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1. 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

2. 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, Harinakshi, Dik, Vincent K, Siersema, Peter D, Bhoo Pathy, Nirmala, Uiterwaal, Cuno S. P. M, Peeters, Petra H. M, González, Carlos A, Zamora Ros, Raul, Overvad, Kim, Tjønneland, Anne, Roswall, Nina, Boutron Ruault, Marie Christine, Fagherazzi, Guy, Racine, Antoine, Kühn, Tilman, Katzke, Verena, Boeing, Heiner, Trichopoulou, Antonia, Trichopoulos, Dimitrio, Lagiou, Pagona, Palli, Domenico, Grioni, Sara, Vineis, Paolo, Tumino, Rosario, Panico, Salvatore, Weiderpass, Elisabete, Skeie, Guri, Braaten, Tonje, Huerta, José María, Sánchez Cantalejo, Emilio, Barricarte, Aurelio, Sonestedt, Emily, Wallstrom, Peter, Nilsson, Lena Maria, Johansson, Ingegerd, Bradbury, Kathryn E, Khaw, Kay Tee, Wareham, Nick, Huybrechts, Inge, Freisling, Heinz, Cross, Amanda J, Riboli, Elio, and Bueno de Mesquita, H. B.

Subjects
Adult, Male, Risk, tea, coffee, UNITED-STATES, Other Research Radboud Institute for Molecular Life Sciences [Radboudumc 0], ALCOHOL, Cohort Studies, HELICOBACTER-PYLORI, Stomach Neoplasms, Stomach Neoplasm, Caffeine, Humans, Prospective Studies, METAANALYSIS, Proportional Hazards Models, decaffeinated coffee, gastric cancer, CONSUMPTION, ADENOCARCINOMA, European Prospective Investigation into Cancer and Nutrition, Middle Aged, BLACK TEA, caffeinated coffee, Prospective Studie, STOMACH-CANCER, Proportional Hazards Model, ESOPHAGUS, Female, SMOKING, Cohort Studie, Human
Abstract

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. What's New? Can drinking coffee or tea lead to cancer? Can they protect against cancer? These popular drinks certainly contain antioxidants, but despite many investigations into the question, we still have no clear answer. A new study has plied the data from the European Prospective Investigation into Cancer and Nutrition (EPIC) in search of a link. Participants self-reported their coffee and tea consumption by questionnaire. The authors found no link between drinking tea or coffee - with or without caffeine - and overall risk of gastric cancer; they did discern a slight increase in gastric cardia cancer with consumption of caffeinated coffee.

Published
2015

3. 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

4. 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, Am, Siersema, Pd, van Duijnhoven, Fj, Vrieling, A, Hulshof, Pj, van Gils, Ch, Overvad, K, Roswall, N, Kyr?, C, Boutron Ruault, Mc, Fagerhazzi, G, Cadeau, C, K?hn, T, Johnson, T, Boeing, H, Aleksandrova, K, Trichopoulou, A, Klinaki, E, Androulidaki, A, Palli, D, Grioni, S, Sacerdote, C, Tumino, R, Panico, Salvatore, Bakker, Mf, Skeie, G, Weiderpass, E, Jakszyn, P, Barricarte, A, Mar?a Huerta, J, Molina Montes, E, Arg?elles, M, Johansson, I, Ljuslinder, I, Key, Tj, Bradbury, Ke, Khaw, Kt, Wareham, Nj, Ferrari, P, Duarte Salles, T, Jenab, M, Gunter, Mj, Vergnaud, Ac, Wark, Pa, Bueno de Mesquita, Hb, LS IRAS EEPI GRA (Gezh.risico-analyse), IRAS RATIA2, and Risk Assessment of Toxic and Immunomodulatory Agents

