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V Fedirko,
A Trichopolou,
C Bamia,
T Duarte-Salles,
E Trepo,
K Aleksandrova,
U Nöthlings,
A Lukanova,
P Lagiou,
P Boffetta, [......],
M Sund,
M Werner,
E Sonestedt,
U Ericson,
T J Key,
K T Khaw,
P Ferrari,
I Romieu,
E Riboli,
M Jenab
[show abstract]
[hide abstract]
ABSTRACT: BACKGROUND: While higher intake of fish and lower consumption of red/processed meats have been suggested to play a protective role in the etiology of several cancers, prospective evidence for hepatocellular carcinoma (HCC) is limited, particularly in Western European populations. METHODS: The associations of fish and meats with HCC risk were analyzed in the EPIC cohort. Between 1992 and 2010, 191 incident HCC were identified among 477 206 participants. Baseline diet was assessed using validated dietary questionnaires. A single 24-h diet recall from a cohort subsample was used for calibration. Multivariable proportional hazard regression was utilized to estimate hazard ratios (HR) and 95% confidence intervals (CI). In a nested case-control subset (HCC = 122), HBV/HCV status and liver function biomarkers were measured. RESULTS: HCC risk was inversely associated with intake of total fish (per 20 g/day increase, HR = 0.83, 95% CI 0.74-0.95 and HR = 0.80, 95% CI 0.69-0.97 before and after calibration, respectively). This inverse association was also suggested after adjusting for HBV/HCV status and liver function score (per 20-g/day increase, RR = 0.86, 95% CI 0.66-1.11 and RR = 0.74, 95% CI 0.50-1.09, respectively) in a nested case-control subset. Intakes of total meats or subgroups of red/processed meats, and poultry were not associated with HCC risk. CONCLUSIONS: In this large European cohort, total fish intake is associated with lower HCC risk.
Annals of Oncology 05/2013; · 6.43 Impact Factor
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R Zamora-Ros,
V Knaze,
I Romieu,
A Scalbert,
N Slimani,
F Clavel-Chapelon,
M Touillaud,
F Perquier,
G Skeie,
D Engeset, [......],
E Wirfält,
U Ericson,
K Overvad,
A Trichopoulou,
V Dilis,
P Vidalis,
H Boeing,
J Förster,
E Riboli,
C A González
[show abstract]
[hide abstract]
ABSTRACT: Thearubigins (TR) are polymeric flavanol-derived compounds formed during the fermentation of tea leaves. Comprising ∼70% of total polyphenols in black tea, TR may contribute majorly to its beneficial effects on health. To date, there is no appropriate food composition data on TR, although several studies have used data from the US Department of Agriculture (USDA) database to estimate TR intakes. We aimed to estimate dietary TR in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort and assess the impact of including TR or not in the calculation of the total dietary flavonoid intake. Dietary data were collected using a single standardized 24-h dietary recall interviewer-administered to 36 037 subjects aged 35-74 years. TR intakes were calculated using the USDA database. TR intakes ranged from 0.9 mg/day in men from Navarra and San Sebastian in Spain to 532.5 mg/day in men from UK general population. TR contributed <5% to the total flavonoid intake in Greece, Spain and Italy, whereas in the UK general population, TR comprised 48% of the total flavonoids. High heterogeneity in TR intake across the EPIC countries was observed. This study shows that total flavonoid intake may be greatly influenced by TR, particularly in high black tea-consuming countries. Further research on identification and quantification of TR is needed to get more accurate dietary TR estimations.European Journal of Clinical Nutrition advance online publication, 24 April 2013; doi:10.1038/ejcn.2013.89.
