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Nirmala Bhoo-Pathy,
Cuno S P M Uiterwaal,
Vincent K Dik,
Suzanne M Jeurnink,
Bodil H Bech,
Kim Overvad,
Jytte Halkjær,
Anne Tjønneland,
Marie-Christine Boutron-Ruault,
Guy Fagherazzi, [......],
Nick Wareham,
Timothy J Key,
Ruth C Travis,
Talita Duarte-Salles,
Heinz Freisling,
Idlir Licaj,
Valentina Gallo,
Dominique S Michaud, Elio Riboli,
H Bas Bueno-de-Mesquita
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ABSTRACT: BACKGROUND & AIMS: Few modifiable risk factors have been implicated in the etiology of pancreatic cancer. There is little evidence for the effects of caffeinated coffee, decaffeinated coffee, or tea intake on risk of pancreatic cancer. We investigated the association of total coffee, caffeinated coffee, decaffeinated coffee, and tea consumption with risk of pancreatic cancer. METHODS: This study was conducted within the European Prospective Investigation into Nutrition and Cancer (EPIC) cohort, comprising male and female participants from 10 European countries. Between 1992 and 2000, 477,312 participants without cancer completed a dietary questionnaire, and were followed to determine pancreatic cancer incidence. Coffee and tea intakes were calibrated with a 24-hour dietary recall. Adjusted hazard ratios (HRs) were computed using multivariable Cox regression. RESULTS: During a mean follow-up of 11.6 y, 865 first incidences of pancreatic cancers were reported. When divided into fourths, neither total intake of coffee (HR,1.03; 95% confidence interval [CI], 0.83-1.27; high vs low intake), decaffeinated coffee (HR, 1.12; 95% CI, 0.76-1.63; high vs low), nor tea were associated with risk of pancreatic cancer (HR, 1.22, 95% CI, 0.95-1.56; high vs low). Moderately low intake of caffeinated coffee was associated with an increased risk of pancreatic cancer (HR, 1.33; 95% CI, 1.02-1.74), compared to low intake. However, no graded dose response was observed, and the association attenuated following restriction to histologically confirmed pancreatic cancers. CONCLUSION: Based on analysis of data from the EPIC cohort, total coffee, decaffeinated coffee, and tea consumption are not related to the risk of pancreatic cancer.
Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association 06/2013; · 5.64 Impact Factor
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Raul Zamora-Ros,
Pietro Ferrari,
Carlos A González,
Anne Tjønneland,
Anja Olsen,
Lea Bredsdorff,
Kim Overvad,
Marina Touillaud,
Florence Perquier,
Guy Fagherazzi, [......],
Emily Sonestedt,
Malin Sund,
Rikard Landberg,
Kay-Thee Khaw,
Nicholas J Wareham,
Ruth C Travis,
Augustin Scalbert,
Heather A Ward,
Elio Riboli,
Isabelle Romieu
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ABSTRACT: Evidence on the association between dietary flavonoids and lignans and breast cancer (BC) risk is inconclusive, with the possible exception of isoflavones in Asian countries. Therefore, we investigated prospectively dietary total and subclasses of flavonoid and lignan intake and BC risk according to menopause and hormonal receptor status in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The study included 334,850 women, mostly aged between 35 and 70 years from ten European countries. At baseline, country-specific validated dietary questionnaires were used. A flavonoid and lignan food composition database was developed from the US Department of Agriculture, the Phenol-Explorer and the UK Food Standards Agency databases. Cox regression models were used to analyse the association between dietary flavonoid/lignan intake and the risk of developing BC. During an average 11.5-year follow-up, 11,576 incident BC cases were identified. No association was observed between the intake of total flavonoids [hazard ratio comparing fifth to first quintile (HRQ5-Q1) 0.97, 95 % confidence interval (CI): 0.90-1.04; P trend = 0.591], isoflavones (HRQ5-Q1 1.00, 95 % CI: 0.91-1.10; P trend = 0.734), or total lignans (HRQ5-Q1 1.02, 95 % CI: 0.93-1.11; P trend = 0.469) and overall BC risk. The stratification of the results by menopausal status at recruitment or the differentiation of BC cases according to oestrogen and progesterone receptors did not affect the results. This study shows no associations between flavonoid and lignan intake and BC risk, overall or after taking into account menopausal status and BC hormone receptors.
