Suplementação de vitaminas na prevenção de câncer
Palavras-chave:
epidemiologia nutricional, quimioprevenção, vitaminas, neoplasias, antioxidantesResumo
Este trabalho constitui uma revisão de dados epidemiológicos sobre a relação entre o consumo de vitaminas e prevenção de câncer. Estudos observacionais evidenciam uma associação inversa consistente entre a ingestão de frutas e hortaliças e risco de câncer, e um efeito protetor das vitaminas C, E e dos carotenóides contra certos tipos de câncer. Resultados de estudos de intervenção, na prevenção primária de câncer, são contraditórios, sendo que em dois desses estudos o β-caroteno, suplementado em doses consideradas farmacológicas, isolado ou associado à vitamina E ou à vitamina A, mostrou-se deletério para tabagistas. Ao contrário, a ingestão de doses mais fisiológicas de antioxidantes parece ser mais eficaz, sendo que a ação sinérgica dessas substâncias na quimioprevenção de câncer já foi demonstrada tanto em modelo in vivo de carcinogênese quanto em estudo epidemiológico de intervenção. Como estratégia de prevenção de câncer preconiza-se o consumo de dietas ricas em frutas e hortaliças, que aportem cerca de 150 mg de vitamina C, 30 mg de vitamina E e 4 mg de carotenóides. A ingestão de quantidades mais elevadas, na forma de suplementos, não está recomendada.
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ALBANES, D., HEINONEN, O.P., HUTTUNEN, J.K., TAYLOR, P.R., VIRTAMO, J., EDWARDS, B.K., HAAPAKOSKI, J., RAUTALAHTI, M., HARTMAN, A.M., PALMGREN, J., GREENWALD, P. Effects of a-tocopherol and β-carotene supplements on cancer incidence in the alpha-tocopherol beta-carotene cancer prevention study. American Journal of Clinical Nutrition, Bethesda, v.62, p.1427S-1430S,1995. Supplement 6.
ALBERTS, D.S., GARCIA, D.J. An overview of clinical cancer chemoprevention studies with emphasis on positive phase III studies. Journal of Nutrition, Philadelphia, v.125, p.692S-697S,1995. Supplement 3.
ALPHA-TOCOPHEROL, Beta-Carotene Cancer Prevention Study Group: the effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in males smokers. New England Journal of Medicine, Boston, v.330, n.15, p.1029-1035, 1994.
ANDERSON, D. Antioxidant defences against reactive oxygen species causing genetic and other damage. Mutation Research, Amsterdam, v.350, n.1, p.103-108,1996.
AZOUBEL, L.M.O., GARCIA, R.W.D., NAVES, M.M.V. Tabela de composição de alimentos. In: DUTRA-DE-OLIVEIRA, J.E., MARCHINI, J.S. Ciências nutricionais. São Paulo : Sarvier, 1998. p.363-376.
BIANCHI, M.L.P., ANTUNES, L.M.G. Radicais livres e os principais antioxidantes da dieta. Revista de Nutrição, Campinas, v.12, n.2, p.123-130, 1999.
BLOCK, G. Vitamin C and cancer prevention: the epidemiologic evidence. American Journal of Clinical Nutrition, Bethesda, v.53, p.270S-282S, 1991. Supplement 1.
BLOCK, G., LANGSETH, L. Antioxidant vitamins and disease prevention. Food Technology, Chicago, v.48, n.7, p.80-84, 1994.
BLOT, W.J., LI, J.Y., TAYLOR, P.R., GUOW., DAWSEY, S., WANG, G.Q., YANG C.S., ZHENG, S.F., GAIL, M., LI, G.Y., YU,Y., LIU, B.Q., TANGREA, J., SUN, Y.H., LIU, F., FRAUMENI JR., J.F., ZHANG, Y.H., LI, B. Nutrition intervention trials in Linxian, China: suplementation with specific vitamin/mineral combinations, cancer incidence, and disease-specific mortality in the general population. Journal of the National Cancer Institute, Bethesda, v.85, n.18, p.1483-1491, 1993.
BLUMBERG, J.B. Considerations of the scientific substantiation for antioxidant vitamins and β-carotene in disease prevention. American Journal of Clinical Nutrition, Bethesda, v.62, p.1521S-1526S,1995. Supplement 6.
BONNE, C.W., KELLOFF, G.J., MALONE, W.E. Identification of candidate cancer chemopreventive agents and their evaluation in animal models and human clinical trials: a review. Cancer Research, Philadelphia, v.50, n.1, p.2-9, 1990.
BRUCE, A. Dietary recommendations in cancer prevention. Annals of Clinical Research, Helsinki, v.19, n.5, p.313-320, 1987.
