Special Issue "Nutrition and Cancer: From Prevention to Survivorship"

A special issue of Nutrients (ISSN 2072-6643).

Deadline for manuscript submissions: closed (15 September 2019).

Special Issue Editor

Dr. Rachel Murphy
E-Mail Website
Guest Editor
School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
Interests: nutrition and chronic disease prevention; obesity; body composition; population health; nutritional epidemiology; dietary patterns

Special Issue Information

Dear Colleagues,

Diet and nutrition play critical roles throughout the cancer continuum. Diet and dietary components can contribute to an increased or decreased risk of cancer development. Diet is also a central component during antineoplastic treatment that may be altered by treatment, and can have a profound influence on health and treatment outcomes. In survivorship, individuals may be motivated to seek information about diet to improve their overall health, and for many survivors, a healthy diet should be a priority.  However, there are a number of challenges in conducting and interpreting diet–cancer relationships related to methodological limitations, the heterogeneity of studies, and the need for replication of findings.

This Special Issue of Nutrients, “Nutrition and Cancer: From Prevention to Survivorship”, aims to inform our knowledge of diet–cancer relationships and welcomes the submission of manuscripts examining the impact of diet and dietary components throughout the cancer continuum. Topics of interest include but are not limited to those described above. Manuscripts that use new technologies and approaches such as the use of biomarkers of dietary exposure and the consideration of dietary patterns are of particular interest. Epidemiological, interventional, and systematic reviews, and meta-analyses, are welcomed.

Dr. Rachel Murphy
Guest Editor

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Keywords

  • Cancer prevention
  • Survivorship
  • Dietary intake
  • Dietary supplements
  • Lifestyle
  • Clinical nutrition

Published Papers (21 papers)

