Dietary supplement use, physical activity, body mass index, and pancreatic cancer

膳食补充剂的使用、体力活动、体重指数和胰腺癌

• 批准号: 7790549
• 负责人: Ka Kahe
• 金额: --
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-04-01 至 2012-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7790549
• 关键词: 18 year old; Address; Adult; Affect; Age; American; Anti-Inflammatory Agents; Anti-inflammatory; Antioxidants; Area; Ascorbic Acid; Behavioral; Benefits and Risks; Beta Carotene; Body Weight; Body mass index; Botanicals; Cancer Etiology; Cancer Prognosis; Carotene; Catchment Area; Cessation of life; Cohort Studies; Country; County; Data; Data Analyses; Development; Diagnosis; Diet; Dietary Component; Disease; Environmental Exposure; Epidemiologic Studies; Folate; Funding; Ginkgo biloba; Goals; Health; High Prevalence; Incidence; Individual; Inflammation; Intake; Investigation; Iron; Knowledge; Life; Life Style; Link; Malignant Neoplasms; Malignant neoplasm of pancreas; Measures; Methods; Minerals; Multivitamin; National Cancer Institute; Non-Insulin-Dependent Diabetes Mellitus; Nutrient; Obesity; Omega-3 Fatty Acids; Out-Migrations; Oxidative Stress; Participant; Pharmaceutical Preparations; Physical activity; Pilot Projects; Prevention; Property; Public Health; Questionnaires; Recording of previous events; Recruitment Activity; Registries; Relative (related person); Resources; Risk; Risk Factors; Role; Selenium; Staging; Survival Rate; System; Time; United States; Variant; Vitamin E; Vitamins; Washington; Woman; aged; anticancer research; base; cancer risk; case control; chronic pancreatitis; cigarette smoking; cohort; conventional therapy; dietary supplements; dosage; energy balance; epidemiologic data; follow-up; interest; lycopene; member; men; modifiable risk; neoplasm registry; non-drug; outcome forecast; prevent; protective effect; public health relevance

DESCRIPTION (provided by applicant): Pancreatic cancer is the fourth most common cause of cancer deaths in the United States (U.S.), has a very poor prognosis, and is generally unresponsive to conventional therapies. Therefore, it is critical to identify modifiable factors that can be used in prevention efforts to reduce risk for developing this disease. Diet, physical activity, and obesity have been postulated to potentially influence pancreatic cancer risk, but results are inconsistent. Also, millions of Americans use dietary (vitamin, mineral, and herbal) supplements to prevent cancer and other diseases, but with few exceptions, there is sparse evidence for either their benefits or risks. Specific Aims The goal of this study is to examine associations of various dietary supplements with pancreatic cancer incidence, using previously collected data from a large cohort study with a high proportion of supplement users. The primary specific aims are to investigate associations of supplemental intakes of nutrients with anti-inflammatory (vitamin E, selenium, and omega-3 fatty acids) and antioxidant properties (vitamin C, vitamin E, beta-carotene, lycopene, and selenium) over the 10-year period ending at baseline with the incidence of pancreatic cancer. Secondary aims are to examine associations of intakes of specific, less common vitamin, mineral, botanical, and other supplements (e.g., folate, iron, gingko biloba) and non- steroidal anti-inflammatory drugs (NSAIDs); as well as physical activity and body mass index levels at baseline and ages 18, 30, and 45 years with pancreatic cancer incidence. Methods Between 2000-2002, 77,738 men and women, aged 50-76 from western Washington State completed a baseline questionnaire that captured detailed information on use of 38 supplements over the previous 10 years, diet, physical activity (using a validated questionnaire), anthropometrics, health history, and cancer risk factors. Supplement users were targeted in recruitment; therefore, supplement use by cohort members is both high and of long duration: 79% were ever users of a supplement, and 66% used multivitamins,46% used individual vitamin C, and 47% used individual vitamin E, typically for 5-8 of the previous 10years. The cohort is being followed for pancreatic cancers by linkage to the western Washington SEER cancer registry, deaths by linkage to the Washington State death file, and out-migration from the SEER catchment area by linkage to the National Change of Address system. This proposal seeks funds to conduct analyses addressing the specific aims. We expect to identify 215 pancreatic cancer cases after a mean follow-up of 8.3 years. The primary exposure would be average intake per day over the previous 10 years of the nutrient of interest (single supplements plus multivitamins), and all analyses will be adjusted for diet and other potential confounders and effect modifiers. Significance The results of this study will be one of the first to examine associations of dietary supplement use, as well as physical activity and obesity, with risk for pancreatic cancer, a disease with a high fatality rate and few known modifiable risk factors. We would use data from the only cohort study specifically focused on the etiologic relationships of dietary supplements with cancer risk which carefully measured supplement use and confounding factors. Importantly, given the high prevalence of dietary supplement use in the U.S., our findings will have important public health implications regardless of whether we find protective effects, increased risks, or no effects of supplements on pancreatic cancer risk. PUBLIC HEALTH RELEVANCE: Pancreatic cancer is a highly fatal disease for which there are few known modifiable risk factors. It has been suggested that diet, physical activity, and obesity may impact pancreatic cancer development, but results are inconsistent. Also, many Americans use dietary (vitamin, mineral, and herbal) supplements with limited knowledge regarding their potential benefits and risks. The goal of this proposed study is to examine associations of various dietary supplements, as well as physical activity and body mass index levels at baseline and ages 18, 30, and 45 years, with pancreatic cancer incidence. To accomplish these aims, we would conduct secondary data analyses within a large cohort of men and women (n=77,738), 50-76 years (at baseline) in western Washington state. Cohort members completed a detailed baseline questionnaire covering supplement use over the past 10 years, diet, physical activity, anthropometrics, health history, and cancer risk factors. An expected 215 pancreatic cancer cases would be identified after a mean follow-up of 8.3 years by linkage to the western Washington SEER cancer registry. This proposed project would provide valuable information regarding whether use of dietary supplements, as well as physical activity and body mass index are associated with pancreatic cancer incidence, and would be useful for the millions of American adults who take supplements, regardless of whether protective effects, no effects, or increased risks for specific supplements are found.

