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2013

Abdominal obesity, weight gain during adulthood and risk of liver and biliary tract cancer in a European cohort

Schlesinger S., Aleksandrova K., Pischon T., Fedirko V., Jenab M., Trepo E., Boffetta P., Dahm C.C., Overvad K., Tjonneland A., Halkjaer J., Fagherazzi G., Boutron-Ruault M.C., Carbonnel F., Kaaks R., Lukanova A., Boeing H., Trichopoulou A., Bamia C., Lagiou P., Palli D., Grioni S., Panico S., Tumino R., Vineis P., Bueno-de-Mesquita H.B., van den Berg S., Peeters P.H., Braaten T., Weiderpass E., Quiros J.R., Travier N., Sanchez M.J., Navarro C., Barricarte A., Dorronsoro M., Lindkvist B., Regner S., Werner M., Sund M., Khaw K.T., Wareham N., Travis R.C., Norat T., Wark P.A., Riboli E., Nothlings U.

Int J Cancer; 2013; 132(3): 645-657

Abstract as provided by PubMed

General obesity has been positively associated with risk of liver and probably with biliary tract cancer, but little is known about abdominal obesity or weight gain during adulthood. We used multivariable Cox proportional hazard models to investigate associations between weight, body mass index, waist and hip circumference, waist-to-hip and waist-to-height ratio (WHtR), weight change during adulthood and risk of hepatocellular carcinoma (HCC), intrahepatic (IBDC) and extrahepatic bile duct system cancer [EBDSC including gallbladder cancer (GBC)] among 359,525 men and women in the European Prospective Investigation into Cancer and Nutrition study. Hepatitis B and C virus status was measured in a nested case-control subset. During a mean follow-up of 8.6 years, 177 cases of HCC, 58 cases of IBDC and 210 cases of EBDSC, including 76 cases of GBC, occurred. All anthropometric measures were positively associated with risk of HCC and GBC. WHtR showed the strongest association with HCC [relative risk (RR) comparing extreme tertiles 3.51, 95% confidence interval (95% CI): 2.09-5.87; p(trend) < 0.0001] and with GBC (RR: 1.56, 95% CI: 1.12-2.16 for an increment of one unit in WHtR). Weight gain during adulthood was also positively associated with HCC when comparing extreme tertiles (RR: 2.48, 95% CI: 1.49-4.13; <0.001). No statistically significant association was observed between obesity and risk of IBDC and EBDSC. Our results provide evidence of an association between obesity, particularly abdominal obesity, and risk of HCC and GBC. Our findings support public health recommendations to reduce the prevalence of obesity and weight gain in adulthood for HCC and GBC prevention in Western populations

Dietary glycemic index, glycemic load, and digestible carbohydrate intake are not associated with risk of type 2 diabetes in eight European countries

Sluijs I., Beulens J.W., van der Schouw Y.T., van der A.D.L., Buckland G., Kuijsten A., Schulze M.B., Amiano P., Ardanaz E., Balkau B., Boeing H., Gavrila D., Grote V.A., Key T.J., Li K., Nilsson P., Overvad K., Palli D., Panico S., Quiros J.R., Rolandsson O., Roswall N., Sacerdote C., Sanchez M.J., Sieri S., Slimani N., Spijkerman A.M., Tjonneland A., Tumino R., Sharp S.J., Langenberg C., Feskens E.J., Forouhi N.G., Riboli E., Wareham N.J.

J Nutr; 2013; 143(1): 93-99

Abstract as provided by PubMed

The association of glycemic index (GI) and glycemic load (GL) with the risk of type 2 diabetes remains unclear. We investigated associations of dietary GI, GL, and digestible carbohydrate with incident type 2 diabetes. We performed a case-cohort study nested within the European Prospective Investigation into Cancer and Nutrition Study, including a random subcohort (n = 16,835) and incident type 2 diabetes cases (n = 12,403). The median follow-up time was 12 y. Baseline dietary intakes were assessed using country-specific dietary questionnaires. Country-specific HR were calculated and pooled using random effects meta-analysis. Dietary GI, GL, and digestible carbohydrate in the subcohort were (mean +/- SD) 56 +/- 4, 127 +/- 23, and 226 +/- 36 g/d, respectively. After adjustment for confounders, GI and GL were not associated with incident diabetes [HR highest vs. lowest quartile (HR(Q4)) for GI: 1.05 (95% CI = 0.96, 1.16); HR(Q4) for GL: 1.07 (95% CI = 0.95, 1.20)]. Digestible carbohydrate intake was not associated with incident diabetes [HR(Q4): 0.98 (95% CI = 0.86, 1.10)]. In additional analyses, we found that discrepancies in the GI value assignment to foods possibly explain differences in GI associations with diabetes within the same study population. In conclusion, an expansion of the GI tables and systematic GI value assignment to foods may be needed to improve the validity of GI values derived in such studies, after which GI associations may need reevaluation. Our study shows that digestible carbohydrate intake is not associated with diabetes risk and suggests that diabetes risk with high-GI and -GL diets may be more modest than initial studies suggested

Physical activity and risk of breast cancer overall and by hormone receptor status: the European prospective investigation into cancer and nutrition

Steindorf K., Ritte R., Eomois P.P., Lukanova A., Tjonneland A., Johnsen N.F., Overvad K., Ostergaard J.N., Clavel-Chapelon F., Fournier A., Dossus L., Teucher B., Rohrmann S., Boeing H., Wientzek A., Trichopoulou A., Karapetyan T., Trichopoulos D., Masala G., Berrino F., Mattiello A., Tumino R., Ricceri F., Quiros J.R., Travier N., Sanchez M.J., Navarro C., Ardanaz E., Amiano P., Bueno-de-Mesquita H.B., van Duijnhoven F., Monninkhof E., May A.M., Khaw K.T., Wareham N., Key T.J., Travis R.C., Borch K.B., Sund M., Andersson A., Fedirko V., Rinaldi S., Romieu I., Wahrendorf J., Riboli E., Kaaks R.

Int J Cancer; 2013; 132(7): 1667-1678

Abstract as provided by PubMed

Physical activity is associated with reduced risks of invasive breast cancer. However, whether this holds true for breast cancer subtypes defined by the estrogen receptor (ER) and the progesterone receptor (PR) status is controversial. The study included 257,805 women from the multinational EPIC-cohort study with detailed information on occupational, recreational and household physical activity and important cofactors assessed at baseline. During 11.6 years of median follow-up, 8,034 incident invasive breast cancer cases were identified. Data on ER, PR and combined ER/PR expression were available for 6,007 (67.6%), 4,814 (54.2%) and 4,798 (53.9%) cases, respectively. Adjusted hazard ratios (HR) were estimated by proportional hazards models. Breast cancer risk was inversely associated with moderate and high levels of total physical activity (HR = 0.92, 95% confidence interval (CI): 0.86-0.99, HR = 0.87, 95%-CI: 0.79-0.97, respectively; p-trend = 0.002), compared to the lowest quartile. Among women diagnosed with breast cancer after age 50, the largest risk reduction was found with highest activity (HR = 0.86, 95%-CI: 0.77-0.97), whereas for cancers diagnosed before age 50 strongest associations were found for moderate total physical activity (HR = 0.78, 95%-CI: 0.64-0.94). Analyses by hormone receptor status suggested differential associations for total physical activity (p-heterogeneity = 0.04), with a somewhat stronger inverse relationship for ER+/PR+ breast tumors, primarily driven by PR+ tumors (p-heterogeneity < 0.01). Household physical activity was inversely associated with ER-/PR- tumors. The results of this largest prospective study on the protective effects of physical activity indicate that moderate and high physical activity are associated with modest decreased breast cancer risk. Heterogeneities by receptor status indicate hormone-related mechanisms

Genetic variation in the lactase gene, dairy product intake and risk for prostate cancer in the European prospective investigation into cancer and nutrition

Travis R.C., Appleby P.N., Siddiq A., Allen N.E., Kaaks R., Canzian F., Feller S., Tjonneland A., Fons Johnsen N., Overvad K., Ramon Quiros J., Gonzalez C.A., Sanchez M.J., Larranaga N., Chirlaque M.D., Barricarte A., Khaw K.T., Wareham N., Trichopoulou A., Valanou E., Oustoglou E., Palli D., Sieri S., Tumino R., Sacerdote C., Bueno-de-Mesquita H.B., Stattin P., Ferrari P., Johansson M., Norat T., Riboli E., Key T.J.

