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Biomedical subjects

R J Hermus

Publications and source records attributed to R J Hermus.

At least 37 records · Page 2Linked to original sources
PubMed1993

A prospective cohort study on selenium status and the risk of lung cancer.

Selenium has been suggested to be anticarcinogenic and to play a role in the cellular defense against oxidative stress. The association between toenail selenium (a marker of long-term selenium status) and lung cancer was investigated in a cohort study of diet and cancer that started in 1986 among 120,852 Dutch men and women aged 55-69 years. After 3.3 years of follow-up, 550 incident cases of lung carcinoma were detected. Toenail selenium data were available for 370 lung cancer cases and 2459 members of a randomly selected subcohort. The rate ratio of lung cancer for subjects in the highest compared to the lowest quintile of toenail selenium, after controlling for age, gender, smoking, and education, was 0.50 (95% confidence interval, 0.30-0.81), with a significant inverse trend across quintiles (P = 0.006). The protective effect of selenium was concentrated in subjects with a relatively low dietary intake of beta-carotene or vitamin C. The rate ratio in the highest compared to the lowest quintile of selenium was 0.45 in the low beta-carotene group (95% confidence interval, 0.22-0.92; trend P = 0.028) and 0.36 in the low vitamin C group (95% confidence interval, 0.17-0.75; trend P < 0.001). The results of this study support an inverse association between selenium status and lung cancer and suggest a modification of the effect of selenium by the antioxidants beta-carotene and vitamin C.

Adenocarcinoma↗
PubMed1993

Cholecystectomy and colorectal cancer: evidence from a cohort study on diet and cancer.

The association between cholecystectomy and subsequent risk for colorectal carcinoma was investigated in a prospective cohort study on diet and cancer (n = 120,852), which is being conducted in the Netherlands from 1986 onwards among 120,852 men and women, aged 55 to 69. After a follow-up period of 3.3 years, 478 incident cases of colorectal cancer (258 men and 220 women) were identified in the cohort, 64 of whom reported at baseline to have undergone previous gall-bladder surgery (21 men and 43 women). After adjustment for age and familial history of large-bowel cancer, the relative rate (RR) for colorectal cancer in subjects who had undergone cholecystectomy compared with those who had not was 1.81 in men (p = 0.02) and 1.47 in women (p = 0.05). Additional adjustment for parity. Quetelet index, alcohol intake and other dietary variables resulted in a RR of 1.78 in men and 1.51 in women. In women, the highest RR was detected in the right colon (RR = 1.89), whereas in men, no site within the large bowel accounted specifically for the increased relative rate. In both men and women, the rate appeared to increase from approximately 6 years after cholecystectomy onward. According to the TNM stage of the disease, cholecystectomized patients were not detected at an earlier stage than the other patients. It is concluded that in this study the positive association between colorectal cancer and cholecystectomy cannot be explained by detection bias or ascertainment bias and is not confounded by risk factors for gallstone disease or dietary factors.

Aged↗
PubMed1993

A prospective cohort study on toenail selenium levels and risk of gastrointestinal cancer.

