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2011

Genetic variability of the forkhead box O3 and prostate cancer risk in the European Prospective Investigation on Cancer

Campa D., Husing A., Dostal L., Stein A., Drogan D., Boeing H., Tjonneland A., Roswall N., Ostergaard J.N., Overvad K., Rodriguez L., Bonet C., Sanchez M.J., Larranaga N., Huerta J.M., Ardanaz E., Khaw K.T., Wareham N., Travis R.C., Allen N.E., Trichopoulou A., Zylis D., Karapetyan T., Palli D., Sieri S., Tumino R., Vineis P., Bueno-de-Mesquita H.B., Lenner P., Johansson M., Jenab M., Cox D., Siddiq A., Kaaks R., Canzian F.

Oncol Rep; 2011; 26(4): 979-986

Abstract as provided by PubMed

Forkhead box O3 (FOXO3) has a wide range of functions: it promotes tumor suppression, cell cycle arrest, repair of damaged DNA, detoxification of reactive oxygen species, apoptosis and plays a pivotal role in promoting longevity. FOXO3 is a key downstream target of the PI3K-Akt pathway in response to cellular stimulation by growth factors or insulin and has been proposed as a bridge between ageing and tumor suppression. Three SNPs in the FOXO3 gene (rs3800231, rs9400239 and rs479744) that have been shown to be strongly and consistently associated with longevity, were examined in relation to PC risk in a case control study of 1571 incident PC cases and 1840 controls nested within the European Prospective Investigation into Cancer and Nutrition (EPIC). There was no statistically significant association between the SNPs and PC risk regardless of the model of inheritance (dominant, codomi-nant and recessive). The associations were not modified by disease aggressiveness, circulating levels of steroid sex hormones, or IGFs or BMI. We conclude that polymorphisms in the FOXO3 gene that are associated with longevity are not major risk factors for PC risk, in this population of Caucasian men

Plasma phospholipid fatty acid concentrations and risk of gastric adenocarcinomas in the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST)

Chajes V., Jenab M., Romieu I., Ferrari P., Dahm C.C., Overvad K., Egeberg R., Tjonneland A., Clavel-Chapelon F., Boutron-Ruault M.C., Engel P., Teucher B., Kaaks R., Floegel A., Boeing H., Trichopoulou A., Dilis V., Karapetyan T., Mattiello A., Tumino R., Grioni S., Palli D., Vineis P., Bueno-de-Mesquita H.B., Numans M.E., Peeters P.H., Lund E., Navarro C., Quiros J.R., Sanchez-Cantalejo E., Gurrea A.B., Dorronsoro M., Regner S., Sonestedt E., Wirfalt E., Khaw K.T., Wareham N., Allen N.E., Crowe F.L., Rinaldi S., Slimani N., Carneiro F., Riboli E., Gonzalez C.A.

Am J Clin Nutr; 2011; 94(5): 1304-1313

Abstract as provided by PubMed

BACKGROUND: Epidemiologic data suggest that diet is a risk factor in the etiology of gastric cancer. However, the role of dietary fatty acids, a modifiable risk factor, remains relatively unexplored. OBJECTIVE: The objective of this study was to determine the association of plasma phospholipid fatty acid concentrations, as biomarkers of exogenous and endogenously derived fatty acids, with the risk of gastric adenocarcinoma in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition-Europe Gastric Cancer (EPIC-EURGAST). DESIGN: Fatty acids were measured by gas chromatography in prediagnostic plasma phospholipids from 238 cases matched to 626 controls by age, sex, study center, and date of blood donation. Conditional logistic regression models adjusted for Helicobacter pylori infection status, BMI, smoking, physical activity, education, and energy intake were used to estimate relative cancer risks. RESULTS: Positive risk associations for gastric cancer were observed in the highest compared with the lowest quartiles of plasma oleic acid (OR: 1.72; 95% CI: 1.01, 2.94), di-homo-gamma-linolenic acid (OR: 1.92; 95% CI: 1.10, 3.35), alpha-linolenic acid (OR: 3.20; 95% CI: 1.70, 6.06), and the ratio of MUFAs to saturated fatty acids, as an indicator of stearoyl-CoA desaturase-1 enzyme activity (OR: 1.40; 95% CI: 0.81, 2.43). An inverse risk association was observed with the ratio of linoleic to alpha-linolenic acid (OR: 0.37; 95% CI: 0.20, 0.66). CONCLUSION: These data suggest that a specific prediagnostic plasma phospholipid fatty acid profile, characterized mainly by high concentrations of oleic acid, alpha-linolenic acid, and di-homo-gamma-linolenic acid, which presumably reflect both a complex dietary pattern and altered fatty acid metabolism, may be related to increased gastric cancer risk

Ecological-Level Associations Between Highly Processed Food Intakes and Plasma Phospholipid Elaidic Acid Concentrations: Results From a Cross-Sectional Study Within the European Prospective Investigation Into Cancer and Nutrition (EPIC)

Chajes V., Biessy C., Byrnes G., Deharveng G., Saadatian-Elahi M., Jenab M., Peeters P.H., Ocke M., Bueno-de-Mesquita H.B., Johansson I., Hallmans G., Manjer J., Wirfalt E., Jakszyn P., Gonzalez C.A., Huerta J.M., Martinez C., Amiano P., Suarez L.R., Ardanaz E., Tjonneland A., Halkjaer J., Overvad K., Jakobsen M.U., Berrino F., Pala V., Palli D., Tumino R., Vineis P., de Magistris M.S., Spencer E.A., Crowe F.L., Bingham S., Khaw K.T., Linseisen J., Rohrmann S., Boeing H., Noethlings U., Olsen K.S., Skeie G., Lund E., Trichopoulou A., Zilis D., Oustoglou E., Clavel-Chapelon F., Riboli E., Slimani N.

Nutr Cancer; 2011; 63(8): 1235-1250

Abstract as provided by PubMed

Elaidic acid is the main unnatural trans fatty acid isomer occurring during partial hydrogenation of vegetable oils used as ingredients for the formulation of processed foods. The main objective is to assess associations between processed food intakes and plasma phospholipid elaidic acid concentrations within the European Prospective Investigation into Cancer and Nutrition study. A cross-sectional study was used to determine fatty acid profiles in 3,003 subjects from 16 centers. Single 24-h dietary recalls (24-HDR) were collected using a standardized computerized interview program. Food intakes were computed according to their degree of processing (moderately/nonprocessed foods, processed staple foods, highly processed foods). Adjusted ecological and individual correlations were calculated between processed food intakes and plasma elaidic acid levels. At the population level, mean intakes of highly processed foods were strongly correlated with mean levels of plasma elaidic acid in men (P = 0.0016) and in women (P = 0.0012). At the individual level, these associations remained but at a much lower level in men (r = 0.08, P = 0.006) and in women (r = 0.09, P = 0.0001). The use of an averaged 24-HDR measure of highly processed food intakes is adequate for predicting mean levels of plasma elaidic acid among European populations

Exposure to environmental tobacco smoke in childhood and incidence of cancer in adulthood in never smokers in the European prospective investigation into cancer and nutrition

Chuang S.C., Gallo V., Michaud D., Overvad K., Tjonneland A., Clavel-Chapelon F., Romieu I., Straif K., Palli D., Pala V., Tumino R., Sacerdote C., Panico S., Peeters P.H., Lund E., Gram I.T., Manjer J., Borgquist S., Riboli E., Vineis P.

