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2009

Consumption of vegetables and fruit and the risk of bladder cancer in the European Prospective Investigation into Cancer and Nutrition

Buchner F.L., Bueno-de-Mesquita H.B., Ros M.M., Kampman E., Egevad L., Overvad K., Raaschou-Nielsen O., Tjonneland A., Roswall N., Clavel-Chapelon F., Boutron-Ruault M.C., Touillaud M., Chang-Claude J., Kaaks R., Boeing H., Weikert S., Trichopoulou A., Lagiou P., Trichopoulos D., Palli D., Sieri S., Vineis P., Tumino R., Panico S., Vrieling A., Peeters P.H., Van Gils C.H., Lund E., Gram I.T., Engeset D., Martinez C., Gonzalez C.A., Larranaga N., Ardanaz E., Navarro C., Rodriguez L., Manjer J., Ehrnstrom R.A., Hallmans G., Ljungberg B., Allen N.E., Roddam A.W., Bingham S., Khaw K.T., Slimani N., Boffetta P., Jenab M., Mouw T., Michaud D.S., Kiemeney L.A., Riboli E.

Int J Cancer; 2009; 125(11): 2643-2651

PMID:19618458

Abstract as provided by PubMed

Previous epidemiologic studies found inconsistent associations between vegetables and fruit consumption and the risk of bladder cancer. We therefore investigated the association between vegetable and fruit consumption and the risk of bladder cancer among participants of the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Data on food consumption and complete follow-up for cancer occurrence was available for a total of 478,533 participants, who were recruited in 10 European countries. Estimates of rate ratios were obtained by Cox proportional hazard models, stratified by age at recruitment, gender and study centre, and adjusted for total energy intake, smoking status, duration of smoking and lifetime intensity of smoking. A calibration study in a subsample was used to control for dietary measurement errors. After a mean follow-up of 8.7 years, 1015 participants were newly diagnosed with bladder cancer. Increments of 100 g/day in fruit and vegetable consumption combined did not affect bladder cancer risk (i.e., calibrated HR = 0.98; 95%CI: 0.95-1.01). Borderline statistically significant lower bladder cancer risks were found among never smokers with increased consumption of fruit and vegetables combined (HR = 0.94 95%CI: 0.87-1.00 with increments of 100 g/day; calibrated HR = 0.92 95%CI 0.79-1.06) and increased consumption of apples and pears (hard fruit; calibrated HR = 0.90 95%CI: 0.82-0.98 with increments of 25 g/day). For none of the associations a statistically significant interaction with smoking status was found. Our findings do not support an effect of fruit and vegetable consumption, combined or separately, on bladder cancer risk

The Association between Diet and Serum Concentrations of IGF-I, IGFBP-1, IGFBP-2, and IGFBP-3 in the European Prospective Investigation into Cancer and Nutrition

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

Cancer Epidemiol Biomarkers Prev; 2009; 18(5): 1333-1340

PMID:19423514

Abstract as provided by PubMed

Circulating concentrations of insulin-like growth factor I (IGF-I) and IGF binding proteins (IGFBP) have been associated with the risk of several types of cancer. Dietary correlates of IGF-I and IGFBPs are not yet well established. The objective of this study was to assess the association between dietary intake and serum concentrations of IGF-I, IGFBP-1, IGFBP-2, and IGFBP-3 in a cross-sectional analysis of 4,731 men and women taking part in the European Prospective Investigation into Cancer and Nutrition. Diet was assessed using country-specific validated dietary questionnaires. Serum concentrations of IGF-I, IGFBP-1, IGFBP-2 and IGFBP-3 were measured, and the associations between diet and IGF-I and IGFBPs were assessed using multiple linear regression adjusting for sex, age, body mass index, smoking status, and alcohol and energy intake. Each 1 SD increment increase in total and dairy protein and calcium intake was associated with an increase in IGF-I concentration of 2.5%, 2.4%, and 3.3%, respectively (P for trend <0.001 for all) and a decrease in IGFBP-2 of 3.5%, 3.5%, and 5.4% (P for trend <0.001 for all), respectively. There were no significant associations between the intake of protein or calcium from nondairy sources and IGF-I. The results from this large cross-sectional analysis show that either the intake of dairy protein or calcium is an important dietary determinant of IGF-I and IGFBP-2 concentrations; however, we suggest that it is more likely to be protein from dairy products. (Cancer Epidemiol Biomarkers Prev 2009;18(5):1333-40)

Total dietary carbohydrate, sugar, starch and fibre intakes in the European Prospective Investigation into Cancer and Nutrition

Cust A.E., Skilton M.R., van Bakel M.M.E., Halkjaer J., Olsen A., Agnoli C., Psaltopoulou T., Buurma E., Sonestedt E., Chirlaque M.D., Rinaldi S., Tjonneland A., Jensen M.K., Clavel-Chapelon F., Boutron-Ruault M.C., Kaaks R., Nothlings U., Chloptsios Y., Zylis D., Mattiello A., Caini S., Ocke M.C., van der Schouw Y.T., Skeie G., Parr C.L., Molina-Montes E., Manjer J., Johansson I., McTaggart A., Key T.J., Bingham S., Riboli E., Slimani N.

Eur J Clin Nutr; 2009; S37-S60

PMID:19888280

Abstract as provided by PubMed

Objective: To describe dietary carbohydrate intakes and their food sources among 27 centres in 10 countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Methods: Between 1995 and 2000, 36 034 subjects, aged between 35-74 years, were administered a standardized, 24-h dietary recall using a computerized interview software programme (EPIC-SOFT). Intakes (g/day) of total carbohydrate, sugars, starch and fibre were estimated using the standardized EPIC Nutrient Database (ENDB). Mean intakes were adjusted for age, total energy intake, height and weight, and were weighted by season and day of recall. Results: Adjusted mean total carbohydrate intakes were highest in Italy and in the UK health-conscious cohort, and were lowest in Spain, Greece and France. Total fibre intakes were highest in the UK health-conscious cohort and lowest in Sweden and the UK general population. Bread contributed the highest proportion of carbohydrates (mainly starches) in every centre. Fruit consumption contributed a greater proportion of total carbohydrates (mainly sugars) among women than among men, and in southern centres compared with northern centres. Bread, fruits and vegetables represented the largest sources of fibre, but food sources varied considerably between centres. In stratified analyses, carbohydrate intakes tended to be higher among subjects who were physically active, never-smokers or non-drinkers of alcohol. Conclusions: Dietary carbohydrate intakes and in particular their food sources varied considerably between these 10 European countries. Intakes also varied according to gender and lifestyle factors. These data will form the basis for future aetiological analyses of the role of dietary carbohydrates in influencing health and disease. European Journal of Clinical Nutrition (2009) 63, S37-S60; doi: 10.1038/ejcn.2009.74

Reproducibility and relative validity of dietary glycaemic index and glycaemic load assessed by the food-frequency questionnaire used in the Dutch cohorts of the European Prospective Investigation into Cancer and Nutrition

Du H., van der A D.L., van Bakel M.M., Verberne L.D., Ocke M., Feskens E.J.

