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2011

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

PMID:20731527

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

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

PMID:21731000

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

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

PMID:21731001

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

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

PMID:21993435

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

PMID:21346093

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

PMID:21378267

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

PMID:21098651

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

PMID:20853322

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

PMID:21953276

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

PMID:20949388

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

PMID:21414225

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

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

PMID:21731003

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

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

PMID:21731002

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

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

PMID:21717116

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

PMID:21921655

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

PMID:21239687

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

PMID:21813404

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

Cigarette smoking and colorectal cancer risk in the European prospective investigation into cancer and nutrition study

Leufkens A.M., van Duijnhoven F.J., Siersema P.D., Boshuizen H.C., Vrieling A., Agudo A., Gram I.T., Weiderpass E., Dahm C., Overvad K., Tjonneland A., Olsen A., Boutron-Ruault M.C., Clavel-Chapelon F., Morois S., Palli D., Grioni S., Tumino R., Sacerdote C., Mattiello A., Herman S., Kaaks R., Steffen A., Boeing H., Trichopoulou A., Lagiou P., Trichopoulos D., Peeters P.H., Van Gils C.H., van Kranen H., Lund E., Dumeaux V., Engeset D., Rodriguez L., Sanchez M.J., Chirlaque M.D., Barricarte A., Manjer J., Almquist M., Van Guelpen B., Hallmans G., Khaw K.T., Wareham N., Tsilidis K.K., Straif K., Leon-Roux M., Vineis P., Norat T., Riboli E., Bueno-de-Mesquita H.B.

Clin Gastroenterol Hepatol; 2011; 9(2): 137-144

PMID:21029790

Abstract as provided by PubMed

BACKGROUND & AIMS: There has been consistent evidence for a relationship between smoking and colorectal cancer (CRC), although it is not clear whether the colon or rectum is more sensitive to the effects of smoking. We investigated the relationships between cigarette smoking and risk of CRC and tumor location. METHODS: We analyzed data from 465,879 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) study; 2741 developed CRC during the follow-up period (mean, 8.7 years). Cox proportional hazard regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: The risk of colon carcinoma was increased among ever smokers (HR, 1.18; 95% CI, 1.06-1.32) and former cigarette smokers (HR, 1.21; 95% CI, 1.08-1.36), compared with never smokers; the increased risk for current smokers was of borderline significance (HR, 1.13; 95% CI, 0.98-1.31). When stratified for tumor location, the risk of proximal colon cancer was increased for former (HR, 1.25; 95% CI, 1.04-1.50) and current smokers (HR, 1.31; 95% CI, 1.06-1.64), but the risks for cancers in the distal colon or rectum were not. Subsite analyses showed a nonsignificant difference between the proximal and distal colon (P = .45) for former smokers and a significant difference for current smokers (P = .02). For smokers who had stopped smoking for at least 20 years, the risk of developing colon cancer was similar to that of never smokers. CONCLUSIONS: Ever smokers have an increased risk of colon cancer, which appeared to be more pronounced in the proximal than the distal colon location

Consumption of meat and fish and risk of lung cancer: results from the European Prospective Investigation into Cancer and Nutrition

Linseisen J., Rohrmann S., Bueno-de-Mesquita B., Buchner F.L., Boshuizen H.C., Agudo A., Gram I.T., Dahm C.C., Overvad K., Egeberg R., Tjonneland A., Boeing H., Steffen A., Kaaks R., Lukanova A., Berrino F., Palli D., Panico S., Tumino R., Ardanaz E., Dorronsoro M., Huerta J.M., Rodriguez L., Sanchez M.J., Rasmuson T., Hallmans G., Manjer J., Wirfalt E., Engeset D., Skeie G., Katsoulis M., Oikonomou E., Trichopoulou A., Peeters P.H., Khaw K.T., Wareham N., Allen N., Key T., Brennan P., Romieu I., Slimani N., Vergnaud A.C., Xun W.W., Vineis P., Riboli E.

