational level, used as an indicator of SES, and data on behaviors (i.e. diet, smoking habits, physical activity, and weight status) were collected using structured questionnaires. Adherence to Mediterranean diet (MD) was assessed by the Mediterranean Diet Score (MDS). Leukocyte LINE-1 methylation was assessed by pyrosequencing. Mediation analysis was conducted using the procedure described by preacher and Hayes. Women with high educational level exhibited higher MDS (β = 0.669; 95%CI 0.173-1.165; p < 0.01) and LINE-1 methylation level (β = 0.033; 95%CI 0.022-0.043; p < 0.001) than their less educated counterpart. In line with this, mediation analysis demonstrated a significant indirect effect of high educational level on LINE-1 methylation through the adherence to MD (β = 0.003; 95%CI 0.001-0.006). Specifically, the mediator could account for 9.5% of the total effect. To our knowledge, this is the first study demonstrating the mediating effect of diet in the relationship between SES and DNA methylation. Although these findings should be confirmed by prospective research, they add value to the promotion of healthy dietary habits in social disadvantaged people. Social determinants can explain health inequalities between and within countries, which should be tackled through Public Health interventions 1. In general, low socioeconomic status (SES)-expressed in terms of educational level, employment and income-is associated with earlier onset of age-related chronic diseases and higher risk of death 2,3. Socioeconomic disadvantaged individuals tend to fare worse with regards to non-communicable diseases (NCD) risk factors, which include unhealthy behaviors 2-6. Thus, strategies aiming to reduce health disparities should also include the promotion of healthy behaviors (e.g. diet, smoking habits and physical activity), which are considered as risk factors for several health conditions and diseases 7. Social disadvantages and unhealthy behaviors-occurring either in utero and during lifetime-may induce sustainable biological changes involved in individual NCD risk profile 8,9. Despite recent strides in this field of research, molecular mechanisms involved are still not fully understood. For this reason, uncovering the epigenetic mechanisms underpinning this relationship might offer a plausible explanation of the effect of SES on human

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Section: Discussionsupporting

confidence: 90%

Adherence to the Mediterranean diet partially mediates socioeconomic differences in leukocyte LINE-1 methylation: evidence from a cross-sectional study in Italian women

Maugeri

Barchitta

Lio

et al. 2020

Sci Rep

Self Cite

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“…HPV infection is necessary but may not be sufficient for the development of cervical cancer, and hence other cofactors may modulate the progression of HPV infection to cervical cancer. For instance, mounting evidence has shown that the consumption of “healthy” foods (e.g., fruits and vegetables) and the intake of certain nutrients (e.g., antioxidants, folates, and minerals) are associated with a decreased risk of HPV infection, precursor lesions, and cervical cancer [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Dietary Antioxidant Intake and Human Papillomavirus Infection: Evidence from a Cross-Sectional Study in Italy

et al. 2020

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Several lines of evidence suggested that antioxidants might play a protective role against high-risk human papillomavirus (hrHPV) infection and cervical cancer. However, the effect of combined intake of antioxidants has not been investigated thus far. The current cross-sectional study aimed to understand the relationship between dietary antioxidant intake and the risk of high-risk HPV (hrHPV) infection among 251 Italian women with normal cervical cytology. Women were tested for hrHPV using the Digene HC2 HPV DNA Test. Dietary antioxidant intakes were assessed using a semi-quantitative food frequency questionnaire, and a Composite Dietary Antioxidant Index (CDAI) was constructed on the basis of zinc, selenium, manganese, vitamin A, vitamin C, vitamin E, carotenoid, and flavonoid intake. Logistic regression analysis was used to assess odds ratio (OR) and 95% confidence interval (95% CI) for the associations of antioxidant intakes or CDAI with hrHPV status, adjusting for age, smoking status, body mass index, parity, educational level, marital status, and use of multivitamins and oral contraceptives. We first observed that hrHPV-positive women (n = 84) reported lower intake of zinc, manganese, and vitamins A and C than non-infected women. Specifically, we found a negative association between dietary intake of zinc and hrHPV-positive status when all antioxidants were considered simultaneously (OR = 0.46; 95% CI = 0.27–0.80; p = 0.006). With respect to cumulative dietary antioxidant intake, we demonstrated that women with high CDAI (third tertile) had lower odds of being hrHPV-positive than those with low CDAI (first tertile) (OR = 0.39; 95% CI = 0.18–0.85; p = 0.018). To our knowledge, this is the first study demonstrating that a diet based on the combined intake of nutrients with antioxidant properties might reduce the risk of hrHPV infection. However, further research is needed to understand whether dietary antioxidant intake is associated with hrHPV infection or its persistence.

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“…Analyses of the different components of the diet on all types of cancer seem to indicate that the beneficial effect of the Mediterranean diet is not due to any specific component, but to the combined effect of a range of nutrients and other components offered by a diet rich in antioxidants, fiber and polyphenols, with a fatty acid profile that favors the consumption of omega-3 fatty acids 13 . Barchitta et al 14 conducted a cross-sectional study in which three dietary patterns and their possible association with the development of high-risk HPV infection were analyzed. The patterns compared were the western diet, the Mediterranean diet, and the prudent diet.…”

Section: Dietary Patterns Foods and Nutrients Associated With An Efmentioning

confidence: 99%

“…The study by Barchitta et al 14 also analyzed whether the prudent diet pattern was associated with the development of CIN2+. The results showed that the prudent diet might be a protective factor against the development of CIN2+ (OR = 0.50; 95% CI = 0.26-0.98; p = 0.039).…”

Section: Role Of Foods and Nutrients In The Control And Elimination Omentioning

confidence: 99%

Immunonutrition in Cervical Cancer: Immune Response Modulation by Diet

Medina-Contreras¹,

Luvian-Morales²,

Valdez-Palomares³

et al. 2020

RIC

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In the development of cervical cancer (CC), the immune response plays an essential role, from the elimination of human papillomavirus (HPV) infection to the response against the tumor. For optimal function of the immune response, various factors are required, one of the most important being an adequate nutrition. The complex interaction between nutrients and microbiota maintains the immune system in homeostasis and in case of infection, it provides the ability to fight against pathogen invasion, as occurs in HPV infection. The purpose of this article is to describe the role of diet, food, and specific nutrients in the immune response from the onset of infection to progression to precancerous lesions and CC, as well as the role of diet and nutrition during oncological treatment. The immunomodulatory role of microbiota is also discussed. A detailed analysis of the evidence leads us to recommend a nutritional pattern very similar to the Mediterranean diet or the prudent diet for an optimal immune response. Moreover, pre-and probiotics favorably modulate the microbiota and induce preventive and therapeutic effects against cancer.

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The Association of Dietary Patterns with High-Risk Human Papillomavirus Infection and Cervical Cancer: A Cross-Sectional Study in Italy

Cited by 41 publications

References 32 publications

Adherence to the Mediterranean diet partially mediates socioeconomic differences in leukocyte LINE-1 methylation: evidence from a cross-sectional study in Italian women

Adherence to the Mediterranean diet partially mediates socioeconomic differences in leukocyte LINE-1 methylation: evidence from a cross-sectional study in Italian women

Dietary Antioxidant Intake and Human Papillomavirus Infection: Evidence from a Cross-Sectional Study in Italy

Immunonutrition in Cervical Cancer: Immune Response Modulation by Diet

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