Association of plant-based diets with the risk of upper gastrointestinal tract cancers:A systematic review and meta-analysis

Background:Diets rich in red or processed meat have been linked to an increased risk of cancers within the digestive system.It has been suggested that a plant-based diet may have protective effects against digestive system cancers.This study aimed to determine the association between plant-based diets and upper gastrointestinal tract cancers(UGTC).Methods:We conducted a systematic review and meta-analysis of observational studies.We searched the PubMed,Medline,Embase,and Web of Science databases for articles published up to September 30,2023.We pooled the risk ratios(RR)with the corresponding 95%confi-dence intervals(CI)using fixed or random-effects models.Results:Our meta-analysis included 16 studies(30 results).The data revealed a strong inverse association between a high intake of plant-based diets and UGTC(RR=0.60,95%CI=0.49-0.72),specifically gastric cancer(GC,RR=0.53,95%CI=0.42-0.67)and esophageal can-cer(EC,RR=0.63,95%CI=0.42-0.96).This relationship was not significant for gastric cardia cancer(GCA)or esophagogastric junctional cancer(EGJC,RR=0.76,95%CI=0.47-1.22).A subgroup analysis showed the association was significant in studies from Asia and Europe,as well as in studies utilizing indices such as a vegetarian diet,Mediterranean diet,the plant-based diet index,and principal component analy-sis(PCA)dietary patterns.There was no indication of publication bias among the analyzed studies.Conclusions:This meta-analysis highlights the potential health benefits of plant-based diets in preventing UGTC,particularly regarding esophageal squamous cell carcinoma(ESCC)and GC.Nevertheless,additional research is required to validate these results and explore the un-derlying mechanisms.

Time-restricted feeding:what we have done and what more we can do?

Obesity and other metabolic syndromes such as hypertension,type 2 diabetes,and hyperlipidemia remain a major public health burden worldwide.Apart from higher incidence of cardiovascular diseases,obesity and other abnormal metabolic status also promote cancer development and poor prognosis of cancer patients(1-3).In addition to using different surgical modalities(4),weight management through lifestyle changes has proven to be a more economical and low-risk approach.For obese patients,whether daily caloric intake can be reasonably restricted is recognized as an important strategy for solving their problem.In the past few years,intermittent fasting(IF),especially time-restricted feeding(TRF),has shown good clinical weight loss effect(>5%loss from baseline)(5).Moreover,people who participate in IF or TRF can often show good compliance,because compared with traditional dieting,IF or TRF does not require participants to record the specific calories of each meal in detail,participants only need to eat within the specified time period and not have any caloric intake at any other time.

Pre-coronavirus disease 2019 brain structure might be associated with social anxiety alterations during the pandemic

To the Editor:As the novel coronavirus disease 2019(COVID-19)pandemic rapidly spreads around the world,it has resulted in unprecedented economic loss,social turmoil,and detrimental effects on public mental health.In particular,the implementation of disease control measures such as nationwide lockdowns,social distancing,school closures,and home quarantine has given rise to a wide range of social anxiety(SA)around the world,from nonclinical manifestations to clinical social anxiety disorder(SAD).[1]Given the potentially severe impairments from SA and the limited mental health care resources,it is vital to identify whether there are vulnerability/risk neuropsychological factors contributing to the progression of SA during the pandemic.