Cancer Causes Control; 2011; 22(6): 909-918

PMID:21479828

Abstract as provided by PubMed

Evidence from case-control studies, but less so from cohort studies, suggests a positive association between meat intake and risk of lung cancer. Therefore, this association was evaluated in the frame of the European Prospective Investigation into Cancer and Nutrition, EPIC. Data from 478,021 participants, recruited from 10 European countries, who completed a dietary questionnaire in 1992-2000 were evaluated; 1,822 incident primary lung cancer cases were included in the present evaluation. Relative risk estimates were calculated for categories of meat intake using multi-variably adjusted Cox proportional hazard models. In addition, the continuous intake variables were calibrated by means of 24-h diet recall data to account for part of the measurement error. There were no consistent associations between meat consumption and the risk of lung cancer. Neither red meat (RR = 1.06, 95% CI 0.89-1.27 per 50 g intake/day; calibrated model) nor processed meat (RR = 1.13, 95% CI 0.95-1.34 per 50 g/day; calibrated model) was significantly related to an increased risk of lung cancer. Also, consumption of white meat and fish was not associated with the risk of lung cancer. These findings do not support the hypothesis that a high intake of red and processed meat is a risk factor for lung cancer

The contribution of risk factors to the higher incidence of invasive and in situ breast cancers in women with higher levels of education in the European prospective investigation into cancer and nutrition

Menvielle G., Kunst A.E., Van Gils C.H., Peeters P.H., Boshuizen H., Overvad K., Olsen A., Tjonneland A., Hermann S., Kaaks R., Bergmann M.M., Illner A.K., Lagiou P., Trichopoulos D., Trichopoulou A., Palli D., Berrino F., Mattiello A., Tumino R., Sacerdote C., May A., Monninkhof E., Braaten T., Lund E., Quiros J.R., Duell E.J., Sanchez M.J., Navarro C., Ardanaz E., Borgquist S., Manjer J., Khaw K.T., Allen N.E., Reeves G.K., Chajes V., Rinaldi S., Slimani N., Gallo V., Vineis P., Riboli E., Bueno-de-Mesquita H.B.

Am J Epidemiol; 2011; 173(1): 26-37

PMID:21084553

Abstract as provided by PubMed

The authors investigated the role of known risk factors in educational differences in breast cancer incidence. Analyses were based on the European Prospective Investigation Into Cancer and Nutrition and included 242,095 women, 433 cases of in situ breast cancer, and 4,469 cases of invasive breast cancer. Reproductive history (age at first full-term pregnancy and parity), exposure to endogenous and exogenous hormones, height, and health behaviors were accounted for in the analyses. Relative indices of inequality (RII) for education were estimated using Cox regression models. A higher risk of invasive breast cancer was found among women with higher levels of education (RII = 1.22, 95% confidence interval (CI): 1.09, 1.37). This association was not observed among nulliparous women (RII = 1.13, 95% CI: 0.84, 1.52). Inequalities in breast cancer incidence decreased substantially after adjusting for reproductive history (RII = 1.11, 95% CI: 0.98, 1.25), with most of the association being explained by age at first full-term pregnancy. Each other risk factor explained a small additional part of the inequalities in breast cancer incidence. Height accounted for most of the remaining differences in incidence. After adjusting for all known risk factors, the authors found no association between education level and risk of invasive breast cancer. Inequalities in incidence were more pronounced for in situ breast cancer, and those inequalities remained after adjustment for all known risk factors (RII = 1.61, 95% CI: 1.07, 2.41), especially among nulliparous women

Eating out, weight and weight gain. A cross-sectional and prospective analysis in the context of the EPIC-PANACEA study

Naska A., Orfanos P., Trichopoulou A., May A.M., Overvad K., Jakobsen M.U., Tjonneland A., Halkjaer J., Fagherazzi G., Clavel-Chapelon F., Boutron-Ruault M.C., Rohrmann S., Hermann S., Steffen A., Haubrock J., Oikonomou E., Dilis V., Katsoulis M., Sacerdote C., Sieri S., Masala G., Tumino R., Mattiello A., Bueno-de-Mesquita H.B., Skeie G., Engeset D., Barricarte A., Rodriguez L., Dorronsoro M., Sanchez M.J., Chirlaque M.D., Agudo A., Manjer J., Wirfalt E., Hellstrom V., Shungin D., Khaw K.T., Wareham N.J., Spencer E.A., Freisling H., Slimani N., Vergnaud A.C., Mouw T., Romaguera D., Odysseos A., Peeters P.H.

