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      Intake Trends of Red Meat, Alcohol, and Fruits and Vegetables as Cancer-Related Dietary Factors from 1998 to 2009

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          Abstract

          Objectives

          Cancer is the leading cause of death worldwide, and cancer incidence and mortality have been increasing steadily in South Korea. This study aimed to examine the change in consumption of three cancer-related dietary factors—red meat, alcohol, and fruits/vegetables, and to evaluate consumption of these dietary factors among Koreans according to the criteria from the recommendations of the World Cancer Research Fund/American Institute of Cancer Research.

          Methods

          Consumption of red meat, alcoholic beverages, and fruits and vegetables was calculated from the 24-hour recall data of 36,486 individuals older than 20 years who were selected from the Korea National Health and Nutrition Examination Survey 1998–2009. The intake adequacy of these three factors was evaluated by the recommended criteria of the World Cancer Research Fund/American Institute of Cancer Research report.

          Results

          The mean red meat intake in the men in their 20s increased sharply (from 91.6 g to 111.3 g, p < 0.05). The mean alcohol intake increased continuously in men (from 10.3 g to 20.0 g, p < 0.05) and women (from 1.5 g to 3.5 g, p < 0.05). The mean fruit/vegetable intake decreased in the 21–29–year age group (from 349.4 g to 306.7 g in men; from 393.3 g to 292.5 g in women; p < 0.05). The percentage of individuals who did not meet the intake criteria for the three cancer-related dietary factors was especially high, and the percentage increased over 10 years in those in their 20s ( p < 0.05).

          Conclusion

          We confirmed that intakes of red meat, alcoholic drink, and fruits and vegetables have moved toward a negative direction in both men and women in their 20s.

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          Most cited references41

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          Is concordance with World Cancer Research Fund/American Institute for Cancer Research guidelines for cancer prevention related to subsequent risk of cancer? Results from the EPIC study.

          In 2007 the World Cancer Research Fund (WCRF) and the American Institute of Cancer Research (AICR) issued 8 recommendations (plus 2 special recommendations) on diet, physical activity, and weight management for cancer prevention on the basis of the most comprehensive collection of available evidence. We aimed to investigate whether concordance with the WCRF/AICR recommendations was related to cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. The present study included 386,355 EPIC participants from 9 European countries. At recruitment, dietary, anthropometric, and lifestyle information was collected. A score was constructed based on the WCRF/AICR recommendations on weight management, physical activity, foods and drinks that promote weight gain, plant foods, animal foods, alcoholic drinks, and breastfeeding for women; the score range was 0-6 for men and 0-7 for women. Higher scores indicated greater concordance with WCRF/AICR recommendations. The association between the score and cancer risk was estimated by using multivariable Cox regression models. Concordance with the score was significantly associated with decreased risk of cancer. A 1-point increment in the score was associated with a risk reduction of 5% (95% CI: 3%, 7%) for total cancer, 12% (95% CI: 9%, 16%) for colorectal cancer, and 16% (95% CI: 9%, 22%) for stomach cancer. Significant associations were also observed for cancers of the breast, endometrium, lung, kidney, upper aerodigestive tract, liver, and esophagus but not for prostate, ovarian, pancreatic, and bladder cancers. Adherence to the WCRF/AICR recommendations for cancer prevention may lower the risk of developing most types of cancer.
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            Estimating usual food intake distributions by using the multiple source method in the EPIC-Potsdam Calibration Study.

