PURPOSE: To date, studies investigating the association between dairy consumption and breast cancer in women have produced conflicting results. As diet is an important, modifiable factor affecting cancer development, the aim of this study was to examine the association between dairy consumption and breast cancer risk. METHODS: PubMed, Embase, and Cochrane Library databases were searched with a priority for prospective cohort studies. Case-control studies were also considered in case of the absence of a cohort study. RESULTS: We analyzed 22 prospective cohort studies (1,566,940 participants) and five case-control studies (33,372 participants). High and modest dairy consumption (>600 and 400-600 g/day, respectively) significantly reduced the risk of breast cancer compared with low dairy consumption (<400 g/day; risk ratio [RR], 0.90, 95% confidence interval [CI], 0.83-0.98, and RR, 0.94, 95% CI, 0.91-0.98, respectively). A significant linear relationship between dairy consumption and breast cancer risk was found on dose-response analysis. Subgroup analysis found that yogurt (RR, 0.91; 95% CI, 0.83-0.99) and low-fat dairy (RR, 0.85; 95% CI, 0.75-0.96) reduced the risk of breast cancer, while other dairy product types did not. A reduced risk was observed for people in the United States (RR, 0.91; 95% CI, 0.83-0.99) and in those followed for > or =10 years (RR, 0.90; 95% CI, 0.81-0.99). Additionally, the highest level of dairy consumption among Asians was associated with a reduced risk of breast cancer (odds ratio, 0.74; 95% CI, 0.62-0.88). CONCLUSION: Dairy consumption was inversely associated with the risk of developing breast cancer and this effect was dependent on the dose, dairy-type, and time.
Asian Continental Ancestry Group* ; Breast Neoplasms* ; Breast* ; Case-Control Studies ; Cohort Studies ; Dairy Products ; Diet ; Female ; Humans ; Odds Ratio ; Prospective Studies ; Risk Assessment ; United States ; Yogurt

Objective: To understand the energy and major nutrients intake of high school students in Shanghai, and to provide basis for formulating target nutritional interventions and health education. Methods: The probability-proportional-to-size sampling technique was used to select 19 high schools, from which 9 boys and 9 girls from same class were randomly recruited for each grade. A total of 900 high school students were surveyed on their energy and major nutrients intake. Results: The medians of intake of energy, protein, fat, carbohydrate, calcium, sodium, iron, vitamin A, vitamin B-1, vitamin B-2, vitamin C and dietary fiber were 2 353 kcal/d, 97.3 g/d, 95.4 g/d, 265.4 g/d, 602.1 mg/d, 4 373 mg/d, 24.3 mg/d, 495.6 μgRE/d, 1.08 mg/d,1.21 mg/d, 83.2 mg/d and 1.01 g/d, respectively. Among of them, the medians of intake of energy, calcium, vitamin A, vitamin B-1, vitamin B-2, vitamin C and dietary fiber for boys and girls were lower than reference standard(P<0.05). The medians of intake of energy and major nutrients in high school students who lived in countryside were less than those lived in suburban and urban(P<0.05), except carbohydrates and iron. The percentages of energy supplied byprotein, fat and carbohydrate were 16.9%, 37.2%and 46.0%, respectively. Conclusion The energy and calorigenic nutrients intake can meet the demand of daily consumption in high school students in Shanghai, but the intake of dietary fiber, some minerals and vitamins have a various degrees of deficiency. The proportion of energy supplied bycalorigenic nutrients is unbalanced.

Objective: To evaluate the comprehensive intervention effect of lunch for primary and secondary school students in Minhang District, so as to provide a theoretical and practical basis for lunch intervention in school. Methods: From October to December 2023, a convenience sampling method was used to select 1 937 students from one primary and secondary school in Minhang District.A comprehensive intervention measure focusing on "reducing oil and salt" for lunch recipe optimization and nutrition education was carried out, and a questionnaire survey was conducted to evaluate the intervention effect three months later. Chi square test and Wilcoxon rank test were used to compare the data before and after the intervention. Results: After intervention, the use of cooking oil and salt, the supply of protein and fat in primary and secondary school lunches were reduced, and had no obvious impact on energy and other major nutrients. After intervention, compared to before intervention, the proportion of primary school students who felt that lunch was greasy decreased (8.9%, 6.2%, χ 2=4.35), and the proportion of primary and secondary school students who felt that lunch were delicious decreased significantly (33.2%, 23.2%; 63.9%, 53.5%, χ 2=26.39, 17.52) ( P < 0.05 ). Secondary school students also felt reduced variety of food ingredients (46.9%, 38.3%, χ 2=16.05, P <0.05). In addition, after intervention, the total surplus rate of primary school students meals decreased (7.4%, 4.4%, χ 2=5.73), mainly reflected in the decrease of the surplus rate of staple foods (7.1%, 2.4%, χ 2=17.39), while the surplus rate of vegetable dishes increased ( 16.0 %, 21.2%, χ 2=6.01) ( P <0.05). Although there was no significant change in the total surplus rate of meals for secondary school students, the surplus rate of staple foods decreased (12.9%, 5.4%, χ 2=33.52), while the surplus rates of meat and vegetable dishes increased (11.2%, 26.9%; 17.5%, 33.2%, χ 2=74.26, 61.88) ( P <0.05). After intervention, there was no statistically significant difference in the overweight and obesity rates of primary school students ( χ 2=0.11,0.43) and secondary school students ( χ 2=0.01,0.00) compared to before intervention( P >0.05). After intervention, the lung capacity of primary school students [1 564 (1 269,1 890) mL] and sitting forward flexion [11.3 (7.6, 15.2) cm] increased compared to before intervention [1 522 (1 259, 1 819 ) mL, 10.5 (6.3, 13.5) cm] ( Z =2.20, 4.68, P <0.01), but there was no statistically significant difference in lung capacity and sitting forward flexion of secondary school students before and after intervention ( Z =-0.46, -0.08, P >0.05). Conclusion The comprehensive intervention of school lunch has promoted a significant decrease in the use of oil and salt in lunch and improved the quality of recipes, and has a positive impact on the situation of leftover lunch and the health of students to a certain extent.

