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1. A prospective evaluation of plasma phospholipid fatty acids and breast cancer risk in the EPIC study

Author: Chajès, V., Assi, N., Biessy, C., Ferrari, P., Rinaldi, S., Slimani, N., Lenoir, G.M., Baglietto, L., His, M., Boutron-Ruault, M.C., Trichopoulou, A., Lagiou, P., Katsoulis, M., Kaaks, R., Kühn, T., Panico, S., Pala, V., Masala, G., Bueno-de-Mesquita, H.B., Peeters, P.H., van Gils, C., Hjartåker, A., Standahl Olsen, K., Borgund Barnung, R., Barricarte, A., Redondo-Sanchez, D., Menéndez, V., Amiano, P., Wennberg, M., Key, T., Khaw, K.T., Merritt, M.A., Riboli, E., Gunter, M.J., and Romieu, I.
Published: 2017
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2. No association of alcohol use and the risk of ulcerative colitis or Crohn's disease: data from a European Prospective cohort study (EPIC)

Author: Bergmann, M M, Hernandez, V, Bernigau, W, Boeing, H, Chan, S S M, Luben, R, Khaw, K-T, Schaik, F van, Oldenburg, B., Bueno-de-Mesquita, B., Overvad, K., Palli, D., Masala, G., Carbonnel, F., Boutron-Ruault, M.C., Olsen, A., and Tjonneland, A.
Subjects: Ulcerative colitis -- Risk factors, Drinking of alcoholic beverages -- Health aspects, Crohn's disease -- Risk factors, Food/cooking/nutrition, Health
Abstract: Background/Objectives: The role of long-term alcohol consumption for the risk of developing ulcerative colitis (UC) and Crohn's disease (CD) is unclear. For the first time, to prospectively assess the role of pre-disease alcohol consumption on the risk of developing UC or CD. Subjects/Methods: Nested within the European Prospective Investigation into Cancer and Nutrition (EPIC-IBD), incident UC and CD cases and matched controls where included. At recruitment, participants completed validated food frequency and lifestyle questionnaires. Alcohol consumption was classified as either: non-use, former, light ([[less-than or slanted equal to]0.5 and 1 drink per week), below the recommended limits (BRL) ([[less-than or slanted equal to]1 and 2 drinks per day), moderate ([[less-than or slanted equal to]2.5 and 5 drinks per day), or heavy use (>2.5 and >5 drinks per day) for women and men, respectively; and was expressed as consumption at enrolment and during lifetime. Conditional logistic regression was applied adjusting for smoking and education, taking light users as the reference. Results: Out of 262 451 participants in six countries, 198 UC incident cases/792 controls and 84 CD cases/336 controls were included. At enrolment, 8%/27%/32%/23%/11% UC cases and 7%/29%/40%/19%/5% CD cases were: non-users, light, BRL, moderate and heavy users, respectively. The corresponding figures for lifetime non-use, former, light, BRL, moderate and heavy use were: 3%/5%/23%/44%/19%/6% and 5%/2%/25%/44%/23%/1% for UC and CD cases, respectively. There were no associations between any categories of alcohol consumption and risk of UC or CD in the unadjusted and adjusted odds ratios. Conclusion: There was no evidence of associations between alcohol use and the odds of developing either UC or CD., Author(s): M M Bergmann [sup.1] , V Hernandez [sup.1] [sup.2] , W Bernigau [sup.1] , H Boeing [sup.1] , S S M Chan [sup.3] [sup.4] , R Luben [sup.5] , [...]
Published: 2017
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3. Pre-diagnostic C-reactive protein concentrations, CRP genetic variation and mortality among individuals with colorectal cancer in Western European populations

Author: Nimptsch, K., Aleksandrova, K., Fedirko, V., Jenab, M., Gunter, M.J., Siersema, P.D., Wu, K., Katzke, V., Kaaks, R., Panico, S., Palli, D., May, A.M., Sieri, S., Bueno-de-Mesquita, B., Standahl, K., Sánchez, M.J., Perez-Cornago, A., Olsen, A., Tjønneland, A., Bonet, C.B., Dahm, C.C., Chirlaque, M.D., Fiano, V., Tumino, R., Gurrea, A.B., Boutron-Ruault, M.C., Menegaux, F., Severi, G., Guelpen, B. van, Lee, Y.A., Pischon, T., Nimptsch, K., Aleksandrova, K., Fedirko, V., Jenab, M., Gunter, M.J., Siersema, P.D., Wu, K., Katzke, V., Kaaks, R., Panico, S., Palli, D., May, A.M., Sieri, S., Bueno-de-Mesquita, B., Standahl, K., Sánchez, M.J., Perez-Cornago, A., Olsen, A., Tjønneland, A., Bonet, C.B., Dahm, C.C., Chirlaque, M.D., Fiano, V., Tumino, R., Gurrea, A.B., Boutron-Ruault, M.C., Menegaux, F., Severi, G., Guelpen, B. van, Lee, Y.A., and Pischon, T.
Abstract: Contains fulltext : 252185.pdf (Publisher’s version ) (Open Access), BACKGROUND: The role of elevated pre-diagnostic C-reactive protein (CRP) concentrations on mortality in individuals with colorectal cancer (CRC) remains unclear. METHODS: We investigated the association between pre-diagnostic high-sensitivity CRP concentrations and CRP genetic variation associated with circulating CRP and CRC-specific and all-cause mortality based on data from 1,235 individuals with CRC within the European Prospective Investigation into Cancer and Nutrition cohort using multivariable-adjusted Cox proportional hazards regression. RESULTS: During a median follow-up of 9.3 years, 455 CRC-specific deaths were recorded, out of 590 deaths from all causes. Pre-diagnostic CRP concentrations were not associated with CRC-specific (hazard ratio, HR highest versus lowest quintile 0.92, 95% confidence interval, CI 0.66, 1.28) or all-cause mortality (HR 0.91, 95% CI 0.68, 1.21). Genetic predisposition to higher CRP (weighted score based on alleles of four CRP SNPs associated with higher circulating CRP) was not significantly associated with CRC-specific mortality (HR per CRP-score unit 0.95, 95% CI 0.86, 1.05) or all-cause mortality (HR 0.98, 95% CI 0.90, 1.07). Among four investigated CRP genetic variants, only SNP rs1205 was significantly associated with CRC-specific (comparing the CT and CC genotypes with TT genotype, HR 0.54, 95% CI 0.35, 0.83 and HR 0.58, 95% CI 0.38, 0.88, respectively) and all-cause mortality (HR 0.58, 95% CI 0.40, 0.85 and 0.64, 95% CI 0.44, 0.92, respectively). CONCLUSIONS: The results of this prospective cohort study do not support a role of pre-diagnostic CRP concentrations on mortality in individuals with CRC. The observed associations with rs1205 deserve further scientific attention.
Published: 2022

4. SCORE2 risk prediction algorithms: new models to estimate 10-year risk of cardiovascular disease in Europe

Author: Hageman, S., Pennells, L., Ojeda, F., Kaptoge, S., Kuulasmaa, K., Vries, T. de, Xu, Z., Kee, F., Chung, R., Wood, A., McEvoy, J.W., Veronesi, G., Bolton, T., Dendale, P., Ference, B.A., Halle, M., Timmis, A., Vardas, P., Danesh, J., Graham, I., Salomaa, V., Visseren, F., Bacquer, D. de, Blankenberg, S., Dorresteijn, J., Angelantonio, E. di, Achenbach, S., Aleksandrova, K., Amiano, P., Amouyel, P., Andersson, J., Bakker, S.J.L., Costa, R.B.D., Beulens, J.W.J., Blaha, M., Bobak, M., Boer, J.M.A., Bonet, C., Bonnet, F., Boutron-Ruault, M.C., Braaten, T., Brenner, H., Brunner, F., Brunner, E.J., Brunstrom, M., Buring, J., Butterworth, A.S., Capkova, N., Cesana, G., Chrysohoou, C., Colorado-Yohar, S., Cook, N.R., Cooper, C., Dahm, C.C., Davidson, K., Dennison, E., Castelnuovo, A. di, Donfrancesco, C., Dorr, M., Dorynska, A., Eliasson, M., Engstrom, G., Ferrari, P., Ferrario, M., Ford, I., Fu, M., Gansevoort, R.T., Giampaoli, S., Gillum, R.F., Camara, A.G. de la, Grassi, G., Hansson, P.O., Huculeci, R., Hveem, K., Iacoviello, L., Ikram, M.K., Jorgensen, T., Joseph, B., Jousilahti, P., Jukema, J.W., Kaaks, R., Katzke, V., Kavousi, M., Kiechl, S., Klotsche, J., Konig, W., Kronmal, R.A., Kubinova, R., Kucharska-Newton, A., Lall, K., Lehmann, N., Leistner, D., Linneberg, A., Pablos, D.L., Lorenz, T., Lu, W.T., Luksiene, D., Lyngbakken, M., Magnussen, C., Malyutina, S., Ibanez, A.M., Masala, G., Mathiesen, E.B., Matsushita, K., Meade, T.W., Melander, O., Meyer, H.E., Moons, K.G.M., Moreno-Iribas, C., Muller, D., Munzel, T., Nikitin, Y., Nordestgaard, B.G., Omland, T., Onland, C., Overvad, K., Packard, C., Pajak, A., Palmieri, L., Panagiotakos, D., Panico, S., Perez-Cornago, A., Peters, A., Pietila, A., Pikhart, H., Psaty, B.M., Quarti-Trevano, F., Garcia, J.R.Q., Riboli, E., Ridker, P.M., Rodriguez, B., Rodriguez-Barranco, M., Rosengren, A., Roussel, R., Sacerdote, C., Sans, S., Sattar, N., Schiborn, C., Schmidt, B., Schottker, B., Schulze, M., Schwartz, J.E., Selmer, R.M., Shea, S., Shipley, M.J., Sieri, S., Soderberg, S., Sofat, R., Tamosiunas, A., Thorand, B., Tillmann, T., Tjonneland, A., Tong, T.Y.N., Trichopoulou, A., Tumino, R., Tunstall-Pedoe, H., Tybjaerg-Hansen, A., Tzoulaki, J., Heijden, A. van der, Schouw, Y.T. van der, Verschuren, W.M.M., Volzke, H., Waldeyer, C., Wareham, N.J., Weiderpass, E., Weidinger, F., Wild, P., Willeit, J., Willeit, P., Wilsgaard, T., Woodward, M., Zeller, T., Zhang, D.D., Zhou, B., SCORE2 Working Grp, ESC Cardiovasc Risk Collaboration, collaboration, SCORE2 working group and ESC Cardiovascular risk, Groningen Institute for Organ Transplantation (GIOT), Groningen Kidney Center (GKC), Cardiovascular Centre (CVC), Epidemiology, Neurology, Achenbach, S, Aleksandrova, K, Amiano, P, San Sebastian, D, Amouyel, P, Andersson, J, Bakker, S, Da Providencia Costa, R, Beulens, J, Blaha, M, Bobak, M, Boer, J, Bonet, C, Bonnet, F, Boutron-Ruault, M, Braaten, T, Brenner, H, Brunner, F, Brunner, E, Brunström, M, Buring, J, Butterworth, A, Capkova, N, Cesana, G, Chrysohoou, C, Colorado-Yohar, S, Cook, N, Cooper, C, Dahm, C, Davidson, K, Dennison, E, Di Castelnuovo, A, Donfrancesco, C, Dörr, M, Doryńska, A, Eliasson, M, Engström, G, Ferrari, P, Ferrario, M, Ford, I, Fu, M, Gansevoort, R, Giampaoli, S, Gillum, R, Gómez de la Cámara, A, Grassi, G, Hansson, P, Huculeci, R, Hveem, K, Iacoviello, L, Ikram, M, Jørgensen, T, Joseph, B, Jousilahti, P, Wouter Jukema, J, Kaaks, R, Katzke, V, Kavousi, M, Kiechl, S, Klotsche, J, König, W, Kronmal, R, Kubinova, R, Kucharska-Newton, A, Läll, K, Lehmann, N, Leistner, D, Linneberg, A, Pablos, D, Lorenz, T, Lu, W, Luksiene, D, Lyngbakken, M, Magnussen, C, Malyutina, S, Ibañez, A, Masala, G, Mathiesen, E, Matsushita, K, Meade, T, Melander, O, Meyer, H, Moons, K, Moreno-Iribas, C, Muller, D, Münzel, T, Nikitin, Y, Nordestgaard, B, Omland, T, Onland, C, Overvad, K, Packard, C, Pająk, A, Palmieri, L, Panagiotakos, D, Panico, S, Perez-Cornago, A, Peters, A, Pietilä, A, Pikhart, H, Psaty, B, Quarti-Trevano, F, Garcia, J, Riboli, E, Ridker, P, Rodriguez, B, Rodriguez-Barranco, M, Rosengren, A, Roussel, R, Sacerdote, C, S, S, Sattar, N, Schiborn, C, Schmidt, B, Schöttker, B, Schulze, M, Schwartz, J, Selmer, R, Shea, S, Shipley, M, Sieri, S, Söderberg, S, Sofat, R, Tamosiunas, A, Thorand, B, Tillmann, T, Tjønneland, A, Tong, T, Trichopoulou, A, Tumino, R, Tunstall-Pedoe, H, Tybjaerg-Hansen, A, Tzoulaki, J, van der Heijden, A, van der Schouw, Y, Verschuren, W, Völzke, H, Waldeyer, C, Wareham, N, Weiderpass, E, Weidinger, F, Wild, P, Willeit, J, Willeit, P, Wilsgaard, T, Woodward, M, Zeller, T, Zhang, D, Zhou, B, and Apollo - University of Cambridge Repository
Subjects: Male, Cardiology, RATIONALE, Blood Pressure, Disease, 030204 cardiovascular system & hematology, PROFILE, ACUTE CORONARY EVENTS, VALIDATION, Europe/epidemiology, 03 medical and health sciences, 0302 clinical medicine, SDG 3 - Good Health and Well-being, DESIGN, Clinical Research, Risk Factors, Diabetes mellitus, medicine, PARTICIPANTS, Humans, 030212 general & internal medicine, Risk factor, Aged, Primary prevention, business.industry, 10-year CVD risk, Incidence (epidemiology), Cardiovascular Diseases/epidemiology, Risk Prediction, Cardiovascular Disease, Primary Prevention, 10-year Cvd Risk, External validation, PRIMARY-CARE, Middle Aged, medicine.disease, Cardiovascular disease, Risk prediction, 3. Good health, Europe, Prediction algorithms, Blood pressure, Cardiovascular Diseases, Smoking status, Female, Cardiology and Cardiovascular Medicine, business, Algorithms, Demography
Abstract: Aims The aim of this study was to develop, validate, and illustrate an updated prediction model (SCORE2) to estimate 10-year fatal and non-fatal cardiovascular disease (CVD) risk in individuals without previous CVD or diabetes aged 40-69 years in Europe.Methods and results We derived risk prediction models using individual-participant data from 45 cohorts in 13 countries (677 684 individuals, 30 121 CVD events). We used sex-specific and competing risk-adjusted models, including age, smoking status, systolic blood pressure, and total- and HDL-cholesterol. We defined four risk regions in Europe according to country-specific CVD mortality, recalibrating models to each region using expected incidences and risk factor distributions. Region-specific incidence was estimated using CVD mortality and incidence data on 10 776 466 individuals. For external validation, we analysed data from 25 additional cohorts in 15 European countries (1 133 181 individuals, 43 492 CVD events). After applying the derived risk prediction models to external validation cohorts, C-indices ranged from 0.67 (0.65-0.68) to 0.81 (0.76-0.86). Predicted CVD risk varied several-fold across European regions. For example, the estimated 10-year CVD risk for a 50-year-old smoker, with a systolic blood pressure of 140 mmHg, total cholesterol of 5.5 mmol/L, and HDL-cholesterol of 1.3 mmol/L, ranged from 5.9% for men in low- risk countries to 14.0% for men in very high-risk countries, and from 4.2% for women in low-risk countries to 13.7% for women in very high-risk countries.Conclusion SCORE2-a new algorithm derived, calibrated, and validated to predict 10-year risk of first-onset CVD in European populations-enhances the identification of individuals at higher risk of developing CVD across Europe. Acknowledgements We thank investigators and participants of the several studies that contributed data to the Emerging Risk Factors Collaboration (ERFC). This research has been conducted using the UK Biobank Resource under Application Number 26865. Data from the Clinical Practice Research Datalink (CPRD) were obtained under licence from the UK Medicines and Healthcare products Regulatory Agency (protocol 162RMn2). CPRD uses data provided by patients and collected by the NHS as part of their care and support. We thank all EPIC participants and staff for their contribution to the study, the laboratory teams at the Medical Research Council Epidemiology Unit for sample management and Cambridge Genomic Services for genotyping, Sarah Spackman for data management and the team at the EPIC-CVD Coordinating Centre for study co-ordination and administration. Funding The ERFC co-ordinating centre was underpinned by programme grants from the British Heart Foundation (SP/09/002; RG/13/13/30194; RG/18/13/33946), BHF Centre of Research Excellence (RE/18/1/34212), the UK Medical Research Council (MR/L003120/1), and the National Institute for Health Research (NIHR) Cambridge Biomedical Research Centre (BRC1215-20014), with project-specific support received from the UK NIHR [*], British United Provident Association UK Foundation and an unrestricted educational grant from GlaxoSmithKline. A variety of funding sources have supported recruitment, follow-up, and laboratory measurements in the studies contributing data to the ERFC, which are listed on the ERFC website (www.phpc.cam.ac.uk/ceu/erfc/list-of-studies). *The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. This work was supported by Health Data Research UK, which is funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation, and Wellcome. The MORGAM Project has received funding from EU projects MORGAM (Biomed BMH4-CT98-3183), GenomEUtwin (FP5, QLG2-CT-2002-01254), ENGAGE (FP7, HEALTH-F4-2007-201413),CHANCES (FP7, HEALTH-F3-2010-242244), BiomarCaRE (FP7,HEALTH-F2-2011-278913), euCanSHare (Horizon 2020, No. 825903) and AFFECT-EU (Horizon 2020, No. 847770); and Medical Research Council, London (G0601463, No. 80983: Biomarkers in the MORGAM Populations). This has supported central coordination, workshops and part of the activities of the MORGAM Data Centre, the MORGAM Laboratories and the MORGAM Participating Centres EPIC-CVD was funded by the European Research Council (268834), and the European Commission Framework Programme 7 (HEALTH-F2-2012-279233). This work was supported by the Estonian Research Council grant PUTs (PRG687, PUT1660, PUT1665, PRG184), by European Union through the European Regional Development Fund project no. MOBERA5 (Norface Network project no 462.16.107), by the Green ICT programme under Norway Grants 2014 – 2021 (grant number EU53928), by the European Union through Horizon 2020 grant no. 810645 and through the European Regional Development Fund (Project No. 2014-2020.4.01.16-0125) and by the PRECISE4Q consortium. PRECISE4Q project has received funding from the European Union’s Horizon 2020 Research and Innovation Programme under Grant agreement 777107. This work was partly funded through the CoMorMent project. CoMorMent has received funding from the European Union’s Horizon 2020 Research and Innovation Programme under Grant agreement 847776. The KORA study was initiated and financed by the Helmholtz Zentrum Mu¨nchen—German Research Center for Environmental Health, which is funded by the German Federal Ministry of Education and Research (BMBF) and by the State of Bavaria. The KORA study was supported by a research grant from the Virtual Institute of Diabetes Research (Helmholtz Zentrum Mu¨nchen), the Clinical Cooperation Group Diabetes between Ludwig-Maximilians-Universita¨t Mu¨nchen and Helmholtz Zentrum Mu¨nchen, and by the German Diabetes Center (DDZ). The HAPIEE project, Institute, was supported by grants from the Wellcome Trust (064947/Z/01/Z; WT081081) and US National Institute on Aging (1R01 and AG23522). The co-ordination of EPIC is financially supported by International Agency for Research on Cancer (IARC) and also by the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, which has additional infrastructure support provided by the NIHR Imperial Biomedical Research Centre (BRC). The national cohorts are supported by: Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Ge´ne´rale de l’Education Nationale, Institut National de la Sante´ et de la Recherche Me´dicale (INSERM) (France); German Cancer Aid, German Cancer Research Center (DKFZ), German Institute of Human Nutrition Potsdam Rehbruecke (DIfE), Federal Ministry of Education and Research (BMBF) (Germany); Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy, Compagnia di SanPaolo and National Research Council (Italy); Dutch 2448 SCORE2 working group and ESC Cardiovascular Risk Collaboration Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands); Health Research Fund (FIS)—Instituto de Salud Carlos III (ISCIII), Regional Governments of Andalucı´a, Asturias, Basque Country, Murcia and Navarra, and the Catalan Institute of Oncology—ICO (Spain); Swedish Cancer Society, Swedish Research Council and County Councils of Ska˚ne and Va¨sterbotten (Sweden); Cancer Research UK (14136 to EPIC-Norfolk; C8221/A29017 to EPIC-Oxford), Medical Research Council (1000143 to EPIC-Norfolk; MR/M012190/1 to EPIC-Oxford) (United Kingdom)
Published: 2021
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5. Dietary intake of the water-soluble vitamins B1, B2, B6, B12 and C in 10 countries in the European Prospective Investigation into Cancer and Nutrition

