Nutritional advice

Objectives:
Even though many studies have examined the possible effect of low-fat diet on breast cancer survival, the relationship remains unclear. Therefore, this review article has been conducted.

Does low-fat diet reduce risk of recurrence of breast cancer?

Study design:
This review article included 2 randomized controlled trials (RCTs) and 1 large multi-center prospective cohort study with 9,966 breast cancer patients.

Results and conclusions:
The investigators found post-diagnostic low-fat diet significantly reduced risk of recurrence of breast cancer by 23% [HR = 0.77, 95% CI = 0.63 to 0.94, p = 0.009] and all cause mortality of breast cancer by 17% [HR = 0.83, 95% CI = 0.69 to 1.00, p = 0.05].

The investigators concluded post-diagnostic low-fat diet reduces risk of recurrence of breast cancer. However, more trials of the relationship between low-fat diet and all-cause mortality of breast cancer are still needed.

Original title:
Effect of low-fat diet on breast cancer survival: a meta-analysis by Xing MY, Xu SZ and Shen P.

Link:
https://pubmed.ncbi.nlm.nih.gov/24606431/

Additional information of El Mondo:
Find more information/studies on fat consumption and breast cancer right here.

A low-fat diet is a diet with maximum 30 En% fat and maximum 7 En% saturated fat.  
30 En% fat means that the amounts of fat contribute 30% to the total calories (kcal) of the diet.
If the diet contains 2000 kcal, 66.7 grams of fat contribute 30% to this 2000 kcal.
1 gram of fat gives 9 kcal. Thus, 66.7 grams of fat provide 600 kcal and 600 kcal is 30% of 2000 kcal.

The most easy way to follow a diet a diet with maximum 30 En% fat and maximum 7 En% saturated fat is to choose only meals/products with maximum 30 En% fat and maximum 7 En% saturated fat. Check here which products contain maximum 30 En% fat and maximum 7 En% saturated fat.

However, the most practical way to follow a diet with maximum 30 En% fat and maximum 7 En% saturated fat is, all meals/products that you eat on a daily basis should contain on average maximum 30 En% fat and maximum 7 En% saturated fat.

To do this, use the 7-points nutritional profile app to see whether your daily diet contains maximum 30 En% fat and maximum 7 En% saturated fat.

Objectives:
The influence of dietary fat upon breast cancer mortality remains largely understudied despite extensive investigation into its influence upon breast cancer risk. Therefore, this review article has been conducted.

Does higher total fat or saturated fat dietary intake increase risk of breast-cancer-specific death (breast cancer mortality) among women?

Study design:
This review article included 15 prospective cohort studies investigating total fat and/or saturated fat intake (g/day) and breast cancer mortality.

Results and conclusions:
The investigators found there was no difference in risk of breast-cancer-specific death [HR = 1.14, 95% CI = 0.86 to 1.52, p = 0.34, n = 6] or all-cause death [HR = 1.73, 95% CI = 0.82 to 3.66, p = 0.15, n = 4] for women in the highest versus lowest category of total fat dietary intake.
No difference because HR of 1 was found in the 95% CI of 0.82 to 3.66. HR of 1 means no risk/association.

The investigators found for the highest versus lowest category of saturated fat dietary intake, a significantly increased risk of 51% for breast-cancer-specific death among women [HR = 1.51, 95% CI = 1.09 to 2.09, p 0.01 n = 4].
Significant because HR of 1 was not found in the 95% CI of 1.09 to 2.09. HR of 1 means no risk/association.

The investigators concluded that higher saturated fat dietary intake increases risk of breast-cancer-specific death among women.

Original title:
Dietary fat and breast cancer mortality: A systematic review and meta-analysis by Brennan SF, Woodside JV, […], Cantwell MM.

Link:
https://pubmed.ncbi.nlm.nih.gov/25692500/

Additional information of El Mondo:
Find more information/studies on fat consumption and breast cancer right here.

A diet high in saturated fat is a diet with more than 10 En% saturated fat.
The most easy way to follow a diet with more than 10 En% saturated fat is to choose only meals/products with more than 10 En% saturated fat. Check here which products contain more than 10 En% saturated fat.

However, the most practical way to follow a diet with more than 10 En% saturated fat is, all meals/products that you eat on a daily basis should contain on average more than 10 En% saturated fat.

To do this, use the 7-points nutritional profile app to see whether your daily diet contains more than 10 En% saturated fat.

However, a diet with more than 10 En% saturated fat is an unhealthy diet.

A diet low in saturated fat is a diet with maximum 7 En% saturated fat.
 

Objectives:
Systematic reviews of case-control studies evaluating the relationship between dietary salt intake and gastric cancer showed a positive association, however a quantitative analysis of longitudinal cohort studies is lacking. Therefore, this review article has been conducted.

Does a high salt intake increase gastric cancer risk?

Study design:
This review article contained 10 cohort studies with 268,718 participants, of which 1,474 gastric cancer events and a follow-up of 6-15 years.

Meta-regression analyses did not detect specific sources of heterogeneity.

There was no evidence of publication bias.

Results and conclusions:
The investigators found for high vs low salt intake a significantly increased risk of 68% for gastric cancer [RR = 1.68, 95% CI = 1.17 to 2.41, p = 0.005].

The investigators found for moderate vs low salt intake a significant increased risk of 41% for gastric cancer [RR = 1.41, 95% CI = 1.03 to 1.93, p = 0.032].

The investigators found the association was stronger in the Japanese population and higher consumption of selected salt-rich foods was also associated with greater risk.

The investigators concluded high salt intake is directly associated with an increased risk of gastric cancer in prospective population studies, with progressively increasing risk across consumption levels.

Original title:
Habitual salt intake and risk of gastric cancer: A meta-analysis of prospective studies by D’Elia L, Rossi G, […], Strazzullo P.

Link:
http://www.clinicalnutritionjournal.com/article/S0261-5614%2812%2900005-2/abstract

Additional information of El Mondo:
Find here more studies/information on sodium/salt and  cancer right here.

According to WHO, a high salt intake is a salt intake of more than 5 grams salt per day.

A diet with more than 5 grams salt per day is a diet with mainly products/meals with more than 0.25 grams salt per 100 kcal. Check here which products contain maximum 5 grams salt per 100 kcal.
Use the 7-points nutritional profile app to see whether your daily diet contains maximum 5 grams salt per 100 kcal.
 

