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For years it has been known that diet and nutrition are key factors in increasing the risk or protection against various types of cancer, something that in Spain is usually studied in depth thanks to Mediterranean diet– Its protective potential stands out here and around the world.

Now a new review posted on Nature wanted to be more specific and has reviewed various meta-analyzes of observational studies where the consumption of certain foods and nutrients was related to the risk of getting up to 11 different types of cancer: alcohol continues to be associated with greater risk, while coffee would have a protective effect.

Currently cancer stands out for being one of the most frequent causes of morbidity and mortality, with 18.1 million annual cases and up to 9.6 deaths only during the past year 2018. Diet, nutrition and physical activity are clear modifiable risk factors to prevent this group of diseases.

It is estimated that diet and nutrition would represent between 20-25% of cancer cases worldwide. On the one hand, the obesogenic effects of a high calorie diet and lack of physical activity would represent 10-15% of the cancer burden, while 5% would be attributed to alcohol and another 5% to specific dietary factors combined. Overall, the current review suggests that there are a limited number of dietary factors that, independently, would be significantly associated with an increased risk of cancer.

In this new study, researchers relied on analyzing robust data, since nutrition studies are characterized by being observational, where participants carry out surveys on time, giving rise to a multitude of inaccurate data.

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In total, 860 meta-analyzes of studies were reviewed in search of the best possible quality of evidence. Of all of them, 10 of the meta-analyzes stood out for strong evidence, with statistically significant results and no evidence of bias.

On the one hand, the alcohol stood out for increasing the risk of colorectal cancer and breast cancer, while the consumption of calcium, dairy products and wholegrain products had a protective effect against colorectal cancer. Thus, alcohol would be associated with an increased risk of cancer of the colon, rectum, esophagus, head and neck, breast and liver.

On the other hand also the café, one of the most consumed beverages in the world, and its relationship with cancer: its intake would be inversely associated with the risk of liver cancer and skin cancer. In other words, it would have a “protective effect”.

Strengths and limitations of the study

Despite the fact that meta-analysis reviews are the type of study with the greatest known evidence, they are not without limitations: all the meta-analyzes studied are based, in turn, on studies already published and only up to last year 2018, and the authors are aware that it is possible that some other work has not been included by mistake, although they believe that it is unlikely.

Various data were studied, such as the incidence and / or mortality from primary cancer, subtypes of different cancer, analysis by sex, menopausal status, tobacco use and hormone replacement therapy use, but they are also aware that they may have missed the opportunity to perform other sub-analyzes if they had more specific data in the studies.

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Likewise, the review was based on results derived only from observational studies, and not from randomized controlled clinical trials. Therefore, it is not possible to demonstrate causal associations as such, but rather relationships with more or less evidence.

However, the authors are aware of the difficulty of conducting controlled trials in the field of nutritional epidemiology, and suggest that better strategies should be used to monitor and improve adherence and follow-up of results in this regard.

Finally, the emphasis is once again on how the aforementioned observational studies are carried out: through self-reported questionnaires participants, prone to measurement errors, especially in the case of consumption of foods that are not consumed regularly. And, to curl the curl, they also highlight the fact that most of the studies analyzed were conducted in populations of European descent.

Therefore, and despite the fact that this is the largest review to date As far as associations between food and cancer are concerned, the authors are aware that their study is not perfect and there could be some error. Although it should be noted that they have tried to minimize them as much as possible.

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