Br J Nutr; 2009; 102(4): 601-604

PMID:19302718

Abstract as provided by PubMed

Limited information is available on the reproducibility and validity of dietary glycaemic index (GI) and glycaemic load (GL) estimated by habitual diet assessment methods such as FFQ, including the FFQ used in the Dutch cohorts of the European Prospective Investigation into Cancer and Nutrition study. To examine the reproducibility and relative validity of GI and GL, we used data from 121 Dutch men and women aged 23-72 years. They completed the FFQ three times at intervals of 6 months and twelve 24-h dietary recalls (24HDR) monthly during 1991-2. GI and GL were calculated using published values. Intra-class correlation coefficients of the three repeated FFQ were 0.78 for GI and 0.74 for GL. Pearson correlation coefficients between the first FFQ and the weighted average of the 24HDR were 0.63 for both GI and GL. Weighted kappa values between the first FFQ and the average of the 24HDR (in quintiles) were 0.40 for GI and 0.41 for GL. Bland-Altman plots showed a proportional bias in GI (beta = 0.46), but not in GL (beta = 0.06). In conclusion, this FFQ can be used in epidemiological studies to investigate the relationship of GI and GL with disease risks, but the proportional bias should be taken into account when using this FFQ to assess the absolute GI values

A bivariate measurement error model for nitrogen and potassium intakes to evaluate the performance of regression calibration in the European Prospective Investigation into Cancer and Nutrition study

Ferrari P., Roddam A., Fahey M.T., Jenab M., Bamia C., Ocke M., Amiano P., Hjartaker A., Biessy C., Rinaldi S., Huybrechts I., Tjonneland A., Dethlefsen C., Niravong M., Clavel-Chapelon F., Linseisen J., Boeing H., Oikonomou E., Orfanos P., Palli D., de Magistris M.S., Bueno-de-Mesquita H.B., Peeters P.H.M., Parr C.L., Braaten T., Dorronsoro M., Berenguer T., Gullberg B., Johansson I., Welch A.A., Riboli E., Bingham S., Slimani N.

Eur J Clin Nutr; 2009; S179-S187

PMID:19888273

Abstract as provided by PubMed

Objectives: Within the European Prospective Investigation into Cancer and Nutrition (EPIC) study, the performance of 24-h dietary recall (24-HDR) measurements as reference measurements in a linear regression calibration model is evaluated critically at the individual (within-centre) and aggregate (between-centre) levels by using unbiased estimates of urinary measurements of nitrogen and potassium intakes. Methods: Between 1995 and 1999, 1072 study subjects (59% women) from 12 EPIC centres volunteered to collect 24-h urine samples. Log-transformed questionnaire, 24-HDR and urinary measurements of nitrogen and potassium intakes were analysed in a multivariate measurement error model to estimate the validity of coefficients and error correlations in self-reported dietary measurements. In parallel, correlations between means of 24-HDR and urinary measurements were computed. Linear regression calibration models were used to estimate the regression dilution (attenuation) factors. Results: After adjustment for sex, centre, age, body mass index and height, the validity coefficients for 24-HDRs were 0.285 (95% confidence interval: 0.194, 0.367) and 0.371 (0.291, 0.446) for nitrogen and potassium intakes, respectively. The attenuation factors estimated in a linear regression calibration model were 0.368 (0.228, 0.508) for nitrogen and 0.500 (0.361, 0.639) for potassium intakes; only the former was different from the estimate obtained using urinary measurements in the measurement error model. The aggregate-level correlation coefficients between means of urinary and 24-HDR measurements were 0.838 (0.637, 0.932) and 0.756 (0.481, 0.895) for nitrogen and potassium intakes, respectively. Conclusions: This study suggests that 24-HDRs can be used as reference measurements at the individual and aggregate levels for potassium intake, whereas, for nitrogen intake, good performance is observed for between-centre calibration, but some limitations are apparent at the individual level. European Journal of Clinical Nutrition (2009) 63, S179-S187; doi: 10.1038/ejcn.2009.80

Intake of total, animal and plant proteins, and their food sources in 10 countries in the European Prospective Investigation into Cancer and Nutrition

Halkjaer J., Olsen A., Bjerregaard L.J., Deharveng G., Tjonneland A., Welch A.A., Crowe F.L., Wirfalt E., Hellstrom V., Niravong M., Touvier M., Linseisen J., Steffen A., Ocke M.C., Peeters P.H.M., Chirlaque M.D., Larranaga N., Ferrari P., Contiero P., Frasca G., Engeset D., Lund E., Misirli G., Kosti M., Riboli E., Slimani N., Bingham S.

Eur J Clin Nutr; 2009; S16-S36

PMID:19888272

Abstract as provided by PubMed

Objective: To describe dietary protein intakes and their food sources among 27 redefined centres in 10 countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). Methods: Between 1995 and 2000, 36 034 persons, aged between 35 and 74 years, were administered a standardized 24-h dietary recall (24-HDR) using a computerized interview software programme (EPIC-SOFT). Intakes (g/day) of total, animal and plant proteins were estimated using the standardized EPIC Nutrient Database (ENDB). Mean intakes were adjusted for age, and weighted by season and day of recall. Results: Mean total and animal protein intakes were highest in the Spanish centres among men, and in the Spanish and French centres among women; the lowest mean intakes were observed in the UK health-conscious group, in Greek men and women, and in women in Potsdam. Intake of plant protein was highest among the UK health-conscious group, followed by some of the Italian centres and Murcia, whereas Sweden and Potsdam had the lowest intake. Cereals contributed to the highest proportion of plant protein in all centres. The combined intake of legumes, vegetables and fruit contributed to a greater proportion of plant protein in the southern than in the northern centres. Total meat intake (with some heterogeneity across subtypes of meat) was, with few exceptions, the most important contributor to animal protein in all centres, followed by dairy and fish products. Conclusions: This study shows that intake of protein, especially of animal origin, differs across the 10 European countries, and also shows some differences in food sources of protein across Europe. European Journal of Clinical Nutrition (2009) 63, S16-S36; doi: 10.1038/ejcn.2009.73

Dietary intakes of retinol, beta-carotene, vitamin D and vitamin E in the European Prospective Investigation into Cancer and Nutrition cohort

Jenab M., Salvini S., Van Gils C.H., Brustad M., Shakya-Shrestha S., Buijsse B., Verhagen H., Touvier M., Biessy C., Wallstrom P., Bouckaert K., Lund E., Waaseth M., Roswall N., Joensen A.M., Linseisen J., Boeing H., Vasilopoulou E., Dilis V., Sieri S., Sacerdote C., Ferrari P., Manjer J., Nilsson S., Welch A.A., Travis R., Boutron-Ruault M.C., Niravong M., Bueno-de-Mesquita H.B., van der Schouw Y.T., Tormo M.J., Barricarte A., Riboli E., Bingham S., Slimani N.

