Cancer Supplements

1.
BMJ Open. 2019 Jun 21;9(6):e029160. doi: 10.1136/bmjopen-2019-029160.
Unmet care needs of community-dwelling stroke survivors: a protocol for systematic review and theme analysis of quantitative and qualitative studies.
Lin B#1, Ding C#1, Mei Y1, Wang P1, Ma F2, Zhang ZX1.
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Abstract
INTRODUCTION:
Stroke is a leading cause of disability worldwide. The average hospital length of stay ranges from 3 to 28 days, and after discharge home the stroke survivors will live with physical, cognitive, even psychological disorders for the rest of their lives. It is essential to review the unmet needs of stroke survivors.

METHODS AND ANALYSIS:
A systematic review of previous quantitative and qualitative studies reporting the unmet needs of stroke survivors in their homes will be conducted. The following six databases will be searched from inception to December 2018 for relevant articles: PubMed, EMBASE, CINAHL, PsycINFO, SCOPUS and China Biology Medicine. We will include studies limited to human and published in English or Chinese, and the patients with stroke should discharge home rather than any other professional organisations including nursing homes or community rehabilitation units and so on. Data of quantitative research will be standardised for comparison, thematic analysis will be used for qualitative data and a narrative synthesis and pooled analysis of the main outcomes will be reported.

ETHICS AND DISSEMINATION:
This review will be submitted to an international professional journal, and the detailed search strategies and analysis flowchart will be openly included as supplements. This study does not require ethical approval as no patient's identifiable data will be used. Our findings will give a new look at the aspect of stroke survivors' unmet needs in their long-term recovery stage, especially the trajectories of unmet needs at different timepoints. What is more, this review will demonstrate the long-term unmet needs of stroke survivors from different countries, will compare any variations between high-income and low-income regions, and the geographical differences of needs will be mapped if necessary. We will endeavour to provide as much information as possible to healthcare professionals and public health policy makers in order to promote further medical reform.

TRIAL REGISTRATION NUMBER:
CRD42018112181.

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

KEYWORDS:
community-dwelling; home; stroke; systematic review; unmet needs

PMID: 31230030 DOI: 10.1136/bmjopen-2019-029160
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2.
JAMA Netw Open. 2019 Jun 5;2(6):e195967. doi: 10.1001/jamanetworkopen.2019.5967.
Estimation of Total Usual Dietary Intakes of Pregnant Women in the United States.
Bailey RL1, Pac SG2, Fulgoni VL 3rd3, Reidy KC2, Catalano PM4.
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Abstract
IMPORTANCE:
Nutrition during pregnancy is a critical dimension not only for women's health but also for the lifelong health of the offspring. Very limited national data exist on the usual dietary intakes of pregnant women.

OBJECTIVE:
To estimate total usual nutrient intakes (from foods and dietary supplements) and the population prevalence of meeting or exceeding the National Academies of Sciences, Engineering, and Medicine Dietary Reference Intake recommendations among pregnant US women.

DESIGN, SETTING, AND PARTICIPANTS:
A cross-sectional analysis was performed of a nationally representative sample of 1003 pregnant US women aged 20 to 40 years from the 2001-2014 National Health and Nutrition Examination Survey.

EXPOSURE:
Usual dietary intakes assessed by two 24-hour dietary recalls (including dietary supplements) adjusted for within-person variation using the National Cancer Institute method.

MAIN OUTCOMES AND MEASURES:
The proportion of women at risk of inadequate dietary intake as determined by the Estimated Average Requirement, the proportion of women assumed to have adequate dietary intake as determined by the Adequate Intake, and the proportion of women at risk of excess dietary intake as determined by the Tolerable Upper Intake Level. Demographic differences between pregnant and nonpregnant women were compared with t tests.

RESULTS:
As representative of the US population, this sample of 1003 pregnant women had a mean (SE) age of 28.0 (0.3) years, was predominantly non-Hispanic white (mean [SE], 54.5% [3.1%]), and was at above 185% of the income to poverty ratio (mean [SE], 56.8% [3.0%]). Most pregnant women used a dietary supplement (mean [SE], 69.8% [2.3%]). A total of 10% or more of pregnant women had a total usual intake that is less than the Estimated Average Requirement for magnesium (mean [SE], 47.5% [2.8%]), vitamin D (mean [SE], 46.4% [2.7%]), vitamin E (mean [SE], 43.3% [2.7%]), iron (mean [SE], 36.2% [2.8%]), vitamin A (mean [SE], 15.5% [2.1%]), folate (mean [SE], 16.4% [1.6%]), calcium (mean [SE], 12.9% [2.4%]), vitamin C (mean [SE], 11.5% [1.9%]), vitamin B6 (mean [SE], 11.5% [1.5%]), and zinc (mean [SE], 10.9% [1.9%]). Some pregnant women exceeded the Adequate Intake for potassium (mean [SE], 41.7% [2.9%]), choline (mean [SE], 7.9% [3.2%]), and vitamin K (mean [SE], 47.9% [4.3%]). Most women exceeded the Tolerable Upper Intake Level for sodium (mean [SE], 95.0% [2.2%]), and some women exceeded the Tolerable Upper Intake Level of folic acid (mean [SE], 33.4% [2.8%]), iron (mean [SE], 27.9% [2.8%]), calcium (mean [SE], 3.0% [0.8%]), and zinc (mean [SE], 7.1% [1.6%]). For iron, the prevalence of an at-risk intake from foods alone was lower among women who used supplements (mean [SE], 80.3% [4.3%]) than those who did not use supplements (mean [SE], 95.3% [7.3%]); however, supplement use increased the risk of excessive iron and folic acid intakes given the amounts that are being consumed from supplemental products.

CONCLUSIONS AND RELEVANCE:
This study suggests that a significant number of pregnant women are not meeting recommendations for vitamins D, C, A, B6, K, and E, as well as folate, choline, iron, calcium, potassium, magnesium, and zinc even with the use of dietary supplements. Almost all pregnant women in this study were at risk of excessive consumption of sodium, and many were at risk of excessive consumption of folic acid and iron. Improved dietary guidance to help pregnant women meet but not exceed dietary recommendations is warranted.

PMID: 31225890 DOI: 10.1001/jamanetworkopen.2019.5967
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3.
Curr Dev Nutr. 2019 Jun 13;3(Suppl 1). pii: nzz039.OR14-07-19. doi: 10.1093/cdn/nzz039.OR14-07-19. eCollection 2019 Jun.
Dietary Supplements Contributed Substantially to Total Intakes and Nutritional Adequacy of Several Micronutrients Among U.S. Adults, NHANES 2011-2014 (OR14-07-19).
Cowan A1, Jun S1, Bhadra A1, Dodd K2, Dwyer J3, Eicher-Miller H4, Gahche J3, Potischman N3, Tooze J5, Bailey R1.
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Abstract
OBJECTIVES:
To estimate total mean usual micronutrient intakes (inclusive of dietary supplements (DS)), Dietary Reference Intakes (DRI) adherence, and the % contribution of DS to total usual micronutrient intakes for U.S. adults (≥19y) using data from the 2011-2014 National Health and Nutrition Examination Survey (NHANES, n = 9474), by sex, age, and race and Hispanic origin groupings.