Thyroid carcinoma is a common cervical tumor. Its occurrence is associated with genetic and environmental factors. The incidence rate of thyroid cancer is increasing. However, the pathogenesis and the influencing factors of thyroid carcinoma are not yet fully understood. Many clinical studies and epidemiological investigations have found that such factors as radiation exposure, female hormone metabolism, and obesity have important links with the occurrence of thyroid cancer, but its association with factors such as dietary factors remains controversial. Therefore, it is urgent to explore and validate the relationship between various factors and thyroid cancer through epidemiological studies. In order to provide reference for the prevention of thyroid cancer, this special column “Thyroid carcinoma and associated risk factors” focused on the associations of female reproductive factors and dietary factors (including intake of iodine-rich foods) with thyroid carcinoma (nodules).

Recently, limiting the excessive intake of added sugar has gradually become an important topic in the field of nutrition. Sugar, sweetened dairy products, and sugar sweetened beverages (SSBs) are the three most important contributions of added sugar in China. For children, adolescents, and young adults, the issue of excessive intake of SSBs is not optimistic for now. Although the daily per capita intake of SSBs in China is currently at a low level on a global scale, the overall trend of SSBs production and consumption are rapidly increasing. Excessive intake of added sugar adversely affects glycolipid metabolism and multiple metabolic diseases, which is widely concerned and discussed. For the purpose of limiting added sugar, the gradually popularized use of sugar substitutes poses entirely new challenges. Multiple sugar-restriction strategies have been implemented and validated abroad. Given the rapid growth of consumption of added sugar and increasing evidence of related health hazards in China, there is a great need to improve the awareness of eating less added sugar for Chinese residents by multilevel strategies, and finally reduce the consumption of SSBs. In this article, the definition, history, and development of added sugar, main dietary sources, recommended limits, and both domestic and international consumption trends of added sugar were narrated. Then, the main health risks of added sugar and the global sugar-restriction strategies were briefly described. The article calls for raising awareness among Chinese residents of the health hazards of added sugar and limiting its excessive intake.

The global production and consumption of sugar-sweetened beverages (SSBs) has been on the rise in recent decades. The intake of SSBs has been increasing in China, and it is more prevalent among children and adolescents. As research continues to intensify, more and more studies have shown that, in addition to the increased risks of dental caries and obesity reported by the World Health Organization (WHO), SSBs intake can also increase risks of chronic diseases such as diabetes, cardiovascular disease, gout, and cancer, and early death, adding to the burden of disease. Due to the health risks associated with the overconsumption of SSBs, many countries around the world have taken measures to control the intake. The main measures currently in place are taxation of SSBs, restrictions on marketing and sales of SSBs, front-of-package labeling and reducing availability of SSBs in schools. In China, the main measures currently in place are to control the sales of beverages in schools, with Shenzhen taking the lead in implementing health warning labeling to alcoholic beverages and carbonated beverages, extending the measures to reduce SSBs intake beyond school grounds.

