Publications (35)141.68 Total impact
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Article: Dietary intake and status of n-3 polyunsaturated fatty acids in a population of fish-eating and non-fish-eating meat-eaters, vegetarians, and vegans and the product-precursor ratio [corrected] of α-linolenic acid to long-chain n-3 polyunsaturated fatty acids: results from the EPIC-Norfolk cohort.
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ABSTRACT: Intakes of n-3 (omega-3) polyunsaturated fatty acids (PUFAs) are important for health. Because fish is the major source of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), non-fish-eaters may have suboptimal n-3 PUFA status, although the importance of the conversion of plant-derived α-linolenic acid (ALA) to EPA and DHA is debated. The objective was to determine intakes, food sources, and status of n-3 PUFAs according to dietary habit (fish-eaters and non-fish-eating meat-eaters, vegetarians, or vegans) and estimated conversion between dietary ALA and circulating long-chain n-3 PUFAs. This study included 14,422 men and women aged 39-78 y from the EPIC (European Prospective Investigation into Cancer and Nutrition)-Norfolk cohort with 7-d diary data and a substudy in 4902 individuals with plasma phospholipid fatty acid measures. Intakes and status of n-3 PUFAs were measured, and the product-precursor ratio [corrected] of ALA to circulating n-3 PUFAs was calculated. Most of the dietary intake of EPA and DHA was supplied by fish; however, meat was the major source in meat-eaters, and spreading fats, soups, and sauces were the major sources in vegetarians. Total n-3 PUFA intakes in non-fish-eaters were 57-80% of those in fish-eaters, but status differences were considerably smaller [corrected]. The estimated product-precursor ratio [corrected] was greater in women than in men and greater in non-fish-eaters than in fish-eaters. Substantial differences in intakes and in sources of n-3 PUFAs existed between the dietary-habit groups, but the differences in status were smaller than expected, possibly because the product-precursor ratio [corrected] was greater in non-fish-eaters than in fish-eaters, potentially indicating increased estimated conversion of ALA. If intervention studies were to confirm these findings, it could have implications for fish requirements.American Journal of Clinical Nutrition 11/2010; 92(5):1040-51. · 6.67 Impact Factor -
Article: Developing a database of vitamin and mineral supplements (ViMiS) for the Norfolk arm of the European Prospective Investigation into Cancer (EPIC-Norfolk).
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ABSTRACT: OBJECTIVE: Supplements are an important source of micronutrient intake, which, unless taken into account, can misclassify individuals with regard to levels of nutrient exposure. A label-based vitamin and mineral supplements (ViMiS) database was developed to contain manufacturers' information and to enter supplement use by participants in the European Prospective Investigation into Cancer and Nutrition in Norfolk (EPIC-Norfolk). The ViMiS database contains information on all ingredients, broken down into nutrient information in order to be combined with nutrient intake derived from food consumption. DESIGN: Development of the ViMiS database and cross-sectional analysis of supplement use in a population-based study. SETTING: Men and women aged 40-79 years from the general population participating in the EPIC-Norfolk study between 1993 and 1997, with data available from 7 d diet diaries (7dDD). SUBJECTS: A subset of 19 330 participants with available 7dDD and known supplement status. RESULTS: To date, the ViMiS database includes 2066 supplements, which altogether contain 16 586 ingredients, with a median of eleven nutrient/ingredients per supplement. Forty per cent of the cohort took a supplement, of which cod liver oil was the most common (24·5 %). CONCLUSIONS: The ViMiS database provides a flexible tool for estimating total nutrient intake. The high prevalence of supplement use in the general population indicates that supplement use needs to be taken into account when examining the relationship of intake of particular nutrients to health outcomes.Public Health Nutrition 11/2010; · 2.17 Impact Factor -
Article: Region-specific nutrient intake patterns exhibit a geographical gradient within and between European countries.