Int J Cancer; 2013; 132(8): 1901-1910

Abstract as provided by PubMed

High dairy protein intake has been found to be associated with increased prostate cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). To further examine this possible relationship, we investigated the hypothesis that a genetic polymorphism in the lactase (LCT) gene might be associated with elevated dairy product intake and increased prostate cancer risk in a case-control study nested in EPIC. The C/T-13910 lactase variant (rs4988235) was genotyped in 630 men with prostate cancer and 873 matched control participants. Dairy product consumption was assessed by diet questionnaire. Odds ratios (ORs) for prostate cancer in relation to lactase genotype were estimated by conditional logistic regression. Lactase genotype frequency varied significantly between countries, with frequencies of the T (lactase persistence) allele ranging from 7% in Greece to 79% in Denmark. Intake of milk and total dairy products varied significantly by lactase genotype after adjustment for recruitment center; adjusted mean intakes of milk were 44.4, 69.8 and 82.3 g/day among men with CC, CT and TT genotypes, respectively. The lactase variant was not significantly associated with prostate cancer risk, both in our data (adjusted OR for TT vs. CC homozygotes: 1.10, 95% CI: 0.76-1.59) and in a meta-analysis of all the published data (combined OR for T allele carriers vs. CC homozygotes: 1.12, 0.96-1.32). These findings show that while variation in the lactase gene is associated with milk intake in men, the lactase polymorphism does not have a large effect on prostate cancer risk

The association between dietary energy density and type 2 diabetes in Europe: results from the EPIC-InterAct Study

van den Berg S.W., van der A D.L., Spijkerman A.M., van Woudenbergh G.J., Tijhuis M.J., Amiano P., Ardanaz E., Beulens J.W., Boeing H., Clavel-Chapelon F., Crowe F.L., de Lauzon-Guillain B., Fagherazzi G., Franks P.W., Freisling H., Gonzalez C., Grioni S., Halkjaer J., Huerta J.M., Huybrechts I., Kaaks R., Khaw K.T., Masala G., Nilsson P.M., Overvad K., Panico S., Quiros J.R., Rolandsson O., Sacerdote C., Sanchez M.J., Schulze M.B., Slimani N., Struijk E.A., Tjonneland A., Tumino R., Sharp S.J., Langenberg C., Forouhi N.G., Feskens E.J., Riboli E., Wareham N.J.

PLoS. One; 2013; 8(5): e59947

Abstract as provided by PubMed

BACKGROUND: Observational studies implicate higher dietary energy density (DED) as a potential risk factor for weight gain and obesity. It has been hypothesized that DED may also be associated with risk of type 2 diabetes (T2D), but limited evidence exists. Therefore, we investigated the association between DED and risk of T2D in a large prospective study with heterogeneity of dietary intake. METHODOLOGY/PRINCIPAL FINDINGS: A case-cohort study was nested within the European Prospective Investigation into Cancer (EPIC) study of 340,234 participants contributing 3.99 million person years of follow-up, identifying 12,403 incident diabetes cases and a random subcohort of 16,835 individuals from 8 European countries. DED was calculated as energy (kcal) from foods (except beverages) divided by the weight (gram) of foods estimated from dietary questionnaires. Prentice-weighted Cox proportional hazard regression models were fitted by country. Risk estimates were pooled by random effects meta-analysis and heterogeneity was evaluated. Estimated mean (sd) DED was 1.5 (0.3) kcal/g among cases and subcohort members, varying across countries (range 1.4-1.7 kcal/g). After adjustment for age, sex, smoking, physical activity, alcohol intake, energy intake from beverages and misreporting of dietary intake, no association was observed between DED and T2D (HR 1.02 (95% CI: 0.93-1.13), which was consistent across countries (I(2) = 2.9%). CONCLUSIONS/SIGNIFICANCE: In this large European case-cohort study no association between DED of solid and semi-solid foods and risk of T2D was observed. However, despite the fact that there currently is no conclusive evidence for an association between DED and T2DM risk, choosing low energy dense foods should be promoted as they support current WHO recommendations to prevent chronic diseases

Adherence to the World Cancer Research Fund/American Institute for Cancer Research guidelines and risk of death in Europe: results from the European Prospective Investigation into Nutrition and Cancer cohort study1,4

Vergnaud A.C., Romaguera D., Peeters P.H., Van Gils C.H., Chan D.S., Romieu I., Freisling H., Ferrari P., Clavel-Chapelon F., Fagherazzi G., Dartois L., Li K., Tikk K., Bergmann M.M., Boeing H., Tjonneland A., Olsen A., Overvad K., Dahm C.C., Redondo M.L., Agudo A., Sanchez M.J., Amiano P., Chirlaque M.D., Ardanaz E., Khaw K.T., Wareham N.J., Crowe F., Trichopoulou A., Orfanos P., Trichopoulos D., Masala G., Sieri S., Tumino R., Vineis P., Panico S., Bueno-de-Mesquita H.B., Ros M.M., May A., Wirfalt E., Sonestedt E., Johansson I., Hallmans G., Lund E., Weiderpass E., Parr C.L., Riboli E., Norat T.

Am J Clin Nutr; 2013; 97(5): 1107-1120

Abstract as provided by PubMed

BACKGROUND: In 2007, the World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) issued recommendations on diet, physical activity, and weight management for cancer prevention on the basis of the most comprehensive collection of available evidence. OBJECTIVE: We investigated whether concordance with WCRF/AICR recommendations is related to risk of death. DESIGN: The current study included 378,864 participants from 9 European countries enrolled in the European Prospective Investigation into Cancer and Nutrition study. At recruitment (1992-1998), dietary, anthropometric, and lifestyle information was collected. A WCRF/AICR score, which incorporated 6 of the WCRF/AICR recommendations for men [regarding body fatness, physical activity, foods and drinks that promote weight gain, plant foods, animal foods, and alcoholic drinks (score range: 0-6)] and 7 WCRF/AICR recommendations for women [plus breastfeeding (score range: 0-7)], was constructed. Higher scores indicated greater concordance with WCRF/AICR recommendations. Associations between the WCRF/AICR score and risks of total and cause-specific death were estimated by using Cox regression analysis. RESULTS: After a median follow-up time of 12.8 y, 23,828 deaths were identified. Participants within the highest category of the WCRF/AICR score (5-6 points in men; 6-7 points in women) had a 34% lower hazard of death (95% CI: 0.59, 0.75) compared with participants within the lowest category of the WCRF/AICR score (0-2 points in men; 0-3 points in women). Significant inverse associations were observed in all countries. The WCRF/AICR score was also significantly associated with a lower hazard of dying from cancer, circulatory disease, and respiratory disease. CONCLUSION: Results of this study suggest that following WCRF/AICR recommendations could significantly increase longevity

Dietary flavonoid intake and esophageal cancer risk in the European prospective investigation into cancer and nutrition cohort

Vermeulen E., Zamora-Ros R., Duell E.J., Lujan-Barroso L., Boeing H., Aleksandrova K., Bueno-de-Mesquita H.B., Scalbert A., Romieu I., Fedirko V., Touillaud M., Fagherazzi G., Perquier F., Molina-Montes E., Chirlaque M.D., Vicente Arguelles M., Amiano P., Barricarte A., Pala V., Mattiello A., Saieva C., Tumino R., Ricceri F., Trichopoulou A., Vasilopoulou E., Ziara G., Crowe F.L., Khaw K.T., Wareham N.J., Lukanova A., Grote V.A., Tjonneland A., Halkjaer J., Bredsdorff L., Overvad K., Siersema P.D., Peeters P.H., May A.M., Weiderpass E., Skeie G., Hjartaker A., Landberg R., Johansson I., Sonestedt E., Ericson U., Riboli E., Gonzalez C.A.