Subjects
Adult, Male, Ascorbic Acid, Antioxidants, Fruits and vegetables, Body Mass Index, Risk Factors, Surveys and Questionnaires, Odds Ratio, Humans, Vitamin E, Vitamin A, Aged, Rectal Neoplasms, Incidence, Vitamins, Middle Aged, Colorectal cancer, Carotenoids, Diet, Europe, Oxidative Stress, Urological cancers Radboud Institute for Health Sciences [Radboudumc 15], Case-Control Studies, Colonic Neoplasms, Multivariate Analysis, Female
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

5. 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

6. Alcohol attributable burden of incidence of cancer in eight European countries based on results from prospective cohort study

Author

Antonio Agudo, Carla H. van Gils, Naomi E. Allen, Miren Dorronsoro, Tobias Pischon, Christina C. Dahm, Antonia Trichopoulou, Madlen Schütze, Sabine Rohrmann, Tara Kehoe, Nadia Slimani, Nicholas J. Wareham, Aurelio Barricarte, Paolo Boffetta, Kim Overvad, Rudolf Kaaks, Petra H.M. Peeters, María José Sánchez, Jürgen Rehm, Anja Olsen, Gerrit Gmel, Laudina Rodríguez, Manuela M. Bergmann, Françoise Clavel-Chapelon, Heiner Boeing, Franco Berrino, Petra A. Wark, Mazda Jenab, Elio Riboli, María Dolores Chirlaque, Vasiliki Benetou, Anne Tjønneland, Dora Romaguera, Kay-Tee Khaw, Rosario Tumino, Paolo Vineis, Marie-Christine Boutron-Ruault, Dimosthenis Zylis, Domenico Palli, Timothy J. Key, Schütze, M., Boeing, H., Pischon, T., Rehm, J., Kehoe, T., Gmel, G., Olsen, A., Tjønneland, A.M., Dahm, C.C., Overvad, K., Clavel-Chapelon, F., Boutron-Ruault, M.C., Trichopoulou, A., Benetou, V., Zylis, D., Kaaks, R., Rohrmann, S., Palli, D., Berrino, F., Tumino, R., Vineis, P., Rodríguez, L., Agudo, A., Sánchez, M.J., Dorronsoro, M., Chirlaque, M.D., Barricarte, A., Peeters, P.H., van Gils, C.H., Khaw, K.T., Wareham, N., Allen, N.E., Key, T.J., Boffetta, P., Slimani, N., Jenab, M., Romaguera, D., Wark, P.A., Riboli, E., Bergmann, M.M., [Schuetze,M, Boeing,H, Pischon,T, Bergmann,MM.] German Inst Human Nutr Potsdam Rehbrucke, Dept Epidemiol, Nuthetal, Germany. [Rehm,J, Kehoe,T, Gmel,G] CAMH, Toronto, ON, Canada. [Rehm, J] Tech Univ Dresden, Inst Clin Psychol & Psychotherapy, Dresden, Germany. [Olsen,A, Tjonneland,AM.] Danish Canc Soc, Inst Canc Epidemiol, Copenhagen, Denmark. [Dahm,CC] Aarhus Univ Hosp, Dept Clin Epidemiol, Aalborg, Denmark. [Overvad,K] Aarhus Univ, Sch Publ Hlth, Dept Epidemiol, Aarhus, Denmark. [Clavel-Chapelon,F, Boutron-Ruault,M-C] Inst Gustave Roussy, Ctr Res Epidemiol & Populat Hlth,Villejuif, France. [Clavel-Chapelon,F, Boutron-Ruault,MC] Paris S Univ, UMRS 1018, Villejuif, France. [Trichopoulou, A, Benetou,V, Zylis,D] Univ Athens, Sch Med, Dept Hyg Epidemiol & Med Stat, WHO Collaborating Ctr Food & Nutr Policies, Athens, Greece. [Kaaks,R, Rohrmann,S] German Canc Res Ctr, Div Canc Epidemiol, Heidelberg, Germany. [Palli,D] Canc Res & Prevent Inst, Mol & Nutr Epidemiol Unit, Florence, Italy. [Berrino, Franco] Fdn IRCCS Ist Nazl Tumori, Dept Prevent & Predict Med, Epidemiol Unit, Milan, Italy. [Tumino,R] Civile MP Arezzo Hosp, Canc Registry, Ragusa, Italy. [Vineis, Paolo] Inst Sci Interchange Fdn, Turin, Italy. [Rodriguez,L] Hlth & Hlth Care Serv Council, Publ Hlth & Participat Directorate, Asturias, Spain. [Tumino,R] Civile MP Arezzo Hosp, Histopathol Unit, Ragusa, Italy. [Agudo,A] Catalan Inst Oncol IDIBELL, Canc Epidemiol Res Programme, Unit Nutr Environm & Canc, Barcelona, Spain. [Sanchez,MJ] Andalusian Sch Publ Hlth, Granada, Spain. [Sanchez,MJ, Dorronsoro,M, Chirlaque,MD, Barricarte,A] CIBERESP, San Sebastian, Spain. [Dorronsoro, Miren] Publ Hlth Dept Gipuzkoa, San Sebastian, Spain. [Chirlaque,MD] Murcia Reg Hlth Council, Dept Epidemiol, Murcia, Spain. [Peeters,PH., van Gils,CH.] Univ Med Ctr, Ctr Hlth Sci & Primary Care, Utrecht, Netherlands. [Khaw,K_T] Univ Cambridge, Dept Publ Hlth & Primary Care, Cambridge, England. [Wareham,N] MRC, Epidemiol Unit, Cambridge, England. [Allen,NE., Key,TJ.] Univ Oxford, Nuffield Dept Clin Med, Canc Epidemiol Unit, England. [Boffetta, P, Slimani,N, Jenab,M] Int Agcy Res Canc, Lyon, France. [Boffetta,P] Mt Sinai Sch Med, Tisch Canc Inst, New York, NY USA. [Vineis,P, Romaguera,D, Wark,PA., Riboli,E] Univ London Imperial Coll Sci Technol & Med, Sch Publ Hlth, Dept Epidemiol & Biostat, London, England., The work was performed (partly) within the coordinated action EPIC (SP23-CT-2005-006438), which has received research funding from the Community’s Sixth Framework Programme, as well as by the 'Europe Against Cancer' Programme of the European Commission (SANCO), Deutsche Krebshilfe, German Cancer Research Center, German Federal Ministry of Education and Research, Danish Cancer Society, Health Research Fund (FIS) of the Spanish Ministry of Health (grant No: Network RCESP C03/09), Spanish Regional Governments of Andalucia, Asturias, Basque Country, Murcia and Navarra, ISCIII, Red de Centros RETIC(RD06/0020) (grant No: C03/09), Cancer Research UK, Medical Research Council, UK, Stroke Association, UK, British Heart Foundation, Department of Health, UK, Food Standards Agency, UK, Wellcome Trust, UK, Italian Association for Research on Cancer (AIRC), Compagnia di San Paolo, Progetto Integrato Oncologia-PIO, Regione Toscana, Dutch Ministry of Public Health, Welfare and Sports, National Cancer Registry of the Netherlands, Greek Ministry of Health and Social Solidarity, and Hellenic Health Foundation and Stavros Niarchos Foundation