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ABSTRACT: Until recently, the study of nutrient patterns was hampered at an international level by a lack of standardization of both dietary methods and nutrient databases. We aimed to describe the diversity of nutrient patterns in the European Prospective Investigation into Cancer and Nutrition (EPIC) study at population level as a starting point for future nutrient pattern analyses and their associations with chronic diseases in multi-center studies. In this cross-sectional study, 36,034 persons aged 35-74 y were administered a single, standardized 24-h dietary recall. Intake of 25 nutrients (excluding intake from dietary supplements) was estimated using a standardized nutrient database. We used a graphic presentation of mean nutrient intakes by region and sex relative to the overall EPIC means to contrast patterns within and between 10 European countries. In Mediterranean regions, including Greece, Italy, and the southern centers of Spain, the nutrient pattern was dominated by relatively high intakes of vitamin E and monounsaturated fatty acids (MUFA), whereas intakes of retinol and vitamin D were relatively low. In contrast, in Nordic countries, including Norway, Sweden, and Denmark, reported intake of these same nutrients resulted in almost the opposite pattern. Population groups in Germany, The Netherlands, and the UK shared a fatty acid pattern of relatively high intakes of PUFA and SFA and relatively low intakes of MUFA, in combination with a relatively high intake of sugar. We confirmed large variability in nutrient intakes across the EPIC study populations and identified 3 main region-specific patterns with a geographical gradient within and between European countries.Journal of Nutrition 07/2010; 140(7):1280-6. · 3.92 Impact Factor -
Article: Urine pH is an indicator of dietary acid-base load, fruit and vegetables and meat intakes: results from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk population study.
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ABSTRACT: Evidence exists that a more acidic diet is detrimental to bone health. Although more precise methods exist for measurement of acid-base balance, urine pH reflects acid-base balance and is readily measurable but has not been related to habitual dietary intake in general populations. The present study investigated the relationship between urine pH and dietary acid-base load (potential renal acid load; PRAL) and its contributory food groups (fruit and vegetables, meats, cereal and dairy foods). There were 22,034 men and women aged 39-78 years living in Norfolk (UK) with casual urine samples and dietary intakes from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk FFQ. A sub-study (n 363) compared pH in casual samples and 24 h urine and intakes from a 7 d diary and the FFQ. A more alkaline diet (low PRAL), high fruit and vegetable intake and lower consumption of meat was significantly associated with a more alkaline urine pH before and after adjustment for age, BMI, physical activity and smoking habit and also after excluding for urinary protein, glucose, ketones, diagnosed high blood pressure and diuretic medication. In the sub-study the strongest relationship was found between the 24 h urine and the 7 d diary. In conclusion, a more alkaline diet, higher fruit and vegetable and lower meat intake were related to more alkaline urine with a magnitude similar to intervention studies. As urine pH relates to dietary acid-base load its use to monitor change in consumption of fruit and vegetables, in individuals, warrants further investigation.The British journal of nutrition 07/2008; 99(6):1335-43. · 3.45 Impact Factor -
Article: Physical activity and fibrinogen concentrations in 23,201 men and women in the EPIC-Norfolk population-based study.
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ABSTRACT: To examine the relationship between usual physical activity and fibrinogen concentrations in a free-living population of men and women. We examined the cross-sectional relationship between habitual combined work and leisure physical activity derived from a validated physical activity questionnaire and plasma fibrinogen concentrations in a population-based study of 23,201 men and women aged 40-79 years. Mean plasma fibrinogen concentrations were lower in people who were physically active compared to those who were physically less active. Mean fibrinogen concentrations were 2.82+/-0.02, 2.87+/-2.87(0.02), 2.90+/-0.02, and 2.97+/-0.02g/L (p for trend<0.0001) for men in the active, moderately active, moderately inactive and inactive physical activity categories respectively, independently of age, smoking, body mass index (BMI), prevalent illnesses, social class and alcohol consumption. The corresponding values for women were 2.95+/-0.02, 2.94+/-0.01, 2.98+/-0.01, and 3.04+/-0.01g/L (p for trend<0.0001). Similar results were observed after adjusting for hormone replacement therapy (HRT) in women. Higher physical activity is significantly inversely associated with plasma fibrinogen concentration independently of other related factors. This might provide an additional plausible mechanism for the cardiovascular health benefits of physical activity.Atherosclerosis 06/2008; 198(2):419-25. · 3.79 Impact Factor -
Article: Measured height loss predicts fractures in middle-aged and older men and women: the EPIC-Norfolk prospective population study.
