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Biomedical subjects

A Giacosa

Publications and source records attributed to A Giacosa.

At least 55 records · Page 3Linked to original sources

Vitamin requirements: present recommendations and future prospects.

Dietary recommendations evolved from instructions directed at prevention of starvation diseases to the level of intake of essential nutrients that are adequate to meet the known nutrient needs of practically all healthy persons. Vitamin requirements have been modified various times over the years and there are still differences in recommended intakes in different countries. A debate on optimal vitamin intake is ongoing, based on the concepts of deficiency, sufficiency and hypothetical identification of a range within which a further biological advantage can be expected. In establishing appropriate criteria for food and nutrient intakes, additional studies are warranted on the physiological interactions between nutrients and non-nutrients and on many other factors such as genetic determinants and lifestyle which could interfere with disease prevention.

Adult↗

Chemoprevention of metachronous adenomas of the large bowel: design and interim results of a randomized trial of calcium and fibre. ECP Colon Group.

A European multicentric intervention study, led by the colon group of the European Cancer Prevention Organization, is under way. The main aim of the study is to test the efficacy of oral calcium supplementation with 2 g calcium per day and oral dietary supplementation with mucilaginous substances (as 3.8 g of ispaghula husk) on adenoma recurrence. Secondary aims are the study of treatment efficacy on colonic cell proliferation and on stool bile acid and sterol concentration. Serum and plasma samples are also collected. To better interpret the effect of the intervention, a diet history questionnaire and an aspirin and anti-inflammatory drug questionnaire are administered. The aim will be achieved through a randomized placebo-controlled clinical trial using a parallel design in patients aged 35 to 75 at entry with a complete colonoscopy and a clean colon. Overall, 655 subjects have been included. All randomized patients are followed up every six months for 3 years. If one of the evaluated interventions proves efficient, the benefits of a simple, safe and inexpensive prophylaxy for a very common cancer will be clear.

Adenoma↗

Sources of macro- and micronutrients in Italian women: results from a food frequency questionnaire for cancer studies.

The knowledge of major sources of macro- and micronutrients is essential in order to interpret differences in the diet-cancer link in various geographical areas and to provide better nutritional guidelines. For this purpose we took advantage of the control group of a case-control study on breast cancer carried out in six Italian areas. The dietary habits of 2,588 cancer-free women aged 20-74 years (median age 56) were elicited between 1991 and 1994 by means of an interviewer-administered food frequency questionnaire (FFQ) that included 78 foods or food groups, in addition to several questions on general dietary pattern (e.g., fat in seasoning). Bread was the first contributor for total energy (12%), protein (8%) and starch (32%) intake, whereas, for saturated fatty acid, the first sources were different types of cheese (28%); for monounsaturated fatty acids the dressing oils of salad and tomatoes (12%); and, for sugars, apples and pears (19%). Raw vegetables and fresh fruit represented the most important source of most vitamins. The first contributors of vitamin C and beta-carotene were citrus fruits (29%) and raw carrots (17%), respectively. Thus, between 40 and 80% of specific macronutrient intake and up to 90% intake of several micronutrients were derived from the first ten foods or food groups. Often, the major contributors to the intake of a specific component were foods with a relatively low content, but eaten in large quantities. This work further highlights the specificity of nutrient sources in southern European populations.

Adult↗

Body size indices and breast cancer risk before and after menopause.

The relationship between various body size indices and breast cancer risk before and after menopause was elucidated by means of a case-control study conducted between June 1991 and April 1994 in 6 Italian centers on 2,569 patients aged below 75 with histologically confirmed breast cancer, and on 2,588 controls admitted to the hospital for a wide spectrum of acute, non-neoplastic, non-hormone-related diseases. Weight and, more consistently, body mass index (BMI, kg/m2) at diagnosis were inversely related to pre-menopausal breast cancer risk and directly to post-menopausal risk. An 8-unit increase in BMI resulted in an odds ratio of 0.8 for pre-menopausal and of 1.2 (significant) for post-menopausal women. Risk seemed to increase gradually after menopause in the 7th (OR for an 8-unit BMI increase, 1.3) and 8th decades (OR, 1.6) of life. Conversely, height, waist-to-hip ratio, bra cup size and weight (or BMI) in adolescence and in young adulthood did not exert a significant or consistent influence on breast cancer risk. The apparent relationship with BMI at middle age and weight gain between age 30 years and diagnosis was eliminated by allowance for BMI at diagnosis. The age-related pattern of the association between BMI and breast cancer risk after menopause may reflect a duration-risk relationship, and resembles the effect of post-menopausal estrogen use, which seems greater among older women.