METHODS:
Dietary data were collected using two 24-hour recalls; DS data was collected via an in-home 30-day questionnaire that ascertained participants' usage in the past 30 days. The National Cancer Institute Method was used to estimate mean total usual micronutrient intakes and the proportion of the population complying with DRI by population subgroups: sex, age, and race and Hispanic origin.

RESULTS:
DS contributed substantially to meeting the DRI recommendations for several key nutrients, including calcium, magnesium, folate, zinc, and vitamins C, D, B6, and K in both men and women. However, approximately half of U.S. adults still failed to meet the estimated average requirement (EAR) for magnesium (45%), and vitamins C (35%), K (45%), and D (63%), even with the inclusion of DS. The proportion of total usual intakes < EAR was significantly higher in men than women for magnesium (46 v 42%) and vitamins C (39 v 32%), and D (66 v 59%). In both men and women, total intakes of folate, zinc, and vitamins A, D, and B12 increased with age. Vitamin D from DS contributed the most towards total intake for most sex and age groups, with the largest contribution being in older women (84%). Non-Hispanic (NH) Blacks and Hispanics had significantly lower total intake of vitamin D than those of NH Whites and Asians, while NH Whites and Hispanics had significantly higher total intakes of calcium than their NH Black and Asian counterparts.

CONCLUSIONS:
Adherence to DRI recommendations for nutrient intake differs significantly by sex, race and other demographic characteristics. Dietary supplements substantially contribute to total intakes for several micronutrients among users; however, many population subgroups continue to be at risk for inadequacy for key nutrients.

FUNDING SOURCES:
This work was supported through the National Institutes of Health.

PMID: 31225063 PMCID: PMC6577327 DOI: 10.1093/cdn/nzz039.OR14-07-19
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4.
Curr Dev Nutr. 2019 Jun 13;3(Suppl 1). pii: nzz036.P13-034-19. doi: 10.1093/cdn/nzz036.P13-034-19. eCollection 2019 Jun.
Operationalizing the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Cancer Prevention Recommendations: A Standardized Scoring System (P13-034-19).
Shams-White M1, Bender A2, Brockton N2, Brown S3, Kahle L4, Mitrou P3, Romaguera D5, Subar A6, Reedy J6.
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Abstract
OBJECTIVES:
To develop a standardized AICR/WCRF Score that measures adherence to the 2018 WCRF/AICR Cancer Prevention Recommendations and provide guidance for its application in research.

METHODS:
Each of the updated 2018 WCRF/AICR Cancer Prevention Recommendations and the associated goals and statements of advice were examined to inform the definition of a new Score. For each of the weight, physical activity, diet, and breastfeeding-specific recommendations, components and subcomponents were created. Standards for scoring each component were established based on quantitative guidance specified in the recommendations; however, if no specificity was provided, other guidelines (e.g., national guidelines), past research that operationalized 2007 WCRF/AICR recommendations, and expert panel advice were evaluated.

RESULTS:
The proposed AICR/WCRF Score includes eight of the ten WCRF/AICR 2018 recommendations: 1) Be a healthy weight, 2) Be physically active, 3) Eat a diet rich in whole grains, vegetables, fruits, and beans, 4) Limit consumption of fast foods and other processed foods high in fat, starches, or sugars, 5) Limit consumption of red and processed meats, 6) Limit consumption of sugar-sweetened beverages, 7) Limit alcohol consumption, and, optionally, 8) For mothers: breastfeed your baby, if you can. Each of the components are worth one point: 1, 0.5, and 0 points for fully, partially, and not meeting the recommendations, respectively (total Score: 0-7 or 8 points). Two recommendations were not included in the Score due to uncertain intent of supplement use (Do not use supplements for cancer prevention) and the redundancy of the dependent components in the final recommendation (After a cancer diagnosis: follow our Recommendations, if you can). Additional guidance will stress the importance of taking into account other risk factors, such as smoking, in relevant models using the new Score.

CONCLUSIONS:
The AICR/WCRF Score is a practical tool operationalizing the 2018 recommendations. Future studies are needed to further examine how adherence to the Score relates to cancer risk and mortality in various populations.

FUNDING SOURCES:
None.

PMID: 31224897 PMCID: PMC6575084 DOI: 10.1093/cdn/nzz036.P13-034-19
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5.
Curr Dev Nutr. 2019 Jun 13;3(Suppl 1). pii: nzz035.P12-040-19. doi: 10.1093/cdn/nzz035.P12-040-19. eCollection 2019 Jun.
Iron Supplementation Necessities for Subjects with Celiac Disease in KSA -A Retrospective Study (P12-040-19).
Sudersanadas K1, Hamdy EM2, Hazazi KA2, Alanazi MG2, Altheyabi N2, Philip W2, Alkhormi AM3.
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Abstract
OBJECTIVES:
To assess the iron (Fe) supplementation necessities for subjects with celiac disease (CD) in KSA.

METHODS:
The study was conducted among the subjects with CD registered in King Abdulaziz Medical City (KAMC), KSA for medical care during 2008-18. Those who are pregnant/lactating or with blood loss due to non-CD causes/gastrointestinal (GI) abnormalities/chronic disease of liver/kidney/febrile diseases/cancer/metabolic disorders were excluded from the study. The design of the study was retrospective cross-sectional. The data of the subjects with CD entered in the Hospital Information system of KAMC was used. Accordingly, 71 subjects with CD were selected by using convenient sampling technique.Demography, clinical manifestations, hematological and Fe profile of the subjects were studied. SPSS Version 22 was used for data analysis. Frequencies, percentages and mean + SD, Student's t and non-parametric Mann-Whitney U tests were used. P-value of <0.05 considered as statistically significant. IRB of KAIMRC, Riyadh approved the study.

RESULTS:
Adults formed 54.8% of the subjects, children and females formed 31% and 78.9% respectively. Diarrhea and vomiting were the major clinical manifestations observed among 55% of the subjects. Anthropometric data indicated that 38.3% of them was malnourished. Reduced RBC counts perceived among 40.1% of the subjects. Among them, 88.23% were females while 18.3% were with low WBC count. Platelet counts < normal were exhibited by 12.7%. MCV, MCHC, and Hematocrit (HCT) values were lower congruently for 16.9, 69 and 41% (66.66% were females) of the subjects. Iron Deficiency Anemia (IDA) pointed out by low hemoglobin (Hb) level was observed in 38.02%. Of them, 88.19% were females. Abridged Serum iron was detected in 67.59% (85.41% are females) while increased TIBC values were shown by 22.9%. Of the subjects (22.53%) with low serum ferritin(SF) values 68.75% were females. There was a significant difference between the values of RBC count, MCV, MCHC, HCT, Hb and SF levels of both genders.