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ABSTRACT: In this large population-based prospective study among middle-aged and older men and women, we found that height loss of >2 cm over a period of 4 yr is a significant predictor of future fractures. Serial measurement of height is, therefore, recommended among the elderly people. Height change can be easily measured and may contribute to fracture risk prediction. We assessed measured height loss and fracture incidence in a prospective population study. Height was measured in participants in the Norfolk cohort of the European Prospective Investigation into Cancer (EPIC-Norfolk) between 1993 and 1997 and repeated between 1997 and 2000. Incident fractures to 2006 were ascertained by hospital record linkage. In 14,921 men and women 42-82 yr of age, during a mean follow-up period of 7.1 yr, there were 390 fractures, including 122 hip fractures. Prior annual height loss in those who had an incident fracture (1.8 +/- 0.3 [SD] mm) was significantly greater than other participants (0.9 +/- 0.2 mm; p < 0.001). Participants with annual height loss >0.5 cm had an age- and sex-adjusted hazard ratio of any fracture of 1.76 (95% CI, 1.16-2.67) and of hip fracture of 2.08 (95% CI, 1.07-4.05) compared with those with no height loss. Each 1 cm/yr height loss was associated with a hazard ratio of 1.86 (95% CI, 1.28-2.72) for all fractures and 2.24 (95% CI, 1.23-4.09) for hip fracture after adjustment for age, sex, past history of fracture, smoking, body mass index, alcohol intake, and heel ultrasound measures. Annual height loss of 1 cm was comparable to having a past history of fracture and equivalent to being approximately 14 yr older in chronological age in terms of the magnitude of relationship with fracture risk. Middle-aged and older men and women with annual height loss >0.5 cm are at increased risk of hip and any fracture. Serial height measurements can contribute to fracture risk prediction.Journal of bone and mineral research: the official journal of the American Society for Bone and Mineral Research 03/2008; 23(3):425-32. · 6.04 Impact Factor -
Article: Plasma vitamin C concentrations predict risk of incident stroke over 10 y in 20 649 participants of the European Prospective Investigation into Cancer Norfolk prospective population study.
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ABSTRACT: The relation between plasma vitamin C and risk of stroke remains unclear. Although clinical trials showed no significant benefit of vitamin C supplementation in reducing stroke risk, they were not able to examine the relation between plasma vitamin C concentrations and stroke risk in a general population. The objective was to examine the relation between baseline plasma vitamin C concentrations and risk of incident stroke in a British population. A population-based prospective study was conducted in 20,649 men and women aged 40-79 y without prevalent stroke at baseline and participating in the European Prospective Investigation into Cancer-Norfolk prospective population study. The participants completed a health questionnaire and attended a clinic during 1993-1997 and were followed up for incident strokes through March 2005. Over 196,713 total person-years (average follow-up: 9.5 y), 448 incident strokes occurred. In a Cox proportional hazards model, persons in the top quartiles of baseline plasma vitamin C concentrations had a 42% lower risk (relative risk: 0.58; 95% CI: 0.43, 0.78) than did those in the bottom quartile, independently of age, sex, smoking, body mass index, systolic blood pressure, cholesterol, physical activity, prevalent diabetes and myocardial infarction, social class, alcohol consumption, and any supplement use. Similar results were obtained after exclusion of persons with illnesses, users of ascorbic acid-containing supplements, and persons with a history of early strokes during the initial 2 y of follow-up. Plasma vitamin C concentrations may serve as a biological marker of lifestyle or other factors associated with reduced stroke risk and may be useful in identifying those at high risk of stroke.American Journal of Clinical Nutrition 02/2008; 87(1):64-9. · 6.67 Impact Factor -
Article: Energy intake at breakfast and weight change: prospective study of 6,764 middle-aged men and women.
