Metformin protection against cancer risk in Orientals is uncertain. We examined the possible metformin effect on total, esophageal, gastric, colorectal (CRC), hepatocellular (HCC) and pancreatic cancers in a Taiwanese cohort. A representative sample of 800,000 was drawn from the Taiwanese National Health Insurance data of 2000. A cohort of 480,984 participants 20 years or older, diabetes-cancer-free on 1st January 2000 was formed and categorized as four groups by DM and metformin usage status. Eligible incident cancer events had to occur one year after the index date until the end of 2007. The Cox proportional-hazards model evaluated relative risk of cancer for treated DM patients with or without metformin. The covariates included age, gender, other oral anti-hyperglycemic medication, Charlson comorbidity index (CCI) score and metformin exposure dosage and duration. With diabetes but no anti-hyperglycemic medication, cancer incidence density increased at least 2-fold for total, CRC and HCC. On metformin, total, CRC and HCC incidences decreased to near non-diabetic levels but to varying degrees depending on gender and cancer type (CRC in women, liver in men). Adjustment for other oral anti-hyperglycemic agents usage and CCI made the benefit of metformin more evident [hazard ratios (95% confidence intervals): total 0.12 (0.08-0.19), CRC 0.36 (0.13-0.98), liver 0.06 (0.02-0.16), pancreas 0.15 (0.03-0.79)]. There was a significant gender interaction with metformin in CRC which favored women. Metformin dosage for a significant decrease in cancer incidence was ≤500 mg/day. Metformin can reduce the incidences of several gastroenterological cancers in treated diabetes.

To assess the relative predictive ability for mortality of the Overall Dietary Index-Revised (ODI-R) and the Dietary Diversity Score (DDS) among representative Taiwanese aged 65 and older.

To confirm whether type 2 diabetes (T2DM) is an affective disorder (AD) precursor, and to establish possible effects of oral anti-hyperglycemic agents (OAAs).

Objective: To compare two Nutrition and Health Surveys in Taiwan (NAHSITs) 15–18 years apart to evaluate secular changes in ultra-processed food (UPF) consumption and expenditure among Taiwanese adolescents aged 16–18 years and the influences of such changes on dietary quality. Design: This cross-sectional study was based on two representative surveys (NAHSIT 1993–1996, n = 788; NAHSIT 2011, n = 1,274) of senior high school students. Dietary information and food expenditure were based on 24-h dietary recall. All food items were classified into original foods, processed culinary ingredients, processed foods, and UPFs based on NOVA criteria. Dietary quality was categorized as poor or good based on the mean of the Youth Healthy Eating Index–Taiwan Revised. Results: Compared to 1993–1996, adolescents consumed less energy from original foods (55 vs. 39%) but more from processed foods (12 vs. 18%) and UPFs (21 vs. 25%) in 2011, with no apparent gender differences. Those who consumed more UPFs had the lowest proportions of protein energy intake in both surveys (13.7 and 13.1%). Those who consumed more UPFs had higher levels of saturated fat and lower levels of monounsaturated and polyunsaturated fat, dietary fiber, and micronutrient intakes. The participants who consumed more UPFs and fewer original foods exhibited poorer dietary quality. Boys and girls exhibited equal UPF expenditure in both surveys despite an increase in UPF energy consumption. The adjusted odds ratios (95% confidence interval) were 1.33 (1.16–1.52) and 1.36 (1.10–1.69) for the risk of poor dietary quality with 10% increases in UPF energy intake and expenditure, respectively, in 2011. Conclusions: UPF energy consumption among Taiwanese adolescents increased between 1993–1996 and 2011. Observed trends in expenditure suggest that lower UPF costs influenced food choices during this period. Increasing UPF intake and expenditure was associated with poor dietary quality.