Breast Cancer Research and Treatment 04/2013; · 4.43 Impact Factor
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Raul Zamora-Ros,
Joseph A Rothwell,
Augustin Scalbert,
Viktoria Knaze,
Isabelle Romieu,
Nadia Slimani,
Guy Fagherazzi,
Florence Perquier,
Marina Touillaud,
Esther Molina-Montes, [......],
Ulrika Ericson, Peter Wallström,
Ingegerd Johansson,
Rikard Landberg,
Elisabete Weiderpass,
Dagrun Engeset,
Guri Skeie,
Petra Wark,
Elio Riboli,
Carlos A González
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ABSTRACT: Phenolic acids are secondary plant metabolites that may have protective effects against oxidative stress, inflammation and cancer in experimental studies. To date, limited data exist on the quantitative intake of phenolic acids. We estimated the intake of phenolic acids and their food sources and associated lifestyle factors in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Phenolic acid intakes were estimated for 36 037 subjects aged 35-74 years and recruited between 1992 and 2000 in ten European countries using a standardised 24 h recall software (EPIC-Soft), and their food sources were identified. Dietary data were linked to the Phenol-Explorer database, which contains data on forty-five aglycones of phenolic acids in 452 foods. The total phenolic acid intake was highest in Aarhus, Denmark (1265·5 and 980·7 mg/d in men and women, respectively), while the intake was lowest in Greece (213·2 and 158·6 mg/d in men and women, respectively). The hydroxycinnamic acid subclass was the main contributor to the total phenolic acid intake, accounting for 84·6-95·3 % of intake depending on the region. Hydroxybenzoic acids accounted for 4·6-14·4 %, hydroxyphenylacetic acids 0·1-0·8 % and hydroxyphenylpropanoic acids ≤ 0·1 % for all regions. An increasing south-north gradient of consumption was also found. Coffee was the main food source of phenolic acids and accounted for 55·3-80·7 % of the total phenolic acid intake, followed by fruits, vegetables and nuts. A high heterogeneity in phenolic acid intake was observed across the European countries in the EPIC cohort, which will allow further exploration of the associations with the risk of diseases.
The British journal of nutrition 03/2013; · 3.45 Impact Factor
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ABSTRACT: Nutrients and other bioactive constituents of foods may interact with each other and the surrounding food matrix in complex ways. Therefore, associations between single nutrients and chronic disease may be difficult to identify and interpret, but when dietary patterns (DPs) are examined the combination of many food factors will be considered. An explorative literature search of published review articles was conducted to obtain a fuller understanding of current DPs in epidemiological research, to discuss pros and cons of DPs in nutrition research, and to identify results of studies linking DPs to chronic disease risk in adults. Randomized feeding trials providing the experimental diets to study participants have repeatedly demonstrated that diets based on current dietary recommendations are associated with important health benefits. Systematic reviews of feeding trials and prospective population studies of DPs and chronic disease risk reach similar conclusions regardless of the methodology used to construct DPs. However, to date only a few review articles of DP studies have followed a systematic process using independent reviewers with strict inclusion, exclusion, and study quality criteria. Diets with plenty of plants foods, fish, and seafood that preferably include vegetable oils and low-fat dairy products are associated with a lower risk of most chronic diseases. In contrast, Western-type DPs with food products low in essential nutrients and high in energy, like sugar-sweetened beverages, sweets, refined cereals and solid fats (e.g. butter), and high in red and processed meats, are associated with adverse health effects. An emphasis on high-quality original research, and systematic reviews following a structured process to objectively select and judge studies, is needed in order to enforce a strong future knowledge base regarding DPs and chronic disease.
Food & Nutrition Research 01/2013; 57.
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ABSTRACT: BACKGROUND: The minor T allele of rs2943641 near the gene encoding for insulin receptor substrate 1 (IRS1) has been associated with decreased risk of type 2 diabetes (T2D) and adiposity in genome-wide association studies. Dietary intake can influence the regulation of IRS1, and studies have indicated sex-specific associations between IRS1 and adiposity. OBJECTIVE: The objective was to examine the interaction between IRS1 rs2943641 and macronutrient intakes on incident T2D and percentage body fat in the Malmö Diet and Cancer cohort. DESIGN: The study included 15,227 women and 9614 men aged 45-74 y without prevalent diabetes. Dietary data were collected with a modified diet history method. During 12 y follow-up, 1567 incident T2D cases were identified. RESULTS: The T allele was associated with lower incidence of T2D (P-trend = 0.003) and, in men, with higher percentage body fat (P-trend = 0.00002). We observed 3-way interactions between sex, rs2943641, and carbohydrate intake (P = 0.01) as well as between sex, rs2943641, and fat intake (P = 0.01) on incident T2D. Among women, the T allele was associated with decreased risk only in the lower tertiles of carbohydrate intake (P-trend = 0.01, P-interaction = 0.01). In contrast, among men, the T allele was associated with decreased risk in the lowest tertile of fat intake (P-trend = 0.01, P-interaction = 0.02). No interaction was observed between macronutrient intakes and rs2943641 on percentage body fat. CONCLUSIONS: Our results indicate that IRS1 rs2943641 interacts with carbohydrate and fat intakes on incident T2D in a sex-specific fashion. A protective association between the rs2943641 T allele and T2D was restricted to women with low carbohydrate intake and to men with low fat intake.
