Methods: The questionnaire contained items on the socio-demographic characteristics, medical condition, quality of life (QOL), nutritional status, functional capacity, and depression status. The forward and backward translation processes of the original English language version of the questionnaire were undertaken by three independent linguistic translators, while its content was validated by an expert team consisting of seven geriatricians, physicians, dietitian, and lecturers. The Malay version of the questionnaire was tested for face validity in 10 older adult patients over 65 years of age. The internal consistency reliability and construct validity were evaluated among 166 older adult patients (mean age, 71.0 years; 73.5% male). The questionnaire was administered through face-to-face interviews with the patients. Minor amendments were made after the content and face validity tests.
Results: The internal consistency reliability was good, as the Cronbach's alpha for most of the scales surpassed 0.70, ranging from 0.70 to 0.98, with only one exception (Mini Nutritional Assessment Short-Form, Cronbach's alpha=0.62). The factor loadings for all scales were satisfactory (>0.40), ranging from 0.45 to 0.90.
Conclusion: The Malay-version CGA showed evidence of satisfactory internal consistency reliability and construct validity in Malaysian geriatric patients.
METHODS AND STUDY DESIGN: Collective food data from MyHeARTs 2012 database were used to construct the MyUM Adolescent FFQ. Seventy-eight participants between 13 and 15 years old in 2014 were selected through convenient sampling for test-retest study. They completed the MyUM Adolescent FFQ twice, with an interval period of one week. One hundred and fifty-six MyHeARTs study participants who were 15 years old in 2014 were randomly selected for this comparative valid-ity study. They completed a 7-day diet history (7DDH) and subsequently completed the self-administered MyUM Adolescent FFQ.
RESULTS: Pearson's correlations between the FFQ and 7DDH for all macronutrients were statistically significant. Energy-adjusted correlations for protein, carbohydrate, and fat were 0.54, 0.63 and 0.49 respectively. Most of the micronutrients and minerals, were statistically correlated ranging from 0.31 to 0.49 after energy adjustment. Cross-classification analyses revealed that more than 70 percent of adolescents were classified into either the same or adjacent quartile of nutrient intake when comparing data of 7DDH and FFQ. No serious systematic bias was evident in the Bland-Altman plots.
CONCLUSION: The 200-item FFQ developed for Malaysian adolescents has moderate to good comparative validity for assessment of macronutrient and micronutrient intake.
METHODS AND STUDY DESIGN: A total of 116 items associated with sociodemographic characteristics (7 items), professional development (3 items), organisational culture's support for the NCP (2 items), knowledge (27 items), attitudes (39 items), practices (20 items), and perceived barriers to implementing the NCP (14 items) were generated for potential inclusion in the KAPB-NCP questionnaire. The questionnaire was reviewed online by an expert panel for its content validity. An in-depth review was conducted by the research team for evaluating the overall comprehensiveness of the questionnaire.
RESULTS: In total, 87 of 100 items of the KAPB sections showed an excellent content validity index (CVI; k* >0.74), whereas 10 showed a satisfactory CVI (k*=0.60-0.74). Only 3 items had a low CVI (k* <0.40). According to the expert panel revisions and the in-depth review, 72 items were incorporated into the questionnaire.
CONCLUSIONS: The KAPB-NCP questionnaire is a content-valid instrument that can assess NCP KAPB.
METHODOLOGY: A total of 396 students from the Management and Science University (MSU) participated during the semester of March 2010. Stratified random sampling was used and consent was obtained before the questionnaire was distributed. ANOVA and the t-test were used for the univariate analysis and multiple linear regression was used for the multivariate analysis.
RESULTS: The participants ages ranged from 18 to 27 years (Mean ± SD = 23.3 ± 1.57), more than half being female (62.4%). The majority were 23 years old or younger, single, Malay and from non-Medical and Health Science faculties and with a family monthly income of less than 10,000 Ringgits Malaysia(79.5%; 99%, 65.9, 52.5%, 63.9%; respectively). Only 18.4% of participants reported a family history of cancer. About 32.1% had a medical check-up in the previous 12 months and 17.4% were smokers. Multivariate analysis showed the faculty type to be significantly associated with knowledge of cancer prevention (p = 0.04). Regular medical check-ups were associated with attitudes and practices of cancer prevention (p = 0.04, p=0.003 respectively), the latter being significantly influenced by sex, family history of cancer and smoking (p = 0.034, p=0.013, p=0.002; respectively).
CONCLUSION: The majority of participants had poor knowledge of nutrition as related to cancer prevention. Attention should be given to regular medical check-ups, awareness of family history and smoking influence.
METHODS: A cross-sectional study was conducted in the Kandy district, Sri Lanka. The nutritional status of older persons was assessed using the Mini Nutritional Assessment -Short Form (MNA-SF). A standardised questionnaire was used to record factors associated with malnutrition: demographic characteristics, financial characteristics, food and appetite, lifestyle, psychological characteristics, physical characteristics, disease and care, oral health, and social factors. Complex sample multinomial logistic regression analysis was performed.
