You are here: Home

Search Result (481 REFERENCES)

2017

Fiber intake modulates the association of alcohol intake with breast cancer

Romieu I., Ferrari P., Chajes V., de Batlle J., Biessy C., Scoccianti C., Dossus L., Christine Boutron M., Bastide N., Overvad K., Olsen A., Tjonneland A., Kaaks R., Boeing H., Trichopoulou A., Lagiou P., Trichopoulos D., Palli D., Sieri S., Tumino R., Vineis P., Panico S., Bueno-de-Mesquita H. B., Gils C. H., Peeters P. H., Lund E., Skeie G., Weiderpass E., Ramon Quiros J., Chirlaque M. D., Ardanaz E., Sanchez M. J., Duell E. J., Amiano Etxezarreta P., Borgquist S., Hallmans G., Johansson I., Maria Nilsson L., Khaw K. T., Wareham N., Key T. J., Travis R. C., Murphy N., Wark P. A., Riboli E.

Int J Cancer; 2017; 140(2): 316-321

PMID:27599758

Abstract as provided by PubMed

Alcohol intake has been related to an increased risk of breast cancer (BC) while dietary fiber intake has been inversely associated to BC risk. A beneficial effect of fibers on ethanol carcinogenesis through their impact on estrogen levels is still controversial. We investigated the role of dietary fiber as a modifying factor of the association of alcohol and BC using data from the European Prospective Investigation into Cancer and Nutrition (EPIC). This study included 334,850 women aged 35-70 years at baseline enrolled in the ten countries of the EPIC study and followed up for 11.0 years on average. Information on fiber and alcohol intake at baseline and average lifetime alcohol intake were calculated from country-specific dietary and lifestyle questionnaires. Hazard ratios (HR) of developing invasive BC according to different levels of alcohol and fiber intake were computed. During 3,670,439 person-years, 11,576 incident BC cases were diagnosed. For subjects with low intake of fiber (<18.5 g/day), the risk of BC per 10 g/day of alcohol intake was 1.06 (1.03-1.08) while among subjects with high intake of fiber (>24.2 g/day) the risk of BC was 1.02 (0.99-1.05) (test for interaction p = 0.011). This modulating effect was stronger for fiber from vegetables. Our results suggest that fiber intake may modulate the positive association of alcohol intake and BC. Alcohol is well known to increase the risk for BC, while a fiber-rich diet has the opposite effect. Here the authors find a significant interaction between both lifestyle factors indicating that high fiber intake can ease the adverse effects associated with alcohol consumption. Consequently, women with high alcohol intake and low fiber intake (<18.5 g/day) had the highest risk for BC. Specific benefits were associated with fibers from vegetable, warranting further investigations into specific fiber sources and their mechanistic interactions with alcohol-induced BC risk.

2016

A method for sensitivity analysis to assess the effects of measurement error in multiple exposure variables using external validation data

Agogo G. O., van der Voet H., van 't Veer P., Ferrari P., Muller D. C., Sanchez-Cantalejo E., Bamia C., Braaten T., Knuppel S., Johansson I., van Eeuwijk F. A., Boshuizen H. C.

BMC Med Res Methodol; 2016; 16(1): 139

PMID:27737637

Abstract as provided by PubMed

BACKGROUND: Measurement error in self-reported dietary intakes is known to bias the association between dietary intake and a health outcome of interest such as risk of a disease. The association can be distorted further by mismeasured confounders, leading to invalid results and conclusions. It is, however, difficult to adjust for the bias in the association when there is no internal validation data. METHODS: We proposed a method to adjust for the bias in the diet-disease association (hereafter, association), due to measurement error in dietary intake and a mismeasured confounder, when there is no internal validation data. The method combines prior information on the validity of the self-report instrument with the observed data to adjust for the bias in the association. We compared the proposed method with the method that ignores the confounder effect, and with the method that ignores measurement errors completely. We assessed the sensitivity of the estimates to various magnitudes of measurement error, error correlations and uncertainty in the literature-reported validation data. We applied the methods to fruits and vegetables (FV) intakes, cigarette smoking (confounder) and all-cause mortality data from the European Prospective Investigation into Cancer and Nutrition study. RESULTS: Using the proposed method resulted in about four times increase in the strength of association between FV intake and mortality. For weakly correlated errors, measurement error in the confounder minimally affected the hazard ratio estimate for FV intake. The effect was more pronounced for strong error correlations. CONCLUSIONS: The proposed method permits sensitivity analysis on measurement error structures and accounts for uncertainties in the reported validity coefficients. The method is useful in assessing the direction and quantifying the magnitude of bias in the association due to measurement errors in the confounders.

A treelet transform analysis to relate nutrient patterns to the risk of hormonal receptor-defined breast cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Assi N., Moskal A., Slimani N., Viallon V., Chajes V., Freisling H., Monni S., Knueppel S., Forster J., Weiderpass E., Lujan-Barroso L., Amiano P., Ardanaz E., Molina-Montes E., Salmeron D., Quiros J. R., Olsen A., Tjonneland A., Dahm C. C., Overvad K., Dossus L., Fournier A., Baglietto L., Fortner R. T., Kaaks R., Trichopoulou A., Bamia C., Orfanos P., De Magistris M. S., Masala G., Agnoli C., Ricceri F., Tumino R., Bueno de Mesquita H. B., Bakker M. F., Peeters P. H., Skeie G., Braaten T., Winkvist A., Johansson I., Khaw K. T., Wareham N. J., Key T., Travis R., Schmidt J. A., Merritt M. A., Riboli E., Romieu I., Ferrari P.

Public Health Nutr; 2016; 19(2): 242-54

PMID:25702596

Abstract as provided by PubMed

OBJECTIVE: Pattern analysis has emerged as a tool to depict the role of multiple nutrients/foods in relation to health outcomes. The present study aimed at extracting nutrient patterns with respect to breast cancer (BC) aetiology. DESIGN: Nutrient patterns were derived with treelet transform (TT) and related to BC risk. TT was applied to twenty-three log-transformed nutrient densities from dietary questionnaires. Hazard ratios (HR) and 95 % confidence intervals computed using Cox proportional hazards models quantified the association between quintiles of nutrient pattern scores and risk of overall BC, and by hormonal receptor and menopausal status. Principal component analysis was applied for comparison. SETTING: The European Prospective Investigation into Cancer and Nutrition (EPIC). SUBJECTS: Women (n 334 850) from the EPIC study. RESULTS: The first TT component (TC1) highlighted a pattern rich in nutrients found in animal foods loading on cholesterol, protein, retinol, vitamins B12 and D, while the second TT component (TC2) reflected a diet rich in beta-carotene, riboflavin, thiamin, vitamins C and B6, fibre, Fe, Ca, K, Mg, P and folate. While TC1 was not associated with BC risk, TC2 was inversely associated with BC risk overall (HRQ5 v. Q1=0.89, 95 % CI 0.83, 0.95, P trend<0.01) and showed a significantly lower risk in oestrogen receptor-positive (HRQ5 v. Q1=0.89, 95 % CI 0.81, 0.98, P trend=0.02) and progesterone receptor-positive tumours (HRQ5 v. Q1=0.87, 95 % CI 0.77, 0.98, P trend<0.01). CONCLUSIONS: TT produces readily interpretable sparse components explaining similar amounts of variation as principal component analysis. Our results suggest that participants with a nutrient pattern high in micronutrients found in vegetables, fruits and cereals had a lower risk of BC.