BACKGROUND: Various animal studies and ecologic studies suggest an inverse association between low dietary selenium intake and risk of various types of cancer. PURPOSE: The goal of this prospective cohort study was to investigate the association between toenail selenium levels and risks of stomach cancer and colorectal cancer. METHODS: Our cohort study on diet and cancer started in The Netherlands in 1986 with enrollment of 120,852 subjects aged 55-69 years. Of this number, 58,279 were men and 62,573 were women. Following the case-cohort approach for analysis of the data, we randomly selected from the cohort a subcohort of 3500 subjects (1688 men and 1812 women). After 3.3 years of follow-up, 155 incident cases of microscopically confirmed stomach cancer, 313 cases of colon cancer, and 166 cases of rectal cancer had been detected in the cohort. Toenail selenium data were available for 104 patients with stomach cancer, 234 with colon cancer, and 113 with rectal cancer and for 2459 subjects from the subcohort. RESULTS: In a multivariate analysis, the relative rates (RRs) of stomach cancer for subjects in increasing quintiles of toenail selenium level were 1.00, 0.44, 0.59, 0.84, and 0.64 (trend, P = .491). For men, there was some evidence for an inverse association between toenail selenium levels and stomach cancer: The RR for those in the highest compared with the lowest quintile of toenail selenium was 0.40 (95% confidence interval = 0.17-0.96), but the trend was not statistically significant (P = .136). For stomach cancer in women, there was no negative association with toenail selenium levels. Toenail selenium level was not associated with the risk of colon or rectal cancer. After exclusion of cases diagnosed in the 1st year of follow-up, the RRs of colon cancer for increasing quintiles of toenail selenium were 1.00, 1.27, 1.17, 0.75, and 1.07 (trend, P = .544); for rectal cancer, RR estimates were 1.00, 1.73, 0.83, 1.58, and 1.12 (trend, P = .890). CONCLUSIONS: These data support a suggestive but inconsistent inverse association between selenium levels and risk of stomach cancer. Our findings, like those of other studies, do not suggest an inverse association with risk of colorectal cancer.

Aged↗
PubMed1993

A prospective cohort study on dietary fat and the risk of postmenopausal breast cancer.

In 1986 a prospective cohort study on diet and cancer was started in the Netherlands among 62,573 women ages 55-69 years. Baseline information on diet and other risk factors was collected with a questionnaire. Cancer incidence was measured by record linkage with cancer registries and a pathology register. A case-cohort approach was used, in which the accumulated person time in the cohort was estimated by follow-up of a randomly selected subcohort (n = 1812). After 3.3 years of follow-up, 471 incident breast cancer cases were available for analysis. Questionnaire data for these cases and the 1716 female subcohort members without a history of cancer other than skin cancer were analyzed. In a multivariate analysis, controlling for traditional risk factors, the relative rates for breast cancer in increasing quintiles of energy-adjusted total fat intake were 1.00, 1.00, 1.34, 1.22, 1.08 (P-trend, 0.32). For saturated fat there was some evidence for a weak positive association when quintiles were used (relative rates in quintiles 1-5, 1.00, 1.22, 1.22, 1.38, 1.39; P-trend, 0.049). The 95% confidence interval (CI) for the top quintile was 0.94-2.06, however; and when saturated fat was used as a continuous variable, the effect was no longer significant (P = 0.20). Relative rate estimates for the highest versus lowest quintiles of monounsaturated fat, polyunsaturated fat, and cholesterol intake were 0.75 (95% CI, 0.50-1.12), 0.95 (95% CI, 0.64-1.40) and 1.09 (95% CI, 0.74-1.61), respectively, with no evidence for significant trends. This prospective study does not support a major role of dietary fat in the etiology of postmenopausal breast cancer.

Aged↗
PubMed1993

Garlic and its significance for the prevention of cancer in humans: a critical view.

Recently published results of epidemiologic case-control studies in China and Italy on gastric carcinoma in relation to diet suggest that consuming garlic may reduce the risk of gastric cancer. Chemical constituents of garlic have been tested for their inhibiting effect on carcinogenesis, using in vitro and in vivo models. In most experiments inhibition of tumour growth was established using fresh garlic extract, garlic compounds or synthetically prepared analogs. In this review the strengths and weaknesses of the experiments are discussed and the outcomes are evaluated to assess the possible significance of garlic or garlic compounds for the prevention of cancer in humans. It is concluded that evidence from laboratory experiments and epidemiologic studies is presently not conclusive as to the preventive activity of garlic. However, the available evidence warrants further research into the possible role of garlic in the prevention of cancer in humans.

Antineoplastic Agents↗
PubMed1993

A continuous in vitro method for estimation of the bioavailability of minerals and trace elements in foods: application to breads varying in phytic acid content.