描述（由申请人提供）：胰腺癌是美国第四大最常见的癌症死亡原因，预后非常差，并且通常对常规疗法没有反应。因此，确定可用于预防工作以降低患这种疾病的风险的可改变因素至关重要。据推测，饮食、体力活动和肥胖可能会影响胰腺癌风险，但结果并不一致。此外，数百万美国人使用膳食补充剂（维生素、矿物质和草药）来预防癌症和其他疾病，但除了极少数例外，很少有证据表明它们的益处或风险。具体目标本研究的目标是利用之前从一项大型队列研究中收集的数据，研究各种膳食补充剂与胰腺癌发病率的关联，该大型队列研究的补充剂使用者比例很高。主要具体目标是调查在基线结束的 10 年期间补充营养素摄入量与抗炎（维生素 E、硒和 omega-3 脂肪酸）和抗氧化特性（维生素 C、维生素 E、β-胡萝卜素、番茄红素和硒）与胰腺癌发病率的关系。次要目标是检查特定的、不太常见的维生素、矿物质、植物和其他补充剂（例如叶酸、铁、银杏）和非甾体抗炎药（NSAID）摄入量之间的关系；以及基线和 18、30 和 45 岁胰腺癌发病率的体力活动和体重指数水平。方法 2000 年至 2002 年间，来自华盛顿州西部的 77,738 名年龄在 50-76 岁之间的男性和女性完成了一份基线调查问卷，其中包含了过去 10 年中使用 38 种补充剂、饮食、体力活动（使用经过验证的调查问卷）、人体测量、健康史和癌症风险因素的详细信息。招募目标是补充剂用户；因此，队列成员的补充剂使用量既高又持续时间长：79% 的人曾经使用过补充剂，66% 的人使用多种维生素，46% 的人使用单独的维生素 C，47% 的人使用单独的维生素 E，通常在过去 10 年中使用 5-8 年。通过与华盛顿州西部 SEER 癌症登记处的链接来跟踪该队列的胰腺癌情况，通过与华盛顿州死亡档案的链接来跟踪死亡情况，并通过与国家地址变更系统的链接来跟踪 SEER 流域的迁出情况。该提案寻求资金来针对具体目标进行分析。我们预计在平均随访 8.3 年后识别出 215 例胰腺癌病例。主要暴露量是过去 10 年中每天平均摄入的相关营养素（单一补充剂加多种维生素），所有分析都将根据饮食和其他潜在的混杂因素和效果调节剂进行调整。意义 这项研究的结果将是第一个研究膳食补充剂的使用以及体力活动和肥胖与胰腺癌风险之间关系的研究之一，胰腺癌是一种死亡率很高的疾病，且已知的可改变危险因素很少。我们将使用唯一一项专门关注膳食补充剂与癌症风险的病因学关系的队列研究的数据，该研究仔细测量了补充剂的使用和混杂因素。重要的是，鉴于膳食补充剂在美国的使用率很高，无论我们是否发现补充剂对胰腺癌风险有保护作用、增加风险或没有影响，我们的研究结果都将对公共健康产生重要影响。公众健康相关性：胰腺癌是一种高度致命的疾病，已知的可改变的危险因素很少。有人认为饮食、体力活动和肥胖可能会影响胰腺癌的发展，但结果并不一致。此外，许多美国人使用膳食补充剂（维生素、矿物质和草药），但对其潜在益处和风险了解有限。这项拟议研究的目标是检查各种膳食补充剂以及基线和 18、30 和 45 岁的体力活动和体重指数水平与胰腺癌发病率的关系。为了实现这些目标，我们将对华盛顿州西部 50-76 岁（基线）的一大群男性和女性 (n=77,738) 进行二次数据分析。队列成员完成了一份详细的基线调查问卷，涵盖过去 10 年的补充剂使用情况、饮食、体力活动、人体测量、健康史和癌症风险因素。通过与华盛顿西部 SEER 癌症登记处的联系，平均随访 8.3 年后，预计将发现 215 例胰腺癌病例。该拟议项目将提供有关膳食补充剂的使用以及体力活动和体重指数是否与胰腺癌发病率相关的有价值的信息，并且对于数百万服用补充剂的美国成年人有用，无论是否发现特定补充剂的保护作用、无作用或增加的风险。