American Journal of Clinical Nutrition 12/2012; · 6.67 Impact Factor
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ABSTRACT: BACKGROUND: Dietary carbohydrates have been implicated in relation to prostate cancer. OBJECTIVE: Our objective was to examine the associations between dietary intakes of carbohydrates, fiber, and their food sources and risk of prostate cancer, overall and by case severity, in the Malmö Diet and Cancer cohort. DESIGN: The analysis included 8128 men aged 45-73 y without a history of cancer, cardiovascular disease, or diabetes and who were classified as adequate energy reporters. After a median follow-up time of 15 y, prostate cancer was diagnosed in 817 men. We used Cox proportional hazards regression to model associations between energy-adjusted nutrient and food intakes with risk of incident prostate cancer, with competing risk of death from non-prostate cancer causes taken into account. RESULTS: After adjustment for age and other known or potential risk factors, we observed no associations between total carbohydrates or dietary fiber and prostate cancer. We observed positive associations between the intake of low-fiber cereals with overall and low-risk prostate cancer and between intakes of cake and biscuits and rice and pasta with low-risk prostate cancer (all P-trend < 0.05). A high intake compared with zero consumption of sugar-sweetened beverages was associated with increased risk of symptomatic prostate cancer (HR: 1.38; 95% CI: 1.04, 1.84). CONCLUSIONS: Results from this large study with high-validity dietary data suggest that a high intake of refined carbohydrates may be associated with increased risk of prostate cancer. However we observed no significant associations with high-risk prostate cancer, and not all foods that are typically high in refined carbohydrates were associated with prostate cancer.
American Journal of Clinical Nutrition 11/2012; · 6.67 Impact Factor
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Raul Zamora-Ros,
Antonio Agudo,
Leila Luján-Barroso,
Isabelle Romieu,
Pietro Ferrari,
Viktoria Knaze,
H Bas Bueno-de-Mesquita,
Max Leenders,
Ruth C Travis,
Carmen Navarro, [......],
Marina Touillaud,
Florence Perquier,
Guy Fagherazzi,
Pilar Amiano,
Eva Ardanaz,
Lea Bredsdorff,
Kim Overvad,
Fulvio Ricceri,
Elio Riboli,
Carlos A González
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ABSTRACT: BACKGROUND: Several experimental studies have suggested potential anticarcinogenic effects of flavonoids, although epidemiologic evidence for the impact of dietary flavonoids on risk of gastric cancer (GC) is limited. OBJECTIVE: We investigated the association between intake of dietary flavonoids and lignans and incident GC. DESIGN: The study followed 477,312 subjects (29.8% men) aged 35-70 y from 10 European countries who participated in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Validated dietary questionnaires and lifestyle information were collected at baseline. A food-composition database on flavonoids and lignans was compiled by using data from USDA and Phenol-Explorer databases. RESULTS: During an average follow-up of 11 y, 683 incident GC cases (57.8% men) were mostly validated by a panel of pathologists and used in this analysis. We observed a significant inverse association between total flavonoid intake and GC risk in women (HR: 0.81; 95% CI: 0.70, 0.94; for the continuous variable after log(2) transformation) but not in men (HR: 0.97; 95% CI: 0.85, 1.09). In women, significant inverse associations with GC risk were also observed for intakes of some flavonoid subgroups (anthocyanidins, flavonols, flavones, and flavanols), particularly with intestinal type tumors for total flavonoid and flavanol intakes (P-heterogeneity < 0.1). After stratification by smoking status and sex, there was no significant heterogeneity in these associations between ever- and never-smokers. CONCLUSION: Total dietary flavonoid intake is associated with a significant reduction in the risk of GC in women.