A continuous in vitro method for the estimation of the bioavailability of minerals and trace elements is presented. This in vitro method is believed to be more representative of in vivo physiological conditions than in vitro methods based on equilibrium dialysis, because dialysable components are continuously removed from the pancreatic digestion mixture. The continuous in vitro method is compared with the equilibrium in vitro method with respect to the dialysability of Ca, Mg, Fe, Cu and Zn from eight different types of bread (varying in phytic acid content). The results show a pronounced effect of continuous removal of dialysable components from the pancreatic digestion mixture on the dialysability of minerals and trace elements. Furthermore, removal of dialysable components influences the effect of phytic acid on the bioavailability of minerals and trace elements. For these two reasons the importance of removal of dialysable components in vitro for the estimation of bioavailability in vivo needs further investigation. The bioavailability of minerals and trace elements from bread samples is not related to the phytic acid content only. Therefore, the effect of phytic acid on the bioavailability of minerals and trace elements cannot be studied separately from the effects of other components on bioavailability.

Bread↗
PubMed1993

Comparison of dietary intake data with guidelines: some potential pitfalls (Dutch nutrition surveillance System).

In evaluating dietary data with reference to guidelines for a healthy diet, some potential pitfalls (i.e., method of food consumption assessment and calculation to include or exclude energy derived from alcohol) were investigated. The percentage of energy intake (en%) derived from total fat, saturated fatty acids (SFA), mono- and disaccharides (MD) and intake of cholesterol and dietary fiber per megajoule were calculated using 2-day records obtained in the Dutch National Food Consumption Survey of 1987-1988. Subjects (aged 4-85, n = 5595) were classified into age-sex groups. Mean values and intake distributions were calculated with and without adjustment for within-person variation. Except for the intake of cholesterol and MD, mean intake levels were not in accord with guidelines. About 20% of the women and 23% of the men met the goal for fat intake, 20% of the men and 27% of the women for dietary fiber, and about 60 and 70% for MD and cholesterol. Only 3% of subjects had SFA intake < or = 10 en%, whereas < 1% had a diet in accord with all criteria studied. After adjustment for within-person variation, percentages meeting the guidelines were generally lower for fat, SFA and dietary fiber and slightly higher for cholesterol and MD. Among elderly, unadjusted results were more in agreement with the prevalence estimates based on habitual dietary intake data than with adjusted ones. Fat intake (en%) was inversely related with intake of added MD and alcohol. Our data indicate that guidelines should state explicitly whether energy-related recommendations include energy derived from alcohol, and that the prevalence of a high-fat intake is more affected by the calculation method than by food consumption assessment.

Adolescent↗
PubMed1993

Bile acids and pH values in total feces and in fecal water from habitually omnivorous and vegetarian subjects.

Twenty habitually omnivorous subjects and 19 habitually lactoovovegetarian subjects aged 59-65 y collected feces during 4 consecutive days. The concentrations of bile acids in total feces did not differ between the omnivores and vegetarians, but the bile acid concentrations in fecal water were significantly lower in the vegetarians. The concentration of the colorectal cancer-predicting bile acid deoxycholic acid in fecal water was explained by the intake of saturated fat and the daily fecal wet weight (r2 = 0.50). Fecal pH did not differ between the omnivores and vegetarians. This variable was significantly (P < 0.05) explained by the intake of calcium (r2 = 0.30); 24-h fecal wet weight and defecation frequency were significantly higher in the vegetarians. In conclusion, our vegetarian subjects had a lower concentration of deoxycholic acid in fecal water, higher fecal wet weight, and higher defecation frequency than the omnivorous subjects.

Aged↗
PubMed1993

The use of vitamins, minerals and other dietary supplements in The Netherlands.

