Association between higher vitamin E intake and lower pancreatic cancer risk meta analysis

Association between higher vitamin E intake and lower pancreatic cancer risk affirmed by meta-analysis

Tuesday, May 12, 2015. The result of a meta-analysis published in the May 1, 2015, issue of Medical Science Monitor indicates a protective effect for a greater intake of vitamin E against the risk of pancreatic cancer, the fourth leading cause of cancer death in the U.S.

"In humans, free radicals, which result from polyunsaturated fatty acids reacting with oxygen in the lipid membranes, might be essential for the occurrence of tumors," write Lujian Peng and colleagues in their introductory remarks. "Vitamin E is an effective antioxidant that prevents the occurrence of some tumors by protecting cells and DNA from free radical damage. Whether vitamin E, as an antioxidant, could reduce the incidence of pancreatic cancer has been under consideration."

For the analysis, Dr Peng and associates selected six case-control studies and four cohort studies that provided data on the vitamin E intake of a total of 2,976 pancreatic cancer patients and 253,431 controls. A 19% lower risk of pancreatic cancer was observed among participants who had a higher intake of vitamin E in comparison with those whose intake was low.

As possible mechanisms for vitamin E in cancer protection, the authors note that its antioxidant property helps prevent DNA damage by scavenging lipid peroxyl radicals and increasing the activity of the body's antioxidant enzyme superoxide dismutase. Vitamin E may also enhance immune response and decrease the activity of pathways involved in cancer growth.

"In our meta-analysis, there was an inverse association between vitamin E intake and the risk of pancreatic cancer," they conclude. "A high level of vitamin E might be a protective factor for populations at risk for pancreatic cancer."

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Higher plasma antioxidant levels associated with lower pancreatic cancer risk

The results of a study published online on August 30, 2014, in the International Journal of Cancer suggest a protective effect for higher antioxidant levels against the risk of cancer of the pancreas.

The case-control study included participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) ongoing multicenter cohort study, which was designed to investigate the relationship between diet and other factors with chronic disease incidence. Four hundred forty-six subjects diagnosed with pancreatic cancer were matched with an equal number of control subjects who were free of the disease. Prediagnostic blood samples were analyzed for plasma carotenoids (including alpha carotene, beta carotene, cryptoxanthin, lycopene, lutein and zeaxanthin), retinol, vitamin C and tocopherol (vitamin E) levels.

For those whose beta carotene levels were among the top 25% of participants, the risk of pancreatic cancer was 48% lower than that of subjects whose levels were among the lowest fourth. A 47% lower risk was observed for those who consumed the most zeaxanthin, and for subjects whose alpha-tocopherol levels were among the top fourth, pancreatic cancer risk was decreased by 38%.

"Vegetables and fruits may play a role in the prevention of pancreatic cancer because they contain potentially protective substances, such as carotenoids, vitamin C and tocopherols, folate and other phytochemicals," authors Suzanne M. Jeurnink of University Medical Center Utrecht and her colleagues note. "Potential mechanisms of such bioactive compounds include protection against free radical damage to DNA, enhancing immune function, and inhibiting insulin-like growth factor (IGF) by binding to IGF receptors."

"Our results show that higher plasma concentrations of beta-carotene, zeaxanthin and alpha tocopherol may be inversely associated with pancreatic cancer," they conclude. "Further research using larger sample sizes is warranted."

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Health Concern

Pancreatic cancer

Individual variations in the capacity to defend against oxidative stress and to repair oxidative DNA damage influence pancreatic cancer risk, and some of these genetic effects are modified by dietary antioxidants (Zhang 2011). Moreover, antioxidant levels are reduced in pancreatic tumors compared to healthy pancreatic tissue, resulting in increases in reactive oxygen species (ROS) that are capable of stimulating cancer growth (Garcea 2005; Vaquero 2004).

An overview of 14 randomized trials (with a total of 170,525 patients) showed significant effects of supplementation with beta-carotene, vitamins A, C, E, and selenium (alone or in combination) versus placebo on pancreatic cancer incidence (Bjelakovic 2004).

Vitamins A, C, and E, as well as selenium, increase antioxidants needed to reduce free-radical damage in the body (Woutersen 1999). A double-blind, placebo-controlled, randomized clinical trial involving 36 cancer patients undergoing surgery for pancreatic cancer evaluated the impact of an oral nutritional supplement (enriched with antioxidants, glutamine and green tea extract) on postoperative oxidative stress. Patients received the antioxidant-enriched supplement twice the day before surgery and once 3 hours before surgery. The nutritional supplement improved total antioxidant capacity (plasma levels of vitamin C, vitamin E, selenium, and zinc) shortly after surgery and increased plasma vitamin C levels (Braga 2011).

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