Background There are few studies on the diet quality of patients with thyroid cancer, and the relationship between diet quality and thyroid cancer remains uncertain. Objective This study aims to assess the diet quality with the Chinese Health Diet Index (CHDI) and to explore the relationship between diet quality and papillary thyroid carcinoma (PTC). Methods A 1∶1 gender- and age-matched hospital-based case-control study included newly diagnosed PTC patients and matched controls from Shanghai Cancer Hospital and Renji Hospital (East) in Shanghai, China. A structured questionnaire was applied to collect data on general characteristics, history of diseases, dietary intakes, and lifestyles. Food intakes in the past one year were assessed using a validated food frequency questionnaire, from which the CHDI score was calculated. The CHDI, according to the Dietary Guidelines for Chinese Residents, was employed to evaluate the diet quality of the two groups. A multiple conditional logistic regression model was conducted to explore the relationship between diet quality and PTC. Results A total of 350 pairs of cases and controls were recruited. The overall median CHDI score of the cases was lower than that of the controls (67.8 vs. 73.4, P<0.001). The cases had lower median scores of fruits (6.8 vs. 9.5), dairy products (3.6 vs. 5.6), and soybeans (4.6 vs. 5.5) than the controls (P<0.05); the cases had a higher median score of refined grains than the controls (5.0 vs. 4.9), and the percentage of the cases that met diet recommendations for refined grains was higher than the percentage of the controls (65.4% vs. 48.6%) (P<0.05); the cases showed lower median scores of whole grains/beans/tubers, total vegetables, dark vegetables, and fish/shrimps (0.9 vs. 1.4, 3.1 vs. 4.4, 3.6 vs. 5.0, and 3.3 vs. 4.0, respectively), and the percentages of the cases meeting their diet recommendations were lower than the percentages of the controls (6.3% vs. 8.6%, 32.6% vs. 42.0%, 38.6% vs. 50.6%, and 34.0% vs. 40.3%, respectively, P<0.05). The results of multiple conditional logistic regression analysis suggested that qualified and good diet quality were associated with a reduced the risk of PTC (qualified diet quality, OR=0.37, 95%CI: 0.23−0.62; good diet quality, OR=0.19, 95%CI: 0.10−0.36); the statistical significance remained after excluding patients who had a history of benign thyroid conditions (qualified diet quality, OR=0.28, 95%CI: 0.15−0.52; good diet quality, OR=0.20, 95%CI: 0.09−0.43). Conclusion Those with qualified or good diet quality have a lower risk of PTC. PTC patients have insufficient intakes of fruits, dairy, soybeans, whole grains/beans/tubers, vegetables, and fish/shrimps.

Background Thyroid carcinoma is a serious threat to human health in Shanghai and a focus of cancer prevention and treatment. Objective This study aims to assess the relationship between foods rich in iodine and papillary thyroid carcinoma (PTC)．Methods In a hospital-based case-control study matched by gender and age (±3 years old), 402 pairs of cases (new incidences) and controls were included and studied. A validated questionnaire and food frequency questionnaire survey was conducted face to face to obtain demographic characteristics and dietary intake. A multiple conditional logistic regression model was applied to explore the relationship between foods rich in iodine (including seaweeds, kelp, and dried shrimps) and PTC. Results The mean age of the participants was (41.17±11.51) years in this study. Compared with the controls, more cases had a lower education and a manual occupation (P<0.05); more cases were overweight or obese, had a history of benign thyroid conditions, and had a family history of thyroid diseases (P<0.05); the two groups were different in the frequency of CT examination in the past ten years (P<0.05). The results of multiple conditional logistic regression analysis showed that consumption of iodine-rich foods was associated with a lower risk of PTC (for <1 time per week, OR=0.20, 95%CI: 0.12−0.35; for 1−2 times per week, OR=0.18, 95%CI: 0.10−0.33; for ≥3 times per week, OR=0.13, 95%CI: 0.04−0.44) (P<0.05). Specifically, those who consumed seaweeds (for <1 time per week, OR=0.18, 95%CI: 0.11−0.30; for 1−2 times per week, OR=0.11, 95%CI: 0.05−0.23; for ≥3 times per week, OR=0.15, 95%CI: 0.03−0.75), kelp (for <1 time per week, OR=0.28, 95%CI: 0.18−0.43; for ≤2 times per week, OR=0.24, 95%CI: 0.11−0.50), and dried shrimps (for <1 time per week, OR=0.44, 95%CI: 0.29−0.69; for ≤2 times per week: OR=0.34, 95%CI: 0.18−0.65) had a lower risk of PTC (P<0.05). After excluding patients who had a history of benign thyroid conditions, the favorable association remained significant among patients who had consumption of iodine-rich foods, seaweeds, shrimps, and kelp (P<0.05). Conclusion Less PTC patients consume iodine-rich foods than the controls.

