You are here: Home

Search Result (502 REFERENCES)

2017

The association between adult attained height and sitting height with mortality in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Sawada N., Wark P. A., Merritt M. A., Tsugane S., Ward H. A., Rinaldi S., Weiderpass E., Dartois L., His M., Boutron-Ruault M. C., Turzanski-Fortner R., Kaaks R., Overvad K., Redondo M. L., Travier N., Molina-Portillo E., Dorronsoro M., Cirera L., Ardanaz E., Perez-Cornago A., Trichopoulou A., Lagiou P., Valanou E., Masala G., Pala V., Hm Peeters P., T. van der Schouw Y, Melander O., Manjer J., da Silva M., Skeie G., Tjonneland A., Olsen A., J. Gunter M, Riboli E., J. Cross A

PLoS ONE; 2017; 12(3): e0173117

PMID:28257491

Abstract as provided by PubMed

Adult height and sitting height may reflect genetic and environmental factors, including early life nutrition, physical and social environments. Previous studies have reported divergent associations for height and chronic disease mortality, with positive associations observed for cancer mortality but inverse associations for circulatory disease mortality. Sitting height might be more strongly associated with insulin resistance; however, data on sitting height and mortality is sparse. Using the European Prospective Investigation into Cancer and Nutrition study, a prospective cohort of 409,748 individuals, we examined adult height and sitting height in relation to all-cause and cause-specific mortality. Height was measured in the majority of participants; sitting height was measured in ~253,000 participants. During an average of 12.5 years of follow-up, 29,810 deaths (11,931 from cancer and 7,346 from circulatory disease) were identified. Hazard ratios (HR) with 95% confidence intervals (CI) for death were calculated using multivariable Cox regression within quintiles of height. Height was positively associated with cancer mortality (men: HRQ5 vs. Q1 = 1.11, 95%CI = 1.00-1.24; women: HRQ5 vs. Q1 = 1.17, 95%CI = 1.07-1.28). In contrast, height was inversely associated with circulatory disease mortality (men: HRQ5 vs. Q1 = 0.63, 95%CI = 0.56-0.71; women: HRQ5 vs. Q1 = 0.81, 95%CI = 0.70-0.93). Although sitting height was not associated with cancer mortality, it was inversely associated with circulatory disease (men: HRQ5 vs. Q1 = 0.64, 95%CI = 0.55-0.75; women: HRQ5 vs. Q1 = 0.60, 95%CI = 0.49-0.74) and respiratory disease mortality (men: HRQ5 vs. Q1 = 0.45, 95%CI = 0.28-0.71; women: HRQ5 vs. Q1 = 0.60, 95%CI = 0.40-0.89). We observed opposing effects of height on cancer and circulatory disease mortality. Sitting height was inversely associated with circulatory disease and respiratory disease mortality.

Pre-diagnostic metabolite concentrations and prostate cancer risk in 1077 cases and 1077 matched controls in the European Prospective Investigation into Cancer and Nutrition

Schmidt J. A., Fensom G. K., Rinaldi S., Scalbert A., Appleby P. N., Achaintre D., Gicquiau A., Gunter M. J., Ferrari P., Kaaks R., Kuhn T., Floegel A., Boeing H., Trichopoulou A., Lagiou P., Anifantis E., Agnoli C., Palli D., Trevisan M., Tumino R., Bueno-de-Mesquita H. B., Agudo A., Larranaga N., Redondo-Sanchez D., Barricarte A., Huerta J. M., Quiros J. R., Wareham N., Khaw K. T., Perez-Cornago A., Johansson M., Cross A. J., Tsilidis K. K., Riboli E., Key T. J., Travis R. C.