European journal of clinical nutrition 04/2013; · 3.07 Impact Factor
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J Castilla,
I Martinez-Baz,
V Martinez-Artola,
M Fernandez-Alonso,
G Reina,
M Guevara,
M Garcia Cenoz,
F Elia,
N Alvarez, A Barricarte,
C Ezpeleta
Euro surveillance: bulletin europeen sur les maladies transmissibles = European communicable disease bulletin 01/2013; 18(7). · 6.15 Impact Factor
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J Castilla,
I Martinez-Baz,
V Martinez-Artola,
G Reina,
F Pozo,
M Garcia Cenoz,
M Guevara,
J Moran,
F Irisarri,
M Arriazu,
E Albeniz,
C Ezpeleta, A Barricarte
Euro surveillance: bulletin europeen sur les maladies transmissibles = European communicable disease bulletin 01/2013; 18(5). · 6.15 Impact Factor
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G Buckland,
N Travier,
V Cottet,
Ca González,
L Luján-Barroso,
A Agudo,
A Trichopoulou,
P Lagiou,
D Trichopoulos,
Ph Peeters, [......],
E Wirfält,
G Hallmans,
I Johansson,
E Lund,
A Hjartåker,
G Skeie,
Ac Vergnaud,
T Norat,
D Romaguera,
E Ríboli
[show abstract]
[hide abstract]
ABSTRACT: Epidemiological evidence suggests the Mediterranean diet (MD) could reduce risk of breast cancer (BC). Since evidence from prospective studies is still scarce and conflicting, we investigated the association between adherence to the MD and risk of BC among 335,062 women recruited from 1992-2000, in 10 European countries, and followed for 11 years on average. Adherence to the MD was estimated through an adapted relative Mediterranean diet (arMED) score excluding alcohol. Cox proportional hazards regression models were used while adjusting for BC risk factors. A total of 9,009 postmenopausal and 1,216 premenopausal first primary incident invasive BC were identified (5,862 estrogen or progesterone receptor positive (ER+/PR+) and 1,018 estrogen and progesterone receptor negative (ER-PR-)). The arMED was inversely associated with risk of BC overall and in postmenopausal women (high versus low arMED score; HR 0.94 (95% CI: 0.88, 1.00) p(trend) =0.048, and HR 0.93 (95% CI: 0.87, 0.99) p(trend) =0.037, respectively). The association was more pronounced in ER-PR- tumors (HR 0.80 (95% CI: 0.65, 0.99) p(trend) =0.043). The arMED score was not associated with BC in premenopausal women. Our findings show that adherence to a MD excluding alcohol was related to a modest reduced risk of BC in postmenopausal women, and this association was stronger in receptor negative tumors. The results support the potential scope for BC prevention through dietary modification. © 2012 Wiley Periodicals, Inc.
International Journal of Cancer 11/2012; · 5.44 Impact Factor
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S Rohrmann,
J Linseisen,
N Allen,
H B Bueno-de-Mesquita,
N F Johnsen,
A Tjønneland,
K Overvad,
R Kaaks,
B Teucher,
H Boeing, [......],
M Johansson,
A Bjartell,
D Ulmert,
K-T Khaw,
N J Wareham,
Pietro Ferrari,
I Romieux,
M J R Gunter,
Elio Riboli,
T J Key
[show abstract]
[hide abstract]
ABSTRACT: Background:Smoking is not associated with prostate cancer incidence in most studies, but associations between smoking and fatal prostate cancer have been reported.Methods:During 1992 and 2000, lifestyle information was assessed via questionnaires and personal interview in a cohort of 145 112 European men. Until 2009, 4623 incident cases of prostate cancer were identified, including 1517 cases of low-grade, 396 cases of high grade, 1516 cases of localised, 808 cases of advanced disease, and 432 fatal cases. Multivariable Cox proportional hazards regression models were used to examine the association of smoking status, smoking intensity, and smoking duration with the risk of incident and fatal prostate cancer.Results:Compared with never smokers, current smokers had a reduced risk of prostate cancer (RR=0.90, 95% CI: 0.83-0.97), which was statistically significant for localised and low-grade disease, but not for advanced or high-grade disease. In contrast, heavy smokers (25+ cigarettes per day) and men who had smoked for a long time (40+ years) had a higher risk of prostate cancer death (RR=1.81, 95% CI: 1.11-2.93; RR=1.38, 95% CI: 1.01-1.87, respectively).Conclusion:The observation of an increased prostate cancer mortality among heavy smokers confirms the results of previous prospective studies.British Journal of Cancer advance online publication, 20 November 2012; doi:10.1038/bjc.2012.520www.bjcancer.com.
