Fats and pancreas cancer

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Hi All,

The conclusion of the pdf-available below

paper may be:

" independently of total energy intake, substituting

polyunsaturated FAs with saturated or monounsaturated FAs may reduce

pancreatic cancer risk, particularly in subjects who are obese. "

Nkondjock A, Krewski D, KC, Ghadirian P.

Dietary patterns and risk of pancreatic cancer.

Int J Cancer. 2005 May 1;114(5):817-23.

PMID: 15609315 [PubMed - in process]

... fatty acid (FA) ... a population-based case-control study of

462 histologically confirmed cases and 4721 frequency-matched

controls in eight Canadian provinces between 1994 and 1997. ...

adjustment for age, province, body mass index, smoking, educational

attainment, fat and total energy intake, statistically significant

inverse associations were observed between pancreatic cancer risk and

palmitate (odds ratios (ORs)=0.73; 95% confidence intervals (CIs)

0.56-0.96; P-trend=0.02), stearate (OR=0.70; 95% CI 0.51-0.94; P-

trend=0.04), oleate (OR=0.75; 95% CI 0.55-1.02; P-trend=0.04),

saturated FAs (OR=0.67; 95% CI 0.50-0.91; P-trend=0.01), and

monounsaturated FAs (OR=0.72; 95% CI 0.53-0.98; P-trend=0.02), when

comparing the highest quartile of intake to the lowest. Significant

interactions were detected between body mass index and both saturated

and monounsaturated FAs, with a markedly reduced risk associated with

intake of stearate (OR=0.36; 95% CI 0.18-0.70; P-trend=0.001), oleate

(OR=0.36; 95% CI 0.19-0.72; P-trend=0.002), saturated FAs (OR=0.35;

95% CI 0.18-0.67; P-trend=0.002), and monounsaturated FAs (OR=0.32;

95% CI 0.16-0.63; P-trend<0.0001) among subjects who are obese. The

results suggest that substituting polyunsaturated FAs with saturated

or monounsaturated FAs may reduce pancreatic cancer risk,

independently of total energy intake, particularly among obese

subjects.

Pancreatic cancer represents the fourth leading cause of cancer-

related deaths in Canada (CCS, 2004), and is among the most rapidly

fatal cancer worldwide (WHO/IARC, 2003).

... cases were more likely to consume high amounts of tobacco. Two

years prior to the diagnosis of cancer, a tendency towards heightened

pancreatic cancer risk with increased BMI was noted, while there were

no appreciable differences between cases and controls with respect to

physical activity. Cases were more likely to have higher fat intake

and greater total energy intake than controls.

... BMI was inversely related to palmitate, saturated and

monounsaturated FAs, but not to stearate or oleate. Smoking was

positively linked with palmitate, stearate, oleate, saturated and

monounsaturated FAs. Educational attainment was positively associated

with palmitate and inversely associated with stearate, but not with

oleate, saturated or monounsaturated FAs.

... Among obese subjects, strong and significant inverse

associations were apparent between stearic acid (OR=0.36; 95% CI 0.18-

0.70; P-trend=0.001), oleic acid (OR=0.36; 95% CI=0.19-0.72; P-

trend=0.002), saturated FAs (OR=0.35; 95% CI 0.18-0.67; P-

trend=0.002), and monounsaturated FAs (OR=0.32; 95% CI 0.16-0.61; P-

trend=0.001) and pancreatic cancer risk

... A high fat intake affects pancreatic cancer risk by

stimulating cholecystokinin (CCK) release, which, in rodents,

increases susceptibility to carcinogens and causes acinar cell

hyperplasia, followed by the development of pancreatic carcinomas

(Longnecker, 1993; Chu et al, 1997). In humans, it has been suggested

that duodenal CCK release might differ significantly according to the

degree of fat saturation, with unsaturated FAs being stronger

stimulants of CCK release than saturated FAs (Beardshall et al,

1989). In response to meals containing different fats, CCK release is

enhanced by one-, two-, and six-fold for saturated, monounsaturated,

and polyunsaturated FAs, respectively.

... A cohort study of pancreatic cancer indicated that dietary

glycaemic load and the glycaemic index are associated with increased

risk of pancreatic cancer among women who were overweight, and among

obese women with low physical activity (Michaud et al, 2002). Obesity

is a physiological state that is accompanied by abnormal glucose

metabolism and greater insulin resistance. Since the pharmacokinetic

properties of both saturated and monounsaturated FAs are not known to

depend on BMI, it is likely that obese subjects may be particularly

susceptible to the type of FA they consume, likely because of some

degree of repression of CCK release.

