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Search Result (484 REFERENCES)

2012

Identifying dietary patterns using a normal mixture model: application to the EPIC study

Fahey M.T., Ferrari P., Slimani N., Vermunt J.K., White I.R., Hoffmann K., Wirfalt E., Bamia C., Touvier M., Linseisen J., Rodriguez-Barranco M., Tumino R., Lund E., Overvad K., Bueno de Mesquita B., Bingham S., Riboli E.

J Epidemiol Community Health; 2012; 66(1): 89-94

Abstract as provided by PubMed

BACKGROUND: Finite mixture models posit the existence of a latent categorical variable and can be used for probabilistic classification. The authors illustrate the use of mixture models for dietary pattern analysis. An advantage of this approach is taking classification uncertainty into account. METHODS: Participants were a random sample of women from the European Prospective Investigation into Cancer. Food consumption was measured using dietary questionnaires. Mixture models identified latent classes in food consumption data, which were interpreted as dietary patterns. RESULTS: Among various assumptions examined, models allowing the variance of foods to vary within and between classes fit better than alternatives assuming constant variance (the K-means method of cluster analysis also makes the latter assumption). An eight-class model was best fitting and five patterns validated well in a second random sample. Patterns with lower classification uncertainty tended to be better validated. One pattern showed low consumption of foods despite being associated with moderate body mass index. CONCLUSION: Mixture modelling for dietary pattern analysis has advantages over both factor and cluster analysis. In contrast to these other methods, it is easy to estimate pattern prevalence, to describe patterns and to use patterns to predict disease taking classification uncertainty into account. Owing to substantial error in food consumptions, any analysis will usually find some patterns that cannot be well validated. While knowledge of classification uncertainty may aid pattern evaluation, any method will better identify patterns from food consumptions measured with less error. Mixture models may be useful to identify individuals who under-report food consumption

Prediagnostic 25-Hydroxyvitamin D, VDR and CASR Polymorphisms, and Survival in Patients with Colorectal Cancer in Western European Populations

Fedirko V., Riboli E., Tjonneland A., Ferrari P., Olsen A., Bueno-de-Mesquita H.B., van Duijnhoven F.J., Norat T., Jansen E.H., Dahm C.C., Overvad K., Boutron-Ruault M.C., Clavel-Chapelon F., Racine A., Lukanova A., Teucher B., Boeing H., Aleksandrova K., Trichopoulou A., Benetou V., Trichopoulos D., Grioni S., Vineis P., Panico S., Palli D., Tumino R., Siersema P.D., Peeters P.H., Skeie G., Brustad M., Chirlaque M.D., Barricarte A., Ramon Quiros J., Sanchez M.J., Dorronsoro M., Bonet C., Palmqvist R., Hallmans G., Key T.J., Crowe F., Khaw K.T., Wareham N., Romieu I., McKay J., Wark P.A., Romaguera D., Jenab M.

Cancer Epidemiol Biomarkers Prev; 2012; 21(4): 582-593

Abstract as provided by PubMed

BACKGROUND: Individuals with higher blood 25-hydroxyvitamin D [25(OH)D] levels have a lower risk of developing colorectal cancer (CRC), but the influence of 25(OH)D on mortality after CRC diagnosis is unknown. METHODS: The association between prediagnostic 25(OH)D levels and CRC-specific (N = 444) and overall mortality (N = 541) was prospectively examined among 1,202 participants diagnosed with CRC between 1992 and 2003 in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Multivariable Cox proportional hazards models were used to calculate HRs and corresponding 95% CIs according to 25(OH)D quintiles and genetic variation within the VDR and CASR genes. Potential dietary, lifestyle, and metabolic effect modifiers were also investigated. RESULTS: There were 541 deaths, 444 (82%) due to CRC. Mean follow-up was 73 months. In multivariable analysis, higher 25(OH)D levels were associated with a statistically significant reduction in CRC-specific (P(trend) = 0.04) and overall mortality (P(trend) = 0.01). Participants with 25(OH)D levels in the highest quintile had an adjusted HR of 0.69 (95% CI: 0.50-0.93) for CRC-specific mortality and 0.67 (95% CI: 0.50-0.88) for overall mortality, compared with the lowest quintile. Except for a possible interaction by prediagnostic dietary calcium intake (P(interaction) = 0.01), no other potential modifying factors related to CRC survival were noted. The VDR (FokI and BsmI) and CASR (rs1801725) genotypes were not associated with survival. CONCLUSIONS: High prediagnostic 25(OH)D levels are associated with improved survival of patients with CRC. Impact: Our findings may stimulate further research directed at investigating the effects of blood vitamin D levels before, at, and after CRC diagnosis on outcomes in CRC patients. Cancer Epidemiol Biomarkers Prev; 21(4); 582-93. (c)2012 AACR

Alcohol dehydrogenase and aldehyde dehydrogenase gene polymorphisms, alcohol intake and the risk of colorectal cancer in the European Prospective Investigation into Cancer and Nutrition study

Ferrari P., McKay J.D., Jenab M., Brennan P., Canzian F., Vogel U., Tjonneland A., Overvad K., Tolstrup J.S., Boutron-Ruault M.C., Clavel-Chapelon F., Morois S., Kaaks R., Boeing H., Bergmann M., Trichopoulou A., Katsoulis M., Trichopoulos D., Krogh V., Panico S., Sacerdote C., Palli D., Tumino R., Peeters P.H., Van Gils C.H., Bueno-de-Mesquita B., Vrieling A., Lund E., Hjartaker A., Agudo A., Suarez L.R., Arriola L., Chirlaque M.D., Ardanaz E., Sanchez M.J., Manjer J., Lindkvist B., Hallmans G., Palmqvist R., Allen N., Key T., Khaw K.T., Slimani N., Rinaldi S., Romieu I., Boffetta P., Romaguera D., Norat T., Riboli E.

Eur J Clin Nutr; 2012; 66(12): 1303-1308

Abstract as provided by PubMed

BACKGROUND/OBJECTIVES: Heavy alcohol drinking is a risk factor of colorectal cancer (CRC), but little is known on the effect of polymorphisms in the alcohol-metabolizing enzymes, alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) on the alcohol-related risk of CRC in Caucasian populations. SUBJECTS/METHODS: A nested case-control study (1269 cases matched to 2107 controls by sex, age, study centre and date of blood collection) was conducted within the European Prospective Investigation into Cancer and Nutrition (EPIC) to evaluate the impact of rs1229984 (ADH1B), rs1573496 (ADH7) and rs441 (ALDH2) polymorphisms on CRC risk. Using the wild-type variant of each polymorphism as reference category, CRC risk estimates were calculated using conditional logistic regression, with adjustment for matching factors. RESULTS: Individuals carrying one copy of the rs1229984(A) (ADH1B) allele (fast metabolizers) showed an average daily alcohol intake of 4.3 g per day lower than subjects with two copies of the rs1229984(G) allele (slow metabolizers) (P(diff)<0.01). None of the polymorphisms was associated with risk of CRC or cancers of the colon or rectum. Heavy alcohol intake was more strongly associated with CRC risk among carriers of the rs1573496(C) allele, with odds ratio equal to 2.13 (95% confidence interval: 1.26-3.59) compared with wild-type subjects with low alcohol consumption (P(interaction)=0.07). CONCLUSIONS: The rs1229984(A) (ADH1B) allele was associated with a reduction in alcohol consumption. The rs1229984 (ADH1B), rs1573496 (ADH7) and rs441 (ALDH2) polymorphisms were not associated with CRC risk overall in Western-European populations. However, the relationship between alcohol and CRC risk might be modulated by the rs1573496 (ADH7) polymorphism

Dietary reporting errors on 24 h recalls and dietary questionnaires are associated with BMI across six European countries as evaluated with recovery biomarkers for protein and potassium intake

Freisling H., van Bakel M.M., Biessy C., May A.M., Byrnes G., Norat T., Rinaldi S., Santucci de Magistris M., Grioni S., Bas Bueno-de-Mesquita H., Ocke M.C., Kaaks R., Teucher B., Vergnaud A.C., Romaguera D., Sacerdote C., Palli D., Crowe F.L., Tumino R., Clavel-Chapelon F., Boutron-Ruault M.C., Khaw K.T., Wareham N.J., Trichopoulou A., Naska A., Orfanos P., Boeing H., Illner A.K., Riboli E., Peeters P.H., Slimani N.