Adult↗

Intake of macronutrients and risk of breast cancer.

BACKGROUND: The association between risk of breast cancer and dietary fat and intakes of other energy sources remains controversial. The Italian population offers special opportunities to assess the influence of high intakes of unsaturated fat and starch and, because the population has low awareness of diet and cancer issues, there is less scope for recall bias. We have assessed the relations of various macronutrient intakes with risk of breast cancer. METHODS: In this case-control study, 2569 women with incident breast cancer (median age 55 years) and 2588 control women (median age 56 years) in hospital with acute, non-neoplastic diseases, were interviewed in six different areas of Italy between 1991 and 1994. A validated food-frequency questionnaire was used. It included questions on 78 foods and recipes grouped into six sections, as well as specific questions on individual fat intake pattern. FINDINGS: The risk of breast cancer decreased with increasing total fat intake (trend p 0.01) whereas the risk increased with increasing intake of available carbohydrates (trend p = 0.002). The odds ratios for women in the highest compared with the lowest quintile of energy-adjusted intake were 0.81 for total fat and 1.30 for available carbohydrates. Starch was the chief contributor to the positive association with available carbohydrates. High intakes of polyunsaturated and unsaturated fatty acids (i.e., polyunsaturated fatty acids plus oleic acid) were associated with a decreased risk of breast cancer (odds ratios for highest vs lowest quintile 0.70 and 0.74, respectively). Conversely, the intakes of saturated fatty acids, protein, and fibre were not significantly associated with breast-cancer risk. INTERPRETATION: This case-controls study shows that unsaturated fatty acids protect against breast cancer, possibly because intake of these nutrients is closely correlated with a high intake of raw vegetables. The findings also suggest a possible risk in southern European populations, of reliance on a diet largely based on starch.

Adult↗

Food intake and body composition in cancer cachexia.

As a complex syndrome, cachexia has different clinical manifestations; anorexia appears to be one of the most frequent findings, together with weight loss. Anorexia is the cause and partly the consequence of metabolic changes and of progressive undernourishment. In cancer cachexia, weight loss is associated with a marked decrease of food intake and severe alteration of body composition. Malnourished cancer patients show a marked loss of adipose tissue and protein mass with BIA evidence of decreased body cell mass and expansion of extracellular water. The mechanisms of anorexia and cachexia are still a matter of debate, but the possible involvement of cytokines in the pathogenesis of this syndrome has opened up new possibilities for its understanding and treatment. As a result of the multifactorial etiology of cancer cachexia/anorexia, therapies that stimulate appetite and promote greater food intake, coupled with factors that influence metabolism and cytokine production may be an optimal therapeutic strategy. Of particular interest appears to be the possible role played by fish oil in antagonizing the negative effects of cytokines. Future research in this field will help clinicians develop new methods to treat patients who have disease-induced starvation and wasting.

Adult↗

Validation of a food-frequency questionnaire to assess dietary intakes in cancer studies in Italy. Results for specific nutrients.

The validity of a 77-item food-frequency questionnaire (FFQ) developed for a multicenter case-control study on diet and cancer in Italy was assessed. Trained interviewers administered the same FFQ to 452 volunteers from three Italian provinces (Pordenone, Genoa, and Forli) completed in two different seasons, at an interval of 3 to 10 months. For 395 (130 males, 265 females; median age = 52 years; range = 35 to 69 years) volunteers, two 7-day dietary (7-DD) records were available. Average intake obtained by means of the FFQ was overestimated by approximately 18% in comparison with the corresponding values based on the two 7-DD records (reference method). Pearson partial correlation coefficients, adjusted for total energy intake between the nutrient intakes assessed by the FFQ and reference method, ranged from 0.19 for vegetable fat to 0.64 for sugar (median value r = 0.46). The unadjusted deattenuated coefficients, which took into account the interindividual variability of consumption, estimated by means of the two 7-DD records, ranged from 0.29 for vegetable fat to 0.72 for starch (median value r = 0.54). The proportion of subjects correctly classified within the lowest two quintiles ranged between 59% for vegetable fat and vitamin E, and 96% for alcohol, and those correctly classified within the highest two quintiles ranged between 44% for vegetable fat and 94% for alcohol. The average proportion of subjects correctly classified within one quintile was 73%. These data indicate that this FFQ provides valid estimates of intakes for major nutrients, comparable to those reported from other studies in North America and other European countries.