Cancer Causes Control; 2011; 22(3): 487-494

Abstract as provided by PubMed

The association between childhood environmental tobacco smoke (ETS) exposure and adult cancer risk is controversial; we examined this relationship in never smokers within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Over an average of 10 years, 8,372 cases of cancer were diagnosed in 112,430 never smokers in EPIC. Childhood ETS was self-reported by participants at baseline, along with other lifestyle factors. Hazard ratios (HR) for ETS exposure in childhood and their 95% confidence intervals (CI) were estimated by Cox proportional hazards models stratified by age, sex, and study center and adjusted for education, alcohol drinking, body mass index, physical activity, non-alcoholic energy intake, fruit and vegetable intake, and adulthood ETS exposure. Models were further adjusted for reproductive factors for female cancers, for meat intake for digestive system cancers, and for diabetes status for pancreatic cancer. No association was observed between childhood ETS exposure and overall cancer risks (HR = 0.97, 95% CI = 0.92-1.02), and for selected sites. The only exception was pancreatic cancer, as previously reported by Vrieling et al., among those who had been exposed daily in childhood (overall HR = 2.09, 95% CI = 1.14-3.84). In conclusion, childhood ETS exposure might not be a major risk factor for common cancers in adulthood

A U-shaped relationship between plasma folate and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition

Chuang S.C., Stolzenberg-Solomon R., Ueland P.M., Vollset S.E., Midttun O., Olsen A., Tjonneland A., Overvad K., Boutron-Ruault M.C., Morois S., Clavel-Chapelon F., Teucher B., Kaaks R., Weikert C., Boeing H., Trichopoulou A., Benetou V., Naska A., Jenab M., Slimani N., Romieu I., Michaud D.S., Palli D., Sieri S., Panico S., Sacerdote C., Tumino R., Skeie G., Duell E.J., Rodriguez L., Molina-Montes E., Huerta J.M., Larranaga N., Gurrea A.B., Johansen D., Manjer J., Ye W., Sund M., Peeters P.H., Jeurnink S., Wareham N., Khaw K.T., Crowe F., Riboli E., Bueno-de-Mesquita B., Vineis P.

Eur J Cancer; 2011; 47(12): 1808-1816

Abstract as provided by PubMed

Folate intake has shown an inverse association with pancreatic cancer; nevertheless, results from plasma measurements were inconsistent. The aim of this study is to examine the association between plasma total homocysteine, methionine, folate, cobalamin, pyridoxal 5'-phosphate, riboflavin, flavin mononucleotide and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). We conducted a nested case-control study in the EPIC cohort, which has an average of 9.6years of follow-up (1992-2006), using 463 incident pancreatic cancer cases. Controls were matched to each case by center, sex, age (+/-1year), date (+/-1year) and time (+/-3h) at blood collection and fasting status. Conditional logistic regression was used to calculate the odds ratios (OR) and 95% confidence intervals (CI), adjusting for education, smoking status, plasma cotinine concentration, alcohol drinking, body mass index and diabetes status. We observed a U-shaped association between plasma folate and pancreatic cancer risk. The ORs for plasma folate 5, 5-10, 10-15 (reference), 15-20, and >20nmol/L were 1.58 (95% CI=0.72-3.46), 1.39 (0.93-2.08), 1.0 (reference), 0.79 (0.52-1.21), and 1.34 (0.89-2.02), respectively. Methionine was associated with an increased risk in men (per quintile increment: OR=1.17, 95% CI=1.00-1.38) but not in women (OR=0.91, 95% CI=0.78-1.07; p for heterogeneity <0.01). Our results suggest a U-shaped association between plasma folate and pancreatic cancer risk in both men and women. The positive association that we observed between methionine and pancreatic cancer may be sex dependent and may differ by time of follow-up. However, the mechanisms behind the observed associations warrant further investigation

Mediterranean dietary pattern and cancer risk in the EPIC cohort

Couto E., Boffetta P., Lagiou P., Ferrari P., Buckland G., Overvad K., Dahm C.C., Tjonneland A., Olsen A., Clavel-Chapelon F., Boutron-Ruault M.C., Cottet V., Trichopoulos D., Naska A., Benetou V., Kaaks R., Rohrmann S., Boeing H., von Ruesten A., Panico S., Pala V., Vineis P., Palli D., Tumino R., May A., Peeters P.H., Bueno-de-Mesquita H.B., Buchner F.L., Lund E., Skeie G., Engeset D., Gonzalez C.A., Navarro C., Rodriguez L., Sanchez M.J., Amiano P., Barricarte A., Hallmans G., Johansson I., Manjer J., Wirfart E., Allen N.E., Crowe F., Khaw K.T., Wareham N., Moskal A., Slimani N., Jenab M., Romaguera D., Mouw T., Norat T., Riboli E., Trichopoulou A.

Br J Cancer; 2011; 104(9): 1493-1499

Abstract as provided by PubMed

BACKGROUND: Although several studies have investigated the association of the Mediterranean diet with overall mortality or risk of specific cancers, data on overall cancer risk are sparse. METHODS: We examined the association between adherence to Mediterranean dietary pattern and overall cancer risk using data from the European Prospective Investigation Into Cancer and nutrition, a multi-centre prospective cohort study including 142,605 men and 335,873. Adherence to Mediterranean diet was examined using a score (range: 0-9) considering the combined intake of fruits and nuts, vegetables, legumes, cereals, lipids, fish, dairy products, meat products, and alcohol. Association with cancer incidence was assessed through Cox regression modelling, controlling for potential confounders. RESULTS: In all, 9669 incident cancers in men and 21,062 in women were identified. A lower overall cancer risk was found among individuals with greater adherence to Mediterranean diet (hazard ratio=0.96, 95% CI 0.95-0.98) for a two-point increment of the Mediterranean diet score. The apparent inverse association was stronger for smoking-related cancers than for cancers not known to be related to tobacco (P (heterogeneity)=0.008). In all, 4.7% of cancers among men and 2.4% in women would be avoided in this population if study subjects had a greater adherence to Mediterranean dietary pattern. CONCLUSION: Greater adherence to a Mediterranean dietary pattern could reduce overall cancer risk

Biomarker-based evaluation of two 24-h recalls for comparing usual fish, fruit and vegetable intakes across European centers in the EFCOVAL Study

Crispim S.P., Geelen A., Souverein O.W., Hulshof P.J., Ruprich J., Dofkova M., Huybrechts I., De Keyzer W., Lillegaard I.T., Andersen L.F., Lafay L., Rousseau A.S., Ocke M.C., Slimani N., Van 't Veer P., de Vries J.H.