American Journal of Clinical Nutrition 10/2012; · 6.67 Impact Factor
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Raul Zamora-Ros,
Viktoria Knaze,
Leila Luján-Barroso,
Isabelle Romieu,
Augustin Scalbert,
Nadia Slimani,
Anette Hjartåker,
Dagrun Engeset,
Guri Skeie,
Kim Overvad, [......],
Verena Grote,
Benedetta Bendinelli,
Heiner Boeing,
Jana Förster,
Marina Touillaud,
Florence Perquier,
Guy Fagherazzi,
Valentina Gallo,
Elio Riboli,
Carlos A González
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ABSTRACT: A greater adherence to the traditional Mediterranean (MED) diet is associated with a reduced risk of developing chronic diseases. This dietary pattern is based on higher consumption of plant products that are rich in flavonoids. We compared the total flavonoid dietary intakes, their food sources and various lifestyle factors between MED and non-MED countries participating in the EPIC study. Flavonoid intakes and their food sources for 35 628 subjects, aged 35-74 years and recruited between 1992 and 2000, in twenty-six study centres were estimated using standardised 24 h dietary recall software (EPIC-Soft®). An ad hoc food composition database on flavonoids was compiled using analytical data from the United States Department of Agriculture and Phenol-Explorer databases. Moreover, it was expanded to include using recipes, estimations of missing values and flavonoid retention factors. No significant differences in total flavonoid mean intake between non-MED countries (373·7 mg/d) and MED countries (370·2 mg/d) were observed. In the non-MED region, the main contributors were proanthocyanidins (48·2 %) and flavan-3-ol monomers (24·9 %) and the principal food sources were tea (25·7 %) and fruits (32·8 %). In the MED region, proanthocyanidins (59·0 %) were by far the most abundant contributor and fruits (55·1 %), wines (16·7 %) and tea (6·8 %) were the main food sources. The present study shows similar results for total dietary flavonoid intakes, but significant differences in flavonoid class intakes, food sources and some characteristics between MED and non-MED countries. These differences should be considered in studies about the relationships between flavonoid intake and chronic diseases.
The British journal of nutrition 09/2012; · 3.45 Impact Factor
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Martine M Ros,
H Bas Bueno-de-Mesquita,
Ellen Kampman,
Katja Kh Aben,
Frederike L Büchner,
Eugene Hjm Jansen,
Carla H van Gils,
Lars Egevad,
Kim Overvad,
Anne Tjønneland, [......], Peter Wallström,
Börje Ljungberg,
Göran Hallmans,
Timothy J Key,
Naomi E Allen,
Kay-Tee Khaw,
Nick Wareham,
Paul Brennan,
Elio Riboli,
Lambertus A Kiemeney
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ABSTRACT: Published associations between dietary carotenoids and vitamin C and bladder cancer risk are inconsistent. Biomarkers may provide more accurate measures of nutrient status.
We investigated the association between plasma carotenoids and vitamin C and risk of urothelial cell carcinoma (UCC) in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition.
A total of 856 patients with newly diagnosed UCC were matched with 856 cohort members by sex, age at baseline, study center, date and time of blood collection, and fasting status. Plasma carotenoids (α- and β-carotene, β-cryptoxanthin, lycopene, lutein, and zeaxanthin) were measured by using reverse-phase HPLC, and plasma vitamin C was measured by using a colorimetric assay. Incidence rate ratios (IRRs) were estimated by using conditional logistic regression with adjustment for smoking status, duration, and intensity.
UCC risk decreased with higher concentrations of the sum of plasma carotenoids (IRR for the highest compared with the lowest quartile: 0.64; 95% CI: 0.44, 0.93; P-trend = 0.04). Plasma β-carotene was inversely associated with aggressive UCC (IRR: 0.51; 95% CI: 0.30, 0.88; P-trend = 0.02). Plasma lutein was inversely associated with risk of nonaggressive UCC (IRR: 0.56; 95% CI: 0.32, 0.98; P-trend = 0.05). No association was observed between plasma vitamin C and risk of UCC.
Although residual confounding by smoking or other factors cannot be excluded, higher concentrations of plasma carotenoids may reduce risk of UCC, in particular aggressive UCC. Plasma lutein may reduce risk of nonaggressive UCC.