...

Table 3 ORsa and 95% CIs for pancreatic cancer associated with

dietary fatty acids

---------------------------------------

----------------------------------Quartiles of fatty acid intakes

Fatty acid Q1 Q2 Q3 Q4 P-trend

------------------------------------

Palmitic acid

Median (g day-1) 7.7 7.7 12 37

Cases/controls 142/1180 100/1182 107/1179 113/1180

Multivariate OR (95% CI) 1.00 0.70 (0.53-0.93) 0.74 (0.56-0.97) 0.73

(0.56-0.96) 0.02

Stearic acid

Median±s.d. (g day-1) 2.7 3.1 3.9 6.8

Cases/controls 123/1180 107/1180 111/1181 121/1180

Multivariate OR (95% CI) 1.00 0.81 (0.61-1.08) 0.82 (0.62-1.09) 0.70

(0.51-0.94) 0.04

Oleic acid

Median (g day-1) 13.7 14.6 17.8 28.4

Cases/controls 121/1180 112/1115 100/1181 125/1180

Multivariate OR (95% CI) 1.00 0.91 (0.69-1.20) 0.78 (0.59-1.04) 0.75

(0.55-1.02) 0.04

Saturated FAs

Median (g day-1) 11.2 12.5 15.7 28.8

Cases/controls 127/1180 110/1180 108/1181 117/1180

Multivariate OR (95% CI) 1.00 0.83 (0.63-1.09) 0.79 (0.60-1.04) 0.67

(0.50-0.91) 0.01

Monounsaturated FAs

Median (g day-1) 13.6 15.4 19.0 30.3

Cases/controls 122/1180 116/1181 101/1180 123/1180

Multivariate OR (95% CI) 1.00 0.88 (0.67-1.16) 0.76 (0.57-1.02) 0.72

(0.53-0.98) 0.02

----------------------------------------------------------------------

-----

aFA=fatty acid; OR=odds ratio; CI=confidence interval. Odds ratios

and 95% confidence intervals from the logistic regression model

adjusted for age, province, educational attainment, smoking, BMI,

total fat and energy intake.

Table 4 ORsa and 95% CIs for pancreatic cancer associated with

saturated and monounsaturated fatty acids and body mass index

------------------------------------

------------------------------------------Quartiles of fatty acid

intakes

-----------------------------------------------

BMI FA Q1 Q2 Q3 Q4 P-trend

-----------------------------------------------

<25

Stearic acid 1.00 0.95 (0.61-1.48) 1.19 (0.78-1.81) 0.71 (0.43-1.17)

0.54

Oleic acid 0.96 (0.62-1.48) 0.92 (0.60-1.42) 0.76 (0.46-1.25) 0.28

Saturated FAs 1.12 (0.72-1.73) 1.08 (0.70-1.68) 0.79 (0.49-1.27)

0.44

Monounsaturated FAs 0.93 (0.61-1.44) 0.91 (0.59-1.41) 0.76 (0.46-

1.26) 0.30

25-29.9

Stearic acid 1.00 0.79 (0.50-1.26) 0.81 (0.51-1.29) 0.95 (0.58-1.55)

0.87

Oleic acid 1.02 (0.64-1.63) 0.88 (0.55-1.42) 1.10 (0.67-1.82) 0.90

Saturated FAs 0.92 (0.58-1.45) 0.82 (0.52-1.30) 0.84 (0.51-1.37)

0.48

Monounsaturated FAs 0.93 (0.59-1.47) 0.84 (0.52-1.35) 1.07 (0.64-

1.76) 0.97

30

Stearic acid 1.00 0.62 (0.34-1.14) 0.38 (0.20-0.74) 0.36 (0.18-0.70)

0.001

Oleic acid 0.67 (0.36-1.23) 0.36 (0.18-0.72) 0.36 (0.19-0.72) 0.002

Saturated FAs 0.40 (0.21-0.76) 0.42 (0.23-0.79) 0.35 (0.18-0.67)

0.002

Monounsaturated FAs 0.72 (0.39-1.31) 0.37 (0.19-0.73) 0.32 (0.16-

0.61) 0.001

----------------------------------------------------------------------

aFA=fatty acid. Odds ratios and 95% confidence intervals from the

logistic regression model adjusted for age, province, educational

attainment, smoking, total fat and energy intake.

Al Pater