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Open AccessArticle
Diet Quality among Cancer Survivors and Participants without Cancer: A Population-Based, Cross-Sectional Study in the Atlantic Partnership for Tomorrow’s Health Project
Nutrients 2019, 11(12), 3027; https://doi.org/10.3390/nu11123027 - 11 Dec 2019
Abstract
Cancer survivors are encouraged to have a healthy lifestyle to reduce health risks and improve survival. An understanding of health behaviors, such as diet, is also important for informing post-diagnosis support. We investigated the diet quality of cancer survivors relative to participants without [...] Read more.
Cancer survivors are encouraged to have a healthy lifestyle to reduce health risks and improve survival. An understanding of health behaviors, such as diet, is also important for informing post-diagnosis support. We investigated the diet quality of cancer survivors relative to participants without cancer, overall and by cancer site and time from diagnosis. A cross-sectional study design within the Atlantic PATH study was used which included 19,973 participants aged 35 to 69 years from Atlantic Canada, of whom 1,930 were cancer survivors. A diet quality score was derived from a food frequency questionnaire. Comparisons of diet quality between cancer survivors and non-cancer controls, cancer site and years since diagnosis were examined in multivariable multi-level models. Cancer survivors had a mean diet quality of 39.1 out of 60 (SD: 8.82) and a higher diet quality than participants without cancer (mean difference: 0.45, 95% CI: 0.07, 0.84) after adjustment for confounders. Odds of high diet quality was greater in breast cancer survivors than participants without cancer (OR = 1.42, 95% CI: 1.06, 1.90), and higher among survivors diagnosed ≤2 years versus >10 years (OR = 1.71, 95% CI: 1.05, 2.80). No other differences by cancer site and years since diagnosis were observed. The difference in diet quality, although statistically significant, is unlikely to be meaningful, suggesting that cancer survivors have similar diet quality as participants without cancer. There was considerable room for dietary improvement regardless of cancer status, highlighting the need for dietary interventions, especially among cancer survivors, who are at higher risk for secondary health problems. Full article
(This article belongs to the Special Issue Nutrition and Cancer: From Prevention to Survivorship)
Open AccessArticle
Adherence to the American Cancer Society Guidelines for Cancer Survivors and Health-Related Quality of Life among Breast Cancer Survivors
Nutrients 2019, 11(12), 2924; https://doi.org/10.3390/nu11122924 - 03 Dec 2019
Abstract
The development and validation of guidelines for breast cancer survivors are of importance due to the increased survival rate for breast cancer. In this cross-sectional study, we aimed to examine the association between adherence to the American Cancer Society (ACS) guidelines for cancer [...] Read more.
The development and validation of guidelines for breast cancer survivors are of importance due to the increased survival rate for breast cancer. In this cross-sectional study, we aimed to examine the association between adherence to the American Cancer Society (ACS) guidelines for cancer survivors and health-related quality of life (HRQoL). A total of 618 breast cancer survivors aged 30 to 81 years who had been diagnosed with stage I to III primary breast cancer and had surgery at least a year before enrollment were included. The participants completed the 36 Item Short-Form Health Survey (SF-36) to evaluate HRQoL, and adherence scores were calculated based on the Nutrition and Physical Activity Guidelines for Cancer Survivors, which were released by the ACS. Increasing adherence scores were associated with increasing scores on the physical component summary (PCS) and the physical functioning (PF), bodily pain (BP), and vitality (VT) domains (p for trend <0.001 for PCS and PF, 0.01 for BP, and 0.02 for VT); these scores were mainly driven by the associations among survivors with stage II–III cancer. Further prospective studies are needed to evaluate whether adherence to these guidelines improves HRQoL scores among breast cancer survivors. Full article
(This article belongs to the Special Issue Nutrition and Cancer: From Prevention to Survivorship)
Open AccessArticle
Meeting Minimum ESPEN Energy Recommendations Is Not Enough to Maintain Muscle Mass in Head and Neck Cancer Patients
Nutrients 2019, 11(11), 2743; https://doi.org/10.3390/nu11112743 - 12 Nov 2019
Abstract
The relationship between dietary intake and body composition changes during cancer treatment has not been well characterized. The aim of this study was to compare dietary intake at diagnosis and end of treatment in relation to changes in muscle mass and adiposity in [...] Read more.
The relationship between dietary intake and body composition changes during cancer treatment has not been well characterized. The aim of this study was to compare dietary intake at diagnosis and end of treatment in relation to changes in muscle mass and adiposity in head and neck cancer (HNC) patients. Dietary intakes (three-day food record) and body composition using computed tomography (CT) were assessed at diagnosis (baseline) and after treatment completion (post-treatment). Skeletal muscle (SM) loss was explored as a consequence of energy and protein intake in relation to the minimum and maximum European Society of Parenteral and Enteral Nutrition (ESPEN) guidelines. Higher energy intakes (kcal/kg/day) and increases in energy intake (%) from baseline to post-treatment were correlated with attenuated muscle loss (r = 0.62, p < 0.01; r = 0.47, p = 0.04, respectively). Post-treatment protein intake demonstrated a weak positive correlation (r = 0.44, p = 0.05) with muscle loss, which did not persist when controlling for covariates. Meeting minimum ESPEN energy guidelines (25 kcal/kg/day) did not attenuate SM loss, whereas intakes >30 kcal/kg/day resulted in fewer participants losing muscle. Greater baseline adiposity correlated with greater SM loss (p < 0.001). Energy intakes of 30 kcal/kg/day may be required to protect against SM loss during treatment in HNC patients. The influence of adiposity on SM loss requires further exploration. Full article
(This article belongs to the Special Issue Nutrition and Cancer: From Prevention to Survivorship)
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Open AccessArticle
Effects of Flaxseed and Its Components on Mammary Gland MiRNome: Identification of Potential Biomarkers to Prevent Breast Cancer Development
Nutrients 2019, 11(11), 2656; https://doi.org/10.3390/nu11112656 - 04 Nov 2019
Abstract
Breast cancer is the most common cancer among women worldwide. We previously showed that early-life exposure to flaxseed (FS) or its components, FS oil (FSO) and secoisolariciresinol diglucoside (SDG), affects the mammary gland (MG) and is associated with the reduction of breast cancer [...] Read more.