BMC Med; 2017; 15(1): 122

PMID:28676103

Abstract as provided by PubMed

BACKGROUND: Little is known about how pre-diagnostic metabolites in blood relate to risk of prostate cancer. We aimed to investigate the prospective association between plasma metabolite concentrations and risk of prostate cancer overall, and by time to diagnosis and tumour characteristics, and risk of death from prostate cancer. METHODS: In a case-control study nested in the European Prospective Investigation into Cancer and Nutrition, pre-diagnostic plasma concentrations of 122 metabolites (including acylcarnitines, amino acids, biogenic amines, glycerophospholipids, hexose and sphingolipids) were measured using targeted mass spectrometry (AbsoluteIDQ p180 Kit) and compared between 1077 prostate cancer cases and 1077 matched controls. Risk of prostate cancer associated with metabolite concentrations was estimated by multi-variable conditional logistic regression, and multiple testing was accounted for by using a false discovery rate controlling procedure. RESULTS: Seven metabolite concentrations, i.e. acylcarnitine C18:1, amino acids citrulline and trans-4-hydroxyproline, glycerophospholipids PC aa C28:1, PC ae C30:0 and PC ae C30:2, and sphingolipid SM (OH) C14:1, were associated with prostate cancer (p < 0.05), but none of the associations were statistically significant after controlling for multiple testing. Citrulline was associated with a decreased risk of prostate cancer (odds ratio (OR1SD) = 0.73; 95% confidence interval (CI) 0.62-0.86; p trend = 0.0002) in the first 5 years of follow-up after taking multiple testing into account, but not after longer follow-up; results for other metabolites did not vary by time to diagnosis. After controlling for multiple testing, 12 glycerophospholipids were inversely associated with advanced stage disease, with risk reduction up to 46% per standard deviation increase in concentration (OR1SD = 0.54; 95% CI 0.40-0.72; p trend = 0.00004 for PC aa C40:3). Death from prostate cancer was associated with higher concentrations of acylcarnitine C3, amino acids methionine and trans-4-hydroxyproline, biogenic amine ADMA, hexose and sphingolipid SM (OH) C14:1 and lower concentration of glycerophospholipid PC aa C42:4. CONCLUSIONS: Several metabolites, i.e. C18:1, citrulline, trans-4-hydroxyproline, three glycerophospholipids and SM (OH) C14:1, might be related to prostate cancer. Analyses by time to diagnosis indicated that citrulline may be a marker of subclinical prostate cancer, while other metabolites might be related to aetiology. Several glycerophospholipids were inversely related to advanced stage disease. More prospective data are needed to confirm these associations.

Vasectomy and Prostate Cancer Risk in the European Prospective Investigation Into Cancer and Nutrition (EPIC)

Smith K., Byrne, Castano J. M., Chirlaque M. D., Lilja H., Agudo A., Ardanaz E., Rodriguez-Barranco M., Boeing H., Kaaks R., Khaw K. T., Larranaga N., Navarro C., Olsen A., Overvad K., Perez-Cornago A., Rohrmann S., Sanchez M. J., Tjonneland A., Tsilidis K. K., Johansson M., Riboli E., Key T. J., Travis R. C.

J Clin Oncol; 2017; 35(12): 1297-1303

PMID:28375714

Abstract as provided by PubMed

Purpose Vasectomy is a commonly used form of male sterilization, and some studies have suggested that it may be associated with an increased risk of prostate cancer, including more aggressive forms of the disease. We investigated the prospective association of vasectomy with prostate cancer in a large European cohort, with a focus on high-grade and advanced-stage tumors, and death due to prostate cancer. Patients and Methods A total of 84,753 men from the European Prospective Investigation into Cancer and Nutrition (EPIC), aged 35 to 79 years, provided information on vasectomy status (15% with vasectomy) at recruitment and were followed for incidence of prostate cancer and death. We estimated the association of vasectomy with prostate cancer risk overall, by tumor subtype, and for death due to prostate cancer, using multivariable-adjusted Cox proportional hazards models. Results During an average follow-up of 15.4 years, 4,377 men were diagnosed with prostate cancer, including 641 who had undergone a vasectomy. Vasectomy was not associated with prostate cancer risk (hazard ratio [HR], 1.05; 95% CI, 0.96 to 1.15), and no evidence for heterogeneity in the association was observed by stage of disease or years since vasectomy. There was some evidence of heterogeneity by tumor grade ( P = .02), with an increased risk for low-intermediate grade (HR, 1.14; 95% CI, 1.01 to 1.29) but not high-grade prostate cancer (HR, 0.83; 95% CI, 0.64 to 1.07). Vasectomy was not associated with death due to prostate cancer (HR, 0.88; 95% CI, 0.68 to 1.12). Conclusion These findings from a large European prospective study show no elevated risk for overall, high-grade or advanced-stage prostate cancer, or death due to prostate cancer in men who have undergone a vasectomy compared with men who have not.