Eur J Clin Nutr; 2011; S38-S47

Abstract as provided by PubMed

BACKGROUND/OBJECTIVES: A standardized methodology is important to enable consistent monitoring of dietary intake across European countries. For this reason, we evaluated the comparability of the assessment of usual food intake collected with two non-consecutive computerized 24-h dietary recalls (24-HDRs) and a food propensity questionnaire (FPQ) among five European centers. SUBJECTS/METHODS: Two 24-HDRs using EPIC-Soft (the software developed to conduct 24-HDRs in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study) were performed to determine fish, fruit and vegetable (FV) consumed by 600 adults in Belgium (BE), the Czech Republic (CZ), France (FR), the Netherlands (NL) and Norway (NO) in a validation study. An FPQ was used to identify non-consumers. Information from the 24-HDRs and FPQ were used to estimate individual usual food intake by the Multiple Source Method (MSM). Blood samples were drawn to determine fatty acids in phospholipids and serum carotenoids as biomarkers of fish, and FV intake, respectively. RESULTS: The pooled correlation between usual fish intake and eicosapentaenoic acid plus docosahexaenoic acid in phospholipids was 0.19 in men and 0.31 in women (P for heterogeneity >0.50) and center-specific correlations ranged between 0.08 (CZ) and 0.28 (BE and NO) in men, and between 0.19 (BE) and 0.55 (FR) in women. For usual FV intake, the pooled correlation with serum carotenoids was 0.31 in men and 0.40 in women (P for heterogeneity >0.10); the center-specific correlations varied between 0.07 (NO) and 0.52 (FR) in men, and between 0.25 (NL) and 0.45 (NO) in women. CoNCLUSION: Two standardized 24-HDRs using EPIC-Soft and an FPQ appeared to be appropriate to rank individuals according to their fish and FV intake in a comparable way among five European centers

A cross-sectional analysis of the associations between adult height, BMI and serum concentrations of IGF-I and IGFBP-1 -2 and -3 in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Crowe F.L., Key T.J., Allen N.E., Appleby P.N., Overvad K., Gronbaek H., Tjonneland A., Halkjaer J., Dossus L., Boeing H., Kroger J., Trichopoulou A., Zylis D., Trichopoulos D., Boutron-Ruault M.C., de Lauzon-Guillain B., Clavel-Chapelon F., Palli D., Berrino F., Panico S., Tumino R., Sacerdote C., Bueno-de-Mesquita H.B., Van Gils C.H., Peeters P.H., Gram I.T., Rodriguez L., Jakszyn P., Molina-Montes E., Navarro C., Barricarte A., Larranaga N., Khaw K.T., Rodwell S., Rinaldi S., Slimani N., Norat T., Gallo V., Riboli E., Kaaks R.

Ann Hum Biol; 2011; 38(2): 194-202

Abstract as provided by PubMed

Background: Height and BMI are risk factors for several types of cancer and may be related to circulating concentrations of insulin-like growth factor-I (IGF-I), a peptide associated with increased cancer risk. Aim: To assess the associations between height, BMI and serum concentrations of IGF-I and IGF binding protein (IGFBP)-1, -2 and -3. Subjects and methods: This cross-sectional analysis included 1142 men and 3589 women aged 32-77 years from the multi-centre study, the European Prospective Investigation of Cancer and Nutrition (EPIC). Results: In men, there was a positive association between height and IGF-I; each 10 cm increment in height was associated with an increase in IGF-I concentrations of 4.3% (95% confidence interval (CI): 1.3-7.5%, p for trend = 0.005), but this association was not statistically significant for women (0.9%, 95% CI: - 0.7 to 2.6%, p for trend = 0.264). In both men and women, the association between IGF-I and BMI was non-linear and those with a BMI of 26-27 kg/m(2) had the highest IGF-I concentration. BMI was strongly inversely related to concentrations of IGFBP-1 and IGFBP-2 in men and in women (p for trend for all < 0.001). Conclusion: Height and BMI are associated with IGF-I and its binding proteins, which may be mechanisms through which body size contributes to increased risk of several cancers

Fruit and vegetable intake and mortality from ischaemic heart disease: results from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Heart study

Crowe F.L., Roddam A.W., Key T.J., Appleby P.N., Overvad K., Jakobsen M.U., Tjonneland A., Hansen L., Boeing H., Weikert C., Linseisen J., Kaaks R., Trichopoulou A., Misirli G., Lagiou P., Sacerdote C., Pala V., Palli D., Tumino R., Panico S., Bueno-de-Mesquita H.B., Boer J., Van Gils C.H., Beulens J.W., Barricarte A., Rodriguez L., Larranaga N., Sanchez M.J., Tormo M.J., Buckland G., Lund E., Hedblad B., Melander O., Jansson J.H., Wennberg P., Wareham N.J., Slimani N., Romieu I., Jenab M., Danesh J., Gallo V., Norat T., Riboli E.

Eur Heart J; 2011; 32(10): 1235-1243

Abstract as provided by PubMed

Aims A higher intake of fruits and vegetables has been associated with a lower risk of ischaemic heart disease (IHD), but there is some uncertainty about the interpretation of this association. The objective was to assess the relation between fruit and vegetable intake and risk of mortality from IHD in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Heart study. Methods and results After an average of 8.4 years of follow-up, there were 1636 deaths from IHD among 313 074 men and women without previous myocardial infarction or stroke from eight European countries. Participants consuming at least eight portions (80 g each) of fruits and vegetables a day had a 22% lower risk of fatal IHD [relative risk (RR) = 0.78, 95% confidence interval (CI): 0.65-0.95] compared with those consuming fewer than three portions a day. After calibration of fruit and vegetable intake to account for differences in dietary assessment between the participating centres, a one portion (80 g) increment in fruit and vegetable intake was associated with a 4% lower risk of fatal IHD (RR = 0.96, 95% CI: 0.92-1.00, P for trend = 0.033). Conclusion Results from this large observational study suggest that a higher intake of fruits and vegetables is associated with a reduced risk of IHD mortality. Whether this association is causal and, if so, the biological mechanism(s) by which fruits and vegetables operate to lower IHD risks remains unclear

The European Food Consumption Validation Project: conclusions and recommendations

de Boer E.J., Slimani N., Van t Veer P., Boeing H., Feinberg M., Leclercq C., Trolle E., Amiano P., Andersen L.F., Freisling H., Geelen A., Harttig U., Huybrechts I., Kaic-Rak A., Lafay L., Lillegaard I.T., Ruprich J., de Vries J.H., Ocke M.C.

Eur J Clin Nutr; 2011; S102-S107

Abstract as provided by PubMed

BACKGROUND/OBJECTIVES: To outline and discuss the main results and conclusions of the European Food Consumption Validation (EFCOVAL) Project. SUBJECTS/METHODS: The EFCOVAL Project was carried out within the EU Sixth Framework Program by researchers in 11 EU countries. The activities focused on (1) the further development of the EPIC-Soft software (the software developed to conduct 24-h dietary recalls (24-HDRs) in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study) and the validation of the 2-day non-consecutive 24-HDR method using EPIC-Soft, (2) defining and investigating the applicability of the most appropriate dietary assessment method to younger age groups and expanding the applicability of the software for use in exposure assessment of some potentially hazardous chemicals and (3) to improve the methodology and statistical methods that estimate usual intake distributions from short-term dietary intake information and develop a methodology to quantify uncertainty in usual intake distributions. RESULTS: The preexisting EPIC-Soft application was reprogrammed into a Windows environment and more than 60 new specifications were implemented in the software. A validation study showed that two non-consecutive EPIC-Soft 24-HDRs are suitable to estimate the usual intake distributions of protein and potassium of European adult populations. The 2-day non-consecutive 24-HDRs in combination with a food propensity questionnaire also appeared to be appropriate to rank individuals according to their fish and fruit and vegetable intake in a comparable way in five European centers. Dietary intake of (young) children can be assessed by the combination of EPIC-Soft 24-HDRs and food recording booklets. The EPIC-Soft-standardized method of describing foods is useful to estimate dietary exposure to potentially hazardous chemicals such as specific flavoring substances. With the developed Multiple Source Method, repeated non-consecutive 24-HDR data in combination with food propensity data can be used to estimate the population distribution of the usual intake by estimating the individual usual intakes. CONCLUSIONS: The findings provide sufficient evidence to conclude that the repeated 24-HDR using EPIC-Soft for standardization in combination with a food propensity questionnaire and modeling of usual intake is a suitable method for pan-European surveillance of nutritional adequacy and food safety among healthy adults and maybe in children aged 7 years and older. To facilitate this methodology in other European countries, the next step is to provide and standardize an implementation plan that accounts for maintenance and updates, sampling designs, national surveillance programs, tailored capacity building and training, and linkage to food composition and occurrence databases