Plasma carotenoids, vitamin C, tocopherols, and retinol and the risk of breast cancer in the European Prospective Investigation into Cancer and Nutrition cohort

Bakker M. F., Peeters P. H., Klaasen V. M., Bueno-de-Mesquita H. B., Jansen E. H., Ros M. M., Travier N., Olsen A., Tjonneland A., Overvad K., Rinaldi S., Romieu I., Brennan P., Boutron-Ruault M. C., Perquier F., Cadeau C., Boeing H., Aleksandrova K., Kaaks R., Kuhn T., Trichopoulou A., Lagiou P., Trichopoulos D., Vineis P., Krogh V., Panico S., Masala G., Tumino R., Weiderpass E., Skeie G., Lund E., Quiros J. R., Ardanaz E., Navarro C., Amiano P., Sanchez M. J., Buckland G., Ericson U., Sonestedt E., Johansson M., Sund M., Travis R. C., Key T. J., Khaw K. T., Wareham N., Riboli E., van Gils C. H.

Am J Clin Nutr; 2016; 103(2): 454-64

PMID:26791185

Abstract as provided by PubMed

BACKGROUND: Carotenoids and vitamin C are thought to be associated with reduced cancer risk because of their antioxidative capacity. OBJECTIVE: This study evaluated the associations of plasma carotenoid, retinol, tocopherol, and vitamin C concentrations and risk of breast cancer. DESIGN: In a nested case-control study within the European Prospective Investigation into Cancer and Nutrition cohort, 1502 female incident breast cancer cases were included, with an oversampling of premenopausal (n = 582) and estrogen receptor-negative (ER-) cases (n = 462). Controls (n = 1502) were individually matched to cases by using incidence density sampling. Prediagnostic samples were analyzed for alpha-carotene, beta-carotene, lycopene, lutein, zeaxanthin, beta-cryptoxanthin, retinol, alpha-tocopherol, gamma-tocopherol, and vitamin C. Breast cancer risk was computed according to hormone receptor status and age at diagnosis (proxy for menopausal status) by using conditional logistic regression and was further stratified by smoking status, alcohol consumption, and body mass index (BMI). All statistical tests were 2-sided. RESULTS: In quintile 5 compared with quintile 1, alpha-carotene (OR: 0.61; 95% CI: 0.39, 0.98) and beta-carotene (OR: 0.41; 95% CI: 0.26, 0.65) were inversely associated with risk of ER- breast tumors. The other analytes were not statistically associated with ER- breast cancer. For estrogen receptor-positive (ER+) tumors, no statistically significant associations were found. The test for heterogeneity between ER- and ER+ tumors was statistically significant only for beta-carotene (P-heterogeneity = 0.03). A higher risk of breast cancer was found for retinol in relation to ER-/progesterone receptor-negative tumors (OR: 2.37; 95% CI: 1.20, 4.67; P-heterogeneity with ER+/progesterone receptor positive = 0.06). We observed no statistically significant interaction between smoking, alcohol, or BMI and all investigated plasma analytes (based on tertile distribution). CONCLUSION: Our results indicate that higher concentrations of plasma beta-carotene and alpha-carotene are associated with lower breast cancer risk of ER- tumors.

The association of substituting carbohydrates with total fat and different types of fatty acids with mortality and weight change among diabetes patients

Campmans-Kuijpers M. J., Sluijs I., Nothlings U., Freisling H., Overvad K., Boeing H., Masala G., Panico S., Tumino R., Sieri S., Johansson I., Winkvist A., Katzke V. A., Kuehn T., Nilsson P. M., Halkjaer J., Tjonneland A., Spijkerman A. M., Arriola L., Sacerdote C., Barricarte A., May A. M., Beulens J. W.

Clin Nutr; 2016; 35(5): 1096-102

PMID:26342536

Abstract as provided by PubMed

BACKGROUND: Substitution of carbohydrates with fat in a diet for type 2 diabetes patients is still debated. OBJECTIVE: This study aimed to investigate the association between dietary carbohydrate intake and isocaloric substitution with (i) total fat, (ii) saturated fatty acids (SFA), (iii) mono-unsaturated fatty acids (MUFA) and (iv) poly-unsaturated fatty acids (PUFA) with all-cause and cardiovascular (CVD) mortality risk and 5-year weight change in patients with type 2 diabetes. METHODS: The study included 6192 patients with type 2 diabetes from 15 cohorts of the European Prospective Investigation into Cancer and Nutrition (EPIC). Dietary intake was assessed at recruitment with country-specific food-frequency questionnaires. Cox and linear regression were used to estimate the associations with (CVD) mortality and weight change, adjusting for confounders and using different methods to adjust for energy intake. RESULTS: After a mean follow-up of 9.2 y +/- SD 2.3 y, 791 (13%) participants had died, of which 268 (4%) due to CVD. Substituting 10 g or 5 energy% of carbohydrates by total fat was associated with a higher all-cause mortality risk (HR 1.07 [1.02-1.13]), or SFAs (HR 1.25 [1.11-1.40]) and a lower risk when replaced by MUFAs (HR 0.89 [0.77-1.02]). When carbohydrates were substituted with SFAs (HR 1.22 [1.00-1.49]) or PUFAs (HR 1.29 [1.02-1.63]) CVD mortality risk increased. The 5-year weight was lower when carbohydrates were substituted with total fat or MUFAs. These results were consistent over different energy adjustment methods. CONCLUSIONS: In diabetes patients, substitution of carbohydrates with SFAs was associated with a higher (CVD) mortality risk and substitution by total fat was associated with a higher all-cause mortality risk. Substitution of carbohydrates with MUFAs may be associated with lower mortality risk and weight reduction. Instead of promoting replacement of carbohydrates by total fat, dietary guideline should continue focusing on replacement by fat-subtypes; especially SFAs by MUFAs.

Circulating Osteopontin and Prediction of Hepatocellular Carcinoma Development in a Large European Population

Duarte-Salles T., Misra S., Stepien M., Plymoth A., Muller D., Overvad K., Olsen A., Tjonneland A., Baglietto L., Severi G., Boutron-Ruault M. C., Turzanski-Fortner R., Kaaks R., Boeing H., Aleksandrova K., Trichopoulou A., Lagiou P., Bamia C., Pala V., Palli D., Mattiello A., Tumino R., Naccarati A., Bueno-de-Mesquita H. B., Peeters P. H., Weiderpass E., Quiros J. R., Agudo A., Sanchez-Cantalejo E., Ardanaz E., Gavrila D., Dorronsoro M., Werner M., Hemmingsson O., Ohlsson B., Sjoberg K., Wareham N. J., Khaw K. T., Bradbury K. E., Gunter M. J., Cross A. J., Riboli E., Jenab M., Hainaut P., Beretta L.

Cancer Prev Res (Phila); 2016; 9(9): 758-65

PMID:27339170

Abstract as provided by PubMed

We previously identified osteopontin (OPN) as a promising marker for the early detection of hepatocellular carcinoma (HCC). In this study, we investigated the association between prediagnostic circulating OPN levels and HCC incidence in a large population-based cohort. A nested case-control study was conducted within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. During a mean follow-up of 4.8 years, 100 HCC cases were identified. Each case was matched to two controls and OPN levels were measured in baseline plasma samples. Viral hepatitis, liver function, and alpha-fetoprotein (AFP) tests were also conducted. Conditional logistic regression models were used to calculate multivariable odds ratio (OR) and 95% confidence intervals (95% CI) for OPN levels in relation to HCC. Receiver operating characteristics curves were constructed to determine the discriminatory accuracy of OPN alone or in combination with other liver biomarkers in the prediction of HCC. OPN levels were positively associated with HCC risk (per 10% increment, ORmultivariable = 1.30; 95% CI, 1.14-1.48). The association was stronger among cases diagnosed within 2 years of follow-up. Adding liver function tests to OPN improved the discriminatory performance for subjects who developed HCC (AUC = 0.86). For cases diagnosed within 2 years, the combination of OPN and AFP was best able to predict HCC risk (AUC = 0.88). The best predictive model for HCC in this low-risk population is OPN in combination with liver function tests. Within 2 years of diagnosis, the combination of OPN and AFP best predicted HCC development, suggesting that measuring OPN and AFP could identify high-risk groups independently of a liver disease diagnosis. Cancer Prev Res; 9(9); 758-65. (c)2016 AACR.