Br J Nutr; 2012; 107(6): 910-920

Abstract as provided by PubMed

Whether there are differences between countries in the validity of self-reported diet in relation to BMI, as evaluated using recovery biomarkers, is not well understood. We aimed to evaluate BMI-related reporting errors on 24 h dietary recalls (24-HDR) and on dietary questionnaires (DQ) using biomarkers for protein and K intake and whether the BMI effect differs between six European countries. Between 1995 and 1999, 1086 men and women participating in the European Prospective Investigation into Cancer and Nutrition completed a single 24-HDR, a DQ and one 24 h urine collection. In regression analysis, controlling for age, sex, education and country, each unit (1 kg/m2) increase in BMI predicted an approximately 1.7 and 1.3 % increase in protein under-reporting on 24-HDR and DQ, respectively (both P < 0.0001). Exclusion of individuals who probably misreported energy intake attenuated BMI-related bias on both instruments. The BMI effect on protein under-reporting did not differ for men and women and neither between countries on both instruments as tested by interaction (all P>0.15). In women, but not in men, the DQ yielded higher mean intakes of protein that were closer to the biomarker-based measurements across BMI groups when compared with 24-HDR. Results for K were similar to those of protein, although BMI-related under-reporting of K was of a smaller magnitude, suggesting differential misreporting of foods. Under-reporting of protein and K appears to be predicted by BMI, but this effect may be driven by 'low-energy reporters'. The BMI effect on under-reporting seems to be the same across countries

Social inequalities and mortality in Europe--results from a large multi-national cohort

Gallo V., Mackenbach J.P., Ezzati M., Menvielle G., Kunst A.E., Rohrmann S., Kaaks R., Teucher B., Boeing H., Bergmann M.M., Tjonneland A., Dalton S.O., Overvad K., Redondo M.L., Agudo A., Daponte A., Arriola L., Navarro C., Gurrea A.B., Khaw K.T., Wareham N., Key T., Naska A., Trichopoulou A., Trichopoulos D., Masala G., Panico S., Contiero P., Tumino R., Bueno-de-Mesquita H.B., Siersema P.D., Peeters P.P., Zackrisson S., Almquist M., Eriksson S., Hallmans G., Skeie G., Braaten T., Lund E., Illner A.K., Mouw T., Riboli E., Vineis P.

PLoS ONE; 2012; 7(7): e39013

Abstract as provided by PubMed

BACKGROUND: Socio-economic inequalities in mortality are observed at the country level in both North America and Europe. The purpose of this work is to investigate the contribution of specific risk factors to social inequalities in cause-specific mortality using a large multi-country cohort of Europeans. METHODS: A total of 3,456,689 person/years follow-up of the European Prospective Investigation into Cancer and Nutrition (EPIC) was analysed. Educational level of subjects coming from 9 European countries was recorded as proxy for socio-economic status (SES). Cox proportional hazard model's with a step-wise inclusion of explanatory variables were used to explore the association between SES and mortality; a Relative Index of Inequality (RII) was calculated as measure of relative inequality. RESULTS: Total mortality among men with the highest education level is reduced by 43% compared to men with the lowest (HR 0.57, 95% C.I. 0.52-0.61); among women by 29% (HR 0.71, 95% C.I. 0.64-0.78). The risk reduction was attenuated by 7% in men and 3% in women by the introduction of smoking and to a lesser extent (2% in men and 3% in women) by introducing body mass index and additional explanatory variables (alcohol consumption, leisure physical activity, fruit and vegetable intake) (3% in men and 5% in women). Social inequalities were highly statistically significant for all causes of death examined in men. In women, social inequalities were less strong, but statistically significant for all causes of death except for cancer-related mortality and injuries. DISCUSSION: In this European study, substantial social inequalities in mortality among European men and women which cannot be fully explained away by accounting for known common risk factors for chronic diseases are reported

Fruit and vegetable intake and the risk of gastric adenocarcinoma: A reanalysis of the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST) study after a longer follow-up

Gonzalez C.A., Lujan-Barroso L., Bueno-de-Mesquita H.B., Jenab M., Duell E.J., Agudo A., Tjonneland A., Boutron-Ruault M.C., Clavel-Chapelon F., Touillaud M., Teucher B., Kaaks R., Boeing H., Steffen A., Trichopoulou A., Roukos D., Karapetyan T., Palli D., Tagliabue G., Mattiello A., Tumino R., Ricceri F., Siersema P.D., Numans M.E., Peeters P.P., Parr C.L., Skeie G., Lund E., Quiros J.R., Sanchez-Cantalejo E., Navarro C., Barricarte A., Dorronsoro M., Ehrnstrom R., Regner S., Khaw K.T., Wareham N., Key T.J., Crowe F.L., Blaker H., Romieu I., Riboli E.

Int J Cancer; 2012; 131(12): 2910-2919

Abstract as provided by PubMed

In a previous European prospective investigation into cancer and nutrition (EPIC) analysis, we found an inverse association between total intake of vegetables, onion and garlic, and risk of intestinal gastric cancer (GC) and between citrus fruit and risk of cardia GC. The aim of this study is to reanalyze the effect of fruit and vegetables (F&V), based on a longer follow-up and twice the number of GC cases. Subjects are 477,312 men and women mostly aged 35 to 70 years participating in the EPIC cohort, including 683 gastric adenocarcinomas with 11 years of follow-up. Information on diet and lifestyle was collected at baseline. A calibration study in a subsample was used to correct for dietary measurement errors. When comparing the highest vs. lowest quintile of intake, we found an inverse association between total intake of V&F and GC risk [hazard ratio (HR) 0.77; 95% confidence interval (CI) 0.57-1.04; p for trend 0.02], between fresh fruit and risk of the diffuse type (HR 0.59; 95% CI 0.36-0.97; p for trend 0.03) and an inverse association between citrus fruit and risk of cardia cancer (HR 0.61; 95% CI 0.38-1.00, p for trend 0.01). Although calibration revealed somewhat stronger inverse associations, none of the risks reached statistical significance. There was no association between total or specific vegetables intake and GC risk. The inverse association between fresh fruit and citrus fruits and risk of GC seems to be restricted to smokers and the Northern European countries. Fresh fruit and citrus fruit consumption may protect against diffuse and cardia GC, respectively

Cigarette smoking and risk of histological subtypes of epithelial ovarian cancer in the EPIC cohort study

Gram I.T., Lukanova A., Brill I., Braaten T., Lund E., Lundin E., Overvad K., Tjonneland A., Clavel-Chapelon F., Chabbert-Buffet N., Bamia C., Trichopoulou A., Zylis D., Masala G., Berrino F., Galasso R., Tumino R., Sacerdote C., Gavrilyuk O., Kristiansen S., Rodriguez L., Bonet C., Huerta J.M., Barricarte A., Sanchez M.J., Dorronsoro M., Jirstrom K., Almquist M., Idahl A., Bueno-de-Mesquita H.B., Braem M., Onland-Moret C., Tsilidis K.K., Allen N.E., Fedirko V., Riboli E., Kaaks R.

