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There is growing evidence for a link between body weight and cancer risk, but there is not a clear consensus yet.We studied the association between body mass index (BMI) and overall, lung, prostate and colon cancer mortality. In 1971/73, weight and height were measured in 2974 men working in Basel, Switzerland. In 1990, the vital status of all participants was assessed.290 men had died from cancer, 87 from lung, 30 from prostate, and 22 from colon cancer. In the predefined Cox Proportional Hazards Regression Models for survival analysis, a baseline hazard was modified multiplicatively by covariates, i.e. the untransformed continuous variable "BMI" was chosen as covariate. In addition it was assumed that the baseline hazard may be different for smokers, non-smokers and different age groups (age at entry into study). Thus, multiple strata, i.e. combinations of smoking status and age groups were allowed. With increasing BMI overall cancer mortality did not change. Accordingly, the relative risk (RR) per 1-unit increase of BMI (unit = 1 kg/m2) was 1.03 (95% CI: 0.99-1.07). In relation to lung cancer, mortality did neither increase nor decrease with increasing BMI (RR = 1.0; 95% CI 0.93- 1.07). The results for prostate cancer mortality were similar, i.e. no correlation with BMI was observed (RR = 0.95; 95% CI: 0.93-1.18). The same was true for colon cancer mortality (RR = 1.09; 95% CI: 0.92-1.24).This investigation provides little evidence of an association between BMI and mortality of all cancers combined, cancer of the lung, the prostate and the colon.

UNLABELLED: Study Type--Prognosis (case control) Level of Evidence 2. What's known on the subject? and What does the study add? Geographical and ethnic differences in the distribution of BPH and the results of migrant studies indicate that not only age, androgens and genetics, but also modifiable factors may play a role in the aetiology of BPH. Oxidative stress induced by chronic inflammation could be a cause and antioxidants, including selenoproteins, may reduce the risk. The published data related to this topic are scarce and are mainly based on cross-sectional and case-control studies. In a nested case-control study, we observed a significant inverse association between serum selenium concentrations and the risk of BPH. These results need to be confirmed in larger, prospective epidemiological studies. Prostate enlargement is an increasing health problem as a result of an ageing population in many countries. Modifiable factors may also play a role. In the present study, before this antioxidant can be recommended as a preventive measure. OBJECTIVE: • To determine whether geographical differences in the distribution of benign prostatic hyperplasia (BPH) and migrant studies indicate that modifiable factors play a role in the aetiology of BPH. Oxidative stress produced by chronic inflammation could represent one of the causes, and antioxidants, including selenoproteins, may reduce the risk. SUBJECTS AND METHODS: • Conditional logistic regression was used to examine the associations of serum selenium and selenoprotein P concentrations and glutathione peroxidase activity with respect to the risk of BPH in a case-control study nested in the European Prospective Investigation into Cancer and Nutrition-Heidelberg cohort, including 111 cases and 214 matched controls. • In addition, dietary glucosinolate intake and the serum glutathione S-transferase α concentration was investigated. RESULTS: • The risk of BPH significantly decreased with an increasing serum selenium concentration; the risk estimate was 0.83 (35% CI 0.69-0.99) per 10 µg/L increase in serum selenium concentration. • However, no significant association was present for serum selenoprotein P concentration or glutathione peroxidase activity. Risk estimates for BPH decreased with a higher intake of glucosinolates, although the results were not statistically significant. CONCLUSION: • A low serum selenium concentration may increase the risk of BPH, although the findings reported in the present study need to be confirmed in larger, well-designed epidemiological studies.

There is accumulating evidence that free radicals may contribute to various diseases such as cancer or cardiovascular disease. Possible health hazards can to some extent be prevented by the body’s multilevel defense system against free radicals, which comprises, besides others, antioxidant vitamins. The 12-year mortality follow-up of 2,974 participants of the Basel Study allowed to test the hypothesis that low antioxidant vitamin plasma concentrations (vitamin A, C, E and carotene) were associated with increased death from cancer of various sites and death from atherosclerosis such as ischemic heart disease and stroke, respectively. For the analysis 204 cancer cases, 132 fatalities from ischemic heart disease (IHD) and 31 deaths from cerebral vascular disease were available.

Das Bundesamt für Statistik führt im Abstand von fünf Jahren Schweizerische Gesundheitsbefragungen (SGB) durch. Die hier vorgestellte SGB07 ist die vierte vergleichbare Erhebung. Die fast 19 000 Personen umfassende Stichprobe ist repräsentativ für die in der Schweiz wohnhafte Bevölkerung ab 15 Jahren. Übergewicht (29%) und Adipositas (8%) sind weit verbreitet, aber seit 2002 sind keine signifikanten Zunahmen mehr zu verzeichnen. Männer sind deutlich häufiger übergewichtig als Frauen (38% vs. 21%). Bezüglich Ernährungsgewohnheiten geben knapp 30% der Befragten an, auf nichts zu achten in ihrer Ernährung. Die empfohlenen fünf Portionen Früchte und Gemüse pro Tag konsumieren nur 30%, die empfohlenen drei Portionen Milch und Milchprodukte nur 10%. 37% essen selten oder nie Fisch, und der tägliche Fleisch/Wurstwarenkonsum liegt bei knapp 20%. Grobe Längsvergleiche der vier SGB ergeben nur geringe Verbesserungen im Essverhalten über die letzten 15 Jahre.