Breast cancer is the most common cancer among women worldwide. We previously showed that early-life exposure to flaxseed (FS) or its components, FS oil (FSO) and secoisolariciresinol diglucoside (SDG), affects the mammary gland (MG) and is associated with the reduction of breast cancer risk during adulthood. However, the underlying mechanisms are not understood. This study aimed to investigate the effect of FS, FSO, and SDG on the MG miRNA signature at a late stage of development. Female C57BL/6 mice, 4–5 weeks of age, were randomized into four groups to receive: (i) basal AIN-93G, (ii) 10% FS, (iii) 3.67% FSO, or (iv) 0.15% SDG. After 21 days, the mice were sacrificed and MG miRNAs were profiled. Diet-specific MG miRNA signatures were identified. Deregulated miRNAs were associated with breast cancer and targeted genes involved in MG development, growth, and cancer. The study allowed for the identification of potential biomarkers or novel therapeutic targets to prevent and/or reduce the risk of breast cancer. Full article
(This article belongs to the Special Issue Nutrition and Cancer: From Prevention to Survivorship)
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Open AccessArticle
Epigenetic Activation of BRCA1 by Genistein In Vivo and Triple Negative Breast Cancer Cells Linked to Antagonism toward Aryl Hydrocarbon Receptor
Nutrients 2019, 11(11), 2559; https://doi.org/10.3390/nu11112559 - 23 Oct 2019
Abstract
Triple negative breast cancers (TNBC) are the most aggressive and lethal breast cancers (BC). The aryl hydrocarbon receptor (AHR) is often overexpressed in TNBC, and its activation results in the epigenetic silencing of BRCA1, which is a necessary factor for the transcriptional [...] Read more.
Triple negative breast cancers (TNBC) are the most aggressive and lethal breast cancers (BC). The aryl hydrocarbon receptor (AHR) is often overexpressed in TNBC, and its activation results in the epigenetic silencing of BRCA1, which is a necessary factor for the transcriptional activation of estrogen receptor (ER)α. The dietary isoflavone genistein (GEN) modulates BRCA1 CpG methylation in BC cells. The purpose of this study was to investigate the effect of GEN on BRCA1 epigenetic regulation and AHR activity in vivo and TNBC cells. Mice were administered a control or GEN-enriched (4 and 10 ppm) diet from gestation through post-natal day 50. Mammary tissue was analyzed for changes in BRCA1 regulation and AhR activity. TNBC cells with constitutively hypermethylated BRCA1 (HCC38) and MCF7 cells were used. Protein levels and mRNA expression were measured by Western blot and real-time PCR, respectively. BRCA1 promoter occupancy and CpG methylation were analyzed by chromatin immunoprecipitation and methylation-specific PCR, respectively. Cell viability was determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. GEN administered in the diet dose-dependently decreased basal Brca1 methylation and AHR activity in the mammary gland of adult mice. HCC38 cells were found to overexpress constitutively active AHR in parallel with BRCA1 hypermethylation. The treatment of HCC38 cells with GEN upregulated BRCA1 protein levels, which was attributable to decreased CpG methylation and AHR binding at BRCA1 exon 1a. In MCF7 cells, GEN prevented the 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD)-dependent localization of AHR at the BRCA1 gene. These effects were consistent with those elicited by control AHR antagonists galangin (GAL), CH-223191, and α-naphthoflavone. The pre-treatment with GEN sensitized HCC38 cells to the antiproliferative effects of 4-hydroxytamoxifen. We conclude that the dietary compound GEN may be effective for the prevention and reversal of AHR-dependent BRCA1 hypermethylation, and the restoration of ERα-mediated response, thus imparting the sensitivity of TNBC to antiestrogen therapy. Full article
(This article belongs to the Special Issue Nutrition and Cancer: From Prevention to Survivorship)
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Open AccessArticle
Effect Modification of Vitamin D Supplementation by Histopathological Characteristics on Survival of Patients with Digestive Tract Cancer: Post Hoc Analysis of the AMATERASU Randomized Clinical Trial
Nutrients 2019, 11(10), 2547; https://doi.org/10.3390/nu11102547 - 22 Oct 2019
Abstract
Some coauthors of this study previously performed the AMATERASU randomized, double-blind, placebo-controlled trial of postoperative oral vitamin D supplementation (2,000 IU/day) in 417 patients with stage I to III digestive tract cancer from the esophagus to the rectum who underwent curative surgery (UMIN000001977). [...] Read more.
Some coauthors of this study previously performed the AMATERASU randomized, double-blind, placebo-controlled trial of postoperative oral vitamin D supplementation (2,000 IU/day) in 417 patients with stage I to III digestive tract cancer from the esophagus to the rectum who underwent curative surgery (UMIN000001977). We conducted a post-hoc analysis of the AMATERASU trial to explore the effects of modification of vitamin D supplementation by histopathological characteristics on survival. Among patients with poorly differentiated adenocarcinoma, the 5-year relapse-free survival rate of patients supplemented with vitamin D was 91% compared with 63% in the placebo group (hazard ratio [HR], 0.25; 95% confidence interval [CI], 0.08 to 0.78; P = 0.017; P for interaction = 0.023). Similarly, the 5-year overall survival rate was 92% in the vitamin D group compared with 72% in the placebo group (HR, 0.25; 95%CI, 0.07 to 0.94; P = 0.040; P for interaction = 0.012). In contrast, there were no significant effects in other histopathological characteristics between vitamin D and placebo groups. These findings generated the hypothesis that oral vitamin D supplementation may improve both relapse-free survival and overall survival in a subgroup of patients with poorly differentiated adenocarcinoma. Full article
(This article belongs to the Special Issue Nutrition and Cancer: From Prevention to Survivorship)
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Open AccessArticle
Diet, Physical Activity, Obesity, and Breastfeeding: How French People Perceive Factors Associated with Cancer Risk
Nutrients 2019, 11(10), 2491; https://doi.org/10.3390/nu11102491 - 16 Oct 2019
Abstract
The French Cancer Barometer, a population-based-survey, is carried out every five years and is, to date, one of the few national studies conducted to investigate individual perception linked to cancer risk factors. The aims of the present study were to describe the perceptions [...] Read more.
The French Cancer Barometer, a population-based-survey, is carried out every five years and is, to date, one of the few national studies conducted to investigate individual perception linked to cancer risk factors. The aims of the present study were to describe the perceptions of the French population in 2015 and to assess their evolution over a 5-year period (2010–2015). The French Cancer Barometer surveyed a randomly selected sample of participants aged 15–75 years (n = 3345 in 2010) and 15–85 years (n = 3764 in 2015), representative of the French population. Questions were on perception of diet, physical activity, obesity, and breastfeeding as cancer risk factors. In 2015, nutritional/activity factors were perceived as having an important role in cancer development for the majority of those surveyed (diet (90.8%), obesity (76%), and physical activity (70%)) with the exception being breastfeeding (34%). However, there was a moderate perception of the risks of red meat (43%) and salt or salty food (55%) consumption. Perceptions of nutritional risk factors were mostly associated with age and education level. Interestingly, there was a greater perception of nutritional risk factors in 2015 compared to 2010, and the participants’ opinions were also stronger. Efforts should be made on individuals with lower educational level and to promote the beneficial effects of breastfeeding. However, to impact food behavior, measures are needed at the environmental level and not only at the individual one. Full article