Author: Olsen, A., Halkjaer, J., van Gils, C.H., Buijsse, B., Verhagen, H., Jenab, M., Boutron-Ruault, M.C., Ericson, U., Ocke, M.C., Peeters, P.H.M., Touvier, M., Niravong, M., Waaseth, M., Skeie, G., Khaw, K.T., Travis, R., Ferrari, P., Sanchez, M.J., Agudo, A., Overvad, K., Linseisen, J., Weikert, C., Sacerdote, C., Evangelista, A., Zylis, D., Tsiotas, K., Manjer, J., van Guelpen, B., Riboli, E., Slimani, N., and Bingham, S.
Subjects: Oncology, Experimental -- Health aspects, Vitamin C -- Health aspects -- Research, Vitamin B -- Health aspects -- Research, Cancer -- Research, Vitamin B in human nutrition -- Research -- Health aspects, Vitamin B complex -- Health aspects -- Research, Recommended daily allowances -- Research -- Health aspects, Food/cooking/nutrition, Health
Abstract: Objectives: To describe the intake of vitamins thiamine (B1), riboflavin (B2), B6 (pyridoxine), B12 (cobalamine) and C (ascorbic acid) and their food sources among 27 centres in 10 countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Methods: Between 1995 and 2000, 36 034 persons aged between 35 and 74 years were administered a standardized 24-h dietary recall using a computerized interview software programme (EPIC-SOFT). Intakes of the four B vitamins and vitamin C were estimated using the standardized EPIC Nutrient Database (ENDB). Mean intakes were adjusted for age and weighted by season and day of recall. Results: Intake of B vitamins did not vary considerably between centres, except in the UK health-conscious cohort, in which substantially higher intakes of thiamine and lower intakes of vitamin B12 were reported compared with other centres. Overall, meat was the most important contributor to the B vitamins in all centres except in the UK health-conscious group. Vitamin C showed a clear geographical gradient, with higher intakes in the southern centres as compared with the northern ones; this was more pronounced in men than in women. Vegetables and fruits were major contributors to vitamin C in all centres, but juices and potatoes were also important sources in the northern centres. Conclusions: This study showed no major differences across centres in the mean intakes of B vitamins (thiamine, riboflavin, B6, B12), whereas a tendency towards a north-south gradient was observed for vitamin C. doi: 10.1038/ejcn.2009.78 Keywords: water-soluble vitamins; 24-h dietary recall; standardization; ENDB; EPIC; Europe, Introduction The B vitamins, together with vitamin C, constitute the water-soluble group of vitamins. Classic syndromes caused by a deficiency of water-soluble vitamins, such as scurvy (vitamin C) and beriberi [...]
Published: 2009
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6. Variation in intakes of calcium, phosphorus, magnesium, iron and potassium in 10 countries in the European Prospective Investigation into Cancer and Nutrition study

Author: Welch, A.A., Fransen, H., Jenab, M., Boutron-Ruault, M.C., Tumino, R., Agnoli, C., Ericson, U., Johansson, I., Ferrari, P., Engeset, D., Lund, E., Lentjes, M., Key, T., Touvier, M., Niravong, M., Larranaga, N., Rodriguez, L., Ocke, M.C., Peeters, P.H.M., Tjonneland, A., Bjerregaard, L., Vasilopoulou, E., Dilis, V., Linseisen, J., Nothlings, U., Riboli, E., Slimani, N., and Bingham, S.
Subjects: Iron in the body -- Health aspects -- Research, Chronic diseases -- Risk factors -- Research, Potassium in the body -- Health aspects -- Research, Calcium, Dietary -- Health aspects -- Research, Cancer -- Risk factors, Phosphorus in the body -- Health aspects -- Research, Magnesium in the body -- Health aspects -- Research, Diet -- Health aspects -- Research, Food/cooking/nutrition, Health
Abstract: Background/objectives: Adequate mineral intake is important for the maintenance of bone health, cellular function and general metabolism, and possibly in the aetiology of cancer and other chronic diseases. This study aimed at investigating variation in intakes of selected minerals across 10 European countries participating in the EPIC (European Prospective Investigation into Cancer and Nutrition) study. Methods: Nutrient intakes for 36 034 subjects, aged between 35 and 74 years, in 27 centres were obtained using standardized 24-h dietary recall software (EPIC-SOFT). Mean intakes of calcium, phosphorus, magnesium, iron and potassium were calculated by centre and weighted by season and day of the week and were also stratified by age group. The contribution of food groups to total nutrient intake was calculated. Results: There was clear geographical variability in intakes, with differences ranging from 35% for magnesium to 90% for iron in men and 36% for potassium to 75% for calcium in women, and a twofold difference in sources of haem iron (meat and fish). There was a geographical gradient in iron intake, with higher intakes in Southern than in Northern Europe and also around a twofold north-south gradient in the contribution of fruits and vegetables to potassium intake. Compared with reference intakes, the majority of age groups and centres had intakes above the recommended levels. Dairy foods and products contributed the most to calcium and phosphorus intake in almost all centres. Cereals and cereal products contributed the most to magnesium and iron intakes, except in Greece and Germany. Conclusions: Intakes of minerals vary substantially throughout Europe, with some geographical variability in their food sources. doi: 10.1038/ejcn.2009.77 Keywords: calcium; phosphorus; magnesium; iron; potassium; EPIC, Introduction Minerals are essential nutrients, and adequate intakes are important not only for the maintenance of bone health but also for cellular function and general metabolism. Aspects of mineral metabolism [...]
Published: 2009
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7. Circulating bilirubin levels and risk of colorectal cancer: serological and Mendelian randomization analyses

Author: Seyed Khoei, N., Jenab, M., Murphy, N., Banbury, B.L., Carreras-Torres, R., Viallon, V., Kühn, T., Bueno-de-Mesquita, B., Aleksandrova, K., Cross, A.J., Weiderpass, E., Stepien, M., Bulmer, A., Tjønneland, A., Boutron-Ruault, M.C., Severi, G., Carbonnel, F., Katzke, V., Boeing, H., Bergmann, M.M., Trichopoulou, A., Karakatsani, A., Martimianaki, G., Palli, D., Tagliabue, G., Panico, S., Tumino, R., Sacerdote, C., Skeie, G., Merino, S., Bonet, C., Rodríguez-Barranco, M., Gil, L., Chirlaque, M.D., Ardanaz, E., Myte, R., Hultdin, J., Perez-Cornago, A., Aune, D., Tsilidis, K.K., Albanes, D., Baron, J.A., Berndt, S.I., Bézieau, S., Brenner, H., Campbell, P.T., Casey, G., Chang-Claude, J., Chanock, S.J., Cotterchio, M., Gallinger, S., Gruber, S.B., Haile, R.W., Hampe, J., Hoffmeister, M., Hopper, J.L., Hsu, L., Huyghe, J.R., Jenkins, M.A., Joshi, A.D., Kampman, E., Larsson, S.C., Le Marchand, L., Li, C.I., Li, L., Lindblom, A., Lindor, N.M., Martín, V., Moreno, V., Newcomb, P.A., Offit, K., Ogino, S., Parfrey, P.S., Pharoah, P.D.P., Rennert, G., Sakoda, L.C., Schafmayer, C., Schmit, S.L., Schoen, R.E., Slattery, M.L., Thibodeau, S.N., Ulrich, C.M., van Duijnhoven, F.J.B., Weigl, K., Weinstein, S.J., White, E., Wolk, A., Woods, M.O., Wu, A.H., Zhang, X., Ferrari, P., Anton, G., Peters, A., Peters, U., Gunter, M.J., Wagner, K.H., and Freisling, H.
Subjects: Bilirubin, Cancer, Colorectal Cancer, Anti-oxidants, Mendelian Randomization Analysis
Abstract: Background Bilirubin, a byproduct of hemoglobin breakdown and purported anti-oxidant, is thought to be cancer preventive. We conducted complementary serological and Mendelian randomization (MR) analyses to investigate whether alterations in circulating levels of bilirubin are associated with risk of colorectal cancer (CRC). We decided a priori to perform analyses separately in men and women based on suggestive evidence that associations may differ by sex. Methods In a case-control study nested in the European Prospective Investigation into Cancer and Nutrition (EPIC), pre-diagnostic unconjugated bilirubin (UCB, the main component of total bilirubin) concentrations were measured by high-performance liquid chromatography in plasma samples of 1386 CRC cases and their individually matched controls. Additionally, 115 single-nucleotide polymorphisms (SNPs) robustly associated (P < 5 x 10(-8)) with circulating total bilirubin were instrumented in a 2-sample MR to test for a potential causal effect of bilirubin on CRC risk in 52,775 CRC cases and 45,940 matched controls in the Genetics and Epidemiology of Colorectal Cancer Consortium (GECCO), the Colon Cancer Family Registry (CCFR), and the Colorectal Transdisciplinary (CORECT) study. Results The associations between circulating UCB levels and CRC risk differed by sex (P-heterogeneity = 0.008). Among men, higher levels of UCB were positively associated with CRC risk (odds ratio [OR] = 1.19, 95% confidence interval [CI] = 1.04-1.36; per 1-SD increment of log-UCB). In women, an inverse association was observed (OR = 0.86 (0.76-0.97)). In the MR analysis of the mainUGT1A1SNP (rs6431625), genetically predicted higher levels of total bilirubin were associated with a 7% increase in CRC risk in men (OR = 1.07 (1.02-1.12);P = 0.006; per 1-SD increment of total bilirubin), while there was no association in women (OR = 1.01 (0.96-1.06);P = 0.73). Raised bilirubin levels, predicted by instrumental variables excluding rs6431625, were suggestive of an inverse association with CRC in men, but not in women. These differences by sex did not reach formal statistical significance (P-heterogeneity >= 0.2). Conclusions Additional insight into the relationship between circulating bilirubin and CRC is needed in order to conclude on a potential causal role of bilirubin in CRC development.
Published: 2020

8. Pigmentary traits and risk of endometriosis

Author: Kvaskoff, M., Bijon, A., Mesrine, S., Clavel-Chapelon, F., and Boutron-Ruault, M.C.
Published: 2010
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9. Vitamin D-Related Genes, Blood Vitamin D Levels and Colorectal Cancer Risk in Western European Populations

Author: Fedirko, V., Mandle, H.B., Zhu, W., Hughes, D.J., Siddiq, A., Ferrari, P., Romieu, I., Riboli, E., Bueno-de-Mesquita, B., Duijnhoven, F. J. B. van, Siersema, P.D., Tjonneland, A., Olsen, A., Perduca, V., Carbonnel, F., Boutron-Ruault, M.C., Kuhn, T., Johnson, T., Krasimira, A., Trichopoulou, A., Makrythanasis, P., Thanos, D., Panico, S., Krogh, V., Sacerdote, C., Skeie, G., Weiderpass, E., Colorado-Yohar, S., Sala, N., Barricarte, A., Sanchez, M.J., Quiros, R., Amiano, P., Gylling, B., Harlid, S., Perez-Cornago, A., Heath, A.K., Tsilidis, K.K., Aune, D., Freisling, H., Murphy, N., Gunter, M.J., Jenab, M., Fedirko, V., Mandle, H.B., Zhu, W., Hughes, D.J., Siddiq, A., Ferrari, P., Romieu, I., Riboli, E., Bueno-de-Mesquita, B., Duijnhoven, F. J. B. van, Siersema, P.D., Tjonneland, A., Olsen, A., Perduca, V., Carbonnel, F., Boutron-Ruault, M.C., Kuhn, T., Johnson, T., Krasimira, A., Trichopoulou, A., Makrythanasis, P., Thanos, D., Panico, S., Krogh, V., Sacerdote, C., Skeie, G., Weiderpass, E., Colorado-Yohar, S., Sala, N., Barricarte, A., Sanchez, M.J., Quiros, R., Amiano, P., Gylling, B., Harlid, S., Perez-Cornago, A., Heath, A.K., Tsilidis, K.K., Aune, D., Freisling, H., Murphy, N., Gunter, M.J., and Jenab, M.
Abstract: Contains fulltext : 215343.pdf (publisher's version ) (Open Access), Higher circulating 25-hydroxyvitamin D levels (25(OH)D) have been found to be associated with lower risk for colorectal cancer (CRC) in prospective studies. Whether this association is modified by genetic variation in genes related to vitamin D metabolism and action has not been well studied in humans. We investigated 1307 functional and tagging single-nucleotide polymorphisms (SNPs; individually, and by gene/pathway) in 86 vitamin D-related genes in 1420 incident CRC cases matched to controls from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. We also evaluated the association between these SNPs and circulating 25(OH)D in a subset of controls. We confirmed previously reported CRC risk associations between SNPs in the VDR, GC, and CYP27B1 genes. We also identified additional associations with 25(OH)D, as well as CRC risk, and several potentially novel SNPs in genes related to vitamin D transport and action (LRP2, CUBN, NCOA7, and HDAC9). However, none of these SNPs were statistically significant after Benjamini-Hochberg (BH) multiple testing correction. When assessed by a priori defined functional pathways, tumor growth factor beta (TGFbeta) signaling was associated with CRC risk (P
Published: 2019

10. Prediagnostic Serum Vitamin D Levels and the Risk of Crohn's Disease and Ulcerative Colitis in European Populations: A Nested Case-Control Study

Author: Opstelten, J.L., Chan, S.S., Hart, A.R., Schaik, F.D. van, Siersema, P.D., Lentjes, E., Khaw, K.T., Luben, R., Key, T.J., Boeing, H., Bergmann, M.M., Overvad, K., Palli, D., Masala, G., Racine, A., Carbonnel, F., Boutron-Ruault, M.C., Tjonneland, A., Olsen, A., Andersen, V., Kaaks, R., Kuhn, T., Tumino, R., Trichopoulou, A., Peeters, P.H., Verschuren, W.M., Witteman, B.J., Oldenburg, B., Opstelten, J.L., Chan, S.S., Hart, A.R., Schaik, F.D. van, Siersema, P.D., Lentjes, E., Khaw, K.T., Luben, R., Key, T.J., Boeing, H., Bergmann, M.M., Overvad, K., Palli, D., Masala, G., Racine, A., Carbonnel, F., Boutron-Ruault, M.C., Tjonneland, A., Olsen, A., Andersen, V., Kaaks, R., Kuhn, T., Tumino, R., Trichopoulou, A., Peeters, P.H., Verschuren, W.M., Witteman, B.J., and Oldenburg, B.
Abstract: Item does not contain fulltext, Background: A low vitamin D status has been put forward as a potential risk factor for the development of inflammatory bowel disease (IBD). This study investigated the association between prediagnostic circulating vitamin D concentrations and dietary intakes of vitamin D, and the risk of Crohn's disease (CD) and ulcerative colitis (UC). Methods: Among 359,728 participants of the European Prospective Investigation into Cancer and Nutrition cohort, individuals who developed CD or UC after enrollment were identified. Each case was matched with2 controls by center, gender, age, date of recruitment, and follow-up time. At cohort entry, blood samples were collected and dietary vitamin D intakes were obtained from validated food frequency questionnaires. Serum 25-hydroxyvitamin D levels were measured using liquid chromatography-tandem mass spectrometry. Conditional logistic regression was performed to determine the odds of CD and UC. Results: Seventy-two participants developed CD and 169 participants developed UC after a median follow-up of 4.7 and 4.1 years, respectively. Compared with the lowest quartile, no associations with the 3 higher quartiles of vitamin D concentrations were observed for CD (p trend = 0.34) or UC (p trend = 0.66). Similarly, no associations were detected when serum vitamin D levels were analyzed as a continuous variable. Dietary vitamin D intakes were not associated with CD (p trend = 0.39) or UC (p trend = 0.83). Conclusions: Vitamin D status was not associated with the development of CD or UC. This does not suggest a major role for vitamin D deficiency in the etiology of IBD, although larger studies are needed to confirm these findings.
Published: 2018