By means of a two-day dietary record, information on the use of dietary supplements has been collected in 1987 and 1988 in a representative sample of the Dutch population aged 1-75 years. More than 17 percent of the population had been using at least one dietary supplement on at least one day of the survey. Age, sex, season, social class, alternative food habits, smoking and diet were related to the use of supplements. In young persons mainly fluoride and vitamin AD preparations were used, while a shift towards other supplements, like garlic and brewer's yeast preparations, was observed as age progresses. The use of single vitamin C supplements was not related to the level of mean daily vitamin C intake by food consumption.

Adolescent↗
PubMed1992

Beta-carotene supplementation in smokers reduces the frequency of micronuclei in sputum.

beta-carotene has been hypothesised to reduce lung cancer risk. We studied the effect of 14 weeks of beta-carotene supplementation (20 mg d-1) on the frequency of micronuclei in sputum in 114 heavy smokers in a double-blind trial. Micronuclei reflect DNA damage in exfoliated cells and may thus provide a marker of early-stage carcinogenesis. Pre-treatment blood levels of cotinine, beta-carotene, retinol and vitamins C and E were similar in the placebo group (n = 61) and the treatment group (n = 53). Plasma beta-carotene levels increased 13-fold in the treatment group during intervention. Initial micronuclei counts (per 3,000 cells) were higher in the treatment group than in the placebo group (5.0 vs 4.0, P < 0.05). During intervention, the treatment group showed a 47% decrease, whereas the placebo group showed a non-significant decrease (16%). After adjustment for the initial levels, the treatment group had 27% lower micronuclei counts than the placebo group at the end of the trial (95% CI: 9-41%). These results indicate that beta-carotene may reduce lung cancer risk in man by preventing DNA damage in early-stage carcinogenesis.

Adult↗
PubMed1992

Clustering of dietary variables and other lifestyle factors (Dutch Nutritional Surveillance System).

STUDY OBJECTIVE: The aim was to investigate whether dietary factors cluster in a favourable or unfavourable way and to characterise the groups identified by lifestyle and sociodemographic variables. DESIGN AND SETTING: This cross sectional study was based on data of the 1987-1988 Dutch national food consumption survey (DNFCS), obtained from a panel by a stratified probability sample of the non-institutionalised Dutch population. PARTICIPANTS: 3781 adults (1802 males and 1979 females) of the DNFCS, aged 19 to 85 years, were studied. MEASUREMENTS AND MAIN RESULTS: To estimate dietary intake two day food records were used. Lifestyle factors were collected by structured questionnaire and sociodemographic variables were available from panel information. Cluster analysis was used to classify subjects into groups based on similarities in dietary variables. Subsequently, these groups were characterised by sociodemographic and lifestyle factors as well as by the consumption of food groups. Eight clusters were found. In comparison with the guidelines, the dietary quality in four clusters was poor. The cluster with the poorest dietary intake (high intake of fat, cholesterol, and alcohol; low intake of dietary fibre) showed on average a high consumption of animal products (except milk), fats and oils, snacks, and alcoholic beverages, and a low consumption of fruit, potatoes, vegetables, and sugar rich products. Smoking, body mass index, dietary regimen on own initiative, hours of sleep, gender, age, socioeconomic status, and day of the week were found to discriminate among the clusters. CONCLUSIONS: Cluster analysis resulted in substantial differences in mean nutrient intake and seems useful for dietary risk group identification. Undesirable lifestyle habits were interrelated in some clusters, but an exclusive lifestyle for health risk has not been found.

Adolescent↗
PubMed1991

Combination of dietary factors in relation to breast-cancer occurrence.