CONCLUSIONS:
The study signifies the importance of the provision of Fe supplements for subjects with CD. Females more than the males with CD are at risk for IDA.

FUNDING SOURCES:
NIL.

SUPPORTING TABLES IMAGES AND/OR GRAPHS:
PMID: 31224868 PMCID: PMC6575055 DOI: 10.1093/cdn/nzz035.P12-040-19
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6.
Curr Dev Nutr. 2019 Jun 13;3(Suppl 1). pii: nzz036.P13-017-19. doi: 10.1093/cdn/nzz036.P13-017-19. eCollection 2019 Jun.
A Change-point Regression Approach for Efficacy Evaluation of Dietary Supplements (P13-017-19).
Hayamizu K1, Yamashita N2, Hattori S3, Kakuma T4.
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Abstract
OBJECTIVES:
In clinical trials for dietary supplements and functional foods, the study population tends to be a mixture of healthy subjects and those who are not so healthy but are not definitely diseased (called "borderline subjects"). For such heterogeneous populations, the t-test and ANCOVA method often fail to provide the desired treatment efficacy. We propose an alternative approach for the efficacy evaluation of dietary supplements and functional foods based on a change-point linear regression model.

METHODS:
Suppose we are interested in analyzing data from a randomized controlled clinical trial of dietary supplements which was conducted under what is called pre-post design. We propose the change-point regression model (CPRM) as new analysis method. The model does not require the assumption of a constant treatment effect and provides clinically interpretable results. By employing the AIC-based profile likelihood method, inferences can be made easily using standard statistical software.

RESULTS:
CPRM method was applied to (-)-hydroxycitric acid (HCA) study data, and the merit of the method was demonstrated by comparing it with traditional methods those are ANCOVA or t-test. The AICs of CPRM, ANCOVA and t-test were 667.2, 685.9 and 685.0 respectively. Therefore, CPRM is well fit than traditional methods. Advantage of CPRM is that it can simultaneously provide information on effect appearance points and we succeeded estimation of the point in (-)-HCA study.

CONCLUSIONS:
We propose an alternative approach for the efficacy evaluation of dietary supplements and functional foods based on a CPRM. By employing the AIC-based profile likelihood method, inferences can be made easily using standard statistical software. The proposed method was applied to the Garcinia study data, and the merit of the method was demonstrated by comparing it with the ANCOVA models.

FUNDING SOURCES:
This research did not received any specific grant from funding agencies in the public. commercial, or not for-profit sectors.

PMID: 31224551 PMCID: PMC6574734 DOI: 10.1093/cdn/nzz036.P13-017-19
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7.
Curr Dev Nutr. 2019 Jun 13;3(Suppl 1). pii: nzz030.P05-011-19. doi: 10.1093/cdn/nzz030.P05-011-19. eCollection 2019 Jun.
Iron Supplements and Oncogenic Effects in Human Intestinal Cells (P05-011-19).
Scheers N1.
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Abstract
OBJECTIVES:
We have previously shown that different iron supplements affect mechanisms for cell growth and viability in different ways and specifically we observed that two common iron supplements/fortificants, ferric citrate and ferric EDTA, promoted induction of the oncogenic growth factor Amphiregulin whilst ferrous sulfate did not. This difference is important and raises the question if some iron compounds should not be used as dietary supplements or for iron fortification of foods.

METHODS:
Therefore, we have been screening iron compounds on the safe list of the European Food Safety Authority (EFSA) using human intestinal cell lines (Hutu-80 and Caco-2) and a proteomic immunoassay for 92 known markers related to cancer.

RESULTS:
Preliminary data show that a few more iron compounds, than the previously observed, have oncogenic properties and that amphiregulin protein levels are up-regulated.

CONCLUSIONS:
These properties need further investigation and translation into the in vivo situation to evaluate if these iron compounds should be avoided as dietary supplements.

FUNDING SOURCES:
FORMAS.

PMID: 31224371 PMCID: PMC6574554 DOI: 10.1093/cdn/nzz030.P05-011-19
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8.
Curr Dev Nutr. 2019 Jun 13;3(Suppl 1). pii: nzz028.P01-001-19. doi: 10.1093/cdn/nzz028.P01-001-19. eCollection 2019 Jun.
Nutritional Status of Older Adults Who Are Overweight or Obese Compared to Those with a Healthy Weight, NHANES 2011-2014 (P01-001-19).
Jun S1, Cowan A1, Bhadra A1, Dodd K2, Dwyer J3, Eicher-Miller H4, Gahche J3, Guenther P5, Potischman N3, Tooze J6, Bailey R1.
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Abstract
OBJECTIVES:
The purpose was to evaluate nutritional status, food security, and related health factors of older adults who were overweight or obese compared to those with a healthy weight.

METHODS:
Data from 2969 adults aged ≥60 years from NHANES 2011-2014 were analyzed. Participants were categorized by sex and body weight status as healthy weight (body mass index (BMI, kg/m2) 18.5-24.9), overweight (BMI 25-29.9), or obese (BMI ≥ 30); underweight individuals were excluded. Healthy Eating Index (HEI)-2015 scores and total usual micronutrient intakes from foods and dietary supplements were estimated using two 24-hour dietary recalls and the National Cancer Institute method. Nutritional biomarkers, including serum vitamin D, vitamin B-12, and methylmalonic acid, and cardiometabolic risk factors were also assessed.

RESULTS:
A substantial proportion of older adults (>30%) had intakes below Estimated Average Requirements (EAR) for calcium, magnesium, and vitamins C and D even with dietary supplements. Men and women with obesity had a higher prevalence of usual magnesium intakes <EAR compared to those with a healthy weight; among women only, the same was true for calcium, vitamins B-6 and D. Both men and women with obesity had significantly lower HEI-2015 scores than those with a healthy weight. The proportion of those with serum 25-hydroxyvitamin D < 40 nmol/L was higher in women with obesity (12%) than in women with a healthy weight (6%). Men and women who were overweight or obese were more likely to self-report fair/poor health, use ≥5 medications, and have cardiometabolic risk factors, including elevated blood pressure, triglycerides, and fasting blood glucose, and reduced high-density lipoprotein cholesterol, compared to individuals with a healthy weight. Women with obesity were more likely to be food-insecure and depressed, while men with obesity were less likely to consume government/community meals, compared to their counterparts.