Objectives:
Branched-chain amino acids (BCAAs; leucine, isoleucine and valine) are essential amino acids involved in immune responses and may have roles in protein malnutrition and sarcopenia (a type of muscle loss (muscle atrophy) that occurs with aging and/​or immobility). Furthermore, certain liver diseases have been associated with a decreased Fischer's ratio (BCAAs to aromatic amino acids; phenylalanine, tyrosine and tryptophan). However, a comprehensive synthesis of the evidence from human controlled studies on the supplemental use of BCAAs during the oncology peri-operative period has not been published. Therefore, this review article (meta-analysis) has been conducted.

Does branched-chain amino acids (BCAAs) supplementation during the oncological surgical period reduce post-operative morbidity from infections and ascites?

Study design:
This review article included 13 RCTs and 6 cohort studies with 2,019 participants.
Mean (or median) ages of the RCTs populations were from 53 to 67 years old and all of the RCTs had a predominantly male population.
9 RCTs (69%) evaluated oral intake of BCAAs and 4 (31%) administered (parenteral) BCAAs intravenously in hospital.
Duration of treatment use in the RCTs ranged from intra-operatively (single intravenous administration) up to a maximum duration of 13 months (oral administration).

Among 13 RCTs, 77% involved liver cancer. Methodological study quality scored substantial risk-of-bias across most RCTs.

Overall, 6 cohort studies were of low methodological quality.

Results and conclusions:
The investigators found meta-analysis of RCTs showed a 38% significantly decreased risk of post-operative infections in BCAAs group compared to controls [RR = 0.62, 95% CI = 0.44 to 0.87, p= 0.006, I2 = 0%, number of RCTs, k = 6, total sample size, n = 389].

The investigators found BCAAs supplementation was also beneficial for ascites [RR = 0.55, 95% CI = 0.35 to 0.86, p = 0.008, I2 = 0%, k = 4, n = 296], body weight [MD = 3.24 kg, 95% CI = 0.44 to 6.04, p = 0.02, I2 = 24%, k = 3, n = 196] and hospitalization length [MD = -2.07 days, 95% CI = -3.97 to -0.17, p = 0.03, I2 = 59%, k = 5, n = 362].

The investigators found no differences between BCAAs and controls for mortality, recurrence, other post-operative complications (liver failure, edema, pleural effusion), blood loss, quality of life, ammonia level and prothrombin time.

The investigators found no serious adverse events were related to BCAAs; however, serious adverse events were reported due to intravenous catheters. No safety concerns from observational studies were identified.

The investigators concluded that branched-chain amino acids (BCAAs) supplementation during the oncological surgical period may reduce important post-operative morbidity from infections and ascites compared to controls. May reduce because the included studies were of low methodological quality. Therefore, blinded, placebo-controlled confirmatory trials of higher methodological quality are warranted, especially using oral, short-term BCAAs-enriched supplements within the context of recent ERAS programs.

Original title:
Are Supplemental Branched-Chain Amino Acids Beneficial During the Oncological Peri-Operative Period: A Systematic Review and Meta-Analysis by Cogo E, Elsayed  M, […], Papadogianis P.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7930658/

Additional information of El Mondo:
Find more information/studies on protein and cancer right here.

Ascites is the buildup of fluid in the space around the organs in the abdomen. When ascites is caused by cancer, it is called malignant ascites.
 

Objectives:
Due to the rapid increase of primary liver cancer incidence and the poor prognosis, it is imperative to identify new modifiable factors such as diet and nutrition for the prevention of liver cancer. Diet high in saturated fatty acids (SFA) has been hypothesized to be associated with increased risk of cancers. However, the associations between dietary fatty acids and liver cancer are not consistent. Therefore, this review article has been conducted.

Does a diet high in saturated fatty acids or cholesterol increase risk of liver cancer?

Study design:
This review article included 14 prospective cohort studies with 15,890 liver cancer cases.

Results and conclusions:
The investigators found for the highest dietary saturated fat versus lowest intake, a significantly increased risk of 34% [RR = 1.34, 95% CI = 1.06 to 1.69, I2 = 16.9%, n = 5] for liver cancer.

The investigators found for every increase with 1 En% saturated fat, a significantly increased risk of 4% [RR = 1.04, 95% CI = 1.01 to 1.07, I2 = 16.8%, n = 5] for liver cancer.

The investigators found per 0.1-unit increase in ratio of monounsaturated fatty acids (MUFA): saturated fat (SFA), a significantly decreased risk of 9% [RR = 0.91, 95% CI = 0.86 to 0.95] for liver cancer.

The investigators found per 0.1-unit increase in ratio of unsaturated fatty acids (UFA):saturated fat (SFA), a significantly decreased risk of 6% [RR = 0.94, 95% CI = 0.90 to 0.97] for liver cancer.

The investigators found for every increase with 100 mg dietary cholesterol intake per day, a significantly increased risk of 16% [RR = 1.16, 95% CI = 1.01 to 1.07, I2 = 0%, n = 2] for liver cancer.

The investigators found for the highest serum total cholesterol levels versus lowest levels, a significantly decreased risk of 58% [RR = 0.42, 95% CI = 0.33 to 0.54, I2 = 90.7%, n = 7] for liver cancer.

The investigators found for the highest serum total cholesterol levels versus lowest levels, a significantly decreased risk of 61% [RR = 0.39, 95% CI = 0.27 to 0.57] for liver cancer among men. 

The investigators found for the highest serum total cholesterol levels versus lowest levels, a significantly decreased risk of 69% [RR = 0.31, 95% CI = 0.26 to 0.38] for liver cancer among women. 

The investigators found for every increase with 1 mmol/L in serum cholesterol level, a significantly decreased risk of 28% [RR = 0.72, 95% CI = 0.69 to 0.75, I2 = 75.3%, n = 7] for liver cancer.

The investigators found for every increase with 1 mmol/L in serum HDL cholesterol level, a significantly decreased risk of 58% [RR = 0.42, 95% CI = 0.27 to 0.64, I2 = 0%, n = 2] for liver cancer.

The investigators found these findings were generally robust and stable in sensitivity analyses.

The investigators concluded there is an increased risk for dietary saturated fat with liver cancer using both category and dose-response analyses. Higher ratios of monounsaturated fatty acids (MUFA):saturated fat (SFA) and unsaturated fatty acids (UFA):saturated fat (SFA) are associated with a lower risk of developing liver cancer. Higher serum total and HDL cholesterol are associated with a lower risk of liver cancer with high between-studies variability.