Die Vermutung ist berechtigt, dass Folsaure nicht nur Neuralrohrdefekte verhindert, sondern auch in der Pravention von anderen Fehlbildungen, kardiovaskularen Krankheiten, Krebs etc. von Bedeutung sein konnte. Die Beweislage fur Neuralrohrdefekte ist unbestritten, fur kardiovaskulare Krankheiten fehlen noch die Ergebnisse von Interventionsstudien. Die Empfehlung perikonzeptionell 0,4 mg Folsaure einzunehmen, um Neuralrohrdefekte zu verhuten, wird nur zogernd umgesetzt. Informationskampagnen und das Anreichern einzelner Lebensmittel mit Folsaure haben weltweit nur begrenzte Erfolge gezeigt. Vor allem Frauen mit ungeplanter Schwangerschaft (in der Schweiz rund 40-50 %) und Frauen der unteren Sozialschichten werden mit diesen Masnahmen nicht erreicht. Deshalb wird in verschiedenen Landern Mehl obligatorisch mit Folsaure angereichert. Dies empfiehlt auch eine Arbeitsgruppe der Eidgenossischen Ernahrungskommission fur die Schweiz. Summary Folic acid is not only of importance in the prevention of neural tube defects but may also play an important role in the prevention of other birth defects, cardiovascular disease and cancer etc. For neural tube defects, evidence is clear, for cardiovascular disease, the results of intervention trials are still missing. Despite the fact that periconceptional intake of 0.4 mg folic acid as a supplement is recommended for several years, this recommendation is insufficiently implemented. Worldwide information campaigns and fortification of single foods with folic acid are of limited effect. Several countries therefore fortify wheat flour on a mandatory basis with folic acid. This has recently also been recommended for Switzerland by a working group of the Swiss Federal Nutrition board. Schlusselworter Folsaure - Neuralrohrdefekt - Fehlbildungen - kardiovaskulare Krankheiten - Krebs - Strategien - Mehl - Schweiz Key words Folic acid - neural tube defects - birth defects - cardiovascular disease - cancer - fortification of wheat flour - Swiss recommendations

Despite worldwide public-health campaigns recommending periconceptional daily supplementation of synthetic folic acid to reduce the risk of neural tube defects, many women are not following these recommendations. At the same time, in most European countries no decline in defects has been recorded in recent years. Vulnerable groups are those with a low standard of education, young people, and women with unplanned pregnancies. Furthermore, in most countries without mandatory fortification, the general population is not consuming the recommended 0.4 mg of food folate per day. Voluntary fortification improves the situation, but does not reach all parts of the population. In the USA, Canada, and Chile, mandatory fortification of flour substantially improved folate and homocysteine status, and neural tube defects rates fell by between 31% and 78%. Nevertheless, many countries do not choose mandatory folic acid fortification, in part because expected additional health benefits are not yet scientifically proven in clinical trials, in part because of feared health risks, and because of the issue of freedom of choice. Thus, additional creative public-health approaches need to be developed to prevent neural tube defects and improve the folate status of the general population.

Die perikonzeptionelle Einnahme von 0.4 mg Folsäure reduziert das Risiko von Neuralrohrdefekten (NRD) wesentlich, aber nicht 100%ig. Das Körpergewicht könnte eine zusätzliche Rolle spielen. Perikonzeptionell eingeschränkte Energiezufuhr erhöhte in einer Fall-Kontroll-Studie das NRD-Risiko. Andere Studien berichteten über ein höheres NRD-Risiko bei ungenügender Gewichtszunahme in der Schwangerschaft. Niedriges Körpergewicht vor der Schwangerschaft ergab widersprüchliche Resultate, was Ausdruck der Heterogenität von Untergewichtigen sein könnte. Zusätzliche Studien sind notwendig, um das Risiko einer reduzierten Energiezufuhr definitiv beurteilen zu können. Mütter, die vor der Schwangerschaft adipös sind, weisen ein rund zweimal höheres NRD-Risiko auf, unabhängig von der Folsäurezufuhr oder einem Diabetes. Der Bedarf adipöser Frauen an perikonzeptioneller Folsäure könnte allerdings erhöht sein. Die Ergebnisse zur Adipositas müssen in Kohorten- und Interventionsstudien bestätigt werden. Empfehlungen zum Körpergewicht von potentiell schwangeren Frauen sollten einen adäquaten Ernährungsstatus gewährleisten. Zusätzlich ist die Einnahme von Folsäuresupplementen zu propagieren.

In Western countries marginal deficiencies of micronutrients are still observed. Risk groups can be defined with data from groups (food balance sheets) and individuals. In Switzerland a comprehensive dietary survey is still lacking. Based on the results of food balance sheets the vitamin recommendations with the exception of folate, vitamin D and pantothenic acid seem to be met. But data from individuals reveal that in many subgroups of the Swiss population marginal deficiencies of the vitamins B 1 , B 2 , and B 6 are present. For the primary prevention of neural tube defects the Swiss Federal Office of Public Health recommends that women capable of becoming pregnant consume 400 μg of folic acid daily from supplements. To improve the limited compliance with this recommendation a new strategy is now being evaluated (education program, fortification of a staple food, fortification of several foodstuffs with folic acid). Due to the fact that the concentration of iodine in the fortified salt was increased several times in the last decades and due to the import of wheat rich in selenium from Northern America, at present requirements of iodine and selenium are met. Calcium and iron requirements on the other hand are insufficiently met by women. Based on the scientific literature and Swiss surveys on consumer knowledge and attitudes about diet, other risk groups for vitamin and mineral deficiencies are expected. People with a low intake of calories and/or with high requirements of micronutrients as well as people with special food habits or inadequate food choice and/or handling are especially at risk. Governmental and non-governmental efforts are made to monitor and improve the micronutrient status of the Swiss population.