Rationale and methods of the European Food Consumption Validation (EFCOVAL) Project

de Boer E.J., Slimani N., Van't Veer P., Boeing H., Feinberg M., Leclercq C., Trolle E., Amiano P., Andersen L.F., Freisling H., Geelen A., Harttig U., Huybrechts I., Kaic-Rak A., Lafay L., Lillegaard I.T., Ruprich J., de Vries J.H., Ocke M.C.

Eur J Clin Nutr; 2011; S1-S4

Abstract as provided by PubMed

BACKGROUND/OBJECTIVES: The overall objective of the European Food Consumption Validation (EFCOVAL) Project was to further develop and validate a trans-European food consumption method to be used for the evaluation of the intake of foods, nutrients and potentially hazardous chemicals within the European population. SUBJECTS/METHODS: The EFCOVAL Project was carried out by 13 institutes from 11 European countries. The main activities were centered on the three main objectives of the project organized in different sub-projects. RESULTS: In EFCOVAL, EPIC-Soft (the software developed to conduct 24-h dietary recalls (24-HDRs) in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study) was reprogrammed and adapted according to prioritized specifications, resulting in a software program working under the Windows operating system. In parallel of the EPIC-Soft development, the repeated 24-HDR method using EPIC-Soft and a food propensity questionnaire was evaluated against biomarkers in 24-h urine collections and in blood samples among adults from Belgium, the Czech Republic, (the South of) France, the Netherlands and Norway. As a result from an expert workshop on a proposed dietary assessment method for children (4-12 years), the suggested method was tested in a feasibility study in Denmark and Spain among children of 4-5, 7-8 and 12-13 years. To ensure that collected data had sufficient detail in food description for the assessment of additives and contaminants to foods the EPIC-Soft databases were adapted. Finally, the EFCOVAL Consortium developed a statistical tool (Multiple Source Method) for estimating the usual intake and distribution, which has been tested using real food consumption data and compared with three other statistical methods through a simulation study. In addition, a methodology was developed to quantify uncertainty due to portion-size estimation in usual intake distributions. CONCLUSION: The findings of EFCOVAL provide sufficient evidence to conclude that the repeated 24-HDR using EPIC-Soft for standardization in combination with a food propensity questionnaire and modeling of usual intake is a suitable method for pan-European surveillance of nutritional adequacy and food safety among healthy adults and maybe in children aged 7 years and older

Alcohol consumption and gastric cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort

Duell E.J., Travier N., Lujan-Barroso L., Clavel-Chapelon F., Boutron-Ruault M.C., Morois S., Palli D., Krogh V., Panico S., Tumino R., Sacerdote C., Quiros J.R., Sanchez-Cantalejo E., Navarro C., Gurrea A.B., Dorronsoro M., Khaw K.T., Allen N.E., Key T.J., Bueno-de-Mesquita H.B., Ros M.M., Numans M.E., Peeters P.H., Trichopoulou A., Naska A., Dilis V., Teucher B., Kaaks R., Boeing H., Schutze M., Regner S., Lindkvist B., Johansson I., Hallmans G., Overvad K., Egeberg R., Tjonneland A., Lund E., Weiderpass E., Braaten T., Romieu I., Ferrari P., Jenab M., Stenling R., Aune D., Norat T., Riboli E., Gonzalez C.A.

Am J Clin Nutr; 2011; 94(5): 1266-1275

Abstract as provided by PubMed

BACKGROUND: Gastric cancer (GC) is the second leading cause of cancer death worldwide. The association between alcohol consumption and GC has been investigated in numerous epidemiologic studies with inconsistent results. OBJECTIVE: We evaluated the association between alcohol consumption and GC risk. DESIGN: We conducted a prospective analysis in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, which included 444 cases of first primary gastric adenocarcinoma. HRs and 95% CIs for GC were estimated by using multivariable Cox proportional hazards regression for consumption of pure ethanol in grams per day, with stratification by smoking status, anatomic subsite (cardia, noncardia), and histologic subtype (diffuse, intestinal). In a subset of participants, results were further adjusted for baseline Helicobacter pylori serostatus. RESULTS: Heavy (compared with very light) alcohol consumption (>/=60 compared with 0.1-4.9 g/d) at baseline was positively associated with GC risk (HR: 1.65; 95% CI: 1.06, 2.58), whereas lower consumption amounts (<60 g/d) were not. When we analyzed GC risk by type of alcoholic beverage, there was a positive association for beer (>/=30 g/d; HR: 1.75; 95% CI: 1.13, 2.73) but not for wine or liquor. Associations were primarily observed at the highest amounts of drinking in men and limited to noncardia subsite and intestinal histology; no statistically significant linear dose-response trends with GC risk were observed. CONCLUSION: Heavy (but not light or moderate) consumption of alcohol at baseline (mainly from beer) is associated with intestinal-type noncardia GC risk in men from the EPIC cohort

Physical activity and gain in abdominal adiposity and body weight: prospective cohort study in 288,498 men and women

Ekelund U., Besson H., Luan J., May A.M., Sharp S.J., Brage S., Travier N., Agudo A., Slimani N., Rinaldi S., Jenab M., Norat T., Mouw T., Rohrmann S., Kaaks R., Bergmann M.M., Boeing H., Clavel-Chapelon F., Boutron-Ruault M.C., Overvad K., Jakobsen M.U., Johnsen N.F., Halkjaer J., Gonzalez C.A., Rodriguez L., Sanchez M.J., Arriola L., Barricarte A., Navarro C., Key T.J., Spencer E.A., Orfanos P., Naska A., Trichopoulou A., Manjer J., Lund E., Palli D., Pala V., Vineis P., Mattiello A., Tumino R., Bueno-de-Mesquita H.B., van den Berg S.W., Odysseos A.D., Riboli E., Wareham N.J., Peeters P.H.