CONCLUSIONS:
Older adults with obesity had higher risk of inadequate intakes for several key micronutrients, lower overall dietary quality, and higher prevalence of cardiometabolic risk factors compared to older adults with a healthy weight.

FUNDING SOURCES:
This work was supported by the National Institutes of Health.

PMID: 31224341 PMCID: PMC6574524 DOI: 10.1093/cdn/nzz028.P01-001-19
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9.
Curr Dev Nutr. 2019 Jun 13;3(Suppl 1). pii: nzz039.P18-116-19. doi: 10.1093/cdn/nzz039.P18-116-19. eCollection 2019 Jun.
Comparison of Cardiometabolic Biomarkers in Two Groups of US Adults Using Multiple Dietary Supplements: A Cross-Sectional Study (P18-116-19).
Park S1, Wang H1, Daggy B1, McManus J1, Jacques P2.
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Abstract
OBJECTIVES:
The aim of the present study is to compare cardiometabolic biomarker levels (MARKERS) from a cohort using multiple (2+) dietary supplements (MDS) manufactured by Shaklee Corporation for 3-5 yr (SHAKLEE) to those from the age-matched MDS users from NHANES 2007-10 (NHANES).

METHODS:
Each subject from SHAKLEE [n = 58; mean age: 48 yr (22-79 yr)], using MDS manufactured by Shaklee Corp for 3-5 yr, voluntarily signed the IRB approved informed consent form before the study participation. Body mass index (BMI), systolic and diastolic blood pressures (SBP and DSP) were measured, and approximately 30 mL of 12-h fasting blood sample was collected. Pregnant women and people with a history of cancer were excluded. MARKERS from SHAKLEE were compared to those from NHANES [n = 1952; mean age: 51 yr (22-79 yr)]. MARKERS included total cholesterol (TC), HDL-c, TC/HDL-c ratio, LDL-c, triglycerides (TG), high sensitivity C-Reactive Protein (CRP), glucose, hemoglobin A1c (HbA1c), and Insulin levels in the blood as well as BMI, SBP, and DBP. Statistical analyses were performed using independent samples t-tests, and P < 0.05 was considered significantly different between groups.

RESULTS:
SHAKLEE had significantly lower TC (189 vs. 201 mg/dL), TC/HDL-c ratio (3.1 vs. 4.0), LDL-c (103 vs. 118 mg/dL), TG (81 vs. 131 mg/dL), glucose (93 vs. 107 mg/dL), HbA1c (5.1 vs. 5.7%), insulin (8.3 vs. 13.4 mIU/L), BMI (26.7 vs. 29.0), and SBP (110 vs. 122 mmHg), and higher HDL-c (69 vs. 55 mg/dL) but had higher DBP (76 vs. 71 mmHg) than NHANES. There was no significant difference in CRP although CRP was slightly lower in SHAKLEE than NHANES (2.9 vs. 3.8 mg/L).

CONCLUSIONS:
The present study showed that 3-5 yr MDS users from the Shaklee cohort had healthier pattern in cardiometabolic biomarkers than the age-matched MDS users from NHANES 2007-2010.

FUNDING SOURCES:
Shaklee Corporation, 4747 Willow Road, Pleasanton, CA 94,588, USA.

PMID: 31224186 PMCID: PMC6574368 DOI: 10.1093/cdn/nzz039.P18-116-19
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10.
Curr Dev Nutr. 2019 Jun 13;3(Suppl 1). pii: nzz031.FS15-02-19. doi: 10.1093/cdn/nzz031.FS15-02-19. eCollection 2019 Jun.
Association of Dietary and Plasma Carotenoids with Urinary F2-isoprostanes (FS15-02-19).
Park YM1, Erve TV'1, O'Brien K1, Nichols H2, Weinberg C1, Sandler D1.
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Abstract
OBJECTIVES:
Carotenoids including β-carotene, α-carotene, lutein + zeaxanthin, lycopene, and β-cryptoxanthin may be protective against cancer and cardiometabolic disease through inhibition of oxidative stress and inflammation pathways. Little is known about which pathway would be more important for the beneficial effects of carotenoids.

METHODS:
From 2003-2009 the Sister Study enrolled 50,884 US women aged 35-74 who had a sister with breast cancer but had never had breast cancer themselves. From this cohort, 524 post-menopausal women were randomly sampled to measure carotenoids and biomarkers of oxidative stress. Plasma carotenoids were quantified by HPLC and adjusted for batch and season. Urinary 8-iso-prostaglandin F2α (8-iso-PGF2α) and its metabolite (8-iso-PGF2α-M) were measured by GC/MS and adjusted for creatinine. The biomarker 8-iso-PGF2α can reflect both oxidative stress and inflammation. To separate the 8-iso-PGF2α biomarker into a more specific oxidative stress component versus inflammation, a novel 8-iso-PGF2α/PGF2αmodeled ratio approach was used, exploiting the fact that the required biomarker, prostaglandin F2α (PGF2α) was also quantitated by our GC/MS assay. Multivariable linear regression models were used to assess the associations of dietary and plasma carotenoids with the measured and calculated biomarker levels.

RESULTS:
Total plasma carotenoids were inversely associated with both 8-iso-PGF2α and 8-iso-PGF2α-M levels (P trend across quartiles = 0.02 and 0.004). This inverse association was also apparent for the 8-iso-PGF2α/PGF2α ratio (P trend across quartile = 0.01), suggesting a greater suppressive effect on oxidative stress. β-carotene and α-carotene were also associated with significant decreases in the fraction of 8-iso-PGF2α from oxidative stress. Interestingly, lutein + zeaxanthin was associated with decreases in both oxidative stress and inflammation, suggesting strong biological effects. Dietary carotenoids were not associated with these oxidative stress markers.

CONCLUSIONS:
Plasma carotenoids were associated with decreased levels of both 8-iso-PGF2α and its metabolite. Health effects of plasma carotenoids may be primarily due to their antioxidant effects. Specific carotenoids might have additional anti-inflammatory effects.

FUNDING SOURCES:
NIH Office of Dietary Supplements and National Institute of Environmental Health Sciences.

PMID: 31224183 PMCID: PMC6574365 DOI: 10.1093/cdn/nzz031.FS15-02-19
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11.
Curr Dev Nutr. 2019 Jun 13;3(Suppl 1). pii: nzz030.P05-024-19. doi: 10.1093/cdn/nzz030.P05-024-19. eCollection 2019 Jun.
Erythrocyte Long Chain Omega 3 Fatty Acids Are Associated with Higher Lean Mass in Postmenopausal Women Newly Diagnosed with Breast Cancer (P05-024-19).
Belury M1, Cole R2, Andridge R3, Xie Q1, Keiter A3, KIecolt-Glaser J1.
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Abstract
OBJECTIVES:
Cancer contributes to adverse changes in body composition that may increase risk of cardiometabolic diseases. Skeletal muscle is a main driver of cardiometabolic health. We hypothesize that higher intake of long chain omega-3 polyunsaturated fatty acids (LCn3PUFAs) is associated with muscle health. This study evaluates whether LCn3PUFA exposure assessed in diet and in blood is associated with markers of muscle health in women with breast cancer.