Circulating copper and zinc levels and risk of hepatobiliary cancers in Europeans

Stepien M., Hughes D. J., Hybsier S., Bamia C., Tjonneland A., Overvad K., Affret A., His M., Boutron-Ruault M. C., Katzke V., Kuhn T., Aleksandrova K., Trichopoulou A., Lagiou P., Orfanos P., Palli D., Sieri S., Tumino R., Ricceri F., Panico S., Bueno-de-Mesquita H. B., Peeters P. H., Weiderpass E., Lasheras C., Bonet Bonet C., Molina-Portillo E., Dorronsoro M., Huerta J. M., Barricarte A., Ohlsson B., Sjoberg K., Werner M., Shungin D., Wareham N., Khaw K. T., Travis R. C., Freisling H., Cross A. J., Schomburg L., Jenab M.

Br J Cancer; 2017; 116(5): 688-696

PMID:28152549

Abstract as provided by PubMed

BACKGROUND: Copper and zinc are essential micronutrients and cofactors of many enzymatic reactions that may be involved in liver-cancer development. We aimed to assess pre-diagnostic circulating levels of copper, zinc and their ratio (Cu/Zn) in relation to hepatocellular carcinoma (HCC), intrahepatic bile duct (IHBD) and gall bladder and biliary tract (GBTC) cancers. METHODS: A nested case-control study was conducted within the European Prospective Investigation into Cancer and Nutrition cohort. Serum zinc and copper levels were measured in baseline blood samples by total reflection X-ray fluorescence in cancer cases (HCC n=106, IHDB n=34, GBTC n=96) and their matched controls (1:1). The Cu/Zn ratio, an indicator of the balance between the micronutrients, was computed. Multivariable adjusted odds ratios and 95% confidence intervals (OR; 95% CI) were used to estimate cancer risk. RESULTS: For HCC, the highest vs lowest tertile showed a strong inverse association for zinc (OR=0.36; 95% CI: 0.13-0.98, Ptrend=0.0123), but no association for copper (OR=1.06; 95% CI: 0.45-2.46, Ptrend=0.8878) in multivariable models. The calculated Cu/Zn ratio showed a positive association for HCC (OR=4.63; 95% CI: 1.41-15.27, Ptrend=0.0135). For IHBC and GBTC, no significant associations were observed. CONCLUSIONS: Zinc may have a role in preventing liver-cancer development, but this finding requires further investigation in other settings.

Pre-diagnostic copper and zinc biomarkers and colorectal cancer risk in the European Prospective Investigation into Cancer and Nutrition cohort

Stepien M., Jenab M., Freisling H., Becker N. P., Czuban M., Tjonneland A., Olsen A., Overvad K., Boutron-Ruault M. C., Mancini F. R., Savoye I., Katzke V., Kuhn T., Boeing H., Iqbal K., Trichopoulou A., Bamia C., Orfanos P., Palli D., Sieri S., Tumino R., Naccarati A., Panico S., Bueno-de-Mesquita H. B. A., Peeters P. H., Weiderpass E., Merino S., Jakszyn P., Sanchez M. J., Dorronsoro M., Huerta J. M., Barricarte A., Boden S., van Guelpen B., Wareham N., Khaw K. T., Bradbury K. E., Cross A. J., Schomburg L., Hughes D. J.