11. A prospective evaluation of plasma phospholipid fatty acids and breast cancer risk in the EPIC study

Author: MS MDL 1, Epi Kanker Team 1, JC onderzoeksprogramma Kanker, Cancer, Epi Kanker Team A, Chajès, V., Assi, Nada, Biessy, C., Ferrari, P., Rinaldi, S., Slimani, N., Lenoir, G.M., Baglietto, L., His, Mathilde, Boutron-Ruault, M.C., Trichopoulou, A., Lagiou, P., Katsoulis, M., Kaaks, R., Kühn, Tilman, Panico, S., Pala, V., Masala, G., Bueno-de-Mesquita, H B, Peeters, P H, van Gils, C, Hjartåker, Anette, Olsen, Karina Standahl, Barnung, Borgund R, Barricarte, A., Sanchez, D Redondo, Menéndez, Virginia, Amiano, P., Wennberg, Maria, Key, T., Khaw, Kay T., Merritt, Melissa A., Riboli, E., Gunter, Marc J., Romieu, I., MS MDL 1, Epi Kanker Team 1, JC onderzoeksprogramma Kanker, Cancer, Epi Kanker Team A, Chajès, V., Assi, Nada, Biessy, C., Ferrari, P., Rinaldi, S., Slimani, N., Lenoir, G.M., Baglietto, L., His, Mathilde, Boutron-Ruault, M.C., Trichopoulou, A., Lagiou, P., Katsoulis, M., Kaaks, R., Kühn, Tilman, Panico, S., Pala, V., Masala, G., Bueno-de-Mesquita, H B, Peeters, P H, van Gils, C, Hjartåker, Anette, Olsen, Karina Standahl, Barnung, Borgund R, Barricarte, A., Sanchez, D Redondo, Menéndez, Virginia, Amiano, P., Wennberg, Maria, Key, T., Khaw, Kay T., Merritt, Melissa A., Riboli, E., Gunter, Marc J., and Romieu, I.
Published: 2017

12. Erratum: No association of alcohol use and the risk of ulcerative colitis or Crohn's disease: data from a European Prospective cohort study (EPIC)

Author: Bergmann, M M, Hernandez, V, Bernigau, W, Boeing, H, Chan, S S M, Luben, R, Khaw, K-T, van Schaik, F., Oldenburg, B., Bueno-de-Mesquita, B., Overvad, K., Palli, D., Masala, G., Carbonnel, F., Boutron-Ruault, M.C., Olsen, A., and Tjonneland, A.
Subjects: Food/cooking/nutrition, Health
Abstract: Correction to: European Journal of Clinical Nutrition advance online publication 25 January 2017; doi:10.1038/ejcn.2016.271 Since the publication of this article, the authors have noticed an error in author affiliation 1. The correct affiliation is: Department of Epidemiology, German Institute of Human Nutrition, Potsdam, Germany., Author(s): M M Bergmann, V Hernandez, W Bernigau, H Boeing, S S M Chan, R Luben, K-T Khaw, F van Schaik, B Oldenburg, B Bueno-de-Mesquita, K Overvad, D Palli, G [...]
Published: 2017
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13. Associations among body size across the life course, adult height and endometriosis

Author: Farland, L.V., primary, Missmer, S.A., additional, Bijon, A., additional, Gusto, G., additional, Gelot, A., additional, Clavel-Chapelon, F., additional, Mesrine, S., additional, Boutron-Ruault, M.C., additional, and Kvaskoff, M., additional
Published: 2017
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14. Exposure to Ambient Air Pollution and the Risk of Inflammatory Bowel Disease: A European Nested Case-Control Study

Author: Opstelten, J.L., Beelen, R.M., Leenders, M., Hoek, G., Brunekreef, B., Schaik, F.D. van, Siersema, P.D., Eriksen, K.T., Raaschou-Nielsen, O., Tjonneland, A., Overvad, K., Boutron-Ruault, M.C., Carbonnel, F., Hoogh, K. de, Key, T.J., Luben, R., Chan, S.S., Hart, A.R., Bueno-de-Mesquita, H.B., Oldenburg, B., Opstelten, J.L., Beelen, R.M., Leenders, M., Hoek, G., Brunekreef, B., Schaik, F.D. van, Siersema, P.D., Eriksen, K.T., Raaschou-Nielsen, O., Tjonneland, A., Overvad, K., Boutron-Ruault, M.C., Carbonnel, F., Hoogh, K. de, Key, T.J., Luben, R., Chan, S.S., Hart, A.R., Bueno-de-Mesquita, H.B., and Oldenburg, B.
Abstract: Contains fulltext : 172523.pdf (Publisher’s version ) (Open Access), BACKGROUND: Industrialization has been linked to the etiology of inflammatory bowel disease (IBD). AIM: We investigated the association between air pollution exposure and IBD. METHODS: The European Prospective Investigation into Cancer and Nutrition cohort was used to identify cases with Crohn's disease (CD) (n = 38) and ulcerative colitis (UC) (n = 104) and controls (n = 568) from Denmark, France, the Netherlands, and the UK, matched for center, gender, age, and date of recruitment. Air pollution data were obtained from the European Study of Cohorts for Air Pollution Effects. Residential exposure was assessed with land-use regression models for particulate matter with diameters of <10 mum (PM10), <2.5 mum (PM2.5), and between 2.5 and 10 mum (PMcoarse), soot (PM2.5 absorbance), nitrogen oxides, and two traffic indicators. Conditional logistic regression analyses were performed to calculate odds ratios (ORs) with 95 % confidence intervals (CIs). RESULTS: Although air pollution was not significantly associated with CD or UC separately, the associations were mostly similar. Individuals with IBD were less likely to have higher exposure levels of PM2.5 and PM10, with ORs of 0.24 (95 % CI 0.07-0.81) per 5 mug/m(3) and 0.25 (95 % CI 0.08-0.78) per 10 mug/m(3), respectively. There was an inverse but nonsignificant association for PMcoarse. A higher nearby traffic load was positively associated with IBD [OR 1.60 (95 % CI 1.04-2.46) per 4,000,000 motor vehicles x m per day]. Other air pollutants were positively but not significantly associated with IBD. CONCLUSION: Exposure to air pollution was not found to be consistently associated with IBD.
Published: 2016

15. Comparison of abdominal adiposity and overall obesity in relation to risk of small intestinal cancer in a European Prospective Cohort

Author: Lu, Y., Cross, A.J., Murphy, N., Freisling, H., Travis, R.C., Ferrari, P., Katzke, V.A., Kaaks, R., Olsson, A., Johansson, I., Renstrom, F., Panico, S., Pala, V., Palli, D., Tumino, R., Peeters, P.H., Siersema, P.D., Bueno-de-Mesquita, H.B., Trichopoulou, A., Klinaki, E., Tsironis, C., Agudo, A., Navarro, C, Sanchez, M.J., Barricarte, A., Boutron-Ruault, M.C., Fagherazzi, G., Racine, A., Weiderpass, E., Gunter, M.J., Riboli, E., Lu, Y., Cross, A.J., Murphy, N., Freisling, H., Travis, R.C., Ferrari, P., Katzke, V.A., Kaaks, R., Olsson, A., Johansson, I., Renstrom, F., Panico, S., Pala, V., Palli, D., Tumino, R., Peeters, P.H., Siersema, P.D., Bueno-de-Mesquita, H.B., Trichopoulou, A., Klinaki, E., Tsironis, C., Agudo, A., Navarro, C, Sanchez, M.J., Barricarte, A., Boutron-Ruault, M.C., Fagherazzi, G., Racine, A., Weiderpass, E., Gunter, M.J., and Riboli, E.
Abstract: Contains fulltext : 172179.pdf (Publisher’s version ) (Open Access), BACKGROUND: The etiology of small intestinal cancer (SIC) is largely unknown, and there are very few epidemiological studies published to date. No studies have investigated abdominal adiposity in relation to SIC. METHODS: We investigated overall obesity and abdominal adiposity in relation to SIC in the European Prospective Investigation into Cancer and Nutrition (EPIC), a large prospective cohort of approximately half a million men and women from ten European countries. Overall obesity and abdominal obesity were assessed by body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). Multivariate Cox proportional hazards regression modeling was performed to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs). Stratified analyses were conducted by sex, BMI, and smoking status. RESULTS: During an average of 13.9 years of follow-up, 131 incident cases of SIC (including 41 adenocarcinomas, 44 malignant carcinoid tumors, 15 sarcomas and 10 lymphomas, and 21 unknown histology) were identified. WC was positively associated with SIC in a crude model that also included BMI (HR per 5-cm increase = 1.20, 95 % CI 1.04, 1.39), but this association attenuated in the multivariable model (HR 1.18, 95 % CI 0.98, 1.42). However, the association between WC and SIC was strengthened when the analysis was restricted to adenocarcinoma of the small intestine (multivariable HR adjusted for BMI = 1.56, 95 % CI 1.11, 2.17). There were no other significant associations. CONCLUSION: WC, rather than BMI, may be positively associated with adenocarcinomas but not carcinoid tumors of the small intestine. IMPACT: Abdominal obesity is a potential risk factor for adenocarcinoma in the small intestine.
Published: 2016

16. Dairy Products, Dietary Calcium, and Risk of Inflammatory Bowel Disease: Results From a European Prospective Cohort Investigation

Author: Opstelten, J.L., Leenders, M., Dik, V.K., Chan, S.S., Schaik, F.D. van, Khaw, K.T., Luben, R., Hallmans, G., Karling, P., Lindgren, S., Grip, O., Key, T.J., Crowe, F.L., Boeing, H., Bergmann, M.M., Overvad, K., Palli, D., Masala, G., Racine, A., Carbonnel, F., Boutron-Ruault, M.C., Tjonneland, A., Olsen, A., Andersen, V., Kaaks, R., Katzke, V.A., Tumino, R., Trichopoulou, A., Siersema, P.D., Bueno-de-Mesquita, H.B., Hart, A.R., Oldenburg, B., Opstelten, J.L., Leenders, M., Dik, V.K., Chan, S.S., Schaik, F.D. van, Khaw, K.T., Luben, R., Hallmans, G., Karling, P., Lindgren, S., Grip, O., Key, T.J., Crowe, F.L., Boeing, H., Bergmann, M.M., Overvad, K., Palli, D., Masala, G., Racine, A., Carbonnel, F., Boutron-Ruault, M.C., Tjonneland, A., Olsen, A., Andersen, V., Kaaks, R., Katzke, V.A., Tumino, R., Trichopoulou, A., Siersema, P.D., Bueno-de-Mesquita, H.B., Hart, A.R., and Oldenburg, B.
Abstract: Item does not contain fulltext, BACKGROUND: Dairy products may be involved in the etiology of inflammatory bowel disease by modulating gut microbiota and immune responses, but data from epidemiological studies examining this relationship are limited. We investigated the association between prediagnostic intake of these foods and dietary calcium, and the subsequent development of Crohn's disease (CD) and ulcerative colitis (UC). METHODS: In total, 401,326 participants were enrolled in the European Prospective Investigation into Cancer and Nutrition cohort. At recruitment, consumption of total and specific dairy products (milk, yogurt, and cheese) and dietary calcium was measured using validated food frequency questionnaires. Cases developing incident CD (n = 110) or UC (n = 244) during follow-up were matched with 4 controls. Conditional logistic regression analyses were used to calculate odds ratios (ORs) with 95% confidence intervals (CIs), adjusted for total energy intake and smoking. RESULTS: Compared with the lowest quartile, the ORs for the highest quartile of total dairy products and dietary calcium intake were 0.61 (95% CI, 0.32-1.19, p trend = 0.19) and 0.63 (95% CI, 0.28-1.42, p trend = 0.23) for CD, and 0.80 (95% CI, 0.50-1.30, p trend = 0.40) and 0.81 (95% CI, 0.49-1.34, p trend = 0.60) for UC, respectively. Compared with nonconsumers, individuals consuming milk had significantly reduced odds of CD (OR 0.30, 95% CI, 0.13-0.65) and nonsignificantly reduced odds of UC (OR 0.85, 95% CI, 0.49-1.47). CONCLUSIONS: Milk consumption may be associated with a decreased risk of developing CD, although a clear dose-response relationship was not established. Further studies are warranted to confirm this possible protective effect.
Published: 2016

17. A Nested Case-Control Study of Metabolically Defined Body Size Phenotypes and Risk of Colorectal Cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Author: Murphy, N., Cross, A.J., Abubakar, M., Jenab, M., Aleksandrova, K., Boutron-Ruault, M.C., Dossus, L., Racine, A., Kuhn, T., Katzke, V.A., Tjonneland, A., Petersen, K.E., Overvad, K., Quiros, J.R., Jakszyn, P., Molina-Montes, E., Dorronsoro, M., Huerta, J.M., Barricarte, A., Khaw, K.T., Wareham, N., Travis, R.C., Trichopoulou, A., Lagiou, P., Trichopoulos, D., Masala, G., Krogh, V., Tumino, R., Vineis, P., Panico, S., Bueno-de-Mesquita, H.B., Siersema, P.D., Peeters, P.H., Ohlsson, B., Ericson, U., Palmqvist, R., Nystrom, H., Weiderpass, E., Skeie, G., Freisling, H., Kong, S.Y., Tsilidis, K., Muller, D.C., Riboli, E., Gunter, M.J., Murphy, N., Cross, A.J., Abubakar, M., Jenab, M., Aleksandrova, K., Boutron-Ruault, M.C., Dossus, L., Racine, A., Kuhn, T., Katzke, V.A., Tjonneland, A., Petersen, K.E., Overvad, K., Quiros, J.R., Jakszyn, P., Molina-Montes, E., Dorronsoro, M., Huerta, J.M., Barricarte, A., Khaw, K.T., Wareham, N., Travis, R.C., Trichopoulou, A., Lagiou, P., Trichopoulos, D., Masala, G., Krogh, V., Tumino, R., Vineis, P., Panico, S., Bueno-de-Mesquita, H.B., Siersema, P.D., Peeters, P.H., Ohlsson, B., Ericson, U., Palmqvist, R., Nystrom, H., Weiderpass, E., Skeie, G., Freisling, H., Kong, S.Y., Tsilidis, K., Muller, D.C., Riboli, E., and Gunter, M.J.
Abstract: Contains fulltext : 165685.pdf (publisher's version ) (Open Access), BACKGROUND: Obesity is positively associated with colorectal cancer. Recently, body size subtypes categorised by the prevalence of hyperinsulinaemia have been defined, and metabolically healthy overweight/obese individuals (without hyperinsulinaemia) have been suggested to be at lower risk of cardiovascular disease than their metabolically unhealthy (hyperinsulinaemic) overweight/obese counterparts. Whether similarly variable relationships exist for metabolically defined body size phenotypes and colorectal cancer risk is unknown. METHODS AND FINDINGS: The association of metabolically defined body size phenotypes with colorectal cancer was investigated in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Metabolic health/body size phenotypes were defined according to hyperinsulinaemia status using serum concentrations of C-peptide, a marker of insulin secretion. A total of 737 incident colorectal cancer cases and 737 matched controls were divided into tertiles based on the distribution of C-peptide concentration amongst the control population, and participants were classified as metabolically healthy if below the first tertile of C-peptide and metabolically unhealthy if above the first tertile. These metabolic health definitions were then combined with body mass index (BMI) measurements to create four metabolic health/body size phenotype categories: (1) metabolically healthy/normal weight (BMI < 25 kg/m2), (2) metabolically healthy/overweight (BMI >/= 25 kg/m2), (3) metabolically unhealthy/normal weight (BMI < 25 kg/m2), and (4) metabolically unhealthy/overweight (BMI >/= 25 kg/m2). Additionally, in separate models, waist circumference measurements (using the International Diabetes Federation cut-points [>/=80 cm for women and >/=94 cm for men]) were used (instead of BMI) to create the four metabolic health/body size phenotype categories. Statistical tests used in the analysis were all two-sided, and a p
Published: 2016

18. Adiposity, mediating biomarkers and risk of colon cancer in the European prospective investigation into cancer and nutrition study

Author: Aleksandrova, K., Drogan, D., Boeing, H., Jenab, M., Bueno-de-Mesquita, H.B., Jansen, E., van Duijnhoven, F.J.B., Rinaldi, S., Fedirko, V., Romieu, I., Kaaks, R., Riboli, E., Gunter, M.J., Romaguera, D., Westhpal, S., Overvad, K., Tjønneland, A., Halkjaer, J., Boutron-Ruault, M.C., Clavel-Chapelon, F., Lukanova, A., Trichopoulou, A., Trichopoulos, D., Vidalis, P., Panico, S., Agnoli, C., Palli, D., Tumino, R., Vineis, P., Buckland, G., Sánchez-Cruz, J.J., Dorronsoro, M., Tormo Díaz, M.J., Barricarte, A., Quiros, J.R., Peeters, P.H., May, A., Hallmans, G., Palmqvist, R., Crowe, F.L., Khaw, K.T., Wareham, N., Pischon, T., Aleksandrova, K, Drogan, D, Boeing, H, Jenab, M, Bas Bueno de Mesquita, H, Jansen, E, van Duijnhoven, Fj, Rinaldi, S, Fedirko, V, Romieu, I, Kaaks, R, Riboli, E, Gunter, Mj, Romaguera, D, Westhpal, S, Overvad, K, Tj?nneland, A, Halkjaer, J, Boutron Ruault, Mc, Clavel Chapelon, F, Lukanova, A, Trichopoulou, A, Trichopoulos, D, Vidalis, P, Panico, Salvatore, Agnoli, C, Palli, D, Tumino, R, Vineis, P, Buckland, G, S?nchez Cruz, Jj, Dorronsoro, M, D?az, Mj, Barricarte, A, Ramon Quiros, J, Peeters, Ph, May, Am, Hallmans, G, Palmqvist, R, Crowe, Fl, Khaw, Kt, Wareham, N, and Pischon, T.
Subjects: Male, Nutritional Status, Middle Aged, Europe, Cardiovascular and Metabolic Diseases, Risk Factors, Case-Control Studies, Colonic Neoplasms, Biomarkers, Tumor, Humans, Female, Prospective Studies, Adiposity, Aged
Abstract: Adiposity is a risk factor for colon cancer, but underlying mechanisms are not well understood. We evaluated the extent to which eleven biomarkers with inflammatory and metabolic actions mediate the association of adiposity measures, waist circumference (WC) and body mass index (BMI), with colon cancer in men and women. We analysed data from a prospective nested case-control study among 662 incident colon cancer cases matched within risk-sets to 662 controls. Relative risks (RRs) and 95% confidence intervals (CIs) were calculated using conditional logistic regression. The percent effect change and corresponding CI-s were estimated after adjusting for biomarkers shown to be associated with colon cancer risk. After multivariable adjustment, WC was associated with colon cancer risk in men (top vs bottom tertile RR 1.68, 95% CI 1.06 - 2.65; Ptrend = 0.02) and in women (RR 1.67, 95% CI 1.09 - 2.56; Ptrend = 0.03). BMI was associated with risk only in men. The association of WC with colon cancer was accounted mostly for by three biomarkers, high-density lipoprotein cholesterol, non-high-molecular-weight adiponectin and soluble leptin receptor, which in combination explained 46% (95% CI 37 to 57%) of the association in men and 50% (95% CI 40 to 65%) of the association in women. Similar results were observed for the associations with BMI in men. These data suggests that alterations in levels of these metabolic biomarkers may represent a primary mechanism of action in the relation of adiposity with colon cancer. Further studies are warranted to determine whether altering their concentrations may reduce colon cancer risk. © 2013 Wiley Periodicals, Inc.
Published: 2014
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19. Variation at ABO histo-blood group and FUT loci and diffuse and intestinal gastric cancer risk in a European population