Am. J Epidemiol; 2013; 178(4): 570-581

Abstract as provided by PubMed

We prospectively investigated dietary flavonoid intake and esophageal cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The study included 477,312 adult subjects from 10 European countries. At baseline, country-specific validated dietary questionnaires were used. During a mean follow-up of 11 years (1992-2010), there were 341 incident esophageal cancer cases, of which 142 were esophageal adenocarcinoma (EAC), 176 were esophageal squamous cell carcinoma (ESCC), and 23 were other types of esophageal cancer. In crude models, a doubling in total dietary flavonoid intake was inversely associated with esophageal cancer risk (hazard ratio (HR) (log(2)) = 0.87, 95% confidence interval (CI): 0.78, 0.98) but not in multivariable models (HR (log(2)) = 0.97, 95% CI: 0.86, 1.10). After covariate adjustment, no statistically significant association was found between any flavonoid subclass and esophageal cancer, EAC, or ESCC. However, among current smokers, flavonols were statistically significantly associated with a reduced esophageal cancer risk (HR (log(2)) = 0.72, 95% CI: 0.56, 0.94), whereas total flavonoids, flavanols, and flavan-3-ol monomers tended to be inversely associated with esophageal cancer risk. No associations were found in either never or former smokers. These findings suggest that dietary flavonoid intake was not associated with overall esophageal cancer, EAC, or ESCC risk, although total flavonoids and some flavonoid subclasses, particularly flavonols, may reduce the esophageal cancer risk among current smokers

Differences in dietary intakes, food sources and determinants of total flavonoids between Mediterranean and non-Mediterranean countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study

Zamora-Ros R., Knaze V., Lujan-Barroso L., Romieu I., Scalbert A., Slimani N., Hjartaker A., Engeset D., Skeie G., Overvad K., Bredsdorff L., Tjonneland A., Halkjaer J., Key T.J., Khaw K.T., Mulligan A.A., Winkvist A., Johansson I., Bueno-de-Mesquita H.B., Peeters P.H., Wallstrom P., Ericson U., Pala V., de Magistris M.S., Polidoro S., Tumino R., Trichopoulou A., Dilis V., Katsoulis M., Huerta J.M., Martinez V., Sanchez M.J., Ardanaz E., Amiano P., Teucher B., Grote V., Bendinelli B., Boeing H., Forster J., Touillaud M., Perquier F., Fagherazzi G., Gallo V., Riboli E., Gonzalez C.A.

Br J Nutr; 2013; 109(8): 1498-1507

Abstract as provided by PubMed

A greater adherence to the traditional Mediterranean (MED) diet is associated with a reduced risk of developing chronic diseases. This dietary pattern is based on higher consumption of plant products that are rich in flavonoids. We compared the total flavonoid dietary intakes, their food sources and various lifestyle factors between MED and non-MED countries participating in the EPIC study. Flavonoid intakes and their food sources for 35,628 subjects, aged 35-74 years and recruited between 1992 and 2000, in twenty-six study centres were estimated using standardised 24 h dietary recall software (EPIC-Soft(R)). An ad hoc food composition database on flavonoids was compiled using analytical data from the United States Department of Agriculture and Phenol-Explorer databases. Moreover, it was expanded to include using recipes, estimations of missing values and flavonoid retention factors. No significant differences in total flavonoid mean intake between non-MED countries (373.7 mg/d) and MED countries (370.2 mg/d) were observed. In the non-MED region, the main contributors were proanthocyanidins (48.2%) and flavan-3-ol monomers (24.9%) and the principal food sources were tea (25.7%) and fruits (32.8%). In the MED region, proanthocyanidins (59.0%) were by far the most abundant contributor and fruits (55.1%), wines (16.7%) and tea (6.8%) were the main food sources. The present study shows similar results for total dietary flavonoid intakes, but significant differences in flavonoid class intakes, food sources and some characteristics between MED and non-MED countries. These differences should be considered in studies about the relationships between flavonoid intake and chronic diseases

Dietary intakes and food sources of phenolic acids in the European Prospective Investigation into Cancer and Nutrition (EPIC) study

Zamora-Ros R., Rothwell J.A., Scalbert A., Knaze V., Romieu I., Slimani N., Fagherazzi G., Perquier F., Touillaud M., Molina-Montes E., Huerta J.M., Barricarte A., Amiano P., Menendez V., Tumino R., de Magistris M.S., Palli D., Ricceri F., Sieri S., Crowe F.L., Khaw K.T., Wareham N.J., Grote V., Li K., Boeing H., Forster J., Trichopoulou A., Benetou V., Tsiotas K., Bueno-de-Mesquita H.B., Ros M., Peeters P.H., Tjonneland A., Halkjaer J., Overvad K., Ericson U., Wallstrom P., Johansson I., Landberg R., Weiderpass E., Engeset D., Skeie G., Wark P., Riboli E., Gonzalez C.A.

Br. J Nutr; 2013; 110(8): 1500-1511

Abstract as provided by PubMed

Phenolic acids are secondary plant metabolites that may have protective effects against oxidative stress, inflammation and cancer in experimental studies. To date, limited data exist on the quantitative intake of phenolic acids. We estimated the intake of phenolic acids and their food sources and associated lifestyle factors in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Phenolic acid intakes were estimated for 36 037 subjects aged 35-74 years and recruited between 1992 and 2000 in ten European countries using a standardised 24 h recall software (EPIC-Soft), and their food sources were identified. Dietary data were linked to the Phenol-Explorer database, which contains data on forty-five aglycones of phenolic acids in 452 foods. The total phenolic acid intake was highest in Aarhus, Denmark (1265.5 and 980.7 mg/d in men and women, respectively), while the intake was lowest in Greece (213.2 and 158.6 mg/d in men and women, respectively). The hydroxycinnamic acid subclass was the main contributor to the total phenolic acid intake, accounting for 84.6-95.3 % of intake depending on the region. Hydroxybenzoic acids accounted for 4.6-14.4 %, hydroxyphenylacetic acids 0.1-0.8 % and hydroxyphenylpropanoic acids </= 0.1 % for all regions. An increasing south-north gradient of consumption was also found. Coffee was the main food source of phenolic acids and accounted for 55.3-80.7 % of the total phenolic acid intake, followed by fruits, vegetables and nuts. A high heterogeneity in phenolic acid intake was observed across the European countries in the EPIC cohort, which will allow further exploration of the associations with the risk of diseases

Dietary flavonoid, lignan and antioxidant capacity and risk of hepatocellular carcinoma in the European prospective investigation into cancer and nutrition study

Zamora-Ros R., Fedirko V., Trichopoulou A., Gonzalez C.A., Bamia C., Trepo E., Nothlings U., Duarte-Salles T., Serafini M., Bredsdorff L., Overvad K., Tjonneland A., Halkjaer J., Fagherazzi G., Perquier F., Boutron-Ruault M.C., Katzke V., Lukanova A., Floegel A., Boeing H., Lagiou P., Trichopoulos D., Saieva C., Agnoli C., Mattiello A., Tumino R., Sacerdote C., Bueno-de-Mesquita H.B., Peeters P.H., Weiderpass E., Engeset D., Skeie G., Arguelles M.V., Molina-Montes E., Dorronsoro M., Tormo M.J., Ardanaz E., Ericson U., Sonestedt E., Sund M., Landberg R., Khaw K.T., Wareham N.J., Crowe F.L., Riboli E., Jenab M.