Adult↗

Physical activity and breast cancer risk.

Data from a multicentric case-control study on breast cancer conducted in Italy were used to analyze the relationship of occupational and leisure-time physical activity with breast cancer risk. Cases were 2569 histologically confirmed incident breast cancer cases, and controls were 2588 patients admitted to the same network of hospitals of cases for acute, nonneoplastic, nonhormone related diseases. After allowance for major identified potential confounding factors (including an estimate of total calorie intake), the odds ratios (ORs) were 0.70, 0.71, 0.64, and 0.54 in subsequent levels of physical activity at work at ages 30-39, compared to the lowest level. The association was similar for occupational physical activity at ages 15-19 and still apparent at ages 50-59, with risk estimates of 0.86, 0.85, 0.85, and 0.62. The ORs for the highest versus the lowest category of leisure-time physical activity were also below unity (ORs for the highest level of leisure-time physical activity at ages 15-19, 0.95; at ages 30-39, 0.76; and at ages 50-59, 0.66). The protection of physical activity was apparently stronger below age 60 at diagnosis and was consistent across the strata of selected covariates, although the protection was somewhat greater for more educated women.

Adolescent↗

Influence of food groups and food diversity on breast cancer risk in Italy.

Although debate on breast cancer and diet has been concentrated on nutrients, assessment of the role of specific foods and food groups and variety of food intake retains a considerable importance. To further elucidate the role of dietary habits, 2,569 women with incident breast cancer (median age 55 years) and 2,588 control women (median age 56 years), hospitalised with acute non-neoplastic diseases, were interviewed between 1991 and 1994 in 6 different Italian areas. The validated food frequency questionnaire included 79 food items and recipes, which were grouped into 18 food groups (5 for "diversity" analyses purpose). After allowance for non-dietary confounding factors and total energy intake, significant trends of increasing breast cancer risk with increasing intake emerged for the following food groups: bread and cereal dishes, pork and processed meats, and sugar and candies. Conversely, high intake of milk, poultry, fish, raw vegetables, potatoes and coffee and tea seemed to exert a protection against the development of breast cancer. Intake of soups, eggs, other meats, cheese, cooked vegetables, citrus fruits, other fruits and cake and desserts were not significantly related to breast cancer risk. The variety of vegetable types consumed weekly seemed to have a beneficial effect beyond the advantage of high vegetable intake per se.

Breast Neoplasms↗

Olive oil, other dietary fats, and the risk of breast cancer (Italy).

Data from a multicenter case-control study on breast cancer conducted in Italy have been used to analyze the relationship of olive oil and other dietary fats to breast cancer risk. Cases were 2,564 women hospitalized with histologically confirmed, incident breast cancer. Controls were 2,588 women admitted to the same network of hospitals for acute, non-neoplastic, non-hormone related, non-digestive tract disorders. Cases and controls were interviewed between 1991 and 1994 using a validated food-frequency questionnaire. The data were modelled through multiple logistic regression controlling for demographic and reproductive breast-cancer risk factors, energy intake and, mutually, for types of dietary fat. For olive oil, compared with the lowest quintile, the odds ratios (OR) were 1.05, 0.99, 0.93, and 0.87 for increasing quintiles of intake; in a model postulating linear logit increase, the OR per unit (30 g) was 0.89 (95 percent confidence interval [CI] = 0.81-0.99, P = 0.03). Among other oils or fats considered, the OR for the highest level of intake was 0.72 (CI = 0.6-0.9) for a group of specific seed oils (including safflower, maize, peanut, and soya) compared with nonusers. The ORs for the highest cf lowest level of intake were 0.80 for mixed or unspecified seed oils, 0.95 for butter, and 0.96 for margarine. The study, based on a large dataset from various Italian regions, shows an inverse relationship of breast cancer risk with intake of olive oil and other vegetable oils, but not with butter or margarine.

