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1.  Dietary α-, β-, γ- and δ-tocopherols in lung cancer risk 
Studies of vitamin E and cancer have focused on the α-tocopherol form of the vitamin. However, other forms of vitamin E, in particular γ-tocopherol may have unique mechanistic characteristics relevant to lung cancer prevention. In an ongoing study of 1,088 incident lung cancer cases and 1,414 healthy matched controls, we studied the associations between 4 tocopherols (α-, β-, γ-, and δ-tocopherol) in the diet and lung cancer risk. Using multiple logistic regression analysis, the adjusted odds ratios (OR) and 95% confidence intervals (CI) of lung cancer for increasing quartiles of dietary α-tocopherol intake were 1.0, 0.63 (0.50–0.79), 0.58 (0.44–0.76) and 0.39 (0.28–0.53), respectively (p-trend < 0.0001). For dietary intake of β-tocopherol, the OR and 95% CI for all subjects were: 1.0, 0.79 (0.63–0.98), 0.59 (0.45–0.78) and 0.56 (0.42–0.74), respectively (p-trend < 0.0001). Similar results for dietary γ-tocopherol intake were observed: 1.0, 0.84 (0.67–1.06), 0.76 (0.59–0.97) and 0.56 (0.42–0.75), respectively (p- trend = 0.0002). No significant association between δ-tocopherol intake and lung cancer risk was detected. When the 4 tocopherols were summed as total tocopherol intake, a monotonic risk reduction was also observed. When we entered the other tocopherols in our model, only the association with dietary α-tocopherol intake remained significant; i.e., increasing intake of dietary α-tocopherol accounted for 34–53% reductions in lung cancer risk. To the best of our knowledge, this is the first report of the independent associations of the 4 forms of dietary tocopherol (α-, β-, γ- and δ-tocohperol) on lung cancer risk. Given the limitations with case-control studies, these findings need to be confirmed in further investigations.
PMCID: PMC3380426  PMID: 18546288
dietary tocopherols; lung cancer risk; diet and lung cancer; vitamin E and lung cancer
2.  Extant health behaviors and uptake of standardized vs tailored health messages among cancer survivors enrolled in the FRESH START trial: a comparison of fighting-spirits vs fatalists 
Psycho-Oncology  2010;21(1):108-113.
Cancer coping styles have been associated with several cancer-related outcomes. We examined whether baseline lifestyle behaviors differed between cancer survivors with fatalistic vs fighting-spirit coping styles, and whether there was differential response to two diet-exercise mailed-print interventions, one standardized and another individually tailored.
Baseline differences by coping style are presented for 628 breast and prostate cancer survivors who participated in the FRESH START trial, along with multivariable analyses on rates of uptake by coping style and arm assignment for those completing the 2-year trial.
At baseline, several differences were observed between fighting-spirits and fatalists, with the former significantly more likely to be white, younger, leaner, more-educated and at risk for depression, and less likely to consume 5+ fruits and vegetables (F&V)/day (p-values<0.05). Improvements in physical activity were observed, with fighting-spirits exhibiting the greatest gains from baseline to Year-1, regardless of intervention type; but by Year-2, these differences diminished as fatalists gained ground. Moreover, fatalists who received standardized intervention material also charted steady improvements in F&V intake over the study period; by Year-2, 58.1% of fatalists achieved the 5-a-day goal vs 44.6% of fighting-spirits (p-value<0.05).
Lifestyle behaviors and health message uptake differs by cancer coping style. Although tailored interventions appear most effective and minimize differential uptake, standardized interventions also can improve behaviors, though fighting-spirits may require additional boosters to maintain change.