American Journal of Clinical Nutrition 09/2012; 96(4):902-10. · 6.67 Impact Factor
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Jin Young Park,
Genevieve Nicolas,
Heinz Freisling,
Carine Biessy,
Augustin Scalbert,
Isabelle Romieu,
Véronique Chajès,
Shu-Chun Chuang,
Ulrika Ericson, Peter Wallström,
Martine M. Ros,
Petra H. M. Peeters,
Amalia Mattiello,
Domenico Palli,
Paolo Vineis,
Nadia Slimani
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ABSTRACT: Folate plays an important role in the synthesis and methylation of DNA as a cofactor in one-carbon metabolism. Inadequate folate intake has been linked to adverse health events. However, comparable information on dietary folate intake across European countries has never been reported. The objective of the present study was to describe the dietary folate intake and its food sources in ten countries in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. A cross-sectional analysis was conducted in 36 034 participants (aged 35–74 years) who completed a single 24 h dietary recall using a computerised interview software program, EPIC-Soft® (International Agency for Research on Cancer, Lyon). Dietary folate intake was estimated using the standardised EPIC Nutrient DataBase, adjusted for age, energy intake, weight and height and weighted by season and day of recall. Adjusted mean dietary folate intake in most centres ranged from 250 to 350 μg/d in men and 200 to 300 μg/d in women. Folate intake tended to be lower among current smokers and heavier alcohol drinkers and to increase with educational level, especially in women. Supplement users (any types) were likely to report higher dietary folate intake in most centres. Vegetables, cereals and fruits, nuts and seeds were the main contributors to folate intake. Nonetheless, the type and pattern of consumption of these main food items varied across the centres. These first comparisons of standardised dietary folate intakes across different European populations show moderate regional differences (except the UK health conscious group), and variation by sex, educational level, smoking and alcohol-drinking status, and supplement use.
The British journal of nutrition 08/2012; 108(03):552 - 569. · 3.45 Impact Factor
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ABSTRACT: OBJECTIVE: To examine how different scoring models for a diet quality index influence associations with mortality outcomes. DESIGN: A study within the Malmö Diet and Cancer cohort. Food and nutrient intakes were estimated using a diet history method. The index included six components: SFA, PUFA, fish and shellfish, fibre, fruit and vegetables, and sucrose. Component scores were assigned using predefined (based on dietary recommendations) and population-based cut-offs (based on median or quintile intakes). Multivariate Cox regression was used to model associations between index scores (low, medium, high) and all-cause and cause-specific mortality by sex. SETTING: Malmö, the third largest city in Sweden. SUBJECTS: Men (n 6940) and women (n 10 186) aged 44-73 years. During a mean follow-up of 14·2 years, 2450 deaths occurred, 1221 from cancer and 709 from CVD. RESULTS: The predictive capability of the index for mortality outcomes varied with type of scoring model and by sex. Stronger associations were seen among men using predefined cut-offs. In contrast, the quintile-based scoring model showed greater predictability for mortality outcomes among women. The scoring model using median-based cut-offs showed low predictability for mortality among both men and women. CONCLUSIONS: The scoring model used for dietary indices may have a significant impact on observed associations with disease outcomes. The rationale for selection of scoring model should be included in studies investigating the association between dietary indices and disease. Adherence to the current dietary recommendations was in the present study associated with decreased risk of all-cause and cause-specific mortality, particularly among men.
Public Health Nutrition 05/2012; · 2.17 Impact Factor
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Paula G Jakszyn,
Naomi E Allen,
Leila Lujan-Barroso,
Carlos A Gonzalez,
Timothy J Key,
Ana Fonseca-Nunes,
Anne Tjønneland,
Nina Føns-Johnsen,
Kim Overvad,
Birgit Teucher, [......],
Esther Molina-Montes,
Nerea Larrañaga,
Elisabet Wirfält, Peter Wallström,
Mattias Johansson,
Pär Stattin,
Kay-Tee Khaw,
Mazda Jenab,
Veronika Fedirko,
Elio Riboli
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ABSTRACT: The evidence about nitrosamines and heme iron intake and cancer risk is limited, despite the biologic plausibility of the hypothesis that these factors might increase cancer risk. We investigated the association between dietary nitrosamines and heme iron and the risk of prostate cancer among participants of European Prospective Investigation into Cancer and Nutrition (EPIC).
Data on food consumption and complete follow-up for cancer occurrence was available for 139,005 men, recruited in 8 European countries. Estimates of HRs were obtained by proportional hazard models, stratified by age at recruitment, and study center, and adjusted for total energy intake, smoking status, marital status, dairy products, educational level, and body mass index.
After a mean follow-up of 10 years, 4,606 participants were diagnosed with first incident prostate cancer. There was no overall association between prostate cancer risk and nitrosamines exposure (preformed and endogenous) or heme iron intake (HR for a doubling of intake: 1.00; 95% CI: 0.98-1.03 for N-Nitrosodimethlyamine, 0.95; 95% CI: 0.88-1.03 for endogenous Nitrosocompounds, and 1.00; 95 CI: 0.97-1.03 for heme iron).
Our findings do not support an effect of nitrosamines (endogenous and exogenous) and heme iron intake on prostate cancer risk.
