Sex-and gender-specific disparities in colorectal cancer risk

Colorectal cancer is one of the most common causes of cancer morbidity both in men and in women.However,females over 65 years old show higher mortality and lower 5-year survival rate of colorectal cancer compared to their age-matched male counterparts.The objective of this review is to suggest gender-based innovations to improve colorectal cancer outcomes in females.Women have a higher risk of developing right-sided(proximal) colon cancer than men,which is associated with more aggressive form of neoplasia compared to left-sided(distal) colon cancer.Despite differences in tumor location between women and men,most of scientific researchers do not consider sex specificity for study design and interpretation.Also,colorectal cancer screening guidelines do not distinguish females from male,which may explain the higher frequency of more advanced neoplasia when tumors are first detected and false negative results in colonoscopy in females.Moreover,socio-cultural barriers within females are present to delay screening and diagnosis.Few studies,among studies that included both men and women,have reported sex-specific estimates of dietary risk factors which are crucial to establish cancer prevention guidelines despite sex-and genderassociated differences in nutrient metabolism and dietary practices.Furthermore,anti-cancer drug use for colorectal cancer treatment can cause toxicity to the reproductive system,and gender-specific recurrence and survival rates are reported.Therefore,by understanding sex-and gender-related biological and socio-cultural differences in colorectal cancer risk,gender-specific strategies for screening,treatment and prevention protocols can be established to reduce the mortality and improve the quality of life.

A systematic review of active video games on rehabilitative outcomes among older patients

Background: Although current research supports the use of active video games(AVGs) in rehabilitation, the evidence has yet to be systematically reviewed or synthesized. The current project systematically reviewed literature, summarized findings, and evaluated the effectiveness of AVGs as a therapeutic tool in improving physical, psychological, and cognitive rehabilitative outcomes among older adults with chronic diseases.Methods: Seven databases(Academic Search Complete, Communication & Mass Media Complete, ERIC, Psyc INFO, Pub Med, SPORTDiscus,and Medline) were searched for studies that evaluated the effectiveness of AVG-based rehabilitation among older patients. The initial search yielded 946 articles; after evaluating against inclusion criteria and removing duplicates, 19 studies of AVG-based rehabilitation remained.Results: Most studies were quasi-experimental in design, with physical functioning the primary outcome investigated with regard to the use of AVGs in rehabilitation. Overall, 9 studies found significant improvements for all study outcomes, whereas 9 studies were mixed, with significant improvements on several study outcomes but no effects observed on other outcomes after AVG-based treatments. One study failed to find any benefits of AVG-based rehabilitation.Conclusion: Findings indicate AVGs have potential in rehabilitation for older patients, with several randomized clinical trials reporting positive effects on rehabilitative outcomes. However, existing evidence is insufficient to support the advantages of AVGs over standard therapy. Given the limited number of studies and concerns with study design quality, more research is warranted to make more definitive conclusions regarding the ability of AVGs to improve rehabilitative outcomes in older patients.

Impact of exergaming on young children's school day energy expenditure and moderate-to-vigorous physical activity levels

Background: Although emerging research is demonstrating the potential health impact of exergaming,investigations have primarily been conducted in laboratory settings among small samples with short-term interventions.Information on the effectiveness of exergaming in underserved children's objective physical activity(PA) in population-based settings is also scarce.Moreover,most empirical studies have only included 1 type of exergame in the intervention.Therefore,this study's purpose was to investigate the long-term impact of a multigame exergaming intervention among underserved children integrated within school curricula.Specifically,this study examined the effect of exergaming on children's accelerometer-determined sedentary behavior(SB),light PA,moderate-to-vigorous PA(MVPA),and energy expenditure(EE) over 2 years as compared with regular physical education(PE) classes.Methods: A total of 261 second-and third-grade children(134 girls,127 boys; mean age 8.27 years) were recruited from 2 Texas elementary schools.Children's pre-test 3-day SB,light PA,MVPA,and EE at school were assessed in the fall of 2012.Participants were assigned to 1 of 2groups:(1) exergaming/PE group(125 min weekly of exergaming-based PA program) and (2) comparison group(125 min weekly of PE).PA(SB,light PA,and MVPA) and EE outcome variables were assessed again in 2013(post-test) and 2014(follow-up).Results: Significant time effects were observed for SB(F(1,162)=25.0,p<0.01,η~2= 0.14),light PA(F(1,162)=9.6,p<0.01,η~2= 0.06),and MVPA(F(1,162)=6.2,p=0.01,η~2= 0.04) but not for EE(F(1,162)=0.63,p>0.05,η~2= 0.004).Subsequent pairwise comparisons revealed significant increases from pre-to post-test for light PA(p<0.01),MVPA(p<0.01),and EE(p=0.02) with no changes in SB(p>0.05).Conversely,significant decreases occurred in light PA(p<0.01) from post-test to follow-up with no differences seen in MVPA(p=0.08) and EE(p=0.06) over the same time period.A significant increase was seen,however,for SB from post-test to follow-up.Conclusion: Exergaming PE can have the same positive effect on children's light PA,MVPA,and EE as regular PE.More research is necessary to discern how to promote long-term PA participation after conclusion of the intervention.

