Inge Huybrechts

International Agency for Research on Cancer · Section of Nutrition and Metabolism

Background/Objectives: Breast cancer is the most common cancer among women globally, and it negatively impacts diet and quality of life, increasing the risk of recurrence. Adhering to World Cancer Research Fund (WCRF) and American Institute for Cancer Research (AICR) lifestyle guidelines, such as healthy eating habits and nutritional status, can he...

Recent epidemiological studies have suggested a positive association between ultra-processed food consumption and breast cancer risk, although some studies also reported no association. Furthermore, the evidence regarding the associations between intake of food with lower degrees of processing and breast cancer risk is limited. Thus, we investigate...

Background Nutri-Score is a scientifically validated 5-color front-of-pack nutrition label reflecting the nutrient profile of foods. It has been implemented in several European countries on a voluntary basis, pending the revision of the European labeling regulation. Hence, scientific evidence is needed regarding the ability of the nutrient profile...

Background It is unknown whether the association between ultra-processed food (UPF) intake and type 2 diabetes mellitus differs from other degrees of food processing. We examined the association between degree of food processing and incident type 2 diabetes mellitus. Methods This was a prospective cohort analysis of the European Prospective Invest...

Background Comprehensive research evidence is lacking on the role of ultra-processed foods (UPF) in the relationship between the consumption of plant-sourced foods and their impact on cardiovascular disease (CVD) outcomes. This study aims to assess CVD risk associated with the dietary contribution of food groups that consider both plant or animal o...

Advanced glycation end‐products (AGEs), formed endogenously or obtained exogenously from diet, may contribute to chronic inflammation, intracellular signaling alterations, and pathogenesis of several chronic diseases including colorectal cancer (CRC). However, the role of AGEs in CRC survival is less known. The associations of pre‐diagnostic circul...

Background: Diet plays an important role in the development of cardiovascular diseases and in maintaining sustainable planetary boundaries. The EAT-Lancet Planetary Health Diet could potentially provide co-benefits for human and environmental health, yet evidence on the association between adherence to the EAT-Lancet Planetary Health Diet and risk...

Background Cancer has become a major health concern due to the increasing morbidity and mortality rates, and its negative social, economic consequences and the heavy financial burden incurred by cancer patients. About 40% of cancers are preventable. The aim of this study was to assess the knowledge, attitudes, and practices regarding cancer prevent...

Dicarbonyl compounds are highly reactive precursors of Advanced Glycation End-products (AGEs), produced endogenously, present in certain foods, and formed during food processing. AGEs contribute to development of adverse metabolic outcomes but health effects of dietary dicarbonyls are largely unexplored. We investigated associations between three d...

Background Emulsifiers are widely used food additives in industrially processed foods to improve texture and enhance shelf-life. Experimental research suggests deleterious effects of emulsifiers on the intestinal microbiota and the metabolome, leading to chronic inflammation and increasing susceptibility to carcinogenesis. However, human epidemiolo...

High-fat diets have been associated with colorectal cancer (CRC) risk, and the role of polyunsaturated fatty acids (PUFAs) has been reported to vary based on the length of PUFAs. We explored the association between dietary omega-6 and omega-3 PUFAs intake and CRC. We analyzed 865 CRC patients and 3206 controls from a case–control study of Iran (IRO...

In this study, we aimed to provide novel evidence on the impact of changing lifestyle habits on cancer risk. In the EPIC cohort, 295,865 middle-aged participants returned a lifestyle questionnaire at baseline and during follow-up. At both timepoints, we calculated a healthy lifestyle index (HLI) score based on cigarette smoking, alcohol consumption...

Background Nutri‐score is now widely available in food packages in Europe. Aim To study the overall nutritional quality of the diet in relation to risks of Crohn's disease (CD) and ulcerative colitis (UC), in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort Methods We collected dietary data at baseline from validated...

Background The EAT-Lancet Commission proposed a global reference diet to promote healthy diets within planetary boundaries. Studies evaluating the associations between the reference diet with health outcomes among adolescents are scarce. Thus, our aim was to assess the association between adherence to the EAT-Lancet diet and cardiovascular health a...

Purpose To investigate the role of adiposity in the associations between ultra-processed food (UPF) consumption and head and neck cancer (HNC) and oesophageal adenocarcinoma (OAC) in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Methods Our study included 450,111 EPIC participants. We used Cox regressions to inves...

Background Colour additives are frequently used in foods. A randomised controlled trial showed that some of them resulted in increased hyperactivity in children. Experimental studies suggested the activation of inflammation, oxidative stress, and genotoxicity. Since estimating dietary exposure to colour additives is challenging, no prospective epid...