Int. J Cancer; 2013; 133(10): 2429-2443

Abstract as provided by PubMed

Limited epidemiological evidence suggests a protective role for plant foods rich in flavonoids and antioxidants in hepatocellular cancer (HCC) etiology. Our aim was to prospectively investigate the association between dietary intake of flavonoids, lignans and nonenzymatic antioxidant capacity (NEAC) and HCC risk. Data from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort including 477,206 subjects (29.8% male) recruited from ten Western European countries, was analyzed. Flavonoid, lignan and NEAC intakes were calculated using a compilation of existing food composition databases linked to dietary information from validated dietary questionnaires. Dietary NEAC was based on ferric reducing antioxidant capacity (FRAP) and total radical-trapping antioxidant parameter (TRAP). Hepatitis B/C status was measured in a nested case-control subset. During a mean follow-up of 11-years, 191 incident HCC cases (66.5% men) were identified. Using Cox regression, multivariable adjusted models showed a borderline nonsignificant association of HCC with total flavonoid intake (highest versus lowest tertile, HR = 0.65, 95% CI: 0.40-1.04; p(trend) = 0.065), but not with lignans. Among flavonoid subclasses, flavanols were inversely associated with HCC risk (HR = 0.62, 95% CI: 0.39-0.99; p(trend) = 0.06). Dietary NEAC was inversely associated with HCC (FRAP: HR 0.50, 95% CI: 0.31-0.81; p(trend) = 0.001; TRAP: HR 0.49, 95% CI: 0.31-0.79; p(trend) = 0.002), but statistical significance was lost after exclusion of the first 2 years of follow-up. This study suggests that higher intake of dietary flavanols and antioxidants may be associated with a reduced HCC risk

Dietary flavonoid and lignan intake and breast cancer risk according to menopause and hormone receptor status in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study

Zamora-Ros R., Ferrari P., Gonzalez C.A., Tjonneland A., Olsen A., Bredsdorff L., Overvad K., Touillaud M., Perquier F., Fagherazzi G., Lukanova A., Tikk K., Aleksandrova K., Boeing H., Trichopoulou A., Trichopoulos D., Dilis V., Masala G., Sieri S., Mattiello A., Tumino R., Ricceri F., Bueno-de-Mesquita H.B., Peeters P.H., Weiderpass E., Skeie G., Engeset D., Menendez V., Travier N., Molina-Montes E., Amiano P., Chirlaque M.D., Barricarte A., Wallstrom P., Sonestedt E., Sund M., Landberg R., Khaw K.T., Wareham N.J., Travis R.C., Scalbert A., Ward H.A., Riboli E., Romieu I.

Breast Cancer Res. Treat; 2013; 139(1): 163-176

Abstract as provided by PubMed

Evidence on the association between dietary flavonoids and lignans and breast cancer (BC) risk is inconclusive, with the possible exception of isoflavones in Asian countries. Therefore, we investigated prospectively dietary total and subclasses of flavonoid and lignan intake and BC risk according to menopause and hormonal receptor status in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The study included 334,850 women, mostly aged between 35 and 70 years from ten European countries. At baseline, country-specific validated dietary questionnaires were used. A flavonoid and lignan food composition database was developed from the US Department of Agriculture, the Phenol-Explorer and the UK Food Standards Agency databases. Cox regression models were used to analyse the association between dietary flavonoid/lignan intake and the risk of developing BC. During an average 11.5-year follow-up, 11,576 incident BC cases were identified. No association was observed between the intake of total flavonoids [hazard ratio comparing fifth to first quintile (HRQ5-Q1) 0.97, 95 % confidence interval (CI): 0.90-1.04; P trend = 0.591], isoflavones (HRQ5-Q1 1.00, 95 % CI: 0.91-1.10; P trend = 0.734), or total lignans (HRQ5-Q1 1.02, 95 % CI: 0.93-1.11; P trend = 0.469) and overall BC risk. The stratification of the results by menopausal status at recruitment or the differentiation of BC cases according to oestrogen and progesterone receptors did not affect the results. This study shows no associations between flavonoid and lignan intake and BC risk, overall or after taking into account menopausal status and BC hormone receptors

Impact of thearubigins on the estimation of total dietary flavonoids in the European Prospective Investigation into Cancer and Nutrition (EPIC) study

Zamora-Ros R., Knaze V., Romieu I., Scalbert A., Slimani N., Clavel-Chapelon F., Touillaud M., Perquier F., Skeie G., Engeset D., Weiderpass E., Johansson I., Landberg R., Bueno-de-Mesquita H.B., Sieri S., Masala G., Peeters P.H., Grote V., Huerta J.M., Barricarte A., Amiano P., Crowe F.L., Molina-Montes E., Khaw K.T., Arguelles M.V., Tjonneland A., Halkjaer J., de Magistris M.S., Ricceri F., Tumino R., Wirfalt E., Ericson U., Overvad K., Trichopoulou A., Dilis V., Vidalis P., Boeing H., Forster J., Riboli E., Gonzalez C.A.

Eur. J Clin Nutr; 2013; 67(7): 779-782

Abstract as provided by PubMed

Thearubigins (TR) are polymeric flavanol-derived compounds formed during the fermentation of tea leaves. Comprising approximately 70% of total polyphenols in black tea, TR may contribute majorly to its beneficial effects on health. To date, there is no appropriate food composition data on TR, although several studies have used data from the US Department of Agriculture (USDA) database to estimate TR intakes. We aimed to estimate dietary TR in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort and assess the impact of including TR or not in the calculation of the total dietary flavonoid intake. Dietary data were collected using a single standardized 24-h dietary recall interviewer-administered to 36 037 subjects aged 35-74 years. TR intakes were calculated using the USDA database. TR intakes ranged from 0.9 mg/day in men from Navarra and San Sebastian in Spain to 532.5 mg/day in men from UK general population. TR contributed <5% to the total flavonoid intake in Greece, Spain and Italy, whereas in the UK general population, TR comprised 48% of the total flavonoids. High heterogeneity in TR intake across the EPIC countries was observed. This study shows that total flavonoid intake may be greatly influenced by TR, particularly in high black tea-consuming countries. Further research on identification and quantification of TR is needed to get more accurate dietary TR estimations

The Association Between Dietary Flavonoid and Lignan Intakes and Incident Type 2 Diabetes in European Populations: The EPIC-InterAct study

Zamora-Ros R., Forouhi N.G., Sharp S.J., Gonzalez C.A., Buijsse B., Guevara M., van der Schouw Y.T., Amiano P., Boeing H., Bredsdorff L., Clavel-Chapelon F., Fagherazzi G., Feskens E.J., Franks P.W., Grioni S., Katzke V., Key T.J., Khaw K.T., Kuhn T., Masala G., Mattiello A., Molina-Montes E., Nilsson P.M., Overvad K., Perquier F., Quiros J.R., Romieu I., Sacerdote C., Scalbert A., Schulze M., Slimani N., Spijkerman A.M., Tjonneland A., Tormo M.J., Tumino R., van der A.DL, Langenberg C., Riboli E., Wareham N.J.