Original title:
Dietary Fats, Serum Cholesterol and Liver Cancer Risk: A Systematic Review and Meta-Analysis of Prospective Studies by Zhao L, Deng C, [...], Zhang X.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8037522/

Additional information of El Mondo:
Find more information/studies on fat and cholesterol consumption and cancer right here.

A diet high in saturated fat (unhealthy fat) is a diet with more than 10 En% saturated fat.

The easiest way to follow a diet with more than 10 En% saturated fat is to choose only products/meals that also contain more than 10 En% saturated fat. Check here which products contain more than 10 En% saturated fat.

More than 10% saturated fat means that the total amounts of saturated fat make up more than 10% of the total kcal of the diet. So a 2000 kcal diet with more than 10 En% saturated fat contains more than 22 grams of saturated fat. 22 grams of saturated fat provides 22x9 kcal = 198 kcal. 198 kcal is 10% of 2000 kcal.

However, products with more than 10 En% saturated fat are unhealthy products.

Objectives:
Does mushroom dietary intake reduce risk of cancer at any site?

Study design:
This review article included 11 case-control studies and 6 cohort studies.

Results and conclusions:
The investigators found higher mushroom consumption significantly reduced total cancer with 34% [pooled RR for the highest compared with the lowest consumption groups = 0.66, 95% CI = 0.55 to 0.78, n = 17].

The investigators found higher mushroom consumption significantly reduced breast cancer with 35% [pooled RR for the highest compared with the lowest consumption groups = 0.65, 95% CI = 0.52 to 0.81, n = 10].

The investigators found higher mushroom consumption significantly reduced nonbreast cancer with 20% [pooled RR for the highest compared with the lowest consumption groups = 0.80, 95% CI = 0.66 to 0.97, n = 13].

The investigators found there was evidence of a significant nonlinear dose-response association between mushroom consumption and the risk of total cancer [p-nonlinearity = 0.001, n = 7].

The investigators concluded higher mushroom consumption reduces risk of cancer, particularly breast cancer.

Original title:
Higher Mushroom Consumption Is Associated with Lower Risk of Cancer: A Systematic Review and Meta-Analysis of Observational Studies by Ba DM, Ssentongo P, […], Richie JP.

Link:
https://pubmed.ncbi.nlm.nih.gov/33724299/

Additional information of El Mondo:
Find more information/studies on vegetables consumption and breast cancer right here.

Objectives:
Controversial results of the association between green tea consumption and risk for esophageal cancer (EC) were reported by previous meta-analysis. Therefore, this review article (meta-analysis) has been conducted.

Does green tea consumption reduce esophageal cancer risk?

Study design:
This review article included 14 studies with a total of 5,057 esophageal cancer cases among 493,332 participants.

Results and conclusions:
The investigators found in the dose-response analysis, no association for a 1 cup/d increase in green tea and esophageal cancer risk [the summary OR = 1.00, 95% CI = 0.95 to 1.04, I2 = 77%].

The investigators found no nonlinearity association was observed between tea consumption and risk for esophageal cancer [p = 0.71 for nonlinearity].

The investigators found in the subgroup analysis of sex, a significantly reduced risk of 21% for esophageal cancer among women for a 1 cup/d increase in green tea [summary OR = 0.79, 95% CI = 0.68 to 0.91, I2 = 0%].
However, this reduced risk was not found for men [summary OR for a 1 cup/d increase in green tea = 1.03, 95% CI = 0.95 to 1.11, I2 = 67%].
Significant because OR of 1 was not found in the 95% CI of 0.68 to 0.91. OR of 1 means no risk/association.

The investigators concluded that a 1 cup/d increase in green tea consumption reduces esophageal cancer among women. Notably, these findings might be influenced by limited studies and potential bias, such as dose of green tea assessment and select bias of case-control studies. Further larger number, prospective and well-designed larger-scale studies are needed to provide more precise evidence, especially in women and more regions (United States and Europe).

Original title:
Green tea consumption and risk for esophageal cancer: A systematic review and dose-response meta-analysis by Zhao H, Mei K, […], Lixia Xie L.

Link:
https://pubmed.ncbi.nlm.nih.gov/33744644/

Additional information of El Mondo:
Find more information/studies on green tea consumption and cancer right here.

Objectives:
The etiology of cancer type may vary significantly due to anatomy, embryology and physiology of the cancer site. Although the association between potato consumption and colorectal cancer (CRC) was summarized in a 2018 meta-analysis of 5 cohort studies, however, no meta-analysis has evaluated potato consumption in relation to multiple cancer sites in adults. Therefore, this review article has been conducted.

Do potato intakes increase multiple cancer sites risk?

Study design:
This review article included 20 prospective cohort studies (with a total of 785,348 participants, of which 19,882 incident cases (persons with cancer)) and 36 case-control studies ( with a total of 21,822 cases (persons with cancer) and 66,502 controls (persons without cancer)).

Certainty of the evidence was low for total cancer, colorectal cancer, colon, rectal, renal, pancreatic, breast, prostate and lung cancer and very low for gastric and bladder cancer.

Results and conclusions:
The investigators found among cohort studies, no association between high versus low intake of total potato (white and yellow) consumption and overall cancers [RR = 1.04, 95% CI = 0.96 to 1.11, tau2 = 0.005, n = 18].

The investigators found no relation between total potato consumption (high compared with low intake) and risk of colorectal, pancreatic, colon, gastric, breast, prostate, kidney, lung or bladder cancer in cohort or case-control studies.

The investigators found no association between high versus low consumption of potato preparations (boiled/fried/mashed/roasted/baked) and risk of gastrointestinal-, sex-hormone-, or urinary-related cancers in cohort or case-control studies.

The investigators concluded that potato intakes or potato preparations are not associated with multiple cancer sites when comparing high and low intake categories. This finding is consistent with the findings from the 2018 meta-analysis regarding potato intake and risk of colorectal cancer.

Original title:
Potato Consumption and Risk of Site-Specific Cancers in Adults: A Systematic Review and Dose-Response Meta-Analysis of Observational Studies by Mofrad MD, Mozaffari H, […], Azadbakht L.