            Estimating usual food intake distributions from short-term quantitative measurements is critical when occasionally or rarely eaten food groups are considered. To overcome this challenge by statistical modeling, the Multiple Source Method (MSM) was developed in 2006. The MSM provides usual food intake distributions from individual short-term estimates by combining the probability and the amount of consumption with incorporation of covariates into the modeling part. Habitual consumption frequency information may be used in 2 ways: first, to distinguish true nonconsumers from occasional nonconsumers in short-term measurements and second, as a covariate in the statistical model. The MSM is therefore able to calculate estimates for occasional nonconsumers. External information on the proportion of nonconsumers of a food can also be handled by the MSM. As a proof-of-concept, we applied the MSM to a data set from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam Calibration Study (2004) comprising 393 participants who completed two 24-h dietary recalls and one FFQ. Usual intake distributions were estimated for 38 food groups with a proportion of nonconsumers > 70% in the 24-h dietary recalls. The intake estimates derived by the MSM corresponded with the observed values such as the group mean. This study shows that the MSM is a useful and applicable statistical technique to estimate usual food intake distributions, if at least 2 repeated measurements per participant are available, even for food groups with a sizeable percentage of nonconsumers.
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              Meta-analysis of soy intake and breast cancer risk.

              High intake of soy foods has been proposed to contribute to the low breast cancer risk in Asian countries. However, results of epidemiologic studies of this association are highly variable, and experimental data suggest that soy constituents can be estrogenic and potentially risk enhancing. Thus, rigorous evaluation of available epidemiologic data is necessary before appropriate recommendations can be made, especially for women at high risk of breast cancer or those who have survived the disease. We performed a meta-analysis of 18 epidemiologic studies (12 case-control and six cohort or nested case-control) published from 1978 through 2004 that examined soy exposure and breast cancer risk. Pooled relative risk estimates were based on either the original soy exposure measure defined in each study or on an estimate of daily soy protein intake. Risk estimates, levels and measures of soy exposure, and control for confounding factors varied considerably across studies. In a pooled analysis, among all women, high soy intake was modestly associated with reduced breast cancer risk (odds ratio [OR] = 0.86, 95% confidence interval [CI] = 0.75 to 0.99); the association was not statistically significant among women in Asian countries (OR = 0.89, 95% CI = 0.71 to 1.12). Among the 10 studies that stratified by menopausal status the inverse association between soy exposure and breast cancer risk was somewhat stronger in premenopausal women (OR = 0.70, 95% CI = 0.58 to 0.85) than in postmenopausal women (OR = 0.77, 95% CI = 0.60 to 0.98); however, eight studies did not provide menopause-specific results, six of which did not support an association. When exposure was analyzed by soy protein intake in grams per day, a statistically significant association with breast cancer risk was seen only among premenopausal women (OR = 0.94, 95% CI = 0.92 to 0.97). Soy intake may be associated with a small reduction in breast cancer risk. However, this result should be interpreted with caution due to potential exposure misclassification, confounding, and lack of a dose response. Given these caveats and results of some experimental studies that suggest adverse effects from soy constituents, recommendations for high-dose isoflavone supplementation to prevent breast cancer or prevent its recurrence are premature.
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                Author and article information

                Contributors
                Journal
                Osong Public Health Res Perspect
                Osong Public Health Res Perspect
                Osong Public Health and Research Perspectives
                Korea Centers for Disease Control and Prevention
                2210-9099
                2233-6052
                05 May 2016
                June 2016
                05 May 2016
                : 7
                : 3
                : 180-189
                Affiliations
                [a ]Department of Food and Nutrition, Seoul National University, Seoul, Korea
                [b ]Research Institute of Human Ecology, Seoul National University, Seoul, Korea
                Author notes
                []Corresponding author. hypaik@ 123456snu.ac.kr
                Article
                S2210-9099(15)30106-5
                10.1016/j.phrp.2016.04.005
                4927666
                27413649
                fb0da024-0561-422e-b3b8-00d5e81c4c50
                Copyright © 2016 Korea Centers for Disease Control and Prevention. Published by Elsevier Korea LLC.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 26 December 2015
                : 17 April 2016
                : 20 April 2016
                Categories
                Original Article

                alcoholic beverages,cancer,fruit,meat,risk factors,vegetables
                alcoholic beverages, cancer, fruit, meat, risk factors, vegetables

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