Cancer Epidemiology Biomarkers & Prevention 03/2012; 21(3):547-51. · 4.12 Impact Factor
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ABSTRACT: The aim of the study was to examine associations between intake of macronutrients and dietary fiber and incident ischemic cardiovascular disease (iCVD) in men and women.
We used data from 8,139 male and 12,535 female participants (aged 44-73 y) of the Swedish population-based Malmö Diet and Cancer cohort. The participants were without history of CVD and diabetes mellitus, and had reported stable dietary habits in the study questionnaire. Diet was assessed by a validated modified diet history method, combining a 7-d registration of cooked meals and cold beverages, a 168-item food questionnaire (covering other foods and meal patterns), and a 1-hour diet interview. Sociodemographic and lifestyle data were collected by questionnaire. iCVD cases, which included coronary events (myocardial infarctions or deaths from chronic ischemic heart disease) and ischemic strokes, were ascertained via national and local registries. Nutrient-disease associations were examined by multivariate Cox regressions.
During a mean follow-up of 13.5 years, we identified 1,089 male and 687 female iCVD cases. High fiber intakes were associated with lower incidence rates of iCVD in women and of ischemic stroke in men. In post-hoc analysis, we discovered statistically significant interactions between intake of fiber and saturated fat; these interactions also differed between men and women (p<0.001).
In this well-defined population, a high fiber intake was associated with lower risk of iCVD, but there were no robust associations between other macronutrients and iCVD risk. Judging from this study, gender-specific nutrient analysis may be preferable in epidemiology.
PLoS ONE 01/2012; 7(2):e31637. · 4.09 Impact Factor
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Mauro Serafini,
Paula Jakszyn,
Leila Luján-Barroso,
Antonio Agudo,
H Bas Bueno-de-Mesquita,
Fränzel J B van Duijnhoven,
Mazda Jenab,
Carmen Navarro,
Domenico Palli,
Heiner Boeing, [......],
Kim Overvad,
Majken Jensen,
Anja Olsen,
Anne Tjonneland,
Eiliv Lund,
Sabina Rinaldi,
Dominique Michaud,
Traci Mouw,
Elio Riboli,
Carlos A González
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ABSTRACT: A high intake of dietary antioxidant compounds has been hypothesized to be an appropriate strategy to reduce gastric cancer (GC) development. We investigated the effect of dietary total antioxidant capacity (TAC) in relation to GC in the European Prospective Investigation into Cancer (EPIC) study including 23 centers in 10 European countries. A total of 521,457 subjects (153,447 men) aged mostly 35-70 years old, were recruited largely between 1992 and 1998. Ferric reducing antioxidant potential (FRAP) and total radical-trapping antioxidant parameter (TRAP), measuring reducing and chain-breaking antioxidant capacity were used to measure dietary TAC from plant foods. Dietary antioxidant intake is associated with a reduction in the risk of GC for both FRAP (adjusted HR 0.66; 95%CI (0.46-0.95) and TRAP (adjusted HR 0.61; 95%CI (0.43-0.87) (highest vs. lowest quintile). The association was observed for both cardia and noncardia cancers. A clear effect was observed in smokers with a significant reduction in GC risk for the fifth quintile of intake for both assays (highest vs. lowest quintile: adjusted HR 0.41; 95%CI (0.22-0.76) p for trend <0.001 for FRAP; adjusted HR 0.52; 95%CI (0.28-0.97) p for trend <0.001 for TRAP) but not in nonsmokers. In former smokers, the association with FRAP intake was statistically significant (highest vs. lowest quintile: adjusted HR 0.4; 95%CI (0.21-0.75) p < 0.05); no association was observed for TRAP. Dietary antioxidant capacity intake from different sources of plant foods is associated with a reduction in the risk of GC.
International Journal of Cancer 11/2011; 131(4):E544-54. · 5.44 Impact Factor
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Robert J Klein,
Christer Hallden,
Amit Gupta,
Caroline J Savage,
Anders Dahlin,
Anders Bjartell,
Jonas Manjer,
Peter T Scardino,
David Ulmert, Peter Wallström,
Andrew J Vickers,
Hans Lilja
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ABSTRACT: Although case-control studies have identified numerous single nucleotide polymorphisms (SNPs) associated with prostate cancer, the clinical role of these SNPs remains unclear.
Evaluate previously identified SNPs for association with prostate cancer and accuracy in predicting prostate cancer in a large prospective population-based cohort of unscreened men.