RESULTS: Among the 999 participants included in the study, 748 (69.3%) were females and 251 (25.1%) were males. The mean age was 70.80 years (95% CI: 70.13, 71.47). The prevalence of malnutrition, risk of malnutrition and well-nutrition was 12.5%, 52.4% and 35.1% respectively. In the multivariate model, hypertension (adjusted OR = 1.71; 95% CI: 1.02, 2.89), alcohol consumption (aOR = 4.06; 95% CI: 1.17, 14.07), and increased age (aOR = 1.06; 95% CI: 1.01, 1.11) were positively associated with malnutrition. An increased number of people living with the older person (aOR: 0.91; 95% CI: 0.85, 0.97) was a protective factor among those at risk for malnutrition.
CONCLUSION: Both the prevalence of malnutrition and risk of malnutrition were commonly observed among community-dwelling older persons in Sri Lanka. The associated factors identified in this study might help public health professionals to implement necessary interventions that improve the nutritional status of this population.
METHODS: Multivariable-adjusted Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). After an average of 13.9 years of follow-up, there were 7024 incident prostate cancers and 934 prostate cancer deaths.
RESULTS: Height was not associated with total prostate cancer risk. Subgroup analyses showed heterogeneity in the association with height by tumour grade (P heterogeneity = 0.002), with a positive association with risk for high-grade but not low-intermediate-grade disease (HR for high-grade disease tallest versus shortest fifth of height, 1.54; 95% CI, 1.18-2.03). Greater height was also associated with a higher risk for prostate cancer death (HR = 1.43, 1.14-1.80). Body mass index (BMI) was significantly inversely associated with total prostate cancer, but there was evidence of heterogeneity by tumour grade (P heterogeneity = 0.01; HR = 0.89, 0.79-0.99 for low-intermediate grade and HR = 1.32, 1.01-1.72 for high-grade prostate cancer) and stage (P heterogeneity = 0.01; HR = 0.86, 0.75-0.99 for localised stage and HR = 1.11, 0.92-1.33 for advanced stage). BMI was positively associated with prostate cancer death (HR = 1.35, 1.09-1.68). The results for waist circumference were generally similar to those for BMI, but the associations were slightly stronger for high-grade (HR = 1.43, 1.07-1.92) and fatal prostate cancer (HR = 1.55, 1.23-1.96).
CONCLUSIONS: The findings from this large prospective study show that men who are taller and who have greater adiposity have an elevated risk of high-grade prostate cancer and prostate cancer death.
RESULTS: Out of 339 participants, 24.8% (95% CI 20.21-29.30) fell into the normal nutritional status range; 49.6% (95% CI 44.29-54.91) were at risk for malnutrition while 24.8% (95% CI 20.21-29.30) were in the malnourished range, based on Mini Nutritional Assessment scores. Our findings revealed that belonging to a Dalit community, being unemployed, having experience of any form of mistreatment, lack of physical exercise, experiencing problems with concentration in past 30 days and taking medication for more than one co-morbidity was significantly associated with the malnutrition status of the elderly.
METHODS: To gain a more comprehensive picture on how these markers can modulate BC risk, alone or in conjunction, we performed simultaneous measurements of LTL and mtDNA copy number in up to 570 BC cases and 538 controls from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. As a first step, we measured LTL and mtDNA copy number in 96 individuals for which a blood sample had been collected twice with an interval of 15 years.
RESULTS: According to the intraclass correlation (ICC), we found very good stability over the time period for both measurements, with ICCs of 0.63 for LTL and 0.60 for mtDNA copy number. In the analysis of the entire study sample, we observed that longer LTL was strongly associated with increased risk of BC (OR 2.71, 95% CI 1.58-4.65, p = 3.07 × 10- 4 for highest vs. lowest quartile; OR 3.20, 95% CI 1.57-6.55, p = 1.41 × 10- 3 as a continuous variable). We did not find any association between mtDNA copy number and BC risk; however, when considering only the functional copies, we observed an increased risk of developing estrogen receptor-positive BC (OR 2.47, 95% CI 1.05-5.80, p = 0.04 for highest vs. lowest quartile).
CONCLUSIONS: We observed a very good correlation between the markers over a period of 15 years. We confirm a role of LTL in BC carcinogenesis and suggest an effect of mtDNA copy number on BC risk.
METHODS: Using data from 272,098 women participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, we assessed dietary intake of 92 foods and nutrients estimated by dietary questionnaires. Cox regression was used to quantify the association between each food/nutrient and risk of breast cancer. A false discovery rate (FDR) of 0.05 was used to select the set of foods and nutrients to be replicated in the independent Netherlands Cohort Study (NLCS).