METHODS:
This is a cross-sectional analysis evaluating LCn3PUFA exposure and markers of muscle health in women (N = 150) prior to treatment for breast cancer. Exposure to LCn3PUFAs was assessed by a diet history questionnaire (DHQ), a question specifically about supplement usage and biomarker of LCn3PUFAs in red blood cells (RBC). Body composition were measured at the same visit using dual x-ray absorptiometry. Linear regression models were used to test for associations.

RESULTS:
13% (N = 19) of women reported using fish oil supplements (e.g., Supplement Users) and had significantly higher levels of RBC LCn3PUFAs than Supplement Non-users. In Supplement Non-users, there was a positive association between reported dietary exposure by DHQ and RBC LCn3PUFA levels. The n3 index (e.g., sum of RBC EPA + DHA) and DHA (22:6n3) were positively associated with appendicular lean mass/BMI. There were no significant correlations between RBC LCn3PUFAs with grip strength and or other measurements of body composition.

CONCLUSIONS:
As a biomarker of intake, RBC LCn3PUFAs are positively associated with appendicular lean mass, a measure of skeletal muscle mass. A future study should prospectively evaluate whether higher LCn3PUFA exposure (as measured in blood) is associated with maintaining better muscle health during and following cancer treatment.

FUNDING SOURCES:
Funding was provided by the National Cattleman's Beef Association, NIH (JKG) CA186720, Ohio Agriculture Research and Development Center and the Carol S. Kennedy Professorship.

PMID: 31224045 PMCID: PMC6574222 DOI: 10.1093/cdn/nzz030.P05-024-19
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12.
Curr Dev Nutr. 2019 Jun 13;3(Suppl 1). pii: nzz031.P06-103-19. doi: 10.1093/cdn/nzz031.P06-103-19. eCollection 2019 Jun.
Analysis of NHANES 2005-2016 Data Showed Significant Association Between Micro and Macronutrient Intake and Various Sleep Variables (P06-103-19).
Ikonte C1, Reider C2, Fulgoni V 3rd3, Mitmesser S1.
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Abstract
OBJECTIVES:
To understand the association between micro and macronutrient intake and sleep variables from the National Health and Nutrition Evaluation Survey (NHANES, 2005-2016).

METHODS:
Data analysis was performed using SAS 9.4; regression analysis was used to assess the relationship (p < 0.05) of nutrient intake with sleep variables. All nutrients were individual usual intakes determined using the National Cancer Institute method from food plus supplements; covariates included age, gender, ethnicity, poverty income ration, current smoking status and physical activity level.Individuals 16+ years of age were included in the analysis; pregnant or lactating females and those with unreliable dietary recalls were excluded in the analysis. Seven (7) Sleep variables included in the analysis were short sleep hours (<7 hrs of sleep) and trouble sleeping (NHANES 2005-2016), sleep disorder (NHANES, 2005-2014) and poor sleep quality, insomnia, sleep latency, and use of sleeping pills >5 times in the last month (NHANES 2005-2008).

RESULTS:
In adults (males and females) 19+ years, 32.7% experienced short sleep; 47.3% poor sleep quality; 8.94% a sleep disorder; 37.9% sleep latency; 9.30% used sleeping pills; 15.1% exhibited insomnia; and 27.7% experienced sleep trouble. Within this population, short sleep was significantly (p < 0.05) associated with the greatest number of nutrients; showing an inverse association with magnesium, niacin, vitamin D, calcium, and dietary fiber intake. Across all seven sleep variables, however, magnesium, niacin and vitamin D demonstrated significant (p < 0.05) inverse association within this population.Inverse associations were also found for dietary fiber intake and short sleep and sleep disorder; phosphorus intake and poor sleep quality, sleep latency and sleep pill use; and vitamin K intake and poor sleep quality, sleep disorder, sleep latency and sleep pill use in the gender combined adults 19+ years. Within this population however, there were direct associations for the intakes of protein and vitamin B6 and short sleep, sleep disorder and sleep trouble; for the intakes of sodium and vitamin A and poor sleep quality, sleep latency and sleep pill use; for the intake of vitamin B12 and poor ADL and insomnia; and for the intake of zinc and sleep quality, sleep latency, sleep pill use, poor ADL and insomnia. Among female adults 19+ years, dietary fiber was the only nutrient that showed an inverse association with all seven sleep variables.

CONCLUSIONS:
These findings demonstrate the importance of micro and macronutrient intake on numerous sleep variables.

FUNDING SOURCES:
This analysis was funded by Pharmavite, LLC.

PMID: 31223980 PMCID: PMC6574146 DOI: 10.1093/cdn/nzz031.P06-103-19
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13.
Curr Dev Nutr. 2019 Jun 13;3(Suppl 1). pii: nzz048.FS08-01-19. doi: 10.1093/cdn/nzz048.FS08-01-19. eCollection 2019 Jun.
Total Usual Dietary Intakes of Pregnant Women in the United States, 2001-2014 (FS08-01-19).
Bailey R1, Pac S2, Fulgoni V 3rd3, Reidy K4.
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Abstract
OBJECTIVES:
Nutrition during pregnancy is a critical dimension not only for women's heath, but also for the offspring's lifelong health. Very limited national data exist on the usual dietary intakes of pregnant women. The objective of this study was to estimate total usual nutrient intakes (from foods and dietary supplements) of pregnant women in the U.S.

METHODS:
Cross-sectional analysis of a nationally-representative sample of pregnant U.S. women, ages 20-40 years (n = 1,003) from NHANES 2001-2014. Total usual dietary intakes were estimated using the National Cancer Institute (NCI) method to adjust 2, 24-hour dietary recalls for within-person variation. Adherence with the Dietary Reference Intakes were used to assess the proportion at risk of inadequacy by the Estimated Average Requirement (%< EAR), assumed to be adequate by the Adequate Intake (% >AI), and at risk of excess by the Tolerable Upper Intake Level (% >UL).

