Anette Hjartåker

Publications (73) View all

• Article: Dietary acrylamide intake of adults in the European Prospective Investigation into Cancer and Nutrition differs greatly according to geographical region.

  Heinz Freisling, Aurelie Moskal, Pietro Ferrari, Geneviève Nicolas, Viktoria Knaze, Françoise Clavel-Chapelon, Marie-Christine Boutron-Ruault, Laura Nailler, Birgit Teucher, Verena A Grote, [......], Petra H M Peeters, Elisabet Wirfält, Ulrika Ericson, Ingvar A Bergdahl, Ingegerd Johansson, Anette Hjartåker, Dagrun Engeset, Guri Skeie, Elio Riboli, Nadia Slimani
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  ABSTRACT: PURPOSE: Methodological differences in assessing dietary acrylamide (AA) often hamper comparisons of intake across populations. Our aim was to describe the mean dietary AA intake in 27 centers of 10 European countries according to selected lifestyle characteristics and its contributing food sources in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. METHODS: In this cross-sectional analysis, 36 994 men and women, aged 35-74 years completed a single, standardized 24-hour dietary recall using EPIC-Soft. Food consumption data were matched to a harmonized AA database. Intake was computed by gender and center, and across categories of habitual alcohol consumption, smoking status, physical activity, education, and body mass index (BMI). Adjustment was made for participants' age, height, weight, and energy intake using linear regression models. RESULTS: Adjusted mean AA intake across centers ranged from 13 to 47 μg/day in men and from 12 to 39 μg/day in women; intakes were higher in northern European centers. In most centers, intake in women was significantly higher among alcohol drinkers compared with abstainers. There were no associations between AA intake and physical activity, BMI, or education. At least 50 % of AA intake across centers came from two food groups "bread, crisp bread, rusks" and "coffee." The third main contributing food group was "potatoes". CONCLUSIONS: Dietary AA intake differs greatly among European adults residing in different geographical regions. This observed heterogeneity in AA intake deserves consideration in the design and interpretation of population-based studies of dietary AA intake and health outcomes.
  European Journal of Nutrition 12/2012; · 2.75 Impact Factor
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  Article: Dietary fibre intake and risks of cancers of the colon and rectum in the European prospective investigation into cancer and nutrition (EPIC).

  Neil Murphy, Teresa Norat, Pietro Ferrari, Mazda Jenab, Bas Bueno-de-Mesquita, Guri Skeie, Christina C Dahm, Kim Overvad, Anja Olsen, Anne Tjønneland, [......], Lena Nilsson, Richard Palmqvist, Kay-Tee Khaw, Nick Wareham, Timothy J Key, Francesca L Crowe, Veronika Fedirko, Petra A Wark, Shu-Chun Chuang, Elio Riboli
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  ABSTRACT: Earlier analyses within the EPIC study showed that dietary fibre intake was inversely associated with colorectal cancer risk, but results from some large cohort studies do not support this finding. We explored whether the association remained after longer follow-up with a near threefold increase in colorectal cancer cases, and if the association varied by gender and tumour location. After a mean follow-up of 11.0 years, 4,517 incident cases of colorectal cancer were documented. Total, cereal, fruit, and vegetable fibre intakes were estimated from dietary questionnaires at baseline. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models stratified by age, sex, and centre, and adjusted for total energy intake, body mass index, physical activity, smoking, education, menopausal status, hormone replacement therapy, oral contraceptive use, and intakes of alcohol, folate, red and processed meats, and calcium. After multivariable adjustments, total dietary fibre was inversely associated with colorectal cancer (HR per 10 g/day increase in fibre 0.87, 95% CI: 0.79-0.96). Similar linear associations were observed for colon and rectal cancers. The association between total dietary fibre and risk of colorectal cancer risk did not differ by age, sex, or anthropometric, lifestyle, and dietary variables. Fibre from cereals and fibre from fruit and vegetables were similarly associated with colon cancer; but for rectal cancer, the inverse association was only evident for fibre from cereals. Our results strengthen the evidence for the role of high dietary fibre intake in colorectal cancer prevention.
  PLoS ONE 01/2012; 7(6):e39361. · 4.09 Impact Factor
• Article: Dietary Flavonoid Intake and Esophageal Cancer Risk in the European Prospective Investigation into Cancer and Nutrition Cohort.