Combinations of dietary factors were studied in relation to breast-cancer occurrence among 133 breast cancer cases and 289 population controls in The Netherlands. Dietary factors were classified according to their possible mechanism of action, i.e., relating either to the intestinal microflora (total fat, fiber, fermented milk products) or to the anti-oxidant hypothesis (beta-carotene, selenium and polyunsaturated fatty acids). From 6 interactions evaluated, the combination of high fiber intake and high intake of fermented milk products was the only one suggesting synergistic protection (age-and-fat-adjusted OR for interaction = 0.48, 95% confidence interval (CI) = 0.21 - 1.13). In order to estimate the extent to which the above dietary factors together might be related to breast cancer, subjects with a supposedly favorable dietary pattern (low fat intake, high fiber intake, high intake of fermented milk products; high intake of beta-carotene and selenium, low intake of polyunsaturated fatty acids) were compared with subjects with an unfavorable dietary pattern. This resulted in an age-adjusted odds ratio of 0.40 (95% CI = 0.14 - 1.15), which was largely attributable to the combination of low intake of fat and high intake of fermented milk products and fiber (age-adjusted OR = 0.33, 95% CI = 0.15 - 0.73). The other factors did not appreciably affect the odds ratio. These analyses show in a quantitative way that a dietary pattern which combines low intake of fat and high intake of fiber and fermented milk products might provide substantial protection against breast cancer.

Adult↗
PubMed1991

Diet and other life-style factors in high and low socio-economic groups (Dutch Nutrition Surveillance System).

Insight into the occurrence of and the association between certain socio-economic variables and life-style characteristics is necessary for preventive nutrition and health policy. The prevalence of and the interdependencies among these variables were examined in 1930 men and 2204 women aged 19 to 85 who participated in the Dutch National Food Consumption Survey 1987-1988. Dietary data were based on a two-day record. The associations among discrete variables were analysed using log-linear models. Analysis of covariance was used to explore the effects of the aggregate socio-economic status (SES) on dietary intake and anthropometry, whereas differences in food intake and SES were assessed by the non-parametric test of Kruskal and Wallis. In comparison to subjects with a high SES in people with a low SES a higher proportion of smokers (48 vs 32 per cent) was observed, a higher prevalence of obesity (39 vs 28 per cent), a higher percentage of heavy coffee drinkers (greater than six cups per day, 23 vs 17 per cent), and more subjects who skipped breakfast (19 vs 11 per cent). In the highest SES class more subjects used nutritional supplements (18 vs 11 per cent), more subjects followed a dietary rule (five vs two per cent), such as a vegetarian diet, and a higher proportion used more than three alcoholic drinks per day (19 vs 15 per cent). A higher SES was associated with a lower fat intake, but the differences (expressed as per cent of energy intake) were rather small and even absent among women when the contribution of alcohol to energy was not taken into account. In general, dietary intake among subjects in higher SES groups tended to be closer to dietary recommendations. The results indicate that a lower SES is accompanied by a higher prevalence of several indicators of an unhealthy life-style.

Adult↗
PubMed1990

Dietary fiber, beta-carotene and breast cancer: results from a case-control study.

To study the association between dietary fiber, beta-carotene and breast cancer, the average daily intake of these dietary components was compared among 133 incident breast cancer cases and 238 population controls. Average daily intake of cereal products, fruit and vegetables was also studied. A statistically significant lower energy-adjusted intake of dietary fiber was observed in cases than in controls (mean +/- SD: 25.4 +/- 6.7 g vs. 27.7 +/- 7.4 g, 95% confidence interval (CI) of the age-adjusted difference = -3.8, -0.8). Intake of beta-carotene was similar for cases and controls. The multivariate adjusted odds ratio (OR) of breast cancer among women in the highest quartile of intake of cereal products, as compared to those in the lowest quartile, was 0.42 (95% CI = 0.19-0.92) and the trend was statistically significant (p = 0.03). The corresponding OR for intake of dietary fiber was 0.55 (95% CI = 0.26-1.17) but the trend was not significant. The OR for the highest quartile of intake of beta-carotene, fruit, vegetables, and all vegetable products combined was less than unity, but there was no significant inverse trend. These results suggest that a high intake of cereal products, especially those rich in fiber, may be inversely related to incidence of breast cancer.

Age Factors↗