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ABSTRACT: To investigate the association between percentage of total daily energy intake consumed at breakfast and weight change in middle-aged men and women, the authors analyzed data from a prospective population-based cohort study from Norfolk, United Kingdom. Participants were 6,764 men and women aged 40-75 years at baseline (1993-1997). Participants completed a 7-day food diary at baseline, and objective measurements of height and weight were carried out at baseline and follow-up (1998-2000). Mean baseline body mass index (weight (kg)/height (m)(2)) was lowest among persons in the highest quintile of percentage of daily energy consumed at breakfast (mean values were 26.0 in the highest quintile and 26.3 in the lowest quintile), despite higher daily total energy intake in this group. Although all participants gained weight, increased percentage of daily energy consumed at breakfast was associated with relatively lower weight gain (adjusted beta coefficient = -0.021, 95% confidence interval: -0.035, -0.007; p = 0.004). The association between percentage of daily energy intake consumed at breakfast and weight gain was independent of age, sex, smoking, total energy intake, macronutrient intake, social class, and physical activity. Redistribution of daily energy intake, so that more energy is consumed at breakfast and less energy is consumed later in the day, may help to reduce weight gain in middle-aged adults.American journal of epidemiology 02/2008; 167(2):188-92. · 5.59 Impact Factor -
Article: Socioeconomic position and risk of short-term weight gain: prospective study of 14,619 middle-aged men and women.
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ABSTRACT: The association between socioeconomic position in middle age and risk of subsequent, short-term weight gain is unknown. We therefore assessed this association in a prospective population based cohort study in Norfolk, UK. We analysed data on 14,619 middle-aged men and women (aged between 40-75 at baseline) with repeated objective measures of weight and height at baseline (1993-1997) and follow up (1998-2000). During follow up 5,064 people gained more than 2.5 kg. Compared with the highest social class, individuals in the lowest social class had around a 30% greater risk of gaining more than 2.5 kg (OR 1.29; 95% CI 1.11-1.51; p for trend = 0.002). This association remained statistically significant following adjustment for sex, age, baseline BMI, smoking, and follow up time (OR 1.25; CI 1.07-1.46; p for trend <0.001). We also found no material difference between unadjusted models and those including all confounders and potential mediators. Individuals of low socioeconomic position are at greatest risk of gaining weight during middle age, which is not explained by classical correlates of socioeconomic position and risk factors for obesity.BMC Public Health 01/2008; 8:112. · 2.00 Impact Factor -
Article: Apolipoprotein E polymorphisms, dietary fat and fibre, and serum lipids: the EPIC Norfolk study.
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ABSTRACT: To investigate whether blood lipid response to dietary fat and fibre vary according to the apolipoprotein E (APOE) gene locus. Regression analysis of intake of dietary fat and lipid fractions according to APOE gene loci was assessed by Pyrosequencing and validated with restriction fragment length polymorphism in 22 915 participants of the Norfolk arm of the European Prospective Investigation of Cancer. There were significant (P < 0.001) differences in serum lipids according to genotype, highest total and low-density lipoprotein (LDL) cholesterol, and lowest high-density lipoprotein and triglycerides in epsilon4/epsilon4 individuals. There were positive associations between total and saturated fat and serum total and LDL cholesterol, and significant inverse associations (P < 0.001) between polyunsaturated fat and dietary fibre and lipid fractions overall. Associations were in the same direction for epsilon2, epsilon3, and epsilon4 expressing individuals with no significant interactions between diet and genotype group on blood lipids, except in the 3% individuals expressing epsilon2/epsilon4 (P < 0.05) in whom the associations were doubled. In this largest study to date, ApoE gene loci status does not confer exemption from population targets to reduce dietary saturated fat and increase dietary fibre in order to reduce blood lipids and risk of coronary heart disease.European Heart Journal 12/2007; 28(23):2930-6. · 10.48 Impact Factor -
Article: Healthy lifestyle choices: could sense of coherence aid health promotion?