Author: Duell, E.J., Bonet, C., Munoz, X., Lujan-Barroso, L., Weiderpass, E., Boutron-Ruault, M.C., Racine, A., Severi, G., Canzian, F., Rizzato, C., Boeing, H., Overvad, K., Tjonneland, A., Arguelles, M., Sanchez-Cantalejo, E., Chamosa, S., Huerta, J.M., Barricarte, A., Khaw, K.T., Wareham, N., Travis, R.C., Trichopoulou, A., Trichopoulos, D., Yiannakouris, N., Palli, D., Agnoli, C., Tumino, R., Naccarati, A., Panico, S., Bueno-de-Mesquita, H.B., Siersema, P.D., Peeters, P.H.M., Ohlsson, B., Lindkvist, B., Johansson, I., Ye, W., Johansson, M., Fenger, C., Riboli, E., Sala, N., Gonzalez, C.A., Duell, E.J., Bonet, C., Munoz, X., Lujan-Barroso, L., Weiderpass, E., Boutron-Ruault, M.C., Racine, A., Severi, G., Canzian, F., Rizzato, C., Boeing, H., Overvad, K., Tjonneland, A., Arguelles, M., Sanchez-Cantalejo, E., Chamosa, S., Huerta, J.M., Barricarte, A., Khaw, K.T., Wareham, N., Travis, R.C., Trichopoulou, A., Trichopoulos, D., Yiannakouris, N., Palli, D., Agnoli, C., Tumino, R., Naccarati, A., Panico, S., Bueno-de-Mesquita, H.B., Siersema, P.D., Peeters, P.H.M., Ohlsson, B., Lindkvist, B., Johansson, I., Ye, W., Johansson, M., Fenger, C., Riboli, E., Sala, N., and Gonzalez, C.A.
Abstract: Item does not contain fulltext, ABO blood serotype A is known to be associated with risk of gastric cancer (GC), but little is known how ABO alleles and the fucosyltransferase (FUT) enzymes and genes which are involved in Lewis antigen formation [and in Helicobacter pylori (H. pylori) binding and pathogenicity] may be related to GC risk in a European population. The authors conducted an investigation of 32 variants at ABO and FUT1-7 loci and GC risk in a case-control study of 365 cases and 1,284 controls nested within the EPIC cohort (the EPIC-Eurgast study). Four variants (including rs505922) in ABO, and allelic blood group A (AO+AA, odds ratio=1.84, 95%CI=1.20-2.80) were associated with diffuse-type GC; however, conditional models with other ABO variants indicated that the associations were largely due to allelic blood group A. One variant in FUT5 was also associated with diffuse-type GC, and four variants (and haplotypes) in FUT2 (Se), FUT3 (Le) and FUT6 with intestinal-type GC. Further, one variant in ABO, two in FUT3 and two in FUT6 were associated with H. pylori infection status in controls, and two of these (in FUT3 and FUT6) were weakly associated with intestinal-type GC risk. None of the individual variants surpassed a Bonferroni corrected p-value cutoff of 0.0016; however, after a gene-based permutation test, two loci [FUT3(Le)/FUT5/FUT6 and FUT2(Se)] were significantly associated with diffuse- and intestinal-type GC, respectively. Replication and functional studies are therefore recommended to clarify the role of ABO and FUT alleles in H. pylori infection and subtype-specific gastric carcinogenesis.
Published: 2015

20. Plasma carotenoids, vitamin C, retinol and tocopherols levels and pancreatic cancer risk within the European Prospective Investigation into Cancer and Nutrition: a nested case-control study: plasma micronutrients and pancreatic cancer risk

Author: Jeurnink, S.M., Ros, M.M., Leenders, M., Duijnhoven, F.J. van, Siersema, P.D., Jansen, E.H., Gils, C.H. van, Bakker, M.F., Overvad, K., Roswall, N., Tjonneland, A., Boutron-Ruault, M.C., Racine, A., Cadeau, C., Grote, V., Kaaks, R., Aleksandrova, K., Boeing, H., Trichopoulou, A., Benetou, V., Valanou, E., Palli, D., Krogh, V., Vineis, P., Tumino, R., Mattiello, A., Weiderpass, E., Skeie, G., Castano, J.M., Duell, E.J., Barricarte, A., Molina-Montes, E., Arguelles, M., Dorronsoro, M., Johansen, D., Lindkvist, B., Sund, M., Crowe, F.L., Khaw, K.T., Jenab, M., Fedirko, V., Riboli, E., Bueno-de-Mesquita, H.B., Jeurnink, S.M., Ros, M.M., Leenders, M., Duijnhoven, F.J. van, Siersema, P.D., Jansen, E.H., Gils, C.H. van, Bakker, M.F., Overvad, K., Roswall, N., Tjonneland, A., Boutron-Ruault, M.C., Racine, A., Cadeau, C., Grote, V., Kaaks, R., Aleksandrova, K., Boeing, H., Trichopoulou, A., Benetou, V., Valanou, E., Palli, D., Krogh, V., Vineis, P., Tumino, R., Mattiello, A., Weiderpass, E., Skeie, G., Castano, J.M., Duell, E.J., Barricarte, A., Molina-Montes, E., Arguelles, M., Dorronsoro, M., Johansen, D., Lindkvist, B., Sund, M., Crowe, F.L., Khaw, K.T., Jenab, M., Fedirko, V., Riboli, E., and Bueno-de-Mesquita, H.B.
Abstract: Item does not contain fulltext, Evidence of a protective effect of several antioxidants and other nutrients on pancreatic cancer risk is inconsistent. The aim of this study was to investigate the association for prediagnostic plasma levels of carotenoids, vitamin C, retinol and tocopherols with risk of pancreatic cancer in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC). 446 incident exocrine pancreatic cancer cases were matched to 446 controls by age at blood collection, study center, sex, date and time of blood collection, fasting status and hormone use. Plasma carotenoids (alpha- and beta-carotene, lycopene, beta-cryptoxanthin, canthaxanthin, zeaxanthin and lutein), alpha- and gamma-tocopherol and retinol were measured by reverse phase high-performance liquid chromatography and plasma vitamin C by a colorimetric assay. Incidence rate ratios (IRRs) with 95% confidence intervals (95%CIs) for pancreatic cancer risk were estimated using a conditional logistic regression analysis, adjusted for smoking status, smoking duration and intensity, waist circumference, cotinine levels and diabetes status. Inverse associations with pancreatic cancer risk were found for plasma beta-carotene (IRR highest vs. lowest quartile 0.52, 95%CI 0.31-0.88, p for trend = 0.02), zeaxanthin (IRR highest vs. lowest quartile 0.53, 95%CI 0.30-0.94, p for trend = 0.06) and alpha-tocopherol (IRR highest vs. lowest quartile 0.62, 95%CI 0.39-0.99, p for trend = 0.08. For alpha- and beta-carotene, lutein, sum of carotenoids and gamma-tocopherol, heterogeneity between geographical regions was observed. In conclusion, our results show that higher plasma concentrations of beta-carotene, zeaxanthin and alpha-tocopherol may be inversely associated with risk of pancreatic cancer, but further studies are warranted.
Published: 2015

21. Subtypes of fruit and vegetables, variety in consumption and risk of colon and rectal cancer in the European Prospective Investigation into Cancer and Nutrition

Author: Leenders, M., Siersema, P.D., Overvad, K., Tjonneland, A., Olsen, A., Boutron-Ruault, M.C., Bastide, N., Fagherazzi, G., Katzke, V., Kuhn, T., Boeing, H., Aleksandrova, K., Trichopoulou, A., Lagiou, P., Klinaki, E., Masala, G., Grioni, S., Magistris, M. Santucci De, Tumino, R., Ricceri, F., Peeters, P.H.M., Lund, E., Skeie, G., Weiderpass, E., Quiros, J.R., Agudo, A., Sanchez, M.J., Dorronsoro, M., Navarro, C, Ardanaz, E., Ohlsson, B., Jirstrom, K., Guelpen, B. van, Wennberg, M., Khaw, K.T., Wareham, N., Key, T.J., Romieu, I., Huybrechts, I., Cross, A.J., Murphy, N., Riboli, E., Bueno-de-Mesquita, H.B., Leenders, M., Siersema, P.D., Overvad, K., Tjonneland, A., Olsen, A., Boutron-Ruault, M.C., Bastide, N., Fagherazzi, G., Katzke, V., Kuhn, T., Boeing, H., Aleksandrova, K., Trichopoulou, A., Lagiou, P., Klinaki, E., Masala, G., Grioni, S., Magistris, M. Santucci De, Tumino, R., Ricceri, F., Peeters, P.H.M., Lund, E., Skeie, G., Weiderpass, E., Quiros, J.R., Agudo, A., Sanchez, M.J., Dorronsoro, M., Navarro, C, Ardanaz, E., Ohlsson, B., Jirstrom, K., Guelpen, B. van, Wennberg, M., Khaw, K.T., Wareham, N., Key, T.J., Romieu, I., Huybrechts, I., Cross, A.J., Murphy, N., Riboli, E., and Bueno-de-Mesquita, H.B.
Abstract: Item does not contain fulltext, Previously, a lower risk of colorectal cancer was observed with fruit and vegetable consumption in the European Prospective Investigation into Cancer and Nutrition within a follow-up period of 9 years which was not fully supported by a recent meta-analysis. Therefore, we were interested in the relation with extended follow-up, also focusing on single subtypes and a variety of intake of fruit and vegetables. Fruit and vegetable consumption was assessed at baseline. After an average of 13 years of follow-up, 3,370 participants were diagnosed with colon or rectal cancer. Diet diversity scores were constructed to quantify variety in fruit and vegetable consumption. A lower risk of colon cancer was observed with higher self-reported consumption of fruit and vegetable combined (HR Q4 vs. Q1 0.87, 95% CI 0.75-1.01, p for trend 0.02), but no consistent association was observed for separate consumption of fruits and vegetables. No associations with risk of rectal cancer were observed. The few observed associations for some fruit and vegetable subtypes with colon cancer risk may have been due to chance. Variety in consumption of fruits and vegetables was not associated with a lower risk of colon or rectal cancer. Although a lower risk of colon cancer is suggested with high consumption of fruit and vegetables, this study does not support a clear inverse association between fruit and vegetable consumption and colon or rectal cancer beyond a follow-up of more than 10 years. Attenuation of the risk estimates from dietary changes over time cannot be excluded, but appears unlikely.
Published: 2015

22. Plasma fetuin-A concentration, genetic variation in the AHSG gene and risk of colorectal cancer

Author: Nimptsch, K., Aleksandrova, K., Boeing, H., Janke, J., Lee, Y.A., Jenab, M., Kong, S.Y., Tsilidis, K.K., Weiderpass, E., Bueno-de-Mesquita, H.B., Siersema, P.D., Jansen, E.H., Trichopoulou, A., Tjonneland, A., Olsen, A., Wu, C., Overvad, K., Boutron-Ruault, M.C., Racine, A., Freisling, H., Katzke, V., Kaaks, R., Lagiou, P., Trichopoulos, D., Severi, G., Naccarati, A., Mattiello, A., Palli, D., Grioni, S., Tumino, R., Peeters, P.H.M., Ljuslinder, I., Nystrom, H., Brandstedt, J., Sanchez, M.J., Gurrea, A.B., Bonet, C.B., Chirlaque, M.D., Dorronsoro, M., Quiros, J.R., Travis, R.C., Khaw, K.T., Wareham, N., Riboli, E., Gunter, M.J., Pischon, T., Nimptsch, K., Aleksandrova, K., Boeing, H., Janke, J., Lee, Y.A., Jenab, M., Kong, S.Y., Tsilidis, K.K., Weiderpass, E., Bueno-de-Mesquita, H.B., Siersema, P.D., Jansen, E.H., Trichopoulou, A., Tjonneland, A., Olsen, A., Wu, C., Overvad, K., Boutron-Ruault, M.C., Racine, A., Freisling, H., Katzke, V., Kaaks, R., Lagiou, P., Trichopoulos, D., Severi, G., Naccarati, A., Mattiello, A., Palli, D., Grioni, S., Tumino, R., Peeters, P.H.M., Ljuslinder, I., Nystrom, H., Brandstedt, J., Sanchez, M.J., Gurrea, A.B., Bonet, C.B., Chirlaque, M.D., Dorronsoro, M., Quiros, J.R., Travis, R.C., Khaw, K.T., Wareham, N., Riboli, E., Gunter, M.J., and Pischon, T.
Abstract: Item does not contain fulltext, Fetuin-A, also referred to as alpha2-Heremans-Schmid glycoprotein (AHSG), is a liver protein known to inhibit insulin actions. Hyperinsulinemia is a possible risk factor for colorectal cancer; however, the role of fetuin-A in the development of colorectal cancer is unclear. We investigated the association between circulating fetuin-A and colorectal cancer risk in a nested case-control study within the European Prospective Investigation into Cancer and Nutrition. Fetuin-A concentrations were measured in prediagnostic plasma samples from 1,367 colorectal cancer cases and 1,367 matched controls. In conditional logistic regression models adjusted for potential confounders, the estimated relative risk (95% confidence interval) of colorectal cancer per 40 microg/mL higher fetuin-A concentrations (approximately one standard deviation) was 1.13 (1.02-1.24) overall, 1.21 (1.05-1.39) in men, 1.06 (0.93-1.22) in women, 1.13 (1.00-1.27) for colon cancer and 1.12 (0.94-1.32) for rectal cancer. To improve causal inference in a Mendelian Randomization approach, five tagging single nucleotide polymorphisms of the AHSG gene were genotyped in a subset of 456 case-control pairs. The AHSG allele-score explained 21% of the interindividual variation in plasma fetuin-A concentrations. In instrumental variable analysis, genetically raised fetuin-A was not associated with colorectal cancer risk (relative risk per 40 microg/mL genetically determined higher fetuin-A was 0.98, 95% confidence interval: 0.73-1.33). The findings of our study indicate a modest linear association between fetuin-A concentrations and risk of colorectal cancer but suggest that fetuin-A may not be causally related to colorectal cancer development.
Published: 2015

23. Total, caffeinated and decaffeinated coffee and tea intake and gastric cancer risk: results from the EPIC cohort study

Author: Sanikini, H., Dik, V.K., Siersema, P.D., Bhoo-Pathy, N., Uiterwaal, C.S., Peeters, P.H.M., Gonzalez, C.A., Zamora-Ros, R., Overvad, K., Tjonneland, A., Roswall, N., Boutron-Ruault, M.C., Fagherazzi, G., Racine, A., Kuhn, T., Katzke, V., Boeing, H., Trichopoulou, A., Trichopoulos, D., Lagiou, P., Palli, D., Grioni, S., Vineis, P., Tumino, R., Panico, S., Weiderpass, E., Skeie, G., Braaten, T., Huerta, J.M., Sanchez-Cantalejo, E., Barricarte, A., Sonestedt, E., Wallstrom, P., Nilsson, L.M., Johansson, I., Bradbury, K.E., Khaw, K.T., Wareham, N., Huybrechts, I., Freisling, H., Cross, A.J., Riboli, E., Bueno-de-Mesquita, H.B., Sanikini, H., Dik, V.K., Siersema, P.D., Bhoo-Pathy, N., Uiterwaal, C.S., Peeters, P.H.M., Gonzalez, C.A., Zamora-Ros, R., Overvad, K., Tjonneland, A., Roswall, N., Boutron-Ruault, M.C., Fagherazzi, G., Racine, A., Kuhn, T., Katzke, V., Boeing, H., Trichopoulou, A., Trichopoulos, D., Lagiou, P., Palli, D., Grioni, S., Vineis, P., Tumino, R., Panico, S., Weiderpass, E., Skeie, G., Braaten, T., Huerta, J.M., Sanchez-Cantalejo, E., Barricarte, A., Sonestedt, E., Wallstrom, P., Nilsson, L.M., Johansson, I., Bradbury, K.E., Khaw, K.T., Wareham, N., Huybrechts, I., Freisling, H., Cross, A.J., Riboli, E., and Bueno-de-Mesquita, H.B.
Abstract: Item does not contain fulltext, Prospective studies examining the association between coffee and tea consumption and gastric cancer risk have shown inconsistent results. We investigated the association between coffee (total, caffeinated and decaffeinated) and tea consumption and the risk of gastric cancer by anatomical site and histological type in the European Prospective Investigation into Cancer and Nutrition study. Coffee and tea consumption were assessed by dietary questionnaires at baseline. Adjusted hazard ratios (HRs) were calculated using Cox regression models. During 11.6 years of follow up, 683 gastric adenocarcinoma cases were identified among 477,312 participants. We found no significant association between overall gastric cancer risk and consumption of total coffee (HR 1.09, 95%-confidence intervals [CI]: 0.84-1.43; quartile 4 vs. non/quartile 1), caffeinated coffee (HR 1.14, 95%-CI: 0.82-1.59; quartile 4 vs. non/quartile 1), decaffeinated coffee (HR 1.07, 95%-CI: 0.75-1.53; tertile 3 vs. non/tertile 1) and tea (HR 0.81, 95%-CI: 0.59-1.09; quartile 4 vs. non/quartile 1). When stratified by anatomical site, we observed a significant positive association between gastric cardia cancer risk and total coffee consumption per increment of 100 mL/day (HR 1.06, 95%-CI: 1.03-1.11). Similarly, a significant positive association was observed between gastric cardia cancer risk and caffeinated coffee consumption (HR 1.98, 95%-CI: 1.16-3.36, p-trend=0.06; quartile 3 vs. non/quartile 1) and per increment of 100 mL/day (HR 1.09, 95%-CI: 1.04-1.14). In conclusion, consumption of total, caffeinated and decaffeinated coffee and tea is not associated with overall gastric cancer risk. However, total and caffeinated coffee consumption may be associated with an increased risk of gastric cardia cancer. Further prospective studies are needed to rule out chance or confounding.
Published: 2015