Link:
https://pubmed.ncbi.nlm.nih.gov/33861304/

Additional information of El Mondo:
Find more information/studies on potato consumption and cancer right here.

Objectives:
Does citrus dietary intake reduce the risk of lung cancer?

Study design:
This review article included 21 observational studies.

Results and conclusions:
The investigators found pooled analyses showed that those with the highest citrus fruit dietary intake compared to the lowest intake had a 9% reduction in lung cancer risk [OR = 0.91, 95% CI = 0.84 to 0.98].

The investigators found a nonlinear association between citrus dietary intake and lung cancer risk in the dose-response analysis [p = 0.0054] and that the risk reached the minimum [OR = 0.91] around 60 g/d.
However, no obvious dose-response association was observed with intakes above 80 g/d.

The investigators concluded that citrus fruit dietary intake is negatively associated with the risk of lung cancer. Besides, there is a nonlinear dose-response relationship between citrus fruit dietary intake and lung cancer risk within a certain range (60-80g per day).

Original title:
Citrus fruit intake and lung cancer risk: A meta-analysis of observational studies by Wang J, Gao J, [...], Qian BY.

Link:
https://pubmed.ncbi.nlm.nih.gov/33529754/

Additional information of El Mondo:
Find more information/studies on fruit consumption and cancer right here.

Citrus fruits include oranges, lemons, limes and grapefruits.

Objetivos:
¿Aumenta un nivel bajo de selenio en los tejidos humanos el riesgo de cáncer de mama?

Diseño del estudio:
Este artículo de revisión incluyó 18 estudios de casos y controles con 3,374 mujeres diagnosticadas con cáncer de mama (grupo de casos) y 3,582 controles sanos (mujeres sin cáncer de mama).

Resultados y conclusiones:
Los investigadores encontraron que el nivel de selenio de grupo de casos (grupo con mujeres diagnosticadas con cáncer de mama) fue significativamente menor que grupo de control (grupo con mujeres sin cáncer de mama) [-0.53 μg/L, 95% IC = -0.72 a -0.34, p 0.001].

Los investigadores encontraron en el análisis de subgrupos que el nivel de selenio sérico de grupo de casos fue significativamente más bajo que grupo de control [-1.14 μg/L, 95% IC = -1.70 a -0.58, p 0.001].

Los investigadores encontraron en el análisis de subgrupos que el nivel de selenio en plasma de grupo de casos fue significativamente más bajo que grupo de control [-0.21 μg/L, 95% IC = -0.37 a -0.04, p 0.014].

Los investigadores encontraron en el análisis de subgrupos que el nivel de selenio de la uña del pie de grupo de casos fue significativamente más bajo que grupo de control [-0.21 μg/L, 95% IC = -0.38 a -0.03, p 0.021].

Los investigadores concluyeron que un nivel bajo de selenio en los tejidos humanos aumenta el riesgo de cáncer de mama, lo que puede mejorar la comprensión de los efectos del selenio en la salud humana.

Título original:
Relationship Between Selenium in Human Tissues and Breast Cancer: a Meta-analysis Based on Case-Control Studies by Zhu X, Pan D, […], Sun G.

Enlace:
https://pubmed.ncbi.nlm.nih.gov/33420696/

Información adicional de El Mondo:
Encontrar aquí más información/estudios sobre el consumon de selenio y el cáncer.

Objectives:
Does a low selenium level in human tissues increase the risk of breast cancer?

Study design:
This review article included 18 case-control studies with 3,374 women diagnosed with breast cancer (case group) and 3,582 healthy controls (women without breast cancer).

Results and conclusions:
The investigators found selenium level of the case group (group with women diagnosed with breast cancer) was significantly lower than the control group (group with women without breast cancer) [-0.53 μg/L, 95% CI = -0.72 to -0.34, p 0.001].

The investigators found in subgroup analysis that serum selenium level of the case group was significantly lower than the control group [-1.14 μg/L, 95% CI = -1.70 to -0.58, p 0.001].

The investigators found in subgroup analysis that plasma selenium level of the case group was significantly lower than the control group [-0.21 μg/L, 95% CI = -0.37 to -0.04, p 0.014].

The investigators found in subgroup analysis that selenium level of toenail of the case group was significantly lower than the control group [-0.21 μg/L, 95% CI = -0.38 to -0.03, p 0.021].

The investigators concluded that a low selenium level in human tissues increases the risk of breast cancer, which may improve the understanding of the effects of selenium on human health.

Original title:
Relationship Between Selenium in Human Tissues and Breast Cancer: a Meta-analysis Based on Case-Control Studies by Zhu X, Pan D, […], Sun G.

Link:
https://pubmed.ncbi.nlm.nih.gov/33420696/

Additional information of El Mondo:
Find more information/studies on selenium and breast cancer right here.

Objectives:
Although several epidemiological studies have investigated associations between poultry and fish consumption and pancreatic cancer (PC) risk, these findings have been inconsistent. Therefore, this review article has been conducted.

Do high dietary poultry or fish intakes increase risk of pancreatic cancer?

Study design:
This review article included 25 studies (cohort studies and case-control studies).

Results and conclusions:
The investigators found for the highest vs. lowest poultry intake category a significantly increased risk of 14% for pancreatic cancer [pooled RR = 1.14, 95% CI = 1.02 to 1.26] in cohort studies.
Significant because RR of 1 was not found in the 95% CI of 1.02 to 1.26. RR of 1 means no risk/association.

The investigators found there was no association between fish intake and pancreatic cancer risk [RR = 1.00, 95% CI = 0.93 to 1.07].
No association because RR of 1 was found in the 95% CI of 0.93 to 1.07. RR of 1 means no risk/association.

The investigators concluded that large amount of poultry intake increases pancreatic cancer risk, while fish intake is unlikely to be linked to pancreatic cancer risk. These findings require further investigation, particularly between poultry and pancreatic cancer.

Original title:
Poultry and Fish Intake and Pancreatic Cancer Risk: A Systematic Review and Meta-Analysis by Gao Y, Ma Y, […], Wang X.

Link:
https://pubmed.ncbi.nlm.nih.gov/33432844/

Additional information of El Mondo:
Find more information/studies on poultry and fish consumption and cancer right here.

Objectives:
Does dietary acrylamide intake increase risk of breast, endometrial and ovarian cancer?

Study design:
This review article included 14 prospective cohort studies.

