How the alcohol industry relies on harmful use of alcohol and works to protect its profits

The alcohol industry have attempted to position themselves as collaborators in alcohol policy making as a way of influencing policies away from a focus on the drivers of the harmful use of alcohol (marketing, over availability and affordability). Their framings of alcohol consumption and harms allow them to argue for ineffective measures, largely targeting heavier consumers, and against population wide measures as the latter will affect moderate drinkers. The goal of their public relations organisations is to ‘promote responsible drinking’. However, analysis of data collected in the International Alcohol Control study and used to estimate how much heavier drinking occasions contribute to the alcohol market in five different countries shows the alcohol industry's reliance on the harmful use of alcohol. In higher income countries heavier drinking occasions make up approximately 50% of sales and in middle income countries it is closer to two‐thirds. It is this reliance on the harmful use of alcohol which underpins the conflicting interests between the transnational alcohol corporations and public health and which militates against their involvement in the alcohol policy arena. [Caswell S, Callinan S, Chaiyasong S, Cuong PV, Kazantseva E, Bayandorj T, Huckle T, Parker K, Railton R, Wall M. How the alcohol industry relies on harmful use of alcohol and works to protect its profits. Drug Alcohol Rev 2016;35:661–664]     

Obesity, age, and oxidative stress in middle-aged and older women

Recent evidence suggests that urinary F(2)-isoprostanes (F(2)-IsoPs) are more accurate markers of oxidative stress than other available biomarkers. Most previous studies used unmetabolized F(2)-IsoPs as a biomarker. Few previous studies measured 15-F(2t)-IsoP-M, a metabolite of one of the most common F(2)-IsoPs, 15-F(2t)-IsoP. Unlike 15-F(2t)-IsoP, 15-F(2t)-IsoP-M is not subject to autoxidation and renal production. To our knowledge, no study has compared the associations of age and body mass index (BMI) with F(2)-IsoPs to those with 15-F(2t)-IsoP-M. Urinary levels of F(2)-IsoPs and 15-F(2t)-IsoP-M were measured using gas chromatography-mass spectrometry for 845 healthy women aged 40-70 years. Both F(2)-IsoPs and 15-F(2t)-IsoP-M were elevated among smokers. The level of 15-F(2t)-IsoP-M increased with age, particularly after menopause, and with BMI. In contrast, F(2)-IsoPs decreased with age, regardless of menopausal status, and was not related to BMI. The association of 15-F(2t)-IsoP-M with age or menopausal status did not differ by BMI category, and the association with BMI was also independent of age or menopausal status. 15-F(2t)-IsoP-M appears to be a valuable biomarker of oxidative stress in age- and obesity-related diseases.     

Plasma carotenoids, tocopherols, retinol and breast cancer risk: results from the Shanghai Women Health Study (SWHS)

Evidence from some previous studies suggests that lipophilic antioxidants, particularly carotenoids, may reduce the risk of breast cancer. We prospectively investigated the associations of plasma levels of tocopherols, retinol, carotenoids with the risk of developing breast cancer among Chinese women. We conducted a study of 365 incident breast cancer cases and 726 individually matched controls nested within a large cohort study of women aged 40–70 years at baseline. We observed no associations between breast cancer risk and any of the tocopherols, retinol, and most carotenoids. However, high levels of plasma lycopene other than trans, 5- and 7-cis or trans α-cryptoxanthin were inversely associated with the risk of developing breast cancer. Our results do not support an overall protective effect of lipophilic antioxidants on breast cancer risk. The few inverse associations observed for subtype of carotenoids may need to be confirmed in future studies.     

Vitamin supplement use and risk for breast cancer: the Shanghai Breast Cancer Study

Objective The influence of vitamin supplements on breast cancer risk is unclear and the interactive effects of dietary and supplemental sources are unknown. This study investigated (1) the association between self-reported vitamin supplement use (multivitamin, A, B, C, and E) and breast cancer and (2) the combined effect of vitamin supplements in relation to dietary vitamin intakes on breast cancer risk. Methods The Shanghai Breast Cancer Study was a population-based case-control study conducted in Shanghai in 1996-1998 (Phase I) and 2002-2004 (Phase II). Participants were aged 25-64 (Phase I) and 20-70 years (Phase II). The analyses included 3,454 incident breast cancer cases and 3,474 controls. Unconditional logistic regression models were used to determine adjusted odds ratios (ORs) for breast cancer risk associated with vitamin supplement use. Results Overall, breast cancer risk was not related to any vitamin supplement intake. However, a 20% reduction in breast cancer risk was observed with vitamin E supplement use among women with low-dietary vitamin E intake (OR = 0.8; 95% confidence interval (CI), 0.6-1.0). A non-significant 20% risk reduction was observed among vitamin B supplement users with low B dietary intake (OR = 0.8; 95% CI, 0.6-1.1). Frequent use of a vitamin B supplement was adversely associated with breast cancer risk among those with high dietary vitamin B intake (OR = 1.4; 95% CI: 0.9-2.1; P for interaction = 0.07). Conclusions This study suggests that vitamins E and B supplements may confer protection against breast cancer among women who have low dietary intake of those vitamins.     