  Esther Vermeulen, Raul Zamora-Ros, Eric J Duell, Leila Luján-Barroso, Heiner Boeing, Krasimira Aleksandrova, H Bas Bueno-de-Mesquita, Augustin Scalbert, Isabelle Romieu, Veronika Fedirko, [......], Anne M May, Elisabete Weiderpass, Guri Skeie, Anette Hjartåker, Rikard Landberg, Ingegerd Johansson, Emily Sonestedt, Ulrika Ericson, Elio Riboli, Carlos A González
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  ABSTRACT: We prospectively investigated dietary flavonoid intake and esophageal cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The study included 477,312 adult subjects from 10 European countries. At baseline, country-specific validated dietary questionnaires were used. During a mean follow-up of 11 years (1992-2010), there were 341 incident esophageal cancer cases, of which 142 were esophageal adenocarcinoma (EAC), 176 were esophageal squamous cell carcinoma (ESCC), and 23 were other types of esophageal cancer. In crude models, a doubling in total dietary flavonoid intake was inversely associated with esophageal cancer risk (hazard ratio (HR) (log2) = 0.87, 95% confidence interval (CI): 0.78, 0.98) but not in multivariable models (HR (log2) = 0.97, 95% CI: 0.86, 1.10). After covariate adjustment, no statistically significant association was found between any flavonoid subclass and esophageal cancer, EAC, or ESCC. However, among current smokers, flavonols were statistically significantly associated with a reduced esophageal cancer risk (HR (log2) = 0.72, 95% CI: 0.56, 0.94), whereas total flavonoids, flavanols, and flavan-3-ol monomers tended to be inversely associated with esophageal cancer risk. No associations were found in either never or former smokers. These findings suggest that dietary flavonoid intake was not associated with overall esophageal cancer, EAC, or ESCC risk, although total flavonoids and some flavonoid subclasses, particularly flavonols, may reduce the esophageal cancer risk among current smokers.
  American journal of epidemiology 05/2013; · 5.59 Impact Factor
• Article: Body mass index, physical activity, and colorectal cancer by anatomical subsites: a systematic review and meta-analysis of cohort studies.

  Trude E Robsahm, Bjarte Aagnes, Anette Hjartåker, Hilde Langseth, Freddie I Bray, Inger K Larsen
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  ABSTRACT: Several studies report varying incidence rates of cancer in subsites of the colorectum, as an increasing proportion appears to develop in the proximal colon. Varying incidence trends together with biological differences between the colorectal segments raise questions of whether lifestyle factors impact on the risk of cancer differently at colorectal subsites. We provide an updated overview of the risk of cancer at different colorectal subsites (proximal colon, distal colon, and rectum) according to BMI and physical activity to shed light on this issue. Cohort studies of colorectal cancer, published in English throughout 2010, were identified using PubMed. The risk estimates from 30 eligible studies were summarized for BMI and physical activity. A positive relationship was found between BMI and cancer for all colorectal subsites, but most pronounced for the distal colon [relative risk (RR) 1.59, 95% confidence interval (CI) 1.34-1.89]. For the proximal colon and rectum, the risk estimates were 1.24 (95% CI 1.08-1.42) and 1.23 (95% CI 1.02-1.48), respectively. Physical activity was related inversely to the risk of cancer at the proximal (RR 0.76, 95% CI 0.70-0.83) and distal colon (RR 0.77, 95% CI 0.71-0.83). Such a relationship could not be established for the rectum (RR 0.98, 95% CI 0.88-1.08). In conclusion, the results suggest minor differences in the associations of BMI and the risk of cancer between the colorectal subsites. For physical activity, the association does not seem to differ between the colonic subsites, but a difference was observed between the colon and the rectum, perhaps indicating that different mechanisms are operating in the development of colon and rectal cancer.
  European journal of cancer prevention: the official journal of the European Cancer Prevention Organisation (ECP) 04/2013; · 2.21 Impact Factor
• Article: Meat intake, cooking methods, and risk of proximal colon, distal colon, and rectal cancer: The Norwegian Women and Cancer (NOWAC) cohort study.

  Christine L Parr, Anette Hjartåker, Eiliv Lund, Marit B Veierød
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  ABSTRACT: Red and processed meat intake is an established risk factor for colorectal cancer (CRC), but epidemiological evidence by subsite and sex are still limited. In the population-based Norwegian Women and Cancer cohort (NOWAC) we examined associations of meat intake with incident proximal colon, distal colon, and rectal cancer, in 84 538 women who completed a validated food frequency questionnaire (FFQ) during 1996-1998 or 2003-2005 (baseline or exposure update) at age 41-70 years, with follow-up by register linkages through 2009. We also examined the effect of meat cooking methods in a subsample (n=43 636). Multivariable hazard ratios (HRs) were estimated by Cox regression. There were 459 colon (242 proximal and 167 distal), and 215 rectal cancer cases with follow-up ≥ 1 (median 11.1) year. Processed meat intake ≥60 vs. <15 g/day was associated with significantly increased cancer risk in all subsites with HRs (95% confidence interval, CI) of 1.69 (1.05-2.72) for proximal colon, 2.13 (1.18-3.83) for distal colon, and 1.71 (1.02-2.85) for rectal cancer. Regression calibration of continuous effects based on repeated 24-hour dietary recalls, indicated attenuation due to measurement errors in FFQ data, but corrected HRs were not statistically significant due to wider CIs. Our study did not support an association between CRC risk and intake of red meat, chicken, or meat cooking methods, but a high processed meat intake was associated with increased risk of proximal colon, distal colon, and rectal cancer. The effect of processed meat was mainly driven by the intake of sausages. © 2013 Wiley Periodicals, Inc.
  International Journal of Cancer 02/2013; · 5.44 Impact Factor