Int J Cancer; 2012; 130(9): 2204-2210

Abstract as provided by PubMed

New data regarding a positive association between smoking and risk of epithelial ovarian cancer (EOC), especially the mucinous tumor type, has started to emerge. The purpose of this study was to examine the association between different measures of smoking exposures and subtypes of EOC in a large cohort of women from 10 European countries. The European Prospective Investigation into Cancer and Nutrition (EPIC) cohort is a multicenter prospective study initiated in 1992. The questionnaires included data about dietary, lifestyle, and health factors. Information about cigarette smoking was collected from individuals in all participating countries. We used Cox proportional hazard regression models to estimate hazard ratio (HR) of EOC overall and serous, mucinous, and endometroid histological subtypes, with 95% confidence intervals (CIs) associated with different measures of smoking exposures adjusting for confounding variables. Altogether 836 incident EOC cases were identified among 326,831 women. The tumors were classified as 400 serous, 83 mucinous, 80 endometroid, 35 clear cell, and 238 unspecified. Compared with never smokers, current smokers had a significantly increased risk for mucinous tumors [HR = 1.85 (95% CI 1.08-3.16)] and those smoking more than 10 cigarettes per day had a doubling in risk [HR = 2.25(95% CI 1.26-4.03)] as did those who had smoked less than 15 pack-years of cigarettes [HR = 2.18 (95% CI 1.07-4.43)]. The results from the EPIC study add further evidence that smoking increases risk of mucinous ovarian cancer and support the notion that the effect of smoking varies according to histological subtype

The association of circulating adiponectin levels with pancreatic cancer risk: a study within the prospective EPIC cohort

Grote V.A., Rohrmann S., Dossus L., Nieters A., Halkjaer J., Tjonneland A., Overvad K., Stegger J., Chabbert-Buffet N., Boutron-Ruault M.C., Clavel-Chapelon F., Teucher B., Becker S., Montonen J., Boeing H., Trichopoulou A., Lagiou P., Trichopoulos D., Palli D., Sieri S., Tumino R., Vineis P., Mattiello A., Arguelles M., Duell E.J., Molina-Montes E., Larranaga N., Chirlaque M.D., Gurrea A.B., Jeurnink S.M., Peeters P.H., Ye W., Sund M., Lindkvist B., Johansen D., Khaw K.T., Wareham N., Crowe F.L., Romieu I., Rinaldi S., Jenab M., Romaguera D., Michaud D.S., Riboli E., Bas Bueno-de-Mesquita H., Kaaks R.

Int J Cancer; 2012; 130(10): 2428-2437

Abstract as provided by PubMed

Excess body weight and type 2 diabetes mellitus, risk factors of pancreatic cancer, are characterized by decreased levels of adiponectin. In addition to anti-inflammatory and anti-proliferative actions, adiponectin has an important role in regulating glucose metabolism, i.e., decreasing circulating blood glucose levels. Prospectively, hyperglycemia has been associated with risk of pancreatic cancer. The aim of this study was to investigate the association of pre-diagnostic adiponectin levels with pancreatic cancer risk. We conducted a case-control study nested within European Prospective Investigation into Cancer and Nutrition. Blood samples of 452 pancreatic cancer cases and 452 individually matched controls were analyzed by immunoassays. Multivariate conditional logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI). Overall, adiponectin showed no association with pancreas cancer risk; however, among never smokers, higher circulating levels of adiponectin were associated with a reduction in pancreatic cancer risk (OR = 0.44 [95% CI 0.23-0.82] for highest vs. lowest quartile), whereas among current smokers there was no significant association (OR = 1.59 [95% CI 0.67-3.76] for highest vs. lowest quartile; p-trend = 0.530; p-interaction = 0.309). In our study, lower adiponectin concentrations may be associated with the development of pancreatic cancer among never smokers, whereas the only other prospective study being conducted so far showed a decrease in risk among male smokers. Therefore, further studies are needed to clarify the role of adiponectin in pancreatic cancer development

The associations of advanced glycation end products and its soluble receptor with pancreatic cancer risk: a case-control study within the prospective EPIC Cohort

Grote V.A., Nieters A., Kaaks R., Tjonneland A., Roswall N., Overvad K., Nielsen M.R., Clavel-Chapelon F., Boutron-Ruault M.C., Racine A., Teucher B., Lukanova A., Boeing H., Drogan D., Trichopoulou A., Trichopoulos D., Lagiou P., Palli D., Sieri S., Tumino R., Vineis P., Mattiello A., Arguelles Suarez M.V., Duell E.J., Sanchez M.J., Dorronsoro M., Huerta Castano J.M., Barricarte A., Jeurnink S.M., Peeters P.H., Sund M., Ye W., Regner S., Lindkvist B., Khaw K.T., Wareham N., Allen N.E., Crowe F.L., Fedirko V., Jenab M., Romaguera D., Siddiq A., Bueno-de-Mesquita H.B., Rohrmann S.

Cancer Epidemiol Biomarkers Prev; 2012; 21(4): 619-628

Abstract as provided by PubMed

BACKGROUND: Advanced glycation end products (AGE) and their receptors (RAGE) have been implicated in cancer development through their proinflammatory capabilities. However, prospective data on their association with cancer of specific sites, including pancreatic cancer, are limited. METHODS: Prediagnostic blood levels of the AGE product Nepsilon-(carboxymethyl)lysine (CML) and the endogenous secreted receptor for AGE (esRAGE) were measured using ELISA in 454 patients with exocrine pancreatic cancer and individually matched controls within the European Prospective Investigation into Cancer and Nutrition (EPIC). Pancreatic cancer risk was estimated by calculating ORs with corresponding 95% confidence intervals (CI). RESULTS: Elevated CML levels tended to be associated with a reduction in pancreatic cancer risk [OR = 0.57 (95% CI, 0.32-1.01) comparing highest with lowest quintile), whereas no association was observed for esRAGE (OR = 0.98; 95% CI, 0.62-1.54). Adjustments for body mass index and smoking attenuated the inverse associations of CML with pancreatic cancer risk (OR = 0.78; 95% CI, 0.41-1.49). There was an inverse association between esRAGE and risk of pancreatic cancer for cases that were diagnosed within the first 2 years of follow-up [OR = 0.46 (95% CI, 0.22-0.96) for a doubling in concentration], whereas there was no association among those with a longer follow-up (OR = 1.11; 95% CI, 0.88-1.39; P(interaction) = 0.002). CONCLUSIONS AND IMPACT: Our results do not provide evidence for an association of higher CML or lower esRAGE levels with risk of pancreatic cancer. The role of AGE/RAGE in pancreatic cancer would benefit from further investigations

Inflammation marker and risk of pancreatic cancer: a nested case-control study within the EPIC cohort

Grote V.A., Kaaks R., Nieters A., Tjonneland A., Halkjaer J., Overvad K., Skjelbo Nielsen M.R., Boutron-Ruault M.C., Clavel-Chapelon F., Racine A., Teucher B., Becker S., Pischon T., Boeing H., Trichopoulou A., Cassapa C., Stratigakou V., Palli D., Krogh V., Tumino R., Vineis P., Panico S., Rodriguez L., Duell E.J., Sanchez M.J., Dorronsoro M., Navarro C., Gurrea A.B., Siersema P.D., Hm Peeters P., Ye W., Sund M., Lindkvist B., Johansen D., Khaw K.T., Wareham N., Allen N.E., Travis R.C., Fedirko V., Jenab M., Michaud D.S., Chuang S.C., Romaguera D., Bueno-de-Mesquita H.B., Rohrmann S.