Diabetes Care; 2013; 36(12): 3961-3970

Abstract as provided by PubMed

OBJECTIVE To study the association between dietary flavonoid and lignan intakes, and the risk of development of type 2 diabetes among European populations. RESEARCH DESIGN AND METHODS The European Prospective Investigation into Cancer and Nutrition-InterAct case-cohort study included 12,403 incident type 2 diabetes cases and a stratified subcohort of 16,154 participants from among 340,234 participants with 3.99 million person-years of follow-up in eight European countries. At baseline, country-specific validated dietary questionnaires were used. A flavonoid and lignan food composition database was developed from the Phenol-Explorer, the U.K. Food Standards Agency, and the U.S. Department of Agriculture databases. Hazard ratios (HRs) from country-specific Prentice-weighted Cox regression models were pooled using random-effects meta-analysis. RESULTS In multivariable models, a trend for an inverse association between total flavonoid intake and type 2 diabetes was observed (HR for the highest vs. the lowest quintile, 0.90 [95% CI 0.77-1.04]; P value trend = 0.040), but not with lignans (HR 0.88 [95% CI 0.72-1.07]; P value trend = 0.119). Among flavonoid subclasses, flavonols (HR 0.81 [95% CI 0.69-0.95]; P value trend = 0.020) and flavanols (HR 0.82 [95% CI 0.68-0.99]; P value trend = 0.012), including flavan-3-ol monomers (HR 0.73 [95% CI 0.57-0.93]; P value trend = 0.029), were associated with a significantly reduced hazard of diabetes. CONCLUSIONS Prospective findings in this large European cohort demonstrate inverse associations between flavonoids, particularly flavanols and flavonols, and incident type 2 diabetes. This suggests a potential protective role of eating a diet rich in flavonoids, a dietary pattern based on plant-based foods, in the prevention of type 2 diabetes

2012

Impact of cigarette smoking on cancer risk in the European prospective investigation into cancer and nutrition study

Agudo A., Bonet C., Travier N., Gonzalez C.A., Vineis P., Bueno-de-Mesquita H.B., Trichopoulos D., Boffetta P., Clavel-Chapelon F., Boutron-Ruault M.C., Kaaks R., Lukanova A., Schutze M., Boeing H., Tjonneland A., Halkjaer J., Overvad K., Dahm C.C., Quiros J.R., Sanchez M.J., Larranaga N., Navarro C., Ardanaz E., Khaw K.T., Wareham N.J., Key T.J., Allen N.E., Trichopoulou A., Lagiou P., Palli D., Sieri S., Tumino R., Panico S., Boshuizen H., Buchner F.L., Peeters P.H., Borgquist S., Almquist M., Hallmans G., Johansson I., Gram I.T., Lund E., Weiderpass E., Romieu I., Riboli E.

J Clin Oncol; 2012; 30(36): 4550-4557

Abstract as provided by PubMed

PURPOSE: Our aim was to assess the impact of cigarette smoking on the risk of the tumors classified by the International Agency for Research on Cancer as causally associated with smoking, referred to as tobacco-related cancers (TRC). METHODS: The study population included 441,211 participants (133,018 men and 308,193 women) from the European Prospective Investigation Into Cancer and Nutrition. We investigated 14,563 participants who developed a TRC during an average follow-up of 11 years. The impact of smoking cigarettes on cancer risk was assessed by the population attributable fraction (AF(p)), calculated using the adjusted hazard ratios and 95% CI for current and former smokers, plus either the prevalence of smoking among cancer cases or estimates from surveys in representative samples of the population in each country. RESULTS: The proportion of all TRC attributable to cigarette smoking was 34.9% (95% CI, 32.5 to 37.4) using the smoking prevalence among cases and 36.2% (95% CI, 33.7 to 38.6) using the smoking prevalence from the population. The AF(p) were above 80% for cancers of the lung and larynx, between 20% and 50% for most respiratory and digestive cancers and tumors from the lower urinary tract, and below 20% for the remaining TRC. CONCLUSION: Using data on cancer incidence for 2008 and our AF(p) estimates, about 270,000 new cancer diagnoses per year can be considered attributable to cigarette smoking in the eight European countries with available data for both men and women (Italy, Spain, United Kingdom, the Netherlands, Greece, Germany, Sweden, Denmark)

Total and high-molecular weight adiponectin and risk of colorectal cancer: the European Prospective Investigation into Cancer and Nutrition Study

Aleksandrova K., Boeing H., Jenab M., Bueno-de-Mesquita H.B., Jansen E., van Duijnhoven F.J., Fedirko V., Rinaldi S., Romieu I., Riboli E., Romaguera D., Westphal S., Overvad K., Tjonneland A., Boutron-Ruault M.C., Clavel-Chapelon F., Kaaks R., Lukanova A., Trichopoulou A., Lagiou P., Trichopoulos D., Agnoli C., Mattiello A., Saieva C., Vineis P., Tumino R., Peeters P.H., Arguelles M., Bonet C., Sanchez M.J., Dorronsoro M., Huerta J.M., Barricarte A., Palmqvist R., Hallmans G., Khaw K.T., Wareham N., Allen N.E., Crowe F.L., Pischon T.

Carcinogenesis; 2012; 33(6): 1211-1218

Abstract as provided by PubMed

Adiponectin-an adipose tissue-derived protein-may provide a molecular link between obesity and colorectal cancer (CRC), but evidence from large prospective studies is limited. In particular, no epidemiological study explored high-molecular weight (HMW) and non-HMW adiponectin fractions in relation to CRC risk, despite them being hypothesized to have differential biological activities, i.e. regulating insulin sensitivity (HMW adiponectin) versus inflammatory response (non-HMW adiponectin). In a prospective, nested case-control study, we investigated whether prediagnostic serum concentrations of total, HMW and non-HMW adiponectin are associated with risk of CRC, independent of obesity and other known CRC risk factors. A total of 1206 incident cases (755 colon and 451 rectal) were matched to 1206 controls using incidence-density sampling. In conditional logistic regression, adjusted for dietary and lifestyle factors, total adiponectin and non-HMW adiponectin concentrations were inversely associated with risk of CRC [relative risk (RR) comparing highest versus lowest quintile = 0.71, 95% confidence interval (CI) = 0.53-0.95, P(trend) = 0.03 for total adiponectin and RR = 0.45, 95% CI = 0.34-0.61, P(trend) < 0.0001 for non-HMW adiponectin]. HMW adiponectin concentrations were not associated with CRC risk (RR = 0.91, 95% CI = 0.68-1.22, P(trend) = 0.55). Non-HMW adiponectin was associated with CRC risk even after adjustment for body mass index and waist circumference (RR = 0.39, 95% CI = 0.26-0.60, P(trend) < 0.0001), whereas the association with total adiponectin was no longer significant (RR = 0.81, 95% CI = 0.60-1.09, P(trend) = 0.23). When stratified by cancer site, non-HMW adiponectin was inversely associated with both colon and rectal cancer. These findings suggest an important role of the relative proportion of non-HMW adiponectin in CRC pathogenesis. Future studies are warranted to confirm these results and to elucidate the underlying mechanisms

Leptin and soluble leptin receptor in risk of colorectal cancer in the European Prospective Investigation into Cancer and Nutrition cohort

Aleksandrova K., Boeing H., Jenab M., Bueno-de-Mesquita H.B., Jansen E., van Duijnhoven F.J., Rinaldi S., Fedirko V., Romieu I., Riboli E., Gunter M.J., Westphal S., Overvad K., Tjonneland A., Halkjaer J., Racine A., Boutron-Ruault M.C., Clavel-Chapelon F., Kaaks R., Lukanova A., Trichopoulou A., Lagiou P., Trichopoulos D., Mattiello A., Pala V., Palli D., Tumino R., Vineis P., Buckland G., Sanchez M.J., Amiano P., Huerta J.M., Barricarte A., Menendez V., Peeters P.H., Soderberg S., Palmqvist R., Allen N.E., Crowe F.L., Khaw K.T., Wareham N., Pischon T.