Carcinogenesis; 2017; 38(7): 699-707

PMID:28575311

Abstract as provided by PubMed

Adequate intake of copper and zinc, two essential micronutrients, are important for antioxidant functions. Their imbalance may have implications for development of diseases like colorectal cancer (CRC), where oxidative stress is thought to be etiologically involved. As evidence from prospective epidemiologic studies is lacking, we conducted a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort to investigate the association between circulating levels of copper and zinc, and their calculated ratio, with risk of CRC development. Copper and zinc levels were measured by reflection X-ray fluorescence spectrometer in 966 cases and 966 matched controls. Multivariable adjusted odds ratios (OR) and 95% confidence intervals (CI) were calculated using conditional logistic regression and are presented for the fifth versus first quintile. Higher circulating concentration of copper was associated with a raised CRC risk (OR = 1.50; 95% CI: 1.06, 2.13; P-trend = 0.02) whereas an inverse association with cancer risk was observed for higher zinc levels (OR = 0.65; 95% CI: 0.43, 0.97; P-trend = 0.07). Consequently, the ratio of copper/zinc was positively associated with CRC (OR = 1.70; 95% CI: 1.20, 2.40; P-trend = 0.0005). In subgroup analyses by follow-up time, the associations remained statistically significant only in those diagnosed within 2 years of blood collection. In conclusion, these data suggest that copper or copper levels in relation to zinc (copper to zinc ratio) become imbalanced in the process of CRC development. Mechanistic studies into the underlying mechanisms of regulation and action are required to further examine a possible role for higher copper and copper/zinc ratio levels in CRC development and progression.

Measured Adiposity in Relation to Head and Neck Cancer Risk in the European Prospective Investigation into Cancer and Nutrition

Ward H. A., Wark P. A., Muller D. C., Steffen A., Johansson M., Norat T., Gunter M. J., Overvad K., Dahm C. C., Halkjaer J., Tjonneland A., Boutron-Ruault M. C., Fagherazzi G., Mesrine S., Brennan P., Freisling H., Li K., Kaaks R., Trichopoulou A., Lagiou P., Panico S., Grioni S., Tumino R., Vineis P., Palli D., Peeters P. H. M., Bueno-de-Mesquita H. B., Weiderpass E., Agudo A., Quiros J. R., Larranaga N., Ardanaz E., Huerta J. M., Sanchez M. J., Laurell G., Johansson I., Westin U., Wallstrom P., Bradbury K. E., Wareham N. J., Khaw K. T., Pearson C., Boeing H., Riboli E.

Cancer Epidemiol Biomarkers Prev; 2017; 26(6): 895-904

PMID:28183827

Abstract as provided by PubMed

Background: Emerging evidence from cohort studies indicates that adiposity is associated with greater incidence of head and neck cancer. However, most studies have used self-reported anthropometry which is prone to error.Methods: Among 363,094 participants in the European Prospective Investigation into Cancer and Nutrition study (EPIC) with measured anthropometry, there were 837 incident cases of head and neck cancer. Head and neck cancer risk was examined in relation to body mass index (BMI) [lean: <22.5 kg/m2, normal weight (reference): 22.5-24.9 kg/m2, overweight 25-29.9 kg/m2, obese: >/=30 kg/m2], waist circumference (WC), hip circumference (HC), and waist-to-hip ratio (WHR) using Cox proportional hazards models.Results: Among men, a BMI < 22.5 kg/m2 was associated with higher head and neck cancer risk [HR 1.62; 95% confidence interval (CI), 1.23-2.12)]; BMI was not associated with head and neck cancer among women. WC and WHR were associated with greater risk of head and neck cancer among women (WC per 5 cm: HR, 1.08; 95% CI, 1.02-1.15; WHR per 0.1 unit: HR, 1.64; 95% CI, 1.38-1.93). After stratification by smoking status, the association for WHR was present only among smokers (Pinteraction = 0.004). Among men, WC and WHR were associated with head and neck cancer only upon additional adjustment for BMI (WC per 5 cm: HR 1.16; 95% CI, 1.07-1.26; WHR per 0.1 unit: HR, 1.42; 95% CI, 1.21-1.65).Conclusions: Central adiposity, particularly among women, may have a stronger association with head and neck cancer risk than previously estimated.Impact: Strategies to reduce obesity may beneficially impact head and neck cancer incidence. Cancer Epidemiol Biomarkers Prev; 26(6); 895-904. (c)2017 AACR.