Vegetable and fruit consumption and the risk of hormone receptor-defined breast cancer in the EPIC cohort

Emaus M. J., Peeters P. H., Bakker M. F., Overvad K., Tjonneland A., Olsen A., Romieu I., Ferrari P., Dossus L., Boutron-Ruault M. C., Baglietto L., Fortner R. T., Kaaks R., Boeing H., Trichopoulou A., Lagiou P., Trichopoulos D., Masala G., Pala V., Panico S., Tumino R., Polidoro S., Skeie G., Lund E., Weiderpass E., Quiros J. R., Travier N., Sanchez M. J., Chirlaque M. D., Ardanaz E., Dorronsoro M., Winkvist A., Wennberg M., Bueno-de-Mesquita H. B., Khaw K. T., Travis R. C., Key T. J., Aune D., Gunter M., Riboli E., van Gils C. H.

Am J Clin Nutr; 2016; 103(1): 168-77

PMID:26607934

Abstract as provided by PubMed

BACKGROUND: The recent literature indicates that a high vegetable intake and not a high fruit intake could be associated with decreased steroid hormone receptor-negative breast cancer risk. OBJECTIVE: This study aimed to investigate the association between vegetable and fruit intake and steroid hormone receptor-defined breast cancer risk. DESIGN: A total of 335,054 female participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort were included in this study (mean +/- SD age: 50.8 +/- 9.8 y). Vegetable and fruit intake was measured by country-specific questionnaires filled out at recruitment between 1992 and 2000 with the use of standardized procedures. Cox proportional hazards models were stratified by age at recruitment and study center and were adjusted for breast cancer risk factors. RESULTS: After a median follow-up of 11.5 y (IQR: 10.1-12.3 y), 10,197 incident invasive breast cancers were diagnosed [3479 estrogen and progesterone receptor positive (ER+PR+); 1021 ER and PR negative (ER-PR-)]. Compared with the lowest quintile, the highest quintile of vegetable intake was associated with a lower risk of overall breast cancer (HRquintile 5-quintile 1: 0.87; 95% CI: 0.80, 0.94). Although the inverse association was most apparent for ER-PR- breast cancer (ER-PR-: HRquintile 5-quintile 1: 0.74; 95% CI: 0.57, 0.96; P-trend = 0.03; ER+PR+: HRquintile 5-quintile 1: 0.91; 95% CI: 0.79, 1.05; P-trend = 0.14), the test for heterogeneity by hormone receptor status was not significant (P-heterogeneity = 0.09). Fruit intake was not significantly associated with total and hormone receptor-defined breast cancer risk. CONCLUSION: This study supports evidence that a high vegetable intake is associated with lower (mainly hormone receptor-negative) breast cancer risk.

Circulating vitamin D in relation to cancer incidence and survival of the head and neck and oesophagus in the EPIC cohort

Fanidi A., Muller D. C., Midttun O., Ueland P. M., Vollset S. E., Relton C., Vineis P., Weiderpass E., Skeie G., Brustad M., Palli D., Tumino R., Grioni S., Sacerdote C., Bueno-de-Mesquita H. B., Peeters P. H., Boutron-Ruault M. C., Kvaskoff M., Cadeau C., Huerta J. M., Sanchez M. J., Agudo A., Lasheras C., Quiros J. R., Chamosa S., Riboli E., Travis R. C., Ward H., Murphy N., Khaw K. T., Trichopoulou A., Lagiou P., Papatesta E. M., Boeing H., Kuehn T., Katzke V., Steffen A., Johansson A., Brennan P., Johansson M.

Sci Rep; 2016; 36017

PMID:27812016

Abstract as provided by PubMed

Experimental and epidemiological data suggest that vitamin D play a role in pathogenesis and progression of cancer, but prospective data on head and neck cancer (HNC) and oesophagus cancer are limited. The European Prospective Investigation into Cancer and Nutrition (EPIC) study recruited 385,747 participants with blood samples between 1992 and 2000. This analysis includes 497 case-control pairs of the head and neck and oesophagus, as well as 443 additional controls. Circulating 25(OH)D3 were measured in pre-diagnostic samples and evaluated in relation to HNC and oesophagus cancer risk and post-diagnosis all-cause mortality. After controlling for risk factors, a doubling of 25(OH)D3 was associated with 30% lower odds of HNC (OR 0.70, 95% confidence interval [95% CI] 0.56-0.88, Ptrend = 0.001). Subsequent analyses by anatomical sub-site indicated clear inverse associations with risk of larynx and hypopharynx cancer combined (OR 0.55, 95CI% 0.39-0.78) and oral cavity cancer (OR 0.60, 95CI% 0.42-0.87). Low 25(OH)D3 concentrations were also associated with higher risk of death from any cause among HNC cases. No clear association was seen with risk or survival for oesophageal cancer. Study participants with elevated circulating concentrations of 25(OH)D3 had decreased risk of HNC, as well as improved survival following diagnosis.

Association of Plasma Phospholipid n-3 and n-6 Polyunsaturated Fatty Acids with Type 2 Diabetes: The EPIC-InterAct Case-Cohort Study

Forouhi N. G., Imamura F., Sharp S. J., Koulman A., Schulze M. B., Zheng J., Ye Z., Sluijs I., Guevara M., Huerta J. M., Kroger J., Wang L. Y., Summerhill K., Griffin J. L., Feskens E. J., Affret A., Amiano P., Boeing H., Dow C., Fagherazzi G., Franks P. W., Gonzalez C., Kaaks R., Key T. J., Khaw K. T., Kuhn T., Mortensen L. M., Nilsson P. M., Overvad K., Pala V., Palli D., Panico S., Quiros J. R., Rodriguez-Barranco M., Rolandsson O., Sacerdote C., Scalbert A., Slimani N., Spijkerman A. M., Tjonneland A., Tormo M. J., Tumino R., van der A. Dl, van der Schouw Y. T., Langenberg C., Riboli E., Wareham N. J.

PLoS Med; 2016; 13(7): e1002094

PMID:27434045

Abstract as provided by PubMed

BACKGROUND: Whether and how n-3 and n-6 polyunsaturated fatty acids (PUFAs) are related to type 2 diabetes (T2D) is debated. Objectively measured plasma PUFAs can help to clarify these associations. METHODS AND FINDINGS: Plasma phospholipid PUFAs were measured by gas chromatography among 12,132 incident T2D cases and 15,919 subcohort participants in the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct study across eight European countries. Country-specific hazard ratios (HRs) were estimated using Prentice-weighted Cox regression and pooled by random-effects meta-analysis. We also systematically reviewed published prospective studies on circulating PUFAs and T2D risk and pooled the quantitative evidence for comparison with results from EPIC-InterAct. In EPIC-InterAct, among long-chain n-3 PUFAs, alpha-linolenic acid (ALA) was inversely associated with T2D (HR per standard deviation [SD] 0.93; 95% CI 0.88-0.98), but eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) were not significantly associated. Among n-6 PUFAs, linoleic acid (LA) (0.80; 95% CI 0.77-0.83) and eicosadienoic acid (EDA) (0.89; 95% CI 0.85-0.94) were inversely related, and arachidonic acid (AA) was not significantly associated, while significant positive associations were observed with gamma-linolenic acid (GLA), dihomo-GLA, docosatetraenoic acid (DTA), and docosapentaenoic acid (n6-DPA), with HRs between 1.13 to 1.46 per SD. These findings from EPIC-InterAct were broadly similar to comparative findings from summary estimates from up to nine studies including between 71 to 2,499 T2D cases. Limitations included potential residual confounding and the inability to distinguish between dietary and metabolic influences on plasma phospholipid PUFAs. CONCLUSIONS: These large-scale findings suggest an important inverse association of circulating plant-origin n-3 PUFA (ALA) but no convincing association of marine-derived n3 PUFAs (EPA and DHA) with T2D. Moreover, they highlight that the most abundant n6-PUFA (LA) is inversely associated with T2D. The detection of associations with previously less well-investigated PUFAs points to the importance of considering individual fatty acids rather than focusing on fatty acid class.