PMCID: PMC3248978  PMID: 21061408
coping; personality traits; diet; exercise; interventions; cancer survivors
3.  Construction of an N-nitroso database for assessing dietary intake 
Dietary N-nitroso compounds are carcinogens synthesized during food processing from two main classes of precursors, oxides of nitrogen and amines or amides. Quantification of the dietary intake of N-nitroso compounds is significant to human cancers, including those of the stomach and upper gastro-intestinal tract, colon, and brain. Previous studies investigating these cancers primarily used proxy estimates of N-nitroso intake and not a full and complete database. In this report, we describe the development of a database to be used in conjunction with a food frequency questionnaire (FFQ) or twenty-four hour dietary records. Published analytical data for N-nitroso compounds were compiled and evaluated for inclusion in the database. The final database consisted of 23 different N-nitroso compounds for 500 foods from 39 different food subgroups. Next, database foods were matched to foods in a standard FFQ by imputation, or calculated value, or assumed zero. Using the FFQ modified with N-nitroso values, we evaluated the ability to compute N-nitroso intakes for a sample of healthy control subjects of cancer epidemiological studies. N-nitroso content of food items ranged from <0.01μg/100 g. to 142 μg/100 g and the richest sources were sausage, smoked meats, bacon, and luncheon meats. The database is useful to quantify N-nitroso intake for observational and epidemiological studies.
PMCID: PMC2786176  PMID: 20161416
N-nitroso compounds; Dietary carcinogens; Food data; Food safety; Food composition database; Food analysis; Food composition
4.  N-Nitroso Compounds: Assessing Agreement between Food Frequency Questionnaires and 7-day Food Records 
N-nitroso compounds are recognized as important dietary carcinogens. Accurate assessment of N-nitroso intake is fundamental to advancing research regarding its role with cancer. Previous studies have not used a quantitative database to estimate their intake. To address this gap a database of N-nitroso values was developed in conjunction with an existing food frequency questionnaire (FFQ). The purpose of this paper is to report on the relative validity of the FFQ instrument modified to estimate N-nitroso compounds. Intake estimates of 23 N-nitroso compounds from FFQ were compared with those from seven days of food records (7DFR) in a cross-sectional study conducted from January 2005 through June 2006. A sample of 98 healthy adult subjects (50.42 ± 12.84 years) completed a FFQ and then recorded foods and beverages consumed (7DFR). Crude and energy-adjusted N-nitroso compounds intakes were significantly higher in the FFQ than the 7DFR(P < 0.001). Spearman correlations for crude and energy-adjusted N-nitroso intakes ranged from 0.004 to 0.48. By tertiles of N-ntiroso compounds, there was moderate agreement (Kappa >0.30) for five compounds. Higher estimates of N-nitroso compounds by FFQ was explained by a greater proportion of subjects who reported eating foods high in N-nitroso compounds on FFQ than reported on 7DFR. The modified FFQ with N-nitroso values is a useful tool for assessing N-nitroso intakes relative to a group, and captures all food items with N-nitroso compounds including those foods with high concentrations and eaten sporadically.
PMCID: PMC2736544  PMID: 19559134
dietary methodology; validation; dietary carcinogens
5.  Dietary magnesium and DNA repair capacity as risk factors for lung cancer 
Carcinogenesis  2008;29(5):949-956.
Magnesium (Mg) is required for maintenance of genomic stability; however, data on the relationship between dietary Mg intake and lung cancer are lacking. In an ongoing lung cancer case–control study, we identified 1139 cases and 1210 matched healthy controls with data on both diet and DNA repair capacity (DRC). Dietary intake was assessed using a modified Block-NCI food frequency questionnaire and DRC was measured using the host-cell reactivation assay to assess repair in lymphocyte cultures. After adjustment for potential confounding factors including DRC, the odds ratios (ORs) and 95% confidence intervals (CIs) for lung cancer with increasing quartiles of dietary Mg intake were 1.0, 0.83 (0.66–1.05), 0.64 (0.50–0.83) and 0.47 (0.36–0.61), respectively, for all subjects (P-trend < 0.0001). Similar results were observed by histology and clinical stage of lung cancer. Low dietary Mg intake was associated with poorer DRC and increased risk of lung cancer. In joint effects analyses, compared with those with high dietary Mg intake and proficient DRC, the OR (95% CI) for lung cancer in the presence of both low dietary Mg and suboptimal DRC was 2.36 (1.83–3.04). Similar results were observed for men and women. The effects were more pronounced among older subjects (>60 years), current or heavier smokers, drinkers, those with a family history of cancer in first-degree relatives, small cell lung cancer and late-stage disease. These intriguing results need to be confirmed in prospective studies.
PMCID: PMC2902380  PMID: 18448487

Results 1-5 (5)