This study used a nested case-control design based on the Malmö Diet and Cancer cohort with 943 men diagnosed with prostate cancer and 2829 matched controls. Blood samples were collected between 1991 and 1996, and follow-up lasted through 2005.
We genotyped 50 SNPs, analyzed prostate-specific antigen (PSA) in blood from baseline, and tested for association with prostate cancer using the Cochran-Mantel-Haenszel test. We further developed a predictive model using SNPs nominally significant in univariate analysis and determined its accuracy to predict prostate cancer.
Eighteen SNPs at 10 independent loci were associated with prostate cancer. Four independent SNPs at four independent loci remained significant after multiple test correction (p<0.001). Seven SNPs at five independent loci were associated with advanced prostate cancer defined as clinical stage≥T3 or evidence of metastasis at diagnosis. Four independent SNPs were associated with advanced or aggressive cancer defined as stage≥T3, metastasis, Gleason score≥8, or World Health Organization grade 3 at diagnosis. Prostate cancer risk prediction with SNPs alone was less accurate than with PSA at baseline (area under the curve of 0.57 vs 0.79), with no benefit from combining SNPs with PSA. This study is limited by our reliance on clinical diagnosis of prostate cancer; there are likely undiagnosed cases among our control group.
Only a few previously reported SNPs were associated with prostate cancer risk in the large prospective Diet and Cancer cohort in Malmö, Sweden. SNPs were less useful in predicting prostate cancer risk than PSA at baseline.
European urology 11/2011; 61(3):471-7. · 7.67 Impact Factor
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Jin Young Park,
Genevieve Nicolas,
Heinz Freisling,
Carine Biessy,
Augustin Scalbert,
Isabelle Romieu,
Véronique Chajès,
Shu-Chun Chuang,
Ulrika Ericson, Peter Wallström, [......],
Birgit Teucher,
Silke Feller,
Guri Skeie,
Dagrun Engeset,
Marie-Christine Boutron-Ruault,
Françoise Clavel-Chapelon,
Francesca Crowe,
Kay-Tee Khaw,
Paolo Vineis,
Nadia Slimani
[show abstract]
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ABSTRACT: Folate plays an important role in the synthesis and methylation of DNA as a cofactor in one-carbon metabolism. Inadequate folate intake has been linked to adverse health events. However, comparable information on dietary folate intake across European countries has never been reported. The objective of the present study was to describe the dietary folate intake and its food sources in ten countries in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. A cross-sectional analysis was conducted in 36 034 participants (aged 35-74 years) who completed a single 24 h dietary recall using a computerised interview software program, EPIC-Soft® (International Agency for Research on Cancer, Lyon). Dietary folate intake was estimated using the standardised EPIC Nutrient DataBase, adjusted for age, energy intake, weight and height and weighted by season and day of recall. Adjusted mean dietary folate intake in most centres ranged from 250 to 350 μg/d in men and 200 to 300 μg/d in women. Folate intake tended to be lower among current smokers and heavier alcohol drinkers and to increase with educational level, especially in women. Supplement users (any types) were likely to report higher dietary folate intake in most centres. Vegetables, cereals and fruits, nuts and seeds were the main contributors to folate intake. Nonetheless, the type and pattern of consumption of these main food items varied across the centres. These first comparisons of standardised dietary folate intakes across different European populations show moderate regional differences (except the UK health conscious group), and variation by sex, educational level, smoking and alcohol-drinking status, and supplement use.
The British journal of nutrition 11/2011; 108(3):552-69. · 3.45 Impact Factor
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Emily Sonestedt,
Elisabet Wirfält, Peter Wallström,
Bo Gullberg,
Isabel Drake,
Joanna Hlebowicz,
Gunilla Nordin Fredrikson,
Bo Hedblad,
Jan Nilsson,
Ronald M Krauss,
Marju Orho-Melander
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ABSTRACT: Increased plasma concentrations of small LDL particles denote an atherogenic lipoprotein phenotype (ALP) that is correlated with increased circulating TAG and reduced HDL-cholesterol. Principal component analyses of subfraction concentrations have previously been used in the Swedish population-based Malmö Diet and Cancer (MDC) cohort to identify three independent components, one pattern representing the ALP. The aim of the present study was to examine the associations between macronutrient intakes and the principal component representing the ALP. We examined 4301 healthy subjects (46-68 years old, 60 % women) at baseline in the MDC cohort. Dietary data were collected using a modified diet history method. Plasma lipoprotein subfractions were measured using a high-resolution ion mobility method. The principal component corresponding to the ALP was significantly associated with a higher intake of disaccharides, and inversely related to protein and alcohol consumption (P < 0·001 for all). The present findings indicate that the ALP may be improved by a low intake of disaccharides, and moderate intakes of protein and alcohol.