Results and conclusions:
The investigators found no significant association between dietary acrylamide intake and the risk of breast [RR = 0.95, 95% CI = 0.90 to 1.01], endometrial [RR = 1.03, 95% CI = 0.89 to 1.19] and ovarian cancers [RR = 1.02, 95% CI = 0.84 to 1.24].
In addition, no significant association between dietary acrylamide intake and the risk of breast, endometrial and ovarian cancers in different subgroup analyses by smoking status, menopausal status, BMI status and different types of breast cancer.

The investigators concluded there is no significant association between dietary acrylamide intake and the risk of breast, endometrial and ovarian cancers.

Original title:
Dietary acrylamide intake and risk of women's cancers: a systematic review and meta-analysis of prospective cohort studies by Benisi-Kohansal S, Salari-Moghaddam A, […], Esmaillzadeh A.

Link:
https://pubmed.ncbi.nlm.nih.gov/33413725/

Additional information of El Mondo:
Find more information/studies on breast cancer right here.

Acrylamide is a chemical that naturally forms in starchy food products during high-temperature cooking processes, such as frying, roasting and baking. Acrylamide in food forms from sugars and an amino acid that are naturally present in food.
 

Objetivos:
¿Reduce el consumo de frutas y verduras el riesgo de cáncer del conducto biliar?

Diseño del estudio:
Este artículo de revisión incluyó 14 estudios.

No hubo sesgo de publicación entre los estudios [p Begg = 0.53, p Egger = 0.84 para hortalizas y p Begg = 0.95, p Egger = 0.64 para frutas].

Resultados y conclusiones:
Los investigadores encontraron para el consumo más alto en comparación con más bajo, un riesgo significativamente reducido del 52% para el cáncer del conducto biliar [RR resumido = 0.48, 95% IC = 0.22 a 0.74, I2 = 86.8%, p 0.001, n = 10] para el consumo de verduras.

Los investigadores encontraron para el consumo más alto en comparación con más bajo, un riesgo significativamente reducido del 53% para el cáncer del conducto biliar [RR resumido = 0.47, 95% IC = 0.32 a 0.61, I2 = 63.3%, p = 0.001, n = 13] para el consumo de fruta.

Los investigadores encontraron por cada incremento de 100 gramos/día de consumo de verduras, un riesgo significativamente reducido del 69% para el cáncer del conducto biliar [RR = 0.31, 95% IC = 0.20 a 0.47, I2 = 63.3, n = 8].

Los investigadores concluyeron que el consumo de frutas y verduras reduce el riesgo de cáncer del conducto biliar. Se necesitan más estudios prospectivos bien diseñados para confirmar estos hallazgos.

Título original:
Vegetable, Fruit Consumption and Risk of Biliary Cancer: Evidence from a Meta-Analysis by Huai J and Xiaohua Ye X.

Enlace:
https://pubmed.ncbi.nlm.nih.gov/32731775/

Información adicional de El Mondo:
Encontrar aquí más información/estudios sobre significativamente/estudios de cohorte, el consumo de frutas y verduras y el cáncer.

Objectives:
Data on the association of nut intake with risk of cancer and its mortality are conflicting. Although previous meta-analyses summarized available findings in this regard, some limitations may distort their findings. Moreover, none of these meta-analyses examined the dose-response associations of total nut intake with the risk of specific cancers as well as associations between specific types of nuts and cancer mortality. Therefore, this review article (meta-analysis) has been conducted.

Do higher nut dietary intakes reduce risk of cancer incidence and mortality?

Study design:
This review article included in total 43 articles (observational studies) on cancer risk and 9 articles (observational studies) on cancer mortality.

Results and conclusions:
The investigators found when comparing the highest with lowest intakes of total nuts, the highest intakes of total nuts (tree nuts and peanuts), significantly reduced risk of cancer with 16% [summary effect size = 0.86, 95% CI = 0.81 to 0.92, p 0.001, I2 = 58.1%, p 0.01].

The investigators found when comparing the highest with lowest intakes of tree nuts, the highest intakes of tree nuts significantly reduced risk of cancer with 13% [pooled effect size = 0.87, 95% CI = 0.78 to 0.96, p 0.01, I2 = 15.8%, p = 0.28].

The investigators found based on the dose-response analysis, a 5-g/d increase in total nut intake was associated with 3%, 6% and 25% lower risks of overall, pancreatic and colon cancers, respectively.  

The investigators found in terms of cancer mortality, 13%, 18% and 8% risk reductions with higher intakes of total nuts, tree nuts and peanuts, respectively.

The investigators found, in addition, a 5-g/d increase in total nut intake was associated with a 4% lower risk of cancer mortality.

The investigators concluded there is a protective association between total nut and tree nut intake and the risk of cancer and its mortality.

Original title:
Association of Total Nut, Tree Nut, Peanut, and Peanut Butter Consumption with Cancer Incidence and Mortality: A Comprehensive Systematic Review and Dose-Response Meta-Analysis of Observational Studies by Naghshi S, Sadeghian M, […], Sadeghi O.

Link:
https://pubmed.ncbi.nlm.nih.gov/33307550/

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Tree nuts in this review article are walnuts, pistachios, macadamia nuts, pecans, cashews, almonds, hazelnuts and Brazil nuts.

Objectives:
Epidemiological studies showing the correlation between folate (folic acid) and the breast cancer risk have revealed inconsistent results. Therefore, this review article (meta-analysis) has been conducted.

Do higher folate dietary intakes or plasma folate levels reduce risk of breast cancer?

Study design:
This review article included 39 studies on folate dietary intake (19 were prospective cohort studies, which included 37,917 cases (persons with breast cancer) and 20 were case-control studies, which included 13,074 cases and 17,497 controls (persons without breast cancer)) and 12 studies on plasma folate level (10 were case-control studies, consisting of 7,850 cases and 8,898 controls and 2 cohort studies, consisting of 815 incident cases).

Results and conclusions:
The investigators found when compared to the lowest folate dietary intake, the highest folate dietary intake significantly reduced risk of breast cancer with 15% [combined OR = 0.85, 95% CI = 0.79 to 0.92, I2 = 75.2%, p 0.001].
This reduced risk was not significant for cohort studies [OR = 0.97, 95% CI = 0.91 to 1.03, I2 = 53.3%, p = 0.316].