Eur J Clin Nutr; 2009; S150-S178

PMID:19888271

Abstract as provided by PubMed

Objectives: To describe the intake of the fat-soluble nutrients retinol, beta-carotene, vitamin E and vitamin D and their food sources among 27 redefined centres in 10 countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Methods: Between 1995 and 2000, 36 034 subjects (age range: 35-74 years) completed a single standardized 24-h dietary recall using a computerized interview software program (EPIC-SOFT). Intakes of the fat-soluble nutrients were estimated using the standardized EPIC Nutrient Database. Results: For all the nutrients, in most centres, men had a higher level of intake than did women, even after adjustments for total energy intake and anthropometric confounders. Distinct regional gradients from northern to southern European countries were observed for all nutrients. The level intake of beta-carotene and vitamin E also showed some differences by level of education, smoking status and physical activity. No meaningful differences in the nutrient intake were observed by age range. Conclusions: These results show differences by study centre, gender, age and various lifestyle variables in the intake of retinol, beta-carotene, vitamin E and vitamin D between 10 European countries. European Journal of Clinical Nutrition (2009) 63, S150-S178; doi: 10.1038/ejcn.2009.79

Vitamin D receptor and calcium sensing receptor polymorphisms and the risk of colorectal cancer in European populations

Jenab M., McKay J., Bueno-de-Mesquita H.B., van Duijnhoven F.J., Ferrari P., Slimani N., Jansen E.H., Pischon T., Rinaldi S., Tjonneland A., Olsen A., Overvad K., Boutron-Ruault M.C., Clavel-Chapelon F., Engel P., Kaaks R., Linseisen J., Boeing H., Fisher E., Trichopoulou A., Dilis V., Oustoglou E., Berrino F., Vineis P., Mattiello A., Masala G., Tumino R., Vrieling A., Van Gils C.H., Peeters P.H., Brustad M., Lund E., Chirlaque M.D., Barricarte A., Suarez L.R., Molina E., Dorronsoro M., Sala N., Hallmans G., Palmqvist R., Roddam A., Key T.J., Khaw K.T., Bingham S., Boffetta P., Autier P., Byrnes G., Norat T., Riboli E.

Cancer Epidemiol Biomarkers Prev; 2009; 18(9): 2485-2491

PMID:19706842

Abstract as provided by PubMed

Increased levels of vitamin D and calcium may play a protective role in colorectal cancer (CRC) risk. It has been suggested that these effects may be mediated by genetic variants of the vitamin D receptor (VDR) and the calcium sensing receptor (CASR). However, current epidemiologic evidence from European populations for a role of these genes in CRC risk is scarce. In addition, it is not clear whether these genes may modulate CRC risk independently or by interaction with blood vitamin D concentration and level of dietary calcium intake. A case-control study was conducted nested within the European Prospective Investigation into Cancer and Nutrition. CRC cases (1,248) were identified and matched to 1,248 control subjects. Genotyping for the VDR (BsmI: rs1544410; Fok1: rs2228570) and CASR (rs1801725) genes was done by Taqman, and serum vitamin D (25OHD) concentrations were measured. Conditional logistic regression was used to estimate the incidence rate ratio (RR). Compared with the wild-type bb, the BB genotype of the VDR BsmI polymorphism was associated with a reduced risk of CRC [RR, 0.76; 95% confidence interval (CI), 0.59-0.98). The association was observed for colon cancer (RR, 0.69; 95% CI, 0.45-0.95) but not rectal cancer (RR, 0.97; 95% CI, 0.62-1.49). The Fok1 and CASR genotypes were not associated with CRC risk in this study. No interactions were noted for any of the polymorphisms with serum 25OHD concentration or level of dietary calcium. These results confirm a role for the BsmI polymorphism of the VDR gene in CRC risk, independent of serum 25OHD concentration and dietary calcium intake

Physical activity and risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort

Johnsen N.F., Tjonneland A., Thomsen B.L., Christensen J., Loft S., Friedenreich C., Key T.J., Allen N.E., Lahmann P.H., Mejlvig L., Overvad K., Kaaks R., Rohrmann S., Boing H., Misirli G., Trichopoulou A., Zylis D., Tumino R., Pala V., Bueno-de-Mesquita H.B., Kiemeney L.A., Suarez L.R., Gonzalez C.A., Sanchez M.J., Huerta J.M., Gurrea A.B., Manjer J., Wirfalt E., Khaw K.T., Wareham N., Boffetta P., Egevad L., Rinaldi S., Riboli E.

Int J Cancer; 2009; 125(4): 902-908

PMID:19415749

Abstract as provided by PubMed

The evidence concerning the possible association between physical activity and the risk of prostate cancer is inconsistent and additional data are needed. We examined the association between risk of prostate cancer and physical activity at work and in leisure time in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. In our study, including 127,923 men aged 20-97 years from 8 European countries, 2,458 cases of prostate cancer were identified during 8.5 years of followup. Using the Cox proportional hazards model, we investigated the associations between prostate cancer incidence rate and occupational activity and leisure time activity in terms of participation in sports, cycling, walking and gardening; a metabolic equivalent (MET) score based on weekly time spent on the 4 activities; and a physical activity index. MET hours per week of leisure time activity, higher score in the physical activity index, participation in any of the 4 leisure time activities, and the number of leisure time activities in which the participants were active were not associated with prostate cancer incidence. However, higher level of occupational physical activity was associated with lower risk of advanced stage prostate cancer (p(trend) = 0.024). In conclusion, our data support the hypothesis of an inverse association between advanced prostate cancer risk and occupational physical activity, but we found no support for an association between prostate cancer risk and leisure time physical activity

Specific food group combinations explaining the variation in intakes of nutrients and other important food components in the European Prospective Investigation into Cancer and Nutrition: an application of the reduced rank regression method

Kroger J., Ferrari P., Jenab M., Bamia C., Touvier M., Bueno-de-Mesquita H.B., Fahey M.T., Benetou V., Schulz M., Wirfalt E., Boeing H., Hoffmann K., Schulze M.B., Orfanos P., Oikonomou E., Huybrechts I., Rohrmann S., Pischon T., Manjer J., Agren A., Navarro C., Jakszyn P., Boutron-Ruault M.C., Niravong M., Khaw K.T., Crowe F., Ocke M.C., van der Schouw Y.T., Mattiello A., Bellegotti M., Engeset D., Hjartaker A., Egeberg R., Overvad K., Riboli E., Bingham S., Slimani N.