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ABSTRACT: A research framework based on the personal characteristic defined by a sense of coherence (SOC) focuses on the effective use of resources to maintain good health. To test the hypothesis that individual differences in SOC are associated with healthier lifestyle choices independently of social class and education. Cross sectional. Population based cohort study recruited through 35 general practice registers. Reported dietary intakes of alcohol, fruit and vegetables, fibre, saturated fat, non-discretionary salt (sodium), and total sugars were assessed by food frequency questionnaire. Current cigarette smoking, physical inactivity, and SOC were assessed through questionnaires. 7,863 men and 10,424 women. Residents of Norfolk (UK). Compared with participants with the weakest SOC, those with the strongest were 28% less likely to be current smokers (odds ratio 0.72 (95% confidence interval (CI), 0.58 to 0.89)), 36% less likely to be physically inactive (0.64 (0.55 to 0.75)), and reportedly consumed on average 63 g/day more fruit and vegetables (95% CI, 46 to 80), and 1.2 g/day more fibre (0.8 to 1.6). These associations were independent of age, sex, social class, and education. For physical inactivity and consumption of fruit, vegetables, and fibre, these differences exceeded those observed between the extremes of social class and education. Individual differences in SOC are associated with healthy lifestyle choices independently of social class and education, and may therefore aid the design of future health promotion interventions.Journal of Epidemiology & Community Health 11/2007; 61(10):871-6. · 3.19 Impact Factor -
Article: Self-reported mental health-related quality of life and mortality in men and women in the European Prospective Investigation into Cancer (EPIC-Norfolk): a prospective population study.
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ABSTRACT: To explore the relationship between self-reported mental functional health and mortality. Participants included 17,777 men and women aged 40 to 79 years at baseline who lived in Norfolk, UK, and had no known cardiovascular disease or cancer, and completed the anglicized Short Form 36-item questionnaire (UK SF-36) during 1996 to 2000 in the European Prospective Investigation into Cancer-Norfolk prospective population study. We examined the relationship between mental functional health derived from the mental component summary scores of the SF-36 and mortality from all causes, cardiovascular disease, cancer, and other causes during an average 6.5-year follow-up. There were 1065 deaths during a total of 115,550 person-years of follow-up. Impaired mental health-related quality of life was associated with increased risk of all-cause mortality in men and women. A decrease of 1 SD (10 points) in SF-36 mental component summary scores was associated with a 14% increase in all-cause mortality (hazards ratio = 1.14; 95% Confidence Interval: 1.07, 1.21) after controlling for age, gender, body mass index, systolic blood pressure, cholesterol, alcohol consumption, diabetes, smoking, social class, and physical functional health. Poor self-reported mental functional health is related to increased risk of all-cause mortality in men and women. Interpretation of this association requires further investigation.Psychosomatic Medicine 07/2007; 69(5):410-4. · 3.97 Impact Factor -
Article: More acidic dietary acid-base load is associated with reduced calcaneal broadband ultrasound attenuation in women but not in men: results from the EPIC-Norfolk cohort study.
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ABSTRACT: Dietary patterns that promote mild metabolic acidosis may have a negative effect on bone density. We investigated the relation between a measure of dietary acid-base load, potential renal acid load (PRAL), and calcaneal broadband ultrasound attenuation (BUA) after adjustment for confounders and also compared the results with different estimates of acid-base load. A cross-sectional study was conducted in 14 563 men and women aged 42-82 y living in Norfolk, United Kingdom, in which measures of calcaneal BUA and dietary PRAL were estimated by using the European Prospective Investigation into Cancer and Nutrition Norfolk (EPIC-Norfolk) food-frequency questionnaire. A more acidic dietary intake (high PRAL) was significantly associated with lower calcaneal BUA in women but not in men; there was a difference of approximately 2% in BUA between the highest and lowest quintiles of PRAL, independent of age, body mass index, smoking habit, physical activity, diagnosed osteoporosis, and history of fracture, and (in women) hormone replacement therapy. No relation was observed between history of fracture or incident fracture and PRAL. Those with the greatest PRAL had higher intakes of meat, fish, eggs, and cereal and cereal products and lower intakes of fruit and vegetables, tea, and coffee. PRAL was inversely associated with bone ultrasound measures in women, but the magnitude of the association was relatively small compared with other known risk factors. Further longitudinal studies are required to establish whether, in the long term, these small effects are important in overall fracture risk in populations.American Journal of Clinical Nutrition 05/2007; 85(4):1134-41. · 6.67 Impact Factor -
Article: Glycated hemoglobin and risk of stroke in people without known diabetes in the European Prospective Investigation into Cancer (EPIC)-Norfolk prospective population study: a threshold relationship?