BURRI, B.J. Beta-carotene and human health: a review of current research. Nutrition Research, New York, v.17, n.3, p.547-580, 1997.
BURTON, G.W., INGOLD, K.U. β-Carotene: an unusual type of lipid antioxidant. Science, Washington DC, v.224, n.4649, p.569-573, 1984.
BYERS, T., PERRY, G. Dietary carotenes, vitamin C and vitamin E as protective antioxidants in human cancer. Annual Review of Nutrition, Palo Alto, v.12, p.139-159, 1992.
CARAGAY, A.B. Cancer-preventive foods and ingredients. Food Technology, Chicago, v.46, n.4, p.65-68, 1992.
CERUTTI, P.A. Oxy-radicals and cancer. Lancet, London, v.344, n.8926, p.862-863, 1994.
COX, D.N., ANDERSON, A.S., REYNOLDS, J., MCKELLAR, S., LEAN, M.E.J., MELA, D.J. Take five, a nutrition education intervention to increase fruit and vegetable intakes: impact on consumer choice and nutrient intakes. British Journal of Nutrition, London, v.80, p.123-131, 1998.
COZZI, R., RICORDY, R., AGLITTI, T., GATTA, V., PERTICONE, P., DE SALVIA, R. Ascorbic acid and β-carotene as modulators of oxidative damage. Carcinogenesis, London, v.18, n.1, p.223-228, 1997.
DE LUCA, L. M., ROSS, S. A. Beta-carotene increases lung cancer incidence in cigarette smokers. Nutrition Reviews, New York, v.54, n.6, p.178-180, 1996.
DOLL, R. Nature and nurture: possibilities for cancer control. Carcinogenesis, London, v.17, n.2, p.177-184, 1996.
EICHHOLZER, M., STÄHELIN, H.B., GEY, K.F., LUDIN, E., BERNASCONI, F. Prediction of male cancer mortality by plasma levels of interacting vitamins:17-year follow-up of the prospective Basel study. International Journal of Cancer, Geneva, v.66, n.2, p.145-150, 1996.
FLAGG, E.W., COATES, R.J., GREENBERG, R. S. Epidemiologic studies of antioxidants and cancer in humans. Journal of the American College of Nutrition, New York, v.14, n.5, p.419-427, 1995.
FREUDENHEIM, JO.L. A review of study designs and methods of dietary assessment in nutritional epidemiology of chronic disease. Journal of Nutrition, Philadelphia, v.123, n.2, p.401-405, 1993.
GODOY, H.T., RODRIGUEZ-AMAYA, D.B. Occurrence of cis-isomers of provitamin A in Brazilian fruits. Journal of Agricultural and Food Chemistry, Washington, v.42, n.6, p.1306-1313, 1994.
HATHCOCK, J.N. Vitamins and minerals: efficacy and safety. merican Journal of Clinical Nutrition, Bethesda, v.66, n.2, p.427-437, 1997.
HAVAS, S., HEIMENDINGER, J., REYNOLDS, K., BARANOWSKI, T., NICKLAS, T.A., BISHOP, D., BULLER, D., SORENSEN, G., BERESFORD, S.A.A., COWAN, A., DAMRON, D. A day for better health: a new research initiative. Journal of the American Dietetic Association, Chicago, v.94, n.1, p.32-36, 1994.
HENNEKENS, C.H., BURING, J.E., MANSON, J.E., STAMPFER, M., ROSNER, B., COOK, N.R., BELANGER, C., LAMOTTE, F., GAZIANO, J.M., RIDKER, P.M., WILLETT, W., PETO, R. Lack of effect of long-term supplementation with beta carotene on the incidence malignant neoplasms and cardiovascular disease. New England Journal of Medicine, London, v.334, n.18, p.1145-1149, 1996.
HERBERT,V. Prooxidant effects of antioxidant vitamins. Journal of Nutrition, Philadelphia, v.126, p.1197S-1200S, 1996. Supplement 4.
HERCBERG, S., GALAN, P., PREZIOSI, P., ROUSSEL, A.M., ARNAUD, J., RICHARD, M.J., MALVY, D., PAUL-DAUPHIN, A., BRIANÇON, S., FAVIER, A. Background and rationale behind the SUVIMAX study, a prevention trial using nutritional doses of a combination of antioxidant vitamins and minerals to reduce cardiovascular diseases and cancers. International Journal for Vitamin and Nutrition Research, Bern, v.68, n.1, p.3-20, 1998.
HUNT, J.R. Position of the American Dietetic Association: vitamin and mineral supplementation. Journal of the American Dietetic Association, Chicago, v.96, n.1, p.73-77, 1996.
KNEKT, P. Epidemiology of vitamin E: evidence for anticancer effects in humans. In: PACKER, L., FUNCHS, J. (Ed.). Vitamin E in health and disease. New York : Marcel Dekker, 1993. p.141-164.