British Journal of Cancer 11/2012; · 5.04 Impact Factor
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V Fedirko,
A Lukanova,
C Bamia,
A Trichopolou,
E Trepo,
U Nöthlings,
S Schlesinger,
K Aleksandrova,
P Boffetta,
A Tjønneland, [......],
B Lindkvist,
M Sund,
M Werner,
F Crowe,
K T Khaw,
P Ferrari,
I Romieu,
S C Chuang,
E Riboli,
M Jenab
[show abstract]
[hide abstract]
ABSTRACT: Background
The type and quantity of dietary carbohydrate as quantified by glycemic index (GI) and glycemic load (GL), and dietary fiber may influence the risk of liver and biliary tract cancers, but convincing evidence is lacking.Patients and methodsThe association between dietary GI/GL and carbohydrate intake with hepatocellular carcinoma (HCC; N = 191), intrahepatic bile duct (IBD; N = 66), and biliary tract (N = 236) cancer risk was investigated in 477 206 participants of the European Prospective Investigation into Cancer and Nutrition cohort. Dietary intake was assessed by country-specific, validated dietary questionnaires. Hazard ratios and 95% confidence intervals were estimated from proportional hazard models. HBV/HCV status was measured in a nested case-control subset.ResultsHigher dietary GI, GL, or increased intake of total carbohydrate was not associated with liver or biliary tract cancer risk. For HCC, divergent risk estimates were observed for total sugar = 1.43 (1.17-1.74) per 50 g/day, total starch = 0.70 (0.55-0.90) per 50 g/day, and total dietary fiber = 0.70 (0.52-0.93) per 10 g/day. The findings for dietary fiber were confirmed among HBV/HCV-free participants [0.48 (0.23-1.01)]. Similar associations were observed for IBD [dietary fiber = 0.59 (0.37-0.99) per 10 g/day], but not biliary tract cancer.Conclusions
Findings suggest that higher consumption of dietary fiber and lower consumption of total sugars are associated with lower HCC risk. In addition, high dietary fiber intake could be associated with lower IBD cancer risk.
Annals of Oncology 11/2012; · 6.43 Impact Factor
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A J Cooper,
N G Forouhi,
Z Ye,
B Buijsse,
L Arriola,
B Balkau, A Barricarte,
J W J Beulens,
H Boeing,
F L Büchner, [......],
I Sluijs,
A M W Spijkerman,
B Teucher,
A Tjonneland,
R Tumino,
S J Sharp,
C Langenberg,
E J M Feskens,
E Riboli,
N J Wareham
[show abstract]
[hide abstract]
ABSTRACT: Fruit and vegetable intake (FVI) may reduce the risk of type 2 diabetes (T2D), but the epidemiological evidence is inconclusive. The aim of this study is to examine the prospective association of FVI with T2D and conduct an updated meta-analysis. In the European Prospective Investigation into Cancer-InterAct (EPIC-InterAct) prospective case-cohort study nested within eight European countries, a representative sample of 16 154 participants and 12 403 incident cases of T2D were identified from 340 234 individuals with 3.99 million person-years of follow-up. For the meta-analysis we identified prospective studies on FVI and T2D risk by systematic searches of MEDLINE and EMBASE until April 2011. In EPIC-InterAct, estimated FVI by dietary questionnaires varied more than twofold between countries. In adjusted analyses the hazard ratio (95% confidence interval) comparing the highest with lowest quartile of reported intake was 0.90 (0.80-1.01) for FVI; 0.89 (0.76-1.04) for fruit and 0.94 (0.84-1.05) for vegetables. Among FV subtypes, only root vegetables were inversely associated with diabetes 0.87 (0.77-0.99). In meta-analysis using pooled data from five studies including EPIC-InterAct, comparing the highest with lowest category for FVI was associated with a lower relative risk of diabetes (0.93 (0.87-1.00)). Fruit or vegetables separately were not associated with diabetes. Among FV subtypes, only green leafy vegetable (GLV) intake (relative risk: 0.84 (0.74-0.94)) was inversely associated with diabetes. Subtypes of vegetables, such as root vegetables or GLVs may be beneficial for the prevention of diabetes, while total FVI may exert a weaker overall effect.