Adult↗

Reproducibility of an Italian food frequency questionnaire for cancer studies. Results for specific nutrients.

The reproducibility of measures of the intake of total energy and 27 selected nutrients from a quantitative food frequency questionnaire (FFQ) used in a case-control study on cancer of the breast, ovary, and digestive tract was evaluated. The results of two FFQ administrations at an interval of 3 to 10 months (median = 5.4 months) to 452 volunteers (144 males and 308 females; median age = 50 years) from three Italian provinces (Pordenone, Genoa, and Forì) were compared. Pearson correlation coefficients (r) between crude nutrient intake (unadjusted for energy) ranged from 0.50 for vegetable fat to 0.80 for alcohol, with most values falling between 0.60 and 0.70 (median r = 0.67). Adjustment of nutrient intakes for total energy slightly decreased most coefficients (median r = 0.60). The agreement between the two measurements did not differ substantially by sex, age, education, and interval between interviews. The contribution of specific FFQ components (i.e., frequency-only questions, open questions, portion size, and fat intake pattern) was also assessed separately with respect to the performance and reproducibility of nutrient measures, yielding, in general, very similar results. The seven questions concerning individual fat intake pattern, which were used to modulate the composition of various recipes, led, however, to a significant increase in mean daily intake of vegetable fat, oleic acid, and vitamin E, but a reduction of estimated daily intake of linoleic acid and polyunsaturated fatty acids.(ABSTRACT TRUNCATED AT 250 WORDS)

Case-Control Studies↗

Chronic gastritis: its clinical and physiopathological meaning.

Chronic gastritis (CG) is the chronic inflammation of gastric mucosa associated with varying degrees of damage of superficial and glandular epithelia. The causes of CG are exogenous (mainly Helicobacter pylori) and endogenous. The process is concluded by atrophy of parenchyma. CG is associated with dyspepsia in approximately 50% of cases, but frequently with gastric and duodenal ulcer. The role of chronic atrophic gastritis (AG) is relevant in development of cancer or of other tumors like carcinoids and polyps. The specific secretive cells of the glandular parenchyma and of the superficial epithelium reveal a good correlation with secretory component behavior, but they are only partially influenced by H. pylori. It emerges that CG is an anatomic-functional condition. The cytofunctional profile in AG causes achlorhydria and therefore chronic luminal alkalosis. This condition favors intestinal metaplasia (IM) and important intraluminal troubles. Finally, nutritional deficiencies or H. pylori seem to interfere with the intragastric metabolism and therefore play a relevant role in the rise of IM.

Atrophy↗

Influence of some covariates on the reproducibility of an Italian semi-quantitative food frequency questionnaire.

We studied the influence of age, sex, education and time between interviews on the reproducibility of a semi-quantitative food frequency questionnaire (FFQ) developed in Italy for a case-control study on cancers of the breast and digestive tract. The questionnaire had been administered twice to 452 Italian men and women and included the weekly consumption of 77 food items or groups of foods, seven summary questions and three questions on some general dietary habits. Spearman correlation coefficients for the 77 dietary items plus the seven summary questions did not differ between males (median 0.61) and females (median 0.58), volunteers younger than 50 years (median 0.58) and aged 50 or more (median 0.59), volunteers with fewer than 10 years of education (median 0.58) and with 10 or more (median 0.59). A slightly higher Spearman correlation coefficient was found when the two interviews were conducted 5-6 months apart (median 0.60) or more than 6 (median 0.59) than when less than 5 (median 0.55). Similarly, Pearson correlation coefficients for the intake of 27 nutrients or micronutrients, plus caloric intake, computed from the FFQ showed no differences between males (median 0.65) and females (median 0.64), two age groups (median 0.67 for subjects aged < 50 years and 0.65 for those aged > or = 50), and two educational levels (median 0.68 for < 10 years and 0.65 for > or = 10 years). The median Pearson correlation coefficient for nutrients was slightly higher for those subjects who were interviewed with the planned interval (5-6 months, median 0.71) than when the interval was shorter (median 0.57) or longer (median 0.64).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