Browsing by Subject "kokonaisantioksidanttikapasiteetti"

Background: Cancer is the leading cause of death worldwide, claiming 7.6 million lives a year. Five behavioural factors have been recognised to be responsible for 30 % of the disease burden. Among them is low fruit and vegetable consumption. Fruit and vegetable consumption has been inversely associated with cancer risk but the mechanisms behind this effect are still largely debated. Dietary antioxidants present in large quantities in plant foods have been hypothesised to contribute to this protection. Objective: The aim of this study was to investigate the relationship between dietary total antioxidant capacity (TAC) and overall cancer incidence. This was done applying a new antioxidant measurement that reflects the whole set of direct antioxidant reducers (vitamin C, alpha-tocopherol, carotenoids and flavonoids) present in diet. The average TAC intake levels of the participants were assessed and the main dietary contributors to the TAC scores were examined. Subjects: Study subjects included 67 634 middle aged French women participating in an on-going prospective cohort study called E3N. Their dietary assessment was made between June 1993 and July 1995 using a semi-quantitative food frequency questionnaire able to quantitatively and qualitatively assess the average daily intake of 208 different foods, recipes and beverages. Cancer cases were self-reported and validated against medical records. The follow up of the participants ended in May 2008. Methods: Four different total antioxidant capacity scores were created using two different TAC methods, the ferric reducing ability parameter (FRAP) and the total radical-trapping antioxidant parameter (TRAP), and including or excluding coffee from the dietary TAC calculation. Coffee exclusion was justified with the fact that it is the largest contributor to the dietary TAC intake, and because of its association with some negative lifestyle behaviours, it can act as a confounder even if adjustments are made. Statistical analyses for cancer risk according to dietary TAC intake were made using Cox proportional hazards model adjusting for energy intake without alcohol, tobacco smoking, alcohol intake, BMI, physical activity level, educational background, region of residence and family history of cancer. Results: When coffee was included in the dietary TAC scores a significant but modest increase in cancer risk was observed towards higher TAC intakes (p for trend < 0.05 for both FRAP and TRAP). On the contrary, when coffee was excluded from the TAC scores a significant although modest decrease in overall cancer risk was observed (p for trend = 0.016 for both FRAP and TRAP without coffee). In the indexes where coffee was included in the score it contributed up to 43 % and 76 % of total FRAP and TRAP scores respectively. After coffee the main contributors to dietary TAC intake were tea, wine, fruits, vegetables, fruit juice and chocolate. The mean daily intake of TAC was 20.5 mmol of FRAP and 20.2 TE of TRAP in the scores including coffee. When coffee was excluded from the scores, the mean intake levels dropped to 9.4 mmol and 4.9 TE. Conclusion: Dietary total antioxidant capacity was associated with a statistically significant but modest decrease in cancer incidence when intake of coffee, the main TAC source, was not taken into account. Coffee seems to be acting as a confounding factor since when it was included in the TAC scores, there was a small but statistically significant positive association with cancer risk. For future studies it would be crucial to standardise the TAC methods so that comparisons between studies could be made. On the other hand in vitro nature of the TAC methods should be kept in mind; a fact that challenges the interpretation of the results from the biological perspective.