Cancer Res; 2012; 72(20): 5328-5337

Abstract as provided by PubMed

Leptin, a peptide hormone produced primarily by the adipocytes, is hypothesized to play a role in the pathogenesis of colorectal cancer (CRC). Soluble leptin receptor (sOB-R) may regulate leptin's physiologic functions; however its relation to CRC risk is unknown. This study explored the association of leptin and sOB-R with risk of CRC in a prospective nested case-control study within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. A total of 1,129 incident CRC cases (713 colon, 416 rectal) were matched within risk sets to 1,129 controls. Conditional logistic regression was used to calculate relative risks (RR) and 95% confidence intervals (CI). After multivariable adjustment including body mass index (BMI), waist circumference, and baseline leptin concentrations, sOB-R was strongly inversely associated with CRC (RR comparing the highest quintile vs. the lowest, 0.55; 95% CI, 0.40-0.76; P(trend) = 0.0004) and colon cancer (RR, 0.42; 95% CI, 0.28-0.63, P(trend) = 0.0001); whereas no association was seen for rectal cancer (RR adjusted for BMI and waist circumference, 0.83; 95% CI, 0.48-1.44, P(trend) = 0.38). In contrast, leptin was not associated with risk of CRC (RR adjusted for BMI and waist circumference, 0.85; 95% CI, 0.56-1.29, P(trend) = 0.23). Additional adjustments for circulating metabolic biomarkers did not attenuate these results. These novel findings suggest a strong inverse association between circulating sOB-R and CRC risk, independent of obesity measures, leptin concentrations, and other metabolic biomarkers. Further research is needed to confirm the potentially important role of sOB-R in CRC pathogenesis

Alcohol consumption and risk of type 2 diabetes in European men and women: influence of beverage type and body size The EPIC-InterAct study

Beulens J.W., van der Schouw Y.T., Bergmann M.M., Rohrmann S., Schulze M.B., Buijsse B., Grobbee D.E., Arriola L., Cauchi S., Tormo M.J., Allen N.E., van der A D.L., Balkau B., Boeing H., Clavel-Chapelon F., de Lauzon-Guillan B., Franks P., Froguel P., Gonzales C., Halkjaer J., Huerta J.M., Kaaks R., Key T.J., Khaw K.T., Krogh V., Molina-Montes E., Nilsson P., Overvad K., Palli D., Panico S., Ramon Quiros J., Ronaldsson O., Romieu I., Romaguera D., Sacerdote C., Sanchez M.J., Spijkerman A.M., Teucher B., Tjonneland A., Tumino R., Sharp S., Forouhi N.G., Langenberg C., Feskens E.J., Riboli E., Wareham N.J.

J Intern Med; 2012; 272(4): 358-370

Abstract as provided by PubMed

OBJECTIVE: To investigate the association between alcohol consumption and type 2 diabetes, and determine whether this is modified by sex, body mass index (BMI) and beverage type. DESIGN: Multicentre prospective case-cohort study. SETTING: Eight countries from the European Prospective Investigation into Cancer and Nutrition cohort. SUBJECTS: A representative baseline sample of 16 154 participants and 12 403 incident cases of type 2 diabetes. INTERVENTIONS: Alcohol consumption assessed using validated dietary questionnaires. MAIN OUTCOME MEASURES: Occurrence of type 2 diabetes based on multiple sources (mainly self-reports), verified against medical information. RESULTS: Amongst men, moderate alcohol consumption was nonsignificantly associated with a lower incidence of diabetes with a hazard ratio (HR) of 0.90 (95% CI: 0.78-1.05) for 6.1-12.0 versus 0.1-6.0 g day(-1) , adjusted for dietary and diabetes risk factors. However, the lowest risk was observed at higher intakes of 24.1-96.0 g day(-1) with an HR of 0.86 (95% CI: 0.75-0.98). Amongst women, moderate alcohol consumption was associated with a lower incidence of diabetes with a hazard ratio of 0.82 (95% CI: 0.72-0.92) for 6.1-12.0 g day(-1) (P interaction gender <0.01). The inverse association between alcohol consumption and diabetes was more pronounced amongst overweight (BMI >/= 25 kg m(-2) ) than normal-weight men and women (P interaction < 0.05). Adjusting for waist and hip circumference did not alter the results for men, but attenuated the association for women (HR=0.90, 95% CI: 0.79-1.03 for 6.1-12.0 g day(-1) ). Wine consumption for men and fortified wine consumption for women were most strongly associated with a reduced risk of diabetes. CONCLUSIONS: The results of this study show that moderate alcohol consumption is associated with a lower risk of type 2 diabetes amongst women only. However, this risk reduction is in part explained by fat distribution. The relation between alcohol consumption and type 2 diabetes was stronger for overweight than normal-weight women and men

Coffee and tea consumption and the risk of ovarian cancer: a prospective cohort study and updated meta-analysis

Braem M.G., Onland-Moret N.C., Schouten L.J., Tjonneland A., Hansen L., Dahm C.C., Overvad K., Lukanova A., Dossus L., Floegel A., Boeing H., Clavel-Chapelon F., Chabbert-Buffet N., Fagherazzi G., Trichopoulou A., Benetou V., Goufa I., Pala V., Galasso R., Mattiello A., Sacerdote C., Palli D., Tumino R., Gram I.T., Lund E., Gavrilyuk O., Sanchez M.J., Quiros R., Gonzales C.A., Dorronsoro M., Castano J.M., Gurrea A.B., Idahl A., Ohlson N., Lundin E., Jirstrom K., Wirfalt E., Allen N.E., Tsilidis K.K., Kaw K.T., Bueno-de-Mesquita H.B., Dik V.K., Rinaldi S., Fedirko V., Norat T., Riboli E., Kaaks R., Peeters P.H.

Am J Clin Nutr; 2012; 95(5): 1172-1181

Abstract as provided by PubMed

BACKGROUND: In 2007 the World Cancer Research Fund Report concluded that there was limited and inconsistent evidence for an effect of coffee and tea consumption on the risk of epithelial ovarian cancer (EOC). OBJECTIVE: In the European Prospective Investigation into Cancer and Nutrition (EPIC), we aimed to investigate whether coffee intakes, tea intakes, or both are associated with the risk of EOC. DESIGN: All women participating in the EPIC (n = 330,849) were included in this study. Data on coffee and tea consumption were collected through validated food-frequency questionnaires at baseline. HRs and 95% CIs were estimated by using Cox proportional hazards models. Furthermore, we performed an updated meta-analysis of all previous prospective studies until April 2011 by comparing the highest and lowest coffee- and tea-consumption categories as well as by using dose-response random-effects meta-regression analyses. RESULTS: During a median follow-up of 11.7 y, 1244 women developed EOC. No association was observed between the risk of EOC and coffee consumption [HR: 1.05 (95% CI: 0.75, 1.46) for the top quintile compared with no intake] or tea consumption [HR: 1.07 (95% CI: 0.78, 1.45) for the top quintile compared with no intake]. This lack of association between coffee and tea intake and EOC risk was confirmed by the results of our meta-analysis. CONCLUSION: Epidemiologic studies do not provide sufficient evidence to support an association between coffee and tea consumption and risk of ovarian cancer

Multiple miscarriages are associated with the risk of ovarian cancer: results from the European Prospective Investigation into Cancer and Nutrition

Braem M.G., Onland-Moret N.C., Schouten L.J., Kruitwagen R.F., Lukanova A., Allen N.E., Wark P.A., Tjonneland A., Hansen L., Brauner C.M., Overvad K., Clavel-Chapelon F., Chabbert-Buffet N., Teucher B., Floegel A., Boeing H., Trichopoulou A., Adarakis G., Plada M., Rinaldi S., Fedirko V., Romieu I., Pala V., Galasso R., Sacerdote C., Palli D., Tumino R., Bueno-de-Mesquita H.B., Gram I.T., Gavrilyuk O., Lund E., Sanchez M.J., Bonet C., Chirlaque M.D., Larranaga N., Gurrea A.B., Quiros J.R., Idahl A., Ohlson N., Lundin E., Jirstrom K., Butt S., Tsilidis K.K., Khaw K.T., Wareham N., Riboli E., Kaaks R., Peeters P.H.