RESULTS:
About 70% of pregnant women use a dietary supplement. Less than 5% of pregnant women have usual diets that are at risk for inadequate intakes of riboflavin (3%), niacin (1%), vitamin B12 (1%), iron (2%), phosphorus (< 0.5%), and selenium (< 0.5%). More pregnant women have usual intakes < EAR for vitamins A (15%), B6 (11%), folate (16%), C (11%), D (46%), E (43%), and minerals including copper (5%), calcium (13%), magnesium (47%) and zinc (11%). Few pregnant females have usual intakes >AI for potassium (2%) and choline (8%), whereas only 48% have vitamin K intakes >AI. The majority of pregnant women (95%) exceed the UL for sodium, while folic acid (34%), iron (28%), calcium (3%), and zinc (7%) were also of concern for intakes >UL.

CONCLUSIONS:
Many U.S. pregnant women ( >10% < EAR or < 10% >AI) do not consume enough of key nutrients during pregnancy specifically vitamins A, C, D, E, K, B6, folate, and choline and minerals including potassium, calcium, magnesium, and zinc, while almost all are at risk of excessive consumption of sodium, and many at risk of excessive consumption of folic acid and iron. Improved dietary guidance to help pregnant women meet and not exceed dietary recommendations is warranted.

FUNDING SOURCES:
Nestle Nutrition.

PMID: 31223675 PMCID: PMC6573815 DOI: 10.1093/cdn/nzz048.FS08-01-19
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14.
J Bone Metab. 2019 May;26(2):65-74. doi: 10.11005/jbm.2019.26.2.65. Epub 2019 May 31.
Sarcopenia Associated with Chronic Obstructive Pulmonary Disease.
Kim SH1, Shin MJ1, Shin YB1, Kim KU2.
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Abstract
Sarcopenia is frequently associated with chronic diseases such as chronic obstructive pulmonary disease (COPD) and cancer. COPD, which is characterized by an irreversible airflow limitation, exacerbates respiratory distress as the disease progresses. The prevalence of sarcopenia in stable COPD was reported to be 15% to 25% in previous foreign studies and 25% in a Korean study. As the amount of activity decreases, muscle mass decreases and eventually oxygen cannot be used effectively, resulting in a vicious cycle of deterioration of exercise capacity. Deconditioning due to decreased activity is a major cause of limb muscle dysfunction in patients with COPD. In these patients, the factors that decrease muscle strength and endurance include chronic inflammation, oxidative stress, inactivity, hypoxemia, hormone abnormality, deficits of nutrients such as protein and vitamin D, and the use of systemic corticosteroid. Therefore, treatment and management should either inhibit this process or should be directed toward supplementing the deficiency, such as with exercise, nutritional support, and medications and supplements. The relationship between sarcopenia and COPD is increasingly being reported, with some overlap in clinical features and treatments. We are fascinated to be able to diagnose 2 diseases through similar physical performance tests and to improve both diseases using the same treatment such as exercise. Therefore, this review summarizes the clinical relevance and integrative management of the 2 diseases.

KEYWORDS:
Chronic obstructive; Exercise therapy; Pulmonary disease; Rehabilitation; Sarcopenia; Vitamin D

PMID: 31223602 PMCID: PMC6561852 DOI: 10.11005/jbm.2019.26.2.65
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Select item 31213494
15.
EMBO J. 2019 Jun 18. pii: e102477. doi: 10.15252/embj.2019102477. [Epub ahead of print]
Of seeds and supplements: structural insights into extended microRNA-target pairing.
Fabian MR1,2.
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PMID: 31213494 DOI: 10.15252/embj.2019102477
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16.
Altern Ther Health Med. 2019 Jul;25(4):16-19.
An Enzyme-Based Nutritional Protocol In Metastatic Cancer: Case Reports Of A Patient With Colon Cancer And A Patient With Lung Cancer.
Isaacs LL.
Abstract
CONTEXT:
The author and others have previously published case reports demonstrating positive results in patients with cancer utilizing lifestyle modification which includes high doses of a product rich in pancreatic enzymes.

OBJECTIVE:
The study reports on outcomes of two patients utilizing this nutritional protocol, one with colon cancer metastatic to the liver and lung, another with lung cancer metastatic to the brain.

DESIGN:
Retrospective case studies.

SETTING:
The patients were seen in an outpatient clinic in New York City, and implemented their protocols in their homes in the United States of America.

PARTICIPANTS:
The patients in these case reports are two men in their 60s.

INTERVENTION:
The patients were instructed in the self-administration of a nutritional protocol consisting of dietary modifications, a supplement protocol including high doses of a pancreas product naturally rich in enzymes, and detoxification including the use of coffee enemas.

OUTCOME MEASURES:
Records were reviewed for evidence of prolonged survival and/or improvement or resolution of radiographically apparent disease.

RESULTS:
The patients experienced both prolongation of life and resolution of radiographically apparent disease.

CONCLUSIONS:
While case reports cannot be considered as proof of efficacy, these cases added to others of patients treated with the same method would suggest that this is a viable option for those patients whose disease cannot be treated successfully with other modalities.

PMID: 31202206
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Select item 30811696
17.
J Eur Acad Dermatol Venereol. 2019 Mar;33 Suppl 2:28-33. doi: 10.1111/jdv.15316.
Overview on vitamin D and sunbed use.
Pierret L1, Suppa M2, Gandini S3, Del Marmol V2, Gutermuth J1.
Author information
Abstract
Vitamin D seems to be associated with a protective effect in a vast range of diseases, including cardiovascular, autoimmune and oncologic conditions. Since ultraviolet (UV) B light is the most important prerequisite for the cutaneous synthesis of vitamin D, sunbeds are able to increase serum vitamin D levels, although only transiently in most cases. In this scenario, the artificial tanning industry relentlessly tries to promote the use of sunbeds as a 'safe' therapeutic measure to achieve an adequate serum vitamin D status. The World Health Organization classified UV-emitting tanning devices, as well as the whole UV spectrum, as group-1 carcinogens, as they significantly increase the risk of melanoma and non-melanoma skin cancer. In case of vitamin D deficiency or insufficiency, the current risk-benefit ratio is therefore in favour of vitamin D supplementation instead of sunbed use. Artificial tanning devices should never be considered as an option to achieve an appropriate vitamin D status. Their supposedly beneficial effects, vastly publicised by the artificial tanning industry, are not worth the carcinogenic risk associated with sunbed use.

© 2019 European Academy of Dermatology and Venereology.