Br J Cancer; 2012; 106(11): 1866-1874

Abstract as provided by PubMed

Background:Established risk factors for pancreatic cancer include smoking, long-standing diabetes, high body fatness, and chronic pancreatitis, all of which can be characterised by aspects of inflammatory processes. However, prospective studies investigating the relation between inflammatory markers and pancreatic cancer risk are scarce.Methods:We conducted a nested case-control study within the European Prospective Investigation into Cancer and Nutrition, measuring prediagnostic blood levels of C-reactive protein (CRP), interleukin-6 (IL-6), and soluble receptors of tumour necrosis factor-alpha (sTNF-R1, R2) in 455 pancreatic cancer cases and 455 matched controls. Odds ratios (ORs) were estimated using conditional logistic regression models.Results:None of the inflammatory markers were significantly associated with risk of pancreatic cancer overall, although a borderline significant association was observed for higher circulating sTNF-R2 (crude OR=1.52 (95% confidence interval (CI) 0.97-2.39), highest vs lowest quartile). In women, however, higher sTNF-R1 levels were significantly associated with risk of pancreatic cancer (crude OR=1.97 (95% CI 1.02-3.79)). For sTNF-R2, risk associations seemed to be stronger for diabetic individuals and those with a higher BMI.Conclusion:Prospectively, CRP and IL-6 do not seem to have a role in our study with respect to risk of pancreatic cancer, whereas sTNF-R1 seemed to be a risk factor in women and sTNF-R2 might be a mediator in the risk relationship between overweight and diabetes with pancreatic cancer. Further large prospective studies are needed to clarify the role of proinflammatory proteins and cytokines in the pathogenesis of exocrine pancreatic cancer

A risk model for lung cancer incidence

Hoggart C., Brennan P., Tjonneland A., Vogel U., Overvad K., Ostergaard J.N., Kaaks R., Canzian F., Boeing H., Steffen A., Trichopoulou A., Bamia C., Trichopoulos D., Johansson M., Palli D., Krogh V., Tumino R., Sacerdote C., Panico S., Boshuizen H., Bueno-de-Mesquita H.B., Peeters P.H., Lund E., Gram I.T., Braaten T., Rodriguez L., Agudo A., Sanchez-Cantalejo E., Arriola L., Chirlaque M.D., Barricarte A., Rasmuson T., Khaw K.T., Wareham N., Allen N.E., Riboli E., Vineis P.

Cancer Prev Res (Phila); 2012; 5(6): 834-846

Abstract as provided by PubMed

Risk models for lung cancer incidence would be useful for prioritizing individuals for screening and participation in clinical trials of chemoprevention. We present a risk model for lung cancer built using prospective cohort data from a general population which predicts individual incidence in a given time period. We build separate risk models for current and former smokers using 169,035 ever smokers from the multicenter European Prospective Investigation into Cancer and Nutrition (EPIC) and considered a model for never smokers. The data set was split into independent training and test sets. Lung cancer incidence was modeled using survival analysis, stratifying by age started smoking, and for former smokers, also smoking duration. Other risk factors considered were smoking intensity, 10 occupational/environmental exposures previously implicated with lung cancer, and single-nucleotide polymorphisms at two loci identified by genome-wide association studies of lung cancer. Individual risk in the test set was measured by the predicted probability of lung cancer incidence in the year preceding last follow-up time, predictive accuracy was measured by the area under the receiver operator characteristic curve (AUC). Using smoking information alone gave good predictive accuracy: the AUC and 95% confidence interval in ever smokers was 0.843 (0.810-0.875), the Bach model applied to the same data gave an AUC of 0.775 (0.737-0.813). Other risk factors had negligible effect on the AUC, including never smokers for whom prediction was poor. Our model is generalizable and straightforward to implement. Its accuracy can be attributed to its modeling of lifetime exposure to smoking. Cancer Prev Res; 5(6); 834-46. (c)2012 AACR

Validity of a short questionnaire to assess physical activity in 10 European countries

InterAct Consortium

Eur J Epidemiol; 2012; 27(1): 15-25

Abstract as provided by PubMed

To accurately examine associations of physical activity (PA) with disease outcomes, a valid method of assessing free-living activity is required. We examined the validity of a brief PA questionnaire (PAQ) used in the European Prospective Investigation into Cancer and Nutrition (EPIC). PA energy expenditure (PAEE) and time spent in moderate and vigorous physical activity (MVPA) was measured in 1,941 healthy individuals from 10 European countries using individually-calibrated combined heart-rate and movement sensing. Participants also completed the short EPIC-PAQ, which refers to past year's activity. Pearson (r) and Spearman (sigma) correlation coefficients were calculated for each country, and random effects meta-analysis was used to calculate the combined correlation across countries to estimate the validity of two previously- and one newly-derived ordered, categorical PA indices ("Cambridge index", "total PA index", and "recreational index") that categorized individuals as inactive, moderately inactive, moderately active, or active. The strongest associations with PAEE and MVPA were observed for the Cambridge index (r = 0.33 and r = 0.25, respectively). No significant heterogeneity by country was observed for this index (I(2) = 36.3%, P = 0.12; I(2) = 0.0%, P = 0.85), whereas heterogeneity was suggested for other indices (I(2) > 48%, P < 0.05, I(2) > 47%, P < 0.05). PAEE increased linearly across self-reported PA categories (P for trend <0.001), with an average difference of approximately 460 kJ/d for men and 365 kJ/d for women, between categories of the Cambridge index. The EPIC-PAQ is suitable for categorizing European men and women into four distinct categories of overall physical activity. The difference in PAEE between categories may be useful when estimating effect sizes from observational research

Dietary intake of heme iron and risk of gastric cancer in the European Prospective Investigation into Cancer and Nutrition study

Jakszyn P., Agudo A., Lujan-Barroso L., Bueno-de-Mesquita H.B., Jenab M., Navarro C., Palli D., Boeing H., Manjer J., Numans M.E., Igali L., Boutron-Ruault M.C., Clavel-Chapelon F., Morois S., Grioni S., Panico C., Tumino R., Sacerdote C., Quiros J.R., Molina-Montes E., Ma Huerta Castano J., Barricarte A., Amiano P., Khaw K.T., Wareham N., Allen N.E., Key T.J., Jeurnink S.M., Peeters P.H., Bamia C., Valanou E., Trichopoulou A., Kaaks R., Lukanova A., Bergmann M.M., Lindkvist B., Stenling R., Johansson I., Dahm C.C., Overvad K., Olsen A., Tjonneland A., Skeie G., Ragnhild Broderstad A., Lund E., Michaud D.S., Mouw T., Riboli E., Gonzalez C.A.