Eur J Clin Nutr; 2009; S263-S274

PMID:19888278

Abstract as provided by PubMed

Objective: To identify combinations of food groups that explain as much variation in absolute intakes of 23 key nutrients and food components as possible within the country-specific populations of the European Prospective Investigation into Cancer and Nutrition (EPIC). Subjects/Methods: The analysis covered single 24-h dietary recalls (24-HDR) from 36 034 subjects (13 025 men and 23 009 women), aged 35-74 years, from all 10 countries participating in the EPIC study. In a set of 39 food groups, reduced rank regression (RRR) was used to identify those combinations (RRR factors) that explain the largest proportion of variation in intake of 23 key nutrients and food components, namely, proteins, saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids, cholesterol, sugars (sum of mono-and disaccharides), starch, fibre, alcohol, calcium, iron, potassium, phosphorus, magnesium, vitamin D, beta-carotene, retinol and vitamins E, B1, B2, B6, B12 and C (RRR responses). Analyses were performed at the country level and for all countries combined. Results: In the country-specific analyses, the first RRR factor explained a considerable proportion of the total nutrient intake variation in all 10 countries (27.4-37.1%). The subsequent RRR factors were much less important in explaining the variation (<= 6%). Strong similarities were observed for the first country-specific RRR factor between the individual countries, largely characterized by consumption of bread, vegetable oils, red meat, milk, cheese, potatoes, margarine and processed meat. The highest explained variation was seen for protein, potassium, phosphorus and magnesium (50-70%), whereas sugars, beta-carotene, retinol and alcohol were only marginally explained (<= 5%). The explained proportion of the other nutrients ranged between these extremes. Conclusions: A combination of food groups was identified that explained a considerable proportion of the nutrient intake variation in 24-HDRs in every country-specific EPIC population in a similar manner. This indicates that, despite the large variability in food and nutrient intakes reported in the EPIC, the variance of intake of important nutrients is explained, to a large extent, by similar food group combinations across countries. European Journal of Clinical Nutrition (2009) 63, S263-S274; doi: 10.1038/ejcn.2009.85

Physical activity and ovarian cancer risk: the European Prospective Investigation into Cancer and Nutrition

Lahmann P.H., Friedenreich C., Schulz M., Cust A.E., Lukanova A., Kaaks R., Tjonneland A., Johnsen N.F., Overvad K., Fournier A., Boutron-Ruault M.C., Clavel Chapelon F., Boeing H., Linseisen J., Rohrmann S., Trichopoulou A., Lagiou P., Trichopoulos D., Palli D., Mattiello A., Sacerdote C., Agnoli C., Tumino R., Quiros J.R., Larranaga N., Agudo A.T., Sanchez M.J., Berglund G., Manjer J., Monninkhof E.M., Peeters P.H., Bueno-de-Mesquita H.B., May A.M., Allen N., Khaw K.T., Bingham S., Rinaldi S., Ferrari P., Riboli E.

Cancer Epidemiol Biomarkers Prev; 2009; 18(1): 351-354

PMID:19124520

Dietary fat intake in the European Prospective Investigation into Cancer and Nutrition: results from the 24-h dietary recalls

Linseisen J., Welch A.A., Ocke M., Amiano P., Agnoli C., Ferrari P., Sonestedt E., Chajes V., Bueno-de-Mesquita H.B., Kaaks R., Weikert C., Dorronsoro M., Rodriguez L., Ermini I., Mattiello A., van der Schouw Y.T., Manjer J., Nilsson S., Jenab M., Lund E., Brustad M., Halkjaer J., Jakobsen M.U., Khaw K.T., Crowe F., Georgila C., Misirli G., Niravong M., Touvier M., Bingham S., Riboli E., Slimani N.

Eur J Clin Nutr; 2009; S61-S80

PMID:19888281

Abstract as provided by PubMed

Objectives: This paper describes the dietary intake of total fat, saturated (SFA), monounsaturated (MUFA) and polyunsaturated fatty acids (PUFA) and cholesterol of participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) in 27 centres across 10 countries. Methods: Between 1995 and 2000, a stratified random sample of 36 034 participants (age range 35-74 years) completed a standardized 24-h dietary recall, assessed by means of the computer software EPIC-SOFT. Lipid intake data were calculated using a standardized nutrient database. Results: On average, the contribution of fat to total energy intake was >= 34% of energy intake (% en) in women and >= 36% en in men for most EPIC centres, except for the British, Dutch and most Italian cohorts. Total fat (> 40% en) and MUFA intakes (21% en, mainly from olive oil) were highest in Greece. Except for the Greek, Spanish and Italian centres, the average MUFA intake ranged between 10 and 13% en, with a high proportion derived from animal sources. SFA intake in women and men was lowest in the Greek, Spanish, Italian and UK cohorts with an average of <= 13% en (down to 9% en), and highest in the Swedish centres (16% en). The mean PUFA intake was in the range of 4-8% en, being highest in the UK health-conscious cohort. The average cholesterol intake across EPIC varied from 140 to 384 mg/d in women and 215-583 mg/d in men. Conclusions: The presented data show differences and similarities in lipid intake across the European EPIC cohorts and also show differences in food sources of dietary lipids. European Journal of Clinical Nutrition (2009) 63, S61-S80; doi: 10.1038/ejcn.2009.75

The role of smoking and diet in explaining educational inequalities in lung cancer incidence

Menvielle G., Boshuizen H., Kunst A.E., Dalton S.O., Vineis P., Bergmann M.M., Hermann S., Ferrari P., Raaschou-Nielsen O., Tjonneland A., Kaaks R., Linseisen J., Kosti M., Trichopoulou A., Dilis V., Palli D., Krogh V., Panico S., Tumino R., Buchner F.L., Van Gils C.H., Peeters P.H., Braaten T., Gram I.T., Lund E., Rodriguez L., Agudo A., Sanchez M.J., Tormo M.J., Ardanaz E., Manjer J., Wirfalt E., Hallmans G., Rasmuson T., Bingham S., Khaw K.T., Allen N., Key T., Boffetta P., Duell E.J., Slimani N., Gallo V., Riboli E., Bueno-de-Mesquita H.B.

J Natl Cancer Inst; 2009; 101(5): 321-330

PMID:19244178

Abstract as provided by PubMed

BACKGROUND: Studies in many countries have reported higher lung cancer incidence and mortality in individuals with lower socioeconomic status. METHODS: To investigate the role of smoking in these inequalities, we used data from 391,251 participants in the European Prospective Investigation into Cancer and Nutrition study, a cohort of individuals in 10 European countries. We collected information on smoking (history and quantity), fruit and vegetable consumption, and education through questionnaires at study entry and gathered data on lung cancer incidence for a mean of 8.4 years. Socioeconomic status was defined as the highest attained level of education, and participants were grouped by sex and region of residence (Northern Europe, Germany, or Southern Europe). Relative indices of inequality (RIIs) of lung cancer risk unadjusted and adjusted for smoking were estimated using Cox regression models. Additional analyses were performed by histological type. RESULTS: During the study period, 939 men and 692 women developed lung cancer. Inequalities in lung cancer risk (RII(men) = 3.62, 95% confidence interval [CI] = 2.77 to 4.73, 117 vs 52 per 100,000 person-years for lowest vs highest education level; RII(women) = 2.39, 95% CI = 1.77 to 3.21, 46 vs 25 per 100,000 person-years) decreased after adjustment for smoking but remained statistically significant (RII(men) = 2.29, 95% CI = 1.75 to 3.01; RII(women) = 1.59, 95% CI = 1.18 to 2.13). Large RIIs were observed among men and women in Northern European countries and among men in Germany, but inequalities in lung cancer risk were reverse (RIIs < 1) among women in Southern European countries. Inequalities differed by histological type. Adjustment for smoking reduced inequalities similarly for all histological types and among men and women in all regions. In all analysis, further adjustment for fruit and vegetable consumption did not change the estimates. CONCLUSION: Self-reported smoking consistently explains approximately 50% of the inequalities in lung cancer risk due to differences in education