Am J Clin Nutr; 2011; 93(4): 826-835

Abstract as provided by PubMed

BACKGROUND: The protective effect of physical activity (PA) on abdominal adiposity is unclear. OBJECTIVE: We examined whether PA independently predicted gains in body weight and abdominal adiposity. DESIGN: In a prospective cohort study [the EPIC (European Prospective Investigation into Cancer and Nutrition)], we followed 84,511 men and 203,987 women for 5.1 y. PA was assessed by a validated questionnaire, and individuals were categorized into 4 groups (inactive, moderately inactive, moderately active, and active). Body weight and waist circumference were measured at baseline and self-reported at follow-up. We used multilevel mixed-effects linear regression models and stratified our analyses by sex with adjustments for age, smoking status, alcohol consumption, educational level, total energy intake, duration of follow-up, baseline body weight, change in body weight, and waist circumference (when applicable). RESULTS: PA significantly predicted a lower waist circumference (in cm) in men (beta = -0.045; 95% CI: -0.057, -0.034) and in women (beta = -0.035; 95% CI: -0.056, -0.015) independent of baseline body weight, baseline waist circumference, and other confounding factors. The magnitude of associations was materially unchanged after adjustment for change in body weight. PA was not significantly associated with annual weight gain (in kg) in men (beta = -0.008; 95% CI: -0.02, 0.003) and women (beta = -0.01; 95% CI: -0.02, 0.0006). The odds of becoming obese were reduced by 7% (P < 0.001) and 10% (P < 0.001) for a one-category difference in baseline PA in men and women, respectively. CONCLUSION: Our results suggest that a higher level of PA reduces abdominal adiposity independent of baseline and changes in body weight and is thus a useful strategy for preventing chronic diseases and premature deaths

Prediagnostic circulating parathyroid hormone concentration and colorectal cancer in the European prospective investigation into cancer and nutrition cohort

Fedirko V., Riboli E., Bueno-de-Mesquita H.B., Rinaldi S., Pischon T., Norat T., Jansen E.H., van Duijnhoven F.J., Tjonneland A., Olsen A., Overvad K., Boutron-Ruault M.C., Clavel-Chapelon F., Engel P., Kaaks R., Teucher B., Boeing H., Buijsse B., Trichopoulou A., Trichopoulos D., Lagiou P., Sieri S., Vineis P., Panico S., Palli D., Tumino R., Van Gils C.H., Peeters P.H., Chirlaque M.D., Gurrea A.B., Rodriguez L., Molina-Montes E., Dorronsoro M., Bonet C., Palmqvist R., Hallmans G., Key T.J., Tsilidis K.K., Khaw K.T., Romieu I., Straif K., Wark P.A., Romaguera D., Jenab M.

Cancer Epidemiol Biomarkers Prev; 2011; 20(5): 767-778

Abstract as provided by PubMed

BACKGROUND: Parathyroid hormone (PTH) has been proposed to play a promoting role in carcinogenesis. However, no epidemiologic studies have yet directly investigated its role in colorectal cancer (CRC). METHODS: A case-control study nested within the European Prospective Investigation into Cancer and Nutrition cohort was conducted with 1,214 incident, sporadic CRC cases matched to 1,214 controls. Circulating prediagnostic PTH and 25-hydroxy vitamin D [25(OH)D] concentrations were measured by enzyme-linked immunosorbent assays. Detailed dietary and lifestyle questionnaire data were collected at baseline. Multivariable conditional logistic regression was used to estimate the incidence rate ratio (RR) with 95% confidence intervals (95% CI) for the association between circulating PTH and CRC risk. RESULTS: In multivariate analyses [including adjustment for 25(OH)D concentration] with a priori defined cutoff points, high levels of serum PTH (>/=65 ng/L) compared with medium PTH levels of 30-65 ng/L were associated with increased CRC risk (RR = 1.41, 95% CI: 1.03-1.93). In analyses by sex, the CRC risk was 1.77 (95% CI: 1.14-2.75) and 1.15 (95% CI: 0.73-1.84) in men and women, respectively (P(heterogeneity) = 0.01). In subgroup analyses by anatomical subsite, the risk for colon cancer was RR = 1.56, 95% CI: 1.03-2.34, and for rectal cancer RR = 1.20, 95% CI: 0.72-2.01 (P(heterogeneity) = 0.21). Effect modification by various risk factors was examined. CONCLUSIONS: The results of this study suggest that high serum PTH levels may be associated with incident, sporadic CRC in Western European populations, and in particular among men. Impact: To our knowledge, this is the first study on PTH and CRC. The role of PTH in carcinogenesis needs to be further investigated. Cancer Epidemiol Biomarkers Prev; 20(5); 767-78. (c)2011 AACR

Infection with hepatitis B and C viruses and risk of lymphoid malignancies in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Franceschi S., Lise M., Trepo C., Berthillon P., Chuang S.C., Nieters A., Travis R.C., Vermeulen R., Overvad K., Tjonneland A., Olsen A., Bergmann M.M., Boeing H., Kaaks R., Becker N., Trichopoulou A., Lagiou P., Bamia C., Palli D., Sieri S., Panico S., Tumino R., Sacerdote C., Bueno-de-Mesquita B., Peeters P.H., Rodriguez L., Barroso L.L., Dorronsoro M., Sanchez M.J., Navarro C., Barricarte A., Regner S., Borgquist S., Melin B., Hallmans G., Khaw K.T., Wareham N., Rinaldi S., Hainaut P., Riboli E., Vineis P.

Cancer Epidemiol Biomarkers Prev; 2011; 20(1): 208-214

Abstract as provided by PubMed

BACKGROUND: Case-control studies suggested a moderate, but consistent, association of hepatitis C virus (HCV) infection with lymphoid tissue malignancies, especially non-Hodgkin lymphoma (NHL). More limited data suggested that hepatitis B virus (HBV) infection might also be associated with NHL. However, prospective studies on the topic are few. METHODS: A nested case-control study was conducted in eight countries participating in the EPIC prospective study. Seven hundred thirty-nine incident cases of NHL, 238 multiple myeloma (MM), and 46 Hodgkin lymphoma (HL) were matched with 2,028 controls. Seropositivity to anti-HCV, anti-HBc, and HBsAg was evaluated and conditional logistic regression was used to estimate odds ratios (OR) and corresponding 95% confidence intervals (CI) for NHL, MM, or HL, and their combination. RESULTS: Anti-HCV seropositivity among controls in different countries ranged from 0% to 5.3%; HBsAg from 0% to 2.7%; and anti-HBc from 1.9% to 45.9%. Similar nonsignificant associations were found with seropositivity to HBsAg for NHL (OR = 1.78; 95% CI: 0.78-4.04), MM (OR = 4.00; 95% CI: 1.00-16.0), and HL (OR = 2.00; 95% CI: 0.13-32.0). The association between HBsAg and the combination of NHL, MM, and HL (OR = 2.21; 95% CI: 1.12-4.33) was similar for cancer diagnosed less than 3 and 3 or more years after blood collection. No significant association was found between anti-HCV and NHL, MM, or HL risk, but the corresponding CIs were very broad. CONCLUSIONS: Chronic HBV infection may increase the risk of lymphoid malignancies among healthy European volunteers. IMPACT: Treatment directed at control of HBV infection should be evaluated in HBsAg-seropositive patients with lymphoid tissue malignancies

Dietary factors and in situ and invasive cervical cancer risk in the European prospective investigation into cancer and nutrition study

Gonzalez C.A., Travier N., Lujan-Barroso L., Castellsague X., Bosch F.X., Roura E., Bueno-de-Mesquita H.B., Palli D., Boeing H., Pala V., Sacerdote C., Tumino R., Panico S., Manjer J., Dillner J., Hallmans G., Kjellberg L., Sanchez M.J., Altzibar J.M., Barricarte A., Navarro C., Rodriguez L., Allen N., Key T.J., Kaaks R., Rohrmann S., Overvad K., Olsen A., Tjonneland A., Munk C., Kjaer S.K., Peeters P.H., van Duijnhoven F.J., Clavel-Chapelon F., Boutron-Ruault M.C., Trichopoulou A., Benetou V., Naska A., Lund E., Engeset D., Skeie G., Franceschi S., Slimani N., Rinaldi S., Riboli E.