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ABSTRACT: Diabetes is a well-recognized risk factor for cardiovascular diseases. Evidence suggests a linear relationship between blood glucose and myocardial infarction, even at blood glucose concentrations below the threshold for diabetes. The relationship between blood glucose concentration and stroke in people without established diabetes has been studied less extensively. We examined the prospective relationship between usual blood glucose level measured by glycohemoglobin (HbA(1c)) concentrations and incident stroke risk in a general population without diabetes and stroke at baseline assessment in the European Prospective Investigation Into Cancer (EPIC)-Norfolk. A total of 10,489 men and women aged 40 to 79 years at baseline were followed up (mean=8.5 years). Mean age, systolic and diastolic blood pressure, body mass index, total cholesterol, triglycerides, and proportion of current smokers increased and mean high-density lipoprotein cholesterol decreased with increasing HbA(1c) concentrations. There were 164 incident strokes identified over 88 652 person-years. After adjustment for age, sex, and cardiovascular risk factors, the relative risks (95% CI) for stroke for participants with HbA(1c) concentrations 5% to 5.4%, 5.5% to 6.9%, and > or =7% were 0.78 (0.50 to 1.22), 0.83 (0.54 to 1.27), and 2.83 (1.40 to 5.74), respectively, compared with those with HbA(1c) <5%. In contrast to the continuous linear relationship observed between blood glucose level and coronary heart disease risk, the association between blood glucose level and stroke risk appears to be more consistent with a threshold relationship. These observations may give insights into the differing pathogenesis of different vascular diseases.Stroke 03/2007; 38(2):271-5. · 5.73 Impact Factor -
Article: Modifiable lifestyle behaviors and functional health in the European Prospective Investigation into Cancer (EPIC)-Norfolk population study.
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ABSTRACT: To examine the association between modifiable lifestyle behaviors and functional health. Population-based cross-sectional study in 16,678 men and women aged 40-79 years at baseline in 1993-1997 participating in the European Prospective Investigation into Cancer (EPIC)-Norfolk cohort. Smoking and physical inactivity were associated with poorer physical functional health, equivalent to being 7 years and 10-13 years older, respectively, and poorer mental functional health compared to non-smoking or being physically active. After adjusting for age, body mass index, social class, education, prevalent illness, and other lifestyles; men and women who currently smoke were more likely to report poor physical functional health compared to non-smokers {Odds Ratio (OR)=1.85 (95% confidence interval (CI): 1.49, 2.30) and 1.56 (1.30, 1.87)} and poor mental functional health {1.38 (1.12, 1.70); 1.77 (1.51, 2.07)}, respectively. The OR for good physical function in those who were physically active compared to inactive was 1.67 (1.41, 1.97) in men and 1.63 (1.39, 1.91) in women. Moderate alcohol consumption was positively associated with good physical and mental functional health. Modifiable behavioral factors are associated with substantial differences in the observed age-related decline in physical functional health and the prevalence of those in good and poor functional health in the community.Preventive Medicine 03/2007; 44(2):109-16. · 3.22 Impact Factor -
Article: Fruit and vegetable consumption and self-reported functional health in men and women in the European Prospective Investigation into Cancer-Norfolk (EPIC-Norfolk): a population-based cross-sectional study.