Subjects
Male, Alcohol drinking, Alcohol use disorder, burden, 0302 clinical medicine, Breast cancer, Cost of Illness, Neoplasms, Medicine, Prospective Studies, 030212 general & internal medicine, Prospective cohort study, Health Education, General Environmental Science, Colon Cancer, Incidence (epidemiology), Hazard ratio, General Engineering, General Medicine, cohort, Middle Aged, Diseases::Neoplasms [Medical Subject Headings], Consumo de bebidas alcohólicas, 3. Good health, European Prospective Investigation into Cancer and Nutrition, Colon cancer, Europe, Oncology, 030220 oncology & carcinogenesis, Female, Incidencia, Alcohol, Cohort study, Adult, medicine.medical_specialty, Alcohol Drinking, Health Promotion, 03 medical and health sciences, Health Care::Environment and Public Health::Public Health::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies [Medical Subject Headings], Breast Cancer, Humans, cancer, Sex Distribution, Aged, Health Care::Health Care Facilities, Manpower, and Services::Health Services::Preventive Health Services::Health Education [Medical Subject Headings], business.industry, Research, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques [Medical Subject Headings], prospective, medicine.disease, Surgery, Epidemiologic Studies, Cardiovascular and Metabolic Diseases, Relative risk, attributable, Attributable risk, Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Drinking Behavior::Alcohol Drinking [Medical Subject Headings], incidence, General Earth and Planetary Sciences, Health Care::Environment and Public Health::Public Health::Epidemiologic Methods::Data Collection::Vital Statistics::Morbidity::Incidence [Medical Subject Headings], business, Quantitative research, Demography
Abstract