Int J Cancer; 2011; 129(2): 449-459

Abstract as provided by PubMed

Some dietary factors could be involved as cofactors in cervical carcinogenesis, but evidence is inconclusive. There are no data about the effect of fruits and vegetables intake (F&V) on cervical cancer from cohort studies. We examined the association between the intake of F&V and selected nutrients and the incidence of carcinoma in situ (CIS) and invasive squamous cervical cancer (ISC) in a prospective study of 299,649 women, participating in the European Prospective Investigation into Cancer and Nutrition study. Cox proportional hazard models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (95% CI). A calibration study was used to control measurement errors in the dietary questionnaire. After a mean of 9 years of follow-up, 253 ISC and 817 CIS cases were diagnosed. In the calibrated model, we observed a statistically significant inverse association of ISC with a daily increase in intake of 100 g of total fruits (HR 0.83; 95% CI 0.72-0.98) and a statistically nonsignificant inverse association with a daily increase in intake of 100 g of total vegetables (HR 0.85: 95% CI 0.65-1.10). Statistically nonsignificant inverse associations were also observed for leafy vegetables, root vegetables, garlic and onions, citrus fruits, vitamin C, vitamin E and retinol for ISC. No association was found regarding beta-carotene, vitamin D and folic acid for ISC. None of the dietary factors examined was associated with CIS. Our study suggests a possible protective role of fruit intake and other dietary factors on ISC that need to be confirmed on a larger number of ISC cases

Diabetes mellitus, glycated haemoglobin and C-peptide levels in relation to pancreatic cancer risk: a study within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort

Grote V.A., Rohrmann S., Nieters A., Dossus L., Tjonneland A., Halkjaer J., Overvad K., Fagherazzi G., Boutron-Ruault M.C., Morois S., Teucher B., Becker S., Sluik D., Boeing H., Trichopoulou A., Lagiou P., Trichopoulos D., Palli D., Pala V., Tumino R., Vineis P., Panico S., Rodriguez L., Duell E.J., Molina-Montes E., Dorronsoro M., Huerta J.M., Ardanaz E., Jeurnink S.M., Beulens J.W., Peeters P.H., Sund M., Ye W., Lindkvist B., Johansen D., Khaw K.T., Wareham N., Allen N., Crowe F., Jenab M., Romieu I., Michaud D.S., Riboli E., Romaguera D., Bueno-de-Mesquita H.B., Kaaks R.

Diabetologia; 2011; 54(12): 3037-3046

Abstract as provided by PubMed

AIMS/HYPOTHESIS: There has been long-standing debate about whether diabetes is a causal risk factor for pancreatic cancer or a consequence of tumour development. Prospective epidemiological studies have shown variable relationships between pancreatic cancer risk and blood markers of glucose and insulin metabolism, overall and as a function of lag times between marker measurements (blood donation) and date of tumour diagnosis. METHODS: Pre-diagnostic levels of HbA(1c) and C-peptide were measured for 466 participants with pancreatic cancer and 466 individually matched controls within the European Prospective Investigation into Cancer and Nutrition. Conditional logistic regression models were used to estimate ORs for pancreatic cancer. RESULTS: Pancreatic cancer risk gradually increased with increasing pre-diagnostic HbA(1c) levels up to an OR of 2.42 (95% CI 1.33, 4.39 highest [>/=6.5%, 48 mmol/mol] vs lowest [</=5.4%, 36 mmol/mol] category), even for individuals with HbA(1c) levels within the non-diabetic range. C-peptide levels showed no significant relationship with pancreatic cancer risk, irrespective of fasting status. Analyses showed no clear trends towards increasing hyperglycaemia (as marked by HbA(1c) levels) or reduced pancreatic beta cell responsiveness (as marked by C-peptide levels) with decreasing time intervals from blood donation to cancer diagnosis. CONCLUSIONS/INTERPRETATION: Our data on HbA(1c) show that individuals who develop exocrine pancreatic cancer tend to have moderate increases in HbA(1c) levels, relatively independently of obesity and insulin resistance-the classic and major risk factors for type 2 diabetes. While there is no strong difference by lag time, more data are needed on this in order to reach a firm conclusion

The European Prospective Investigation into Cancer and Nutrition biobank

Hainaut P., Vozar B., Rinaldi S., Riboli E., Caboux E.

Methods Mol Biol; 2011; 179-191

Abstract as provided by PubMed

The European Prospective Investigation into Cancer and Nutrition (EPIC) is a multi-center prospective cohort study designed to investigate the relationship between nutrition and cancer, with the potential for studying many etiologic or genetic factors as well as other disease end-points. The study includes 521,448 participants (367,993 women and 153,455 men, mostly aged 35-70 years) recruited in 23 centers located in ten European countries, who are followed up for cancer incidence and cause-specific mortality for several decades. At enrolment, which took place between 1992 and 2000 at each of the centers, information was collected through a non-dietary questionnaire on lifestyle variables and through a dietary questionnaire addressing usual diet. Anthropometric measurements were performed and blood samples taken, from which plasma, serum, red cells, and buffy coat fractions were separated and aliquoted. A central biobanking facility, located at the International Agency for Research on Cancer, Lyon, was developed for the long-term storage of the specimens in liquid nitrogen. The biobank operates as a service provider and sample distribution center for scientific consortia engaged in studies involving biomarker analyses. To date, EPIC represents the largest single resource worldwide for prospective investigations on the etiology of cancers that can integrate questionnaire data on lifestyle and diet, and can also provide access to measurements of biomarkers of diet and of endogenous metabolism (e.g., hormones and growth factors) and genetic polymorphisms. This chapter describes the building up of the EPIC central biobank and the mechanisms that have been developed to manage the access to specimens by a large number of different users

The association of education with body mass index and waist circumference in the EPIC-PANACEA study

Hermann S., Rohrmann S., Linseisen J., May A.M., Kunst A., Besson H., Romaguera D., Travier N., Tormo M.J., Molina E., Dorronsoro M., Barricarte A., Rodriguez L., Crowe F.L., Khaw K.T., Wareham N.J., van Boeckel P.G., Bueno-de-Mesquita H.B., Overvad K., Jakobsen M.U., Tjonneland A., Halkjaer J., Agnoli C., Mattiello A., Tumino R., Masala G., Vineis P., Naska A., Orfanos P., Trichopoulou A., Kaaks R., Bergmann M.M., Steffen A., Van Guelpen B., Johansson I., Borgquist S., Manjer J., Braaten T., Fagherazzi G., Clavel-Chapelon F., Mouw T., Norat T., Riboli E., Rinaldi S., Slimani N., Peeters P.H.