Physical activity and risk of Amyotrophic Lateral Sclerosis in a prospective cohort study

Gallo V., Vanacore N., Bueno-de-Mesquita H. B., Vermeulen R., Brayne C., Pearce N., Wark P. A., Ward H. A., Ferrari P., Jenab M., Andersen P. M., Wennberg P., Wareham N., Katzke V., Kaaks R., Weiderpass E., Peeters P. H., Mattiello A., Pala V., Barricante A., Chirlaque M. D., Travier N., Travis R. C., Sanchez M. J., Pessah-Rasmussen H., Petersson J., Tjonneland A., Tumino R., Quiros J. R., Trichopoulou A., Kyrozis A., Oikonomidou D., Masala G., Sacerdote C., Arriola L., Boeing H., Vigl M., Claver-Chapelon F., Middleton L., Riboli E., Vineis P.

Eur J Epidemiol; 2016; 31(3): 255-66

PMID:26968841

Abstract as provided by PubMed

Previous case-control studies have suggested a possible increased risk of Amyotrophic Lateral Sclerosis (ALS) with physical activity (PA), but this association has never been studied in prospective cohort studies. We therefore assessed the association between PA and risk of death from ALS in the European Prospective Investigation into Cancer and Nutrition. A total of 472,100 individuals were included in the analysis, yielding 219 ALS deaths. At recruitment, information on PA was collected thorough standardised questionnaires. Total PA was expressed by the Cambridge Physical Activity Index (CPAI) and analysed in relation to ALS mortality, using Cox hazard models. Interactions with age, sex, and anthropometric measures were assessed. Total PA was weakly inversely associated with ALS mortality with a borderline statistically significant trend across categories (p = 0.042), with those physically active being 33% less likely to die from ALS compared to those inactive: HR = 0.67 (95% CI 0.42-1.06). Anthropometric measures, sex, and age did not modify the association with CPAI. The present study shows a slightly decreased-not increased like in case-control studies-risk of dying from ALS in those with high levels of total PA at enrolment. This association does not appear confounded by age, gender, anthropometry, smoking, and education. Ours was the first prospective cohort study on ALS and physical activity.

Prediagnostic selenium status and hepatobiliary cancer risk in the European Prospective Investigation into Cancer and Nutrition cohort

Hughes D. J., Duarte-Salles T., Hybsier S., Trichopoulou A., Stepien M., Aleksandrova K., Overvad K., Tjonneland A., Olsen A., Affret A., Fagherazzi G., Boutron-Ruault M. C., Katzke V., Kaaks R., Boeing H., Bamia C., Lagiou P., Peppa E., Palli D., Krogh V., Panico S., Tumino R., Sacerdote C., Bueno-de-Mesquita H. B., Peeters P. H., Engeset D., Weiderpass E., Lasheras C., Agudo A., Sanchez M. J., Navarro C., Ardanaz E., Dorronsoro M., Hemmingsson O., Wareham N. J., Khaw K. T., Bradbury K. E., Cross A. J., Gunter M., Riboli E., Romieu I., Schomburg L., Jenab M.

Am J Clin Nutr; 2016; 104(2): 406-14

PMID:27357089

Abstract as provided by PubMed

BACKGROUND: Selenium status is suboptimal in many Europeans and may be a risk factor for the development of various cancers, including those of the liver and biliary tract. OBJECTIVE: We wished to examine whether selenium status in advance of cancer onset is associated with hepatobiliary cancers in the EPIC (European Prospective Investigation into Cancer and Nutrition) study. DESIGN: We assessed prediagnostic selenium status by measuring serum concentrations of selenium and selenoprotein P (SePP; the major circulating selenium transfer protein) and examined the association with hepatocellular carcinoma (HCC; n = 121), gallbladder and biliary tract cancers (GBTCs; n = 100), and intrahepatic bile duct cancer (IHBC; n = 40) risk in a nested case-control design within the EPIC study. Selenium was measured by total reflection X-ray fluorescence, and SePP was determined by a colorimetric sandwich ELISA. Multivariable ORs and 95% CIs were calculated by using conditional logistic regression. RESULTS: HCC and GBTC cases, but not IHBC cases, showed significantly lower circulating selenium and SePP concentrations than their matched controls. Higher circulating selenium was associated with a significantly lower HCC risk (OR per 20-mug/L increase: 0.41; 95% CI: 0.23, 0.72) but not with the risk of GBTC or IHBC. Similarly, higher SePP concentrations were associated with lowered HCC risk only in both the categorical and continuous analyses (HCC: P-trend </= 0.0001; OR per 1.5-mg/L increase: 0.37; 95% CI: 0.21, 0.63). CONCLUSION: These findings from a large prospective cohort provide evidence that suboptimal selenium status in Europeans may be associated with an appreciably increased risk of HCC development.

Meal patterns across ten European countries - results from the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study

Huseinovic E., Winkvist A., Slimani N., Park M. K., Freisling H., Boeing H., Buckland G., Schwingshackl L., Weiderpass E., Rostgaard-Hansen A. L., Tjonneland A., Affret A., Boutron-Ruault M. C., Fagherazzi G., Katzke V., Kuhn T., Naska A., Orfanos P., Trichopoulou A., Pala V., Palli D., Ricceri F., Santucci de Magistris M., Tumino R., Engeset D., Enget T., Skeie G., Barricarte A., Bonet C. B., Chirlaque M. D., Amiano P., Quiros J. R., Sanchez M. J., Dias J. A., Drake I., Wennberg M., Boer J., Ocke M. C., Verschuren W., Lassale C., Perez-Cornago A., Riboli E., Ward H., Forslund H. B.

Public Health Nutr; 2016; 19(15): 2769-80

PMID:27194183

Abstract as provided by PubMed

OBJECTIVE: To characterize meal patterns across ten European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study. DESIGN: Cross-sectional study utilizing dietary data collected through a standardized 24 h diet recall during 1995-2000. Eleven predefined intake occasions across a 24 h period were assessed during the interview. In the present descriptive report, meal patterns were analysed in terms of daily number of intake occasions, the proportion reporting each intake occasion and the energy contributions from each intake occasion. SETTING: Twenty-seven centres across ten European countries. SUBJECTS: Women (64 %) and men (36 %) aged 35-74 years (n 36 020). RESULTS: Pronounced differences in meal patterns emerged both across centres within the same country and across different countries, with a trend for fewer intake occasions per day in Mediterranean countries compared with central and northern Europe. Differences were also found for daily energy intake provided by lunch, with 38-43 % for women and 41-45 % for men within Mediterranean countries compared with 16-27 % for women and 20-26 % for men in central and northern European countries. Likewise, a south-north gradient was found for daily energy intake from snacks, with 13-20 % (women) and 10-17 % (men) in Mediterranean countries compared with 24-34 % (women) and 23-35 % (men) in central/northern Europe. CONCLUSIONS: We found distinct differences in meal patterns with marked diversity for intake frequency and lunch and snack consumption between Mediterranean and central/northern European countries. Monitoring of meal patterns across various cultures and populations could provide critical context to the research efforts to characterize relationships between dietary intake and health.

An epidemiological model for prediction of endometrial cancer risk in Europe

Husing A., Dossus L., Ferrari P., Tjonneland A., Hansen L., Fagherazzi G., Baglietto L., Schock H., Chang-Claude J., Boeing H., Steffen A., Trichopoulou A., Bamia C., Katsoulis M., Krogh V., Palli D., Panico S., Onland-Moret N. C., Peeters P. H., Bueno-de-Mesquita H. B., Weiderpass E., Gram I. T., Ardanaz E., Obon-Santacana M., Navarro C., Sanchez-Cantalejo E., Etxezarreta N., Allen N. E., Khaw K. T., Wareham N., Rinaldi S., Romieu I., Merritt M. A., Gunter M., Riboli E., Kaaks R.