KUHN, R.E., GUZMÁN-SILVA, M.A., GUIMARÃES, J.S.P. Dialquilnitrosaminas e câncer. Revista Brasileira de Cancerologia, Rio de Janeiro, v.37, n.1/4, p.19-26, 1991.
LOTAN, R. Retinoids in cancer chemoprevention. FASEB Journal, Bethesda, v.10, n.9, p.1031-1039, 1996.
MANGELS, A.R., HOLDEN, J.M., BEECHER, G.R., FORMAN, M.R., LANZA, E. Carotenoid content of fruits and vegetables: an evolution of analytic data. Journal of the American Dietetic Association, Chicago, v.93, n.3, p.284-296, 1993.
MATHEWS-ROTH, M.M. Carotenoids and cancer prevention: experimental and epidemiological studies. Pure and Applied Chemistry, London, v.57, n.5, p.717-722, 1985.
MORENO, F.S., RIZZI, M.B.S.L., DAGLI, M.L.Z., PENTEADO, M.C.V. Inhibitory effects of β-carotene on preneoplastic lesions induced in Wistar rats by the resistant hepatocyte model. Carcinogenesis, London, v.12, n.10, p.1817-1822, 1991.
NAVES, M.M.V. Beta-caroteno e câncer. Revista de Nutrição, Campinas, v.11, n.2, p.99-115, 1998.
NAVES, M.M.V., MORENO, F.S. β-Carotene and cancer chemoprevention: from epidemiological associations to cellular mechanisms of action. Nutrition Research, New York, v.18, n.10, p.1807-1824, 1998.
NAVES, M.M.V., MORENO, F.S. Comunicações intercelulares com conexinas: importância na carcinogênese e papel modulador dos carotenóides. Revista Brasileira de Ciências Farmacêuticas, São Paulo, v.36, n.1, p.1-11, 2000.
NIKI, E. α-Tocopherol. In: CADENAS, E., PACKER, L. (Ed.). Handbook of antioxidants. New York : Marcel Dekker, 1996. p.3-25.
NIKI, E., NOGUCHI, N., TSUCHIHASHI, H., GOTOH, N. Interaction among vitamin C, vitamin E, and β-carotene. American Journal of Clinical Nutrition, Bethesda, v.62, p.1322S-1326S, 1995. Supplement 6.
OLSON, J.A. Provitamin A function of carotenoids: the conversion of β-carotene into vitamin A. Journal of Nutrition, Philadelphia, v.119, n.1, p.105-108, 1989.
OLSON, J.A. Vitamins: the tortuous path from needs to fantasies. Journal of Nutrition, Philadelphia, v.124, p.1771S-1776S, 1994.
OLSON, J.A. Benefits and liabilities of vitamin A and carotenoids. Journal of Nutrition, Philadelphia, v.126, p.1208S-1212S, 1996. Supplement 4.
OMENN, G.S., GOODMAN, G.E., THORNQUIST, M.D., BALMES, J., CULLEN, M.R., GLASS, A., KEOGH, J.P., MEYSKENS JR., F.L., VALANIS, B., WILLIAMS JR., J.H., BARNHART, S., CHERNIACK, M.G., BRODKIN, C.A., HAMMAR, S. Risk factors for lung cancer and for intervention effects in CARET, the beta-carotene and retinol efficacy trial. Journal of the National Cancer Institute, Bethesda, v.88, n.21, p.1550-1558, 1996.
ORGANIZACIÓN MUNDIAL DE LA SALUD. Dieta, nutrición y prevención de enfermedades crónicas. Ginebra, 1990. p.97-132. (Série de Informes Técnicos, 797).
PALOZZA, P. Prooxidant actions of carotenoids in biologic systems. Nutrition Reviews, New York, v.56, n.9, p.257-265, 1998.
PATTERSON, R.E., WHITE, E., KRISTAL, A.R., NEUHOUSER, M.L., POTTER, J.D. Vitamin supplements and cancer risk: the epidemiologic evidence. Cancer: Causes and Control, London, v.8, n.5, p.786-802, 1997.
PAUL, A.A., SOUTHGATE, D.A.T. McCance and Widdowson’s the composition of foods. 4.ed. Amsterdam : Elsevier-North, 1978.
PINHEIRO, A.B.V., LACERDA, E.M.A., BENZECRY, E.H., GOMES, M.C.S., COSTA, V.M. Tabela para avaliação de consumo alimentar em medidas caseiras. 4.ed. São Paulo : Atheneu, 2001.
PITOT, H.C., DRAGAN, Y.P. Chemical carcinogenesis. In: KLAASSEN, C.D. (Ed.). Casarett and Doull’s toxicology: the basic science of poisons. 5.ed. New York : McGraw-Hill, 1996. p.201-267.