PLoS ONE; 2012; 7(5): e37141

Abstract as provided by PubMed

While the risk of ovarian cancer clearly reduces with each full-term pregnancy, the effect of incomplete pregnancies is unclear. We investigated whether incomplete pregnancies (miscarriages and induced abortions) are associated with risk of epithelial ovarian cancer. This observational study was carried out in female participants of the European Prospective Investigation into Cancer and Nutrition (EPIC). A total of 274,442 women were followed from 1992 until 2010. The baseline questionnaire elicited information on miscarriages and induced abortions, reproductive history, and lifestyle-related factors. During a median follow-up of 11.5 years, 1,035 women were diagnosed with incident epithelial ovarian cancer. Despite the lack of an overall association (ever vs. never), risk of ovarian cancer was higher among women with multiple incomplete pregnancies (HR(>/=4vs.0): 1.74, 95% CI: 1.20-2.70; number of cases in this category: n = 23). This association was particularly evident for multiple miscarriages (HR(>/=4vs.0): 1.99, 95% CI: 1.06-3.73; number of cases in this category: n = 10), with no significant association for multiple induced abortions (HR(>/=4vs.0): 1.46, 95% CI: 0.68-3.14; number of cases in this category: n = 7). Our findings suggest that multiple miscarriages are associated with an increased risk of epithelial ovarian cancer, possibly through a shared cluster of etiological factors or a common underlying pathology. These findings should be interpreted with caution as this is the first study to show this association and given the small number of cases in the highest exposure categories

Sources of Pre-Analytical Variations in Yield of DNA Extracted from Blood Samples: Analysis of 50,000 DNA Samples in EPIC

Caboux E., Lallemand C., Ferro G., Hemon B., Mendy M., Biessy C., Sims M., Wareham N., Britten A., Boland A., Hutchinson A., Siddiq A., Vineis P., Riboli E., Romieu I., Rinaldi S., Gunter M.J., Peeters P.H., van der Schouw Y.T., Travis R., Bueno-de-Mesquita H.B., Canzian F., Sanchez M.J., Skeie G., Olsen K.S., Lund E., Bilbao R., Sala N., Barricarte A., Palli D., Navarro C., Panico S., Redondo M.L., Polidoro S., Dossus L., Boutron-Ruault M.C., Clavel-Chapelon F., Trichopoulou A., Trichopoulos D., Lagiou P., Boeing H., Fisher E., Tumino R., Agnoli C., Hainaut P.

PLoS ONE; 2012; 7(7): e39821

Abstract as provided by PubMed

The European Prospective Investigation into Cancer and nutrition (EPIC) is a long-term, multi-centric prospective study in Europe investigating the relationships between cancer and nutrition. This study has served as a basis for a number of Genome-Wide Association Studies (GWAS) and other types of genetic analyses. Over a period of 5 years, 52,256 EPIC DNA samples have been extracted using an automated DNA extraction platform. Here we have evaluated the pre-analytical factors affecting DNA yield, including anthropometric, epidemiological and technical factors such as center of subject recruitment, age, gender, body-mass index, disease case or control status, tobacco consumption, number of aliquots of buffy coat used for DNA extraction, extraction machine or procedure, DNA quantification method, degree of haemolysis and variations in the timing of sample processing. We show that the largest significant variations in DNA yield were observed with degree of haemolysis and with center of subject recruitment. Age, gender, body-mass index, cancer case or control status and tobacco consumption also significantly impacted DNA yield. Feedback from laboratories which have analyzed DNA with different SNP genotyping technologies demonstrate that the vast majority of samples (approximately 88%) performed adequately in different types of assays. To our knowledge this study is the largest to date to evaluate the sources of pre-analytical variations in DNA extracted from peripheral leucocytes. The results provide a strong evidence-based rationale for standardized recommendations on blood collection and processing protocols for large-scale genetic studies

Fiber intake and total and cause-specific mortality in the European Prospective Investigation into Cancer and Nutrition cohort

Chuang S.C., Norat T., Murphy N., Olsen A., Tjonneland A., Overvad K., Boutron-Ruault M.C., Perquier F., Dartois L., Kaaks R., Teucher B., Bergmann M.M., Boeing H., Trichopoulou A., Lagiou P., Trichopoulos D., Grioni S., Sacerdote C., Panico S., Palli D., Tumino R., Peeters P.H., Bueno-de-Mesquita B., Ros M.M., Brustad M., Asli L.A., Skeie G., Quiros J.R., Gonzalez C.A., Sanchez M.J., Navarro C., Ardanaz Aicua E., Dorronsoro M., Drake I., Sonestedt E., Johansson I., Hallmans G., Key T., Crowe F., Khaw K.T., Wareham N., Ferrari P., Slimani N., Romieu I., Gallo V., Riboli E., Vineis P.

Am J Clin Nutr; 2012; 96(1): 164-174

Abstract as provided by PubMed

BACKGROUND: Previous studies have shown that high fiber intake is associated with lower mortality. However, little is known about the association of dietary fiber with specific causes of death other than cardiovascular disease (CVD). OBJECTIVE: The aim of this study was to assess the relation between fiber intake, mortality, and cause-specific mortality in a large European prospective study of 452,717 men and women. DESIGN: HRs and 95% CIs were estimated by using Cox proportional hazards models, stratified by age, sex, and center and adjusted for education, smoking, alcohol consumption, BMI, physical activity, total energy intake, and, in women, ever use of menopausal hormone therapy. RESULTS: During a mean follow-up of 12.7 y, a total of 23,582 deaths were recorded. Fiber intake was inversely associated with total mortality (HR(per 10-g/d increase): 0.90; 95% CI: 0.88, 0.92); with mortality from circulatory (HR(per 10-g/d increase): 0.90 and 0.88 for men and women, respectively), digestive (HR: 0.61 and 0.64), respiratory (HR: 0.77 and 0.62), and non-CVD noncancer inflammatory (HR: 0.85 and 0.80) diseases; and with smoking-related cancers (HR: 0.86 and 0.89) but not with non-smoking-related cancers (HR: 1.05 and 0.97). The associations were more evident for fiber from cereals and vegetables than from fruit. The associations were similar across BMI and physical activity categories but were stronger in smokers and participants who consumed >18 g alcohol/d. CONCLUSIONS: Higher fiber intake is associated with lower mortality, particularly from circulatory, digestive, and non-CVD noncancer inflammatory diseases. Our results support current recommendations of high dietary fiber intake for health maintenance

Fruit and vegetable intake and type 2 diabetes: EPIC-InterAct prospective study and meta-analysis

Cooper A.J., Forouhi N.G., Ye Z., Buijsse B., Arriola L., Balkau B., Barricarte A., Beulens J.W., Boeing H., Buchner F.L., Dahm C.C., de Lauzon-Guillain B., Fagherazzi G., Franks P.W., Gonzalez C., Grioni S., Kaaks R., Key T.J., Masala G., Navarro C., Nilsson P., Overvad K., Panico S., Ramon Quiros J., Rolandsson O., Roswall N., Sacerdote C., Sanchez M.J., Slimani N., Sluijs I., Spijkerman A.M., Teucher B., Tjonneland A., Tumino R., Sharp S.J., Langenberg C., Feskens E.J., Riboli E., Wareham N.J.

Eur J Clin Nutr; 2012; 66(10): 1082-1092

Abstract as provided by PubMed

Fruit and vegetable intake (FVI) may reduce the risk of type 2 diabetes (T2D), but the epidemiological evidence is inconclusive. The aim of this study is to examine the prospective association of FVI with T2D and conduct an updated meta-analysis. In the European Prospective Investigation into Cancer-InterAct (EPIC-InterAct) prospective case-cohort study nested within eight European countries, a representative sample of 16,154 participants and 12,403 incident cases of T2D were identified from 340,234 individuals with 3.99 million person-years of follow-up. For the meta-analysis we identified prospective studies on FVI and T2D risk by systematic searches of MEDLINE and EMBASE until April 2011. In EPIC-InterAct, estimated FVI by dietary questionnaires varied more than twofold between countries. In adjusted analyses the hazard ratio (95% confidence interval) comparing the highest with lowest quartile of reported intake was 0.90 (0.80-1.01) for FVI; 0.89 (0.76-1.04) for fruit and 0.94 (0.84-1.05) for vegetables. Among FV subtypes, only root vegetables were inversely associated with diabetes 0.87 (0.77-0.99). In meta-analysis using pooled data from five studies including EPIC-InterAct, comparing the highest with lowest category for FVI was associated with a lower relative risk of diabetes (0.93 (0.87-1.00)). Fruit or vegetables separately were not associated with diabetes. Among FV subtypes, only green leafy vegetable (GLV) intake (relative risk: 0.84 (0.74-0.94)) was inversely associated with diabetes. Subtypes of vegetables, such as root vegetables or GLVs may be beneficial for the prevention of diabetes, while total FVI may exert a weaker overall effect

