To study the effects of meat intake, including heterocyclic amine exposure, on the risk of breast... more To study the effects of meat intake, including heterocyclic amine exposure, on the risk of breast cancer, we conducted a hospital-based case-control study involving 352 patients with breast cancer and 382 controls. A strong effect of red meat, total meat, beef, fried meat, and heterocyclic amine exposure was found, after controlling for potential confounders. The odds ratio for the highest quartile of 2-amino-3-methylimidazo [4,5-f]quinoline exposure was 3.34 (95% confidence interval 1.85-6.02). According to these results, meat intake and chemicals formed during the cooking process appear to be strong risk factors in human breast carcinogenesis.
Background: In 1995, Remer and Manz reported potential renal acid load (PRAL) values of various f... more Background: In 1995, Remer and Manz reported potential renal acid load (PRAL) values of various foods, quantifying their estimated impact on acid–base balance. Their estimation considered ionic dissociation, sulphur metabolism and intestinal absorption rates for several micronutrients and proteins. Notably, PRAL values are based on food content data from the early 1990s and may nowadays no longer adequately reflect accurate estimates. Some foods’ macronutrient and mineral content has declined over the past three decades due to changes in soil mineral health. Aim: We hypothesize that the 1995 PRAL values no longer adequately reflect reliable estimates of the current acid–base impact of some foods. Methods: Based on specific examples, we argue that these values overestimate the alkalizing effects of various fruits and vegetables. Conclusion: Discussing evidence in favour of (and against) our hypothesis, we conclude that the 1995 PRAL estimates should nowadays rather be used as a relative guidance and reviewed carefully.
Cancer treatment and research communications, 2021
BACKGROUND Dysregulation of the endogenous acid-base balance can contribute to inflammation and c... more BACKGROUND Dysregulation of the endogenous acid-base balance can contribute to inflammation and cancer development if metabolic acidosis is sustained. The epidemiologic evidence on the association between diet-dependent acid load and cancer risk is scarce and inconsistent. We aim to explore the possible role of dietary acid load in lung cancer (LC) risk. METHODS A case-control study was performed on 843 LC cases and 1466 controls by using a multi-topic questionnaire, including a food frequency questionnaire. Controls were matched to cases by age-frequency, urban/rural residence, and region. Food-derived nutrients were calculated from available databases. The dietary acid load was calculated using validated measures as potential renal acid load (PRAL) score and net endogenous acid production (NEAP) score. Odds ratios (ORs) were estimated by logistic regression. RESULTS We found direct associations between dietary acid load and LC risk. The highest quartile of the NEAP score was significantly associated (OR=2.22, ptrend<0.001). The PRAL score displayed similar associations in simpler regression models, but there was no association when a more complex one was used (OR=0.99, ptrend =0.94). The NEAP score was associated with a significant risk increase in all cell types, except for small cell cancers, but the PRAL score did not show any association. CONCLUSIONS The NEAP scores, directly associated with meat intake and inversely associated with plant-based foods intake, suggest that a high acid load dietary style may increase LC risk. Studies focused on food groups, and nutritional patterns are in line with our findings. Although the data shown here represent the first one to be published on this issue, further studies are needed to confirm these findings.
In the time period 1996-2004, a case-control study of colorectal cancer was conducted in Montevid... more In the time period 1996-2004, a case-control study of colorectal cancer was conducted in Montevideo, Uruguay. The study included 610 cases and 1,220 controls, frequency matched for age, sex, and residence. All cases were newly diagnosed and microscopically confirmed and controls were drawn from the same hospitals. Controls were submitted to factor analysis (principal components method) and 4 dietary patterns for men (prudent, traditional, Western, drinker) and 3 for women (prudent, Western, drinker) were retained. These were rotated and normalized by the Kaiser method. Scores were applied to all participants (cases and controls) and odds ratios were estimated by logistic regression and polynomial regression. The Western pattern showed an OR of 2.62 (95 % CI 1.36-5.08) for colon cancer among men, and women displayed a similar increase in risk. However, rectal cancer was not associated with this diet, rather being inversely associated with the prudent and traditional patterns among men (OR 0.49, 95 % CI 0.28-0.57 for the traditional pattern). In conclusion, whereas the Western pattern was directly associated with colon cancer, the prudent pattern was strongly protective for rectal cancer.