(This article belongs to the Special Issue Nutrition and Cancer: From Prevention to Survivorship)
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Open AccessArticle
Exploring Views of Healthcare Professionals, Researchers, and People Living with and beyond Colorectal Cancer on a Healthy-Eating and Active Lifestyle Resource
Nutrients 2019, 11(10), 2482; https://doi.org/10.3390/nu11102482 - 16 Oct 2019
Abstract
Background: People after bowel cancer are at high risk of cancer recurrences and co-morbidities, and therefore strategies are needed to reduce these risks. One promising strategy targets modifiable lifestyle factors including diet and physical activity. However, effective, evidence-based resources in adopting new lifestyle [...] Read more.
Background: People after bowel cancer are at high risk of cancer recurrences and co-morbidities, and therefore strategies are needed to reduce these risks. One promising strategy targets modifiable lifestyle factors including diet and physical activity. However, effective, evidence-based resources in adopting new lifestyle habits are currently lacking. Methods: The Healthy-Eating and Active Lifestyle After Bowel Cancer (HEAL ABC) resource was developed incorporating behavior change theory and World Cancer Research Fund and American Institute of Cancer Research guidelines. Focus groups and telephone interviews were conducted with professionals and survivors (age ≥18 years) to obtain feedback on the resource layout, structure, and content. Recorded data were transcribed verbatim and analyzed using framework analysis. Results: Thirty participants evaluated the resource—19 cancer survivors and 11 professionals. Survivors’ mean age was 62 years (SD 11.5), 11 (58%) were females and 8 (42%) were male. Professionals were all females and mean age was 40 years (SD 6.06). Both survivors and professionals evaluated the resource as useful and provided suggestions for improvements. Conclusions: HEAL ABC is an evidence-based resource designed to aid cancer survivors in translating their motivation into action. It was valued positively by both survivors and healthcare professionals and viewed as filling a gap in post-treatment advice. Full article
(This article belongs to the Special Issue Nutrition and Cancer: From Prevention to Survivorship)
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Open AccessArticle
Lifelong n-3 Polyunsaturated Fatty Acid Exposure Modulates Size of Mammary Epithelial Cell Populations and Expression of Caveolae Resident Proteins in Fat-1 Mice
Nutrients 2019, 11(10), 2477; https://doi.org/10.3390/nu11102477 - 15 Oct 2019
Abstract
Omega-3 polyunsaturated fatty acids (n-3 PUFA) have been associated with reduced breast cancer risk; however, the exact mechanism remains elusive. Female wildtype (WT) and fat-1 mice were fed a 10% safflower diet until 6 weeks of age. Mammary gland epithelial cells (EC) were [...] Read more.
Omega-3 polyunsaturated fatty acids (n-3 PUFA) have been associated with reduced breast cancer risk; however, the exact mechanism remains elusive. Female wildtype (WT) and fat-1 mice were fed a 10% safflower diet until 6 weeks of age. Mammary gland epithelial cells (EC) were isolated and EC populations were determined by CD24 surface expression. Fat-1 mice expressed 65%, 20%, and 15% while WT mice expressed 65%, 26% and 9% for non-, myo- and luminal ECs, respectively. The luminal EC population was significantly greater in fat-1 mice (p ≤ 0.05), while the total number of mammary ECs were similar between groups (p = 0.79). Caveolae was isolated from ECs and Her-2/neu, ER-α and cav-1 protein expression was determined by Western blotting. Fat-1 mice had a two-fold greater ER-α (p ≤ 0.05) and a 1.5-fold greater cav-1 (p ≤ 0.05) expression than WT with a similar amount of Her-2/neu protein (p = 0.990) between groups. Overall, this study provides novel mechanistic evidence by which n-3 PUFA modifies early mammary gland development that may potentially reduce breast cancer risk later in life. Full article
(This article belongs to the Special Issue Nutrition and Cancer: From Prevention to Survivorship)
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Open AccessArticle
Primary Outcomes of a Randomized Controlled Crossover Trial to Explore the Effects of a High Chlorophyll Dietary Intervention to Reduce Colon Cancer Risk in Adults: The Meat and Three Greens (M3G) Feasibility Trial
Nutrients 2019, 11(10), 2349; https://doi.org/10.3390/nu11102349 - 02 Oct 2019
Abstract
Preclinical and observational research suggests green leafy vegetables (GLVs) may reduce the risk of red meat (RM)-induced colonic DNA damage and colon cancer (CC). We sought to determine the feasibility of a high GLV dietary intervention in adults with an increased risk of [...] Read more.
Preclinical and observational research suggests green leafy vegetables (GLVs) may reduce the risk of red meat (RM)-induced colonic DNA damage and colon cancer (CC). We sought to determine the feasibility of a high GLV dietary intervention in adults with an increased risk of CC (NCT03582306) via a 12-week randomized controlled crossover trial. Participants were randomized to immediate or delayed (post-4-week washout) intervention groups. During the 4-week intervention period, participants were given frozen GLVs and counseled to consume one cooked cup equivalent daily. The primary outcomes were: accrual—recruiting 50 adults in 9 months; retention—retaining 80% of participants at completion; and adherence—meeting GLV intake goals on 90% of days. Adherence data were collected twice weekly and 24-h dietary recalls at each time point provided nutrient and food group measures. The Food Acceptability Questionnaire (FAQ) was completed to determine acceptability. On each of the four study visits, anthropometrics, stool, saliva, and blood were obtained. Fifty adults were recruited in 44 days. Participants were 48 ± 13 years of age, 62% female, and 80% Caucasian, with an average BMI at screening of 35.9 ± 5.1. Forty-eight (96%) participants were retained and completed the study. During the intervention phase, participants consumed GLVs on 88.8% of days; the adherence goal of one cup was met on 73.2% of days. Dietary recall-derived Vitamin K and GLVs significantly increased for all participants during the intervention periods. Overall satisfaction did not differ between intervention and control periods (p = 0.214). This feasibility trial achieved accrual, retention and acceptability goals, but fell slightly short of the benchmark for adherence. The analysis of biological specimens will determine the effects of GLVs on gut microbiota, oxidative DNA damage, and inflammatory cytokines. Full article
(This article belongs to the Special Issue Nutrition and Cancer: From Prevention to Survivorship)