24. Healthy lifestyle index and risk of gastric adenocarcinoma in the EPIC cohort study

Author: Buckland, G., Travier, N., Huerta, J.M., Bueno-de-Mesquita, H.B., Siersema, P.D., Skeie, G., Weiderpass, E., Engeset, D., Ericson, U., Ohlsson, B., Agudo, A., Romieu, I., Ferrari, P., Freisling, H., Colorado-Yohar, S., Li, K., Kaaks, R., Pala, V., Cross, A.J., Riboli, E., Trichopoulou, A., Lagiou, P., Bamia, C., Boutron-Ruault, M.C., Fagherazzi, G., Dartois, L., May, A.M., Peeters, P.H.M., Panico, S., Johansson, M., Wallner, B., Palli, D., Key, T.J., Khaw, K.T., Ardanaz, E., Overvad, K., Tjonneland, A., Dorronsoro, M., Sanchez, M.J., Quiros, J.R., Naccarati, A., Tumino, R., Boeing, H., Gonzalez, C.A., Buckland, G., Travier, N., Huerta, J.M., Bueno-de-Mesquita, H.B., Siersema, P.D., Skeie, G., Weiderpass, E., Engeset, D., Ericson, U., Ohlsson, B., Agudo, A., Romieu, I., Ferrari, P., Freisling, H., Colorado-Yohar, S., Li, K., Kaaks, R., Pala, V., Cross, A.J., Riboli, E., Trichopoulou, A., Lagiou, P., Bamia, C., Boutron-Ruault, M.C., Fagherazzi, G., Dartois, L., May, A.M., Peeters, P.H.M., Panico, S., Johansson, M., Wallner, B., Palli, D., Key, T.J., Khaw, K.T., Ardanaz, E., Overvad, K., Tjonneland, A., Dorronsoro, M., Sanchez, M.J., Quiros, J.R., Naccarati, A., Tumino, R., Boeing, H., and Gonzalez, C.A.
Abstract: Item does not contain fulltext, Several modifiable lifestyle factors, including smoking, alcohol, certain dietary factors and weight are independently associated with gastric cancer (GC); however, their combined impact on GC risk is unknown. We constructed a healthy lifestyle index to investigate the joint influence of these behaviors on GC risk within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The analysis included 461,550 participants (662 first incident GC cases) with a mean follow-up of 11.4 years. A healthy lifestyle index was constructed, assigning 1 point for each healthy behavior related to smoking status, alcohol consumption and diet quality (represented by the Mediterranean diet) for assessing overall GC and also body mass index for cardia GC and 0 points otherwise. Risk of GC was calculated using Cox proportional hazards regression models while adjusting for relevant confounders. The highest versus lowest score in the healthy lifestyle index was associated with a significant lower risk of GC, by 51% overall (HR 0.49 95% CI 0.35, 0.70), by 77% for cardia GC (HR 0.23 95% CI 0.08, 0.68) and by 47% for noncardia GC (HR 0.53 (95% CI 0.32, 0.87), p-trends<0.001. Population attributable risk calculations showed that 18.8% of all GC and 62.4% of cardia GC cases could have been prevented if participants in this population had followed the healthy lifestyle behaviors of this index. Adopting several healthy lifestyle behaviors including not smoking, limiting alcohol consumption, eating a healthy diet and maintaining a normal weight is associated with a large decreased risk of GC.
Published: 2015

25. A prospective study of the immune system activation biomarker neopterin and colorectal cancer risk

Author: Aleksandrova, K., Chuang, S.C., Boeing, H., Zuo, Huijuan, Tell, G.S., Pischon, T., Jenab, M., Bueno-De-Mesquita, B., Vollset, S.E., Midttun, Øivind, Ueland, P.M., Fedirko, V., Johansson, M., Weiderpass, E., Severi, G., Racine, A., Boutron-Ruault, M.C., Kaaks, R., Kühn, Tilman, Tjønneland, A., Overvad, K., Quirós, José R., Jakszyn, P., Sánchez, M.-J, Dorronsoro, M., Chirlaque, M.D., Ardanaz, E., Khaw, Kay T., Wareham, Nicholas J., Travis, Ruth C., Trichopoulou, A., Lagiou, P., Trichopoulos, D., Palli, D., Sieri, S., Tumino, R., Panico, S., May, A.M., Palmqvist, R., Ljuslinder, Ingrid, Kong, S.Y.J., Freisling, H., Gunter, Marc J., Lu, Y., Cross, Amanda J., Riboli, E., Vineis, P., Aleksandrova, K., Chuang, S.C., Boeing, H., Zuo, Huijuan, Tell, G.S., Pischon, T., Jenab, M., Bueno-De-Mesquita, B., Vollset, S.E., Midttun, Øivind, Ueland, P.M., Fedirko, V., Johansson, M., Weiderpass, E., Severi, G., Racine, A., Boutron-Ruault, M.C., Kaaks, R., Kühn, Tilman, Tjønneland, A., Overvad, K., Quirós, José R., Jakszyn, P., Sánchez, M.-J, Dorronsoro, M., Chirlaque, M.D., Ardanaz, E., Khaw, Kay T., Wareham, Nicholas J., Travis, Ruth C., Trichopoulou, A., Lagiou, P., Trichopoulos, D., Palli, D., Sieri, S., Tumino, R., Panico, S., May, A.M., Palmqvist, R., Ljuslinder, Ingrid, Kong, S.Y.J., Freisling, H., Gunter, Marc J., Lu, Y., Cross, Amanda J., Riboli, E., and Vineis, P.
Published: 2015

26. Pre-diagnostic concordance with the WCRF/AICR guidelines and survival in European colorectal cancer patients: a cohort study

Author: Romaguera, D., Ward, H., Wark, P.A., Vergnaud, A.C., Peeters, P.H.M., Gils, C.H. van, Ferrari, P., Fedirko, V., Jenab, M., Boutron-Ruault, M.C., Dossus, L., Dartois, L., Hansen, C.P., Dahm, C.C., Buckland, G., Sanchez, M.J., Dorronsoro, M., Navarro, C, Barricarte, A., Key, T.J., Trichopoulou, A., Tsironis, C., Lagiou, P., Masala, G., Pala, V., Tumino, R., Vineis, P., Panico, S., Bueno-de-Mesquita, H.B., Siersema, P.D., Ohlsson, B., Jirstrom, K., Wennberg, M., Nilsson, L.M., Weiderpass, E., Kuhn, T., Katzke, V., Khaw, K.T., Wareham, N.J., Tjonneland, A., Boeing, H., Quiros, J.R., Gunter, M.J., Riboli, E., Norat, T., Romaguera, D., Ward, H., Wark, P.A., Vergnaud, A.C., Peeters, P.H.M., Gils, C.H. van, Ferrari, P., Fedirko, V., Jenab, M., Boutron-Ruault, M.C., Dossus, L., Dartois, L., Hansen, C.P., Dahm, C.C., Buckland, G., Sanchez, M.J., Dorronsoro, M., Navarro, C, Barricarte, A., Key, T.J., Trichopoulou, A., Tsironis, C., Lagiou, P., Masala, G., Pala, V., Tumino, R., Vineis, P., Panico, S., Bueno-de-Mesquita, H.B., Siersema, P.D., Ohlsson, B., Jirstrom, K., Wennberg, M., Nilsson, L.M., Weiderpass, E., Kuhn, T., Katzke, V., Khaw, K.T., Wareham, N.J., Tjonneland, A., Boeing, H., Quiros, J.R., Gunter, M.J., Riboli, E., and Norat, T.
Abstract: Contains fulltext : 152598.pdf (publisher's version ) (Open Access), BACKGROUND: Cancer survivors are advised to follow lifestyle recommendations on diet, physical activity, and body fatness proposed by the World Cancer Research Fund/American Institute of Cancer Research (WCRF/AICR) for cancer prevention. Previous studies have demonstrated that higher concordance with these recommendations measured using an index score (the WCRF/AICR score) was associated with lower cancer incidence and mortality. The aim of this study was to evaluate the association between pre-diagnostic concordance with WCRF/AICR recommendations and mortality in colorectal cancer (CRC) patients. METHODS: The association between the WCRF/AICR score (score range 0-6 in men and 0-7 in women; higher scores indicate greater concordance) assessed on average 6.4 years before diagnosis and CRC-specific (n = 872) and overall mortality (n = 1,113) was prospectively examined among 3,292 participants diagnosed with CRC in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort (mean follow-up time after diagnosis 4.2 years). Multivariable Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality. RESULTS: The HRs (95% CIs) for CRC-specific mortality among participants in the second (score range in men/women: 2.25-2.75/3.25-3.75), third (3-3.75/4-4.75), and fourth (4-6/5-7) categories of the score were 0.87 (0.72-1.06), 0.74 (0.61-0.90), and 0.70 (0.56-0.89), respectively (P for trend <0.0001), compared to participants with the lowest concordance with the recommendations (category 1 of the score: 0-2/0-3). Similar HRs for overall mortality were observed (P for trend 0.004). Meeting the recommendations on body fatness and plant food consumption were associated with improved survival among CRC cases in mutually adjusted models. CONCLUSIONS: Greater concordance with the WCRF/AICR recommendations on diet, physical activity, and body fatness prior to CRC diagnosis is associated with improved surv
Published: 2015

27. A prospective study of the immune system activation biomarker neopterin and colorectal cancer risk

Author: MS MDL 1, Cancer, Epi Kanker Team 1, JC onderzoeksprogramma Kanker, Aleksandrova, K., Chuang, S.C., Boeing, H., Zuo, Huijuan, Tell, G.S., Pischon, T., Jenab, M., Bueno-De-Mesquita, B., Vollset, S.E., Midttun, Øivind, Ueland, P.M., Fedirko, V., Johansson, M., Weiderpass, E., Severi, G., Racine, A., Boutron-Ruault, M.C., Kaaks, R., Kühn, Tilman, Tjønneland, A., Overvad, K., Quirós, José R., Jakszyn, P., Sánchez, M.-J, Dorronsoro, M., Chirlaque, M.D., Ardanaz, E., Khaw, Kay T., Wareham, Nicholas J., Travis, Ruth C., Trichopoulou, A., Lagiou, P., Trichopoulos, D., Palli, D., Sieri, S., Tumino, R., Panico, S., May, A.M., Palmqvist, R., Ljuslinder, Ingrid, Kong, S.Y.J., Freisling, H., Gunter, Marc J., Lu, Y., Cross, Amanda J., Riboli, E., Vineis, P., MS MDL 1, Cancer, Epi Kanker Team 1, JC onderzoeksprogramma Kanker, Aleksandrova, K., Chuang, S.C., Boeing, H., Zuo, Huijuan, Tell, G.S., Pischon, T., Jenab, M., Bueno-De-Mesquita, B., Vollset, S.E., Midttun, Øivind, Ueland, P.M., Fedirko, V., Johansson, M., Weiderpass, E., Severi, G., Racine, A., Boutron-Ruault, M.C., Kaaks, R., Kühn, Tilman, Tjønneland, A., Overvad, K., Quirós, José R., Jakszyn, P., Sánchez, M.-J, Dorronsoro, M., Chirlaque, M.D., Ardanaz, E., Khaw, Kay T., Wareham, Nicholas J., Travis, Ruth C., Trichopoulou, A., Lagiou, P., Trichopoulos, D., Palli, D., Sieri, S., Tumino, R., Panico, S., May, A.M., Palmqvist, R., Ljuslinder, Ingrid, Kong, S.Y.J., Freisling, H., Gunter, Marc J., Lu, Y., Cross, Amanda J., Riboli, E., and Vineis, P.
Published: 2015

28. Body iron status and gastric cancer risk in the EURGAST study

Author: Ciències Mèdiques Bàsiques, Universitat Rovira i Virgili, Fonseca-Nunes A., Agudo A., Aranda N., Arija V., Cross A.J., Molina E., Sanchez M.J., Bueno-De-Mesquita H.B., Siersema P., Weiderpass E., Krogh V., Mattiello A., Tumino R., Saieva C., Naccarati A., Ohlsson B., Sjöberg K., Boutron-Ruault M.C., Cadeau C., Fagherazzi G., Boeing H., Steffen A., Kühn T., Katzke V., Tjønneland A., Olsen A., Khaw K.T., Wareham N., Key T., Lu Y., Riboli E., Peeters P.H., Gavrila D., Dorronsoro M., Quirõs J.R., Barricarte A., Jenab M., Zamora-Ros R., Freisling H., Trichopoulou A., Fonseca-Nunes A., Agudo A., Aranda N., Ciències Mèdiques Bàsiques, Universitat Rovira i Virgili, and Fonseca-Nunes A., Agudo A., Aranda N., Arija V., Cross A.J., Molina E., Sanchez M.J., Bueno-De-Mesquita H.B., Siersema P., Weiderpass E., Krogh V., Mattiello A., Tumino R., Saieva C., Naccarati A., Ohlsson B., Sjöberg K., Boutron-Ruault M.C., Cadeau C., Fagherazzi G., Boeing H., Steffen A., Kühn T., Katzke V., Tjønneland A., Olsen A., Khaw K.T., Wareham N., Key T., Lu Y., Riboli E., Peeters P.H., Gavrila D., Dorronsoro M., Quirõs J.R., Barricarte A., Jenab M., Zamora-Ros R., Freisling H., Trichopoulou A., Fonseca-Nunes A., Agudo A., Aranda N.
Abstract: Although it appears biologically plausible for iron to be associated with gastric carcinogenesis, the evidence is insufficient to lead to any conclusions. To further investigate the relationship between body iron status and gastric cancer risk, we conducted a nested case-control study in the multicentric European Prospective Investigation into Cancer and Nutrition (EPIC) study. The study included 456 primary incident gastric adenocarcinoma cases and 900 matched controls that occurred during an average of 11 years of follow-up. We measured prediagnostic serum iron, ferritin, transferrin and C-reactive protein, and further estimated total iron-binding capacity (TIBC) and transferrin saturation (TS). Odds ratios (ORs) and 95% confidence intervals (CIs) for the risk of gastric cancer by iron metrics were estimated from multivariable conditional logistic regression models. After adjusting for relevant confounders, we observed a statistically significant inverse association between gastric cancer and ferritin and TS indices (ORlog2 ?=?0.80, 95% CI?=?0.72-0.88; OR10%increment ?=?0.87, 95% CI?=?0.78-0.97, respectively). These associations appear to be restricted to noncardia gastric cancer (ferritin showed a p for heterogeneity?=?0.04 and TS had a p for heterogeneity?=?0.02), and no differences were found by histological type. TIBC increased risk of overall gastric cancer (OR50 µg/dl ?=?1.13, 95% CI?=?1.02-1.2) and also with noncardia gastric cancer (p for heterogeneity?=?0.04). Additional analysis suggests that time between blood draw and gastric cancer diagnosis could modify these findings. In conclusion, our results showed a decreased risk of gastric cancer related to higher body iron stores as measured by serum iron and ferritin. Further investigation is needed to clarify t
Published: 2015

29. Vitamin C transporter gene (SLC23A1 and SLC23A2) polymorphisms, plasma vitamin C levels, and gastric cancer risk in the EPIC cohort

Author: Duell, E.J., Lujan-Barroso, L, Llivina, C., Muñoz, X., Jenab, M., Boutron-Ruault, M.C., Clavel-Chapelon, F., Racine, A., Boeing, H., Buijsse, B., Canzian, F., Johnson, T., Dalgård, C., Overvad, K., Tjønneland, A., Olsen, A., Sánchez, S.C., Sánchez-Cantalejo, E., Huerta, J.M., Ardanaz, E., Dorronsoro, M., Khaw, K.T., Travis, R.C., Trichopoulou, A., Trichopoulos, D., Bueno de Mesquita, H.B., Numans, M.E., Peeters, P.H.M., and et al, X
Published: 2013

30. Plasma antibodies to oral bacteria and risk of pancreatic cancer in a large European prospective cohort study

Author: Michaud, D.S. Izard, J. Wilhelm-Benartzi, C.S. You, D.-H. Grote, V.A. Tjønneland, A. Dahm, C.C. Overvad, K. Jenab, M. Fedirko, V. Boutron-Ruault, M.C. Clavel-Chapelon, F. Racine, A. Kaaks, R. Boeing, H. Foerster, J. Trichopoulou, A. Lagiou, P. Trichopoulos, D. Sacerdote, C. Sieri, S. Palli, D. Tumino, R. Panico, S. Siersema, P.D. Peeters, P.H.M. Lund, E. Barricarte, A. Huerta, J.-M. Molina-Montes, E. Dorronsoro, M. Ramón Quirós, J. Duell, E.J. Ye, W. Sund, M. Lindkvist, B. Johansen, D. Khaw, K.-T. Wareham, N. Travis, R.C. Vineis, P. Bas Bueno-De-Mesquita, H. Riboli, E.
Abstract: Objective: Examine the relationship between antibodies to 25 oral bacteria and pancreatic cancer risk in a prospective cohort study. Design We measured antibodies to oral bacteria in prediagnosis blood samples from 405 pancreatic cancer cases and 416 matched controls, nested within the European Prospective Investigation into Cancer and Nutrition study. Analyses were conducted using conditional logistic regression and additionally adjusted for smoking status and body mass index. Results: Individuals with high levels of antibodies against Porphyromonas gingivalis ATTC 53978, a pathogenic periodontal bacteria, had a twofold higher risk of pancreatic cancer than individuals with lower levels of these antibodies (OR 2.14; 95% CI 1.05 to 4.36; >200 ng/ml vs ≤200 ng/ml). To explore the association with commensal (non-pathogenic) oral bacteria, we performed a cluster analysis and identified two groups of individuals, based on their antibody profiles. A cluster with overall higher levels of antibodies had a 45% lower risk of pancreatic cancer than a cluster with overall lower levels of antibodies (OR 0.55; 95% CI 0.36 to 0.83). Conclusions: Periodontal disease might increase the risk for pancreatic cancer. Moreover, increased levels of antibodies against specific commensal oral bacteria, which can inhibit growth of pathogenic bacteria, might reduce the risk of pancreatic cancer. Studies are needed to determine whether oral bacteria have direct effects on pancreatic cancer pathogenesis or serve as markers of the immune response.
Published: 2013