European journal of clinical nutrition 08/2012; 66(10):1082-1092. · 3.07 Impact Factor
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P Guallar-Castillón,
F Rodríguez-Artalejo,
M J Tormo,
M J Sánchez,
L Rodríguez,
J R Quirós,
C Navarro,
E Molina,
C Martínez,
P Marín, [......],
J M Huerta,
M Dorronsoro,
M D Chirlaque,
G Buckland, A Barricarte,
J R Banegas,
L Arriola,
E Ardanaz,
C A González,
C Moreno-Iribas
[show abstract]
[hide abstract]
ABSTRACT: No previous study has assessed the association between major dietary patterns and the risk of coronary heart disease (CHD) in a large cohort from a Mediterranean country.
We studied prospectively 40,757 persons, aged 29-69 years, participating in the Spanish cohort of the EPIC study. Food consumption was collected between 1992 and 1996 with a validated history method. Individuals were followed-up until 2004 through record linkage with hospital discharge registers, population-based registers of myocardial infarction, and mortality registers to ascertain CHD events (fatal and non-fatal acute myocardial infarction or angina requiring revascularization). Two major dietary patterns were identified from factor analysis. The first pattern was labeled as Westernized, because of the frequent consumption of refined cereals and red meat; the second was called the evolved Mediterranean pattern, because of the frequent intake of plant-based foods and olive oil. During a median follow-up of 11 years, 606 CHD events were ascertained. No association was found between the Westernized pattern and CHD risk. In contrast, the score for the evolved Mediterranean pattern was inversely associated with CHD risk (p for trend = 0.0013); when compared with the lowest quintile of the evolved Mediterranean pattern score, the multivariable hazard ratios for CHD were 0.77 (95% confidence interval 0.61-0.98) for the second quintile, 0.64 (95% CI 0.50-0.83) for the third quintile, 0.56 (95% CI 0.43-0.73) for the fourth quintile, and 0.73 (95% CI 0.57-0.94) for the fifth quintile.
A Mediterranean diet, as consumed in this study population, was associated with a lower risk of CHD.
Nutrition, metabolism, and cardiovascular diseases: NMCD 03/2012; 22(3):192-9. · 3.52 Impact Factor
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C A González,
F Megraud,
A Buissonniere,
L Lujan Barroso,
A Agudo,
E J Duell,
M C Boutron-Ruault,
F Clavel-Chapelon,
D Palli,
V Krogh, [......],
K Bakken,
V Dumeaux,
E Lund,
M Jenab,
I Romieu,
D Michaud,
T Mouw,
F Carneiro,
C Fenge,
E Riboli
[show abstract]
[hide abstract]
ABSTRACT: In epidemiological studies, Helicobacter pylori infection is usually detected by enzyme-linked immunosorbent assay (ELISA). However, infection can spontaneously clear from the mucosa during the progression of atrophy and could lead to substantial under-detection of infection and underestimation of its effect on gastric cancer (GC) risk. Antibodies detected by western blot are known to persist longer after the loss of the infection.
In a nested case-control study from the Eurogast-EPIC cohort, including 88 noncardia GC cases and 338 controls, we assessed the association between noncardia GC and H. pylori infection comparing antibodies detected by western blot (HELICOBLOT2.1) to those detected by ELISA (Pyloriset EIA-GIII(®)).
By immunoblot, 82 cases (93.2%) were H. pylori positive, 10 of these cases (11.4%) were negative by ELISA and only 6 cases (6.8%) were negative by both ELISA and immunoblot. Multivariable odds ratio (OR) for noncardia GC comparing immunoglobulin G positive versus negative by ELISA was 6.8 [95% confidence interval (CI) 3.0-15.1], and by immunoblot, the OR was 21.4 (95% CI 7.1-64.4).
Using a western blot assay, nearly all noncardia GC were classified as H. pylori positive and the OR was more than threefold higher than the OR assessed by ELISA, supporting the hypothesis that H. pylori infection is a necessary condition for noncardia GC.