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Open AccessArticle
Dietary Fiber, Whole Grains, and Head and Neck Cancer Prognosis: Findings from a Prospective Cohort Study
Nutrients 2019, 11(10), 2304; https://doi.org/10.3390/nu11102304 - 27 Sep 2019
Abstract
No studies, to date, have examined the relationship between dietary fiber and recurrence or survival after head and neck cancer diagnosis. The aim of this study was to determine whether pretreatment intake of dietary fiber or whole grains predicted recurrence and survival outcomes [...] Read more.
No studies, to date, have examined the relationship between dietary fiber and recurrence or survival after head and neck cancer diagnosis. The aim of this study was to determine whether pretreatment intake of dietary fiber or whole grains predicted recurrence and survival outcomes in newly diagnosed head and neck cancer (HNC) patients. This was a prospective cohort study of 463 participants baring a new head and neck cancer diagnosis who were recruited into the study prior to the initiation of any cancer therapy. Baseline (pre-treatment) dietary and clinical data were measured upon entry into the study cohort. Clinical outcomes were ascertained at annual medical reviews. Cox proportional hazard models were fit to examine the relationships between dietary fiber and whole grain intakes with recurrence and survival. There were 112 recurrence events, 121 deaths, and 77 cancer-related deaths during the study period. Pretreatment dietary fiber intake was inversely associated with risk of all-cause mortality (hazard ratio (HR): 0.37, 95% confidence interval (CI): 0.14–0.95, ptrend = 0.04). No statistically significant associations between whole grains and prognostic outcomes were found. We conclude that higher dietary fiber intake, prior to the initiation of treatment, may prolong survival time, in those with a new HNC diagnosis. Full article
(This article belongs to the Special Issue Nutrition and Cancer: From Prevention to Survivorship)
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Open AccessArticle
Dietary Fat-Accelerating Leptin Signaling Promotes Protumorigenic Gastric Environment in Mice
Nutrients 2019, 11(9), 2127; https://doi.org/10.3390/nu11092127 - 06 Sep 2019
Abstract
Excess of fat intake leads to obesity and causes a variety of metabolic diseases and cancer. We previously demonstrated that high-lard diet induces intestinal metaplasia, a precancerous lesion of the stomach mediated by leptin signaling. This study aims to investigate which kinds of [...] Read more.
Excess of fat intake leads to obesity and causes a variety of metabolic diseases and cancer. We previously demonstrated that high-lard diet induces intestinal metaplasia, a precancerous lesion of the stomach mediated by leptin signaling. This study aims to investigate which kinds of dietary fat cause the intestinal metaplasia onset. We fed eight kinds of high-fat diets (HFDs) of animal or plant origin to mice evaluated their effect on gastric pathogenesis. Five types of dietary fat were divided according to their observed effects: Obese with high metaplasia (group I; beef tallow, lard, and hydrogenated coconut oil), non-obese with high metaplasia (group II; linseed oil), obese without metaplasia (group III; corn oil and olive oil), non-obese without metaplasia (group IV, soybean oil) and lean without metaplasia (group V; cocoa butter). The group I and II diets induced leptin, phosphorylated leptin receptor (ObR), signal transducer and activator 3 (STAT3), and increased intracellular β-catenin accumulation in the stomach. Moreover, mice fed these HFDs with 1-methyl-3-nitro-1-nitrosoguanidine (MNNG), a gastric carcinogen, and further accelerated dysplasia in the stomach. Lactobacillus occupancy in the stomach increased in all HFDs except hydrogenated coconut oil. Our findings suggest that HFDs inducing leptin signaling accelerate the enhancement of protumorigenic gastric microenvironment independent of body mass gain or microbiome changes. Full article
(This article belongs to the Special Issue Nutrition and Cancer: From Prevention to Survivorship)
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Open AccessArticle
Sedentary Behavior and Alcohol Consumption Increase Breast Cancer Risk Regardless of Menopausal Status: A Case-Control Study
Nutrients 2019, 11(8), 1871; https://doi.org/10.3390/nu11081871 - 12 Aug 2019
Abstract
Identification of modifiable risk factors for breast cancer is critical for primary prevention of the disease. The aim of this study was to evaluate how certain lifestyle variables modify the chances of developing breast cancer based on menopausal status. A case-control study was [...] Read more.
Identification of modifiable risk factors for breast cancer is critical for primary prevention of the disease. The aim of this study was to evaluate how certain lifestyle variables modify the chances of developing breast cancer based on menopausal status. A case-control study was performed in a group of 542 women, 197 who were diagnosed with breast cancer and 344 control individuals. The groups were matched by age, body mass index, and menopausal status. Participants were evaluated for level of physical activity, alcohol consumption, smoking habit, weight, height, and waist circumference (WC). A multivariate logistic regression model was used to estimate odds ratios and 95% confidence intervals (95% CI). Regular consumption of alcoholic beverages (2.91, 95% CI 1.58–5.38 and 1.86, 95% CI 1.15–3.03) and sedentary behavior (2.08; 95% CI 1.12–3.85 and 1.81; 95% CI 1.12–2.94) were associated with breast cancer risk in pre- and postmenopausal women, respectively. High WC (3.31, 95% CI 1.45–7.55) was associated with an increased risk of developing breast cancer in premenopausal women. While in postmenopausal women, current smoking (2.43, 95% CI 1.01–5.83) or previous history of smoking (1.90; 95% CI 1.14–3.14) increased the chances of developing breast cancer. Sedentary behavior and current consumption of alcoholic beverages were more likely to increase the risk of developing breast cancer regardless of menopausal status. Full article
(This article belongs to the Special Issue Nutrition and Cancer: From Prevention to Survivorship)
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Open AccessArticle
Association of Folate and Vitamins Involved in the 1-Carbon Cycle with Polymorphisms in the Methylenetetrahydrofolate Reductase Gene (MTHFR) and Global DNA Methylation in Patients with Colorectal Cancer
Nutrients 2019, 11(6), 1368; https://doi.org/10.3390/nu11061368 - 18 Jun 2019
Abstract
Folate, vitamin B2, vitamin B6, vitamin B12, choline, and betaine are nutrients involved in the 1-carbon cycle that can alter the levels of DNA methylation and influence genesis and/or tumor progression. Thus, the objective of this study was to evaluate the association of [...] Read more.