31. Fruit and vegetable consumption and mortality: European prospective investigation into cancer and nutrition

Author: Leenders, M., van der Sluijs, I., Ros, M.M., Boshuizen, H.C., Siersema, P.D., Ferrari, P., Weikert, C., Tjonneland, A., Olsen, A., Boutron-Ruault, M.C., Clavel-Chapelon, F., Nailler, L., Teucher, B., Li, K.R., Boeing, H., Bergmann, M.M., Trichopoulou, A., Lagiou, P., Trichopoulos, D., Palli, D., Pala, V., Panico, S., Tumino, R., Sacerdote, C., Peeters, P.H.M., van Gils, C.H., Lund, E., Engeset, D., Redondo, M.L., Agudo, A., Sanchez, M.J., Navarro, C., Ardanaz, E., Sonestedt, E., Ericson, U., Nilsson, L.M., Khaw, K.T., Warcham, N.J., Key, T.J., Crowe, F.L., Romieu, I., Gunter, M.J., Gallo, V., Overvad, K., Riboli, E., Bueno-de-Mesquita, H.B., Leenders, M, Sluijs, I, Ros, Mm, Boshuizen, Hc, Siersema, Pd, Ferrari, P, Weikert, C, Tj?nneland, A, Olsen, A, Boutron Ruault, Mc, Clavel Chapelon, F, Nailler, L, Teucher, B, Li, K, Boeing, H, Bergmann, Mm, Trichopoulou, A, Lagiou, P, Trichopoulos, D, Palli, D, Pala, V, Panico, Salvatore, Tumino, R, Sacerdote, C, Peeters, Ph, van Gils, Ch, Lund, E, Engeset, D, Redondo, Ml, Agudo, A, S?nchez, Mj, Navarro, C, Ardanaz, E, Sonestedt, E, Ericson, U, Nilsson, Lm, Khaw, Kt, Wareham, Nj, Key, Tj, Crowe, Fl, Romieu, I, Gunter, Mj, Gallo, V, Overvad, K, Riboli, E, and Bueno de Mesquita, Hb
Subjects: Adult, Male, Nutrition and Disease, cardiovascular-disease, men, population, Diet Surveys, Wiskundige en Statistische Methoden - Biometris, Cause of Death, Neoplasms, Voeding en Ziekte, Vegetables, Humans, oxidative stress, Prospective Studies, Mathematical and Statistical Methods - Biometris, Aged, Proportional Hazards Models, risk, Molecular epidemiology Aetiology, screening and detection [NCEBP 1], dietary assessment, health, Middle Aged, PE&RC, calibration, Survival Analysis, heart-disease, Europe, Fruit, impact, Female
Abstract: In this study, the relation between fruit and vegetable consumption and mortality was investigated within the European Prospective Investigation Into Cancer and Nutrition. Survival analyses were performed, including 451,151 participants from 10 European countries, recruited between 1992 and 2000 and followed until 2010. Hazard ratios, rate advancement periods, and preventable proportions to respectively compare risk of death between quartiles of consumption, to estimate the period by which the risk of death was postponed among high consumers, and to estimate proportions of deaths that could be prevented if all participants would shift their consumption 1 quartile upward. Consumption of fruits and vegetables was inversely associated with all-cause mortality (for the highest quartile, hazard ratio = 0.90, 95% confidence interval (CI): 0.86, 0.94), with a rate advancement period of 1.12 years (95% CI: 0.70, 1.54), and with a preventable proportion of 2.95%. This association was driven mainly by cardiovascular disease mortality (for the highest quartile, hazard ratio = 0.85, 95% CI: 0.77, 0.93). Stronger inverse associations were observed for participants with high alcohol consumption or high body mass index and suggested in smokers. Inverse associations were stronger for raw than for cooked vegetable consumption. These results support the evidence that fruit and vegetable consumption is associated with a lower risk of death. In this study, the relation between fruit and vegetable consumption and mortality was investigated within the European Prospective Investigation Into Cancer and Nutrition. Survival analyses were performed, including 451,151 participants from 10 European countries, recruited between 1992 and 2000 and followed until 2010. Hazard ratios, rate advancement periods, and preventable proportions to respectively compare risk of death between quartiles of consumption, to estimate the period by which the risk of death was postponed among high consumers, and to estimate proportions of deaths that could be prevented if all participants would shift their consumption 1 quartile upward. Consumption of fruits and vegetables was inversely associated with all-cause mortality (for the highest quartile, hazard ratio = 0.90, 95% confidence interval (CI): 0.86, 0.94), with a rate advancement period of 1.12 years (95% CI: 0.70, 1.54), and with a preventable proportion of 2.95%. This association was driven mainly by cardiovascular disease mortality (for the highest quartile, hazard ratio = 0.85, 95% CI: 0.77, 0.93). Stronger inverse associations were observed for participants with high alcohol consumption or high body mass index and suggested in smokers. Inverse associations were stronger for raw than for cooked vegetable consumption. These results support the evidence that fruit and vegetable consumption is associated with a lower risk of death.
Published: 2013
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32. Fruit and vegetable intake and the risk of gastric adenocarcinoma: A reanalysis of the european prospective investigation into cancer and nutrition (EPIC-EURGAST) study after a longer follow-up

Author: Gonzalez, C.A. Lujan-Barroso, L. Bueno-De-Mesquita, H.B. Jenab, M. Duell, E.J. Agudo, A. Tjønneland, A. Boutron-Ruault, M.C. Clavel-Chapelon, F. Touillaud, M. Teucher, B. Kaaks, R. Boeing, H. Steffen, A. Trichopoulou, A. Roukos, D. Karapetyan, T. Palli, D. Tagliabue, G. Mattiello, A. Tumino, R. Ricceri, F. Siersema, P.D. Numans, M.E. Peeters, P.P.H. Parr, C.L. Skeie, G. Lund, E. Quirõs, J.R. Sánchez-Cantalejo, E. Navarro, C. Barricarte, A. Dorronsoro, M. Ehrnström, R. Regner, S. Khaw, K.-T. Wareham, N. Key, T.J. Crowe, F.L. Blaker, H. Romieu, I. Riboli, E.
Subjects: food and beverages
Abstract: In a previous European prospective investigation into cancer and nutrition (EPIC) analysis, we found an inverse association between total intake of vegetables, onion and garlic, and risk of intestinal gastric cancer (GC) and between citrus fruit and risk of cardia GC. The aim of this study is to reanalyze the effect of fruit and vegetables (F&V), based on a longer follow-up and twice the number of GC cases. Subjects are 477,312 men and women mostly aged 35 to 70 years participating in the EPIC cohort, including 683 gastric adenocarcinomas with 11 years of follow-up. Information on diet and lifestyle was collected at baseline. A calibration study in a subsample was used to correct for dietary measurement errors. When comparing the highest vs. lowest quintile of intake, we found an inverse association between total intake of V&F and GC risk [hazard ratio (HR) 0.77; 95% confidence interval (CI) 0.57-1.04; p for trend 0.02], between fresh fruit and risk of the diffuse type (HR 0.59; 95% CI 0.36-0.97; p for trend 0.03) and an inverse association between citrus fruit and risk of cardia cancer (HR 0.61; 95% CI 0.38-1.00, p for trend 0.01). Although calibration revealed somewhat stronger inverse associations, none of the risks reached statistical significance. There was no association between total or specific vegetables intake and GC risk. The inverse association between fresh fruit and citrus fruits and risk of GC seems to be restricted to smokers and the Northern European countries. Fresh fruit and citrus fruit consumption may protect against diffuse and cardia GC, respectively. Copyright © 2012 UICC.
Published: 2012

33. Sources of pre-analytical variations in yield of DNA extracted from blood samples: Analysis of 50,000 DNA samples in EPIC

Author: Caboux, E. Lallemand, C. Ferro, G. Hémon, B. Mendy, M. Biessy, C. Sims, M. Wareham, N. Britten, A. Boland, A. Hutchinson, A. Siddiq, A. Vineis, P. Riboli, E. Romieu, I. Rinaldi, S. Gunter, M.J. Peeters, P.H.M. van der Schouw, Y.T. Travis, R. Bueno-de-Mesquita, H.B. Canzian, F. Sánchez, M.-J. Skeie, G. Olsen, K.S. Lund, E. Bilbao, R. Sala, N. Barricarte, A. Palli, D. Navarro, C. Panico, S. Redondo, M.L. Polidoro, S. Dossus, L. Boutron-Ruault, M.C. Clavel-Chapelon, F. Trichopoulou, A. Trichopoulos, D. Lagiou, P. Boeing, H. Fisher, E. Tumino, R. Agnoli, C. Hainaut, P.
Abstract: The European Prospective Investigation into Cancer and nutrition (EPIC) is a long-term, multi-centric prospective study in Europe investigating the relationships between cancer and nutrition. This study has served as a basis for a number of Genome-Wide Association Studies (GWAS) and other types of genetic analyses. Over a period of 5 years, 52,256 EPIC DNA samples have been extracted using an automated DNA extraction platform. Here we have evaluated the pre-analytical factors affecting DNA yield, including anthropometric, epidemiological and technical factors such as center of subject recruitment, age, gender, body-mass index, disease case or control status, tobacco consumption, number of aliquots of buffy coat used for DNA extraction, extraction machine or procedure, DNA quantification method, degree of haemolysis and variations in the timing of sample processing. We show that the largest significant variations in DNA yield were observed with degree of haemolysis and with center of subject recruitment. Age, gender, body-mass index, cancer case or control status and tobacco consumption also significantly impacted DNA yield. Feedback from laboratories which have analyzed DNA with different SNP genotyping technologies demonstrate that the vast majority of samples (approximately 88%) performed adequately in different types of assays. To our knowledge this study is the largest to date to evaluate the sources of pre-analytical variations in DNA extracted from peripheral leucocytes. The results provide a strong evidence-based rationale for standardized recommendations on blood collection and processing protocols for large-scale genetic studies. © 2012 Caboux et al.
Published: 2012

34. Consumption of meat and dairy and lymphoma risk in the European Prospective Investigation into Cancer and Nutrition

Author: Rohrmann, S. Linseisen, J. Jakobsen, M.U. Overvad, K. Raaschou-Nielsen, O. Tjonneland, A. Boutron-Ruault, M.C. Kaaks, R. Becker, N. Bergmann, M. Boeing, H. Khaw, K.-T. Wareham, N.J. Key, T.J. Travis, R. Benetou, V. Naska, A. Trichopoulou, A. Pala, V. Tumino, R. Masala, G. Mattiello, A. Brustad, M. Lund, E. Skeie, G. Bueno-De-Mesquita, H.B. Peeters, P.H.M. Vermeulen, R.C.H. Jakszyn, P. Dorronsoro, M. Barricarte, A. Tormo, M.-J. Molina, E. Argüelles, M. Melin, B. Ericson, U. Manjer, J. Rinaldi, S. Slimani, N. Boffetta, P. Vergnaud, A.-C. Khan, A. Norat, T. Vineis, P.
Subjects: immune system diseases, hemic and lymphatic diseases
Abstract: The consumption of meat and other foods of animal origin is a risk factor for several types of cancer, but the results for lymphomas are inconclusive. Therefore, we examined these associations among 411,097 participants of the European Prospective Investigation into Cancer and Nutrition. During a median follow-up of 8.5 years, 1,334 lymphomas (1,267 non-Hodgkin lymphoma (NHL) and 67 Hodgkin lymphomas) were identified. Consumption of red and processed meat, poultry, milk and dairy products was assessed by dietary questionnaires. Cox proportional hazard regression was used to evaluate the association of the consumption of these food groups with lymphoma risk. Overall, the consumption of foods of animal origin was not associated with an increased risk of NHLS or HL, but the associations with specific subgroups of NHL entities were noted. A high intake of processed meat was associated with an increased risk of B-cell chronic lymphocytic leukemia (BCLL) [relative risk (RR) per 50 g intake = 1.31, 95% confidence interval (CI) 1.06-1.63], but a decreased risk of follicular lymphomas (FL) (RR = 0.58; CI 0.38-0.89). A high intake of poultry was related to an increased risk of B-cell lymphomas (RR = 1.22; CI 1.05-1.42 per 10 g intake), FL (RR = 1.65; CI 1.18-2.32) and BCLL (RR = 1.54; CI 1.18-2.01) in the continuous models. In conclusion, no consistent associations between red and processed meat consumption and lymphoma risk were observed, but we found that the consumption of poultry was related to an increased risk of B-cell lymphomas. Chance is a plausible explanation of the observed associations, which need to be confirmed in further studies. Copyright © 2010 UICC.
Published: 2011

35. Variation in genes coding for AMP-activated protein kinase (AMPK) and breast cancer risk in the European Prospective Investigation on Cancer (EPIC)

Author: Campa, D. Claus, R. Dostal, L. Stein, A. Chang-Claude, J. Meidtner, K. Boeing, H. Olsen, A. Tjønneland, A. Overvad, K. Rodríguez, L. Bonet, C. Sánchez, M.-J. Amiano, P. Huerta, J.M. Barricarte, A. Khaw, K.-T. Wareham, N. Travis, R.C. Allen, N.E. Trichopoulou, A. Bamia, C. Benetou, V. Palli, D. Agnoli, C. Panico, S. Tumino, R. Sacerdote, C. Van Kranen, H. Bas Bueno-De-Mesquita, H. Peeters, P.H.M. Van Gils, C.H. Lenner, P. Sund, M. Lund, E. Gram, I.T. Rinaldi, S. Chajes, V. Romieu, I. Engel, P. Boutron-Ruault, M.C. Clavel-Chapelon, F. Siddiq, A. Riboli, E. Canzian, F. Kaaks, R.
Abstract: AMP-activated protein kinase (AMPK) is an energy sensing/signalling intracellular protein which is activated by an increase in the cellular AMP:ATP ratio after ATP depletion. Once activated, AMPK inhibits fatty acid synthesis and the Akt-mTOR pathway, and activates the p53-p21 axis. All these molecular mechanisms are thought to play a key role in breast carcinogenesis. We investigated the genetic variability of four genes encoding AMPK (PRKAA1, PRKAA2, PRKAB1 and PRKAB2). Using a tagging approach and selecting SNPs we covered all the common genetic variation of these genes. We tested association of tagging SNPs in our four candidate genes with breast cancer (BC) risk in a study of 1340 BC cases and 2536 controls nested into the European Prospective Investigation into Cancer and Nutrition (EPIC). Given the relevance of AMPK on fatty acid synthesis and the importance of body fatness as a BC risk factor, we tested association of SNPs and body-mass index as well. We observed no statistically significant association between the SNPs in the PRKAs genes and BC risk and BMI after correction for multiple testing. © 2010 Springer Science+Business Media, LLC.
Published: 2011

36. Dietary β-carotene, vitamin C and e intake and breast cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Author: Nagel, G. Linseisen, J. Van Gils, C.H. Peeters, P.H. Boutron-Ruault, M.C. Clavel-Chapelon, F. Romieu, I. Tjønneland, A. Olsen, A. Roswall, N. Witt, P.M. Overvad, K. Rohrmann, S. Kaaks, R. Drogan, D. Boeing, H. Trichopoulou, A. Stratigakou, V. Zylis, D. Engeset, D. Lund, E. Skeie, G. Berrino, F. Grioni, S. Mattiello, A. Masala, G. Tumino, R. Zanetti, R. Ros, M.M. Bueno-De-Mesquita, H.B. Ardanaz, E. Sánchez, M.J. Huerta, J.M. Amiano, P. Rodríguez, L. Manjer, J. Wirfält, E. Lenner, P. Hallmans, G. Spencer, E.A. Key, T.J. Bingham, S. Khaw, K.T. Rinaldi, S. Slimani, N. Boffetta, P. Gallo, V. Norat, T. Riboli, E.
Abstract: So far, studies on dietary antioxidant intake, including β-carotene, vitamin C and vitamin E, and breast cancer risk are inconclusive. Thus, we addressed this question in the European Prospective Investigation into Cancer and Nutrition. During a median follow-up time of 8.8 years, 7,502 primary invasive breast cancer cases were identified. Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI). All analyses were run stratified by menopausal status at recruitment and, additionally, by smoking status, alcohol intake, use of exogenous hormones and use of dietary supplements. In the multivariate analyses, dietary intake of β-carotene, vitamin C and E was not associated with breast cancer risk in premenopausal [highest vs. lowest quintile: HR, 1.04 (95% CI, 0.85-1.27), 1.12 (0.92-1.36) and 1.11 (0.84-1.46), respectively] and postmenopausal women [0.93 (0.82-1.04), 0.98 (0.87-1.11) and 0.92 (0.77-1.11), respectively]. However, in postmenopausal women using exogenous hormones, high intake of β-carotene [highest vs. lowest quintile; HR 0.79 (95% CI, 0.66-0.96), P trend 0.06] and vitamin C [0.88 (0.72-1.07), P trend 0.05] was associated with reduced breast cancer risk. In addition, dietary β-carotene was associated with a decreased risk in postmenopausal women with high alcohol intake. Overall, dietary intake of β-carotene, vitamin C and E was not related to breast cancer risk in neither pre- nor postmenopausal women. However, in subgroups of postmenopausal women, a weak protective effect between β-carotene and vitamin E from food and breast cancer risk cannot be excluded. © 2009 Springer Science+Business Media, LLC.
Published: 2010

37. Adherence to the Mediterranean diet and risk of bladder cancer in the EPIC cohort study

Author: Buckland, G., Ros, M.M., Roswall, N., Bueno-De-Mesquita, H.B., Travier, N., Tjonneland, A., Kiemeney, B., Sacerdote, C., Tumino, R., Ljungberg, B, Gram, I.T., Weiderpass, E., Skeie, G., Malm, J., Ehrnstrom, R., Chang-Claude, J., Mattiello, A., Agnoli, C., Peeters, P.H.M., Boutron-Ruault, M.C., Fagherazzi, G., Clavel-Chapelon, F., Nilsson, L.M., Amiano, P., Trichopoulou, A., Oikonomou, E., Tsiotas, K., Sanchez, M.J., Overvad, K., Quiros, J.R., Chirlaque, M.D., Barricarte, A., Key, T.J., Allen, N.E., Khaw, K.T., Wareham, N., Riboli, E., Kaaks, R., Boeing, H., Palli, D., Romieu, I., Romaguera, D., Gonzalez, C.A., Buckland, G., Ros, M.M., Roswall, N., Bueno-De-Mesquita, H.B., Travier, N., Tjonneland, A., Kiemeney, B., Sacerdote, C., Tumino, R., Ljungberg, B, Gram, I.T., Weiderpass, E., Skeie, G., Malm, J., Ehrnstrom, R., Chang-Claude, J., Mattiello, A., Agnoli, C., Peeters, P.H.M., Boutron-Ruault, M.C., Fagherazzi, G., Clavel-Chapelon, F., Nilsson, L.M., Amiano, P., Trichopoulou, A., Oikonomou, E., Tsiotas, K., Sanchez, M.J., Overvad, K., Quiros, J.R., Chirlaque, M.D., Barricarte, A., Key, T.J., Allen, N.E., Khaw, K.T., Wareham, N., Riboli, E., Kaaks, R., Boeing, H., Palli, D., Romieu, I., Romaguera, D., and Gonzalez, C.A.
Abstract: Item does not contain fulltext, There is growing evidence of the protective role of the Mediterranean diet (MD) on cancer. However, to date no epidemiological study has investigated the influence of the MD on bladder cancer. We evaluated the association between adherence to the MD and risk of urothelial cell bladder cancer (UCC), according to tumor aggressiveness, in the European Prospective Investigation into Cancer and Nutrition (EPIC). The analysis included 477,312 participants, recruited from ten European countries between 1991 and 2000. Information from validated dietary questionnaires was used to develop a relative Mediterranean diet score (rMED), including nine dietary components. Cox regression models were used to assess the effect of the rMED on UCC risk, while adjusting for dietary energy and tobacco smoking of any kind. Stratified analyses were performed by sex, BMI, smoking status, European region and age at diagnosis. During an average follow-up of 11 years, 1,425 participants (70.9% male) were diagnosed with a first primary UCC. There was a negative but non-significant association between a high versus low rMED score and risk of UCC overall (HR: 0.84 [95% CI 0.69, 1.03]) and risk of aggressive (HR: 0.88 [95% CI 0.61, 1.28]) and non-aggressive tumors (HR: 0.78 [95% CI 0.54, 1.14]). Although there was no effect modification in the stratified analyses, there was a significant 34% (p = 0.043) decreased risk of UCC in current smokers with a high rMED score. In EPIC, the MD was not significantly associated with risk of UCC, although we cannot exclude that a MD may reduce risk in current smokers.
Published: 2014