History of benign breast disease and risk of breast cancer among women in China: a case–control study

Background  Data from the Shanghai Breast Cancer Study were analyzed to evaluate the relationship between benign breast disease (BBD) and breast cancer among Chinese women with a self-report of physician-diagnosed BBD. Methods  Study participants consisted of 3,452 breast cancer cases and 3,474 population controls recruited by the Shanghai Breast Cancer Study. In-person interviews were conducted to collect information on demographics and suspected risk factors for breast cancer, including a detailed history of BBD. Unconditional logistic regression was used to derive adjusted odds ratios (OR_adj) and 95% confidence intervals (CI) for the association between self-reported BBD and breast cancer. Results  Women with breast cancer were significantly more likely to have a self-reported history of BBD including lobular proliferation (OR_adj = 1.6; 95% CI 1.4–1.8), fibroadenoma (OR_adj = 1.9; 95% CI 1.6–2.3), and other BBD (OR_adj = 1.6; 95% CI 1.3–2.1). Breast cancer risk was lower for surgically treated fibroadenoma as compared to non-surgically treated and higher for other BBDs that were surgically treated versus non-surgically treated. Conclusions  Our results suggest that personal history of BBD is associated with an increased risk of future breast cancer among women in China. Surgical intervention for fibroadenoma may reduce the risk.     

Impact of menopausal symptoms on quality of life 6?months after systemic breast cancer treatment: results from the Shanghai Breast Cancer Survival Study

Menopausal symptoms (MPS) after breast cancer treatment are associated with reduced health-related quality of life (QOL) among Caucasian women. Little is known about whether MPS similarly impact QOL in Asian women with breast cancer. QOL was assessed by using the generic quality of life instruments, Medical Outcome Study of Quality of Life Inventory (MOSQOL-74) or Short Form-36 Health Survey (SF-36) in 4,976 Chinese participants of the Shanghai Breast Cancer Survival Study who were treated for incident, non-metastatic breast cancer within the 6 months before the study interview. Relationships between MPS and QOL were assessed by multiple linear regression, controlling for potential confounders. About 71.4% of study participants experienced MPS, including hot flashes, night sweats, vaginal dryness, depressed mood, and/or dry skin. Women with MPS reported lower overall QOL than women without MPS [mean scores 61.0 vs. 64.0, respectively (MOSQOL-74) and 54.9 vs. 66.9, respectively (SF-36); P < 0.01]. Adjusted mean differences (β) in overall QOL in the presence and absence of MPS were −3.1 (95% CI −3.8, −2.4) with the MOSQOL-74 and −12.3 (95% CI −13.8, −10.9) with the SF-36. Women with any MPS had lower scores for the MOSQOL-74 physical and psychological domains and for the SF-36 social and emotional subscales than those without MPS (P < 0.05 for all). Having several MPS predicted poorer QOL in all domains measured regardless of the instrument used (P _trend < 0.01 for all). Our study indicates that in Chinese women recently treated for breast cancer, MPS adversely impacts QOL. Actively soliciting and treating MPS in these women should significantly improve their QOL.     

Use of oral contraceptives,intrauterine devices and tubal sterilization and cancer risk in a large prospective study,from 1996 to 2006

The association of contraceptive methods, including oral contraceptives (OC), intrauterine devices (IUD) and tubal sterilization (TS), with overall and site‐specific cancer were prospectively investigated in a cohort of 66,661 Chinese women in Shanghai, 76.7% of whom used contraception. During a median follow‐up time of 7.5 years, 2,250 women were diagnosed with cancer. Ever‐use of any contraceptive method was not associated with overall cancer risk [adjusted hazard ratio (HR_adj) = 1.02, 95% CI, 0.92–1.12]. Use of any contraceptive method was associated with increased risk of rectal cancer (HR_adj = 1.68, 95% CI, 1.08–2.62) and reduced risk of thyroid cancer (HR_adj = 0.63, 95% CI, 0.38–1.04). Risk of gallbladder cancer increased with ever use of OC (HR_adj = 2.38, 95% CI, 1.26–4.49). IUD use was associated with a possible reduced risk of thyroid cancer (HR_adj = 0.64, 95% CI, 0.38–1.07). Longer duration of IUD use decreased risk for breast, thyroid and lung cancers. Ever having a TS was associated with increased uterine body cancer (HR_adj = 2.50, 95% CI, 1.47–4.25) and decreased risk of stomach cancer (HR_adj = 0.59, 95% CI, 0.39–0.91). We did not find any contraceptive method to be related to the risk of ovarian cancer but the analyses were based on few events. Although chance findings are a likely explanation for some of the associations found in our study, these findings suggest that various contraceptive methods or reproductive patterns may play a role in the etiology of cancer. © 2008 Wiley‐Liss, Inc.     

Soy intake in association with menopausal symptoms during the first 6 and 36 months after breast cancer diagnosis

It has been suggested that soy food and its components may relieve menopausal symptoms (MPS) including hot flashes, night sweats, and vaginal dryness in healthy women. However, little is known about the effect of soy food intake on MPS in women with breast cancer. We examined associations of occurrence of MPS with soy food intake in 4,842 Chinese women aged 20–75 years who had non-metastatic breast cancer and had not used hormone replacement therapy. MPS were assessed at 6 and 36 months after cancer diagnosis using a standardized questionnaire, and associations with soy food intake were evaluated in multivariate regression analyses. Daily soy food intake was assessed at 6 months postdiagnosis and over the first 36 months postdiagnosis using a validated food frequency questionnaire. The prevalence of MPS was 56% at 6 months and 63% at 36 months postdiagnosis with the hotflash being the most common MPS (~44–55%). Hot flashes occurred mainly in premenopausal breast cancer patients who were in the highest quartile of isoflavone intake at 6 months postdiagnosis (OR = 1.20, 95% CI: 0.98–1.59) compared with the lowest quartile. This association was stronger at 36 months postdiagnosis (OR = 1.59, 95% CI: 1.02–2.48). We found no significant associations for any MPS, night sweats, or vaginal dryness. Neither tamoxifen use nor BMI modified the association between MPS and isoflavone intake. There was no evidence that soy food consumption reduced MPS among breast cancer patients. High soy intake may increase the prevalence of hotflashes among premenopausal patients. Our study suggests that soy acts as an estrogen antagonist in breast cancer patients.