Objective To compute the burden of cancer attributable to current and former alcohol consumption in eight European countries based on direct relative risk estimates from a cohort study. Design Combination of prospective cohort study with representative population based data on alcohol exposure. Setting Eight countries (France, Italy, Spain, United Kingdom, the Netherlands, Greece, Germany, Denmark) participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Participants 109 118 men and 254 870 women, mainly aged 37-70. Main outcome measures Hazard rate ratios expressing the relative risk of cancer incidence for former and current alcohol consumption among EPIC participants. Hazard rate ratios combined with representative information on alcohol consumption to calculate alcohol attributable fractions of causally related cancers by country and sex. Partial alcohol attributable fractions for consumption higher than the recommended upper limit (two drinks a day for men with about 24 g alcohol, one for women with about 12 g alcohol) and the estimated total annual number of cases of alcohol attributable cancer. Results If we assume causality, among men and women, 10% (95% confidence interval 7 to 13%) and 3% (1 to 5%) of the incidence of total cancer was attributable to former and current alcohol consumption in the selected European countries. For selected cancers the figures were 44% (31 to 56%) and 25% (5 to 46%) for upper aerodigestive tract, 33% (11 to 54%) and 18% (−3 to 38%) for liver, 17% (10 to 25%) and 4% (−1 to 10%) for colorectal cancer for men and women, respectively, and 5.0% (2 to 8%) for female breast cancer. A substantial part of the alcohol attributable fraction in 2008 was associated with alcohol consumption higher than the recommended upper limit: 33 037 of 178 578 alcohol related cancer cases in men and 17 470 of 397 043 alcohol related cases in women. Conclusions In western Europe, an important proportion of cases of cancer can be attributable to alcohol consumption, especially consumption higher than the recommended upper limits. These data support current political efforts to reduce or to abstain from alcohol consumption to reduce the incidence of cancer.

Published
2011

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

Author

Kay-Tee Khaw, Petra H.M. Peeters, Aurelio Barricarte, Esther Molina, Nikolaus Becker, Androniki Naska, Miren Dorronsoro, Vassiliki Benetou, Jonas Manjer, Nadia Slimani, Valeria Pala, Guri Skeie, Ulrika Ericson, Ruth C. Travis, Magritt Brustad, Kim Overvad, Rosario Tumino, Nicholas J. Wareham, Ole Raaschou-Nielsen, Beatrice Melin, Jakob Linseisen, Aneire E. Khan, Paolo Vineis, Giovanna Masala, Paolo Boffetta, Eiliv Lund, H. Bas Bueno-de-Mesquita, Antonia Trichopoulou, Teresa Norat, Heiner Boeing, Anne-Claire Vergnaud, Roel Vermeulen, Sabina Rinaldi, Rudolf Kaaks, Paula Jakszyn, Amalia Mattiello, Marianne Uhre Jakobsen, Marie-Christine Boutron-Ruault, Anne Tjønneland, María José Tormo, Timothy J. Key, Manuela M. Bergmann, Sabine Rohrmann, Marcial Argüelles, University of Zurich, Rohrmann, S, 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., and Vineis, P.