The investigators found for every 100-μg/day increase in folate dieatary intake, a significantly reduced risk of 2% for breast cancer [combined OR = 0.98, 95% CI = 0.97 to 0.99, I2 = 72.8%, p = 0.002].
This reduced risk was also significantly in cohort studies [summary OR = 0.99, 95% CI = 0.98 to 1.00]. 
Significant means that there is an association with a 95% confidence.

The investigators found stratification by menopausal status showed that a higher folate dietary intake significantly reduced risk of breast cancer in premenopausal women with 20% [OR = 0.80, 95% CI = 0.66 to 0.97, p = 0.022] but not in postmenopausal women [OR = 0.94, 95% CI = 0.83 to 1.06, p = 0.320].
Significant because OR of 1 was not found in the 95% CI of 0.66 to 0.97. OR of 1 means no risk.

The investigators found the highest versus lowest plasma folate levels had no correlation with the risk of breast cancer [combined OR = 0.98, 95% CI = 0.82 to 1.17, I2 = 63.0%, p = 0.822].

The investigators concluded there is a negative correlation between folate dieatary intake, at least 100-μg/day and the risk of breast cancer. However, plasma folate levels have no correlation with the risk of breast cancer. Therefore, whether folate dietary intake has practical clinical significance requires further study and the use of additional folate supplements should be carefully considered.

Original title:
Association of folate intake and plasma folate level with the risk of breast cancer: a dose-response meta-analysis of observational studies by Ren X, Xu P, [...], Dai Z.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7695428/

Additional information of El Mondo:
Find more information/studies on significant/cohot studies, folate (folic acid) consumption and breast cancer right here.

The plasma folate level can be increased by taking folate-rich foods and/or folate supplements.

Objectives:
The association between vitamin C intake and breast cancer is unclear. Therefore, this review article (meta-analysis) has been conducted.

Does a higher vitamin C intake reduce risk of breast cancer incidence, mortality and recurrence?

Study design:
This review article included 24 cohort studies and 30 case-control studies.

Results and conclusions:
The investigators found pooled results suggested that the highest versus lowest vitamin C intake was significantly associated with a 14% lower risk of breast cancer incidence [relative risk = 0.86, 95% = 0.81 to 0.92, I2 = 78.7%, p 0.00].
Sensitivity analysis indicated that the overall results remained consistent even after excluding studies individually.

The investigators found the use of random-effects model indicated that a 100-mg/day increment in vitamin C intake had no significant effect on breast cancer risk.

The investigators found stratification by study design showed a 26% lower risk of breast cancer incidence for vitamin C intake in case-control studies [RR = 0.74, 95% CI = 0.65 to 0.84, p 0.001]. However, a non-significant inverse association was found in cohort studies [RR = 0.96, 95% CI = 0.89 to 1.04, p = 0.295].

The investigators found when the studies were stratified by the source of vitamin C, a 11% lower risk of breast cancer incidence with dietary intake [RR = 0.89, 95% CI = 0.82 to 0.96, p = 0.004] but not with supplements [RR = 1.02, 95% CI = 0.94 to 1.10, p = 0.678].

The investigators found that the highest versus lowest vitamin C intake was significantly associated with a 22% lower risk of breast cancer mortality [HR = 0.78, 95% CI = 0.69 to 0.88, I2 = 2.6%].

The investigators found that the highest versus lowest vitamin C intake was significantly associated with a 19% lower risk of breast cancer recurrence [HR = 0.81, 95% CI = 0.67 to 0.99, p = 0.043, I2 = 0.0%].

The investigators concluded that higher vitamin C dietary intake is significantly associated with a reduced risk of breast cancer incidence, mortality and recurrence.

Original title:
Association of vitamin C intake with breast cancer risk and mortality: a meta-analysis of observational studies by Zhang D, Xu P, [...], Dai Z.

Link:
https://www.aging-us.com/article/103769/text

Additional information of El Mondo:
Find more information/studies on significant/cohot studies, vitamin C consumption and cancer right here.
 

Objectives:
Heated debates have been on-going about tea consumption and the incidence of cancer, especially in head and neck cancer types. Therefore, this review article (meta-analysis) has been conducted.

Does habitual tea consumption reduce risk of nasopharyngeal cancer?

Study design:
This review article included 6 articles.

Results and conclusions:
The investigators found that habitual tea consumption significantly reduced risk of nasopharyngeal cancer with 13.5% [OR = 0.865, 95% CI = 0.806 to 0.929].

The investigators concluded that habitual tea consumption is associated with prevention of nasopharyngeal cancer development. Additional studies are needed to further understand the molecular role of bioactive compound and potential health benefit of tea consumption in nasopharyngeal cancer prevention.

Original title:
The Association between Tea Consumption and Nasopharyngeal Cancer: A Systematic Review and Meta-Analysis by Okekpa SI, Basria R, […], Musa MY.

Link:
https://pubmed.ncbi.nlm.nih.gov/32856842/

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Objectives:
The number of cancer survivors is growing rapidly worldwide, especially long-term survivors. Although a healthy diet with a high vegetable and fruit consumption is a key factor in primary cancer prevention, there is a lack of specific dietary recommendations for cancer survivors, except in the case of breast cancer [World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) report]. Therefore, this review article (meta-analysis) has been conducted.

Does the general recommendation to consume ≥5 servings of vegetables and fruit per day (400 g/d) meet the needs of cancer survivors?

Study design:
This review article included 28 cohort studies.

Results and conclusions:
The investigators found a high vegetable intake before diagnosis significantly reduced overall mortality in survivors of head and neck cancer with 25% [HR = 0.75, 95% CI = 0.65 to 0.87].  

The investigators found a high vegetable intake before diagnosis significantly reduced overall mortality in survivors of ovarian cancer with 22% [HR = 0.78, 95% CI = 0.66 to 0.91].  

The investigators found a high fruit intake before diagnosis significantly reduced overall mortality in survivors of ovarian cancer with 18% [HR = 0.82, 95% CI = 0.70 to 0.96].  

The investigators found the evidence was insufficient for survivors of other cancers, although these associations generally tended to be protective. Therefore, more studies are needed to clarify the association between vegetable and fruit consumption and the prognosis of these different types of cancer.

The investigators concluded the general recommendation to consume ≥5 servings of vegetables and fruit per day (400 g/d) could underestimate the needs of cancer survivors, particularly those with ovarian tumors, in which the recommendation could increase to 600 g/d (i.e., 300 g/d of vegetables and 300 g/d of fruit).