Purpose Changes in eating habits and food preferences caused by circadian rhythm disruptions in s... more Purpose Changes in eating habits and food preferences caused by circadian rhythm disruptions in shift workers increase the risk for chronic diseases. Several studies demonstrated that shift work exerts adverse effects on various risk factors for cardiometabolic disease and cancer. Moreover, shift work leads to altered eating patterns, including diets low in alkaline foods (such as vegetables, fruit and legumes) and high in acidogenic foods (such as meat, fish and cheese). Previously not examined, this imbalance could result in a high dietary acid load (DAL). DAL has been linked to low-grade metabolic acidosis, tissue inflammation and other metabolic alterations. The aim of this study was to investigate the hypothesis that shift work is positively associated with an increased DAL. Design/methodology/approach The authors used cross-sectional data from the National Health and Nutrition Examination Surveys (2007–2010). The sample for this analysis was drawn from a representative multistage-probability sample of US civilians. DAL estimations included potential renal acid load (PRAL) and net endogenous acid production (NEAP). Acid load scores and nutrient intake were compared between regular day workers (n = 3,814; mean age, 43.7 ± 0.3; mean body mass index (BMI), 28.6 ± 0.1; females 46.9%) and shift workers (n = 881; age, 37.4 ± 0.6; BMI, 28.4 ± 0.3; females 48.1%). Evening/night shift workers combined with rotating shift workers were contrasted to participants on a regular daytime schedule. Findings Potassium and magnesium intake were significantly lower in shift workers, whereas no significant differences with regard to total energy intake were found. The authors found significantly higher crude NEAPF scores in shift workers (mean: 61.8 ± 1.2 mEq/day) compared to regular day workers (mean: 58.7 ± 0.5 mEq/day, P = 0.023). After adjustment for confounders, however, this association remained no longer significant. There were no significant intergroup differences regarding NEAPR and PRALR. Research limitations/implications This study revealed significant differences in crude NEAPF scores between shift workers and day workers. After adjustment for confounders, this association was no longer significant. Such discrepancy is probably because of the scarce homogeneity in the analyzed sample which represents the main limitation of this study. Thus, the results did not confirm the hypothesis that shift work is associated with elevated DAL scores. Importantly, the data suggest significant intergroup differences in nutrient intakes without confirming our initial hypothesis with regard to DAL. Originality/value In light of the detrimental health outcomes associated with an increased DAL, this study reinforces the call for evidence-based dietary guidelines in shift workers. Studies in other shift working populations are thus warranted.
To study the effects of meat intake, including heterocyclic amine exposure, on the risk of breast... more To study the effects of meat intake, including heterocyclic amine exposure, on the risk of breast cancer, we conducted a hospital-based case-control study involving 352 patients with breast cancer and 382 controls. A strong effect of red meat, total meat, beef, fried meat, and heterocyclic amine exposure was found, after controlling for potential confounders. The odds ratio for the highest quartile of 2-amino-3-methylimidazo [4,5-f]quinoline exposure was 3.34 (95% confidence interval 1.85-6.02). According to these results, meat intake and chemicals formed during the cooking process appear to be strong risk factors in human breast carcinogenesis.
Background: In 1995, Remer and Manz reported potential renal acid load (PRAL) values of various f... more Background: In 1995, Remer and Manz reported potential renal acid load (PRAL) values of various foods, quantifying their estimated impact on acid–base balance. Their estimation considered ionic dissociation, sulphur metabolism and intestinal absorption rates for several micronutrients and proteins. Notably, PRAL values are based on food content data from the early 1990s and may nowadays no longer adequately reflect accurate estimates. Some foods’ macronutrient and mineral content has declined over the past three decades due to changes in soil mineral health. Aim: We hypothesize that the 1995 PRAL values no longer adequately reflect reliable estimates of the current acid–base impact of some foods. Methods: Based on specific examples, we argue that these values overestimate the alkalizing effects of various fruits and vegetables. Conclusion: Discussing evidence in favour of (and against) our hypothesis, we conclude that the 1995 PRAL estimates should nowadays rather be used as a relative guidance and reviewed carefully.