The British journal of nutrition 10/2011; 107(7):1062-9. · 3.45 Impact Factor
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ABSTRACT: It is unclear whether specific dairy products are associated with risk of cardiovascular disease (CVD). The aim of this project was therefore to examine the association between intake of milk, cheese, cream and butter, and incidence of CVD in the Swedish Malmö Diet and Cancer cohort. Milk was separated into fermented (yoghurt and cultured sour milk) versus non-fermented milk, and low-fat versus high-fat milk. Among 26,445 individuals without a history of myocardial infarction, stroke and diabetes (44-74 years; 62% females), 2,520 CVD cases (coronary and stroke events) were identified during a mean follow-up time of 12 years. Dietary data was collected using a modified diet history method. Overall consumption of dairy products was inversely associated with risk of CVD (P (trend) = 0.05). Among the specific dairy products, a statistically significant inverse relationship was observed only for fermented milk. The highest versus lowest intake category of fermented milk was associated with 15% (95% CI: 5-24%; P (trend) = 0.003) decreased incidence of CVD. We observed a statistically significant interaction between sex and cheese intake (P = 0.046). Cheese intake was significantly associated with decreased CVD risk in women (P (trend) = 0.03), but not in men (P (trend) = 0.98). The main finding was that a high intake of fermented milk may reduce the risk of CVD. This study suggests that it is important to examine dairy products separately when investigating their health effects.
European Journal of Epidemiology 06/2011; 26(8):609-18. · 4.71 Impact Factor
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ABSTRACT: To examine the associations between food patterns constructed using cluster analysis and markers of systemic and vascular inflammation, and incident cardiovascular disease (CVD) after 13 years of follow-up.
Population-based, prospective cohort study.
Cluster analysis identified six food patterns from 43 food group variables among 4999 subjects, aged 45-68 years, who participated in the Malmö Diet and Cancer cardiovascular programme between 1991 and 1994. Lipoprotein-associated phospholipase A(2) (Lp-PLA(2) ), C-reactive protein concentration and white blood cell (WBC) count were measured using blood samples at baseline. Incidence of CVD (coronary events and ischaemic stroke) was monitored over 13 years of follow-up.
The fibre-rich bread pattern was associated with favourable effects on WBC count in women, and the low-fat and high-fibre pattern with favourable effects on Lp-PLA(2) mass in women, and on Lp-PLA(2) activity in men. However, the milk fat and sweets and cakes patterns were both associated with adverse effects; the former on WBC count in women and on Lp-PLA(2) mass in men, and the latter on WBC count and Lp-PLA(2) mass in women. The milk fat and sweets and cakes patterns were associated with increased CVD risk in women.
The results of this study support the present Nordic dietary recommendations indicating that diets rich in high-fibre, low-fat and low-sugar foods are favourably associated with markers of inflammation and, potentially, with CVD risk.
Journal of Internal Medicine 03/2011; 270(4):365-76. · 5.48 Impact Factor
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ABSTRACT: To develop a diet quality index (DQI) that assesses adherence to the Swedish nutrition recommendations (SNR) and the Swedish dietary guidelines (SDG).
A cross-sectional study within the Malmö Diet and Cancer (MDC) cohort. A diet history method collected dietary data, a structured questionnaire lifestyle and socio-economic information, and anthropometric data were collected by direct measurements. The index (DQI-SNR) included six components: SFA, PUFA, fish and shellfish, dietary fibre, fruit and vegetables, and sucrose.
Malmö, Sweden.
Men (n 4525) and women (n 8491) of the MDC cohort enrolled from September 1994 to October 1996.
For participants with high DQI-SNR scores, nutrient and food intakes were close to recommendations. However, most of the study population exceeded the recommended intake for SFA (98%) and few reached recommended intakes for dietary fibre (24%), fruit and vegetables (32%), vitamin D (18%) and folate (2%). A high DQI-SNR score was positively associated with age, physical activity, not smoking, past food habit change, education and socio-economic status. Individuals with high scores were more likely to have a diabetes diagnosis or experienced a cardiovascular event.
Results suggest that the DQI-SNR is a useful tool for assessing adherence to the SNR 2005 and the SDG in the MDC cohort. No index has previously been developed with the aim of evaluating adherence to the current dietary recommendations in Sweden. Further validation of the DQI-SNR, and evaluation of its utility, is needed.
Public Health Nutrition 02/2011; 14(5):835-45. · 2.17 Impact Factor
