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Self-reported dietary intake is assessed by methods of real-time recording (food diaries and the duplicate portion method) and methods of recall (dietary histories, food frequency questionnaires, and 24-hour dietary recalls). Being less labor intensive, recall methods are more frequently employed in nutritional epidemiological investigations. However, sources of error, which include the participants' inability to fully and accurately recall their intakes as well as limitations inherent in the food composition databases applied to convert the reported food consumption to energy and nutrient intakes, may limit the validity of the generated information. The use of dietary biomarkers is often recommended to overcome such errors and better capture intra-individual variability in intake; nevertheless, it has its own challenges. To address measurement error associated with dietary questionnaires, large epidemiological investigations often integrate sub-studies for the validation and calibration of the questionnaires and/or administer a combination of different assessment methods (e.g. administration of different questionnaires and assessment of biomarker levels). Recent advances in the omics field could enrich the list of reliable nutrition biomarkers, whereas new approaches employing web-based and smart phone applications could reduce respondent burden and, possibly, reporting bias. Novel technologies are increasingly integrated with traditional methods, but some sources of error still remain. In the analyses, food and nutrient intakes always need to be adjusted for total daily energy intake to account for errors related to reporting.

Background Dyslipidemia represents an important risk factor for cardiovascular diseases, although its optimal management after kidney transplantation remains unclear. The present meta-analysis aimed to shed light on the efficacy and safety of statins among kidney transplant recipients, evaluating their potential effects on the risk of cardiovascular events, mortality and graft survival. Methods Medline, Scopus, Web of Science, CENTRAL, Clinicaltrials.gov and Google Scholar were systematically searched from their inception through April 20, 2024. Both randomized controlled trials and observational studies evaluating the effects of statin administration after kidney transplantation were held eligible. Random-effects models were fitted using the maximum likelihood method, while the certainty of evidence was appraised following the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) approach. Results Overall, 27 studies (10 randomized controlled trials and 17 observational studies) were included. Statin use compared to no use was associated with a lower risk of major adverse cardiovascular events [Relative risk (RR): 0.87, 95% confidence interval (CI): 0.67–0.96, moderate certainty] and overall mortality (RR: 0.84, 95% CI: 0.74–0.94, low certainty). The risk of graft loss did not differ between the compared groups (RR: 0.72, 95% CI: 0.48–1.08, very low certainty). Regarding safety endpoints, statin use was associated with a lower risk of hepatotoxicity (RR: 0.81, 95% CI: 0.70–0.93, moderate certainty), but with a greater risk of rhabdomyolysis (RR: 1.37, 95% CI: 1.10–1.70, low certainty) and cataract (RR: 1.22, 95% CI: 1.14–1.31, moderate certainty). No statistically significant differences between the compared groups with and without statin use were observed concerning the risk of creatine kinase elevation, post-transplant diabetes mellitus, hip fracture, venous thromboembolism, or cancer. Conclusions Among kidney transplant recipients, statin use is associated with a lower risk of cardiovascular events and better patient survival, presenting an acceptable safety profile. Further large-scale studies are needed to determine the optimal statin dosing strategy and lipid-lowering goals, depending on comorbidities and immunosuppression regimens. Registration https://doi.org/10.17504/protocols.io.5qpvok3yzl4o/v1 .

On December 1, 2014, the epidemiology community bade farewell to one of its most distinguished members. Dimitrios Trichopoulos passed away leaving several colleagues and students in both sides of the Atlantic and all over the world saddened by the loss of a great scientist, mentor and friend. Dimitrios Trichopoulos was Professor of Cancer Prevention and Professor of Epidemiology at the Harvard School of Public Health, Member of the Athens Academy and President of the Hellenic Health Foundation in Greece. He had served as director of the Harvard Center for Cancer Prevention; chairman of the Epidemiology Departments at the University of Athens and at Harvard; and adjunct professor of medical epidemiology at the Karolinska Institute in Sweden. He had published the first study linking passive smoking to lung cancer, had done early work on the association of hepatitis B and C infections and tobacco smoking with hepatocellular carcinoma, and conducted key studies on the role of intrauterine exposures in breast cancer etiology. He received several awards and distinctions, including honorary Doctorates, the Brinker International Award for Breast Cancer Clinical Research, the Julius Richmond Award for the documentation of the role of involuntary smoking in the etiology of lung cancer, and the Medal of Honor of the International Agency for Research on Cancer for his contributions in cancer epidemiology and etiology. He was the teacher and mentor of legions of epidemiologists, medical doctors and other health scientists across the world.