Annals of Oncology 09/2011; 23(5):1320-4. · 6.43 Impact Factor
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B Schlehofer,
B Siegmund,
J Linseisen,
J Schüz,
S Rohrmann,
S Becker,
D Michaud,
B Melin,
H Bas Bueno-de-Mesquita,
P H M Peeters, [......],
M-D Chirlaque, A Barricarte,
S Borgquist,
J Manjer,
V Gallo,
N E Allen,
T J Key,
E Riboli,
R Kaaks,
J Wahrendorf
[show abstract]
[hide abstract]
ABSTRACT: Case-control studies suggest that patients with allergic diseases have a lower risk of developing glioma but not meningioma or schwannoma. However, those data can be differentially biased. Prospective studies with objective measurements of immunologic biomarkers, like immunoglobulin E (IgE), in blood obtained before cancer diagnosis could help to clarify whether an aetiological association exists.
The present case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) measured specific serum IgE as a biomarker for the most common inhalant allergens in 275 glioma, 175 meningioma and 49 schwannoma cases and 963 matched controls using the ImmunoCAP specific IgE test. Subjects with an IgE level ≥0.35 kUA/l (kilo antibody units per litre) were classified as sensitized by allergens. Odds ratios (OR) and 95% confidence intervals (CI) were estimated by adjusted conditional logistic regression models for each tumour subtype. The effect of dose-response relationship was assessed in five increasing IgE level categories to estimate P-values for trend.
The risk of glioma was inversely related to allergic sensitization (OR = 0.73; 95% CI 0.51-1.06), especially pronounced in women (OR = 0.53; 95% CI 0.30-0.95). In dose-response analyses, for high-grade glioma, the lowest OR was observed in sera with the highest IgE levels (P for trend = 0.04). No association was seen for meningioma and schwannoma.
The results, based on serum samples prospectively collected in a cohort study, provide some support for the hypothesis that individuals with allergic sensitization are at reduced risk of glioma and confirm results from previous case-control studies.
Allergy 07/2011; 66(11):1434-41. · 6.27 Impact Factor
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C Langenberg,
S Sharp,
N G Forouhi,
P W Franks,
M B Schulze,
N Kerrison,
U Ekelund,
I Barroso,
S Panico,
M J Tormo, [......],
B Teucher,
A Tjonneland,
R Tumino,
D L van der A,
W M M Verschuren,
J Tuomilehto,
E Feskens,
M McCarthy,
E Riboli,
N J Wareham
[show abstract]
[hide abstract]
ABSTRACT: Studying gene-lifestyle interaction may help to identify lifestyle factors that modify genetic susceptibility and uncover genetic loci exerting important subgroup effects. Adequately powered studies with prospective, unbiased, standardised assessment of key behavioural factors for gene-lifestyle studies are lacking. This case-cohort study aims to investigate how genetic and potentially modifiable lifestyle and behavioural factors, particularly diet and physical activity, interact in their influence on the risk of developing type 2 diabetes.
Incident cases of type 2 diabetes occurring in European Prospective Investigation into Cancer and Nutrition (EPIC) cohorts between 1991 and 2007 from eight of the ten EPIC countries were ascertained and verified. Prentice-weighted Cox regression and random-effects meta-analyses were used to investigate differences in diabetes incidence by age and sex.
A total of 12,403 verified incident cases of type 2 diabetes occurred during 3.99 million person-years of follow-up of 340,234 EPIC participants eligible for InterAct. We defined a centre-stratified subcohort of 16,154 individuals for comparative analyses. Individuals with incident diabetes who were randomly selected into the subcohort (n = 778) were included as cases in the analyses. All prevalent diabetes cases were excluded from the study. InterAct cases were followed-up for an average of 6.9 years; 49.7% were men. Mean baseline age and age at diagnosis were 55.6 and 62.5 years, mean BMI and waist circumference values were 29.4 kg/m(2) and 102.7 cm in men, and 30.1 kg/m(2) and 92.8 cm in women, respectively. Risk of type 2 diabetes increased linearly with age, with an overall HR of 1.56 (95% CI 1.48-1.64) for a 10 year age difference, adjusted for sex. A male excess in the risk of incident diabetes was consistently observed across all countries, with a pooled HR of 1.51 (95% CI 1.39-1.64), adjusted for age.