Background Emulsifiers are the most ubiquitous food additives. Experimental studies showed an emulsifier-induced gut microbiota dysbiosis stimulating inflammation. This study is the first to investigate the association between food additive emulsifiers and type 2 diabetes risk in a large population-based cohort. Methods Repeated 24h dietary record...

Background Diet has a direct impact on our health and as such is an important leverage in public health prevention strategies. Nutri-Score is a scientifically validated 5-color front-of-pack nutrition label based on a nutrient profile called FSAm-NPS that was proposed as a tool to help people choose healthier foods. It has been adopted by several E...

Purpose Previously reported associations of protein-rich foods with stroke subtypes have prompted interest in the assessment of individual amino acids. We examined the associations of dietary amino acids with risks of ischaemic and haemorrhagic stroke in the EPIC study. Methods We analysed data from 356,142 participants from seven European countri...

The aim of this literature review was to identify and provide a summary update on the validity and applicability of the most promising dietary biomarkers reflecting the intake of important foods in the Western diet for application in epidemiological studies. Many dietary biomarker candidates, reflecting intake of common foods and their specific con...

Objective To assess the associations between exposure to food additive emulsifiers and risk of cardiovascular disease (CVD). Design Prospective cohort study. Setting French NutriNet-Santé study, 2009-21. Participants 95 442 adults (>18 years) without prevalent CVD who completed at least three 24 hour dietary records during the first two years of...

Acute leukemia commonly occurs in young children with peak incidence at the age of 2–5 years. However, the etiology is still unclear and many preventable risk factors still deserve to be reviewed. The focus of this systematic review and meta-analysis is to summarize the evidence concerning early life nourishment (breastfeeding, early life diet), ne...

Background: The aim of this study is to determine the correlations between dietary fatty acid (FA) intakes and plasma phospholipid (PL) FA levels in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Methods: The dietary intake of 60 individual FAs was estimated using centre-specific validated dietary questionnaires....

Background: Hepatic disorders are often complex and multifactorial, modulated by genetic and environmental determinants. During the last years, the hepatic disease has been progressively established from early stages in life. The use of genetic risk scores (GRS) to predict the genetic susceptibility to a particular phenotype among youth has gained...

Background Previously reported associations of protein-rich foods with stroke subtypes have prompted interest in assessment of individual amino acids. We examined the associations of dietary amino acids with risks of ischaemic and haemorrhagic stroke in the EPIC study. Methods We analysed data on 356,142 participants from seven European countries....

Objective: To study the relationships between artificial sweeteners, accounting for all dietary sources(total and by type of artificial sweetener) and risk of type 2 diabetes (T2D), in a large-scale prospective cohort. Research design and methods: The analyses included 105,588 participants from the web-based NutriNet-Santé study (France, 2009-20...

Purpose The incidence of small intestinal cancer (SIC) is increasing, however, its aetiology remains unclear due to a lack of data from large-scale prospective cohorts. We examined modifiable risk factors in relation to SIC overall and by histological subtype. Methods We analysed 450,107 participants enrolled in the European Prospective Investigat...

The assignment of foods to one of four categories proposed by the Nova framework may be challenging in the absence of information on how these foods were prepared and their specific composition. A three-step iterative approach can make the categorization process more efficient and transparent, thereby increasing the accuracy of Nova estimates.

[This corrects the article DOI: 10.3389/fnut.2022.1035580.].

Purpose The EAT-Lancet Commission proposed an evidence-based global reference diet to improve human health within planetary boundaries. Recently, the Planetary Health Diet Index (PHDI) was developed based on the EAT-Lancet recommendations and validated among Brazilian adults. However, the relative validity of the PHDI in adolescents has yet to be a...

Purpose Updated evidence for the treatment of obesity in cancer survivors includes behavioural lifestyle interventions underpinning at least one theoretical framework. The aim of this systematic review was to assess the effectiveness of theory-based lifestyle interventions for the treatment of overweight/obesity in breast cancer survivors and to re...

Background: Since the first version of the dietary inflammatory index (DII®) developed in the past decade, several other versions have been developed. However, to date no study has attempted to compare these versions with respect to their associations with biomarkers of inflammation. Objective: We aimed to investigate the relationship between fo...

Many studies have investigated the etiology of acute leukemia, one of the most common types of cancer in children; however, there is a lack of clarity regarding preventable risk factors. This systematic review and meta-analysis aimed to summarize the current evidence regarding the role of maternal dietary factors in the development of childhood leu...