Eur J Epidemiol; 2016; 31(1): 51-60

PMID:25968175

Abstract as provided by PubMed

Endometrial cancer (EC) is the fourth most frequent cancer in women in Europe, and as its incidence is increasing, prevention strategies gain further pertinence. Risk prediction models can be a useful tool for identifying women likely to benefit from targeted prevention measures. On the basis of data from 201,811 women (mostly aged 30-65 years) including 855 incident EC cases from eight countries in the European Prospective Investigation into Cancer and Nutrition cohort, a model to predict EC was developed. A step-wise model selection process was used to select confirmed predictive epidemiologic risk factors. Piece-wise constant hazard rates in 5-year age-intervals were estimated in a cause-specific competing risks model, five-fold-cross-validation was applied for internal validation. Risk factors included in the risk prediction model were body-mass index (BMI), menopausal status, age at menarche and at menopause, oral contraceptive use, overall and by different BMI categories and overall duration of use, parity, age at first full-term pregnancy, duration of menopausal hormone therapy and smoking status (specific for pre, peri- and post-menopausal women). These variables improved the discriminating capacity to predict risk over 5 years from 71% for a model based on age alone to 77% (overall C statistic), and the model was well-calibrated (ratio of expected to observed cases = 0.99). Our model could be used for the identification of women at increased risk of EC in Western Europe. To achieve an EC-risk model with general validity, a large-scale cohort-consortium approach would be needed to assess and adjust for population variation.

Serum Endotoxins and Flagellin and Risk of Colorectal Cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) Cohort

Kong S. Y., Tran H. Q., Gewirtz A. T., McKeown-Eyssen G., Fedirko V., Romieu I., Tjonneland A., Olsen A., Overvad K., Boutron-Ruault M. C., Bastide N., Affret A., Kuhn T., Kaaks R., Boeing H., Aleksandrova K., Trichopoulou A., Kritikou M., Vasilopoulou E., Palli D., Krogh V., Mattiello A., Tumino R., Naccarati A., Bueno-de-Mesquita H. B., Peeters P. H., Weiderpass E., Quiros J. R., Sala N., Sanchez M. J., Castano J. M., Barricarte A., Dorronsoro M., Werner M., Wareham N. J., Khaw K. T., Bradbury K. E., Freisling H., Stavropoulou F., Ferrari P., Gunter M. J., Cross A. J., Riboli E., Bruce W. R., Jenab M.

Cancer Epidemiol Biomarkers Prev; 2016; 25(2): 291-301

PMID:26823475

Abstract as provided by PubMed

BACKGROUND: Chronic inflammation and oxidative stress are thought to be involved in colorectal cancer development. These processes may contribute to leakage of bacterial products, such as lipopolysaccharide (LPS) and flagellin, across the gut barrier. The objective of this study, nested within a prospective cohort, was to examine associations between circulating LPS and flagellin serum antibody levels and colorectal cancer risk. METHODS: A total of 1,065 incident colorectal cancer cases (colon, n = 667; rectal, n = 398) were matched (1:1) to control subjects. Serum flagellin- and LPS-specific IgA and IgG levels were quantitated by ELISA. Multivariable conditional logistic regression models were used to calculate ORs and 95% confidence intervals (CI), adjusting for multiple relevant confouding factors. RESULTS: Overall, elevated anti-LPS and anti-flagellin biomarker levels were not associated with colorectal cancer risk. After testing potential interactions by various factors relevant for colorectal cancer risk and anti-LPS and anti-flagellin, sex was identified as a statistically significant interaction factor (Pinteraction < 0.05 for all the biomarkers). Analyses stratified by sex showed a statistically significant positive colorectal cancer risk association for men (fully-adjusted OR for highest vs. lowest quartile for total anti-LPS + flagellin, 1.66; 95% CI, 1.10-2.51; Ptrend, 0.049), whereas a borderline statistically significant inverse association was observed for women (fully-adjusted OR, 0.70; 95% CI, 0.47-1.02; Ptrend, 0.18). CONCLUSION: In this prospective study on European populations, we found bacterial exposure levels to be positively associated to colorectal cancer risk among men, whereas in women, a possible inverse association may exist. IMPACT: Further studies are warranted to better clarify these preliminary observations.

Diet Quality Scores and Prediction of All-Cause, Cardiovascular and Cancer Mortality in a Pan-European Cohort Study

Lassale C., Gunter M. J., Romaguera D., Peelen L. M., Van der Schouw Y. T., Beulens J. W., Freisling H., Muller D. C., Ferrari P., Huybrechts I., Fagherazzi G., Boutron-Ruault M. C., Affret A., Overvad K., Dahm C. C., Olsen A., Roswall N., Tsilidis K. K., Katzke V. A., Kuhn T., Buijsse B., Quiros J. R., Sanchez-Cantalejo E., Etxezarreta N., Huerta J. M., Barricarte A., Bonet C., Khaw K. T., Key T. J., Trichopoulou A., Bamia C., Lagiou P., Palli D., Agnoli C., Tumino R., Fasanelli F., Panico S., Bueno-de-Mesquita H. B., Boer J. M., Sonestedt E., Nilsson L. M., Renstrom F., Weiderpass E., Skeie G., Lund E., Moons K. G., Riboli E., Tzoulaki I.

PLoS ONE; 2016; 11(7): e0159025

PMID:27409582

Abstract as provided by PubMed

Scores of overall diet quality have received increasing attention in relation to disease aetiology; however, their value in risk prediction has been little examined. The objective was to assess and compare the association and predictive performance of 10 diet quality scores on 10-year risk of all-cause, CVD and cancer mortality in 451,256 healthy participants to the European Prospective Investigation into Cancer and Nutrition, followed-up for a median of 12.8y. All dietary scores studied showed significant inverse associations with all outcomes. The range of HRs (95% CI) in the top vs. lowest quartile of dietary scores in a composite model including non-invasive factors (age, sex, smoking, body mass index, education, physical activity and study centre) was 0.75 (0.72-0.79) to 0.88 (0.84-0.92) for all-cause, 0.76 (0.69-0.83) to 0.84 (0.76-0.92) for CVD and 0.78 (0.73-0.83) to 0.91 (0.85-0.97) for cancer mortality. Models with dietary scores alone showed low discrimination, but composite models also including age, sex and other non-invasive factors showed good discrimination and calibration, which varied little between different diet scores examined. Mean C-statistic of full models was 0.73, 0.80 and 0.71 for all-cause, CVD and cancer mortality. Dietary scores have poor predictive performance for 10-year mortality risk when used in isolation but display good predictive ability in combination with other non-invasive common risk factors.

Comparison of abdominal adiposity and overall obesity in relation to risk of small intestinal cancer in a European Prospective Cohort

Lu Y., Cross A. J., Murphy N., Freisling H., Travis R. C., Ferrari P., Katzke V. A., Kaaks R., Olsson A., Johansson I., Renstrom F., Panico S., Pala V., Palli D., Tumino R., Peeters P. H., Siersema P. D., Bueno-de-Mesquita H. B., Trichopoulou A., Klinaki E., Tsironis C., Agudo A., Navarro C., Sanchez M. J., Barricarte A., Boutron-Ruault M. C., Fagherazzi G., Racine A., Weiderpass E., Gunter M. J., Riboli E.