Energy intake and sources of energy intake in the European Prospective Investigation into Cancer and Nutrition

Ocke M.C., Larranaga N., Grioni S., van den Berg S.W., Ferrari P., Salvini S., Benetou V., Linseisen J., Wirfalt E., Rinaldi S., Jenab M., Halkjaer J., Jakobsen M.U., Niravong M., Clavel-Chapelon F., Kaaks R., Bergmann M., Moutsiou E., Trichopoulou A., Lauria C., Sacerdote C., Bueno-de-Mesquita H.B., Peeters P.H.M., Hjartaker A., Parr C.L., Tormo M.J., Sanchez M.J., Manjer J., Hellstrom V., Mulligan A., Spencer E.A., Riboli E., Bingham S., Slimani N.

Eur J Clin Nutr; 2009; S3-S15

PMID:19888279

Abstract as provided by PubMed

Objectives: To describe energy intake and its macronutrient and food sources among 27 regions in 10 countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Methods: Between 1995 and 2000, 36 034 subjects aged 35-74 years were administered a standardized 24-h dietary recall. Intakes of macronutrients (g/day) and energy (kcal/day) were estimated using standardized national nutrient databases. Mean intakes were weighted by season and day of the week and were adjusted for age, height and weight, after stratification by gender. Extreme low- and high-energy reporters were identified using Goldberg's cutoff points (ratio of energy intake and estimated basal metabolic rate <0.88 or >2.72), and their effects on macronutrient and energy intakes were studied. Results: Low-energy reporting was more prevalent in women than in men. The exclusion of extreme-energy reporters substantially lowered the EPIC-wide range in mean energy intake from 2196-2877 to 2309-2866 kcal among men. For women, these ranges were 1659-2070 and 1873-2108 kcal. There was no north-south gradient in energy intake or in the prevalence of low-energy reporting. In most centres, cereals and cereal products were the largest contributors to energy intake. The food groups meat, dairy products and fats and oils were also important energy sources. In many centres, the highest mean energy intakes were observed on Saturdays. Conclusions: These data highlight and quantify the variations and similarities in energy intake and sources of energy intake among 10 European countries. The prevalence of low-energy reporting indicates that the study of energy intake is hampered by the problem of underreporting. European Journal of Clinical Nutrition (2009) 63, S3-S15; doi: 10.1038/ejcn.2009.72

Dietary intake of the water-soluble vitamins B1, B2, B6, B12 and C in 10 countries in the European Prospective Investigation into Cancer and Nutrition

Olsen A., Halkjaer J., Van Gils C.H., Buijsse B., Verhagen H., Jenab M., Boutron-Ruault M.C., Ericson U., Ocke M.C., Peeters P.H.M., Touvier M., Niravong M., Waaseth M., Skeie G., Khaw K.T., Travis R., Ferrari P., Sanchez M.J., Agudo A., Overvad K., Linseisen J., Weikert C., Sacerdote C., Evangelista A., Zylis D., Tsiotas K., Manjer J., Van Guelpen B., Riboli E., Slimani N., Bingham S.

Eur J Clin Nutr; 2009; S122-S149

PMID:19888270

Abstract as provided by PubMed

Objectives: To describe the intake of vitamins thiamine (B1), riboflavin (B2), B6 (pyridoxine), B12 (cobalamine) and C (ascorbic acid) and their food sources among 27 centres in 10 countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Methods: Between 1995 and 2000, 36 034 persons aged between 35 and 74 years were administered a standardized 24-h dietary recall using a computerized interview software programme (EPIC-SOFT). Intakes of the four B vitamins and vitamin C were estimated using the standardized EPIC Nutrient Database (ENDB). Mean intakes were adjusted for age and weighted by season and day of recall. Results: Intake of B vitamins did not vary considerably between centres, except in the UK health-conscious cohort, in which substantially higher intakes of thiamine and lower intakes of vitamin B12 were reported compared with other centres. Overall, meat was the most important contributor to the B vitamins in all centres except in the UK health-conscious group. Vitamin C showed a clear geographical gradient, with higher intakes in the southern centres as compared with the northern ones; this was more pronounced in men than in women. Vegetables and fruits were major contributors to vitamin C in all centres, but juices and potatoes were also important sources in the northern centres. Conclusions: This study showed no major differences across centres in the mean intakes of B vitamins (thiamine, riboflavin, B6, B12), whereas a tendency towards a north-south gradient was observed for vitamin C. European Journal of Clinical Nutrition (2009) 63, S122-S149; doi: 10.1038/ejcn.2009.78

Eating out of home: energy, macro- and micronutrient intakes in 10 European countries. The European Prospective Investigation into Cancer and Nutrition

Orfanos P., Naska A., Trichopoulou A., Grioni S., Boer J.M.A., van Bakel M.M.E., Ericson U., Rohrmann S., Boeing H., Rodriguez L., Ardanaz E., Sacerdote C., Giurdanella M.C., Niekerk E.M., Peeters P.H.M., Manjer J., Van Guelpen B., Deharveng G., Skeie G., Engeset D., Halkjaer J., Jensen A.M., McTaggart A., Crowe F., Stratigakou V., Oikonomou E., Touvier M., Niravong M., Riboli E., Bingham S., Slimani N.