Background Early risk stratification is necessary to prevent chronic kidney disease progression and complications. This systematic review aims to evaluate the association of soluble suppression of tumorigenicity 2 (sST2), a member of the interleukin-1 receptor family, with all-cause mortality, cardiovascular disease and renal function deterioration among chronic kidney disease patients. Methods PubMed, Scopus, Web of Science, CENTRAL and Google Scholar were systematically searched from inception to December 20, 2023. Cohort studies examining the prognostic role of sST2 levels in pre-dialysis and dialysis patients were included. In case of 3 or more studies per outcome, conventional and dose–response meta-analyses were conducted. Results Overall, 21 studies were included comprising 15,100 patients. In pre-dialysis patients, the qualitative synthesis of studies suggested that high sST2 is associated with significantly increased all-cause mortality, while evidence regarding cardiovascular events or kidney disease progression was conflicting. In the dialysis population, high sST2 was linked to an elevated risk of all-cause (Hazard ratio-HR: 3.00, 95% confidence intervals-CI: 1.95–4.61) and cardiovascular (HR: 2.38, 95% CI: 1.69–3.34) mortality. Dose–response meta-analysis suggested a log-linear association of sST2 with both all-cause ( χ 2 : 34.65, p value  < 0.001) and cardiovascular ( χ 2 : 29.14, p value  < 0.001) mortality, whereas findings regarding cardiovascular events were limited with mixed results. Conclusions High sST2 values are associated with an increased risk of all-cause mortality in pre-dialysis and dialysis patients, as well as with an elevated risk of cardiovascular mortality in the dialysis population. Further studies are needed to elucidate its potential association with cardiovascular events and kidney disease progression.

Sodium-glucose co-transporter 2 inhibitors (SGLT2i), glucagon-like peptide-1 receptor agonists (GLP1a), and non-steroidal mineralocorticoid receptor antagonists (ns-MRA) are promising treatments for chronic kidney disease. This umbrella review of network meta-analyses evaluated their effects on cardiovascular outcomes, kidney disease progression, and adverse events, using the TOPSIS method to identify the optimal intervention based on P-scores. A total of 19 network meta-analyses and 44 randomized controlled trials involving 86,150 chronic kidney disease patients were included. Compared to placebo, SGLT2i were associated with reduced risks of cardiovascular events [Hazard ratio (HR): 0.776, 95% confidence intervals (CI): 0.727–0.998], kidney disease progression (HR: 0.679, 95% CI: 0.629–0.733), acute kidney injury (HR: 0.873, 95% CI: 0.773–0.907), and serious adverse events (HR: 0.881, 95% CI: 0.847–0.916). GLP1a and ns-MRA were also associated with significant reductions in cardiovascular and kidney-specific composite outcomes. Indirect evidence showed that SGLT2i demonstrated a lower risk of kidney disease progression compared to GLP1a (HR: 0.826, 95% CI: 0.716–0.952) and ns-MRA (HR: 0.818, 95% CI: 0.673–0.995), representing the best intervention across all endpoints. In conclusion, while SGLT2i, GLP1a, and ns-MRA all reduce cardiovascular and kidney disease risks in chronic kidney disease, SGLT2i appears to provide the most favorable balance of efficacy and safety.

HPV-positive and HPV-negative head and neck squamous cell carcinoma (HNSCC) are recognized as distinct entities. There remains uncertainty surrounding the causal effects of smoking and alcohol on the development of these two cancer types. Here we perform multivariable Mendelian randomization (MR) to evaluate the causal effects of smoking and alcohol on the risk of HPV-positive and HPV-negative HNSCC in 3431 cases and 3469 controls. Lifetime smoking exposure, as measured by the Comprehensive Smoking Index (CSI), is associated with increased risk of both HPV-negative HNSCC (OR = 3.03, 95%CI:1.75-5.24, P  = 7.00E-05) and HPV-positive HNSCC (OR = 2.73, 95%CI:1.39-5.36, P  = 0.003). Drinks Per Week is also linked with increased risk of both HPV-negative HNSCC (OR = 7.72, 95%CI:3.63-16.4, P  = 1.00E-07) and HPV-positive HNSCC (OR = 2.66, 95%CI:1.06-6.68, P  = 0.038). Smoking and alcohol independently increase the risk of both HPV-positive and HPV-negative HNSCC. These findings have important implications for understanding the modifying risk factors between HNSCC subtypes. Head and neck squamous cell carcinoma can occur with and without the presence of HPV infection. Here, the authors utilise Mendelian randomization to assess the causal effects of smoking and alcohol on HPV-positive and HPV-negative head and neck cancer development.

