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 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The current decade has witnessed an increasing interest in the diet-cancer issue as a central one for public health. Notwithstanding a substantial amount of epidemiological investigations, firm evidence of carcinogenicity exists only for alcoholic beverages with respect to cancers at several sites, and for aflatoxin with respect to liver cancer; also, the relation is established between diet related excess of energy intake, as translated into obesity, and cancer of endometrium and gallbladder. For a number of other dietary factors the evidence for a causal or protective role still remains at a presumptive level (e.g. intake of fresh vegetables and fruits with respect to cancers at several sites), or is still frankly open to debate (e.g. fat with respect to breast and colon cancer). Methodological inadequacies in past studies have been identified and clearer results should derive in the coming decade from epidemiological investigations substantially improved in methodology, particularly from the long-term prospective studies as now planned by the International Agency for Research on Cancer. Fortunately for cancer prevention, such dietary advice as can be derived from the highly incomplete and unsatisfactory knowledge on the role of dietary factors on cancer, turns out to be in broad agreement with the advice aimed at preventing other major diseases such as ischaemic heart disease and hypertension. This allows the issuing of a set of simple but important 'prudent diet' recommendations.
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PMID:The diet and cancer hypothesis: current trends. 223 43

Currently, there is no commonly practiced tool for assessing calcium status of individuals or populations. Few biochemical markers reflect calcium status. Fasting urinary calcium:creatinine ratios may hold promise as an easy, inexpensive method to indicate recent calcium status. Calcium status may best be assessed by integrated measures of calcium assimilation, such as total-body calcium. Although bone-mass measurements do not correlate well with recent dietary intakes of calcium, long-term adequacy of calcium intake influences bone mass. Whether low calcium intakes lead to calcium deficiencies depends on one's ability to adapt and conserve calcium. The relationship between calcium status and a particular disease state, such as osteoporosis, hypertension, or colon cancer, cannot be established until a reliable indicator of calcium status is found.
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PMID:Assessing calcium status and metabolism. 224 90

Genetic factors play an important role in the development of many common diseases of adulthood that result in early morbidity and mortality. Prevention of these disorders and their sequelae is best established through early detection and early intervention. Although it may be feasible to screen the entire population for some disorders (e.g., hypertension), this approach would be expensive and impractical for others (e.g., colon cancer). The family history provides an inexpensive and convenient method of identifying families at risk for premature diseases of adulthood. Family screening for a disorder should be recommended if there is increased risk for the disorder among family members, if screening methods are available to detect the condition at an early age or preclinical stage, and if early intervention will alter the course of the disease. For many disorders screening and intervention can prevent the occurrence of clinical disease. The prenatal counseling session affords an ideal setting for identifying families at risk for diseases of adulthood with major genetic components. By reviewing the family history, key family members can be identified and investigated, in order to establish a specific genetic diagnosis. At-risk relatives can then be counseled and screened for the disorder preclinically and premorbidly. The screening and intervention available for a disease depends on the nature of the disorder, our understanding of its physiology and etiology, and our current technology. The disorders discussed earlier are typical of conditions of adulthood that are influenced strongly by genetic factors, especially when they appear in younger adults. Atherosclerosis, colon cancer, and diabetes are complex phenotypes. Each can be caused by single-gene defects, but commonly the genetics are more complex. Empiric data help to establish the risk to an individual in the latter cases. In all three examples, early detection should lead to treatment, which can prevent more serious sequelae: by treating the dyslipidemia, coronary artery disease can be prevented; by removing the benign polyp, malignant cancer can be avoided; and when impaired glucose tolerance is detected, diet and exercise can prevent or delay frank diabetes and its complications. The complete evaluation of individuals at risk for disorders such as those in Table 1 and their families can be a complicated task. Referral to a center experienced in the genetics of common diseases often may be necessary.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Genetics of common diseases of adulthood. Implications for prenatal counseling and diagnosis. 228 33