Eur J Clin Nutr; 2009; S239-S262

PMID:19888277

Abstract as provided by PubMed

Objectives: To assess the contribution of out-of-home (OH) energy and nutrient intake to total dietary intake, and to compare out-versus in-home nutrient patterns among 27 centres in 10 countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Methods: Between 1995 and 2000, 36 034 participants aged between 35-74 years completed a standardized 24-h dietary recall using a software programme (EPIC-Soft) that recorded the place of food/drink consumption. Eating OH was defined as the consumption of foods and beverages anywhere other than in household premises, irrespective of the place of purchase/preparation. Nutrient intakes were estimated using a standardized nutrient database. Mean intakes were adjusted for age and weighted by season and day of recall. Results: Among women, OH eating contributed more to total fat intake than to intakes of protein and carbohydrates. Among both genders, and particularly in southern Europe, OH eating contributed more to sugar and starch intakes and less to total fibre intake. The contribution of OH eating was also lower for calcium and vitamin C intakes. The composition of diet at home was different from that consumed out of home in southern countries, but was relatively similar in the north. Conclusions: In northern Europe, OH and in-home eating are homogeneous, whereas southern Europeans consider OH eating as a distinctive occasion. In most centres, women selected more fat-rich items when eating out. European Journal of Clinical Nutrition (2009) 63, S239-S262; doi: 10.1038/ejcn.2009.84

Meat, eggs, dairy products, and risk of breast cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort

Pala V., Krogh V., Berrino F., Sieri S., Grioni S., Tjonneland A., Olsen A., Jakobsen M.U., Overvad K., Clavel-Chapelon F., Boutron-Ruault M.C., Romieu I., Linseisen J., Rohrmann S., Boeing H., Steffen A., Trichopoulou A., Benetou V., Naska A., Vineis P., Tumino R., Panico S., Masala G., Agnoli C., Engeset D., Skeie G., Lund E., Ardanaz E., Navarro C., Sanchez M.J., Amiano P., Svatetz C.A., Rodriguez L., Wirfalt E., Manjer J., Lenner P., Hallmans G., Peeters P.H., Van Gils C.H., Bueno-de-Mesquita H.B., van Duijnhoven F.J., Key T.J., Spencer E., Bingham S., Khaw K.T., Ferrari P., Byrnes G., Rinaldi S., Norat T., Michaud D.S., Riboli E.

Am J Clin Nutr; 2009; 90(3): 602-612

PMID:19491385

Abstract as provided by PubMed

BACKGROUND: A Western diet is associated with breast cancer risk. OBJECTIVE: We investigated the relation of meat, egg, and dairy product consumption with breast cancer risk by using data from the European Prospective Investigation into Cancer and Nutrition (EPIC). DESIGN: Between 1992 and 2003, information on diet was collected from 319,826 women. Disease hazard ratios were estimated with multivariate Cox proportional hazard models. RESULTS: Breast cancer cases (n = 7119) were observed during 8.8 y (median) of follow-up. No consistent association was found between breast cancer risk and the consumption of any of the food groups under study, when analyzed by both categorical and continuous exposure variable models. High processed meat consumption was associated with a modest increase in breast cancer risk in the categorical model (hazard ratio: 1.10; 95% CI: 1.00, 1.20; highest compared with lowest quintile: P for trend = 0.07). Subgroup analyses suggested an association with butter consumption, limited to premenopausal women (hazard ratio: 1.28; 95% CI: 1.06, 1.53; highest compared with lowest quintile: P for trend = 0.21). Between-country heterogeneity was found for red meat (Q statistic = 18.03; P = 0.05) and was significantly explained (P = 0.023) by the proportion of meat cooked at high temperature. CONCLUSIONS: We have not consistently identified intakes of meat, eggs, or dairy products as risk factors for breast cancer. Future studies should investigate the possible role of high-temperature cooking in the relation of red meat intake with breast cancer risk

Ethanol intake and the risk of pancreatic cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Rohrmann S., Linseisen J., Vrieling A., Boffetta P., Stolzenberg-Solomon R.Z., Lowenfels A.B., Jensen M.K., Overvad K., Olsen A., Tjonneland A., Boutron-Ruault M.C., Clavel-Chapelon F., Fagherazzi G., Misirli G., Lagiou P., Trichopoulou A., Kaaks R., Bergmann M.M., Boeing H., Bingham S., Khaw K.T., Allen N., Roddam A., Palli D., Pala V., Panico S., Tumino R., Vineis P., Peeters P.H., Hjartaker A., Lund E., Redondo Cornejo M.L., Agudo A., Arriola L., Sanchez M.J., Tormo M.J., Barricarte Gurrea A., Lindkvist B., Manjer J., Johansson I., Ye W., Slimani N., Duell E.J., Jenab M., Michaud D.S., Mouw T., Riboli E., Bueno-de-Mesquita H.B.

Cancer Causes Control; 2009; 20(5): 785-794

PMID:19145468

Abstract as provided by PubMed

OBJECTIVE: To examine the association of baseline and lifetime ethanol intake with cancer of the pancreas in the European Prospective Investigation into Cancer and Nutrition (EPIC). METHODS: Included in this analysis were 478,400 subjects, of whom detailed information on the intake of alcoholic beverages at baseline and over lifetime was collected between 1992 and 2000. During a median follow-up time of 8.9 years, 555 non-endocrine pancreatic cancer cases were observed. Multivariate Cox proportional hazard models were used to examine the association of ethanol intake at recruitment and average lifetime ethanol intake and pancreatic cancer adjusting for smoking, height, weight, and history of diabetes. RESULTS: Overall, neither ethanol intake at recruitment (relative risk (RR) = 0.94, 95% confidence interval (CI) 0.69-1.27 comparing 30+ g/d vs. 0.1-4.9 g/d) nor average lifetime ethanol intake (RR = 0.95, 95% CI 0.65-1.39) was associated with pancreatic cancer risk. High lifetime ethanol intake from spirits/liquor at recruitment tended to be associated with a higher risk (RR = 1.40, 95% CI 0.93-2.10 comparing 10+ g/d vs. 0.1-4.9 g/d), but no associations were observed for wine and beer consumption. CONCLUSION: These results suggest no association of alcohol consumption with the risk of pancreatic cancer

Plasma phospholipid fatty acid profiles and their association with food intakes: results from a cross-sectional study within the European Prospective Investigation into Cancer and Nutrition

Saadatian-Elahi M., Slimani N., Chajes V., Jenab M., Goudable J., Biessy C., Ferrari P., Byrnes G., Autier P., Peeters P.H., Ocke M., Bueno de Mesquita B., Johansson I., Hallmans G., Manjer J., Wirfalt E., Gonzalez C.A., Navarro C., 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., Santucci de Magistris M., 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., Oustoglou E., Clavel-Chapelon F., Riboli E.