Folate, vitamin B2, vitamin B6, vitamin B12, choline, and betaine are nutrients involved in the 1-carbon cycle that can alter the levels of DNA methylation and influence genesis and/or tumor progression. Thus, the objective of this study was to evaluate the association of folate and vitamins involved in the 1-carbon cycle and MTHFR polymorphisms in global DNA methylation in patients with colorectal cancer gene. The study included 189 patients with colorectal adenocarcinoma answering a clinical evaluation questionnaire and the Food Frequency Questionnaire (FFQ) validated for patients with colon and rectal cancer. Blood samples were collected for evaluation of MTHFR gene polymorphisms in global DNA methylation in blood and in tumor. The values for serum folate were positively correlated with the equivalent total dietary folate (total DFE) (rho = 0.51, p = 0.03) and global DNA methylation (rho = 0.20, p = 0.03). Individuals aged over 61 years (p = 0.01) in clinicopathological staging III and IV (p = 0.01) and with + heterozygous mutated homozygous genotypes for the MTHFR A1298C gene had higher levels of global DNA methylation (p = 0.04). The association between dietary intake of folate, serum folate, and tumor stage were predictive of global DNA methylation in patients’ blood. The levels of serum folate, the dietary folate and the status of DNA methylation can influence clinicopathological staging. Full article
(This article belongs to the Special Issue Nutrition and Cancer: From Prevention to Survivorship)
Open AccessArticle
Adherence to Cancer Prevention Guidelines among Older White and Black Adults in the Health ABC Study
Nutrients 2019, 11(5), 1008; https://doi.org/10.3390/nu11051008 - 03 May 2019
Abstract
One-third of cancers can be prevented through healthy lifestyles. This study investigates the prevalence of and factors associated with engagement in cancer prevention guidelines in a population-based cohort of 2124 older white and black men and women. We used Health ABC data to [...] Read more.
One-third of cancers can be prevented through healthy lifestyles. This study investigates the prevalence of and factors associated with engagement in cancer prevention guidelines in a population-based cohort of 2124 older white and black men and women. We used Health ABC data to construct a score from 0 (lowest adherence) to 7 (greatest adherence) based on the sum of seven recommendations for cancer prevention from the World Cancer Research Fund/American Institute for Cancer Research; body fatness (maintenance of healthy body weight), physical activity (at least moderately physically active), diet (fruit, vegetables, fiber, and red and processed meat), and alcohol. Mean (SD) scores in men and women were 3.24 (1.09) and 3.17 (1.10). Lower scores were associated with younger age (women only), black race, current smoking, and prevalent cardiovascular disease. Less than 1% of men and women adhered to all recommendations. Of the individual guidelines, adherence was lowest for fiber (9% of men; 6% of women) followed by physical activity (26% of men; 18% of women), and body weight (21% of men; 26% of women). These results suggest a critical public health need, especially given the growing older population. Black older adults, smokers, and those with prevalent disease may be at higher risk and thus warrant additional focus. Full article
(This article belongs to the Special Issue Nutrition and Cancer: From Prevention to Survivorship)
Open AccessArticle
Clinical Significance of Serum Glutamine Level in Patients with Colorectal Cancer
Nutrients 2019, 11(4), 898; https://doi.org/10.3390/nu11040898 - 21 Apr 2019
Abstract
Limited studies have assessed the associations of pretreatment serum glutamine level with clinicopathological characteristics and prognosis of colorectal cancer (CRC) patients. This study focuses on clarifying the clinical significance of baseline serum glutamine level in CRC patients. We retrospectively examine 123 patients with [...] Read more.
Limited studies have assessed the associations of pretreatment serum glutamine level with clinicopathological characteristics and prognosis of colorectal cancer (CRC) patients. This study focuses on clarifying the clinical significance of baseline serum glutamine level in CRC patients. We retrospectively examine 123 patients with newly diagnosed CRC between 2009 and 2011. The associations of pretreatment serum glutamine level with clinicopathological characteristics, proinflammatory cytokines, overall survival (OS), and progression-free survival (PFS) were analyzed. We executed univariate and multivariate analyses to assess the associations between serum glutamine level and clinicopathological variables able to predict survival. Low glutamine levels were associated with older age, advanced stage, decreased albumin levels, elevated carcinoembryonic antigen levels, higher C-reactive protein levels, higher modified Glasgow prognostic scores, and higher proinflammatory cytokine levels. Furthermore, patients with low glutamine levels had poorer OS and PFS than those with high glutamine levels (p < 0.001 for both). In multivariate analysis, pretreatment glutamine level independently predicted OS (p = 0.016) and PFS (p = 0.037) in CRC patients. Pretreatment serum glutamine level constitutes an independent prognostic marker to predict survival and progression in CRC patients. Full article
(This article belongs to the Special Issue Nutrition and Cancer: From Prevention to Survivorship)
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Open AccessArticle
Serum Concentration of Genistein, Luteolin and Colorectal Cancer Prognosis
Nutrients 2019, 11(3), 600; https://doi.org/10.3390/nu11030600 - 12 Mar 2019
Abstract
Although flavonoid phytoestrogens have been suggested to be associated with reduced risk of colorectal cancer (CRC), their influence on CRC prognosis remains uncertain. A population-based cohort of 2051 patients diagnosed with stage I–III CRC in southwest Germany in 2003–2010 were followed for five [...] Read more.
Although flavonoid phytoestrogens have been suggested to be associated with reduced risk of colorectal cancer (CRC), their influence on CRC prognosis remains uncertain. A population-based cohort of 2051 patients diagnosed with stage I–III CRC in southwest Germany in 2003–2010 were followed for five years. Post-diagnostic serum concentration of genistein and luteolin were measured using Ultra-Performance Liquid Chromatography with mass spectrometry. Multivariable Cox regression analysis was conducted to calculate the Hazard Ratios (HRs) and 95% confidence interval (CI) for the association between flavonoids concentration and overall morality, CRC-specific mortality, CRC recurrence, and disease-free survival (DFS). Median (interquartile range) serum concentration of genistein and luteolin was 11.90 ng/µL (10.08–14.13) and 7.20 ng/µL (6.40–8.16), respectively. Neither serum genistein nor luteolin was associated with CRC prognosis. There was no clear evidence of departure from linearity. However, the association might be differential by adjuvant chemotherapy. Associations pointed towards lower risk in patients who received chemotherapy and higher risk in those without chemotherapy for overall mortality regarding serum genistein (P-interaction = 0.02) and correspondingly for CRC recurrence (P-interaction: 0.03) and DFS (P-interaction: 0.01) with respect to luteolin. Our study provides little evidence that serum genistein and luteolin are associated with colorectal cancer prognosis. Future studies are warranted to evaluate the potential interaction with adjuvant chemotherapy. Full article
(This article belongs to the Special Issue Nutrition and Cancer: From Prevention to Survivorship)
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Review