InterAct is a large, well-powered, prospective study that will inform our understanding of the interplay between genes and lifestyle factors on the risk of type 2 diabetes development.
Diabetologia 06/2011; 54(9):2272-82. · 6.81 Impact Factor
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M M Bergmann,
M Schütze,
A Steffen,
H Boeing,
J Halkjaer,
A Tjonneland,
N Travier,
A Agudo,
N Slimani,
S Rinaldi, [......],
D Palli,
S Grioni,
P Vineis,
S Panico,
R Tumino,
E Riboli,
N J Wareham,
B Bueno-de-Mesquita,
A May,
P H M Peeters
[show abstract]
[hide abstract]
ABSTRACT: The relation between lifetime use of alcohol and measures of abdominal and general adiposity is unknown.
Among 99,381 men and 158,796 women of the European Prospective Investigation into Cancer and Nutrition (EPIC) study, means of waist circumference (WC), waist-to-hip-ratio (WHR) and body mass index (BMI), and odds ratios (OR) for a larger WC than predicted for a given BMI (WClp=positive residuals of gender specific linear regression of BMI on WC) across categories of average lifetime use of alcohol (total, from wine and from beer) were calculated, all adjusted for socio-demographic, lifestyle and health factors.
WC, WHR and BMI in men using lifetime ≤6 g/d alcohol were 95.1 cm, 0.942 and 27.3 kg/m(2), and 96.2 cm, 0.961 and 28.3 kg/m(2) when using >96 g/d. WC and WHR in women was 83.2 cm and 0.813 for ≤6 g/d, and 84.6 cm and 0.830 for >60 g/d, whereas BMI deviated only slightly with the lowest BMI (26.7 kg/m(2)) observed for >6-24 g/d. Compared with ≤6 g/d, OR for a WClp in both genders increased steadily across categories of alcohol use (up to 1.40 (95% confidence interval 1.32, 1.49) in men using >60 g/d and 1.63 (1.54, 1.73) in women using >24 g/d), though increase was higher for alcohol from beer than from wine (P for difference between beer and wine<0.001 (men) and=0.002 (women)).
Lifetime alcohol use is positively related to abdominal and general adiposity in men, possibly following the male weight gain pattern; in women, it is positively related only to abdominal adiposity. In this context, beer may contribute additionally to abdominal adiposity.
European journal of clinical nutrition 05/2011; 65(10):1079-87. · 3.07 Impact Factor
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M M Bergmann,
M Sch|[uuml]|tze,
A Steffen,
H Boeing,
J Halkjaer,
A Tjonneland,
N Travier,
A Agudo,
N Slimani,
S Rinaldi, [......],
D Palli,
S Grioni,
P Vineis,
S Panico,
R Tumino,
E Riboli,
N J Wareham,
B Bueno-de-Mesquita,
A May,
P H M Peeters
[show abstract]
[hide abstract]
ABSTRACT: Background/Objectives: The relation between lifetime use of alcohol and measures of abdominal and general adiposity is unknown.
European Journal of Clinical Nutrition 05/2011; 65(10):1079-1087. · 2.46 Impact Factor
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E Couto,
P Boffetta,
P Lagiou,
P Ferrari,
G Buckland,
K Overvad,
C C Dahm,
A Tj|[oslash]|nneland,
A Olsen,
F Clavel-Chapelon, [......],
K-T Khaw,
N Wareham,
A Moskal,
N Slimani,
M Jenab,
D Romaguera,
T Mouw,
T Norat,
E Riboli,
A Trichopoulou
[show abstract]
[hide abstract]
ABSTRACT: Background: Although several studies have investigated the association of the Mediterranean diet with overall mortality or risk of specific cancers, data on overall cancer risk are sparse.