Background Food processing has been hypothesised to play a role in cancer development; however, data from large-scale epidemiological studies are scarce. This study investigated the association between dietary intake according to amount of food processing and risk of cancer at 25 anatomical sites using data from the European Prospective Investigati...

Background: Regulating meal timing may have efficacy for improving metabolic health for preventing or managing chronic disease. However, the reliability of measuring meal timing with commonly used dietary assessment tools needs characterization prior to investigating meal timing and health outcomes in epidemiologic studies. Objective: To evaluat...

Background Amino acid metabolism is dysregulated in colorectal cancer patients; however, it is not clear whether pre-diagnostic levels of amino acids are associated with subsequent risk of colorectal cancer. We investigated circulating levels of amino acids in relation to colorectal cancer risk in the European Prospective Investigation into Cancer...

Background Diet may impact important risk factors for endometrial cancer such as obesity and inflammation. However, evidence on the role of specific dietary factors is limited. We investigated associations between dietary fatty acids and endometrial cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). Methods Thi...

Background: Iron is an essential micronutrient with differing intake patterns and metabolism between men and women. Epidemiologic evidence on the association of dietary iron and its heme and non-heme components with colorectal cancer (CRC) development is inconclusive. Methods: We examined baseline dietary questionnaire-assessed intakes of total,...

Background: Global dietary patterns are increasingly dominated by relatively cheap, highly palatable, and ready-to-eat ultra-processed foods (UPFs). However, prospective evidence is limited on cancer development and mortality in relation to UPF consumption. This study examines associations between UPF consumption and risk of cancer and associated...

Background and aim: This study evaluates the associations between dietary intakes and circulating blood levels of methionine, choline or betaine and breast cancer risk, which remains currently unclear. Methods: Systematic searches for observational epidemiological studies were performed of the MEDLINE, Embase, and Web of Science databases throug...

OBJECTIVE The deleterious effects of trans fatty acids (TFAs) on cardiovascular health are well established; however, their impact on type 2 diabetes remains poorly understood. In particular, little is known about the impact of specific TFA types on type 2 diabetes etiology. We aimed to explore the associations between different types of TFAs (tota...

Background Nitrates and nitrites are used as food additives in processed meats. They are also commonly ingested from water and several foods. Several short‐term clinical studies suggested beneficial effects of dietary nitrates on blood pressure, while deleterious effects on oxidative damage have been suggested in some experimental studies. However,...

Background Epidemiological studies have demonstrated an association between the degree of food processing in our diet and the risk of various chronic diseases. Much of this evidence is based on the international Nova classification system, which classifies food into four groups based on the type of processing: (1) Unprocessed and minimally processe...

As colorectal cancer (CRC) is largely due to modifiable lifestyle habits, the awareness on its risk factors is highly important. Dietary fatty acids have been linked to CRC risk. We explored the association between dietary trans fatty acids (TFAs) intake and CRC risk. We analyzed 865 CRC cases (434 in colon and 404 in rectum) and 3206 controls of t...

The evolving trends in colorectal cancer (CRC) as one of the most common malignancies worldwide, have likely been influenced by the implementation of screening programs and changes in lifestyle habits. Changing lifestyle, including the shift in diet composition with higher fat, sugar, and animal-source foods intake, led to an increasing burden of C...

Objective To investigate the associations between portion sizes (PS) from different food groups and energy, nutrient intakes in European adolescents. Methods A sample of 1631 adolescents (54.2 % girls) were included from the Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional (HELENA) study. Mean food PS was calculated by divid...

Background Dietary patterns worldwide are increasingly displaced by many cheap, highly palatable, and ready-to-eat ultra-processed foods (UPFs). Higher UPF consumption has been linked to increased risk for obesity and cardiometabolic diseases, but prospective evidence is limited on cancer outcomes. This study aimed to examine the association betwee...

Background Artificial sweeteners are widely used today by the food industry as sugar alternatives. Potential adverse effects of these food additives on cardiovascular disease (CVD) have been suggested in experimental studies, but data from studies involving humans remain very limited. Previous cohorts have focused on artificially sweetened beverage...

Background Food additive emulsifiers are found in thousands of industrial foods and may exert deleterious effects on gut microbiota and carcinogenesis according to experimental studies. However, their associations with cancer risk has not been investigated yet. This study aimed to investigate these associations in a large population-based prospecti...