PODMORE, I.D., GRIFFITHS, H.R., HERBERT, K.E., MISTRY, N., MISTRY, P., LUNEC, J. Vitamin C exhibits pro-oxidant properties. Nature, London, v.392, n.6676, p.559, 1998.
POOL-ZOBEL, B.L., BUB, A., MÜLLER, H., WOLLOWSKI, I., RECHKEMMER, G. Consumption of vegetables reduces genetic damage in humans: first results of a human intervention trial with carotenoid-rich foods. Carcinogenesis, London, v.18, n.9, p.1847-1850, 1997.
PREZIOSI, P., GALAN, P., HERBETH, B., VALEIX, P., ROUSSEL, A.M., MALVY, D., PAUL-DAUPHIN, A., ARNAUD, J., RICHARD, M.J., BRIANCON, S., FAVIER, A., HERCBERG, S. Effects of supplementation with a combination of antioxidant vitamins and trace elements, at nutritional doses, on biochemical indicators markers of the antioxidant system in adult subjects. Journal of the American College of Nutrition, New York, v.17, n.3, p.244-249, 1998.
RIZZI, M.B.S.L., DAGLI, M.L.Z., JORDÃO JR., A.A., PENTEADO, M.V.C., MORENO, F.S. β-Carotene inhibits persistent and stimulates remodeling γGT-positive preneoplastic lesions during early promotion of hepatocarcinogenesis. International Journal for Vitamin and Nutrition Research, Bern, v.67, n.6, p.415-422, 1997.
ROCK, C.L., JACOB, R.A., BOWEN, P.E. Update on the biological characteristics of the antioxidant micronutrients: vitamin C, vitamin E, and the carotenoids. Journal of the American Dietetic Association, Chicago, v.96, p.693-702, 1996.
SHKLAR, G., SCHWARTZ, J., TRICKLER,D., CHEVERIE,S.R. The effectiveness of a mixture of β-carotene, α-tocopherol, glutathione, and ascorbic acid for cancer prevention. Nutrition and Cancer, Philadelphia, v.20, n.2, p.145-151, 1993.
SILVA, M.R., NAVES, M.M.V. (Org.) Manual de nutrição e dietética. 2.ed. rev. atual. Goiânia : UFG, 1998. cap. 2: Recomendações de energia e nutrientes, p. 21-34.
SPORN, M.B., ROBERTS, A.B. What is a retinoid? Ciba Foundation Symposium, London, v.113, p.1-5, 1985.
STAHL, W., SIES, H. Antioxidant defense: vitamins E and C and carotenoids. Diabetes, New York, v.46, n.5, p.14S-18S,1997. Supplement 2.
TAVANI, A., LA VECCHIA, C. Fruit and vegetable consumption and cancer risk in mediterranean population. American Journal of Clinical Nutrition, Bethesda, v.61, p.1374S-1377S, 1995. Supplement 6.
Van POPPEL, G., Van den BERG, H. Vitamins and cancer. Cancer Letters, Shannon, v.114, p.195-202, 1997.
WEBER, P., BENDICH, A., SCHALCH, W. Vitamin C and human health: a review of recent data relevant to human requirements. International Journal for Vitamin and Nutrition Research, Bern, v.66, n.1, p.19-30, 1996.
WHITNEY, E.N., ROLFES, S.R. Understanding nutrition. 8.ed. Belmont : ITP, 1999. Appendix H: Table of food composition.
WILLETT, W.C. Diet and health: what should we eat? Science, Washington DC, v.264, p.532-537, April 22, 1994. ZEISEL, S.H. Is there a metabolic basis for dietary supplementation? American Journal of Clinical Nutrition, Bethesda, v.72, p.507S-511S, 2000. Supplement 2.
ZIEGLER, R.G., SUBAR, A.F., CRAFT, N.E., URSIN, G., PATTERSON, B.H., GRAUBARD, B.I. Does β-carotene explain why reduced cancer risk is associated ith vegetable and fruit intake? Cancer Research, Philadelphia, v.52, p.2060S-2066S, 1992. Supplement 7.
ZIEGLER, R.G., COLAVITO, E.A., HARTGE, P., MCADAMS, M.J., SCHOENBERG, J.B., MASON, T.J., FRAUMENI JR., J.F. Importance of α-carotene, β-carotene, and other phytochemicals in the etiology of lung cancer. Journal of the National Cancer Institute, Bethesda, v.88, n.9, p.612-615, 1996a.
ZIEGLER, R.G., MAYNE, S.T., SWANSON, C.A. Nutrition and lung cancer. Cancer Causes and Control, London, v.7, n.1, p.157-177, 1996b.
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