Cancer Causes Control; 2016; 27(7): 919-27

PMID:27294726

Abstract as provided by PubMed

BACKGROUND: The etiology of small intestinal cancer (SIC) is largely unknown, and there are very few epidemiological studies published to date. No studies have investigated abdominal adiposity in relation to SIC. METHODS: We investigated overall obesity and abdominal adiposity in relation to SIC in the European Prospective Investigation into Cancer and Nutrition (EPIC), a large prospective cohort of approximately half a million men and women from ten European countries. Overall obesity and abdominal obesity were assessed by body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). Multivariate Cox proportional hazards regression modeling was performed to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs). Stratified analyses were conducted by sex, BMI, and smoking status. RESULTS: During an average of 13.9 years of follow-up, 131 incident cases of SIC (including 41 adenocarcinomas, 44 malignant carcinoid tumors, 15 sarcomas and 10 lymphomas, and 21 unknown histology) were identified. WC was positively associated with SIC in a crude model that also included BMI (HR per 5-cm increase = 1.20, 95 % CI 1.04, 1.39), but this association attenuated in the multivariable model (HR 1.18, 95 % CI 0.98, 1.42). However, the association between WC and SIC was strengthened when the analysis was restricted to adenocarcinoma of the small intestine (multivariable HR adjusted for BMI = 1.56, 95 % CI 1.11, 2.17). There were no other significant associations. CONCLUSION: WC, rather than BMI, may be positively associated with adenocarcinomas but not carcinoid tumors of the small intestine. IMPACT: Abdominal obesity is a potential risk factor for adenocarcinoma in the small intestine.

Healthy Lifestyle and Risk of Cancer in the European Prospective Investigation Into Cancer and Nutrition Cohort Study

McKenzie F., Biessy C., Ferrari P., Freisling H., Rinaldi S., Chajes V., Dahm C. C., Overvad K., Dossus L., Lagiou P., Trichopoulos D., Trichopoulou A., Bueno-de-Mesquita H. B., May A., Peeters P. H., Weiderpass E., Sanchez M. J., Navarro C., Ardanaz E., Ericson U., Wirfalt E., Travis R. C., Romieu I.

Medicine (Baltimore); 2016; 95(16): e2850

PMID:27100409

Abstract as provided by PubMed

It has been estimated that at least a third of the most common cancers are related to lifestyle and as such are preventable. Key modifiable lifestyle factors have been individually associated with cancer risk; however, less is known about the combined effects of these factors. This study generated a healthy lifestyle index score (HLIS) to investigate the joint effect of modifiable factors on the risk of overall cancers, alcohol-related cancers, tobacco-related cancers, obesity-related cancers, and reproductive-related cancers. The study included 391,608 men and women from the multinational European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The HLIS was constructed from 5 factors assessed at baseline (diet, physical activity, smoking, alcohol consumption, and anthropometry) by assigning scores of 0 to 4 to categories of each factor, for which higher values indicate healthier behaviors. Hazard ratios (HR) were estimated by Cox proportional regression and population attributable fractions (PAFs) estimated from the adjusted models. There was a 5% lower risk (adjusted HR 0.952, 95% confidence interval (CI): 0.946, 0.958) of all cancers per point score of the index for men and 4% (adjusted HR 0.961, 95% CI: 0.956, 0.966) for women. The fourth versus the second category of the HLIS was associated with a 28% and 24% lower risk for men and women respectively across all cancers, 41% and 33% for alcohol-related, 49% and 46% for tobacco-related, 41% and 26% for obesity-related, and 21% for female reproductive cancers. Findings suggest simple behavior modifications could have a sizeable impact on cancer prevention, especially for men.

Nutrient-wide association study of 57 foods/nutrients and epithelial ovarian cancer in the European Prospective Investigation into Cancer and Nutrition study and the Netherlands Cohort Study

Merritt M. A., Tzoulaki I., van den Brandt P. A., Schouten L. J., Tsilidis K. K., Weiderpass E., Patel C. J., Tjonneland A., Hansen L., Overvad K., His M., Dartois L., Boutron-Ruault M. C., Fortner R. T., Kaaks R., Aleksandrova K., Boeing H., Trichopoulou A., Lagiou P., Bamia C., Palli D., Krogh V., Tumino R., Ricceri F., Mattiello A., Bueno-de-Mesquita H. B., Onland-Moret N. C., Peeters P. H., Skeie G., Jareid M., Quiros J. R., Obon-Santacana M., Sanchez M. J., Chamosa S., Huerta J. M., Barricarte A., Dias J. A., Sonestedt E., Idahl A., Lundin E., Wareham N. J., Khaw K. T., Travis R. C., Ferrari P., Riboli E., Gunter M. J.

Am J Clin Nutr; 2016; 103(1): 161-7

PMID:26607939

Abstract as provided by PubMed

BACKGROUND: Studies of the role of dietary factors in epithelial ovarian cancer (EOC) development have been limited, and no specific dietary factors have been consistently associated with EOC risk. OBJECTIVE: We used a nutrient-wide association study approach to systematically test the association between dietary factors and invasive EOC risk while accounting for multiple hypothesis testing by using the false discovery rate and evaluated the findings in an independent cohort. DESIGN: We assessed dietary intake amounts of 28 foods/food groups and 29 nutrients estimated by using dietary questionnaires in the EPIC (European Prospective Investigation into Cancer and Nutrition) study (n = 1095 cases). We selected 4 foods/nutrients that were statistically significantly associated with EOC risk when comparing the extreme quartiles of intake in the EPIC study (false discovery rate = 0.43) and evaluated these factors in the NLCS (Netherlands Cohort Study; n = 383 cases). Cox regression models were used to estimate HRs and 95% CIs. RESULTS: None of the 4 dietary factors that were associated with EOC risk in the EPIC study (cholesterol, polyunsaturated and saturated fat, and bananas) were statistically significantly associated with EOC risk in the NLCS; however, in meta-analysis of the EPIC study and the NLCS, we observed a higher risk of EOC with a high than with a low intake of saturated fat (quartile 4 compared with quartile 1; overall HR: 1.21; 95% CI: 1.04, 1.41). CONCLUSION: In the meta-analysis of both studies, there was a higher risk of EOC with a high than with a low intake of saturated fat.

Flavonoid and lignan intake and pancreatic cancer risk in the European prospective investigation into cancer and nutrition cohort

Molina-Montes E., Sanchez M. J., Zamora-Ros R., Bueno-de-Mesquita H. B., Wark P. A., Obon-Santacana M., Kuhn T., Katzke V., Travis R. C., Ye W., Sund M., Naccarati A., Mattiello A., Krogh V., Martorana C., Masala G., Amiano P., Huerta J. M., Barricarte A., Quiros J. R., Weiderpass E., Angell Asli L., Skeie G., Ericson U., Sonestedt E., Peeters P. H., Romieu I., Scalbert A., Overvad K., Clemens M., Boeing H., Trichopoulou A., Peppa E., Vidalis P., Khaw K. T., Wareham N., Olsen A., Tjonneland A., Boutroun-Rualt M. C., Clavel-Chapelon F., Cross A. J., Lu Y., Riboli E., Duell E. J.

Int J Cancer; 2016; 139(7): 1480-92

PMID:27184434

Abstract as provided by PubMed

Despite the potential cancer preventive effects of flavonoids and lignans, their ability to reduce pancreatic cancer risk has not been demonstrated in epidemiological studies. Our aim was to examine the association between dietary intakes of flavonoids and lignans and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. A total of 865 exocrine pancreatic cancer cases occurred after 11.3 years of follow-up of 477,309 cohort members. Dietary flavonoid and lignan intake was estimated through validated dietary questionnaires and the US Department of Agriculture (USDA) and Phenol Explorer databases. Hazard ratios (HR) and 95% confidence intervals (CIs) were calculated using age, sex and center-stratified Cox proportional hazards models, adjusted for energy intake, body mass index (BMI), smoking, alcohol and diabetes status. Our results showed that neither overall dietary intake of flavonoids nor of lignans were associated with pancreatic cancer risk (multivariable-adjusted HR for a doubling of intake = 1.03, 95% CI: 0.95-1.11 and 1.02; 95% CI: 0.89-1.17, respectively). Statistically significant associations were also not observed by flavonoid subclasses. An inverse association between intake of flavanones and pancreatic cancer risk was apparent, without reaching statistical significance, in microscopically confirmed cases (HR for a doubling of intake = 0.96, 95% CI: 0.91-1.00). In conclusion, we did not observe an association between intake of flavonoids, flavonoid subclasses or lignans and pancreatic cancer risk in the EPIC cohort.