Am J Clin Nutr; 2009; 89(1): 331-346

PMID:19056549

Abstract as provided by PubMed

BACKGROUND: Plasma phospholipid fatty acids have been correlated with food intakes in populations with homogeneous dietary patterns. However, few data are available on populations with heterogeneous dietary patterns. OBJECTIVE: The objective was to investigate whether plasma phospholipid fatty acids are suitable biomarkers of dietary intakes across populations involved in a large European multicenter study. DESIGN: A cross-sectional study design nested to the European Prospective Investigation into Cancer and Nutrition (EPIC) was conducted to determine plasma fatty acid profiles in >3,000 subjects from 16 centers, who had also completed 24-h dietary recalls and dietary questionnaires. Plasma fatty acids were assessed by capillary gas chromatography. Ecological and individual correlations were calculated between fatty acids and select food groups. RESULTS: The most important determinant of plasma fatty acids was region, which suggests that the variations across regions are largely due to different food intakes. Strong ecological correlations were observed between fish intake and long-chain n-3 polyunsaturated fatty acids (r = 0.78, P < 0.01), olive oil and oleic acid (r = 0.73, P < 0.01), and margarine and elaidic acid (r = 0.76, P < 0.01). Individual correlations varied across the regions, particularly between olive oil and oleic acid and between alcohol and the saturation index, as an indicator of stearoyl CoA desaturase activity. CONCLUSIONS: These findings indicate that specific plasma phospholipid fatty acids are suitable biomarkers of some food intakes in the EPIC Study. Moreover, these findings suggest complex interactions between alcohol intake and fatty acid metabolism, which warrants further attention in epidemiologic studies relating dietary fatty acids to alcohol-related cancers and other chronic diseases

Alcohol consumption patterns, diet and body weight in 10 European countries

Sieri S., Krogh V., Saieva C., Grobbee D.E., Bergmann M., Rohrmann S., Tjonneland A., Ferrari P., Chloptsios Y., Dilis V., Jenab M., Linseisen J., Wallstrom P., Johansson I., Chirlaque M.D., Sanchez M.J., Niravong M., Clavel-Chapelon F., Welch A.A., Allen N.E., Bueno-de-Mesquita H.B., van der Schouw Y.T., Sacerdote C., Panico S., Parr C.L., Braaten T., Olsen A., Jensen M.K., Bingham S., Riboli E., Slimani N.

Eur J Clin Nutr; 2009; S81-S100

PMID:19888282

Abstract as provided by PubMed

Background/objectives: Europe has the highest level of alcohol consumption in the world. As drinking patterns are important determinants of the beneficial and harmful effects of alcohol consumption, we investigated alcohol consumption in relation to nutrient intake, place of consumption, education and body weight in a sample of adults from 10 European countries. Methods: A 24-h dietary recall interview was conducted on 13 025 men and 23 009 women, aged 35-74 years, from 27 centres participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Means and standard errors of alcohol consumption, adjusted for age, were calculated, stratified by gender and centre. Results: In many centres, higher level drinkers (males consuming 424 g of ethanol/day, equivalent to 42 standard drinks and females consuming 412 g of ethanol/day equivalent to 41 standard drink) obtained more energy from fat and protein and less from sugar than did abstainers. The proportion of energy from starch tended to be higher for male and lower for female higher level drinkers than for abstainers. Female higher level drinkers had a lower body mass index than did abstainers, whereas male higher level drinkers generally weighed more. Male higher level drinkers were less educated than abstainers in Mediterranean countries, but were more educated elsewhere. Female higher level drinkers were usually more educated than were abstainers. Outside the home, consumption (both genders) tended to be at friends' homes, particularly among men in Northern and Central Europe, and in bars in Spain. Conclusions: This study reveals clear geographical differences in drinking habits across Europe, and shows that the characteristics of different alcohol consumption categories also vary. European Journal of Clinical Nutrition (2009) 63, S81-S100; doi: 10.1038/ejcn.2009.76

Use of dietary supplements in the European Prospective Investigation into Cancer and Nutrition calibration study

Skeie G., Braaten T., Hjartaker A., Lentjes M., Amiano P., Jakszyn P., Pala V., Palanca A., Niekerk E.M., Verhagen H., Avloniti K., Psaltopoulou T., Niravong M., Touvier M., Nimptsch K., Haubrock J., Walker L., Spencer E.A., Roswall N., Olsen A., Wallstrom P., Nilsson S., Casagrande C., Deharveng G., Hellstrom V., Boutron-Ruault M.C., Tjonneland A., Joensen A.M., Clavel-Chapelon F., Trichopoulou A., Martinez C., Rodriguez L., Frasca G., Sacerdote C., Peeters P.H.M., Linseisen J., Schienkiewitz A., Welch A.A., Manjer J., Ferrari P., Riboli E., Bingham S., Engeset D., Lund E., Slimani N.

Eur J Clin Nutr; 2009; S226-S238

PMID:19888276

Abstract as provided by PubMed

Background: Dietary supplement use is increasing, but there are few comparable data on supplement intakes and how they affect the nutrition and health of European consumers. The aim of this study was to describe the use of dietary supplements in subsamples of the 10 countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). Methods: Specific questions on dietary supplement use were asked as a part of single 24-h recalls performed on 36 034 men and women aged 35-74 years from 1995 to 2000. Results: Between countries, the mean percentage of dietary supplement use varied almost 10-fold among women and even more among men. There was a clear north-south gradient in use, with a higher consumption in northern countries. The lowest crude mean percentage of use was found in Greece (2.0% among men, 6.7% among women), and the highest was in Denmark (51.0% among men, 65.8% among women). Use was higher in women than in men. Vitamins, minerals or combinations of them were the predominant types of supplements reported, but there were striking differences between countries. Conclusions: This study indicates that there are wide variations in supplement use in Europe, which may affect individual and population nutrient intakes. The results underline the need to monitor consumption of dietary supplements in Europe, as well as to evaluate the risks and benefits. European Journal of Clinical Nutrition (2009) 63, S226-S238; doi: 10.1038/ejcn.2009.83

Contribution of highly industrially processed foods to the nutrient intakes and patterns of middle-aged populations in the European Prospective Investigation into Cancer and Nutrition study

Slimani N., Deharveng G., Southgate D.A.T., Biessy C., Chajes V., van Bakel M.M.E., Boutron-Ruault M.C., McTaggart A., Grioni S., Verkaik-Kloosterman J., Huybrechts I., Amiano P., Jenab M., Vignat J., Bouckaert K., Casagrande C., Ferrari P., Zourna P., Trichopoulou A., Wirfalt E., Johansson G., Rohrmann S., Illner A.K., Barricarte A., Rodriguez L., Touvier M., Niravong M., Mulligan A., Crowe F., Ocke M.C., van der Schouw Y.T., Bendinelli B., Lauria C., Brustad M., Hjartaker A., Tjonneland A., Jensen A.M., Riboli E., Bingham S.