PMID: 30811696 DOI: 10.1111/jdv.15316
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Select item 30655033
18.
J Formos Med Assoc. 2019 Mar;118 Suppl 1:S32-S41. doi: 10.1016/j.jfma.2019.01.002. Epub 2019 Jan 14.
Microbiota and gastrointestinal cancer.
Weng MT1, Chiu YT2, Wei PY2, Chiang CW2, Fang HL3, Wei SC4.
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Abstract
Gut microbiota plays important roles in many diseases, including cancer. It may promote carcinogenesis by inducing oxidative stress, genotoxicity, host immune response disturbance, and chronic inflammation. Colorectal cancer, hepatocellular carcinoma, and gastric cancer are the major gastrointestinal tract cancers in Taiwan. The microbiota detected in patients with tubular adenoma and villous/tubulovillous polyps is different from that in healthy controls and patients with hyperplastic polyps. Normalization of the microbiota is observed in patients after colorectal cancer treatment. Furthermore, the liver is exposed to microbiota-associated molecular patterns (MAMPs), bacterial metabolites, and toxins, as it is anatomically connected to the gut via the portal vein. Patients with cirrhosis have significantly higher plasma endotoxin levels than healthy controls. Helicobacter pylori is a well-established risk factor for gastric cancer. Some nitrosating bacteria convert nitrogen compounds in gastric fluid to potentially carcinogenic N-nitroso compounds, which also contribute to gastric cancer development. Growing evidence demonstrates that gut microbiota promotes carcinogenesis. In this review, we discuss the mechanisms and types of microbiota changes involved in these gastrointestinal cancers and the future treatment choices.

Copyright © 2019 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

KEYWORDS:
Colorectal cancer; Gastric cancer; Gut; HCC; Microbiota

PMID: 30655033 DOI: 10.1016/j.jfma.2019.01.002
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19.
Arch Oral Biol. 2019 Feb;98:280-284. doi: 10.1016/j.archoralbio.2018.12.003. Epub 2018 Dec 7.
Is there any association between green tea consumption and the risk of head and neck squamous cell carcinoma: Finding from a case-control study.
Rafieian N1, Azimi S2, Manifar S3, Julideh H4, ShirKhoda M5.
Author information
Abstract
OBJECTIVE:
Green tea consumption has been shown to reduce the incidence of head and neck squamous cell carcinoma (HNSCC) in experimental animal models, however the results from human studies are inconclusive. The aim of this study was to evaluate the relationship between green tea consumption and the risk of HNSCC.

DESIGN:
The study utilised a standardised questionnaire to investigate the relationship between green tea consumption and HNSCC experience. Data about amount of green tea consumption was recorded from 147 patients with HNSCC and 263 age and gender matched controls. The results were analyzed with SPSS statistical software Version 21 using Chi- square test, and Logistic Regression (with a 95% confidence interval). Significance levels were set at 95% and p-values less than 0.05 were considered significant.

RESULTS:
Statistical analysis indicated significant differences between different groups of tea consumers in terms of HNSCC risk (P < 0.001). The risk of developing oral cancer those who consume <1 cup of green tea daily was (OR = 0.29 (0.16-0.52) and for the group of > = 1 cup green tea consumers was 0.38(0.17-0.86) of those who never consume green tea (Reference point) after adjustment for other risk factors.

CONCLUSIONS:
The findings support that green tea consumption may reduce the risk of HNSCC. To confirm the efficacy of green tea intake in preventing the development of HNSCC in humans further investigation is needed.

Copyright © 2018 Elsevier Ltd. All rights reserved.

KEYWORDS:
Case-control; Green tea; Head and neck; Squamous cell cancer

PMID: 30583134 DOI: 10.1016/j.archoralbio.2018.12.003
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Select item 29911794
20.
Minerva Chir. 2018 Jun;73(3):288-294. doi: 10.23736/S0026-4733.18.07667-8.
Supplementation with Robuvit® in post-mastectomy post-radiation arm lymphedema.
Belcaro G1,2, Dugall M3,4, Cotellese R4, Feragalli B4, Cianchetti E3,4, Cesarone MR3,4.
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Abstract
BACKGROUND:
Post-mastectomy lymphedema is one of the most significant, non-life-threatening complications following breast cancer surgery and radiotherapy. Post-mastectomy post-radiotherapy (PMPR) lymphedema is related to damages to lymphatics and/or veins during/after axillary surgery and radiotherapy. The management of this condition is very challenging; the comprehensive decongestive therapy (CTD), which combines physiotherapy, self-management, and hygiene, and is currently considered the standard management (SM). The aim of this registry study was to evaluate whether the supplementation with Robuvit® as a lymphedema controlling agent added to CTD over a 2-month period could be more effective than CTD alone.

METHODS:
A group of 65 patients with PMPR lymphedema was included in this registry study and followed up for 2 months; 33 were treated with current SM only (control group), and 32 were also supplemented with 600 mg/day of Robuvit® (active treatment group).

RESULTS:
At 1- and 2-month follow-up, the decrease in volume was significantly greater in the supplement group (P<0.05), with a final reduction in volume after two months of 654±21 mL (-19.82%) versus 433±23 mL (-12.81%) in the control group. A more significant decrease in skin thickness and symptoms was also observed in the Robuvit® group. No side effects were reported.

CONCLUSIONS:
CTD, combined with self-management, can effectively control the excess of limb volume in post-mastectomy lymphedema. Supplementation with Robuvit® is useful to further reduce limb volume. Later stages of lymphedema seem to be more difficult to manage and may require surgery or more invasive treatments.

PMID: 29911794 DOI: 10.23736/S0026-4733.18.07667-8
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Select item 29744676
21.
Breast Cancer Res Treat. 2018 Aug;171(1):189-198. doi: 10.1007/s10549-018-4805-z. Epub 2018 May 9.
Associations of dietary intake and supplement use with post-therapy cognitive recovery in breast cancer survivors.
Huang Z1, Shi Y2, Bao P1, Cai H3, Hong Z4, Ding D4, Jackson J5, Shu XO3, Dai Q3.
Author information
Abstract
PURPOSE:
Cognitive impairment induced by cancer therapy is common and can be long lasting after completion of therapy. Little is known on factors that influence recovery from the impairment. We evaluated the associations of dietary intake and supplement use with post-therapy cognitive recovery in a large cohort of breast cancer survivors.

METHODS:
This study included 1047 breast cancer patients aged 20-75 who were recruited to the Shanghai Breast Cancer Survival Study between 2002 and 2006 at approximately 6.5 months post-cancer diagnosis. Two cognitive assessments covering immediate memory, delayed memory, verbal fluency, and attention, were conducted at 18 and 36 months post-diagnosis. We used food frequency questionnaire to collect information on their dietary intake and supplement use between 18 and 36 months post-diagnosis. Linear regression models were used to examine the associations of dietary intake and supplement use with mean cognitive scores at 36 months post-diagnosis and with differences in cognitive scores between 18 and 36 months post-diagnosis.

RESULTS:
Higher vegetable, fruit and fish intake, supplementation with vitamin B and vitamin E, and tea drinking were associated with higher cognitive scores, while alcohol drinking was associated with lower cognitive scores at 36 months post-diagnosis. Vegetable intake was positively associated with improvement in verbal fluency, while tea drinking and fish oil supplementation were associated with greater improvements in delayed memory between 18 and 36 months post-diagnosis.