Original title:
Vegetable and Fruit Consumption and Prognosis Among Cancer Survivors: A Systematic Review and Meta-Analysis of Cohort Studies by Hurtado-Barroso S, Trius-Soler M, […], Zamora-Ros R.

Link:
https://pubmed.ncbi.nlm.nih.gov/32717747/

Additional information of El Mondo:
Find more information/studies on vegetables and fruit and cancer right here.

Objectives:
It is unclear how dietary intake influences the ovarian cancer. Therefore, this review article (meta-analysis) has been conducted.

Is there a relationship between dietary intake of different nutrients/food groups and ovarian cancer risk?

Study design:
This review article included 97 cohort studies.

Results and conclusions:
The investigators found no significant association between dietary intake and risk of ovarian cancer.

The investigators found in subgroup analyses that dietary intake of green leafy vegetables significantly reduced risk of ovarian cancer with 9% [RR = 0.91, 95% CI = 0.85 to 0.98].

The investigators found in subgroup analyses that dietary intake of allium vegetables significantly reduced risk of ovarian cancer with 21% [RR = 0.79, 95% CI = 0.64 to 0.96].

The investigators found in subgroup analyses that dietary intake of fiber significantly reduced risk of ovarian cancer with 11% [RR = 0.89, 95% CI = 0.81 to 0.98].

The investigators found in subgroup analyses that dietary intake of flavonoids significantly reduced risk of ovarian cancer with 17% [RR = 0.83, 95% CI = 0.78 to 0.89].

The investigators found in subgroup analyses that dietary intake of green tea significantly reduced risk of ovarian cancer with 39% [RR = 0.61, 95% CI = 0.49 to 0.76].

The investigators found in subgroup analyses that dietary intake of tota fat significantly increased risk of ovarian cancer with 10% [RR = 1.10, 95% CI = 1.02 to 1.18].

The investigators found in subgroup analyses that dietary intake of saturated fat significantly increased risk of ovarian cancer with 11% [RR = 1.11, 95% CI = 1.01 to 1.22].

The investigators found in subgroup analyses that dietary intake of saturated fatty acid significantly increased risk of ovarian cancer with 19% [RR = 1.19, 95% CI = 1.04 to 1.36].

The investigators found in subgroup analyses that dietary intake of cholesterol significantly increased risk of ovarian cancer with 13% [RR = 1.13, 95% CI = 1.04 to 1.22].

The investigators found in subgroup analyses that dietary intake of retinol (vitamin A) significantly increased risk of ovarian cancer with 14% [RR = 1.14, 95% CI = 1.00 to 1.30].

The investigators found, in addition, acrylamide, nitrate, water disinfectants and polychlorinated biphenyls were significantly associated with an increased risk of ovarian cancer.

The investigators concluded that dietary intakes of green leafy vegetables, allium vegetables, fiber, flavonoids and green tea reduce ovarian cancer.

Original title:
Association between dietary intake and risk of ovarian cancer: a systematic review and meta-analysis by Khodavandi A, Alizadeh F and Razis AFA.

Link:
https://pubmed.ncbi.nlm.nih.gov/32661683/

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Find more information/studies on different food groups and cancer right here.

Objectives:
Some evidence indicates that carotenoids may reduce the risk of bladder cancer (BC), but the association is unclear. Therefore, this review article (meta-analysis) has been conducted.

Do dietary carotenoid (β-cryptoxanthin, α-carotene, β-carotene and lutein and zeaxanthin) intakes or circulating carotenoid concentrations reduce bladder cancer risk in men and women?

Study design:
This review article included 22 studies (case-control and cohort studies), involving 516,740 adults.

Results and conclusions:
The investigators found no association for the highest compared with the lowest category of carotenoid dietary intake and reduced risk of bladder cancer [RR = 0.88, 95% CI = 0.76 to 1.03].
No association because RR of 1 was found in the 95% CI of 0.76 to 1.03. RR of 1 means no risk/association.

The investigators found no association for the highest compared with the lowest category of circulating carotenoid concentrations and reduced risk of bladder cancer [RR = 0.36, 95% CI = 0.12 to 1.07].

The investigators found for the highest compared with the lowest category of circulating lutein and zeaxanthin concentrations a significantly reduced risk of 47% for bladder cancer [RR = 0.53, 95% CI = 0.33 to 0.84].
Significant because RR of 1 was not found in the 95% CI of 0.33 to 0.84. RR of 1 means no risk/association.

The investigators found dose-response analysis showed that bladder cancer risk significantly decreased by 42% [RR = 0.58, 95% CI = 0.36 to 0.94] for every 1 mg increase in daily dietary β-cryptoxanthin intake.

The investigators found dose-response analysis showed that bladder cancer risk significantly decreased by 76% [RR = 0.24, 95% CI = 0.08 to 0.67] for every 1 μmol/L increase in circulating concentration of α-carotene.

The investigators found dose-response analysis showed that bladder cancer risk significantly decreased by 27% [RR = 0.73, 95% CI = 0.57 to 0.94] for every 1 μmol/L increase in circulating concentration of β-carotene.

The investigators found dose-response analysis showed that bladder cancer risk significantly decreased by 56% [RR = 0.44, 95% CI = 0.28 to 0.67] for every 1 μmol/L increase in circulating concentrations of lutein and zeaxanthin.

The investigators concluded dietary β-cryptoxanthin intake and circulating concentrations of α-carotene, β-carotene and lutein and zeaxanthin reduce risk of bladder cancer.

Original title:
Carotenoid Intake and Circulating Carotenoids Are Inversely Associated With the Risk of Bladder Cancer: A Dose-Response Meta-analysis by Wu S, Liu Y, […], Ramirez AG.

Link:
https://pubmed.ncbi.nlm.nih.gov/31800007/

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Objectives:
A growing number of epidemiological studies have suggested a possible association between long-chain omega-3 polyunsaturated fatty acid (PUFA) intake and the risk of cancers, but the results have been inconsistent. Therefore, this review article (meta-analysis) has been conducted.

Does dietary intake of omega-3 PUFAs reduce digestive system cancers?

Study design:
This review article included 8 case-control studies and 17 cohort studies, involving 1,247,271 participants and 23,173 patients with digestive system cancers.

Visual inspection of funnel plots and the Begg's and Egger's tests revealed no evidence of publication bias.

