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Metabolomics is now widely used to characterize metabolic phenotypes associated with lifestyle risk factors such as obesity. The objective of the present study was to explore the associations of body mass index (BMI) with 145 metabolites measured in blood samples in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Metabolites were measured in blood from 392 men from the Oxford (UK) cohort (EPIC-Oxford) and in 327 control subjects who were part of a nested case-control study on hepatobiliary carcinomas (EPIC-Hepatobiliary). Measured metabolites included amino acids, acylcarnitines, hexoses, biogenic amines, phosphatidylcholines, and sphingomyelins. Linear regression models controlled for potential confounders and multiple testing were run to evaluate the associations of metabolite concentrations with BMI. 40 and 45 individual metabolites showed significant differences according to BMI variations, in the EPIC-Oxford and EPIC-Hepatobiliary subcohorts, respectively. Twenty two individual metabolites (kynurenine, one sphingomyelin, glutamate and 19 phosphatidylcholines) were associated with BMI in both subcohorts. The present findings provide additional knowledge on blood metabolic signatures of BMI in European adults, which may help identify mechanisms mediating the relationship of BMI with obesity-related diseases.

Dietary flavonoids and lignans may protect against several chronic diseases, but there is little evidence on the relationship between flavonoid and lignan intake and mortality. We investigated the association between both all-cause and specific-cause mortality and intake of flavonoids and lignans in the Spanish European Prospective Investigation into Cancer and Nutrition (EPIC-Spain) cohort.

An ecological design was used to study the relationship between cancer incidence and both socio-economic and environmental features in Southern Spain. Twenty-four sites and 26,380 cases diagnosed in 1985–1996 were analysed. Generalised Additive Models were used for data analysis. Except for lip cancer, the urban areas showed an increase in cancer risk for all sites. The relative risks among urban and rural municipalities ranges between 1.09 for skin non-melanoma (95% CI: 1.00–1.18) and 1.64 for cervix cancer (95% CI: 1.28–2.12). The relative risk among areas with high and low unemployment was 1.29 for stomach cancer (95% CI: 1.07–1.57), 1.45 for oral cavity cancer (95% CI: 1.10–1.93) and 1.77 for oesophagus cancer (95% CI: 1.02–3.05). Areas with highest unemployment showed the lowest incidence of melanoma. Risk for leukaemia, gall bladder, breast and prostate cancer showed a significant decreases by approximately 28% in the municipalities with the highest illiteracy score. A high percentage of land under cultivation was related to uterine tumours, larynx, rectum, lung, skin non-melanoma and brain cancers. For these sites, the risk had a significant increase by between 23%(skin non-melanoma) and 70%(rectum). Areas with high intensive farming showed a significant increase in cancer risk for lip, oral cavity, larynx, oesophagus, colon, lung, and bladder cancer. The relative risks ranges between 1.16 for colon cancer (95% CI: 1.04–1.29) and 1.47 for oesophagus cancer (95% CI: 1.15–1.87). The results of this study reveal how important socio-economic and environmental factors are for the analysis of cancer incidence in small areas of Southern Spain.

One of the most important challenges in the management of childhood immunization programmes is the persistence of some population groups with deficient immunization coverage. In the present study we identify some factors associated with deficient immunization coverage in pre-school populations living in Murcia (Spain). The main purpose is to develop some instruments to help managers of immunization programmes in developing strategies directed at high risk groups. Case-control study was designed on the basis of pre-school population (8579 children) living in the city during 1989 and 1990. All of the 380 cases and a similar number of randomly chosen controls were studied. Multivariate logistic regression method was used for statistical analysis. Secondly, two nominal group techniques were conducted with health and social professionals, and, lastly, one group interview was conducted with some mothers of deficiently immunized children. Variables associated with a deficient immunization coverage included: a large number of children in the family, being born at public hospitals, a greater age of the child, and living in certain city zones. The most important problems detected by professionals are lack of social and health services coordination, poor functioning of administrative registers, lack of strategies to catch marginal groups, and missed opportunities for the immunization of high-risk children. Mothers identified some problems in services accessibility, inadequate information from health professionals, and special characteristics of marginal groups. Information from registers (case-control study), professionals, and consumers proves some useful in the management of preventive services. Early identification of high-risk children with deficient immunization coverage would make it possible to assign more resources to groups with greater needs.