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Open AccessReview
From the Table to the Tumor: The Role of Mediterranean and Western Dietary Patterns in Shifting Microbial-Mediated Signaling to Impact Breast Cancer Risk
Nutrients 2019, 11(11), 2565; https://doi.org/10.3390/nu11112565 - 24 Oct 2019
Abstract
Diet is a modifiable component of lifestyle that could influence breast cancer development. The Mediterranean dietary pattern is considered one of the healthiest of all dietary patterns. Adherence to the Mediterranean diet protects against diabetes, cardiovascular disease, and cancer. Reported consumption of a [...] Read more.
Diet is a modifiable component of lifestyle that could influence breast cancer development. The Mediterranean dietary pattern is considered one of the healthiest of all dietary patterns. Adherence to the Mediterranean diet protects against diabetes, cardiovascular disease, and cancer. Reported consumption of a Mediterranean diet pattern was associated with lower breast cancer risk for women with all subtypes of breast cancer, and a Western diet pattern was associated with greater risk. In this review, we contrast the available epidemiological breast cancer data, comparing the impact of consuming a Mediterranean diet to the Western diet. Furthermore, we will review the preclinical data highlighting the anticancer molecular mechanism of Mediterranean diet consumption in both cancer prevention and therapeutic outcomes. Diet composition is a major constituent shaping the gut microbiome. Distinct patterns of gut microbiota composition are associated with the habitual consumption of animal fats, high-fiber diets, and vegetable-based diets. We will review the impact of Mediterranean diet on the gut microbiome and inflammation. Outside of the gut, we recently demonstrated that Mediterranean diet consumption led to distinct microbiota shifts in the mammary gland tissue, suggesting possible anticancer effects by diet on breast-specific microbiome. Taken together, these data support the anti-breast-cancer impact of Mediterranean diet consumption. Full article
(This article belongs to the Special Issue Nutrition and Cancer: From Prevention to Survivorship)
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Open AccessReview
Chemosensory Changes from Cancer Treatment and Their Effects on Patients’ Food Behavior: A Scoping Review
Nutrients 2019, 11(10), 2285; https://doi.org/10.3390/nu11102285 - 24 Sep 2019
Abstract
Individuals undergoing treatment for cancer can experience changes in taste or smell that are often assumed to affect constructs related to food behavior, although this relationship is rarely measured directly. To ascertain the extent to which measured changes in taste and smell during [...] Read more.
Individuals undergoing treatment for cancer can experience changes in taste or smell that are often assumed to affect constructs related to food behavior, although this relationship is rarely measured directly. To ascertain the extent to which measured changes in taste and smell during and after cancer treatment affect food behavior, we conducted a scoping review and completed a comparative analysis for studies that met our criteria, which were: they directly measured cancer patients’ (a) psychophysical response to taste and/or olfactory stimuli, and (b) food behavior (including food enjoyment, food preference, dietary intake) in people affected by cancer. Eleven studies met these criteria and were included in the review. All 11 studies evaluated taste and five also measured smell. A comparative analysis exploring taste and food behavior shows that a reduced sweet taste function (decreased sensitivity) was associated with a reduced intake of a variety of different macro and micro nutrients, reduced appetite, and overall lower energy intake. One out of six studies that measured smell and food measured observed changes in olfactory function following cancer treatment. There were no significant relationships reported between olfactory measures and food behavior. Taste changes that arise from cancer treatment appear to have a direct effect on food behavior, although there is a need for more research using standardized measures and larger sample sizes. A better understanding of taste alterations and their implications for dietary intake and food enjoyment will support optimal nutritional health by identifying strategies to help patients eat well during and after cancer treatment. Full article
(This article belongs to the Special Issue Nutrition and Cancer: From Prevention to Survivorship)
Open AccessReview
Effects of Intestinal Microbial–Elaborated Butyrate on Oncogenic Signaling Pathways
Nutrients 2019, 11(5), 1026; https://doi.org/10.3390/nu11051026 - 07 May 2019
Cited by 4
Abstract
The intestinal microbiota is well known to have multiple benefits on human health, including cancer prevention and treatment. The effects are partially mediated by microbiota-produced short chain fatty acids (SCFAs) such as butyrate, propionate and acetate. The anti-cancer effect of butyrate has been [...] Read more.
The intestinal microbiota is well known to have multiple benefits on human health, including cancer prevention and treatment. The effects are partially mediated by microbiota-produced short chain fatty acids (SCFAs) such as butyrate, propionate and acetate. The anti-cancer effect of butyrate has been demonstrated in cancer cell cultures and animal models of cancer. Butyrate, as a signaling molecule, has effects on multiple signaling pathways. The most studied effect is its inhibition on histone deacetylase (HDAC), which leads to alterations of several important oncogenic signaling pathways such as JAK2/STAT3, VEGF. Butyrate can interfere with both mitochondrial apoptotic and extrinsic apoptotic pathways. In addition, butyrate also reduces gut inflammation by promoting T-regulatory cell differentiation with decreased activities of the NF-κB and STAT3 pathways. Through PKC and Wnt pathways, butyrate increases cancer cell differentiation. Furthermore, butyrate regulates oncogenic signaling molecules through microRNAs and methylation. Therefore, butyrate has the potential to be incorporated into cancer prevention and treatment regimens. In this review we summarize recent progress in butyrate research and discuss the future development of butyrate as an anti-cancer agent with emphasis on its effects on oncogenic signaling pathways. The low bioavailability of butyrate is a problem, which precludes clinical application. The disadvantage of butyrate for medicinal applications may be overcome by several approaches including nano-delivery, analogue development and combination use with other anti-cancer agents or phytochemicals. Full article
(This article belongs to the Special Issue Nutrition and Cancer: From Prevention to Survivorship)
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Other