Int J Cancer; 2012; 130(11): 2654-2663

Abstract as provided by PubMed

Even though recent studies suggest that a high intake of heme iron is associated with several types of cancer, epidemiological studies in relation to gastric cancer (GC) are lacking. Our previous results show a positive association between red and processed meat and non cardia gastric cancer, especially in Helicobacter pylori infected subjects. The aim of the study is to investigate the association between heme iron intake and GC risk in the European prospective investigation into cancer and nutrition (EURGAST-EPIC). Dietary intake was assessed by validated center-specific questionnaires. Heme iron was calculated as a type-specific percentage of the total iron content in meat intake, derived from the literature. Antibodies of H. pylori infection and vitamin C levels were measured in a sub-sample of cases and matched controls included in a nested case-control study within the cohort. The study included 481,419 individuals and 444 incident cases of GC that occurred during an average of 8.7 years of followup. We observed a statistically significant association between heme iron intake and GC risk (HR 1.13 95% CI: 1.01-1.26 for a doubling of intake) adjusted by sex, age, BMI, education level, tobacco smoking and energy intake. The positive association between heme iron and the risk of GC was statistically significant in subjects with plasma vitamin C <39 mmol/l only (log2 HR 1.54 95% CI (1.01-2.35). We found a positive association between heme iron intake and gastric cancer risk

Nitrosamines and heme iron and risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition

Jakszyn P.G., Allen N.E., Lujan-Barroso L., Gonzalez C.A., Key T.J., Fonseca-Nunes A., Tjonneland A., Fons-Johnsen N., Overvad K., Teucher B., Li K., Boeing H., Trichopoulou A., Oikonomou E., Sarantopoulou M., Saieva C., Krogh V., Tumino R., Ricceri F., Bueno-de-Mesquita H.B., Huerta J.M., Ardanaz E., Arguelles M.V., Molina-Montes E., Larranaga N., Wirfalt E., Wallstrom P., Johansson M., Stattin P., Khaw K.T., Jenab M., Fedirko V., Riboli E.

Cancer Epidemiol Biomarkers Prev; 2012; 21(3): 547-551

Abstract as provided by PubMed

BACKGROUND: The evidence about nitrosamines and heme iron intake and cancer risk is limited, despite the biologic plausibility of the hypothesis that these factors might increase cancer risk. We investigated the association between dietary nitrosamines and heme iron and the risk of prostate cancer among participants of European Prospective Investigation into Cancer and Nutrition (EPIC). METHODS: Data on food consumption and complete follow-up for cancer occurrence was available for 139,005 men, recruited in 8 European countries. Estimates of HRs were obtained by proportional hazard models, stratified by age at recruitment, and study center, and adjusted for total energy intake, smoking status, marital status, dairy products, educational level, and body mass index. RESULTS: After a mean follow-up of 10 years, 4,606 participants were diagnosed with first incident prostate cancer. There was no overall association between prostate cancer risk and nitrosamines exposure (preformed and endogenous) or heme iron intake (HR for a doubling of intake: 1.00; 95% CI: 0.98-1.03 for N-Nitrosodimethlyamine, 0.95; 95% CI: 0.88-1.03 for endogenous Nitrosocompounds, and 1.00; 95 CI: 0.97-1.03 for heme iron). Conclusions and Impact: Our findings do not support an effect of nitrosamines (endogenous and exogenous) and heme iron intake on prostate cancer risk. Cancer Epidemiol Biomarkers Prev; 21(3); 547-51. (c)2012 AACR

Variety in vegetable and fruit consumption and the risk of gastric and esophageal cancer in the European Prospective Investigation into Cancer and Nutrition

Jeurnink S.M., Buchner F.L., Bueno-de-Mesquita H.B., Siersema P.D., Boshuizen H.C., Numans M.E., Dahm C.C., Overvad K., Tjonneland A., Roswall N., Clavel-Chapelon F., Boutron-Ruault M.C., Morois S., Kaaks R., Teucher B., Boeing H., Buijsse B., Trichopoulou A., Benetou V., Zylis D., Palli D., Sieri S., Vineis P., Tumino R., Panico S., Ocke M.C., Peeters P.H., Skeie G., Brustad M., Lund E., Sanchez-Cantalejo E., Navarro C., Amiano P., Ardanaz E., Ramon Quiros J., Hallmans G., Johansson I., Lindkvist B., Regner S., Khaw K.T., Wareham N., Key T.J., Slimani N., Norat T., Vergnaud A.C., Romaguera D., Gonzalez C.A.

Int J Cancer; 2012; 131(6): E963-E973

Abstract as provided by PubMed

Diets high in vegetables and fruits have been suggested to be inversely associated with risk of gastric cancer. However, the evidence of the effect of variety of consumption is limited. We therefore investigated whether consumption of a variety of vegetables and fruit is associated with gastric and esophageal cancer in the European Prospective Investigation into Cancer and Nutrition study. Data on food consumption and follow-up on cancer incidence were available for 452,269 participants from 10 European countries. After a mean follow-up of 8.4 years, 475 cases of gastric and esophageal adenocarcinomas (180 noncardia, 185 cardia, gastric esophageal junction and esophagus, 110 not specified) and 98 esophageal squamous cell carcinomas were observed. Diet Diversity Scores were used to quantify the variety in vegetable and fruit consumption. We used multivariable Cox proportional hazard models to calculate risk ratios. Independent from quantity of consumption, variety in the consumption of vegetables and fruit combined and of fruit consumption alone were statistically significantly inversely associated with the risk of esophageal squamous cell carcinoma (continuous hazard ratio per 2 products increment 0.88; 95% CI 0.79-0.97 and 0.76; 95% CI 0.62-0.94, respectively) with the latter particularly seen in ever smokers. Variety in vegetable and/or fruit consumption was not associated with risk of gastric and esophageal adenocarcinomas. Independent from quantity of consumption, more variety in vegetable and fruit consumption combined and in fruit consumption alone may decrease the risk of esophageal squamous cell carcinoma. However, residual confounding by lifestyle factors cannot be excluded

Intake estimation of total and individual flavan-3-ols, proanthocyanidins and theaflavins, their food sources and determinants in the European Prospective Investigation into Cancer and Nutrition (EPIC) study

Knaze V., Zamora-Ros R., Lujan-Barroso L., Romieu I., Scalbert A., Slimani N., Riboli E., van Rossum C.T., Bueno-de-Mesquita H.B., Trichopoulou A., Dilis V., Tsiotas K., Skeie G., Engeset D., Ramon Quiros J., Molina E., Huerta J.M., Crowe F., Wirfal E., Ericson U., Peeters P.H., Kaaks R., Teucher B., Johansson G., Johansson I., Tumino R., Boeing H., Drogan D., Amiano P., Mattiello A., Khaw K.T., Luben R., Krogh V., Ardanaz E., Sacerdote C., Salvini S., Overvad K., Tjonneland A., Olsen A., Boutron-Ruault M.C., Fagherazzi G., Perquier F., Gonzalez C.A.

Br J Nutr; 2012; 108(6): 1095-1108

Abstract as provided by PubMed

Epidemiological studies suggest health-protective effects of flavan-3-ols and their derived compounds on chronic diseases. The present study aimed to estimate dietary flavan-3-ol, proanthocyanidin (PA) and theaflavin intakes, their food sources and potential determinants in the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration cohort. Dietary data were collected using a standardised 24 h dietary recall software administered to 36 037 subjects aged 35-74 years. Dietary data were linked with a flavanoid food composition database compiled from the latest US Department of Agriculture and Phenol-Explorer databases and expanded to include recipes, estimations and retention factors. Total flavan-3-ol intake was the highest in UK Health-conscious men (453.6 mg/d) and women of UK General population (377.6 mg/d), while the intake was the lowest in Greece (men: 160.5 mg/d; women: 124.8 mg/d). Monomer intake was the highest in UK General population (men: 213.5 mg/d; women: 178.6 mg/d) and the lowest in Greece (men: 26.6 mg/d in men; women: 20.7 mg/d). Theaflavin intake was the highest in UK General population (men: 29.3 mg/d; women: 25.3 mg/d) and close to zero in Greece and Spain. PA intake was the highest in Asturias (men: 455.2 mg/d) and San Sebastian (women: 253 mg/d), while being the lowest in Greece (men: 134.6 mg/d; women: 101.0 mg/d). Except for the UK, non-citrus fruits (apples/pears) were the highest contributors to the total flavan-3-ol intake. Tea was the main contributor of total flavan-3-ols in the UK. Flavan-3-ol, PA and theaflavin intakes were significantly different among all assessed groups. This study showed heterogeneity in flavan-3-ol, PA and theaflavin intake throughout the EPIC countries