Background Nutrition is a well-established risk factor for cardiovascular diseases (CVD) that can be leveraged by public health prevention strategies. In addition to dietary guidelines, front-of-pack nutrition labels (FoPNL) can help consumers make healthier food choices. Nutri-Score, a scientifically validated 5-color FopNL based on the nutrient p...

Type 2 diabetes (T2D) is one of the most common noncommunicable diseases worldwide, with an increasing prevalence and a considerable global health burden. Substantial evidence has linked consumption of trans fatty acids (TFAs) to an increased risk of cardiovascular disease. However, the effects of T2D remain unclear. We aimed to investigate the ass...

Background & aims: Industrial foods have been associated with increased risks of several chronic conditions. We investigated the relation between degree of food processing, and risks of Crohn's disease (CD) and ulcerative colitis (UC) in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Methods: Analyses included 41...

Background: The association between protein intake and prostate cancer risk remains unclear. Aims: To prospectively investigate the associations of dietary intakes of total protein, protein from different dietary sources, and amino acids with prostate cancer risk and mortality. Methods: In 131,425 men from the European Prospective Investigatio...

Objectives To study the associations between artificial sweeteners from all dietary sources (beverages, but also table top sweeteners, dairy products, etc), overall and by molecule (aspartame, acesulfame potassium, and sucralose), and risk of cardiovascular diseases (overall, coronary heart disease, and cerebrovascular disease). Design Population...

The Oxford WebQ is an online 24 h dietary assessment tool used by several large prospective studies. This study describes the creation of the new individual fatty acid (FA) dataset for the Oxford WebQ and reports intakes and sources of dietary individual FAs in the UK Biobank. Participants who completed ≥1 (maximum of five) 24 h dietary assessments...

Purpose There is existing evidence on the potential role of chronic inflammation in the pathogenesis of pancreatic cancer (PC) and on how risk may be modulated by dietary factors. Pro-inflammatory diets are suggested to be associated with increased risk of PC but, so far, evidence remains not conclusive. We examined the association between the diet...

Objective The aim of this study was to investigate the association between the consumption of foods and drinks from different food processing categories using the NOVA classification and CRC risk among Moroccan adults. Methods 1453 cases and 1453 matched controls aged at least 18 years and recruited from the 5 greater Moroccan regions were intervi...

Background: Physical activity has been associated with a lower risk of colorectal cancer in studies mainly conducted in high-income countries, while sedentary behavior has been suggested to increase CRC risk. In this study, we aimed to investigate the role of physical activity and sedentary behavior on CRC risk in the Moroccan population. Methods...

Endogenous and exogenous metabolite concentrations may be susceptible to variation over time. This variability can lead to misclassification of exposure levels and in turn to biased results. To assess the reproducibility of metabolites, the intra-class correlation coefficient (ICC) is computed. A literature search in three databases from 2000 until...

Introduction Circulating levels of acylcarnitines (ACs) have been associated with risk of various diseases such as cancer and type 2 diabetes. Diet and lifestyle factors have been shown to influence AC concentrations but a better understanding of their biological, lifestyle and metabolic determinants is needed. Methods Circulating ACs were measure...

Purpose Chronic inflammation is thought to initiate or promote differentiated thyroid cancer (DTC) and previous studies have shown that diet can modulate this inflammatory process. We aimed to evaluate the association of several dietary scores reflecting the inflammatory potential of the diet with DTC risk. Methods Within the EPIC cohort, 450,063...

A good assessment of dietary methyl-group donor intake (folate, choline, betaine, methionine) is needed to investigate the effect of methyl-group donor intake on children’s health. The aim is to develop and validate a food-frequency questionnaire (FFQ) to estimate the daily intake of methyl-group donors in preschoolers. For the relative validity an...

Background and Aims This study aims to examine associations of food portion sizes (PS) with markers of insulin resistance (IR) and clustered of metabolic risk score in European adolescents. Methods 495 adolescents (53.5% females) from the HELENA study were included. The association between PS from food groups and HOMA-IR index, VO2 max, and metabo...

One of the current main public health problems is the prevalence of obesity in children. Unhealthy lifestyle behaviors such as poor dietary habits, high sedentary screen time (SST), and low levels of physical activity (PA) have a strong tendency to track from childhood into adulthood. The aim of this manuscript is to assess the association between...

Background: Obesity is a risk factor for endometrial cancer but whether metabolic dysfunction is associated with endometrial cancer independent of body size is not known. Methods: The association of metabolically-defined body size phenotypes with endometrial cancer risk was investigated in a nested case-control study (817 cases/ 817 controls) wi...