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BACKGROUND: Stroke risk is modifiable through many risk factors, one being healthy dietary habits. Fibre intake was associated with a reduced stroke risk in recent meta-analyses; however, data were contributed by relatively few studies, and few examined different stroke types. METHODS: A total of 27 373 disease-free women were followed up for 14.4 years. Diet was assessed with a 217-item food frequency questionnaire and stroke cases were identified using English Hospital Episode Statistics and mortality records. Survival analysis was applied to assess the risk of total, ischaemic or haemorrhagic stroke in relation to fibre intake. RESULTS: A total of 135 haemorrhagic and 184 ischaemic stroke cases were identified in addition to 138 cases where the stroke type was unknown or not recorded. Greater intake of total fibre, higher fibre density and greater soluble fibre, insoluble fibre and fibre from cereals were associated with a significantly lower risk for total stroke. For total stroke, the hazard ratio per 6 g/day total fibre intake was 0.89 (95% confidence intervals: 0.81-0.99). Different findings were observed for haemorrhagic and ischaemic stroke in healthy-weight or overweight women. Total fibre, insoluble fibre and cereal fibre were inversely associated with haemorrhagic stroke risk in overweight/obese participants, and in healthy-weight women greater cereal fibre was associated with a lower ischaemic stroke risk. In non-hypertensive women, higher fibre density was associated with lower ischaemic stroke risk. CONCLUSIONS: Greater total fibre and fibre from cereals are associated with a lower stroke risk, and associations were more consistent with ischaemic stroke. The different observations by stroke type, body mass index group or hypertensive status indicates potentially different mechanisms. European Journal of Clinical Nutrition (2015) 69, 467-474; doi: 10.1038/ejcn.2014.260; published online 3 December 2014, INTRODUCTION Across Europe, using the latest available records for each country, there are estimated to be over 200 000 premature stroke deaths (under 75 years) in men and around 160 [...]

BACKGROUND/OBJECTIVES: In spite of several studies relating dietary patterns to breast cancer risk, evidence so far remains inconsistent. This study aimed to investigate associations of dietary patterns derived with three different methods with breast cancer risk. SUBJECTS/METHODS: The Mediterranean Diet Score (MDS), principal components analyses (PCA) and reduced rank regression (RRR) were used to derive dietary patterns in a case-control study of 610 breast cancer cases and 1891 matched controls within four UK cohort studies. Dietary intakes were collected prospectively using 4- to 7-day food diaries and resulting food consumption data were grouped into 42 food groups. Conditional logistic regression models were used to estimate odds ratios (ORs) for associations between pattern scores and breast cancer risk adjusting for relevant covariates. A separate model was fitted for post- menopausal women only. RESULTS: The MDS was not associated with breast cancer risk (OR comparing first tertile with third 1.20 (95% CI 0.92;1.56)), nor the first PCA-derived dietary pattern, explaining 2.7% of variation of diet and characterized by cheese, crisps and savoury snacks, legumes, nuts and seeds (OR 1.18 (95% CI 0.91; 1.53)). The first RRR-derived pattern, a 'high-alcohol' pattern, was associated with a higher risk of breast cancer (OR 1.27;95% CI 1.00;1.62), which was most pronounced in post-menopausal women (OR 1.46 (95% CI 1.08;1.98)). CONCLUSIONS: A 'high-alcohol' dietary pattern derived with RRR was associated with an increased breast cancer risk;no evidence of associations of other dietary patterns with breast cancer risk was observed in this study. European Journal of Clinical Nutrition (2014) 68, 1353-1358; doi: 10.1038/ejcn.2014.135; published online 23 July 2014, INTRODUCTION Diet could play a role in the on-going rise of breast cancer incidence, (1,2) but to what extent is still unclear. Individual dietary risk factors have been studied in [...]