Main nutrient patterns and colorectal cancer risk in the European Prospective Investigation into Cancer and Nutrition study

Moskal A., Freisling H., Byrnes G., Assi N., Fahey M. T., Jenab M., Ferrari P., Tjonneland A., Petersen K. E., Dahm C. C., Hansen C. P., Affret A., Boutron-Ruault M. C., Cadeau C., Kuhn T., Katzke V., Iqbal K., Boeing H., Trichopoulou A., Bamia C., Naska A., Masala G., de Magistris M. S., Sieri S., Tumino R., Sacerdote C., Peeters P. H., Bueno-de-Mesquita B. H., Engeset D., Licaj I., Skeie G., Ardanaz E., Buckland G., Castano J. M., Quiros J. R., Amiano P., Molina-Portillo E., Winkvist A., Myte R., Ericson U., Sonestedt E., Perez-Cornago A., Wareham N., Khaw K. T., Huybrechts I., Tsilidis K. K., Ward H., Gunter M. J., Slimani N.

Br J Cancer; 2016; 115(11): 1430-1440

PMID:27764841

Abstract as provided by PubMed

BACKGROUND: Much of the current literature on diet-colorectal cancer (CRC) associations focused on studies of single foods/nutrients, whereas less is known about nutrient patterns. We investigated the association between major nutrient patterns and CRC risk in participants of the European Prospective Investigation into Cancer and Nutrition (EPIC) study. METHODS: Among 477 312 participants, intakes of 23 nutrients were estimated from validated dietary questionnaires. Using results from a previous principal component (PC) analysis, four major nutrient patterns were identified. Hazard ratios (HRs) and 95% confidence intervals (CIs) were computed for the association of each of the four patterns and CRC incidence using multivariate Cox proportional hazards models with adjustment for established CRC risk factors. RESULTS: During an average of 11 years of follow-up, 4517 incident cases of CRC were documented. A nutrient pattern characterised by high intakes of vitamins and minerals was inversely associated with CRC (HR per 1 s.d.=0.94, 95% CI: 0.92-0.98) as was a pattern characterised by total protein, riboflavin, phosphorus and calcium (HR (1 s.d.)=0.96, 95% CI: 0.93-0.99). The remaining two patterns were not significantly associated with CRC risk. CONCLUSIONS: Analysing nutrient patterns may improve our understanding of how groups of nutrients relate to CRC.

A Nested Case-Control Study of Metabolically Defined Body Size Phenotypes and Risk of Colorectal Cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Murphy N., Cross A. J., Abubakar M., Jenab M., Aleksandrova K., Boutron-Ruault M. C., Dossus L., Racine A., Kuhn T., Katzke V. A., Tjonneland A., Petersen K. E., Overvad K., Quiros J. R., Jakszyn P., Molina-Montes E., Dorronsoro M., Huerta J. M., Barricarte A., Khaw K. T., Wareham N., Travis R. C., Trichopoulou A., Lagiou P., Trichopoulos D., Masala G., Krogh V., Tumino R., Vineis P., Panico S., Bueno-de-Mesquita H. B., Siersema P. D., Peeters P. H., Ohlsson B., Ericson U., Palmqvist R., Nystrom H., Weiderpass E., Skeie G., Freisling H., Kong S. Y., Tsilidis K., Muller D. C., Riboli E., Gunter M. J.

PLoS Med; 2016; 13(4): e1001988

PMID:27046222

Abstract as provided by PubMed

BACKGROUND: Obesity is positively associated with colorectal cancer. Recently, body size subtypes categorised by the prevalence of hyperinsulinaemia have been defined, and metabolically healthy overweight/obese individuals (without hyperinsulinaemia) have been suggested to be at lower risk of cardiovascular disease than their metabolically unhealthy (hyperinsulinaemic) overweight/obese counterparts. Whether similarly variable relationships exist for metabolically defined body size phenotypes and colorectal cancer risk is unknown. METHODS AND FINDINGS: The association of metabolically defined body size phenotypes with colorectal cancer was investigated in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Metabolic health/body size phenotypes were defined according to hyperinsulinaemia status using serum concentrations of C-peptide, a marker of insulin secretion. A total of 737 incident colorectal cancer cases and 737 matched controls were divided into tertiles based on the distribution of C-peptide concentration amongst the control population, and participants were classified as metabolically healthy if below the first tertile of C-peptide and metabolically unhealthy if above the first tertile. These metabolic health definitions were then combined with body mass index (BMI) measurements to create four metabolic health/body size phenotype categories: (1) metabolically healthy/normal weight (BMI < 25 kg/m2), (2) metabolically healthy/overweight (BMI >/= 25 kg/m2), (3) metabolically unhealthy/normal weight (BMI < 25 kg/m2), and (4) metabolically unhealthy/overweight (BMI >/= 25 kg/m2). Additionally, in separate models, waist circumference measurements (using the International Diabetes Federation cut-points [>/=80 cm for women and >/=94 cm for men]) were used (instead of BMI) to create the four metabolic health/body size phenotype categories. Statistical tests used in the analysis were all two-sided, and a p-value of <0.05 was considered statistically significant. In multivariable-adjusted conditional logistic regression models with BMI used to define adiposity, compared with metabolically healthy/normal weight individuals, we observed a higher colorectal cancer risk among metabolically unhealthy/normal weight (odds ratio [OR] = 1.59, 95% CI 1.10-2.28) and metabolically unhealthy/overweight (OR = 1.40, 95% CI 1.01-1.94) participants, but not among metabolically healthy/overweight individuals (OR = 0.96, 95% CI 0.65-1.42). Among the overweight individuals, lower colorectal cancer risk was observed for metabolically healthy/overweight individuals compared with metabolically unhealthy/overweight individuals (OR = 0.69, 95% CI 0.49-0.96). These associations were generally consistent when waist circumference was used as the measure of adiposity. To our knowledge, there is no universally accepted clinical definition for using C-peptide level as an indication of hyperinsulinaemia. Therefore, a possible limitation of our analysis was that the classification of individuals as being hyperinsulinaemic-based on their C-peptide level-was arbitrary. However, when we used quartiles or the median of C-peptide, instead of tertiles, as the cut-point of hyperinsulinaemia, a similar pattern of associations was observed. CONCLUSIONS: These results support the idea that individuals with the metabolically healthy/overweight phenotype (with normal insulin levels) are at lower colorectal cancer risk than those with hyperinsulinaemia. The combination of anthropometric measures with metabolic parameters, such as C-peptide, may be useful for defining strata of the population at greater risk of colorectal cancer.

Sweet-beverage consumption and risk of pancreatic cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Navarrete-Munoz E. M., Wark P. A., Romaguera D., Bhoo-Pathy N., Michaud D., Molina-Montes E., Tjonneland A., Olsen A., Overvad K., Boutron-Ruault M. C., Clavel-Chapelon F., Fagherazzi G., Katzke V. A., Kuhn T., Steffen A., Trichopoulou A., Klinaki E., Papatesta E. M., Masala G., Krogh V., Tumino R., Naccarati A., Mattiello A., Peeters P. H., Rylander C., Parr C. L., Skeie G., Weiderpass E., Quiros J. R., Duell E. J., Dorronsoro M., Huerta J. M., Ardanaz E., Wareham N., Khaw K. T., Travis R. C., Key T., Stepien M., Freisling H., Riboli E., Bueno-de-Mesquita H. B.