BMC Public Health; 2011; 169

Abstract as provided by PubMed

ABSTRACT: BACKGROUND: To examine the association of education with body mass index (BMI) and waist circumference (WC) in the European Prospective Investigation into Cancer and Nutrition (EPIC). METHOD: This study included 141,230 male and 336,637 female EPIC-participants, who were recruited between 1992 and 2000. Education, which was assessed by questionnaire, was classified into four categories; BMI and WC, measured by trained personnel in most participating centers, were modeled as continuous dependent variables. Associations were estimated using multilevel mixed effects linear regression models. RESULTS: Compared with the lowest education level, BMI and WC were significantly lower for all three higher education categories, which was consistent for all countries. Women with university degree had a 2.1 kg/m2 lower BMI compared with women with lowest education level. For men, a statistically significant, but less pronounced difference was observed (1.3 kg/m2). The association between WC and education level was also of greater magnitude for women: compared with the lowest education level, average WC of women was lower by 5.2 cm for women in the highest category. For men the difference was 2.9 cm. CONCLUSION: In this European cohort, there is an inverse association between higher BMI as well as higher WC and lower education level. Public Health Programs that aim to reduce overweight and obesity should primarily focus on the lower educated population

Inventory of experiences from national/regional dietary monitoring surveys using EPIC-Soft

Huybrechts I., Casagrande C., Nicolas G., Geelen A., Crispim S.P., De Keyzer W., Freisling H., De Henauw S., De Maeyer M., Krems C., Amiano P., de Boer E.J., Ocke M.C., de Vries J.H., Slimani N.

Eur J Clin Nutr; 2011; S16-S28

Abstract as provided by PubMed

BACKGROUND/OBJECTIVES: The EPIC-Soft 24-h recall (the software developed to conduct 24-h dietary recalls (24-HDRs) in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study) has been used in several regional/national dietary monitoring surveys. The main objective of the study was to present and discuss design, settings, logistics, data management and quality controls of dietary monitoring surveys that used EPIC-Soft for the collection of food consumption data. SUBJECTS/METHODS: Within European Food Consumption Validation (EFCOVAL), a questionnaire including questions on current/past EPIC-Soft experiences and requirements for the future was developed and sent to all institutes that used EPIC-Soft in their food consumption survey(s) (five surveys in four different countries). RESULTS: EPIC-Soft was used in the national food consumption survey in Belgium (>/= 15-97 years), Germany (14-80 years), the Netherlands (19-30 years and 2-6 years) and Spain (regional only; 4-18 years). Participation rates in these surveys were 46% (Belgium), 42% (Germany), 42% (Dutch survey in adults), 79% (Dutch survey in children) and 77% (Basque survey). Two 24-HDRs were collected by conducting face-to-face interviews in Belgium and Spain, and through telephone interviews in Germany and the Netherlands. Except the Netherlands (19-30 years), where the study was conducted only in autumn, in all other countries the study was conducted throughout the four seasons, including all days of the week. Interviews were conducted by dietitians, except in Germany and Spain. Mean EPIC-Soft interview time was 20-34 min. The dropout rate between the first and second interviews was low (<7.5%) in all surveys. CONCLUSION: EPIC-Soft has been used in different study settings and populations for nutritional exposure assessments. To guarantee the comparability of data across countries, recommendations for the design of future pan-European dietary monitoring surveys using EPIC-Soft should be drawn

Respondents' evaluation of the 24-h dietary recall method (EPIC-Soft) in the EFCOVAL Project

Huybrechts I., Geelen A., de Vries J.H., Casagrande C., Nicolas G., De Keyzer W., Lillegaard I.T., Ruprich J., Lafay L., Wilson-van den Hooven EC, Niekerk E.M., Margaritis I., Rehurkova I., Crispim S.P., Freisling H., De Henauw S., Slimani N.

Eur J Clin Nutr; 2011; S29-S37

Abstract as provided by PubMed

BACKGROUND: To improve participation rate, accuracy and respondents' compliance, it is important to know the respondents' viewpoint. OBJECTIVE: To evaluate respondents' preferences and perception about the EPIC-Soft (the software developed to conduct 24-h dietary recalls (24-HDRs) in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study) 24-HDR interviews and to compare these preferences and perception between population groups (for example, between genders). DESIGN: Data were collected in Belgium, Czech Republic, France, the Netherlands and Norway in 2007. Two 24-HDRs (face-to-face and telephone administered) were conducted using EPIC-Soft. An evaluation questionnaire on different study aspects was completed by the respondents. SETTING: Data were collected in the European Food Consumption Validation Study. SUBJECTS: A convenience sample of 600 apparently healthy men and women, 45-65 years old and including all educational levels, were recruited (120 subjects per country). Differences among population groups were compared by means of the chi (2)-test. RESULTS: A total of 585 respondents completed the evaluation questionnaire. In all, 88% experienced problems only to a low degree when answering face-to-face and telephone-administered 24-HDR using EPIC-Soft. A total of 15% would have preferred help of another person during the face-to-face interview in the study center (mainly men: P < 0.001). Significantly, more subjects in the Netherlands and in Norway preferred two telephone (instead of face-to-face) interviews compared with the other countries (P<0.001). CONCLUSION: Most subjects only experienced problems to a low degree during the EPIC-Soft interviews. Differences in preferences and capabilities to answer the EPIC-Soft interviews were identified between population groups (for example, gender differences). Therefore, the methods and the design to be used in a survey should be adapted according to the study population, so as to optimize response rate and compliance

Design and cohort description of the InterAct Project: an examination of the interaction of genetic and lifestyle factors on the incidence of type 2 diabetes in the EPIC Study

InterAct Consortium

Diabetologia; 2011; 54(9): 2272-2282

Abstract as provided by PubMed

AIMS/HYPOTHESIS: Studying gene-lifestyle interaction may help to identify lifestyle factors that modify genetic susceptibility and uncover genetic loci exerting important subgroup effects. Adequately powered studies with prospective, unbiased, standardised assessment of key behavioural factors for gene-lifestyle studies are lacking. This case-cohort study aims to investigate how genetic and potentially modifiable lifestyle and behavioural factors, particularly diet and physical activity, interact in their influence on the risk of developing type 2 diabetes. METHODS: Incident cases of type 2 diabetes occurring in European Prospective Investigation into Cancer and Nutrition (EPIC) cohorts between 1991 and 2007 from eight of the ten EPIC countries were ascertained and verified. Prentice-weighted Cox regression and random-effects meta-analyses were used to investigate differences in diabetes incidence by age and sex. RESULTS: A total of 12,403 verified incident cases of type 2 diabetes occurred during 3.99 million person-years of follow-up of 340,234 EPIC participants eligible for InterAct. We defined a centre-stratified subcohort of 16,154 individuals for comparative analyses. Individuals with incident diabetes who were randomly selected into the subcohort (n = 778) were included as cases in the analyses. All prevalent diabetes cases were excluded from the study. InterAct cases were followed-up for an average of 6.9 years; 49.7% were men. Mean baseline age and age at diagnosis were 55.6 and 62.5 years, mean BMI and waist circumference values were 29.4 kg/m(2) and 102.7 cm in men, and 30.1 kg/m(2) and 92.8 cm in women, respectively. Risk of type 2 diabetes increased linearly with age, with an overall HR of 1.56 (95% CI 1.48-1.64) for a 10 year age difference, adjusted for sex. A male excess in the risk of incident diabetes was consistently observed across all countries, with a pooled HR of 1.51 (95% CI 1.39-1.64), adjusted for age. CONCLUSIONS/INTERPRETATION: InterAct is a large, well-powered, prospective study that will inform our understanding of the interplay between genes and lifestyle factors on the risk of type 2 diabetes development

Plasma Phospholipid Long-Chain n-3 Polyunsaturated Fatty Acids and Body Weight Change

Jakobsen M.U., Dethlefsen C., Due K.M., Slimani N., Chajes V., May A.M., Sorensen T.I., Halkjaer J., Tjonneland A., Clavel-Chapelon F., Boutron-Ruault M.C., Fagherazzi G., Teucher B., Kaaks R., Boeing H., Schutze M., Trichopoulou A., Zylis D., Makrygiannis G., Palli D., Mattiello A., Tagliabue G., van der A.DL, Bueno-de-Mesquita H.B., Rodriguez L., Travier N., Molina-Montes E., Huerta J.M., Barricarte A., Amiano P., Manjer J., Wirfalt E., Johansson I., Hallmans G., Khaw K.T., Wareham N.J., Crowe F., Romieu I., Riboli E., Peeters P.H., Overvad K.