Dietary flavonoid intake and colorectal cancer risk in the European prospective investigation into cancer and nutrition (EPIC) cohort

Zamora-Ros R., Barupal D. K., Rothwell J. A., Jenab M., Fedirko V., Romieu I., Aleksandrova K., Overvad K., Kyro C., Tjonneland A., Affret A., His M., Boutron-Ruault M. C., Katzke V., Kuhn T., Boeing H., Trichopoulou A., Naska A., Kritikou M., Saieva C., Agnoli C., Santucci de Magistris M., Tumino R., Fasanelli F., Weiderpass E., Skeie G., Merino S., Jakszyn P., Sanchez M. J., Dorronsoro M., Navarro C., Ardanaz E., Sonestedt E., Ericson U., Maria Nilsson L., Boden S., Bueno-de-Mesquita H. B., Peeters P. H., Perez-Cornago A., Wareham N. J., Khaw K. T., Freisling H., Cross A. J., Riboli E., Scalbert A.

Int J Cancer; 2017; 140(8): 1836-1844

PMID:28006847

Abstract as provided by PubMed

Flavonoids have been shown to inhibit colon cancer cell proliferation in vitro and protect against colorectal carcinogenesis in animal models. However, epidemiological evidence on the potential role of flavonoid intake in colorectal cancer (CRC) development remains sparse and inconsistent. We evaluated the association between dietary intakes of total flavonoids and their subclasses and risk of development of CRC, within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. A cohort of 477,312 adult men and women were recruited in 10 European countries. At baseline, dietary intakes of total flavonoids and individual subclasses were estimated using centre-specific validated dietary questionnaires and composition data from the Phenol-Explorer database. During an average of 11 years of follow-up, 4,517 new cases of primary CRC were identified, of which 2,869 were colon (proximal = 1,298 and distal = 1,266) and 1,648 rectal tumours. No association was found between total flavonoid intake and the risk of overall CRC (HR for comparison of extreme quintiles 1.05, 95% CI 0.93-1.18; p-trend = 0.58) or any CRC subtype. No association was also observed with any intake of individual flavonoid subclasses. Similar results were observed for flavonoid intake expressed as glycosides or aglycone equivalents. Intake of total flavonoids and flavonoid subclasses, as estimated from dietary questionnaires, did not show any association with risk of CRC development.

Consumption of Fish Is Not Associated with Risk of Differentiated Thyroid Carcinoma in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study

Zamora-Ros R., Castaneda J., Rinaldi S., Cayssials V., Slimani N., Weiderpass E., Tsilidis K. K., Boutron-Ruault M. C., Overvad K., Eriksen A. K., Tjonneland A., Kuhn T., Katzke V., Boeing H., Trichopoulou A., La Vecchia C., Kotanidou A., Palli D., Grioni S., Mattiello A., Tumino R., Sciannameo V., Lund E., Merino S., Salamanca-Fernandez E., Amiano P., Huerta J. M., Barricarte A., Ericson U., Almquist M., Hennings J., Sandstrom M., Bueno-de-Mesquita H. B., Peeters P. H., Khaw K. T., Wareham N. J., Schmidt J. A., Cross A. J., Riboli E., Scalbert A., Romieu I., Agudo A., Franceschi S.