38. Plasma and dietary carotenoids and vitamins A, C and E and risk of colon and rectal cancer in the European Prospective Investigation into Cancer and Nutrition

Author: Leenders, M., Leufkens, A.M., Siersema, P.D., Duijnhoven, F.J.B. van, Vrieling, A., Hulshof, P.J., Gils, C.H. van, Overvad, K., Roswall, N., Kyro, C., Boutron-Ruault, M.C., Fagerhazzi, G., Cadeau, C., Kuhn, T., Johnson, T., Boeing, H., Aleksandrova, K., Trichopoulou, A., Klinaki, E., Androulidaki, A., Palli, D., Grioni, S., Sacerdote, C., Tumino, R., Panico, S., Bakker, M.F., Skeie, G., Weiderpass, E., Jakszyn, P., Barricarte, A., Huerta, J. Maria, Molina-Montes, E., Arguelles, M., Johansson, I., Ljuslinder, I., Key, T.J., Bradbury, K.E., Khaw, K.T., Wareham, N.J., Ferrari, P., Duarte-Salles, T., Jenab, M., Gunter, M.J., Vergnaud, A.C., Wark, P.A., Bueno-De-Mesquita, H.B., Leenders, M., Leufkens, A.M., Siersema, P.D., Duijnhoven, F.J.B. van, Vrieling, A., Hulshof, P.J., Gils, C.H. van, Overvad, K., Roswall, N., Kyro, C., Boutron-Ruault, M.C., Fagerhazzi, G., Cadeau, C., Kuhn, T., Johnson, T., Boeing, H., Aleksandrova, K., Trichopoulou, A., Klinaki, E., Androulidaki, A., Palli, D., Grioni, S., Sacerdote, C., Tumino, R., Panico, S., Bakker, M.F., Skeie, G., Weiderpass, E., Jakszyn, P., Barricarte, A., Huerta, J. Maria, Molina-Montes, E., Arguelles, M., Johansson, I., Ljuslinder, I., Key, T.J., Bradbury, K.E., Khaw, K.T., Wareham, N.J., Ferrari, P., Duarte-Salles, T., Jenab, M., Gunter, M.J., Vergnaud, A.C., Wark, P.A., and Bueno-De-Mesquita, H.B.
Abstract: Item does not contain fulltext, Carotenoids and vitamins A, C and E are possibly associated with a reduced colorectal cancer (CRC) risk through antioxidative properties. The association of prediagnostic plasma concentrations and dietary consumption of carotenoids and vitamins A, C and E with the risk of colon and rectal cancer was examined in this case-control study, nested within the European Prospective Investigation into Cancer and Nutrition study. Plasma concentrations of carotenoids (alpha- and beta-carotene, canthaxanthin, beta-cryptoxanthin, lutein, lycopene, zeaxanthin) and vitamins A (retinol), C and E (alpha-, beta- and gamma- and delta-tocopherol) and dietary consumption of beta-carotene and vitamins A, C and E were determined in 898 colon cancer cases, 501 rectal cancer cases and 1,399 matched controls. Multivariable conditional logistic regression models were performed to estimate incidence rate ratios (IRR) and corresponding 95% confidence intervals (CIs). An association was observed between higher prediagnostic plasma retinol concentration and a lower risk of colon cancer (IRR for highest quartile = 0.63, 95% CI: 0.46, 0.87, p for trend = 0.01), most notably proximal colon cancer (IRR for highest quartile = 0.46, 95% CI: 0.27, 0.77, p for trend = 0.01). Additionally, inverse associations for dietary beta-carotene and dietary vitamins C and E with (distal) colon cancer were observed. Although other associations were suggested, there seems little evidence for a role of these selected compounds in preventing CRC through their antioxidative properties.
Published: 2014

39. Lifetime and baseline alcohol intake and risk of cancer of the upper aero-digestive tract in the European prospective investigation into cancer and nutrition (EPIC) study

Author: Weikert, C. Dietrich, T. Boeing, H. Bergmann, M.M. Boutron-Ruault, M.C. Clavel-Chapelon, F. Allen, N. Key, T. Lund, E. Olsen, A. Tjønneland, A. Overvad, K. Rohrmann, S. Linseisen, J. Pischon, T. Trichopoulou, A. Weinehall, L. Johansson, I. Sánchez, M.-J. Agudo, A. Barricarte, A. Amiano, P. Chirlaque, M.-D. Quirós, J.R. Wirfalt, E. Peeters, P.H. Bueno-de-Mesquita, H.B. Vrieling, A. Pala, V. Palli, D. Vineis, P. Tumino, R. Panico, S. Bingham, S. Khaw, K.-T. Norat, T. Jenab, M. Ferrari, P. Slimani, N. Riboli, E.
Abstract: Recent alcohol consumption is an established risk factor for squamous cell carcinoma (SCC) of the upper aero-digestive tract. In contrast, the role of lifetime exposure to alcohol with regard to risk of SCC is not well established. Historical data on alcohol use are available in 271,253 participants of the European Prospective Investigation into Cancer and Nutrition (EPIC). During 2,330,381 person years, 392 incident SCC cases (279 men and 113 women) were identified. Cox regression was applied to model sex-specific associations between lifetime alcohol intake and SCC risk adjusting for potential confounders including smoking. Compared to men who drank 0.1-6.0 g/day alcohol at lifetime, the relative risks (RR) for developing SCC were significantly increased for men who drank 30.1-60.0 g/day (RR 1.65, 95% confidence interval: 1.00-2.71), 60.1-96.0 g/day (RR 2.20, 95%CI 1.23-3.95), and >96.0 g/day, (RR 4.63, 95% CI 2.52-8.48), and for former drinkers (RR 4.14, 95%CI 2.38-7.19). These risk estimates did not considerably change when baseline alcohol intake was analyzed. Compared to women who drank 0.1-6.0 g/day alcohol intake at lifetime, the RR were significantly increased for women who drank >30 g/d (RR 6.05, 95%CI 2.98-12.3). Applying similar categories, the relative risk for baseline alcohol intake was 3.26 (95%CI 1.82-5.87). We observed a stronger association between alcohol intake at lifetime and risk of SCC in women compared to men (p for interaction 5 0.045). The strong dose-response relation for lifetime alcohol use underscores that alcohol is an important risk factor of SCC of the upper aero-digestive tract throughout life. © 2009 UICC.
Published: 2009

40. A cross-sectional analysis of physical activity and obesity indicators in European participants of the EPIC-PANACEA study

Author: Besson, H. Ekelund, U. Luan, J. May, A.M. Sharp, S. Travier, N. Agudo, A. Slimani, N. Rinaldi, S. Jenab, M. Norat, T. Mouw, T. Rohrmann, S. Kaaks, R. Bergmann, M. Boeing, H. Clavel-Chapelon, F. Boutron-Ruault, M.C. Overvad, K. Andreasen, E.L. Johnsen, N.F. Halkjaer, J. Gonzalez, C. Rodriguez, L. Sanchez, M.J. Arriola, L. Barricarte, A. Navarro, C. Key, T.J. Spencer, E.A. Orfanos, P. Naska, A. Trichopoulou, A. Manjer, J. Wirfält, E. Lund, E. Palli, D. Agnoli, C. Vineis, P. Panico, S. Tumino, R. Bueno-De-Mesquita, H.B. Van Den Berg, S.W. Odysseos, A.D. Riboli, E. Wareham, N.J. Peeters, P.H.
Abstract: Objectives: Cross-sectional data suggest a strong association between low levels of physical activity and obesity. The EPIC-PANACEA (European Prospective Investigation into Cancer-Physical Activity, Nutrition, Alcohol, Cessation of Smoking, Eating out of home And obesity) project was designed to investigate the associations between physical activity and body mass index (BMI) and waist circumference based on individual data collected across nine European countries. Methods: In the European Prospective Investigation into Cancer and Nutrition (EPIC), 519 931 volunteers were recruited between 1992 and 2000, of whom 405 819 had data on main variables of interest. Height, body weight and waist circumference were measured using standardized procedures. Physical activity was assessed using a validated four-category index reflecting a self-reported usual activity during work and leisure time. The associations between physical activity and BMI and waist circumference were estimated using multilevel mixed effects linear regression models, adjusted for age, total energy intake, smoking status, alcohol consumption and educational level. Results: A total of 125 629 men and 280 190 women with a mean age of 52.9 (s.d. 9.7) and 51.5 (s.d. 10.0) years, respectively were included. The mean BMI was 26.6 kg/m 2 (s.d. 3.6) in men and 25.0 kg/m 2 (s.d. 4.5) in women. Fifty percent of men and 30% of women were categorized as being active or moderately active. A one-category difference in the physical activity index was inversely associated with a difference of 0.18 kg/m 2 in the mean BMI (95% confidence interval, CI, 0.11, 0.24) and 1.04-cm (95% CI 0.82, 1.26) difference in waist circumference in men. The equivalent figures for women were 0.31 kg/m 2 (95% CI 0.23, 0.38) and 0.90 cm (95% CI 0.71, 1.08), respectively. Conclusions: Physical activity is inversely associated with both BMI and waist circumference across nine European countries. Although we cannot interpret the association causally, our results were observed in a large and diverse cohort independently from many potential confounders. © 2009 Macmillan Publishers Limited. All rights reserved.
Published: 2009

41. Specific food group combinations explaining the variation in intakes of nutrients and other important food components in the european prospective investigation into cancer and nutrition: An application of the reduced rank regression method

Author: Kröger, J. Ferrari, P. Jenab, M. Bamia, C. Touvier, M. Bueno-De-Mesquita, H.B. Fahey, M.T. Benetou, V. Schulz, M. Wirfält, E. Boeing, H. Hoffmann, K. Schulze, M.B. Orfanos, P. Oikonomou, E. Huybrechts, I. Rohrmann, S. Pischon, T. Manjer, J. Agren, A. Navarro, C. Jakszyn, P. Boutron-Ruault, M.C. Niravong, M. Khaw, K.T. Crowe, F. Ocké, M.C. Van Der Schouw, Y.T. Mattiello, A. Bellegotti, M. Engeset, D. Hjartåker, A. Egeberg, R. Overvad, K. Riboli, E. Bingham, S. Slimani, N.
Abstract: Objective:To identify combinations of food groups that explain as much variation in absolute intakes of 23 key nutrients and food components as possible within the country-specific populations of the European Prospective Investigation into Cancer and Nutrition (EPIC).Subjects/Methods:The analysis covered single 24-h dietary recalls (24-HDR) from 36 034 subjects (13 025 men and 23 009 women), aged 35–74 years, from all 10 countries participating in the EPIC study. In a set of 39 food groups, reduced rank regression (RRR) was used to identify those combinations (RRR factors) that explain the largest proportion of variation in intake of 23 key nutrients and food components, namely, proteins, saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids, cholesterol, sugars (sum of mono- and disaccharides), starch, fibre, alcohol, calcium, iron, potassium, phosphorus, magnesium, vitamin D, β-carotene, retinol and vitamins E, B1, B2, B6, B12 and C (RRR responses). Analyses were performed at the country level and for all countries combined. Results: In the country-specific analyses, the first RRR factor explained a considerable proportion of the total nutrient intake variation in all 10 countries (27.4–37.1%). The subsequent RRR factors were much less important in explaining the variation (⩽6%). Strong similarities were observed for the first country-specific RRR factor between the individual countries, largely characterized by consumption of bread, vegetable oils, red meat, milk, cheese, potatoes, margarine and processed meat. The highest explained variation was seen for protein, potassium, phosphorus and magnesium (50–70%), whereas sugars, β-carotene, retinol and alcohol were only marginally explained (⩽5%). The explained proportion of the other nutrients ranged between these extremes.Conclusions:A combination of food groups was identified that explained a considerable proportion of the nutrient intake variation in 24-HDRs in every country-specific EPIC population in a similar manner. This indicates that, despite the large variability in food and nutrient intakes reported in the EPIC, the variance of intake of important nutrients is explained, to a large extent, by similar food group combinations across countries. © 2009 Macmillan Publishers Limited. All rights reserved.
Published: 2009

42. Dietary patterns and survival of older Europeans: The EPIC-Elderly Study (European Prospective Investigation into Cancer and Nutrition)

Author: Bamia, C. Trichopoulos, D. Ferrari, P. Overvad, K. Bjerregaard, L. Tjønneland, A. Halkjær, J. Clavel-Chapelon, F. Kesse, E. Boutron-Ruault, M.C. Boffetta, P. Nagel, G. Linseisen, J. Boeing, H. Hoffmann, K. Kasapa, C. Orfanou, A. Travezea, C. Slimani, N. Norat, T. Palli, D. Pala, V. Panico, S. Tumino, R. Sacerdote, C. Bueno-de-Mesquita, H.B. Waijers, P.M.C.M. Peeters, P.H.M. Van Der Schouw, Y.T. Berenguer, A. Martinez-Garcia, C. Navarro, C. Barricarte, A. Dorronsoro, M. Berglund, G. Wirfält, E. Johansson, I. Johansson, G. Bingham, S. Khaw, K.-T. Spencer, E.A. Key, T. Riboli, E. Trichopoulou, A.
Abstract: Objective: To investigate the association of a posteriori dietary patterns with overall survival of older Europeans. Design and setting: This is a multi-centre cohort study. Cox regression analysis was used to investigate the association of the prevailing, a posteriori-derived, plant-based dietary pattern with all-cause mortality in a population of subjects who were 60 years or older at recruitment to the European Prospective Investigation into Cancer and Nutrition (EPIC-Elderly cohort). Analyses controlled for all known potential risk factors. Subjects: In total, 74 607 men and women, 60 years or older at enrolment and without previous coronary heart disease, stroke or cancer, with complete information about dietary intakes and potentially confounding variables, and with known survival status as of December 2003, were included in the analysis. Results: An increase in the score which measures the adherence to the plant-based diet was associated with a lower overall mortality, a one standard deviation increment corresponding to a statistically significant reduction of 14% (95% confidence interval 5-23%). In country-specific analyses the apparent association was stronger in Greece, Spain, Denmark and The Netherlands, and absent in the UK and Germany. Conclusions: Greater adherence to the plant-based diet that was defined a posteriori in this population of European elders is associated with lower all-cause mortality. This dietary score is moderately positively correlated with the Modified Mediterranean Diet Score that has been constructed a priori and was also shown to be beneficial for the survival of the same EPIC-Elderly cohort. © 2007 The Authors.
Published: 2007

43. Diet, serum insulin-like growth factor-I and IGF-binding protein-3 in European women

Author: Norat, T. Dossus, L. Rinaldi, S. Overvad, K. Grønbæk, H. Tjønneland, A. Olsen, A. Clavel-Chapelon, F. Boutron-Ruault, M.C. Boeing, H. Lahmann, P.H. Linseisen, J. Nagel, G. Trichopoulou, A. Trichopoulos, D. Kalapothaki, V. Sieri, S. Palli, D. Panico, S. Tumino, R. Sacerdote, C. Bueno-de-Mesquita, H.B. Peeters, P.H.M. van Gils, C.H. Agudo, A. Amiano, P. Ardanoz, E. Martinez, C. Quirós, R. Tormo, M.J. Bingham, S. Key, T.J. Allen, N.E. Ferrari, P. Slimani, N. Riboli, E. Kaaks, R.
Abstract: Objective: The aim of this study was to examine the relationship of diet with serum insulin-like growth factor-I (IGF-I) and IGF-binding protein-3 in women. Design: Cross-sectional study. Setting and subjects: The population are 2109 women who were control subjects in a case-control study of breast cancer nested in the European Prospective Investigation into Cancer and Nutrition. Control subjects were randomly chosen among risk sets consisting of female cohort members alive and free of cancer (except non-melanoma skin cancer) at the time of diagnosis of the index case. Matching criteria were age at enrolment, follow-up time, time of the day of blood collection and study centre. Diet was measured through validated questionnaires. Serum hormone concentrations were measured by enzyme-linked immunosorbent assays. The relationship between serum IGF-I, IGFBP-3, and intake of nutrients and foods was explored by linear regression in models adjusted for energy intake, age, body mass index, smoking, physical activity, centre and laboratory batch. Results: Serum IGF-I levels were positively related to protein intake (Ptrend < 0.001), but not related to energy, fat or carbohydrate intake. Positive relationships were observed with the intake of milk (Ptrend = 0.007), calcium (Ptrend < 0.001), magnesium (Ptrend = 0.003), phosphorus (Ptrend < 0.001), potassium (Ptrend = 0.002), vitamin B6 (Ptrend = 0.03), vitamin B2 (Ptrend = 0.001) and inverse relationships with vegetables (Ptrend = 0.02) and beta-carotene (Ptrend = 0.02). IGFBP-3 was not related with most of the nutrients and foods in this study. Conclusions: In this population, circulating IGF-I is modestly related with the intake of protein and minerals, and with milk and cheese, while IGFBP-3 does not appear to be related with diet.
Published: 2007

44. Consumption and portion sizes of tree nuts, peanuts and seeds in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohorts from 10 European countries

