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Dissertation - University Access Only
Doctor of Philosophy (PhD)
Health and Nutritional Sciences
Cancer rates are different among countries due to a variety of reasons including nutrition status of a population. Cross-cultural studies have found huge differences in cancer incidences. Dietary macronutrients have been associated with these differences based on the comparison of various cancer incidences across populations. Flavonoids function as cancer preventive components due to their biological functions. Although some information is available on the relationship between cancer risks and the consumption of macronutrients and flavonoids, these relationships have not been observed on national or global levels. The consumptions of macronutrients for each country were estimated using food consumption data from the Food and Agriculture Organization of the United Nations (FAO). The flavonoid intakes were derived from the same and combined with the United States Department of Agriculture (USDA) flavonoid databases. The cancer incidence data was obtained from the World Health Organization (WHO). Then, multiple regression analyses were performed to establish the associations between cancer incidence rates and the consumption of macronutrients and flavonoids. European, Australian and North American countries tended to have higher consumption of fat, protein and energy, while Middle Eastern countries tended to have higher consumption of CHO. European and part of South American countries tended to have higher consumption of total flavonoids and flavan-3-ols. The highest flavone consumption was among Asian and Middle Eastern countries, theaflavin among South American countries, flavanone among Central American countries, anthocyanidin among Asian, European and Middle Eastern countries and flavonol among South American, Asian, European and Middle Eastern countries. Our study demonstrated a negative association between the consumption of total flavonoids and cancer incidence rates of the liver and cervix uteri. However, incidence rates of most other cancers were positively associated with the total flavonoids consumption. Multiple regression models showed incidence rates of most cancers are positively associated with the consumption of flavonols. The same is true for flavan-3-ols, but to a lesser degree. However, incidence rates of most cancers are negatively associated with the consumption of flavone. The same is true for theaflavin, but to a lesser degree. A similar negative association exists between cervix uteri cancer and the consumption of anthocyanidin. Flavanones were positively associated to prostate and lip with oral cavity cancers, whereas flavones were positively related to lip with oral cavity and pharynx cancers. Bringing in fat, CHO and protein consumptions to the model did not change the associations between the consumption of flavoniods and cancer incidence rates. However, bringing in flavoniods consumption to the macronutrient model changed the associations between cancer incidence rates and the macronutrient consumption. The most significant positive associations were between the consumption of protein and stomach cancer and the consumption of fat and prostate cancer. However, dietary fat intake has negative association with stomach cancer. Our findings suggest that low energy, fat, flavonol and flavan-3-ol, high theaflavin and flavone are associated with lower incidence rates of most cancers. However, cancers of lip with oral cavity and pharynx vs. flavones, liver vs. flavan-3-ol, stomach vs. fat and cervix uteri and liver vs. energy are exceptions to this rule.
Library of Congress Subject Headings
Cancer -- Risk factors
Includes bibliographical references (pages 93-117)
Number of Pages
South Dakota State University
In Copyright - Educational Use Permitted
Turkistani, Arwa, "A Global Study of Associations Between Cancer Risks and Consumption of Macronutrients and Flavonoids" (2014). Electronic Theses and Dissertations. 1599.