Plasma cotinine levels and pancreatic cancer in the EPIC cohort study

Leenders M., Chuang S.C., Dahm C.C., Overvad K., Ueland P.M., Midttun O., Vollset S.E., Tjonneland A., Halkjaer J., Jenab M., Clavel-Chapelon F., Boutron-Ruault M.C., Kaaks R., Canzian F., Boeing H., Weikert C., Trichopoulou A., Bamia C., Naska A., Palli D., Pala V., Mattiello A., Tumino R., Sacerdote C., van Duijnhoven F.J., Peeters P.H., Van Gils C.H., Lund E., Rodriguez L., Duell E.J., Perez M.J., Molina-Montes E., Castano J.M., Barricarte A., Larranaga N., Johansen D., Lindkvist B., Sund M., Ye W., Khaw K.T., Wareham N.J., Michaud D.S., Riboli E., Xun W.W., Allen N.E., Crowe F.L., Bueno-de-Mesquita H.B., Vineis P.

Int J Cancer; 2012; 131(4): 997-1002

Abstract as provided by PubMed

Smoking is an established risk factor for pancreatic cancer, previously investigated by the means of questionnaires. Using cotinine as a biomarker for tobacco exposure allows more accurate quantitative analyses to be performed. This study on pancreatic cancer, nested within the European Prospective Investigation into Cancer and Nutrition (EPIC cohort), included 146 cases and 146 matched controls. Using liquid chromatography-mass spectrometry, plasma cotinine levels were analyzed on average 8.0 years before cancer onset (5-95% range: 2.8-12.0 years). The relation between plasma cotinine levels and pancreatic cancer was analyzed with conditional logistic regression for different levels of cotinine in a population of never and current smokers. This was also done for the self-reported number of smoked cigarettes per day at baseline. Every increase of 350 nmol/L of plasma cotinine was found to significantly elevate risk of pancreatic cancer [odds ratio (OR): 1.33, 95% confidence interval (CI): 1.11-1.60]. People with a cotinine level over 1187.8 nmol/L, a level comparable to smoking 17 cigarettes per day, have an elevated risk of pancreatic cancer, compared to people with cotinine levels below 55 nmol/L (OR: 3.66, 95% CI: 1.44-9.26). The results for self-reported smoking at baseline also show an increased risk of pancreatic cancer from cigarette smoking based on questionnaire information. People who smoke more than 30 cigarettes per day showed the highest risk compared to never smokers (OR: 4.15, 95% CI: 1.02-16.42). This study is the first to show that plasma cotinine levels are strongly related to pancreatic cancer

Educational level and risk of colorectal cancer in EPIC with specific reference to tumor location

Leufkens A.M., van Duijnhoven F.J., Boshuizen H.C., Siersema P.D., Kunst A.E., Mouw T., Tjonneland A., Olsen A., Overvad K., Boutron-Ruault M.C., Clavel-Chapelon F., Morois S., Krogh V., Tumino R., Panico S., Polidoro S., Palli D., Kaaks R., Teucher B., Pischon T., Trichopoulou A., Orfanos P., Goufa I., Peeters P.H., Skeie G., Braaten T., Rodriguez L., Lujan-Barroso L., Sanchez-Perez M.J., Navarro C., Barricarte A., Zackrisson S., Almquist M., Hallmans G., Palmqvist R., Tsilidis K.K., Khaw K.T., Wareham N., Gallo V., Jenab M., Riboli E., Bueno-de-Mesquita H.B.

Int J Cancer; 2012; 130(3): 622-630

Abstract as provided by PubMed

Existing evidence is inconclusive on whether socioeconomic status (SES) and educational inequalities influence colorectal cancer (CRC) risk, and whether low or high SES/educational level is associated with developing CRC. The aim of our study was to investigate the relationship between educational level and CRC. We studied data from 400,510 participants in the EPIC (European Prospective Investigation into Cancer and Nutrition) study, of whom 2,447 developed CRC (colon: 1,551, rectum: 896, mean follow-up 8.3 years). Cox proportional hazard regression analysis stratified by age, gender and center, and adjusted for potential confounders were used to estimate hazard ratios (HR) and 95% confidence intervals (95%CI). Relative indices of inequality (RII) for education were estimated using Cox regression models. We conducted separate analyses for tumor location, gender and geographical region. Compared with participants with college/university education, participants with vocational secondary education or less had a nonsignificantly lower risk of developing CRC. When further stratified for tumor location, adjusted risk estimates for the proximal colon were statistically significant for primary education or less (HR 0.73, 95%CI 0.57-0.94) and for vocational secondary education (HR 0.76, 95%CI 0.58-0.98). The inverse association between low education and CRC risk was particularly found in women and Southern Europe. These associations were statistically significant for CRC, for colon cancer and for proximal colon cancer. In conclusion, CRC risk, especially in the proximal colon, is lower in subjects with a lower educational level compared to those with a higher educational level. This association is most pronounced in women and Southern Europe

Biomarkers of oxidative stress and risk of developing colorectal cancer: a cohort-nested case-control study in the European Prospective Investigation Into Cancer and Nutrition

Leufkens A.M., van Duijnhoven F.J., Woudt S.H., Siersema P.D., Jenab M., Jansen E.H., Pischon T., Tjonneland A., Olsen A., Overvad K., Boutron-Ruault M.C., Clavel-Chapelon F., Morois S., Palli D., Pala V., Tumino R., Vineis P., Panico S., Kaaks R., Lukanova A., Boeing H., Aleksandrova K., Trichopoulou A., Trichopoulos D., Dilis V., Peeters P.H., Skeie G., Gonzalez C.A., Arguelles M., Sanchez M.J., Dorronsoro M., Huerta J.M., Ardanaz E., Hallmans G., Palmqvist R., Khaw K.T., Wareham N., Allen N.E., Crowe F.L., Fedirko V., Norat T., Riboli E., Bueno-de-Mesquita H.B.

Am J Epidemiol; 2012; 175(7): 653-663

Abstract as provided by PubMed

Oxidative stress has been shown to play an important role in carcinogenesis, but prospective evidence for an association between biomarkers of oxidative stress and colorectal cancer (CRC) risk is limited. The authors investigated the association between prediagnostic serum levels of oxidative stress indicators (i.e., reactive oxygen metabolites (ROM) and ferric reducing ability of plasma (FRAP)) and CRC risk. This was examined in a nested case-control study (1,064 CRC cases, 1,064 matched controls) in the European Prospective Investigation Into Cancer and Nutrition cohort (1992-2003). Incidence rate ratios and 95% confidence intervals were calculated using conditional logistic regression analyses. ROM were associated with overall CRC risk (highest tertile vs. lowest: adjusted incidence rate ratio (IRR(adj)) = 1.91, 95% confidence interval (CI): 1.47, 2.48), proximal (IRR(adj) = 1.89, 95% CI: 1.06, 3.36) and distal (IRR(adj) = 2.31, 95% CI: 1.37, 3.89) colon cancer, and rectal cancer (IRR(adj) = 1.69, 95% CI: 1.05, 2.72). When results were stratified by tertile of follow-up time, the association remained significant only in participants with less than 2.63 years of follow-up (IRR(adj) = 2.28, 95% CI: 1.78, 2.94; P-heterogeneity < 0.01). FRAP was not associated with CRC risk. In conclusion, prediagnostic serum ROM levels were associated with increased risk of CRC. However, this association was seen only in subjects with relatively short follow-up, suggesting that the association results from production of reactive oxygen species by preclinical tumors