Author: Jenab, M. Sabaté, J. Slimani, N. Ferrari, P. Mazuir, M. Casagrande, C. Deharveng, G. Tjønneland, A. Olsen, A. Overvad, K. Boutron-Ruault, M.C. Clavel-Chapelon, F. Boeing, H. Weikert, C. Linseisen, J. Rohrmann, S. Trichopoulou, A. Naska, A. Palli, D. Sacerdote, C. Tumino, R. Mattiello, A. Pala, V. Bueno-De-Mesquita, H.B. Ocké, M.C. Peeters, P.H. Engeset, D. Skeie, G. Jakszyn, P. Ardanaz, E. Quirós, J.R. Chirlaque, M.D. Martinez, C. Amiano, P. Berglund, G. Palmqvist, R. Van Guelpen, B. Bingham, S. Key, T. Riboli, E.
Subjects: food and beverages
Abstract: Tree nuts, peanuts and seeds are nutrient dense foods whose intake has been shown to be associated with reduced risk of some chronic diseases. They are regularly consumed in European diets either as whole, in spreads or from hidden sources (e.g. commercial products). However, little is known about their intake profiles or differences in consumption between European countries or geographic regions. The objective of this study was to analyse the population mean intake and average portion sizes in subjects reporting intake of nuts and seeds consumed as whole, derived from hidden sources or from spreads. Data was obtained from standardised 24-hour dietary recalls collected from 36 994 subjects in 10 different countries that are part of the European Prospective Investigation into Cancer and Nutrition (EPIC). Overall, for nuts and seeds consumed as whole, the percentage of subjects reporting intake on the day of the recall was: tree nuts = 4· 4%, peanuts = 2·3% and seeds = 1·3%. The data show a clear northern (Sweden: mean intake = 0·15 g/d, average portion size = 15·1 g/d) to southern (Spain: mean intake = 2·99 g/d, average portion size = 34·7 g/d) European gradient of whole tree nut intake. The three most popular tree nuts were walnuts, almonds and hazelnuts, respectively. In general, tree nuts were more widely consumed than peanuts or seeds. In subjects reporting intake, men consumed a significantly higher average portion size of tree nuts (28·5 v. 23·1 g/d, P,0·01) and peanuts (46·1 v. 35·1 g/d, P,0·01) per day than women. These data may be useful in devising research initiatives and health policy strategies based on the intake of this food group. © The Authors 2006.
Published: 2006

45. Relationship of alcohol intake and sex steroid concentrations in blood in pre- and post-menopausal women: The European Prospective Investigation into Cancer and Nutrition

Author: Rinaldi, S. Peeters, P.H.M. Bezemer, I.D. Dossus, L. Biessy, C. Sacerdote, C. Berrino, F. Panico, S. Palli, D. Tumino, R. Khaw, K.T. Bingham, S. Allen, N.E. Key, T. Jensen, M.K. Overvad, K. Olsen, A. Tjonneland, A. Amiano, P. Ardanaz, E. Agudo, A. Martinez-García, C. Quirós, J.R. Tormo, M.J. Nagel, G. Linseisen, J. Boeing, H. Schulz, M. Grobbee, D.E. Bueno-De-Mesquita, H.B. Koliva, M. Kyriazi, G. Thrichopoulou, A. Boutron-Ruault, M.C. Clavel-Chapelon, F. Ferrari, P. Slimani, N. Saracci, R. Riboli, E. Kaaks, R.
Abstract: Objective: Women with a moderate intake of alcohol have higher concentrations of sex steroids in serum, and higher risk of developing breast cancer, compared to non-drinkers. In the present study, we investigate the relationships between alcohol consumption and serum levels of sex steroids and sex-hormone binding globulin (SHBG) in 790 pre- and 1,291 post-menopausal women, who were part of the European Prospective Investigation into Cancer and Nutrition (EPIC). Methods: Serum levels of testosterone (T), androstenedione (Δ4), dehydroepiandrosterone sulphate (DHEAS), estrone (E 1), estradiol (E2) and SHBG were measured by direct immunoassays. Free T (fT) and free E2 (fE2) were calculated according to mass action laws. Current alcohol intake exposure to alcohol was assessed from dietary questionnaires. Results: Pre-menopausal women who consumed more than 25 g/day of alcohol had about 30% higher DHEAS, T and fT, 20% higher Δ4 and about 40% higher E1, concentrations compared to women who were non-consumers. E2, fE 2 and SHBG concentrations showed no association with current alcohol intake. In post-menopausal women, DHEAS, fT, T, Δ4, and E 1 concentrations were between 10% and 20% higher in women who consumed more than 25 g/day of alcohol compared to non-consumers. E2 or fE2 were not associated with alcohol intake at all. SHBG levels were about 15% lower in alcohol consumers compared to non-consumers. Conclusion: This study supports the hypothesis of an influence of alcohol intake on sex hormone concentrations in blood. © Springer Science+Business Media B.V. 2006.
Published: 2006

46. Intake of fruits and vegetables and risk of cancer of the upper aero-digestive tract: The prospective EPIC-study

Author: Boeing, H. Dietrich, T. Hoffmann, K. Pischon, T. Ferrari, P. Lahmann, P.H. Boutron-Ruault, M.C. Clavel-Chapelon, F. Allen, N. Key, T. Skeie, G. Lund, E. Olsen, A. Tjonneland, A. Overvad, K. Jensen, M.K. Rohrmann, S. Linseisen, J. Trichopoulou, A. Bamia, C. Psaltopoulou, T. Weinehall, L. Johansson, I. Sánchez, M.-J. Jakszyn, P. Ardanaz, E. Amiano, P. Chirlaque, M.D. Quirós, J.R. Wirfalt, E. Berglund, G. Peeters, P.H. Van Gils, C.H. Bueno-De-Mesquita, H.B. Büchner, F.L. Berrino, F. Palli, D. Sacerdote, C. Tumino, R. Panico, S. Bingham, S. Khaw, K.-T. Slimani, N. Norat, T. Jenab, M. Riboli, E.
Abstract: Epidemiologic studies suggest that a high intake of fruits and vegetables is associated with decreased risk of cancers of the upper aero-digestive tract. We studied data from 345,904 subjects of the prospective European Investigation into Cancer and Nutrition (EPIC) recruited in seven European countries, who had completed a dietary questionnaire in 1992-1998. During 2,182,560 person years of observation 352 histologically verified incident squamous cell cancer (SCC) cases (255 males; 97 females) of the oral cavity, pharynx, larynx, and esophagus were identified. Linear and restricted cubic spline Cox regressions were fitted on variables of intake of fruits and vegetables and adjusted for potential confounders. We observed a significant inverse association with combined total fruits and vegetables intake (estimated relative risk (RR) = 0.91; 95% confidence interval (95% CI) 0.83-1.00 per 80 g/d of consumption), and nearly significant inverse associations in separate analyses with total fruits and total vegetables intake (RR: 0.97 (95% CI: 0.92-1.02) and RR = 0.89 (95% CI: 0.78-1.02) per 40 g/d of consumption). Overall, vegetable subgroups were not related to risk with the exception of intake of root vegetables in men. Restricted cubic spline regression did not improve the linear model fits except for total fruits and vegetables and total fruits with a significant decrease in risk at low intake levels (
Published: 2006

47. Macronutrient intake and risk of urothelial cell carcinoma in the European prospective investigation into cancer and nutrition

Author: Allen, N.E., Appleby, P.N., Key, T.J., Bueno-De-Mesquita, H.B., Ros, M.M., Kiemeney, L.A.L.M., Tjonneland, A., Roswall, N., Overvad, K., Weikert, S., Boeing, H., Chang-Claude, J., Teucher, B., Panico, S., Sacerdote, C., Tumino, R., Palli, D., Sieri, S., Peeters, P., Quiros, J.R., Jakszyn, P., Molina-Montes, E., Chirlaque, M.D., Ardanaz, E., Dorronsoro, M., Khaw, K.T., Wareham, N., Ljungberg, B, Hallmans, G., Ehrnstrom, R., Ericson, U., Gram, I.T., Parr, C.L., Trichopoulou, A., Karapetyan, T., Dilis, V., Clavel-Chapelon, F., Boutron-Ruault, M.C., Fagherrazzi, G., Romieu, I., Gunter, M.J., Riboli, E., Allen, N.E., Appleby, P.N., Key, T.J., Bueno-De-Mesquita, H.B., Ros, M.M., Kiemeney, L.A.L.M., Tjonneland, A., Roswall, N., Overvad, K., Weikert, S., Boeing, H., Chang-Claude, J., Teucher, B., Panico, S., Sacerdote, C., Tumino, R., Palli, D., Sieri, S., Peeters, P., Quiros, J.R., Jakszyn, P., Molina-Montes, E., Chirlaque, M.D., Ardanaz, E., Dorronsoro, M., Khaw, K.T., Wareham, N., Ljungberg, B, Hallmans, G., Ehrnstrom, R., Ericson, U., Gram, I.T., Parr, C.L., Trichopoulou, A., Karapetyan, T., Dilis, V., Clavel-Chapelon, F., Boutron-Ruault, M.C., Fagherrazzi, G., Romieu, I., Gunter, M.J., and Riboli, E.
Abstract: Item does not contain fulltext, Previous studies have suggested that dietary factors may be important in the development of bladder cancer. We examined macronutrient intake in relation to risk of urothelial cell carcinoma among 469,339 men and women in the European Prospective Investigation into Cancer and Nutrition. Associations were examined using Cox regression, stratified by sex, age at recruitment and centre and further adjusted for smoking status and duration, body mass index and total energy intake. After an average of 11.3 years of follow-up, 1,416 new cases of urothelial cell carcinoma were identified. After allowing for measurement error, a 3% increase in the consumption of energy intake from animal protein was associated with a 15% higher risk (95% confidence interval [CI]: 3-30%; p(trend) = 0.01) and a 2% increase in energy from plant protein intake was associated with a 23% lower risk (95% CI: 36-7%, p(trend) = 0.006). Dietary intake of fat, carbohydrate, fibre or calcium was not associated with risk. These findings suggest that animal and/or plant protein may affect the risk of urothelial cell carcinoma, and examination of these associations in other studies is needed.
Published: 2013

48. North-south gradients in plasma concentrations of B-vitamins and other components of one-carbon metabolism in Western Europe: results from the European Prospective Investigation into Cancer and Nutrition (EPIC) Study

Author: Eussen, S.J., Nilsen, R.M., Midttun, O., Hustad, S., N, I.J., Meyer, K., Fredriksen, A., Ulvik, A., Ueland, P.M., Brennan, P., Johansson, M., Bueno-de-Mesquita, B., Vineis, P., Chuang, S.C., Boutron-Ruault, M.C., Dossus, L., Perquier, F., Overvad, K., Teucher, B., Grote, V.A., Trichopoulou, A., Adarakis, G., Plada, M., Sieri, S., Tumino, R., Magistris, M.S. de, Ros, M.M., Peeters, P.H.M., Redondo, M.L., Zamora-Ros, R., Chirlaque, M.D., Ardanaz, E., Sonestedt, E., Ericson, U., Schneede, J., Guelpen, B. van, Wark, P.A., Gallo, V., Norat, T., Riboli, E., Vollset, S.E., Eussen, S.J., Nilsen, R.M., Midttun, O., Hustad, S., N, I.J., Meyer, K., Fredriksen, A., Ulvik, A., Ueland, P.M., Brennan, P., Johansson, M., Bueno-de-Mesquita, B., Vineis, P., Chuang, S.C., Boutron-Ruault, M.C., Dossus, L., Perquier, F., Overvad, K., Teucher, B., Grote, V.A., Trichopoulou, A., Adarakis, G., Plada, M., Sieri, S., Tumino, R., Magistris, M.S. de, Ros, M.M., Peeters, P.H.M., Redondo, M.L., Zamora-Ros, R., Chirlaque, M.D., Ardanaz, E., Sonestedt, E., Ericson, U., Schneede, J., Guelpen, B. van, Wark, P.A., Gallo, V., Norat, T., Riboli, E., and Vollset, S.E.
Abstract: Item does not contain fulltext, Different lifestyle patterns across Europe may influence plasma concentrations of B-vitamins and one-carbon metabolites and their relation to chronic disease. Comparison of published data on one-carbon metabolites in Western European regions is difficult due to differences in sampling procedures and analytical methods between studies. The present study aimed, to compare plasma concentrations of one-carbon metabolites in Western European regions with one laboratory performing all biochemical analyses. We performed the present study in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort among 5446 presumptively healthy individuals. Quantile regression was used to compare sex-specific median concentrations between Northern (Denmark and Sweden), Central (France, Germany, The Netherlands and United Kingdom) and Southern (Greece, Spain and Italy) European regions. The lowest folate concentrations were observed in Northern Europe (men, 10.4 nmol/l; women, 10.7 nmol/l) and highest concentrations in Central Europe. Cobalamin concentrations were slightly higher in Northern Europe (men, 330 pmol/l; women, 352 pmol/l) compared with Central and Southern Europe, but did not show a clear north-south gradient. Vitamin B(2) concentrations were highest in Northern Europe (men, 22.2 nmol/l; women, 26.0 nmol/l) and decreased towards Southern Europe (P trend< 0.001). Vitamin B(6) concentrations were highest in Central Europe in men (77.3 nmol/l) and highest in the North among women (70.4 nmol/l), with decreasing concentrations towards Southern Europe in women (P trend< 0.001). In men, concentrations of serine, glycine and sarcosine increased from the north to south. In women, sarcosine increased from Northern to Southern Europe. These findings may provide relevant information for the study of regional differences of chronic disease incidence in association with lifestyle.
Published: 2013

49. Vitamin C transporter gene (SLC23A1 and SLC23A2) polymorphisms, plasma vitamin C levels, and gastric cancer risk in the EPIC cohort

Author: JC onderzoeksprogramma Kanker, JC Overig onderzoek, Other research (not in main researchprogram), Cancer, MS MDL 1, General Practice & Nursing Science, Epidemiology & Health Economics, Duell, E.J., Lujan-Barroso, L, Llivina, C., Muñoz, X., Jenab, M., Boutron-Ruault, M.C., Clavel-Chapelon, F., Racine, A., Boeing, H., Buijsse, B., Canzian, F., Johnson, T., Dalgård, C., Overvad, K., Tjønneland, A., Olsen, A., Sánchez, S.C., Sánchez-Cantalejo, E., Huerta, J.M., Ardanaz, E., Dorronsoro, M., Khaw, K.T., Travis, R.C., Trichopoulou, A., Trichopoulos, D., Bueno de Mesquita, H.B., Numans, M.E., Peeters, P.H.M., et al, X, JC onderzoeksprogramma Kanker, JC Overig onderzoek, Other research (not in main researchprogram), Cancer, MS MDL 1, General Practice & Nursing Science, Epidemiology & Health Economics, Duell, E.J., Lujan-Barroso, L, Llivina, C., Muñoz, X., Jenab, M., Boutron-Ruault, M.C., Clavel-Chapelon, F., Racine, A., Boeing, H., Buijsse, B., Canzian, F., Johnson, T., Dalgård, C., Overvad, K., Tjønneland, A., Olsen, A., Sánchez, S.C., Sánchez-Cantalejo, E., Huerta, J.M., Ardanaz, E., Dorronsoro, M., Khaw, K.T., Travis, R.C., Trichopoulou, A., Trichopoulos, D., Bueno de Mesquita, H.B., Numans, M.E., Peeters, P.H.M., and et al, X
Published: 2013

50. Nort-South gradients in plasma concentrations of B-vitamins and other components of one-carbon metabolism in Western Europe: results from the European Prospective Investigation into Cancer and Nutrition (EPIC) Study

Author: Eussen, S.J.P.M., Nilsen, R.M., Midttun, O., Hustad, S., IJssenagger, N., Meyer, K., Fredriksen, A., Ulvik, A., Ueland, P.M., Brennan, P., Johansson, M., Bueno-de-Mesquita, B., Vineis, P., Chuang, S.C., Boutron-Ruault, M.C., Dossus, L., Perquier, F., Overvad, K., Teucher, B., Grote, V.A., Trichopoulou, A., Adarakis, G., Plada, M., Sieri, S., Tumino, R., Santucci de Magistris, M., Ros, M.M., Peeters, P.H.M., Redondo, M.L., Zamora-Ros, R., Chirlaque, M.D., Ardanaz, E., Sonestedt, E., Ericson, U., Schneede, J., Guelpen, B., Wark, P.A., Gallo, V., Norat, T., Riboli, E., Vollset, S.E., Eussen, S.J.P.M., Nilsen, R.M., Midttun, O., Hustad, S., IJssenagger, N., Meyer, K., Fredriksen, A., Ulvik, A., Ueland, P.M., Brennan, P., Johansson, M., Bueno-de-Mesquita, B., Vineis, P., Chuang, S.C., Boutron-Ruault, M.C., Dossus, L., Perquier, F., Overvad, K., Teucher, B., Grote, V.A., Trichopoulou, A., Adarakis, G., Plada, M., Sieri, S., Tumino, R., Santucci de Magistris, M., Ros, M.M., Peeters, P.H.M., Redondo, M.L., Zamora-Ros, R., Chirlaque, M.D., Ardanaz, E., Sonestedt, E., Ericson, U., Schneede, J., Guelpen, B., Wark, P.A., Gallo, V., Norat, T., Riboli, E., and Vollset, S.E.
Abstract: Different lifestyle patterns across Europe may influence plasma concentrations of B-vitamins and one-carbon metabolites and their relation to chronic disease. Comparison of published data on one-carbon metabolites in Western European regions is difficult due to differences in sampling procedures and analytical methods between studies. The present study aimed, to compare plasma concentrations of one-carbon metabolites in Western European regions with one laboratory performing all biochemical analyses. We performed the present study in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort among 5446 presumptively healthy individuals. Quantile regression was used to compare sex-specific median concentrations between Northern (Denmark and Sweden), Central (France, Germany, The Netherlands and United Kingdom) and Southern (Greece, Spain and Italy) European regions. The lowest folate concentrations were observed in Northern Europe (men, 10·4 nmol/l; women, 10·7 nmol/l) and highest concentrations in Central Europe. Cobalamin concentrations were slightly higher in Northern Europe (men, 330 pmol/l; women, 352 pmol/l) compared with Central and Southern Europe, but did not show a clear north–south gradient. Vitamin B2 concentrations were highest in Northern Europe (men, 22·2 nmol/l; women, 26·0 nmol/l) and decreased towards Southern Europe (P trend <0·001). Vitamin B6 concentrations were highest in Central Europe in men (77·3 nmol/l) and highest in the North among women (70·4 nmol/l), with decreasing concentrations towards Southern Europe in women (P trend <0·001). In men, concentrations of serine, glycine and sarcosine increased from the north to south. In women, sarcosine increased from Northern to Southern Europe. These findings may provide relevant information for the study of regional differences of chronic disease incidence in association with lifestyle.
Published: 2013

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