BACKGROUND/OBJECTIVES: To determine whether general dietary supplement use is associated with cancer risk in UK women and to estimate risks related to use at one and two recording points. SUBJECTS/METHODS: Cox's proportional hazard regression models were used to estimate cancer risks for 32 665 middle-aged women in the UK Women's Cohort Study relating to any current supplement use recorded in a baseline questionnaire. During a median follow-up of 15 years, there were 3936 registered cancer incidences, including 1344 breast, 429 smoking-related and 362 colorectal cancers. Cancer risks for 12 948 of these women, who also completed questionnaires on average 4.4 years later, were estimated in relation to any supplement use at both time points (1527 cancers, including 561 breast, 131 smoking-related and 141 colorectal cancers). Adjustments were made for baseline confounders. RESULTS: Total smoking-related cancers were associated with baseline supplement use (hazard ratio (HR) = 1.41, 95% confidence interval (CI): 1.10, 1.81) compared with non-use, but not associated with use at both recording points (HR = 1.29;95% CI: 0.78, 2.13) compared with use at neither. There was no evidence of the associations between total, colorectal or breast cancers and baseline supplement use, or use at both recording points. In sub-analyses, no significant associations with breast cancer were found for premenopausal or postmenopausal baseline users, or similarly for use at both points (HR = 1.35, 95% CI: 0.91, 2.01; and HR = 0.93, 95% CI: 0.68, 1.26, respectively). CONCLUSIONS: There was evidence that general supplement use was associated with increased smoking-related cancer risk, but there was no evidence of associations with total, colorectal and breast cancers. European Journal of Clinical Nutrition (2014) 68, 1095-1100; doi: 10.1038/ejcn.2014.85; published online 7 May 2014, INTRODUCTION A large proportion of UK women take supplements; 41% of women in the 2008/9 National Diet and Nutrition Survey reported using supplements in the previous year. (1) Some women [...]

Background/Objectives: Vitamin C intake has been inversely associated with breast cancer risk in case-control studies, but not in meta-analyses of cohort studies using Food Frequency Questionnaires, which can over-report fruit and vegetable intake, the main source of vitamin C. This is the first study to investigate associations between vitamin C intake and breast cancer risk using food diaries. Subjects/Methods: Estimated dietary vitamin C intake was derived from 4-7 day food diaries pooled from five prospective studies in the UK Dietary Cohort Consortium. This nested case--control study of 707 incident breast cancer cases and 2144 matched controls examined breast cancer risk in relation to dietary vitamin C intake using conditional logistic regression adjusting for relevant covariates. Additionally, total vitamin C intake from supplements and diet was analysed in three cohorts. Results: No evidence of associations was observed between breast cancer risk and vitamin C intake analysed for dietary vitamin C intake (odds ratios (OR) = 0.98 per 60 mg/day, 95% confidence interval (CI): 0.88-1.09, [P.sub.trend] = 0.7), dietary vitamin C density (OR = 0.97 per 60 mg/day, 95% CI: 0.87-1.07, [P.sub.trend] = 0.5) or total vitamin C intake (OR = 1.01 per 60 mg/day, 95% CI: 0.99-1.03, [P.sub.trend] = 0.3). Additionally, there was no significant association for post-menopausal women (OR = 1.02 per 60 mg/day, 95% CI: 0.99-1.05, [P.sub.trend] = 0.3). Conclusions: This pooled analysis of individual UK women found no evidence of significant associations between breast cancer incidence and dietary or total vitamin C intake derived uniquely from detailed diary recordings. European Journal of Clinical Nutrition (2012) 66, 561-568; doi: 10.1038/ejcn.2011.197; published online 30 November 2011 Keywords: breast cancer; vitamin C; cohort studies; food diaries, Introduction In the UK a woman's cumulative risk of being diagnosed with breast cancer is 6% by the age of 65, and 11% over a lifetime (Office for National Statistics, [...]

Background/Objective: To assess the risk of developing breast cancer associated with consumption of two common dietary patterns: a Mediterranean dietary pattern and a dietary pattern, which conforms to the World Health Organization Healthy Diet Index (WHO HDI). Subjects/Methods: Dietary data from a 217-item food frequency questionnaire were used to generate two dietary patterns according to pre-defined criteria in women from the UK Women's Cohort Study. Survival analysis using Cox regression was used to estimate hazards ratios for risk of breast cancer adjusted for known confounders. Results: This analysis included 828 incident cases of breast cancer in 33 731 women with a mean follow-up of 9 years. There were no statistically significant associations between either the Mediterranean dietary pattern or the WHO HDI and risk of breast cancer. In premenopausal women, there was a nonsignificant trend suggesting that increasing compliance with the Mediterranean diet was associated with lower risk of breast cancer. Maximal adherence to the Mediterranean diet was associated with hazards ratio = 0.65 (95% confidence interval: 0.42-1.02, P trend = 0.09) compared with minimal adherence. In postmenopausal women, no clear trends were observed. Conclusions: In this study, no strong association between the risk of breast cancer and the consumption of either a Mediterranean-type diet or one characterized by adherence to the WHO HDI was observed. In premenopausal, but not postmenopausal women, there was a nonsignificant inverse association with increasing adherence to the Mediterranean diet pattern. European Journal of Clinical Nutrition (2011) 65, 920-928; doi: 10.1038/ejcn.2011.69; published online 18 May 2011 Keywords: dietary pattern; breast cancer; cohort; Mediterranean, Introduction Exploration of dietary patterns may be a helpful addition to the traditional approach to studying diet and breast cancer, which has focused on single foods and nutrients (Hu, 2002). [...]