CONCLUSIONS:
Our results indicate that higher vegetable intake, tea drinking, and fish oil supplementation may help post-therapy cognitive recovery for cancer patients.

KEYWORDS:
Breast cancer survivor; Cognition; Diet; Supplement

PMID: 29744676 DOI: 10.1007/s10549-018-4805-z
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22.
Am J Epidemiol. 2018 Aug 1;187(8):1721-1732. doi: 10.1093/aje/kwy017.
Serum Metabolomic Profiling of All-Cause Mortality: A Prospective Analysis in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study Cohort.
Huang J1, Weinstein SJ1, Moore SC1, Derkach A1, Hua X1, Liao LM1, Gu F1,2, Mondul AM3, Sampson JN1, Albanes D1.
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Abstract
Tobacco use, hypertension, hyperglycemia, overweight, and inactivity are leading causes of overall and cardiovascular disease (CVD) mortality worldwide, yet the relevant metabolic alterations responsible are largely unknown. We conducted a serum metabolomic analysis of 620 men in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study (1985-2013). During 28 years of follow-up, there were 435 deaths (197 CVD and 107 cancer). The analysis included 406 known metabolites measured with ultra-high-performance liquid chromatography/mass spectrometry-gas chromatography/mass spectrometry. We used Cox regression to estimate mortality hazard ratios for a 1-standard-deviation difference in metabolite signals. The strongest associations with overall mortality were N-acetylvaline (hazard ratio (HR) = 1.28; P < 4.1 × 10-5, below Bonferroni statistical threshold) and dimethylglycine, 7-methylguanine, C-glycosyltryptophan, taurocholate, and N-acetyltryptophan (1.23 ≤ HR ≤ 1.32; 5 × 10-5 ≤ P ≤ 1 × 10-4). C-Glycosyltryptophan, 7-methylguanine, and 4-androsten-3β,17β-diol disulfate were statistically significantly associated with CVD mortality (1.49 ≤ HR ≤ 1.62, P < 4.1 × 10-5). No metabolite was associated with cancer mortality, at a false discovery rate of <0.1. Individuals with a 1-standard-deviation higher metabolite risk score had increased all-cause and CVD mortality in the test set (HR = 1.4, P = 0.05; HR = 1.8, P = 0.003, respectively). The several serum metabolites and their composite risk score independently associated with all-cause and CVD mortality may provide potential leads regarding the molecular basis of mortality.

PMID: 29390044 PMCID: PMC6070082 DOI: 10.1093/aje/kwy017
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Select item 29271084
23.
Cancer Med. 2018 Jan;7(1):270-281. doi: 10.1002/cam4.1166. Epub 2017 Dec 22.
Vitamin D deficiency and supplementation in patients with aggressive B-cell lymphomas treated with immunochemotherapy.
Hohaus S1, Tisi MC1, Bellesi S1, Maiolo E1, Alma E1, Tartaglia G1, Corrente F1, Cuccaro A1, D'Alo' F1, Basile U2, Larocca LM3, De Stefano V1.
Author information
Abstract
Vitamin D deficiency has been reported to be a negative prognostic factor in elderly patients with aggressive B-cell lymphomas. In vitro data suggest that vitamin D supplementation may enhance rituximab-mediated cytotoxicity. We prospectively assessed 25-hydroxyvitamin D [25(OH)D] levels at diagnosis in a cohort of 155 patients with aggressive B-cell lymphomas of whom 128 had diffuse large B-cell lymphoma (DLBCL) not otherwise specified. 25(OH)D levels were deficient (<20 ng/mL) in 105 (67%), insufficient (20-29 ng/mL) in 32 (21%), and normal (≥30 ng/mL) in 18 (12%) patients with a seasonal variation. Patient characteristics associated with lower 25(OH)D levels were poor performance status, overweight, B-symptoms, elevated LDH, lower albumin and hemoglobin levels. As a result of a change in practice pattern, 116 patients received vitamin D3 (cholecalciferol) supplementation that included a loading phase with daily replacement and subsequent maintenance phase with a weekly dose of 25,000 IU until end of treatment. This resulted in a significant increase in 25(OH)D levels, with normalization in 56% of patients. We analyzed the impact of 25(OH)D levels on event-free survival in patients treated with Rituximab-CHOP. 25(OH)D levels below 20 ng/mL at diagnosis and IPI were independently associated with inferior EFS. Moreover, patients with normalized 25(OH)D levels following supplementation showed better EFS than patients with persistently deficient/insufficient 25(OH)D levels. Our study provides the first evidence that achievement of normal 25(OH)D levels after vitamin D3 supplementation is associated with improved outcome in patients with DLBCL and deficient/insufficient 25(OH)D levels when receiving rituximab-based treatment.

© 2017 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

KEYWORDS:
Aggressive B-cell lymphoma; Vitamin D; prognosis; supplementation

PMID: 29271084 PMCID: PMC5773978 DOI: 10.1002/cam4.1166
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Select item 28933290
24.
Curr Med Chem. 2019;26(6):973-987. doi: 10.2174/0929867324666170920144130.
Nutraceuticals and "Repurposed" Drugs of Phytochemical Origin in Prevention and Interception of Chronic Degenerative Diseases and Cancer.
Albini A1, Bassani B1, Baci D1, Dallaglio K2, Gallazzi M1,3, Corradino P1, Bruno A1, Noonan DM1,3.
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Abstract
BACKGROUND:
Chronic, degenerative diseases are often characterized by inflammation and aberrant angiogenesis. For these pathologies, including rheumatoid arthritis, cardiovascular and autoimmune diseases, cancer, diabetes, and obesity, current therapies have limited efficacy.

OBJECTIVES:
The validation of novel (chemo)preventive and interceptive approaches, and the use of new or repurposed agents, alone or in combination with registered drugs, are urgently required.

RESULTS:
Phytochemicals (triterpenoids, flavonoids, retinoids) and their derivatives, nonsteroidal anti-inflammatory drugs (aspirin) as well as biguanides (metformin and phenformin) originally developed from phytochemical backbones, are multi-target agents showing antiangiogenic and anti-anti-inflammatory proprieties. Many of them target AMPK and metabolic pathways such as the mTOR axis. We summarize the beneficial effects of several compounds in conferring protection and supporting therapy, and as a paradigm, we present data on terpenoids & biquanides on beer hop xanthohumol and hydroxytryrosol from olive mill waste waters.

CONCLUSIONS:
These molecules could be employed for combinatorial chemoprevention and interception approaches or chemoprevention/therapy regimens for cancer and other chronic complex diseases.

Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.

KEYWORDS:
CD; Nutraceuticals; aberrant angiogenesis; cancer; phytochemical drugs; repurposed drugs.

PMID: 28933290 DOI: 10.2174/0929867324666170920144130
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