Vitamin B6 and colorectal cancer:Current evidence and future directions

Colorectal cancer remains the third most common cancer in both women and men worldwide.Identifying modifiable dietary factors is crucial in developing primary prevention strategies.Vitamin B6 is involved in more than 100 coenzyme reactions,and may influence colorectal cancer risk in multiple ways including through its role in one-carbon metabolism related DNA synthesis and methylation and by reducing inflammation,cell proliferation,and oxidative stress.Observational studies of dietary or dietary plus supplementary intake of vitamin B6 and colorectal cancer risk have been inconsistent with most studies reporting nonsignificant positive or inverse associations.However,published studies of plasma pyridoxal 5'-phosphate(the active form of vitamin B6) levels consistently support an approximately 30%-50% reduction in risk of colorectal cancer comparing high with low concentrations.The reasons for the discrepancy in the results between dietary-based and plasma-based studies remain unresolved.Other unresolved questions include the effects of vitamin B6 intake in early life(i.e.,childhood or adolescence) and of suboptimal vitamin B6 status on colorectal cancer risk,whether the associations with vitamin B6 differ across molecular subtypes of colorectal cancer,and whether the vitamin B6-colorectal cancer association is modified by genetic variants of one-carbon metabolism.

Consumption of red and processed meat and esophageal cancer risk:Meta-analysis

To summarize the evidence about the association between red and processed meat intake and the risk of esophageal cancer,we systematically searched the PubMed and EMBASE databases up to May 2012,with a restriction to English publications,and the references of the retrieved articles.We combined the studyspecific relative risks(RRs) and 95%CI,comparing the highest with the lowest categories of consumption by using a random-effects model.A total of 4 cohort studies and 23 case-control studies were included in the meta-analysis.The combined RRs(95%CI) of the cohort studies comparing the highest and lowest categories were 1.26(1.00-1.59) for red meat and 1.25(0.83-1.86) for processed meat.For the case-control studies,the combined RRs(95%CI) comparing the highest and lowest categories were 1.44(1.16-1.80)for red meat and 1.36(1.07-1.74) for processed meat.Findings from this meta-analysis suggest that a higher consumption of red meat was associated with a greater risk of esophageal cancer.

Circulating levels of vitamin D and colorectal adenoma: A case-control study and a meta-analysis

AIM: To examine the association between circulating 25-hydroxyvitamin D [25(OH)D] levels and colorectal adenoma in a case-control study and a meta-analysis. METHODS: We conducted a matched case-control study(112 cases and 112 matched controls) and combined 15 studies, including our study, in a metaanalysis. The study-specific odds ratios(ORs) and 95% confidence intervals(CIs) were pooled using a randomeffects model. In total, 5454 colorectal adenomas and 6656 controls were included in the meta-analysis. RESULTS: In a meta-analysis including 14 previous studies and our study, we observed a significant inverse association between circulating 25(OH)D levels and colorectal adenoma(OR = 0.68; 95%CI: 0.54-0.82) when comparing the highest category with the lowest category. Stratification by adenoma location(proximal or distal adenoma) showed similar estimates. When we stratified by study region, the ORs(95%CIs) were 0.70(0.52-0.88) in the US and 0.66(0.34-0.97) in Asia. CONCLUSION: These data suggest an inverse association between circulating 25(OH) Dlevels and colorectal adenoma in both Western and Asian populations.

Predicted pro-inflammatory hs-CRP score and non-alcoholic fatty liver disease

Background:Non-alcoholic fatty liver disease(NAFLD)is a major contributor to liver diseases globally,yet there are limited studies investigating the impact of diet and lifestyle factors on its development.This study aimed to examine the association between the prevalence of NAFLD and predicted pro-inflammatory high-sensitivity C-reactive protein(hs-CRP)score.Methods:We included 1,076 Korean adults who underwent a medical examination at the Seoul National University Hospital Gangnam Healthcare Center in Korea between May and December 2011 and updated in 2021.The predicted pro-inflammatory hs-CRP score was derived from pro-inflammatory demographic,lifestyle,dietary,and anthropometric factors,and NAFLD was diagnosed using liver ultrasound.Multivariable-adjusted odds ratios(ORs)and 95%confidence intervals(CIs)of NAFLD odds according to predicted pro-inflammatory hs-CRP score were estimated using logistic regression at a two-sided P<0.05.Results:Among the 1,076 participants,320 had NAFLD.The multivariable-adjusted ORs and 95%CIs for NAFLD by tertiles of predicted pro-inflammatory hs-CRP score were 1.00,3.30(2.06,5.30),18.25(10.47,31.81;P<0.0001)in men and women combined,1.00,1.77(1.10,2.84),and 3.26(2.02,5.28;P<0.0001)among men only,and 1.00,3.03(1.39,6.62),and 16.71(7.05,39.63;P<0.0001)among women only.Conclusions:Predicted pro-inflammatory hs-CRP score was associated with higher odds of NAFLD.Adopting dietary and lifestyle changes related to lower inflammation might be a valuable strategy for preventing NAFLD.