Dietary intake of iron, heme-iron and magnesium and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition cohort

Molina-Montes E., Wark P.A., Sanchez M.J., Norat T., Jakszyn P., Lujan-Barroso L., Michaud D.S., Crowe F., Allen N., Khaw K.T., Wareham N., Trichopoulou A., Adarakis G., Katarachia H., Skeie G., Henningsen M., Broderstad A.R., Berrino F., Tumino R., Palli D., Mattiello A., Vineis P., Amiano P., Barricarte A., Huerta J.M., Duell E.J., Quiros J.R., Ye W., Sund M., Lindkvist B., Johansen D., Overvad K., Tjonneland A., Roswall N., Li K., Grote V.A., Steffen A., Boeing H., Racine A., Boutron-Ruault M.C., Carbonnel F., Peeters P.H., Siersema P.D., Fedirko V., Jenab M., Riboli E., Bueno-de-Mesquita B.

Int J Cancer; 2012; 131(7): E1134-E1147

Abstract as provided by PubMed

Several studies support a protective effect of dietary magnesium against type 2 diabetes, but a harmful effect for iron. As diabetes has been linked to pancreatic cancer, intake of these nutrients may be also associated with this cancer. We examined the association between dietary intake of magnesium, total iron and heme-iron and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. In total, 142,203 men and 334,999 women, recruited between 1992 and 2000, were included. After an average follow-up of 11.3 years, 396 men and 469 women developed exocrine pancreatic cancer. Hazard ratios and 95% confidence intervals (CIs) were obtained using Cox regression stratified by age and center, and adjusted for energy intake, smoking status, height, weight, and self-reported diabetes status. Neither intake of magnesium, total iron nor heme-iron was associated with pancreatic cancer risk. In stratified analyses, a borderline inverse association was observed among overweight men (body mass index, >/=25 kg/m(2) ) with magnesium (HR(per 100 mg/day increase) = 0.79, 95% CI = 0.63-1.01) although this was less apparent using calibrated intake. In female smokers, a higher intake of heme-iron was associated with a higher pancreatic cancer risk (HR (per 1 mg/day increase) = 1.38, 95% CI = 1.10-1.74). After calibration, this risk increased significantly to 2.5-fold (95% CI = 1.22-5.28). Overall, dietary magnesium, total iron and heme-iron were not associated with pancreatic cancer risk during the follow-up period. Our observation that heme-iron was associated with increased pancreatic cancer risk in female smokers warrants replication in additional study populations

Dietary Fibre Intake and Risks of Cancers of the Colon and Rectum in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Murphy N., Norat T., Ferrari P., Jenab M., Bueno-de-Mesquita B., Skeie G., Dahm C.C., Overvad K., Olsen A., Tjonneland A., Clavel-Chapelon F., Boutron-Ruault M.C., Racine A., Kaaks R., Teucher B., Boeing H., Bergmann M.M., Trichopoulou A., Trichopoulos D., Lagiou P., Palli D., Pala V., Panico S., Tumino R., Vineis P., Siersema P., van Duijnhoven F., Peeters P.H., Hjartaker A., Engeset D., Gonzalez C.A., Sanchez M.J., Dorronsoro M., Navarro C., Ardanaz E., Quiros J.R., Sonestedt E., Ericson U., Nilsson L., Palmqvist R., Khaw K.T., Wareham N., Key T.J., Crowe F.L., Fedirko V., Wark P.A., Chuang S.C., Riboli E.

PLoS ONE; 2012; 7(6): e39361

Abstract as provided by PubMed

BACKGROUND: Earlier analyses within the EPIC study showed that dietary fibre intake was inversely associated with colorectal cancer risk, but results from some large cohort studies do not support this finding. We explored whether the association remained after longer follow-up with a near threefold increase in colorectal cancer cases, and if the association varied by gender and tumour location. METHODOLOGY/PRINCIPAL FINDINGS: After a mean follow-up of 11.0 years, 4,517 incident cases of colorectal cancer were documented. Total, cereal, fruit, and vegetable fibre intakes were estimated from dietary questionnaires at baseline. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models stratified by age, sex, and centre, and adjusted for total energy intake, body mass index, physical activity, smoking, education, menopausal status, hormone replacement therapy, oral contraceptive use, and intakes of alcohol, folate, red and processed meats, and calcium. After multivariable adjustments, total dietary fibre was inversely associated with colorectal cancer (HR per 10 g/day increase in fibre 0.87, 95% CI: 0.79-0.96). Similar linear associations were observed for colon and rectal cancers. The association between total dietary fibre and risk of colorectal cancer risk did not differ by age, sex, or anthropometric, lifestyle, and dietary variables. Fibre from cereals and fibre from fruit and vegetables were similarly associated with colon cancer; but for rectal cancer, the inverse association was only evident for fibre from cereals. CONCLUSIONS/SIGNIFICANCE: Our results strengthen the evidence for the role of high dietary fibre intake in colorectal cancer prevention

Comparison of standardised dietary folate intake across ten countries participating in the European Prospective Investigation into Cancer and Nutrition

Park J.Y., Nicolas G., Freisling H., Biessy C., Scalbert A., Romieu I., Chajes V., Chuang S.C., Ericson U., Wallstrom P., Ros M.M., Peeters P.H., Mattiello A., Palli D., Maria Huerta J., Amiano P., Halkjaer J., Dahm C.C., Trichopoulou A., Orfanos P., Teucher B., Feller S., Skeie G., Engeset D., Boutron-Ruault M.C., Clavel-Chapelon F., Crowe F., Khaw K.T., Vineis P., Slimani N.

Br J Nutr; 2012; 108(3): 552-569

Abstract as provided by PubMed

Folate plays an important role in the synthesis and methylation of DNA as a cofactor in one-carbon metabolism. Inadequate folate intake has been linked to adverse health events. However, comparable information on dietary folate intake across European countries has never been reported. The objective of the present study was to describe the dietary folate intake and its food sources in ten countries in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. A cross-sectional analysis was conducted in 36 034 participants (aged 35-74 years) who completed a single 24 h dietary recall using a computerised interview software program, EPIC-Soft(R) (International Agency for Research on Cancer, Lyon). Dietary folate intake was estimated using the standardised EPIC Nutrient DataBase, adjusted for age, energy intake, weight and height and weighted by season and day of recall. Adjusted mean dietary folate intake in most centres ranged from 250 to 350 mug/d in men and 200 to 300 mug/d in women. Folate intake tended to be lower among current smokers and heavier alcohol drinkers and to increase with educational level, especially in women. Supplement users (any types) were likely to report higher dietary folate intake in most centres. Vegetables, cereals and fruits, nuts and seeds were the main contributors to folate intake. Nonetheless, the type and pattern of consumption of these main food items varied across the centres. These first comparisons of standardised dietary folate intakes across different European populations show moderate regional differences (except the UK health conscious group), and variation by sex, educational level, smoking and alcohol-drinking status, and supplement use

The prospective association between total and type of fish intake and type 2 diabetes in 8 European countries: EPIC-InterAct Study

Patel P.S., Forouhi N.G., Kuijsten A., Schulze M.B., van Woudenbergh G.J., Ardanaz E., Amiano P., Arriola L., Balkau B., Barricarte A., Beulens J.W., Boeing H., Buijsse B., Crowe F.L., de Lauzon-Guillan B., Fagherazzi G., Franks P.W., Gonzalez C., Grioni S., Halkjaer J., Huerta J.M., Key T.J., Kuhn T., Masala G., Nilsson P., Overvad K., Panico S., Quiros J.R., Rolandsson O., Sacerdote C., Sanchez M.J., Schmidt E.B., Slimani N., Spijkerman A.M., Teucher B., Tjonneland A., Tormo M.J., Tumino R., van der A D.L., van der Schouw Y.T., Sharp S.J., Langenberg C., Feskens E.J., Riboli E., Wareham N.J.