RESULTS: Six foods and nutrients were identified as associated with risk of breast cancer in the EPIC study (10,979 cases). Higher intake of alcohol overall was associated with a higher risk of breast cancer (hazard ratio (HR) for a 1 SD increment in intake = 1.05, 95% CI 1.03-1.07), as was beer/cider intake and wine intake (HRs per 1 SD increment = 1.05, 95% CI 1.03-1.06 and 1.04, 95% CI 1.02-1.06, respectively), whereas higher intakes of fibre, apple/pear, and carbohydrates were associated with a lower risk of breast cancer (HRs per 1 SD increment = 0.96, 95% CI 0.94-0.98; 0.96, 95% CI 0.94-0.99; and 0.96, 95% CI 0.95-0.98, respectively). When evaluated in the NLCS (2368 cases), estimates for each of these foods and nutrients were similar in magnitude and direction, with the exception of beer/cider intake, which was not associated with risk in the NLCS.
CONCLUSIONS: Our findings confirm a positive association of alcohol consumption and suggest an inverse association of dietary fibre and possibly fruit intake with breast cancer risk.
METHODS: Over half a million participants from 10 European countries were followed up for over 11 years, after which 865 newly diagnosed exocrine pancreatic cancer cases were identified. Adherence to the MD was estimated through an adapted score without the alcohol component (arMED) to discount alcohol-related harmful effects. Cox proportional hazards regression models, stratified by age, sex and centre, and adjusted for energy intake, body mass index, smoking status, alcohol intake and diabetes status at recruitment, were used to estimate hazard ratios (HRs) associated with pancreatic cancer and their corresponding 95% confidence intervals (CIs).
RESULTS: Adherence to the arMED score was not associated with risk of pancreatic cancer (HR high vs low adherence=0.99; 95% CI: 0.77-1.26, and HR per increments of two units in adherence to arMED=1.00; 95% CI: 0.94-1.06). There was no convincing evidence for heterogeneity by smoking status, body mass index, diabetes or European region. There was also no evidence of significant associations in analyses involving microscopically confirmed cases, plausible reporters of energy intake or other definitions of the MD pattern.
CONCLUSIONS: A high adherence to the MD is not associated with pancreatic cancer risk in the EPIC study.
METHODS: A total of 1,065 incident colorectal cancer cases (colon, n = 667; rectal, n = 398) were matched (1:1) to control subjects. Serum flagellin- and LPS-specific IgA and IgG levels were quantitated by ELISA. Multivariable conditional logistic regression models were used to calculate ORs and 95% confidence intervals (CI), adjusting for multiple relevant confouding factors.
RESULTS: Overall, elevated anti-LPS and anti-flagellin biomarker levels were not associated with colorectal cancer risk. After testing potential interactions by various factors relevant for colorectal cancer risk and anti-LPS and anti-flagellin, sex was identified as a statistically significant interaction factor (Pinteraction < 0.05 for all the biomarkers). Analyses stratified by sex showed a statistically significant positive colorectal cancer risk association for men (fully-adjusted OR for highest vs. lowest quartile for total anti-LPS + flagellin, 1.66; 95% CI, 1.10-2.51; Ptrend, 0.049), whereas a borderline statistically significant inverse association was observed for women (fully-adjusted OR, 0.70; 95% CI, 0.47-1.02; Ptrend, 0.18).
CONCLUSION: In this prospective study on European populations, we found bacterial exposure levels to be positively associated to colorectal cancer risk among men, whereas in women, a possible inverse association may exist.
IMPACT: Further studies are warranted to better clarify these preliminary observations.
METHODS: Data on highest education attained were gathered for 459,170 participants (70% women) from 10 European countries. A relative index of inequality (RII) based on adult education was calculated for comparability across countries and generations. Cox regression models were applied to estimate relative inequality in pancreatic cancer risk, stratifying by age, gender, and center, and adjusting for known pancreatic cancer risk factors.
RESULTS: A total of 1,223 incident pancreatic cancer cases were included after a mean follow-up of 13.9 (±4.0) years. An inverse social trend was found in models adjusted for age, sex, and center for both sexes [HR of RII, 1.27; 95% confidence interval (CI), 1.02-1.59], which was also significant among women (HR, 1.42; 95% CI, 1.05-1.92). Further adjusting by smoking intensity, alcohol consumption, body mass index, prevalent diabetes, and physical activity led to an attenuation of the RII risk and loss of statistical significance.
CONCLUSIONS: The present reanalysis does not sustain the existence of an independent social inequality influence on pancreatic cancer risk in Western European women and men, using an index based on adult education, the most relevant social indicator linked to individual lifestyles, in a context of very low pancreatic cancer survival from (quasi) universal public health systems.
IMPACT: The results do not support an association between education and risk of pancreatic cancer.