J Nutr; 2017; 147(7): 1366-1373

PMID:28592517

Abstract as provided by PubMed

Background: Differentiated thyroid cancer (TC) is the most common endocrine cancer. Fish can be an important source of iodine and other micronutrients and contaminants that may affect the thyroid gland and TC risk.Objective: We prospectively evaluated the relations between the consumption of total fish and different fish types and shellfish and TC risk in the EPIC (European Prospective Investigation into Cancer and Nutrition) study.Methods: EPIC is a cohort of >500,000 men and women, mostly aged 35-70 y, who were recruited in 10 European countries. After a mean follow-up of 14 y, 748 primary differentiated TC cases were diagnosed; 666 were in women and 601 were papillary TC. Data on intakes of lean fish, fatty fish, fish products, and shellfish were collected by using country-specific validated dietary questionnaires at recruitment. Multivariable Cox regression was used to calculate HRs and 95% CIs adjusted for many potential confounders, including dietary and nondietary factors.Results: No significant association was observed between total fish consumption and differentiated TC risk for the highest compared with the lowest quartile (HR: 1.03; 95% CI: 0.81, 1.32; P-trend = 0.67). Likewise, no significant association was observed with the intake of any specific type of fish, fish product, or shellfish. No significant heterogeneity was found by TC subtype (papillary or follicular tumors), by sex, or between countries with low and high TC incidence.Conclusion: This large study shows that the intake of fish and shellfish was not associated with differentiated TC risk in Europe, a region in which iodine deficiency or excess is rare.

Evaluation of urinary resveratrol as a biomarker of dietary resveratrol intake in the European Prospective Investigation into Cancer and Nutrition (EPIC) study

Zamora-Ros R., Rothwell J. A., Achaintre D., Ferrari P., Boutron-Ruault M. C., Mancini F. R., Affret A., Kuhn T., Katzke V., Boeing H., Kuppel S., Trichopoulou A., Lagiou P., La Vecchia C., Palli D., Contiero P., Panico S., Tumino R., Ricceri F., Noh H., Freisling H., Romieu I., Scalbert A.

Br J Nutr; 2017; 117(11): 1596-1602

PMID:28637522

Abstract as provided by PubMed

In vitro studies have shown several beneficial properties of resveratrol. Epidemiological evidence is still scarce, probably because of the difficulty in estimating resveratrol exposure accurately. The current study aimed to assess the relationships between acute and habitual dietary resveratrol and wine intake and urinary resveratrol excretion in a European population. A stratified random subsample of 475 men and women from four countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) cross-sectional study, who had provided 24-h urine samples and completed a 24-h dietary recall (24-HDR) on the same day, were included. Acute and habitual dietary data were collected using standardised 24-HDR software and a validated country-specific dietary questionnaire, respectively. Phenol-Explorer was used to estimate the intake of resveratrol and other stilbenes. Urinary resveratrol was analysed using tandem MS. Spearman's correlation coefficients between estimated dietary intakes of resveratrol and other stilbenes and consumption of wine, their main food source, were very high (r>0.9) when measured using dietary questionnaires and were slightly lower with 24-HDR (r>0.8). Partial Spearman's correlations between urinary resveratrol excretion and intake of resveratrol, total stilbenes or wine were found to be higher when using the 24-HDR (R 2 partial approximately 0.6) than when using the dietary questionnaires (R 2 partial approximately 0.5). Moderate to high correlations between dietary resveratrol, total stilbenes and wine, and urinary resveratrol concentrations were observed. These support the earlier findings that 24-h urinary resveratrol is an effective biomarker of both resveratrol and wine intakes. These correlations also support the validity of the estimation of resveratrol intake using the dietary questionnaire and Phenol-Explorer.

Association between plasma phospholipid saturated fatty acids and metabolic markers of lipid, hepatic, inflammation and glycaemic pathways in eight European countries: a cross-sectional analysis in the EPIC-InterAct study

Zheng J. S., Sharp S. J., Imamura F., Koulman A., Schulze M. B., Ye Z., Griffin J., Guevara M., Huerta J. M., Kroger J., Sluijs I., Agudo A., Barricarte A., Boeing H., Colorado-Yohar S., Dow C., Dorronsoro M., Dinesen P. T., Fagherazzi G., Franks P. W., Feskens E. J. M., Kuhn T., Katzke V. A., Key T. J., Khaw K. T., de Magistris M. S., Mancini F. R., Molina-Portillo E., Nilsson P. M., Olsen A., Overvad K., Palli D., Quiros J. R., Rolandsson O., Ricceri F., Spijkerman A. M. W., Slimani N., Tagliabue G., Tjonneland A., Tumino R., van der Schouw Y. T., Langenberg C., Riboli E., Forouhi N. G., Wareham N. J.