Am J Clin Nutr; 2012; 95(6): 1445-1453

Abstract as provided by PubMed

BACKGROUND: Epidemiologic evidence of an association between fish intake and type 2 diabetes (T2D) is inconsistent and unresolved. OBJECTIVE: The objective was to examine the association between total and type of fish intake and T2D in 8 European countries. DESIGN: This was a case-cohort study, nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) study, with 3.99 million person-years of follow-up, 12,403 incident diabetes cases, and a random subcohort of 16,835 individuals from 8 European countries. Habitual fish intake (lean fish, fatty fish, total fish, shellfish, and combined fish and shellfish) was assessed by country-specific dietary questionnaires. HRs were estimated in each country by using Prentice-weighted Cox regression models and pooled by using a random-effects meta-analysis. RESULTS: No overall association was found between combined fish and shellfish intake and incident T2D per quartile (adjusted HR: 1.00; 95% CI: 0.94, 1.06; P-trend = 0.99). Total fish, lean fish, and shellfish intakes separately were also not associated with T2D, but fatty fish intake was weakly inversely associated with T2D: adjusted HR per quartile 0.97 (0.94, 1.00), with an HR of 0.84 (0.70, 1.01), 0.85 (0.76, 0.95), and 0.87 (0.78, 0.97) for a comparison of the second, third, and fourth quartiles with the lowest quartile of intake, respectively (P-trend = 0.06). CONCLUSIONS: These findings suggest that lean fish, total fish, and shellfish intakes are not associated with incident diabetes but that fatty fish intake may be weakly inversely associated. Replication of these findings in other populations and investigation of the mechanisms underlying these associations are warranted. Meanwhile, current public health recommendations on fish intake should remain unchanged

Insulin-like Growth Factor-I Concentration and Risk of Prostate Cancer: Results from the European Prospective Investigation into Cancer and Nutrition

Price A.J., Allen N.E., Appleby P.N., Crowe F.L., Travis R.C., Tipper S.J., Overvad K., Gronbaek H., Tjonneland A., Johnsen N.F., Rinaldi S., Kaaks R., Lukanova A., Boeing H., Aleksandrova K., Trichopoulou A., Trichopoulos D., Andarakis G., Palli D., Krogh V., Tumino R., Sacerdote C., Bueno-de-Mesquita H.B., Arguelles M.V., Sanchez M.J., Chirlaque M.D., Barricarte A., Larranaga N., Gonzalez C.A., Stattin P., Johansson M., Khaw K.T., Wareham N., Gunter M., Riboli E., Key T.

Cancer Epidemiol Biomarkers Prev; 2012; 21(9): 1531-1541

Abstract as provided by PubMed

BACKGROUND: High circulating insulin-like growth factor-I (IGF-I) concentrations have been associated with increased risk for prostate cancer in several prospective epidemiological studies. In this study, we investigate the association between circulating IGF-I concentration and risk of prostate cancer over the long term in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. METHODS: In a nested case-control design, 1,542 incident prostate cancer cases from eight European countries were individually matched to 1,542 controls by study center, age at recruitment, duration of follow-up, time of day, and duration of fasting at blood collection. Conditional logistic regression models were used to calculate risk for prostate cancer associated with IGF-I concentration, overall and by various subgroups. RESULTS: Circulating IGF-I concentration was associated with a significant increased risk for prostate cancer [OR for highest vs. lowest quartile, 1.69; 95% confidence interval (CI), 1.35-2.13; P(trend) = 0.0002]. This positive association did not differ according to duration of follow-up [ORs for highest vs. lowest quartile were 2.01 (1.35-2.99), 1.37 (0.94-2.00), and 1.80 (1.17-2.77) for cancers diagnosed <4, 4-7, and >7 years after blood collection, respectively (P(heterogeneity) = 0.77)] or by stage, grade, and age at diagnosis or age at blood collection (all subgroups P(heterogeneity) >0.05). CONCLUSION: In this European population, high circulating IGF-I concentration is positively associated with risk for prostate cancer over the short and long term. Impact: As IGF-I is the only potentially modifiable risk factor so far identified, research into the effects of reducing circulating IGF-I levels on subsequent prostate cancer risk is warranted. Cancer Epidemiol Biomarkers Prev; 21(9); 1531-41. (c)2012 AACR

Concentrations of IGF-I and IGFBP-3 and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition

Rohrmann S., Grote V.A., Becker S., Rinaldi S., Tjonneland A., Roswall N., Gronbaek H., Overvad K., Boutron-Ruault M.C., Clavel-Chapelon F., Racine A., Teucher B., Boeing H., Drogan D., Dilis V., Lagiou P., Trichopoulou A., Palli D., Tagliabue G., Tumino R., Vineis P., Mattiello A., Rodriguez L., Duell E.J., Molina-Montes E., Dorronsoro M., Huerta J.M., Ardanaz E., Jeurnink S., Peeters P.H., Lindkvist B., Johansen D., Sund M., Ye W., Khaw K.T., Wareham N.J., Allen N.E., Crowe F.L., Fedirko V., Jenab M., Michaud D.S., Norat T., Riboli E., Bueno-de-Mesquita H.B., Kaaks R.

Br J Cancer; 2012; 106(5): 1004-1010

Abstract as provided by PubMed

Background:Insulin-like growth factors (IGFs) and their binding proteins (BPs) regulate cell differentiation, proliferation and apoptosis, and may have a role in the aetiology of various cancers. Information on their role in pancreatic cancer is limited and was examined here in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition.Methods:Serum concentrations of IGF-I and IGFBP-3 were measured using enzyme-linked immunosorbent assays in 422 cases and 422 controls matched on age, sex, study centre, recruitment date, and time since last meal. Conditional logistic regression was used to compute odds ratios (OR) and 95% confidence intervals (CI) adjusted for confounding variables.Results:Neither circulating levels of IGF-I (OR=1.21, 95% CI 0.75-1.93 for top vs bottom quartile, P-trend 0.301), IGFBP-3 (OR=1.00, 95% CI 0.66-1.51, P-trend 0.79), nor the molar IGF-I/IGFBP-3 ratio, an indicator of free IGF-I level (OR=1.22, 95% CI 0.75-1.97, P-trend 0.27), were statistically significantly associated with the risk of pancreatic cancer. In a cross-classification, however, a high concentration of IGF-I with concurrently low levels of IGFBP-3 was related to an increased risk of pancreatic cancer (OR=1.72, 95% CI 1.05-2.83; P-interaction=0.154).Conclusion:On the basis of these results, circulating levels of components of the IGF axis do not appear to be the risk factors for pancreatic cancer. However, on the basis of the results of a subanalysis, it cannot be excluded that a relatively large amount of IGF-1 together with very low levels of IGFBP-3 might still be associated with an increase in pancreatic cancer risk

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