Int J Obes (Lond); 2011; 35(3): 416-426

PMID:20661252

Abstract as provided by PubMed

Objective:The aim of this study was to examine the association of body mass index (BMI) and weight gain with eating at restaurants and similar establishments or eating at work among 10 European countries of the European Prospective Investigation into Cancer and Nutrition (EPIC) study.Subjects:This study included a representative sample of 24 310 randomly selected EPIC participants.Methods:Single 24-h dietary recalls with information on the place of consumption were collected using standardized procedures between 1995 and 2000. Eating at restaurants was defined to include all eating and drinking occasions at restaurants, cafeterias, bars and fast food outlets. Eating at work included all eating and drinking occasions at the workplace. Associations between eating at restaurants or eating at work and BMI or annual weight changes were assessed using sex-specific linear mixed-effects models, controlling for potential confounders.Results:In southern Europe energy intake at restaurants was higher than intake at work, whereas in northern Europe eating at work appeared to contribute more to the mean daily intake than eating at restaurants. Cross-sectionally, eating at restaurants was found to be positively associated with BMI only among men (beta=+0.24, P=0.003). Essentially no association was found between BMI and eating at work among both genders. In a prospective analysis among men, eating at restaurants was found to be positively, albeit nonsignificantly, associated with weight gain (beta=+0.05, P=0.368). No association was detected between energy intake at restaurants and weight changes, controlling for total energy intake.Conclusion:Among men, eating at restaurants and similar establishments was associated with higher BMI and possibly weight gain

Occupation and risk of lymphoma: a multicentre prospective cohort study (EPIC)

Neasham D., Sifi A., Nielsen K.R., Overvad K., Raaschou-Nielsen O., Tjonneland A., Barricarte A., Gonzalez C.A., Navarro C., Rodriguez Suarez L., Travis R.C., Key T., Linseisen J., Kaaks R., Crosignani P., Berrino F., Rosso S., Mattiello A., Vermeulen R.C., Bueno-de-Mesquita H.B., Berglund G., Manjer J., Zackrisson S., Hallmans G., Malmer B., Bingham S., Khaw K.T., Bergmann M.M., Boeing H., Trichopoulou A., Masala G., Tumino R., Lund E., Slimani N., Ferrari P., Boffetta P., Vineis P., Riboli E.

Occup Environ Med; 2011; 68(1): 77-81

PMID:20884795

Abstract as provided by PubMed

OBJECTIVES: Evidence suggests that certain occupations and related exposures may increase the risk of malignant lymphoma. Farming, printing and paper industry, wood processing, meat handling and processing, welding, shoe and leather manufacturing and teaching profession are among the categories that have been implicated in previous studies. The relationship between occupation and malignant lymphoma has been investigated in a large European prospective study. METHODS: We investigated occupational risks for lymphomas in the European Prospective Investigation into Cancer and Nutrition (EPIC). The mean follow-up time for 348,555 subjects was 9 years (SD: 2 years). The analysis was based on 866 and 48 newly diagnosed cases of non-Hodgkin's lymphoma (NHL) and Hodgkin's lymphoma (HL). These were identified in the EPIC subcohorts with occupational data. Data on 52 occupations were collected through standardised questionnaires. Cox proportional hazard models were used to explore the association between occupation and risk of malignant lymphoma. RESULTS: The following occupations were positively associated with malignant NHL after adjustment for study centre, age, sex, socioeconomic status (SES), smoking and alcohol: butchers (HR=1.53, 95% CI 1.05 to 2.48, including multiple myeloma/plasmacytoma; HR=1.30, 95% CI 1.00 to 2.66, excluding multiple myeloma/plasmacytoma) and car repair workers (HR=1.50, 95% CI 1.01 to 2.00, including multiple myeloma/plasmacytoma; HR=1.51, 95% CI 1.01 to 2.31, excluding multiple myeloma/plasmacytoma). HL was associated with gasoline station occupation (HR=4.59, 95% CI 1.08 to 19.6). CONCLUSION: The findings in this current study of a higher risk of NHL among car repair workers and butchers and a higher risk of HL among gasoline station workers suggest a possible role from occupationally related exposures, such as solvents and zoonotic viruses, as risk factors for malignant lymphoma