Am J Clin Nutr; 2016; 104(3): 760-8

PMID:27510540

Abstract as provided by PubMed

BACKGROUND: The consumption of sweet beverages has been associated with greater risk of type 2 diabetes and obesity, which may be involved in the development of pancreatic cancer. Therefore, it has been hypothesized that sweet beverages may increase pancreatic cancer risk as well. OBJECTIVE: We examined the association between sweet-beverage consumption (including total, sugar-sweetened, and artificially sweetened soft drink and juice and nectar consumption) and pancreatic cancer risk. DESIGN: The study was conducted within the European Prospective Investigation into Cancer and Nutrition cohort. A total of 477,199 participants (70.2% women) with a mean age of 51 y at baseline were included, and 865 exocrine pancreatic cancers were diagnosed after a median follow-up of 11.60 y (IQR: 10.10-12.60 y). Sweet-beverage consumption was assessed with the use of validated dietary questionnaires at baseline. HRs and 95% CIs were obtained with the use of multivariable Cox regression models that were stratified by age, sex, and center and adjusted for educational level, physical activity, smoking status, and alcohol consumption. Associations with total soft-drink consumption were adjusted for juice and nectar consumption and vice versa. RESULTS: Total soft-drink consumption (HR per 100 g/d: 1.03; 95% CI: 0.99, 1.07), sugar-sweetened soft-drink consumption (HR per 100 g/d: 1.02; 95% CI: 0.97, 1.08), and artificially sweetened soft-drink consumption (HR per 100 g/d: 1.04; 95% CI: 0.98, 1.10) were not associated with pancreatic cancer risk. Juice and nectar consumption was inversely associated with pancreatic cancer risk (HR per 100 g/d: 0.91; 95% CI: 0.84, 0.99); this association remained statistically significant after adjustment for body size, type 2 diabetes, and energy intake. CONCLUSIONS: Soft-drink consumption does not seem to be associated with pancreatic cancer risk. Juice and nectar consumption might be associated with a modest decreased pancreatic cancer risk. Additional studies with specific information on juice and nectar subtypes are warranted to clarify these results.

Compilation of a standardised international folate database for EPIC

Nicolas G., Witthoft C. M., Vignat J., Knaze V., Huybrechts I., Roe M., Finglas P., Slimani N.

Food Chem; 2016; 134-40

PMID:26433299

Abstract as provided by PubMed

This paper describes the methodology applied for compiling an "international end-user" folate database. This work benefits from the unique dataset offered by the European Prospective Investigation into Cancer and Nutrition (EPIC) (N=520,000 subjects in 23 centres). Compilation was done in four steps: (1) identify folate-free foods then find folate values for (2) folate-rich foods common across EPIC countries, (3) the remaining "common" foods, and (4) "country-specific" foods. Compiled folate values were concurrently standardised in terms of unit, mode of expression and chemical analysis, using information in national food composition tables (FCT). 43-70% total folate values were documented as measured by microbiological assay. Foods reported in EPIC were either matched directly to FCT foods, treated as recipes or weighted averages. This work has produced the first standardised folate dataset in Europe, which was used to calculate folate intakes in EPIC; a prerequisite to study the relation between folate intake and diseases.

Acrylamide and glycidamide hemoglobin adduct levels and endometrial cancer risk: A nested case-control study in nonsmoking postmenopausal women from the EPIC cohort

Obon-Santacana M., Freisling H., Peeters P. H., Lujan-Barroso L., Ferrari P., Boutron-Ruault M. C., Mesrine S., Baglietto L., Turzanski-Fortner R., Katzke V. A., Boeing H., Quiros J. R., Molina-Portillo E., Larranaga N., Chirlaque M. D., Barricarte A., Khaw K. T., Wareham N., Travis R. C., Merritt M. A., Gunter M. J., Trichopoulou A., Lagiou P., Naska A., Palli D., Sieri S., Tumino R., Fiano V., Galassom R., Bueno-de-Mesquita H. B., Onland-Moret N. C., Idahl A., Lundin E., Weiderpass E., Vesper H., Riboli E., Duell E. J.

Int J Cancer; 2016; 138(5): 1129-38

PMID:26376083

Abstract as provided by PubMed

Acrylamide, classified in 1994 by IARC as "probably carcinogenic to humans," was discovered in 2002 in some heat-treated, carbohydrate-rich foods. Four prospective studies have evaluated the association between dietary acrylamide intake and endometrial cancer (EC) risk with inconsistent results. The purpose of this nested case-control study, based on the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, was to evaluate, for the first time, the association between hemoglobin adducts of acrylamide (HbAA) and glycidamide (HbGA) and the risk of developing EC in non-smoking postmenopausal women. Hemoglobin adducts were measured in red blood cells by HPLC/MS/MS. Four exposure variables were evaluated: HbAA, HbGA, their sum (HbAA+HbGA), and their ratio (HbGA/HbAA). The association between hemoglobin adducts and EC was evaluated using unconditional multivariable logistic regression models, and included 383 EC cases (171 were type-I EC), and 385 controls. Exposure variables were analyzed in quintiles based on control distributions. None of the biomarker variables had an effect on overall EC (HRHbAA;Q5vsQ1 : 0.84, 95%CI: 0.49-1.48; HRHbGA;Q5vsQ1 : 0.94, 95%CI: 0.54-1.63) or type-I EC risk. Additionally, none of the subgroups investigated (BMI < 25 vs. >/=25 kg m(-2) , alcohol drinkers vs. never drinkers, oral contraceptive users vs. non-users) demonstrated effect measure modification. Hemoglobin adducts of acrylamide or glycidamide were not associated with EC or type-I EC risk in 768 nonsmoking postmenopausal women from the EPIC cohort.

Acrylamide and Glycidamide Hemoglobin Adducts and Epithelial Ovarian Cancer: A Nested Case-Control Study in Nonsmoking Postmenopausal Women from the EPIC Cohort

Obon-Santacana M., Lujan-Barroso L., Travis R. C., Freisling H., Ferrari P., Severi G., Baglietto L., Boutron-Ruault M. C., Fortner R. T., Ose J., Boeing H., Menendez V., Sanchez-Cantalejo E., Chamosa S., Castano J. M., Ardanaz E., Khaw K. T., Wareham N., Merritt M. A., Gunter M. J., Trichopoulou A., Papatesta E. M., Klinaki E., Saieva C., Tagliabue G., Tumino R., Sacerdote C., Mattiello A., Bueno-de-Mesquita H. B., Peeters P. H., Onland-Moret N. C., Idahl A., Lundin E., Weiderpass E., Vesper H. W., Riboli E., Duell E. J.

Cancer Epidemiol Biomarkers Prev; 2016; 25(1): 127-34

PMID:26598536

Abstract as provided by PubMed

BACKGROUND: Acrylamide was classified as "probably carcinogenic to humans (group 2A)" by the International Agency for Research on Cancer. Epithelial ovarian cancer (EOC) is the fourth cause of cancer mortality in women. Five epidemiological studies have evaluated the association between EOC risk and dietary acrylamide intake assessed using food frequency questionnaires, and one nested case-control study evaluated hemoglobin adducts of acrylamide (HbAA) and its metabolite glycidamide (HbGA) and EOC risk; the results of these studies were inconsistent. METHODS: A nested case-control study in nonsmoking postmenopausal women (334 cases, 417 controls) was conducted within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Unconditional logistic regression models were used to estimate ORs and 95% confidence intervals (CI) for the association between HbAA, HbGA, HbAA+HbGA, and HbGA/HbAA and EOC and invasive serous EOC risk. RESULTS: No overall associations were observed between biomarkers of acrylamide exposure analyzed in quintiles and EOC risk; however, positive associations were observed between some middle quintiles of HbGA and HbAA+HbGA. Elevated but nonstatistically significant ORs for serous EOC were observed for HbGA and HbAA+HbGA (ORQ5vsQ1, 1.91; 95% CI, 0.96-3.81 and ORQ5vsQ1, 1.90; 95% CI, 0.94-3.83, respectively); however, no linear dose-response trends were observed. CONCLUSION: This EPIC nested case-control study failed to observe a clear association between biomarkers of acrylamide exposure and the risk of EOC or invasive serous EOC. IMPACT: It is unlikely that dietary acrylamide exposure increases ovarian cancer risk; however, additional studies with larger sample size should be performed to exclude any possible association with EOC risk. Cancer Epidemiol Biomarkers Prev; 25(1); 127-34. (c)2015 AACR.

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20