Adjuvant Nutritional Intervention in Cancer (ANICA) was a clinical study carried out in Denmark in the 1990s with 32 typical patients with breast cancer, aged 32-81 yr and classified high risk because of tumor spread to the lymph nodes. The patients received standard therapy for their breast cancer, but got from the start additionally an adjuvant therapy in form of a cocktail consisting of vitamin C (2,850 mg/day), vitamin E (2,500 IU/day), beta-carotene (32.5 IU/day), selenium (Se; 387 micrograms/day), various other vitamins and essential trace elements, essential fatty acids (1.2 g gamma-linolenic acid/day and 3.5 g omega-3 PUFAs/day), and coenzyme Q10 (CoQ10, 90 mg/day). The protocol was later changed, with reduction of the Se intake and more coenzyme Q10 than when the study was started. The average survival of high-risk breast patients in the study was 50% after 5 yr, whereas for low-risk breast cancer patients (without metastases in the axilla when treatment was started), the average survival was 90% after ten years. The main investigator died, and the final report from the ANICA study was therefore never written. However, the published preliminary results from the trial were very promising; it seems, therefore, important to follow-up this study.
The U.S. National Cancer Institute and the Finnish National Public Institute jointly sponsored a large double-blind, placebo-controlled primary-prevention trial to examine the effects of vitamin E and beta-carotene supplementation on reducing the incidence of lung cancers in male smokers, ages 50-69 years. Supplementation did not result in a significant reduction in lung cancer, and a higher incidence of lung cancer was observed in the group receiving beta-carotene. These results should be examined within the context of the population studied before they are cited as definitive.
The Alpha-Tocopherol, Beta-Carotene (ATBC) Lung Cancer Prevention Study was a randomized, double-blind, placebo-controlled, 2 x 2 factorial design, primary prevention trial testing the hypothesis that alpha-tocopherol (50 mg/day) and beta-carotene (20 mg/day) supplements reduce the incidence of lung cancer and possibly other cancers. Total and disease-specific mortality and incidence of various diseases and symptoms were monitored for safety. Between 1985 and 1993, 29,133 eligible male smokers aged 50 to 69 years at entry were randomized to receive daily active supplements or placebo capsules for 5 to 8 years (median 6.1 years), accumulating 169,751 follow-up years. This report describes the study design, methods, and protocol as well as the baseline characteristics and capsule compliance of the participants. The ATBC Study is the largest lung cancer chemoprevention trial conducted to date.
Comment In: Ann Epidemiol. 1994 Jan;4(1):758205274
Epidemiologists sometimes study the association between two measurements of exposure on the same subjects by grouping the original bivariate continuous data into categories that are defined by the empirical quantiles of the two marginal distributions. Although such grouped data are presented in a two-way contingency table, the cell counts in this table do not have a multinomial distribution. We describe the joint distribution of counts in such a table by the term empirical bivariate quantile-partitioned (EBQP) distribution. Blomqvist (1950, Annals of Mathematical Statistics 21, 539-600) gave an asymptotic EBQP theory for bivariate data partitioned by the sample medians. We demonstrate that his asymptotic theory is not correct, however, except in special cases. We present a general asymptotic theory for tables of arbitrary dimensions and apply this theory to construct confidence intervals for the kappa statistic. We show by simulations that the confidence interval procedures we propose have near nominal coverage for sample sizes exceeding 60 for both 2 x 2 and 3 x 3 tables. These simulations also illustrate that the asymptotic theory of Blomqvist (1950) and the methods that Fleiss, Cohen, and Everitt (1969, Psychological Bulletin 72, 323-327) give for multinomial tables can yield subnominal coverage for kappa calculated from EBQP tables, although in some cases the coverage for these procedures is near nominal levels.