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Open AccessBrief Report
Serum ‘Vitamin-Mineral’ Profiles: Associations with Postmenopausal Breast Cancer Risk Including Dietary Patterns and Supplementation. A Case-Control Study
Nutrients 2019, 11(9), 2244; https://doi.org/10.3390/nu11092244 - 18 Sep 2019
Abstract
Breast cancer is the most prevalent cancer in females worldwide. Studies evaluating the blood vitamins and minerals status in the breast cancer etiology are limited, and the results are inconclusive. This study analyzed the association between serum vitamin-mineral profiles (V-MPs) and breast cancer [...] Read more.
Breast cancer is the most prevalent cancer in females worldwide. Studies evaluating the blood vitamins and minerals status in the breast cancer etiology are limited, and the results are inconclusive. This study analyzed the association between serum vitamin-mineral profiles (V-MPs) and breast cancer (BC) risk with including dietary patterns (DPs) and the use of supplements. This case-control study involved 420 women aged 40–79 years from north-eastern Poland, including 190 newly diagnosed breast cancer cases. The fasting serum concentrations of vitamins (folate, cobalamin, 25(OH) vitamin D) and minerals (iron, calcium, magnesium) were measured in 129 post-menopausal women, including 82 controls and 47 cases. Three V-MPs were derived with a Principal Component Analysis (PCA). A logistic regression analysis was performed to estimate the odds ratio (OR) and 95% confidence interval (95% CI) of the breast cancer risk associated with serum V-MPs and serum levels of single biomarkers. The risk of BC was lower by 88% (OR: 0.12; 95% Cl: 0.02–0.88; p < 0.05) in the upper tertile of the serum ‘Iron-Calcium’ profile compared to the bottom tertile, lower by 67% (OR: 0.33; 95% Cl: 0.11–0.97; p < 0.05) at the level of serum 25(OH) vitamin D ≥24.6 ng/mL and lower by 68% (OR: 0.32; 95% Cl: 0.11–0.91; p < 0.05) at the level of serum calcium ≥9.6 mg/dL. There was an inverse association of the serum ‘Magnesium’ profile or serum level of iron with the risk of BC, which disappeared after adjustment for the set of confounders accounted for: age, body mass index (BMI), socioeconomic status, overall physical activity, smoking status, age at menarche, number of full-term pregnancies, oral contraceptive use, hormone-replacement therapy use, family history of breast cancer, vitamin/mineral supplement use, the molecular subtype of breast cancer, and dietary patterns. No significant association was found between BC risk and the serum ‘Folate-Cobalamin-Vitamin D’ profile or serum folate, cobalamin or magnesium considered separately. These findings highlight that a higher-normal serum level of both iron and calcium, considered together as the serum profile, as well as a higher-normal serum level of calcium, considered separately, and a slightly below the normal range of serum vitamin D level may protect against breast cancer among postmenopausal women, independent of dietary patterns or the use of vitamin/mineral supplements. Therefore, the maintenance of the adequate status of vitamins and minerals and the regular monitoring of their blood markers should be included in breast cancer prevention. Full article
(This article belongs to the Special Issue Nutrition and Cancer: From Prevention to Survivorship)
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