A retrospective review of all patients undergoing radiotherapy for carcinoma of the colon, pancreas, stomach, small bowel and bile ducts, lymphomas of the stomach, and other GI sites and retroperitoneal sarcomas was completed to assess the effects of secondary irradiation on the kidney. Eighty-six adult patients were identified who were treated with curative intent, received greater than 50% unilateral kidney irradiation to doses of at least 2600 cGy and survived for 1 year or more. Following treatment, the clinical course, blood pressure, addition of anti-hypertensive medications, serum creatinine and creatinine clearance were determined. Creatinine clearance was calculated by the formula: creatinine clearance equals [(140-age) X (weight in kilograms)] divided by (72 X serum creatinine) which has a close correlation to creatinine clearances measured by 24 hr. urine measurements. The percent change in creatinine clearance from pre-treatment values was analyzed. Of the thirteen patients with pre-radiotherapy hypertension, four required an increase in the number of medications for control and nine required no change in medication. Two patients developed hypertension in follow-up, one controlled with medication and the other malignant hypertension. Acute or chronic renal failure was not observed in any patient. The serum creatinine for all 86 patients prior to radiation therapy was below 2 mg/100 ml; in follow-up it rose to between 2.2-2.9 mg/100 ml. in five patients. The mean creatinine clearance for all 86 patients prior to radiotherapy was 77 ml/minute and for 16 patients with at least 5 years of follow-up it was 62 ml/minute. The mean percent decrease in creatinine clearance appeared to correspond to the percentage of kidney irradiated: for 38 patients with only 50% of the kidney irradiated the mean percent decrease was 10%, whereas for 31 patients having 90 to 100% of the kidney treated the decrease was 24%. Although physiologic changes were seen in patients receiving 50% or more unilateral kidney irradiation, the development of significant clinical sequelae was limited to one patient.
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PMID:Renal complications secondary to radiation treatment of upper abdominal malignancies. 375 86

In a nine-year follow-up of a southern California community of 2,852 men and women aged 60-79 years, systolic blood pressure was a significant predictor of subsequent cancer mortality in men. This effect was independent of age, antihypertensive medication, smoking, obesity, and plasma cholesterol. Trends in women were similar but not statistically significant. Compared with those still alive, higher initial systolic blood pressure levels were apparent in those who died of colon cancer, stomach cancer, and all other cancers combined except for lung and prostate cancer. Possible mechanisms for this association and the implications of the data with regard to the benefits of measures to treat high blood pressure or lower population distribution of blood pressure are discussed.
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PMID:Systolic blood pressure and cancer mortality in an elderly population. 647 25

Combined molecular and epidemiological studies are advancing our understanding of the genetic basis of multifactorial diseases. Several of the results obtained during the past year highlight methodological issues associated with these approaches. For example, the affected sib-pair method has been applied successfully to detect linkage between the angiotensinogen gene and susceptibility to hypertension, and a large multi-centre epidemiological study has demonstrated association of a polymorphism of the angiotensin-converting enzyme gene with increased risk of myocardial infarction. The study of Mendelian forms of multifactorial diseases has also led to many new results. These include the characterization of mutations in the glucokinase gene in maturity onset diabetes of the young, localization to chromosome 2 of a gene involved in familial colon cancer, and localization to chromosome 19 of a gene responsible for hemiplegic migraine. New insights have been provided into the genetics of multifactorial disorders such as diabetes and hypertension through the study of animal models. Localization of susceptibility loci in such models has recently led to the identification of new candidate genes that may be implicated in disease.
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PMID:Genetic approaches to common diseases. 776 64

Calcium is the fifth most abundant element in the earth's crust and is necessary for both plant and animal life today. Moreover, the natural diets of all mammals are rich in calcium. The diet of Stone Age human adults is estimated to have contained from 50 to 75 mmol of calcium (2000 to 3000 mg)/d, three to five times the median calcium intake of present-day US adults. Human physiology has adapted to this environmental abundance with an intestinal absorptive barrier and inefficient renal conservation of calcium. Although mammalian physiology contains mechanisms by which organisms can adjust to temporary environmental shortages, chronic calcium retention has a number of health consequences, most notably bone fragility, high blood pressure, and colon cancer. Evidence indicates that improvement in calcium intake (or in vitamin D status) prevents some portion of each of these multifactorial problems. At least 14 intervention studies have established the skeletal benefit of increased calcium intake during growth and among women in the late postmenopause. Other evidence suggests that adequate calcium may protect against salt-sensitive and pregnancy-associated hypertension and that high intakes of both dietary calcium and vitamin D reduce development of precancerous changes in colonic mucosa.
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PMID:ADSA Foundation Lecture. Low calcium intake: the culprit in many chronic diseases. 804 60