The increase of ubiquinone content in myocardial mitochondria and succinateubiquinone reductase activity in rat blood leucocytes under hypoxic hypoxia and acute microfocal myocardial damage [table: see text] have been shown. At the same time the succinateubiquinone reductase activity of rat myocardial mitochondria do not change substantially. We simultaneously observe the dramatic drop in NADH-ubiquinone reductase activity under experimental myocarditis. This fact demonstrates higher stability of succinateubiquinone reductase system and differences in metabolical processes under hypoxic conditions of different origin. All vitamin E derivatives studied demonstrate substantial antihypoxic activity, which is connected with increased animals' survivability, ubiquinone content in myocardial mitochondria and stabilization and leveling of succinateubiquinone reducatse activity in rat blood leucocytes. alpha-Tocopherolacetate with shortened to six carbon atoms side chain is the most effective in this respect. We discuss possible mechanisms for the realization of vitamin E and its active derivative's antihypoxic effect.
The anti-phlogistic effect of dietary vitamin E supplementation on the acute inflammation observed in experimental lens-induced uveitis in Brown Norway rats was studied. The effects of vitamin E were examined using histopathologic parameters as well as by measuring the levels of arachidonic acid metabolites. Histologic examination of the eyes revealed that the vitamin E-deficient animals had the most severe destruction of the retina, while those animals receiving the vitamin E-supplemented diet exhibited the best preservation of the retinal architecture. Levels of arachidonic acid metabolites, as determined by radioimmunoassay, were significantly higher in vitamin E deficient rats as compared with rats on a normal diet.
Antioxidant dietary status and genetic cardiovascular risk, or how an adequate intake of a-tocopherol, selenium, taurine, magnesium and various other natural antioxidants may overcome the deleterious metabolic consequences related to the E4-4 type of apolipoprotein E.
A cross-sectional study was designed to investigate the association between current consumption of a series of 26 common antioxidant-rich foods (ARF) with serum total antioxidant status (TAS) and plasma vitamin C and E levels in community-dwelling older adults. A convenience sample of the first 94 non-smoking Caucasian men (54%) and women (46%) enrolled in the Quebec Longitudinal Study NuAge were selected. The "Functional Foods Consumption Frequency Questionnaire" (FFCFQ) was administered at recruitment (T1) to ascertain patterns of consumption of ARF over the lifetime. The total Oxygen Radical Antioxidant Capacity (ORAC) of 25 ARF reported by subjects was estimated using published values. Serum TAS was determined based on the Trolox equivalent antioxidant capacity (TEAC) assay while plasma vitamins C and E (a- and ?-tocopherol) levels were analyzed by HPLC. The numbers of ARF eaten daily at T1, estimated from the FFCFQ and calculated from the diet recalls, were significantly correlated (r=0.51, P
Antioxidant vitamins have attracted considerable attention in previous studies of esophageal squamous-cell carcinoma, but dietary studies of adenocarcinoma of the esophagus and gastric cardia remain sparse. Treating these tumors as distinct diseases, we studied intakes of vitamin C, beta-carotene and alpha-tocopherol in a nationwide population-based case-control study in Sweden, with 185, 165, and 258 cases of esophageal adenocarcinoma, esophageal squamous-cell carcinoma, and gastric cardia adenocarcinoma, respectively, and 815 controls. Subjects with a high parallel intake of vitamin C, beta-carotene, and alpha-tocopherol showed a 40-50% decreased risk of both histological types of esophageal cancer compared with subjects with a low parallel intake. Antioxidant intake was not associated with the risk of gastric cardia adenocarcinoma. Separately, vitamin C and beta-carotene reduced the risk of esophageal cancers more than alpha-tocopherol. We found that antioxidant intake is associated with similar risk reductions for both main histological types of esophageal cancer. Our findings indicate that antioxidants do not explain the diverging incidence rates of the 2 histological types of esophageal cancer. Moreover, our data suggest that inverse associations with esophageal squamous-cell carcinoma and adenocarcinoma may be stronger among subjects under presumed higher oxidative stress due to smoking or gastroesophageal reflux, respectively. Our results may be relevant for the implementation of focused, cost-effective preventive measures.