Cancer chemoprevention refers to the use of agents for the inhibition, delay, or reversal of carcinogenesis before invasion. In the present review, agents examined in the context of cancer chemoprevention are classified in four major categories-hormonal, medications, diet-related agents, and vaccines-and the main representatives of each category are presented. Although there are serious constraints in the documentation of effectiveness of chemopreventive agents, mainly stemming from the long latency of the condition they are addressing and the frequent lack of intermediate biomarkers, there is little disagreement about the role of aspirin, whereas a diet rich in vegetables and fruits appears to convey more protection than individual micronutrients. Among categories of cancer chemopreventive agents, hormonal ones and vaccines might hold more promise for the future. Also, the identification of individuals who would benefit most from chemopreventive interventions on the basis of their genetic profiles could open new prospects for cancer chemoprevention.

Objective:The Mediterranean diet (MD) is a dietary pattern associated with several health benefits, including reduction of risk for various cancers. We conducted a study to investigate associations between adherence to the MD and colorectal cancer (CRC) subtype risk among Moroccan adults.Design:A matched case–control study.Setting:The five major university hospitals in Morocco.Participants:A total of 3032 subjects (1516 CRC patients and 1516 controls) matched on age, sex and centre were recruited between September 2009 and February 2017 at five major hospitals in Morocco. Diet was assessed using a validated FFQ. Adherence to the MD was assessed through a score, ranging from 0 (no adherence) to 10 (maximal adherence) and divided into three categories (low, middle and high). Conditional logistic regression was performed to calculate multivariable OR and 95 % CI with low adherence (score 0–3) as referent, adjusting for potential confounding factors.Results:Close adherence to the MD (score 6–9) was associated with reduced risk of CRC (ORa = 0.74, 95 % CI 0.63, 0.86), rectal cancer (ORa = 0.73, 95 % CI 0.58, 0.90) and colon cancer (ORa = 0.74, 95 % CI 0.60, 0.92).Conclusion:Our study, conducted in a southern Mediterranean population, adds to the evidence suggesting a protective effect of MD against CRC risk.

Physical inactivity has emerged as an important risk factor for a number of diseases, but the typically crude exposure assessments in epidemiological studies, with entailing variation in measurement accuracy, may be a source of heterogeneity contributing to inconsistent results among studies. Consequently, the choice of method for the assessment of physical activity in epidemiological studies is important. Good methods increase our chances of avoiding misclassification and may enhance our understanding of the association between physical activity and health. Since physical activity is also a potential confounder of other lifestyle-health relationships, good methods may enhance our ability to control for confounding. But despite a steadily increasing selection of methods to choose from, no method is suitable for every situation and every population. Although the questionnaire is the most widely used method in epidemiological studies, and laboratory methods are mainly used for validation purposes, improved technology may change our ways of assessing physical activity in the future. This paper describes different methods to measure physical activity and energy expenditure from the epidemiological perspective, and attempts to address the concepts related to the measurement of physical activity.

BackgroundEvidence from epidemiological studies on the role of tea drinking in gastric cancer risk remains inconsistent. We aimed to investigate and quantify the relationship between tea consumption and gastric cancer in the Stomach cancer Pooling (StoP) Project consortium.MethodsA total of 9438 cases and 20,451 controls from 22 studies worldwide were included. Odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) of gastric cancer for regular versus non-regular tea drinkers were estimated by one and two-stage modelling analyses, including terms for sex, age and the main recognised risk factors for gastric cancer.ResultsCompared to non-regular drinkers, the estimated adjusted pooled OR for regular tea drinkers was 0.91 (95% CI: 0.85–0.97). When the amount of tea consumed was considered, the OR for consumption of 1–2 cups/day was 1.01 (95% CI: 0.94–1.09) and for >3 cups/day was 0.91 (95% CI: 0.80–1.03). Stronger inverse associations emerged among regular drinkers in China and Japan (OR: 0.67, 95% CI: 0.49–0.91) where green tea is consumed, in subjects with H. pylori infection (OR: 0.68, 95% CI: 0.58–0.80), and for gastric cardia cancer (OR: 0.64, 95% CI: 0.49–0.84).ConclusionOur results indicate a weak inverse association between tea consumption and gastric cancer.