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ABSTRACT: To investigate the association between fruit and vegetable consumption and self-reported physical and mental functional health measured by an anglicised short-form 36-item questionnaire (UK SF-36). Population-based cross-sectional study. General community in Norfolk, UK. A total of 16,792 men and women aged 40-79 years recruited from general practice population registers as part of the European Prospective Investigation into Cancer (EPIC)-Norfolk study, who completed food-frequency questionnaires in 1993-1997 and Health and Life Experiences Questionnaires 18 months later, were enrolled in the study. Mean SF-36 physical component summary scores increased significantly with increasing total fruit and vegetable consumption in both men and women (P < 0.0001 for trend). Men and women in the top quartile of consumption compared with the bottom quartile had a significantly higher likelihood of reporting good physical health (defined as a score > or = 55); odds ratio (OR) 1.30, 95% confidence interval (CI) 1.11-1.53 for men and OR 1.28, 95% CI 1.11-1.48 for women, after controlling for age, body mass index, smoking, education, social class, prevalent illness and total energy intake. Exclusion of current smokers and people with prevalent illness did not alter the associations. Higher fruit and vegetable consumption is associated with better self-reported physical functional health within a general population. Increasing daily intake by two portions of fruit and vegetables was associated with an 11% higher likelihood of good functional health. Since the current average consumption of fruit and vegetables in the UK is about three portions, the recommended 'five a day' strategy may have additional benefit for functional as well as other health outcomes in the population.Public Health Nutrition 02/2007; 10(1):34-41. · 2.17 Impact Factor -
Article: Dietary fish intake and plasma phospholipid n-3 polyunsaturated fatty acid concentrations in men and women in the European Prospective Investigation into Cancer-Norfolk United Kingdom cohort.
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ABSTRACT: The n-3 polyunsaturated fatty acids (n-3 PUFAs) docosahexaenoic acid and eicosapentaenoic acid, found in fish and fish-oil supplements and also formed by conversion of alpha-linolenic acid in soy and rapeseed (canola) oils, are thought to have cardioprotective effects. Because the relative feasibility and measurement error of dietary methods varies, this study compared fish and fish-oil intakes obtained from 4 dietary methods with plasma n-3 PUFAs in men and women in a general population. The study participants were 4949 men and women aged 40-79 y from the European Prospective Investigation into Cancer-Norfolk United Kingdom cohort. Measurements of plasma phospholipid n-3 PUFA concentrations and fish intakes were made with the use of 4 dietary methods (food-frequency questionnaire, health and lifestyle questionnaire, 7-d diary, and first-day recall from the 7-d diary). Amounts of fish consumed and relations with plasma phospholipid n-3 PUFAs were not substantially different between the 4 dietary methods. Plasma n-3 PUFA concentrations were significantly higher in women than in men, were 20% higher in fish-oil consumers than in non-fish-oil consumers, and were twice as high in fatty fish consumers as in total fish consumers. Only approximately 25% of the variation in plasma n-3 PUFA was explained by fish and fish-oil consumption. This large study found no substantial differences between dietary methods and observed clear sex differences in plasma n-3 PUFAs. Because variation in n-3 PUFA was only partially determined by fish and fish-oil consumption, this could explain the inconsistent results of observational and intervention studies on coronary artery disease protection.American Journal of Clinical Nutrition 01/2007; 84(6):1330-9. · 6.67 Impact Factor -
Article: Habitual fish consumption and risk of incident stroke: the European Prospective Investigation into Cancer (EPIC)-Norfolk prospective population study.