BMC Med; 2017; 15(1): 203

PMID:29145892

Abstract as provided by PubMed

BACKGROUND: Accumulating evidence suggests that individual circulating saturated fatty acids (SFAs) are heterogeneous in their associations with cardio-metabolic diseases, but evidence about associations of SFAs with metabolic markers of different pathogenic pathways is limited. We aimed to examine the associations between plasma phospholipid SFAs and the metabolic markers of lipid, hepatic, glycaemic and inflammation pathways. METHODS: We measured nine individual plasma phospholipid SFAs and derived three SFA groups (odd-chain: C15:0 + C17:0, even-chain: C14:0 + C16:0 + C18:0, and very-long-chain: C20:0 + C22:0 + C23:0 + C24:0) in individuals from the subcohort of the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct case-cohort study across eight European countries. Using linear regression in 15,919 subcohort members, adjusted for potential confounders and corrected for multiple testing, we examined cross-sectional associations of SFAs with 13 metabolic markers. Multiplicative interactions of the three SFA groups with pre-specified factors, including body mass index (BMI) and alcohol consumption, were tested. RESULTS: Higher levels of odd-chain SFA group were associated with lower levels of major lipids (total cholesterol (TC), triglycerides, apolipoprotein A-1 (ApoA1), apolipoprotein B (ApoB)) and hepatic markers (alanine transaminase (ALT), aspartate transaminase (AST), gamma-glutamyl transferase (GGT)). Higher even-chain SFA group levels were associated with higher levels of low-density lipoprotein cholesterol (LDL-C), TC/high-density lipoprotein cholesterol (HDL-C) ratio, triglycerides, ApoB, ApoB/A1 ratio, ALT, AST, GGT and CRP, and lower levels of HDL-C and ApoA1. Very-long-chain SFA group levels showed inverse associations with triglycerides, ApoA1 and GGT, and positive associations with TC, LDL-C, TC/HDL-C, ApoB and ApoB/A1. Associations were generally stronger at higher levels of BMI or alcohol consumption. CONCLUSIONS: Subtypes of SFAs are associated in a differential way with metabolic markers of lipid metabolism, liver function and chronic inflammation, suggesting that odd-chain SFAs are associated with lower metabolic risk and even-chain SFAs with adverse metabolic risk, whereas mixed findings were obtained for very-long-chain SFAs. The clinical and biochemical implications of these findings may vary by adiposity and alcohol intake.

2016

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

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

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

PMID:27737637

Abstract as provided by PubMed

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

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

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

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

PMID:25702596

Abstract as provided by PubMed

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

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

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

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

PMID:26791185

Abstract as provided by PubMed

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

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

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

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

PMID:26342536

Abstract as provided by PubMed

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

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

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

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

PMID:27339170

Abstract as provided by PubMed

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

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

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

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

PMID:26607934

Abstract as provided by PubMed

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

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

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

Sci Rep; 2016; 36017

PMID:27812016

Abstract as provided by PubMed

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

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

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

PLoS Med; 2016; 13(7): e1002094

PMID:27434045

Abstract as provided by PubMed

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

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

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

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

PMID:26968841

Abstract as provided by PubMed

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

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

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

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

PMID:27357089

Abstract as provided by PubMed

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

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

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

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

PMID:27194183

Abstract as provided by PubMed

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

An epidemiological model for prediction of endometrial cancer risk in Europe

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

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

PMID:25968175

Abstract as provided by PubMed

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

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

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

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

PMID:26823475

Abstract as provided by PubMed

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

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

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

PLoS ONE; 2016; 11(7): e0159025

PMID:27409582

Abstract as provided by PubMed

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

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

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

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

PMID:27294726

Abstract as provided by PubMed

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

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21