Results and conclusions:
The investigators found the risk of digestive system cancers significantly decreased by 17% in individuals who consumed omega-3 PUFAs [RR = 0.83, 95% CI = 0.76 to 0.91].

The investigators found the risk estimates of digestive system cancers varied by cancer sites, study location, study design, type of omega-3 PUFAs and other confounders (smoking, alcohol consumption, body mass index and physical activity).

The investigators concluded omega-3 PUFA is a healthy dietary component for the prevention of digestive system cancers. Cancer incidence decreases with increasing omega-3 PUFAs intake for most digestive system cancer sites. The relation between omega-3 PUFAs and digestive system cancers RR is similar among different populations.

Original title:
Omega-3 PUFA Intake and the Risk of Digestive System Cancers: A Meta-Analysis of Observational Studies by Jian J, Zhang and Zhao L.

Link:
https://pubmed.ncbi.nlm.nih.gov/32384489/

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Objectives:
An increased risk of gastric cancer for pickled vegetable and salted fish intake has been suggested, yet the lack of a dose-response association warrants a quantitative analysis. Therefore, this review article (meta-analysis) has been conducted.

Do pickled vegetable and salted fish intakes increase risk of gastric cancer?

Study design:
This review article included 21 cohort studies with a total of 195,624 participants for the analysis of pickled vegetable intake and 16 cohort studies with a total of

196,384 participants for the analysis of salted fish intake.

Results and conclusions:
The investigators found in a dose-response meta-analysis of 6 studies, a significantly increased risk of 15% [combined RR = 1.15, 95% CI = 1.07 to 1.23, p for heterogeneity = 0.14] for gastric cancer incidence for a 40 g/day increment in pickled vegetable intake.

The investigators found in the categorical meta-analysis of 6 studies, a marginally significant increase in the risk of gastric cancer incidence, comparing the highest to the lowest intake of salted fish [RR = 1.17, 95% CI = 0.99 to 1.38, p for heterogeneity = 0.26].

The investigators concluded intake of 40 g/day of pickled vegetable increases risk of gastric cancer incidence.

Original title:
Pickled Vegetable and Salted Fish Intake and the Risk of Gastric Cancer: Two Prospective Cohort Studies and a Meta-Analysis by Yoo JY, Cho HJ, […], Park SK.

Link:
https://www.mdpi.com/2072-6694/12/4/996/htm

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Objectives:
Epidemiologic studies focusing on the association between 1-carbon metabolism-related vitamins (ie, folate, vitamin B6, vitamin B2, vitamin B12) and breast cancer risk have reported inconsistent findings. Therefore, this review article (meta-analysis) has been conducted.

Does higher dietary intake of folate (folic acid), vitamin B2, B6 or B12 reduce breast cancer risk?

Study design:
This review article included 27 studies (case-control and cohort studies) with a total of 49,707 cases (persons with breast cancer) among 1,274,060 individuals.

Results and conclusions:
The investigators found for the highest folate dietary intake compared with the lowest, a significantly reduced risk of 7% [pooled relative risk = 0.93, 95% CI = 0.88 to 0.99, p = 0.018] for breast cancer.

The investigators found for the highest vitamin B6 dietary intake compared with the lowest, a significantly reduced risk of 6% [pooled relative risk = 0.94, 95% CI = 0.89 to 1.00, p = 0.037] for breast cancer.

The investigators found for the highest vitamin B2 dietary intake compared with the lowest, a significantly reduced risk of 10% [pooled relative risk = 0.90, 95% CI = 0.82 to 0.99, p = 0.026] for breast cancer.

The investigators found no significant association between vitamin B12 and breast cancer risk [RR = 0.99, 95% CI = 0.94 to 1.04, p = 0.604].

The investigators found folate and vitamin B6 dietary intake significantly decreased the risk of estrogen receptor-negative (ER-)/progesterone receptor-negative (PR-) breast cancer but not ER+/PR+ breast cancer.

The investigators found an increment of 100 μg/d folate dietary intake corresponded to a 7% [RR = 0.93, 95% CI = 0.89 to 0.98, p = 9.007] deceased risk of ER-/PR- breast cancer.

The investigators concluded both higher folate, vitamin B2 and B6 dietary intake decreases risk of breast cancer, especially ER-/PR- breast cancer.

Original title:
Association Between One-carbon Metabolism-related Vitamins and Risk of Breast Cancer: A Systematic Review and Meta-analysis of Prospective Studies by Zeng J, Gu Y, […], Chang H.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32241696

Additional information of El Mondo:
Find more information/studies on folate, vitamin B2 and B6 intake and breast cancer right here.

If breast cancer cells have estrogen receptors, the cancer is called ER-positive breast cancer. If breast cancer cells have progesterone receptors, the cancer is called PR-positive breast cancer. If the cells do not have either of these 2 receptors, the cancer is called ER/PR-negative.

Objectives:
The impact of light-intensity physical activity (LPA) in preventing cancer mortality has been questioned. Therefore, this review article has been conducted.

Does light-intensity physical activity reduce cancer mortality?

Study design:
This review article included 5 prospective cohort studies, in which the definition of light-intensity physical activity based on accelerometer readings was mainly set within 100 to 2,100 counts/min.

Results and conclusions:
The investigators found 30 min/day of light-intensity physical activity significantly reduced cancer mortality with 14% [summary HR = 0.86, 95% CI = 0.79 to 0.95, I2 1%] and the association between light-intensity physical activity and risk reduction in cancer mortality was linearly shaped [p nonlinearity = 0.72].

The investigators found light-intensity physical activity exhibited a comparable magnitude of risk reduction in cancer mortality of moderate-to-vigorous physical activity regardless of equal time-length [0.87 per 30 min/day vs. 0.94 per 30 min/day, p interaction = 0.46] or equal amount [0.74 vs. 0.94 per 150 metabolic equivalents-min/day, p interaction = 0.11].

The investigators found, furthermore, replacing sedentary time by light-intensity physical activity of 30 min/day significantly decreased the risk of cancer mortality by 9%.

The investigators concluded 30 min/day of light-intensity physical activity reduce cancer mortality.

Original title:
Objectively-Measured Light-Intensity Physical Activity and Risk of Cancer Mortality: A Meta-analysis of Prospective Cohort Studies by Qiu S, Cai X, […], Schumann U.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32303534

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Light intensity physical activity is an activity that is classified as 3 METS.