Dietary fibre intake and ischaemic heart disease mortality: the European Prospective Investigation into Cancer and Nutrition-Heart study

Crowe F.L., Key T.J., Appleby P.N., Overvad K., Schmidt E.B., Egeberg R., Tjonneland A., Kaaks R., Teucher B., Boeing H., Weikert C., Trichopoulou A., Ouranos V., Valanou E., Masala G., Sieri S., Panico S., Tumino R., Matullo G., Bueno-de-Mesquita H.B., Boer J.M., Beulens J.W., van der Schouw Y.T., Quiros J.R., Buckland G., Sanchez M.J., Dorronsoro M., Huerta J.M., Moreno-Iribas C., Hedblad B., Jansson J.H., Wennberg P., Khaw K.T., Wareham N., Ferrari P., Illner A.K., Chuang S.C., Norat T., Danesh J., Riboli E.

Eur J Clin Nutr; 2012; 66(8): 950-956

Abstract as provided by PubMed

Background/objectives:Evidence from prospective studies is consistent in showing an inverse association between dietary fibre intake and risk of ischaemic heart disease (IHD), but whether dietary fibre from various food sources differ in their effect on IHD risk is less clear. The objective of this study was to assess the associations of total and food sources of dietary fibre with IHD mortality in the European Prospective Investigation into Cancer and Nutrition-Heart study.Subjects/methods:Participants were 306 331 men and women from eight European countries. Dietary fibre intake was assessed using centre or country-specific diet questionnaires and calibrated using a 24-h diet recall.Results:After an average follow-up of 11.5 years, there were 2381 IHD deaths among participants without cardiovascular disease at baseline. The calibrated intake of dietary fibre was inversely related with IHD mortality; each 10 g/day was associated with a 15% lower risk (relative risk (RR) 0.85; 95% confidence interval (CI): 0.73-0.99, P=0.031). There was no difference in the associations of the individual food sources of dietary fibre with the risk of IHD mortality; RR for each 5 g/day higher cereal fibre intake was 0.91 (CI: 0.82-1.01), RR for each 2.5 g/day fruit fibre intake was 0.94 (CI: 0.88-1.01) and RR for each 2.5 g/day vegetable fibre intake was 0.90 (95% CI: 0.76-1.07).Conclusion:A higher consumption of dietary fibre is associated with a lower risk of fatal IHD with no clear difference in the association with IHD for fibre from cereals, fruits or vegetables

Fatty acid patterns and risk of prostate cancer in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition

Dahm C.C., Gorst-Rasmussen A., Crowe F.L., Roswall N., Tjonneland A., Drogan D., Boeing H., Teucher B., Kaaks R., Adarakis G., Zylis D., Trichopoulou A., Fedirko V., Chajes V., Jenab M., Palli D., Pala V., Tumino R., Ricceri F., van Krane H., Bueno-de-Mesquita H.B., Quiros J.R., Sanchez M.J., Lujan-Barroso L., Larranaga N., Chirlaque M.D., Ardanaz E., Johansson M., Stattin P., Khaw K.T., Wareham N., Wark P.A., Norat T., Riboli E., Key T.J., Overvad K.

Am J Clin Nutr; 2012; 96(6): 1354-1361

Abstract as provided by PubMed

BACKGROUND: Fatty acids in blood may be related to the risk of prostate cancer, but epidemiologic evidence is inconsistent. Blood fatty acids are correlated through shared food sources and common endogenous desaturation and elongation pathways. Studies of individual fatty acids cannot take this into account, but pattern analysis can. Treelet transform (TT) is a novel method that uses data correlation structures to derive sparse factors that explain variation. OBJECTIVE: The objective was to gain further insight in the association between plasma fatty acids and risk of prostate cancer by applying TT to take data correlations into account. DESIGN: We reanalyzed previously published data from a case-control study of prostate cancer nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. TT was used to derive factors explaining the variation in 26 plasma phospholipid fatty acids of 962 incident prostate cancer cases matched to 1061 controls. Multiple imputation was used to deal with missing data in covariates. ORs of prostate cancer according to factor scores were determined by using multivariable conditional logistic regression. RESULTS: Four simple factors explained 38% of the variation in plasma fatty acids. A high score on a factor reflecting a long-chain n-3 PUFA pattern was associated with greater risk of prostate cancer (OR for highest compared with lowest quintile: 1.36; 95% CI: 0.99, 1.86; P-trend = 0.041). CONCLUSION: Pattern analyses using TT groupings of correlated fatty acids indicate that intake or metabolism of long-chain n-3 PUFAs may be relevant to prostate cancer etiology

Genetic variation in alcohol dehydrogenase (ADH1A, ADH1B, ADH1C, ADH7) and aldehyde dehydrogenase (ALDH2), alcohol consumption and gastric cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort

Duell E.J., Sala N., Travier N., Munoz X., Boutron-Ruault M.C., Clavel-Chapelon F., Barricarte A., Arriola L., Navarro C., Sanchez-Cantalejo E., Quiros J.R., Krogh V., Vineis P., Mattiello A., Tumino R., Khaw K.T., Wareham N., Allen N.E., Peeters P.H., Numans M.E., Bueno-de-Mesquita H.B., van Oijen M.G., Bamia C., Benetou V., Trichopoulos D., Canzian F., Kaaks R., Boeing H., Bergmann M.M., Lund E., Ehrnstrom R., Johansen D., Hallmans G., Stenling R., Tjonneland A., Overvad K., Ostergaard J.N., Ferrari P., Fedirko V., Jenab M., Nesi G., Riboli E., Gonzalez C.A.

Carcinogenesis; 2012; 33(2): 361-367

Abstract as provided by PubMed

Studies that have examined the association between alcohol consumption and gastric cancer (GC) risk have been inconsistent. We conducted an investigation of 29 genetic variants in alcohol metabolism loci (alcohol dehydrogenase, ADH1 gene cluster: ADH1A, ADH1B and ADH1C; ADH7 and aldehyde dehydrogenase, ALDH2), alcohol intake and GC risk. We analyzed data from a nested case-control study (364 cases and 1272 controls) within the European Prospective Investigation into Cancer and Nutrition cohort. Single nucleotide polymorphisms (SNPs) were genotyped using a customized array. We observed a statistically significant association between a common 3'-flanking SNP near ADH1A (rs1230025) and GC risk [allelic odds ratio (OR)(A v T) = 1.30, 95% confidence interval (CI) = 1.07-1.59]. Two intronic variants, one in ADH1C (rs283411) and one in ALDH2 (rs16941667), also were associated with GC risk (OR(T v C) = 0.59; 95% CI = 0.38-0.91 and OR(T v C) = 1.34; 95% CI = 1.00-1.79, respectively). Individuals carrying variant alleles at both ADH1 (rs1230025) and ALDH2 (rs16941667) were twice as likely to develop GC (OR(A+T) = 2.0; 95% CI = 1.25-3.20) as those not carrying variant alleles. The association between rs1230025 and GC was modified by alcohol intake (<5 g/day: OR(A) = 0.89, 95% CI = 0.57-1.39; >/=5 g/day: OR(A) = 1.45, 95% CI = 1.08-1.94, P-value = 0.05). The association was also modified by ethanol intake from beer. A known functional SNP in ADH1B (rs1229984) was associated with alcohol intake (P-value = 0.04) but not GC risk. Variants in ADH7 were not associated with alcohol intake or GC risk. In conclusion, genetic variants at ADH1 and ALDH2 loci may influence GC risk, and alcohol intake may further modify the effect of ADH1 rs1230025. Additional population-based studies are needed to confirm our results

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