Potential and requirements for a standardized pan-European food consumption survey using the EPIC-Soft software

Ocke M.C., Slimani N., Brants H., Buurma-Rethans E., Casagrande C., Nicolas G., Dofkova M., le Donne C., Freisling H., Geelen A., Huybrechts I., De Keyzer W., van der Laan J.D., Lafay L., Lillegaard I.T., Niekerk E.M., de Vries J.H., Wilson-van den Hooven EC, de Boer E.J.

Eur J Clin Nutr; 2011; S48-S57

PMID:21731005

Abstract as provided by PubMed

BACKGROUND/OBJECTIVES: To describe the strengths, limitations and requirements of using EPIC-Soft software (the software developed to conduct 24-h dietary recalls in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study) in pan-European food consumption surveys, and to discuss potentials and barriers for a harmonized pan-European food consumption survey. SUBJECTS/METHODS: The paper is based on the experiences in the 'European Food Consumption and Validation' Project, which included updating six existing and preparing one new country-specific EPIC-Soft version, applying EPIC-Soft in validation and feasibility studies, and estimating the intake of nutrients and flavoring substances. The experiences were discussed in the September 2009 workshop 'Pan-European Food Consumption Surveys--for Standardized and Comparable Transnational Data Collection'. RESULTS: EPIC-Soft is suitable for detailed and standardized food consumption data collection in pan-European food consumption surveys. A thorough preparation of all aspects of the food consumption survey is important for the quality and efficiency during data collection and processing. The preparation and data-handling phase of working with EPIC-Soft is labor intensive and requires trained, motivated and qualified personnel. CONCLUSIONS: Given the suitability of EPIC-Soft as standardized dietary assessment tool in European dietary monitoring, the proposed strategy toward a pan-European food consumption survey is to prepare well, to allow flexibility in national extensions and to start with a limited number of countries that are interested

Endogenous Sex Steroids and Risk of Cervical Carcinoma: Results from the EPIC Study

Rinaldi S., Plummer M., Biessy C., Castellsague X., Overvad K., Kruger Kjaer S., Tjonneland A., Clavel-Chapelon F., Chabbert-Buffet N., Mesrine S., Lukanova A., Kaaks R., Weikert C., Boeing H., Trichopoulou A., Lagiou P., Trichopoulos D., Palli D., Agnoli C., Tumino R., Vineis P., Panico S., Bueno-de-Mesquita B., van Kranen H.J., Peeters P.H., Bakken K., Lund E., Gram I.T., Rodriguez L., Bosch F.X., Sanchez M.J., Dorronsoro M., Navarro C., Gurrea A.B., Kjellberg L., Dillner J., Manjer J., Butt S., Khaw K.T., Wareham N., Allen N.E., Travis R., Romieu I., Ferrari P., Riboli E., Franceschi S.

