The Combined Effects of Animal Products Intake and Physical Activity With Cause-specific and All-cause Mortality Among Patients With Type 2 Diabetes Mellitus in China: A Prospective Cohort Study

BackgroundTo determine the associations of animal products intake and physical activity and their combined effects with cause-specific and all-cause mortality among type 2 diabetes mellitus (T2DM) patients in China.MethodsBaseline data of 7311 type 2 diabetes mellitus (T2DM) patients recruited with a stratified random cluster sampling method were collected from December 2013 to January 2014. Participants were followed up until the date of their death or December 2019 for survivors, whichever came first. Nonlinear trends of cause-specific and all-cause mortality were assessed using restricted cubic splines with three knots placed at centiles 10, 50, and 90 of diet intake. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the combined relationship of physical activity and animal products with cause-specific and all-cause mortality.ResultsDuring a median follow-up of 6.1 years, 692 (9.5%) T2DM patients died. The main cause of death was cardiovascular disease (CVD) (35.8%), followed by cancer (20.6%). After multivariable adjustment, a higher level of physical activity was nonlinearly associated with lower all-cause and CVD mortality in a J-shaped pattern, with the protective effect observed >8 MET-h/d. Higher consumption of red meat, poultry, and aquatic products was associated with a lower risk of all-cause mortality (HR = 0.75, 0.64, 0.75, respectively, all P<0.05). In the highest tertiles of physical activity, a higher intake of red meat, poultry, and aquatic products was associated with a lower risk for all-cause mortality than in the lowest tertiles (red meat, HR = 0.80, 0.62, 0.51, and 0.48; poultry, HR = 0.85, 0.51, 0.48, and 0.45; aquatic products, HR = 0.80, 0.57, 0.55, and 0.40, respectively). Similarly, the protective effect of moderate to high intake of poultry, aquatic products, and eggs on CVD mortality in high physical activity was found. ConclusionsOur study highlights that in T2DM patients, better adherence to moderate to high consumption of animal products, including red meat, poultry, and aquatic products, together with engaging in moderate to high levels of physical activity exerts a beneficial effect in lowering cause-specific and all-cause mortality in China.

Title: Risk Factors for the Diagnosis of Colorectal Cancer

Background Colorectal cancer defined as cancer of the colon or rectum, is the third most frequently diagnosed cancer in men and the second in women, and, according to the World Health Organization database GLOBOCAN, it accounts for nearly 1.4 million new cases annually worldwide. The occurrence of colorectal cancer is associated with nonmodifiable risk factors, including age and hereditary factors, as well as with modifiable environmental and lifestyle factors. Methods The study included 800 patients, 400 diagnosed with colorectal cancer and 400 within the control group, who gave their written informed consent to participate in the study. Patients with cancer other than colorectal cancer were randomly selected for control group I, and patients with no cancer diagnosis were selected for control group II. The method used was a case-control study – an observational and analytical study with a control group, conducted among patients of the Clinical Oncology Centre and the Provincial Hospital in the years 2019–2020. The study comparing the exposure was carried out in a group of people who developed the endpoint, that is colorectal cancer, with the exposure in a well-matched group of controls who did not reach the endpoint. Assessment of activity and BMI was used according to WHO recommendations, as well as the expert system. The data were tested for the distribution and the homogeneity of variance was validated before applying the parameter tests. Comparison of quantitative variables between groups was performed using ANOVA. Results The mean age of the patients was 64.53 ± 8.86 years, of the control group I – 59.64 ± 9.33 and the control group II – 57.5 (7.83). There was a strong positive association between the incidence of ulcerative colitis and the risk of colorectal cancer ( P < .01). Among obese subjects, the risk of developing colorectal cancer was 1.27 (95% CI, 1.06–1.53) compared with nonobese subjects. A strong positive relationship was found between low physical activity converted to metabolic equivalent of MET effort per week and the risk of colorectal cancer ( P < .001). The relative risk for current smokers was 2.17 (95% CI 1.79–2.66). There was an association between higher fat consumption and higher red meat consumption and the risk of developing colorectal cancer ( P < .01). Conclusions Obesity, low physical activity, active and passive smoking and high salt and red meat consumption have been associated with an increased risk of colorectal cancer. These findings provide further evidence of the importance of maintaining a healthy lifestyle.

Amino Acids and Lipids Associated with Long-Term and Short-Term Red Meat Consumption in the Chinese Population: An Untargeted Metabolomics Study

Red meat (RM) consumption is correlated with multiple health outcomes. This study aims to identify potential biomarkers of RM consumption in the Chinese population and evaluate their predictive ability. We selected 500 adults who participated in the 2015 China Health and Nutrition Survey and examined their overall metabolome differences by RM consumption by using elastic-net regression, then evaluate the predictivity of a combination of filtered metabolites; 1108 metabolites were detected. In the long-term RM consumption analysis 12,13-DiHOME, androstenediol (3α, 17α) monosulfate 2, and gamma-Glutamyl-2-aminobutyrate were positively associated, 2-naphthol sulfate and S-methylcysteine were negatively associated with long-term high RM consumption, the combination of metabolites prediction model evaluated by area under the receiver operating characteristic curve (AUC) was 70.4% (95% CI: 59.9–80.9%). In the short-term RM consumption analysis, asparagine, 4-hydroxyproline, and 3-hydroxyisobutyrate were positively associated, behenoyl sphingomyelin (d18:1/22:0) was negatively associated with short-term high RM consumption. Combination prediction model AUC was 75.6% (95% CI: 65.5–85.6%). We identified 10 and 11 serum metabolites that differed according to LT and ST RM consumption which mainly involved branch-chained amino acids, arginine and proline, urea cycle and polyunsaturated fatty acid metabolism. These metabolites may become a mediator of some chronic diseases among high RM consumers and provide new evidence for RM biomarkers.

Indication of a Type of DNA Damage Called "Alkylation" as High Levels of Tumor Alkylation Damage

In this recent study, DNA data from 900 patients with colorectal cancer were reviewed. Analysis of the data showed a distinct mutation signature, a pattern that had never been identified before but indicated a type of DNA damage called "alkylation." Red meat contains chemicals that can cause alkylation. High levels of tumor alkylation damage are seen only in patients who consume an average of more than 150 grams of meat per day, roughly equivalent to two or more meals. On the other hand, a group of researchers in 2019 in a controversial conclusion stated that they do not have much confidence in reducing deaths from colon cancer by avoiding red meat. Keywords: Cancer; Cells; Tissues; Tumors; Prevention; Prognosis; Diagnosis; Imaging; Screening, Treatment; Management

Communicating Food Risk-Benefit Assessments: Edible Insects as Red Meat Replacers

Risk-benefit Assessment (RBA) is an emerging methodology in the area of Food and Nutrition that offers a simultaneous evaluation of both risks and benefits linked to dietary choices. Communication of such research to consumers may present a challenge due to the dual nature of RBA. We present a case study of a communication strategy developed for the NovRBA-project. The NovRBA-project (Novel foods as red meat replacers—an insight using Risk Benefit Assessment methods) performed a risk-benefit assessment to evaluate the overall health impact of substituting red meat (beef) by a novel food (house cricket), considering the microbial, toxicological and nutritional characteristics of the respective dietary choices. A literature review of risk perceptions and acceptance of beef and insects as food formed the basis of the communication strategy for the study's results, drawing on environmental and emotional as well as health-related motivations to consume or avoid either food and considering the sociodemographic characteristics of likely consumers. Challenges and future directions for consumer protection organizations communicating findings of risk-benefit analyses on food safety are discussed.