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ABSTRACT: To examine the association between fish consumption and stroke risk. Prospective population cohort study.Setting: Norfolk, UK cohort of the European Prospective Investigation into Cancer (EPIC-Norfolk). Subjects were 24 312 men and women aged 40-79 years who had no previous history of stroke at baseline.Methods: Fish consumption was assessed using a food-frequency questionnaire at baseline in 1993-1997 and stroke incidence ascertained to 2004. A total of 421 incident strokes were identified (mean follow-up=8.5 years, total person-years=209 238). There were no significant relationships between total fish, shellfish or fish roe consumption and risk of stroke in men and women after adjusting for age, systolic blood pressure, body mass index, smoking, cholesterol, diabetes, physical activity, alcohol consumption, fish oil supplement use and total energy intake using Cox regression analyses. Oily fish consumption was significantly lower in women who subsequently had a stroke (odds ratio (OR) for consumers vs. non-consumers=0.69, 95% confidence interval (CI) 0.51-0.94, P=0.02). The trend in men was similar but not significant (OR for consumers vs. non-consumers=0.88, 95% CI 0.65-1.19, P=0.41). There was no consistent relationship between fish consumption and stroke in this British population. Inconsistencies in the observed health effects of fish consumption in different populations may reflect different patterns and type of fish consumed and preparation methods.Public Health Nutrition 11/2006; 9(7):882-8. · 2.17 Impact Factor -
Article: Relation between self-reported physical functional health and chronic disease mortality in men and women in the European Prospective Investigation into Cancer (EPIC-Norfolk): a prospective population study.
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ABSTRACT: To explore the relationship between self-reported physical functional health and mortality. A cohort of 17,777 men and women aged 41-80 years who completed the anglicised 36-item short-form questionnaire (UK SF-36) in 1996-2000 were followed prospectively until 2004, average 6.5 years, for mortality from all causes, from cardiovascular disease, from cancer, and from all other causes. During 115,527 person-years of follow-up, 1065 deaths occurred. After adjusting for age, body mass index, systolic blood pressure, cholesterol, smoking, diabetes, and social class, the relative risks (RR) for all cause mortality were 2.15 (95% CI: 1.54, 2.99) and 2.42 (1.57, 3.74), cardiovascular mortality were RR = 2.71 (1.47, 4.98) and 3.09 (1.30, 7.33), and death from other causes excluding cancer RR = 2.88 (1.43, 5.79) and 5.22 (1.21, 22.53) in men and women respectively for those who were in the lowest compared to top quintile of SF-36 scores. These associations remained unchanged after exclusion of deaths during the first two years of follow-up and were also consistent in different age groups. Poor self-reported physical functional health in men and women without known instances of prevalent cardiovascular disease or cancer predicts total and cardiovascular disease mortality in the general population independently of known risk factors.Annals of Epidemiology 07/2006; 16(6):492-500. · 3.21 Impact Factor -
Article: Obesity indices and self-reported functional health in men and women in the EPIC-Norfolk.
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ABSTRACT: To investigate the association between two indices of obesity, BMI and waist-to-hip ratio (WHR), and self-reported physical and mental functional health. We examined the relationship between obesity indices and self-reported physical and mental functional health measured by the Anglicized version of the Short-Form 36-item questionnaire in a population-based cross sectional study of 16,806 men and women 40 to 79 years old living in the general community in Norfolk, United Kingdom. Higher BMI and WHR were both independently associated with poorer self-reported physical functional health in men and women. The effect of BMI was greater in women compared with men, and the effect of WHR was greater in men compared with women, for poor physical functional health. Higher WHR but not BMI was associated with lower mental functional health in men and women. High BMI and WHR seem to be adversely related to self-perceived functional health in both men and women, although their relative impacts seem to differ by sex. Our findings also highlight the importance of using WHR in addition to BMI in assessing the impact of obesity on health outcome.Obesity 06/2006; 14(5):884-93. · 4.28 Impact Factor
Top co-authors
Top Journals
Institutions
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2010
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University of East Anglia
Norwich, ENG, United Kingdom
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2004–2010
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University of Cambridge
- Department of Public Health and Primary Care
Cambridge, ENG, United Kingdom -
University of Birmingham
Birmingham, ENG, United Kingdom
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2004–2005
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Harvard University
- Department of Medicine Brigham and Women's Hospital
Boston, MA, USA
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2003–2004
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International Agency for Research on Cancer
Lyon, Rhone-Alpes, France
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