Cancer Epidemiol Biomarkers Prev; 2011; 20(12): 2532-2540

PMID:21994406

Abstract as provided by PubMed

BACKGROUND: Epidemiologic data and animal models suggest that, despite the predominant role of human papillomavirus infection, sex steroid hormones are also involved in the etiology of invasive cervical carcinoma (ICC). METHODS: Ninety-nine ICC cases, 121 cervical intraepithelial neoplasia grade 3 (CIN3) cases and 2 control women matched with each case for center, age, menopausal status and blood collection-related variables, were identified in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Circulating levels of testosterone (T) and estradiol (E(2)); dehydroepiandrosterone sulfate (DHEAS); progesterone (premenopausal women); and sex hormone-binding globulin (SHBG) were measured using immunoassays. Levels of free (f) T and E(2) were calculated from absolute concentrations of T, E(2), and SHBG. Odds ratios (ORs) and 95% confidence intervals (CI) were computed using regularized conditional logistic regression. RESULTS: Among premenopausal women, associations with ICC were observed for fT (OR for highest vs. lowest tertile = 5.16, 95% CI, 1.50-20.1). SHBG level was associated with a significant downward trend in ICC risk. T, E(2), fE(2), and DHEAS showed nonsignificant positive association with ICC. Progesterone was uninfluential. Among postmenopausal women, associations with ICC were found for T (OR = 3.14; 95% CI, 1.21-9.37), whereas E(2) and fT showed nonsignificant positive association. SHBG level was unrelated to ICC risk in postmenopausal women. No associations between any hormone and CIN3 were detected in either pre- or postmenopausal women. CONCLUSIONS: Our findings suggest for the first time that T and possibly E(2) may be involved in the etiology of ICC. Impact: The responsiveness of cervical tumors to hormone modulators is worth exploring. Cancer Epidemiol Biomarkers Prev; 20(12); 2532-40. (c)2011 AACR

Consumption of meat and dairy and lymphoma risk in the European Prospective Investigation into Cancer and Nutrition

Rohrmann S., Linseisen J., Jakobsen M.U., Overvad K., Raaschou-Nielsen O., Tjonneland A., Boutron-Ruault M.C., Kaaks R., Becker N., Bergmann M., Boeing H., Khaw K.T., Wareham N.J., Key T.J., Travis R., Benetou V., Naska A., Trichopoulou A., Pala V., Tumino R., Masala G., Mattiello A., Brustad M., Lund E., Skeie G., Bueno-de-Mesquita H.B., Peeters P.H., Vermeulen R.C., Jakszyn P., Dorronsoro M., Barricarte A., Tormo M.J., Molina E., Arguelles M., Melin B., Ericson U., Manjer J., Rinaldi S., Slimani N., Boffetta P., Vergnaud A.C., Khan A., Norat T., Vineis P.

Int J Cancer; 2011; 128(3): 623-634

PMID:20473877

Abstract as provided by PubMed

The consumption of meat and other foods of animal origin is a risk factor for several types of cancer, but the results for lymphomas are inconclusive. Therefore, we examined these associations among 411,097 participants of the European Prospective Investigation into Cancer and Nutrition. During a median follow-up of 8.5 years, 1,334 lymphomas (1,267 non-Hodgkin lymphoma (NHL) and 67 Hodgkin lymphomas) were identified. Consumption of red and processed meat, poultry, milk and dairy products was assessed by dietary questionnaires. Cox proportional hazard regression was used to evaluate the association of the consumption of these food groups with lymphoma risk. Overall, the consumption of foods of animal origin was not associated with an increased risk of NHLS or HL, but the associations with specific subgroups of NHL entities were noted. A high intake of processed meat was associated with an increased risk of B-cell chronic lymphocytic leukemia (BCLL) [relative risk (RR) per 50 g intake = 1.31, 95% confidence interval (CI) 1.06-1.63], but a decreased risk of follicular lymphomas (FL) (RR = 0.58; CI 0.38-0.89). A high intake of poultry was related to an increased risk of B-cell lymphomas (RR = 1.22; CI 1.05-1.42 per 10 g intake), FL (RR = 1.65; CI 1.18-2.32) and BCLL (RR = 1.54; CI 1.18-2.01) in the continuous models. In conclusion, no consistent associations between red and processed meat consumption and lymphoma risk were observed, but we found that the consumption of poultry was related to an increased risk of B-cell lymphomas. Chance is a plausible explanation of the observed associations, which need to be confirmed in further studies

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