British Journal of Cancer 04/2011; 104(9):1493-1499. · 5.04 Impact Factor
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E Couto,
P Boffetta,
P Lagiou,
P Ferrari,
G Buckland,
K Overvad,
C C Dahm,
A Tjønneland,
A Olsen,
F Clavel-Chapelon, [......],
K-T Khaw,
N Wareham,
A Moskal,
N Slimani,
M Jenab,
D Romaguera,
T Mouw,
T Norat,
E Riboli,
A Trichopoulou
[show abstract]
[hide abstract]
ABSTRACT: Although several studies have investigated the association of the Mediterranean diet with overall mortality or risk of specific cancers, data on overall cancer risk are sparse.
We examined the association between adherence to Mediterranean dietary pattern and overall cancer risk using data from the European Prospective Investigation Into Cancer and nutrition, a multi-centre prospective cohort study including 142,605 men and 335,873. Adherence to Mediterranean diet was examined using a score (range: 0-9) considering the combined intake of fruits and nuts, vegetables, legumes, cereals, lipids, fish, dairy products, meat products, and alcohol. Association with cancer incidence was assessed through Cox regression modelling, controlling for potential confounders.
In all, 9669 incident cancers in men and 21,062 in women were identified. A lower overall cancer risk was found among individuals with greater adherence to Mediterranean diet (hazard ratio=0.96, 95% CI 0.95-0.98) for a two-point increment of the Mediterranean diet score. The apparent inverse association was stronger for smoking-related cancers than for cancers not known to be related to tobacco (P (heterogeneity)=0.008). In all, 4.7% of cancers among men and 2.4% in women would be avoided in this population if study subjects had a greater adherence to Mediterranean dietary pattern.
Greater adherence to a Mediterranean dietary pattern could reduce overall cancer risk.
British Journal of Cancer 04/2011; 104(9):1493-9. · 5.04 Impact Factor
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A Naska,
P Orfanos,
A Trichopoulou,
A M May,
K Overvad,
M U Jakobsen,
A Tjønneland,
J Halkjær,
G Fagherazzi,
F Clavel-Chapelon, [......],
K-T Khaw,
N J Wareham,
E A Spencer,
H Freisling,
N Slimani,
A-C Vergnaud,
T Mouw,
D Romaguera,
A Odysseos,
P H M Peeters
[show abstract]
[hide abstract]
ABSTRACT: The aim of this study was to examine the association of body mass index (BMI) and weight gain with eating at restaurants and similar establishments or eating at work among 10 European countries of the European Prospective Investigation into Cancer and Nutrition (EPIC) study.
This study included a representative sample of 24,310 randomly selected EPIC participants.
Single 24-h dietary recalls with information on the place of consumption were collected using standardized procedures between 1995 and 2000. Eating at restaurants was defined to include all eating and drinking occasions at restaurants, cafeterias, bars and fast food outlets. Eating at work included all eating and drinking occasions at the workplace. Associations between eating at restaurants or eating at work and BMI or annual weight changes were assessed using sex-specific linear mixed-effects models, controlling for potential confounders.
In southern Europe energy intake at restaurants was higher than intake at work, whereas in northern Europe eating at work appeared to contribute more to the mean daily intake than eating at restaurants. Cross-sectionally, eating at restaurants was found to be positively associated with BMI only among men (β=+0.24, P=0.003). Essentially no association was found between BMI and eating at work among both genders. In a prospective analysis among men, eating at restaurants was found to be positively, albeit nonsignificantly, associated with weight gain (β=+0.05, P=0.368). No association was detected between energy intake at restaurants and weight changes, controlling for total energy intake.
Among men, eating at restaurants and similar establishments was associated with higher BMI and possibly weight gain.
International journal of obesity (2005) 03/2011; 35(3):416-26. · 4.34 Impact Factor
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K K Tsilidis,
N E Allen,
T J Key,
K Bakken,
E Lund,
F Berrino,
A Fournier,
A Olsen,
A Tj|[oslash]|nneland,
K Overvad, [......],
M Dorronsoro,
S Borgquist,
J Manjer,
B van Guelpen,
G Hallmans,
S A Rodwell,
K-T Khaw,
T Norat,
D Romaguera,
E Riboli
[show abstract]
[hide abstract]
ABSTRACT: Background: Oral contraceptive use and reproductive factors may initiate long-term changes to the hormonal milieu and thereby, possibly influence colorectal cancer risk.