This paper examines the evidence that connects calcium intake and vitamin D status to bone fragility, hypertension, colon cancer, and breast cancer. Human calcium physiology, with an intestinal absorptive barrier and inefficient conservation, reflects the abundance of calcium in the primordial human food supply. The calcium intake of stone-age adults is estimated at 50 to 75 mmol/d, three to five times the median calcium intake of present-day U.S. adults. Long-term calcium restriction and/or insufficient vitamin D may promote the development of bone fragility, high blood pressure, colon cancer, and breast cancer in susceptible individuals. Conversely, improvement in calcium intake and/or in vitamin D status may help to prevent these serious health problems. At least 12 intervention studies have established the skeletal benefit of increased calcium intake among women in the late postmenopause. Other reports suggest that adequate calcium may protect against salt-sensitive and pregnancy-associated hypertension. High intakes of both dietary calcium and vitamin D are associated with reduced development of precancerous changes in colonic mucosa. Preliminary findings also suggest that vitamin D has a protective effect against breast cancer.
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PMID:The role of calcium intake in preventing bone fragility, hypertension, and certain cancers. 806 93

Intensive animal rearing, manipulation of crop production and food processing have altered the qualitative and quantitative balance of nutrients of foods consumed by Western society. This change, to which the physiology and biochemistry of man may not be presently adapted to, is thought to be responsible for the chronic diseases that are rampant in the Industrialised Western Countries. Agriculture production and food processing practices, dietary habits and lifestyle of the West is being fostered without any appraisal of the health implications by most developing countries. Consequently, a rising trend in the incidences of obesity, diabetes, high blood pressure, cardiovascular diseases, dental decay and appendicitis is apparent. Mediterranean countries are adopting the agriculture and food practices of northern Europe as the result of the harmonisation of European food and agriculture policy. It is predicted that the low incidence of morbidity and mortality from coronary heart disease, stroke, diabetes and breast and colon cancer of the Mediterranean countries would rise to the high northern European level in the foreseeable future. Most of these chronic diseases are lifestyle related and are preventable. This can be realised by tackling the root problem which is food production and processing practices and not by dispensing designer drugs or opening more hospital beds.
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PMID:Nutrition and health in relation to food production and processing. 806 63

Although Ca in small quantities plays a fundamental role in cell activation, excessive intracellular Ca accumulation results in severe cellular damage and is a major factor in the pathophysiology of multiple diseases. Paradoxically, high Ca intake may be beneficial in unrelated disorders such as arterial hypertension, nephrolithiasis and in the prevention of colon cancer. Parathyroid hormone (PTH) could be the link capable to explain this paradox. PTH stimulates cellular calcium influx. Under normal conditions, this effect takes place only in target tissues for the hormone, but in the presence of altered cell-membrane permeability for calcium, normal plasma PTH may be detrimental, enhancing cellular calcium influx. Thus, the suppression of PTH secretion by a high Ca intake would result in a reduced PTH-induced cellular Ca accumulation in genetically predisposed tissues with a loose cellular Ca control. Thus, parathyroid ablation in dystrophic hamster reduces the elevated muscle Ca observed in muscular dystrophy and causes histological improvement without altering the serum Ca concentration. The amount of dietary Ca required is not firmly established, but anthropological observations suggest a daily intake of approximately 1600 mg, much higher than the present average Ca intake in Western societies. Thus, a higher Ca intake would be beneficial in the treatment, and more importantly, in the prevention of multiple diseases.
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PMID:[New perspectives in calcium metabolism]. 820 35


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