Eur J Clin Nutr; 2009; S206-S225

PMID:19888275

Abstract as provided by PubMed

Objectives: To describe the contribution of highly processed foods to total diet, nutrient intakes and patterns among 27 redefined centres in the 10 countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). Methods: Single 24-hour dietary recalls were collected from 36 034 individuals (aged 35-74 years) using a standardized computerized interview programme (EPIC-SOFT). Centre-specific mean food intakes (g/day) were computed according to their degree of food processing (that is, highly, moderately and non-processed foods) using a specifically designed classification system. The contribution (%) of highly processed foods to the centre mean intakes of diet and 26 nutrients (including energy) was estimated using a standardized nutrient database (ENDB). The effect of different possible confounders was also investigated. Results: Highly processed foods were an important source of the nutrients considered, contributing between 61% (Spain) and 78-79% (the Netherlands and Germany) of mean energy intakes. Only two nutrients, beta-carotene (34-46%) and vitamin C (28-36%), had a contribution from highly processed foods below 50% in Nordic countries, in Germany, the Netherlands and the United Kingdom, whereas for the other nutrients, the contribution varied from 50 to 91% (excluding alcohol). In southern countries (Greece, Spain, Italy and France), the overall contribution of highly processed foods to nutrient intakes was lower and consisted largely of staple or basic foods (for example, bread, pasta/rice, milk, vegetable oils), whereas highly processed foods such as crisp bread, breakfast cereals, margarine and other commercial foods contributed more in Nordic and central European centres. Conclusions: Highly industrially processed foods dominate diets and nutrient patterns in Nordic and central European countries. The greater variations observed within southern countries may reflect both a larger contribution of non/moderately processed staple foods along with a move from traditional to more industrialized dietary patterns. European Journal of Clinical Nutrition (2009) 63, S206-S225; doi: 10.1038/ejcn.2009.82

Prospective study of the association between grapefruit intake and risk of breast cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Spencer E.A., Key T.J., Appleby P.N., Van Gils C.H., Olsen A., Tjonneland A., Clavel-Chapelon F., Boutron-Ruault M.C., Touillaud M., Sanchez M.J., Bingham S., Khaw K.T., Slimani N., Kaaks R., Riboli E.

Cancer Causes Control; 2009; 20(6): 803-809

PMID:19224379

Abstract as provided by PubMed

Grapefruit inhibits cytochrome P450 3A4 and may affect estrogen metabolism. In the European Prospective Investigation into Cancer and Nutrition (EPIC), we examined the relationships of grapefruit intake with risk of breast cancer and with serum sex hormone levels. 114,504 women with information on dietary intake of grapefruit and on reproductive and lifestyle risk factors were followed for a median 9.5 years and 3,747 incident breast cancers were identified. Fifty-nine percent of women reported eating grapefruit, 4% ate > or = 60 g/day. Cox proportional hazard models were used to estimate the hazard ratio (HR) for breast cancer according to grapefruit intake, adjusting for study centre, reproductive factors, body mass index, energy intake, and alcohol intake. Grapefruit intake was not related to the risk of breast cancer: compared with women who ate no grapefruit, women with the highest intake of > or =60 g/day had a HR of 0.93 (95% CI 0.77-1.13), p for linear trend = 0.5. There was no relationship between grapefruit intake and breast cancer risk among premenopausal women, all postmenopausal women, or postmenopausal women categorized by hormone replacement therapy use (all p>0.05). There was no association between grapefruit intake and estradiol or estrone among postmenopausal women. In this study, we found no evidence of an association between grapefruit intake and risk of breast cancer

Anthropometry and esophageal cancer risk in the European prospective investigation into cancer and nutrition

Steffen A., Schulze M.B., Pischon T., Dietrich T., Molina E., Chirlaque M.D., Barricarte A., Amiano P., Quiros J.R., Tumino R., Mattiello A., Palli D., Vineis P., Agnoli C., Misirli G., Boffetta P., Kaaks R., Rohrmann S., Bueno-de-Mesquita H.B., Peeters P.H., May A.M., Spencer E.A., Allen N.E., Bingham S., Tjonneland A., Halkjaer J., Overvad K., Stegger J., Manjer J., Lindkvist B., Hallmanns G., Stenling R., Lund E., Riboli E., Gonzalez C.A., Boeing H.

Cancer Epidemiol Biomarkers Prev; 2009; 18(7): 2079-2089

PMID:19567501

Abstract as provided by PubMed

BACKGROUND: Increasing evidence suggests that general obesity [measured by body mass index (BMI)] is positively associated with risk of esophageal adenocarcinoma (EAC). In contrast, previous studies have shown inverse relations with esophageal squamous cell carcinoma (ESCC). However, it is still unclear whether body fat distribution, particularly abdominal obesity, is associated with each type of esophageal cancer. METHODS: We applied multivariable adjusted Cox proportional hazards regression to investigate the association between anthropometric measures and risk of EAC and ESCC among 346,554 men and women participating in the European Prospective Investigation into Cancer and Nutrition. All statistical tests were two sided. RESULTS: During 8.9 years of follow-up, we documented 88 incident cases of EAC and 110 cases of ESCC. BMI, waist circumference, and waist-to-hip ratio (WHR) were positively associated with EAC risk [highest versus lowest quintile; relative risk (RR), 2.60; 95% confidence interval (95% CI), 1.23-5.51; P(trend) < 0.01; RR, 3.07; 95% CI, 1.35-6.98; P(trend) < 0.003; and RR, 2.12; 95% CI, 0.98-4.57; P(trend) < 0.004]. In contrast, BMI and waist circumference were inversely related to ESCC risk, whereas WHR showed no association with ESCC. In stratified analyses, BMI and waist circumference were significantly inversely related to ESCC only among smokers but not among nonsmokers. However, when controlled for BMI, we found positive associations for waist circumference and WHR with ESCC, and these associations were observed among smokers and nonsmokers. CONCLUSION: General and abdominal obesity were associated with higher EAC risk. Further, our study suggests that particularly an abdominal body fat distribution might also be a risk factor for ESCC

A prospective analysis of the association between dietary fiber intake and prostate cancer risk in EPIC

Suzuki R., Allen N.E., Key T.J., Appleby P.N., Tjonneland A., Johnsen N.F., Jensen M.K., Overvad K., Boeing H., Pischon T., Kaaks R., Rohrmann S., Trichopoulou A., Misirli G., Trichopoulos D., Bueno-de-Mesquita H.B., van Duijnhoven F., Sacerdote C., Pala V., Palli D., Tumino R., Ardanaz E., Quiros J.R., Larranaga N., Sanchez M.J., Tormo M.J., Jakszyn P., Johansson I., Stattin P., Berglund G., Manjer J., Bingham S., Khaw K.T., Egevad L., Ferrari P., Jenab M., Riboli E.

Int J Cancer; 2009; 124(1): 245-249

PMID:18814263

Abstract as provided by PubMed

Few studies have examined the association between dietary fiber intake and prostate cancer risk. We evaluated the association between dietary fiber intake and the risk of prostate cancer among 142,590 men in the European Prospective Investigation into Cancer and Nutrition (EPIC). Consumption of dietary fiber (total, cereal, fruit and vegetable fiber) was estimated by validated dietary questionnaires and calibrated using 24-hr dietary recalls. Incidence rate ratios were estimated using Cox regression and adjusted for potential confounding factors. During an average of 8.7 years follow-up, prostate cancer was diagnosed in 2,747 men. Overall, there was no association between dietary fiber intake (total, cereal, fruit or vegetable fiber) and prostate cancer risk, although calibrated intakes of total fiber and fruit fiber were associated with nonstatistically significant reductions in risk. There was no association between fiber derived from cereals or vegetables and risk and no evidence for heterogeneity in any of the risk estimates by stage or grade of disease. Our results suggest that dietary fiber intake is not associated with prostate cancer risk. (c) 2008 Wiley-Liss, Inc

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