Background Both domestic and foreign studies on the diet quality of patients with thyroid nodules are rare at present, and the relationship between thyroid nodules and diet quality is still unclear. Objective This study aims to evaluate the diet quality of thyroid nodules with the China Healthy Diet Index (CHDI) and to explore the relationship between diet quality and thyroid nodules. Methods We conducted a hospital-based case-control study in which 387 patients with thyroid nodules were matched individually (1∶1) by gender and age (±3 years) to the controls who ordered a routine physical examine and with negative thyroid nodules reported by B-ultrasound in the same hospital. A structured questionnaire was applied to collect data on general characteristics and diet. CHDI was employed to evaluate the diet quality of the two groups. CHDI is based on the Dietary Guidelines for Chinese Residents and the recommended food intake in the balanced diet pagoda, combined with the dietary nutritional status of Chinese population. The index contains 13 scoring components, and the highest total score is 100, with a higher score representing better dietary quality. CHDI scores < 60, 60-<80, and ≥80 are recognized as unqualified, qualified, and good diet quality, respectively. Results The scores of the thyroid nodule cases were lower than the scores of the controls in total vegetables, dark vegetables, fruits, and fish/shrimps (all Ps<0.05). The nonparametric test results found that there were significant differences in the distributions of scores in total vegetables, dark vegetables, fruits, soybeans, and fish/shrimps between the case and the control groups (all Ps<0.05). The percentages reaching the full scores in food variety, meat and eggs, and empty calories in both groups exceeded 60%, while the percentages reaching the full scores in whole grains/beans/tubers, dairy, soybeans, and sodium were lower than 30% in the two groups. The median CHDI scores of the thyroid nodule cases and the controls were 69.1 and 72.9, respectively; the cases' CHDI score was lower than the controls' (P<0.05). The proportions of unqualified diet in the case and the control groups accounted for 23.0% and 13.7% respectively (P=0.001). After being adjusted for education level, marital status, occupation, monthly household income per capita, body mass index, hypertension/diabetes, energy, and iodine intake, the results of logistic regression analysis showed that the risk for thyroid nodules was negatively associated with CHDI score (CHDI qualified group vs. CHDI unqualified group, OR=0.484, 95%CI: 0.291-0.804; CHDI good dietary quality group vs. CHDI unqualified group, OR=0.414, 95%CI: 0.230−0.746). Conclusion The diet quality of patients with thyroid nodules is lower than that of the control group, as the former reported lower consumptions of total vegetables, dark vegetables, fruits, and fish/shrimps. Those who have good or qualified diet quality show a reduced risk of thyroid nodules than those with unqualified dietary quality.

Background The retail milk tea industry is in a period of rapid development, but there is little research on its nutrient content, which restricts the nutritional guidance of milk tea. Objective To determine the levels of nutrients in best-selling handcrafted milk tea in Shanghai and analyze the nutritional characteristics. Methods In 2018 and 2021, a total of 13 handcrafted milk tea brands with ≥3 branch stores in Shanghai were selected by searching for milk tea on Meituan and Ele.me food delivery platforms, and a total of 122 types of handcrafted milk tea products were collected from the top three sales [milk tea (including all sweetness levels available), milk cover tea, and fruit tea]. National standard methods were used to detect energy, protein, fat, carbohydrate, sugar, trans fatty acid, calcium, caffeine, and tea polyphenol. Results The median energy of the milk tea samples was 310 kJ (per 100 g sample). The main sources of energy were carbohydrate and fat. The levels of energy, protein, and fat in milk cover tea and milk tea were significantly higher than those in fruit tea (P＜0.05), and there was no significant difference in carbohydrate among them. The total sugar, fructose, and glucose levels in milk tea were significantly lower than those in milk cover tea and fruit tea, and the lactose level in fruit tea was significantly lower than those in milk tea and milk cover tea (P＜0.05). Themedian trans fat acid level in milk cover tea was higher than that in milk tea (P＜0.05). The median levels of caffeine and tea polyphenol were higher in milk tea than in milk cover tea (P＜0.05). The levels of energy, carbohydrate, sucrose, total sugar, and calcium in milk tea were positively correlated with the number of ingredients added (0-3) (r=0.386, 0.371, 0.238, 0.698, 0.466, respectively, P < 0.05). The levels of energy, carbohydrate, and total sugar tended to increase with increasing sweetness (P<0.05), and total sugar was mainly sucrose, followed by fructose and glucose. The total sugar levels of the samples labeled sugar free, light sugar, half sugar, less sugar, and regular sugar were 3.40 (2.20, 4.9), 4.97 (4.25, 5.97), 5.80 (4.31, 6.88), 6.59 (5.17, 8.53), and 7.96 (6.82, 9.20) g, respectively; the proportions of the samples containing more than 0.5 g of total sugar were 93.3% for sugar free milk tea, 47.4% for light sugar milk tea, and 94.0% for regular sugar milk tea; the proportion of the regular sugar samples with sugar content greater than 10 g was 18.0% (all samples with nominal sugar content were measured per 100 g). Conclusion The retail handcrafted milk tea in Shanghai is characterized by high energy, high added sugar, high fat, and low protein. It is necessary to standardize the added sugar content and sweetness labeling, strengthen the nutrition education of milk tea, and guide residents to limit its intake.