Obes Facts; 2011; 4(4): 312-318

Abstract as provided by PubMed

Objective: We investigated the association between the proportion of long-chain n-3 polyunsaturated fatty acids (PUFA) in plasma phospholipids from blood samples drawn at enrollment and subsequent change in body weight. Sex, age, and BMI were considered as potential effect modifiers. Method: A total of 1,998 women and men participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) were followed for a median of 4.9 years. The associations between the proportion of plasma phospholipid long-chain n-3 PUFA and change in weight were investigated using mixed-effect linear regression. Results: The proportion of long-chain n-3 PUFA was not associated with change in weight. Among all participants, the 1-year weight change was -0.7 g per 1% point higher long-chain n-3 PUFA level (95% confidence interval: -20.7 to 19.3). The results when stratified by sex, age, or BMI groups were not systematically different. Conclusion: The results of this study suggest that the proportion of long-chain n-3 PUFA in plasma phospholipids is not associated with subsequent change in body weight within the range of exposure in the general population

Red Meat, Dietary Nitrosamines, and Heme Iron and Risk of Bladder Cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Jakszyn P., Gonzalez C.A., Lujan-Barroso L., Ros M.M., Bueno-de-Mesquita H.B., Roswall N., Tjonneland A.M., Buchner F.L., Egevad L., Overvad K., Raaschou-Nielsen O., Clavel-Chapelon F., Boutron-Ruault M.C., Touillaud M.S., Chang-Claude J., Allen N.E., Kiemeney L.A., Key T.J., Kaaks R., Boeing H., Weikert S., Trichopoulou A., Oikonomou E., Zylis D., Palli D., Berrino F., Vineis P., Tumino R., Mattiello A., Peeters P.H., Parr C.L., Gram I.T., Skeie G., Sanchez M.J., Larranaga N., Ardanaz E., Navarro C., Rodriguez L., Ulmert D., Ehrnstrom R., Hallmans G., Ljungberg B., Roddam A.W., Bingham S.A., Khaw K.T., Slimani N., Boffetta P.A., Jenab M., Mouw T., Michaud D.S., Riboli E.

Cancer Epidemiol Biomarkers Prev; 2011; 20(3): 555-559

Abstract as provided by PubMed

BACKGROUND: Previous epidemiologic studies found inconsistent results for the association between red meat intake, nitrosamines [NDMA: N-nitrosodimethylamine, and ENOC (endogenous nitroso compounds)], and the risk of bladder cancer. We investigated the association between red meat consumption, dietary nitrosamines, and heme iron and the risk of bladder cancer among participants of the European Prospective Investigation into Cancer and Nutrition (EPIC). METHODS: Data on food consumption and complete follow-up for cancer occurrence were available for a total of 481,419 participants, recruited in 10 European countries. Estimates of HRs were obtained by proportional hazard models, stratified by age at recruitment, gender, and study center and adjusted for total energy intake, smoking status, lifetime intensity of smoking, duration of smoking, educational level, and BMI. RESULTS: After a mean follow-up of 8.7 years, 1,001 participants were diagnosed with bladder cancer. We found no overall association between intake of red meat (log(2) HR: 1.06; 95% CI: 0.99-1.13), nitrosamines (log(2) HR: 1.09; 95% CI: 0.92-1.30 and HR: 0.98; 95% CI: 0.92-1.05 for ENOC and NDMA, respectively) or heme iron (log(2) HR: 1.05; 95 CI: 0.99-1.12) and bladder cancer risk. The associations did not vary by sex, high- versus low-risk bladder cancers, smoking status, or occupation (high vs. low risk). CONCLUSIONS: Our findings do not support an effect of red meat intake, nitrosamines (endogenous or exogenous), or heme iron intake on bladder cancer risk. Cancer Epidemiol Biomarkers Prev; 20(3); 555-9. (c)2011 AACR

Postmenopausal serum sex steroids and risk of hormone receptor-positive and -negative breast cancer: a nested case-control study

James R.E., Lukanova A., Dossus L., Becker S., Rinaldi S., Tjonneland A., Olsen A., Overvad K., Mesrine S., Engel P., Clavel-Chapelon F., Chang-Claude J., Vrieling A., Boeing H., Schutze M., Trichopoulou A., Lagiou P., Trichopoulos D., Palli D., Krogh V., Panico S., Tumino R., Sacerdote C., Rodriguez L., Buckland G., Sanchez M.J., Amiano P., Ardanaz E., Bueno-de-Mesquita B., Ros M.M., Van Gils C.H., Peeters P.H., Khaw K.T., Wareham N., Key T.J., Allen N.E., Romieu I., Siddiq A., Cox D., Riboli E., Kaaks R.

Cancer Prev Res (Phila); 2011; 4(10): 1626-1635

Abstract as provided by PubMed

Prediagnostic endogenous sex steroid hormone levels have well established associations with overall risk of breast cancer. While evidence toward the existence of distinct subtypes of breast cancer accumulates, few studies have investigated the associations of sex steroid hormone levels with risk of hormone receptor [estrogen receptor (ER) and/or progesterone receptor (PR)] defined breast cancer. In a case-control study nested within the EPIC cohort (European Prospective Investigation into Cancer and Nutrition), estradiol, testosterone, and sex hormone-binding globulin levels were measured in prediagnostic serum samples from postmenopausal women not using hormone replacement therapy at blood donation. A total of 554 women who developed invasive breast cancer with information on receptor status were matched with 821 control subjects. Conditional logistic regression models estimated breast cancer risk with hormone concentrations according to hormone receptor status of the tumor. Sex steroid hormones were associated with risks of not only ER+PR+ breast cancer [estradiol OR for highest vs. lowest tertile = 2.91 (95% CI: 1.62-5.23), P(trend) = 0.002; testosterone OR = 2.27 (95% CI: 1.35-3.81), P(trend) = 0.002] but also of ER-PR- breast cancer [estradiol OR = 2.11 (95% CI: 1.00-4.46), P(trend) = 0.05; testosterone OR = 2.06 (95% CI: 0.95-4.46), P(trend) = 0.03], with associations appearing somewhat stronger in the receptor-positive disease. Serum androgens and estrogens are associated with risks of both hormone receptor-negative as well as receptor-positive breast tumors. Further research is needed to establish through which molecular pathways, and during which evolutionary stages of development, androgens and estrogens can promote the occurrence of both receptor-positive and -negative clinical breast tumors. Cancer Prev Res; 4(10); 1626-35. (c)2011 AACR

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