Nutrition-Cancer

Question 1

Factor associated with exposure of interest, outcome of interest and is not in the causal pathway; thus it may distort the association between the study and the exposure.

Answer 1

Confounder

Question 2

What type of regulatory gene is p53, which is a common target for mutation in many different cancer?

Answer 2

Tumor suppressor gene.

Question 3

4 steps in risk assessment

Answer 3

1) Hazard identification 2) Dose response 3) Exposure assessment 4) Risk characterization

Question 4

Bias that happens when the accuracy of info collected on subjects is not equal between cases/controls or exposed/unexposed groups.

Answer 4

Measurement (information) bias

Question 5

A mutation in genes that results in a mutator phenotype

Answer 5

DNA repair genes

Question 6

Study design that is the only ethical design for potentially hazardous exposures

Answer 6

Observational studies

Question 7

7 changes that determine malignant phenotypes

Answer 7

1) Defects in DNA repair 2) Evasion of apoptosis 3) Sustained angiogenesis 4) Limitless reproductive potential 5) Tissue invasion/metastasis 6) Insensitivity to anti-growth signals 7) Self sufficiency growth signals

Question 8

Charring of meats produces what class of carcinogens

Answer 8

Heterocyclic amines. Charring food produces polycyclic aromatic hydrocarbons

Question 9

Most of known carcinogens are metabolized by what family of enzymes?

Answer 9

P450-dependent mono-oxygenases

Question 10

2 classes of anticancer properties of plant-based food

Answer 10

1) Direct inhibitor actions (reduces DNA damage and pro-apoptotic effects for damaged cells) 2) Microenvironment (anti-angiogenesis and anti-inflammatory

Question 11

Bradford Hill criteria used in assessing causality

Answer 11

Temporality, Strength of association, Dose-response, Reversibility, Consistency, Biologic plausibility, Specificity, Analogy

Question 12

Indirect acting carcinogens must undergo what process?

Answer 12

Metabolic conversion (also called biotransfromation and bioactivation)

Question 13

Overweight and obesity are though to impact cancer risk through effects on what 4 areas?

Answer 13

Immune function/inflammation, hormone levels/metabolism, growth factors, proteins that make hormones more or less available.

Question 14

Eating fruits and vegetables is associated with level I evidence of decrease in cancer risk of what organs?

Answer 14

GI tract (mouth, pharynx, esophagus, stomach, colon, rectum) and lung.

Question 15

What proportion of cancers may be due to diet?

Answer 15

35.00%

Question 16

Nitrates and nitrites are converted to what substance that is a mutagen/carcinogen in animals? How can you inhibit this?

Answer 16

Nitrosamines. Vitamin C is supposed to be an antioxidant that limits the radicals.

Question 17

Class of chemicals that provide the chemopreventive properties of plant-based food thought to aid in blocking the progression of latent micro tumors?

Answer 17

Phytochemicals

Question 18

2 overarching concepts of dietary guidelines for Americans

Answer 18

1) Maintain calorie balance to achieve a healthy weight 2) Consume nutrient dense food and beverages

Question 19

Reversible, heritable changes in gene expression without mutation, involving post-translational modification of histones and DNA methylation, which may directly contribute to tumor development.

Answer 19

Epigenetics

Question 20

Group of fatty acids that are pro-inflammatory

Answer 20

Omega 6

Question 21

Group of fatty acids that are anti-inflammatory

Answer 21

Omega 3

Question 22

4 classes of regulatory genes that are the primary targets of genetic damage in carcinogenesis

Answer 22

1) Proto-oncogenes 2) Tumor suppressor genes 3) Apoptosis genes 4) DNA repair genes

Question 23

Fallacy that may occur in interpreting results from a study when the exposure is only known for groups but not for individuals within the groups

Answer 23

Ecologic

Question 24

2 mechanisms possibly associated with increased prostate cancer risk with increased dairy consumption

Answer 24

Increased insulin growth factor 1 (IGF1) levels and impaired vitamin D metabolism

Question 25

10 recommendations for cancer prevention form WCRF/AICR

Answer 25

1) Be lean 2) Be active 3) Avoid soda 4) Eat whole foods, plants and veggies 5) Limit red meat, avoid processed meat 6) Limit alcohol 7) Limit salt 8) Don’t use supplements 9) Breast feed at least 6 months 10) Follow these steps after cancer treatment

Question 26

What study designs have the greatest strength of evidence?

Answer 26

1) Meta-Analysis 2) Systematic review 3) Randomized controlled trial 4) Cohort 5) Case control 6) Case series/report 7) Animal research

Question 27

4 things shown to increase breast cancer survival

Answer 27

1) Decreased body fat 2) Decreased dietary fat 3) Increased fruits/veggies/exercise 4) Soy 2 servings/day

Question 28

3 stages of carcinogenesis

Answer 28

1) Initiation (mutation gets locked in) 2) Promotion (mutation drives proliferation) 3) Progression (things go bad)

Question 29

Product produced by mold on grains and nuts that causes cancer

Answer 29

Aflatoxin B1

Question 30

Father of toxicology that basically said too little of a substance and too much of a substance is bad

Answer 30

Paracelsus

Question 31

3 most important modifiable risk factors for cancer in Americans

Answer 31

1) Diet 2) Weight control 3) Physical activity

Question 32

In addition to excess estrogen in excess fat, a high fat, low fiber diet may increase estrogen levels by what mechanism?

Answer 32

Enterohepatic circulation recirculates estrogen

Question 33

30% risk of cancer with the “meat-sweet” diet

Answer 33

Breast cancer