British Journal of Cancer 11/2010; 103(11):1755-1759. · 5.04 Impact Factor
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K K Tsilidis,
N E Allen,
T J Key,
K Bakken,
E Lund,
F Berrino,
A Fournier,
A Olsen,
A Tjønneland,
K Overvad, [......],
M Dorronsoro,
S Borgquist,
J Manjer,
B van Guelpen,
G Hallmans,
S A Rodwell,
K-T Khaw,
T Norat,
D Romaguera,
E Riboli
[show abstract]
[hide abstract]
ABSTRACT: Oral contraceptive use and reproductive factors may initiate long-term changes to the hormonal milieu and thereby, possibly influence colorectal cancer risk.
We examined the association of hormonal and reproductive factors with risk of colorectal cancer among 337,802 women in the European Prospective Investigation into Cancer and Nutrition, of whom 1878 developed colorectal cancer.
After stratification for center and age, and adjustment for body mass index, smoking, diabetes mellitus, physical activity and alcohol consumption, ever use of oral contraceptives was marginally inversely associated with colorectal cancer risk (hazard ratio (HR), 0.92; 95% confidence interval (CI), 0.83-1.02), although this association was stronger among post-menopausal women (HR, 0.84; 95% CI: 0.74-0.95). Duration of oral contraceptive use and reproductive factors, including age at menarche, age at menopause, type of menopause, ever having an abortion, parity, age at first full-term pregnancy and breastfeeding, were not associated with colorectal cancer risk.
Our findings provide limited support for a potential inverse association between oral contraceptives and colorectal cancer risk.
British Journal of Cancer 11/2010; 103(11):1755-9. · 5.04 Impact Factor
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Valerie A McCormack,
Antonio Agudo,
Christina C Dahm,
Kim Overvad,
Anja Olsen,
Anne Tjonneland,
Rudolf Kaaks,
Heiner Boeing,
Jonas Manjer,
Martin Almquist, [......], Aurelio Barricarte,
Miren Dorronsoro,
Laudina Rodriguez,
Maria Luisa Redondo,
Kay-Tee Khaw,
Nick Wareham,
Naomi Allen,
Tim Key,
Elio Riboli,
Paolo Boffetta
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ABSTRACT: The carcinogenicity of cigar and pipe smoking is established but the effect of detailed smoking characteristics is less well defined. We examined the effects on cancer incidence of exclusive cigar and pipe smoking, and in combination with cigarettes, among 102,395 men from Denmark, Germany, Spain, Sweden and the United Kingdom in the EPIC cohort. Hazard ratios (HR) and their 95% confidence intervals (CI) for cancer during a median 9-year follow-up from ages 35 to 70 years were estimated using proportional hazards models. Compared to never smokers, HR of cancers of lung, upper aerodigestive tract and bladder combined was 2.2 (95% CI: 1.3, 3.8) for exclusive cigar smokers (16 cases), 3.0 (2.1, 4.5) for exclusive pipe smokers (33 cases) and 5.3 (4.4, 6.4) for exclusive cigarette smokers (1,069 cases). For each smoking type, effects were stronger in current smokers than in ex-smokers and in inhalers than in non-inhalers. Ever smokers of both cigarettes and cigars [HR 5.7 (4.4, 7.3), 120 cases] and cigarettes and pipes [5.1 (4.1, 6.4), 247 cases] had as high a raised risk as had exclusive cigarette smokers. In these smokers, the magnitude of the raised risk was smaller if they had switched to cigars or pipes only (i.e., quit cigarettes) and had not compensated with greater smoking intensity. Cigar and pipe smoking is not a safe alternative to cigarette smoking. The lower cancer risk of cigar and pipe smokers as compared to cigarette smokers is explained by lesser degree of inhalation and lower smoking intensity.
International Journal of Cancer 02/2010; 127(10):2402-11. · 5.44 Impact Factor