Cancer treatment and research communications, 2021
BACKGROUND Dysregulation of the endogenous acid-base balance can contribute to inflammation and c... more BACKGROUND Dysregulation of the endogenous acid-base balance can contribute to inflammation and cancer development if metabolic acidosis is sustained. The epidemiologic evidence on the association between diet-dependent acid load and cancer risk is scarce and inconsistent. We aim to explore the possible role of dietary acid load in lung cancer (LC) risk. METHODS A case-control study was performed on 843 LC cases and 1466 controls by using a multi-topic questionnaire, including a food frequency questionnaire. Controls were matched to cases by age-frequency, urban/rural residence, and region. Food-derived nutrients were calculated from available databases. The dietary acid load was calculated using validated measures as potential renal acid load (PRAL) score and net endogenous acid production (NEAP) score. Odds ratios (ORs) were estimated by logistic regression. RESULTS We found direct associations between dietary acid load and LC risk. The highest quartile of the NEAP score was significantly associated (OR=2.22, ptrend<0.001). The PRAL score displayed similar associations in simpler regression models, but there was no association when a more complex one was used (OR=0.99, ptrend =0.94). The NEAP score was associated with a significant risk increase in all cell types, except for small cell cancers, but the PRAL score did not show any association. CONCLUSIONS The NEAP scores, directly associated with meat intake and inversely associated with plant-based foods intake, suggest that a high acid load dietary style may increase LC risk. Studies focused on food groups, and nutritional patterns are in line with our findings. Although the data shown here represent the first one to be published on this issue, further studies are needed to confirm these findings.
In the time period 1996-2004, a case-control study of colorectal cancer was conducted in Montevid... more In the time period 1996-2004, a case-control study of colorectal cancer was conducted in Montevideo, Uruguay. The study included 610 cases and 1,220 controls, frequency matched for age, sex, and residence. All cases were newly diagnosed and microscopically confirmed and controls were drawn from the same hospitals. Controls were submitted to factor analysis (principal components method) and 4 dietary patterns for men (prudent, traditional, Western, drinker) and 3 for women (prudent, Western, drinker) were retained. These were rotated and normalized by the Kaiser method. Scores were applied to all participants (cases and controls) and odds ratios were estimated by logistic regression and polynomial regression. The Western pattern showed an OR of 2.62 (95 % CI 1.36-5.08) for colon cancer among men, and women displayed a similar increase in risk. However, rectal cancer was not associated with this diet, rather being inversely associated with the prudent and traditional patterns among men (OR 0.49, 95 % CI 0.28-0.57 for the traditional pattern). In conclusion, whereas the Western pattern was directly associated with colon cancer, the prudent pattern was strongly protective for rectal cancer.
Purpose Changes in eating habits and food preferences caused by circadian rhythm disruptions in s... more Purpose Changes in eating habits and food preferences caused by circadian rhythm disruptions in shift workers increase the risk for chronic diseases. Several studies demonstrated that shift work exerts adverse effects on various risk factors for cardiometabolic disease and cancer. Moreover, shift work leads to altered eating patterns, including diets low in alkaline foods (such as vegetables, fruit and legumes) and high in acidogenic foods (such as meat, fish and cheese). Previously not examined, this imbalance could result in a high dietary acid load (DAL). DAL has been linked to low-grade metabolic acidosis, tissue inflammation and other metabolic alterations. The aim of this study was to investigate the hypothesis that shift work is positively associated with an increased DAL. Design/methodology/approach The authors used cross-sectional data from the National Health and Nutrition Examination Surveys (2007–2010). The sample for this analysis was drawn from a representative multistage-probability sample of US civilians. DAL estimations included potential renal acid load (PRAL) and net endogenous acid production (NEAP). Acid load scores and nutrient intake were compared between regular day workers (n = 3,814; mean age, 43.7 ± 0.3; mean body mass index (BMI), 28.6 ± 0.1; females 46.9%) and shift workers (n = 881; age, 37.4 ± 0.6; BMI, 28.4 ± 0.3; females 48.1%). Evening/night shift workers combined with rotating shift workers were contrasted to participants on a regular daytime schedule. Findings Potassium and magnesium intake were significantly lower in shift workers, whereas no significant differences with regard to total energy intake were found. The authors found significantly higher crude NEAPF scores in shift workers (mean: 61.8 ± 1.2 mEq/day) compared to regular day workers (mean: 58.7 ± 0.5 mEq/day, P = 0.023). After adjustment for confounders, however, this association remained no longer significant. There were no significant intergroup differences regarding NEAPR and PRALR. Research limitations/implications This study revealed significant differences in crude NEAPF scores between shift workers and day workers. After adjustment for confounders, this association was no longer significant. Such discrepancy is probably because of the scarce homogeneity in the analyzed sample which represents the main limitation of this study. Thus, the results did not confirm the hypothesis that shift work is associated with elevated DAL scores. Importantly, the data suggest significant intergroup differences in nutrient intakes without confirming our initial hypothesis with regard to DAL. Originality/value In light of the detrimental health outcomes associated with an increased DAL, this study reinforces the call for evidence-based dietary guidelines in shift workers. Studies in other shift working populations are thus warranted.
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Papers by Alvaro Ronco