Subjects
Male, Oncology, medicine.medical_specialty, Cancer Research, Lymphoma, B-Cell, Consumption, lymphoma, 610 Medicine & health, Lymphoma, T-Cell, Risk Assessment, Cohort Studies, Food group, meat, Cheese, immune system diseases, Internal medicine, hemic and lymphatic diseases, lymhomas, meat consumption, dairy consumption, cohort study, Humans, Medicine, 1306 Cancer Research, ddc:610, Risk factor, risk, business.industry, Lymphoma, Non-Hodgkin, Cancer, 10060 Epidemiology, Biostatistics and Prevention Institute (EBPI), European Prospective Investigation into Cancer and Nutrition, Yogurt, medicine.disease, Lymphoma, Europe, Relative risk, Immunology, dairy, Female, 2730 Oncology, Dairy Products, Waldenstrom Macroglobulinemia, business, Risk assessment, Cohort study
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
2010

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

Author

Christina Kasapa, Emmanuelle Kesse, Elisabet Wirfält, Domenico Palli, Salvatore Panico, J. Linseisen, Paolo Boffetta, Pietro Ferrari, Kim Overvad, Carmen Martinez-Garcia, Miren Dorronsoro, Göran Berglund, H. Bas Bueno-de-Mesquita, Nadia Slimani, Aurelio Barricarte, Marie-Christine Boutron-Ruault, Carlotta Sacerdote, Yvonne T. van der Schouw, Chrysoula Travezea, Christina Bamia, Teresa Norat, Elizabeth A Spencer, Sheila Bingham, Timothy J. Key, Françoise Clavel-Chapelon, Jytte Halkjær, Valeria Pala, Anastasia Orfanou, Lone Jeppesen Bjerregaard, Elio Riboli, Antonia Trichopoulou, Patricia M C M Waijers, Petra H.M. Peeters, Dimitrios Trichopoulos, Rosario Tumino, Ingegerd Johansson, Gerd Johansson, Kurt Hoffmann, Gabriele Nagel, Anne Tjønneland, Heiner Boeing, Kay-Tee Khaw, Antonio Berenguer, Carmen Navarro, Bamia, C, Trichopoulos, D, Ferrari, P, Overvad, K, Bjerregaard, L, Tjonneland, A, Halkjaer, J, CLAVEL CHAPELON, F, Kesse, E, BOUTRON RUAULT, Mc, 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, Salvatore, Tumino, R, Sacerdote, C, BUENO DE MESQUITA, Hb, Waijers, Pm, Peeters, Ph, VAN DER SCHOUW, Yt, Berenguer, A, MARTINEZ GARCIA, C, Navarro, C, Barricarte, A, Dorronsoro, M, Berglund, G, Wirfalt, E, Johansson, I, Johansson, G, Bingham, S, Khaw, Kt, Spencer, Ea, Key, T, Riboli, E, Trichopoulou, A., 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., and Riboli, E.

Subjects
Gerontology, Male, Mediterranean diet, Population, Longevity, Medicine (miscellaneous), Diet, Mediterranean, Cohort Studies, Cause of Death, Vegetables, Medicine, Humans, Prospective Studies, ddc:610, Prospective cohort study, education, Survival analysis, Aged, Proportional Hazards Models, Dietary patterns survival older EPIC-Elderly Study European Prospective Investigation Cancer Nutrition, Aged, 80 and over, education.field_of_study, Nutrition and Dietetics, business.industry, Proportional hazards model, Public Health, Environmental and Occupational Health, Middle Aged, Survival Analysis, European Prospective Investigation into Cancer and Nutrition, Diet, Europe, Cohort, Female, business, Demography, Cohort study
Abstract

ObjectiveTo investigate the association of a posteriori dietary patterns with overall survival of older Europeans.Design and settingThis 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.SubjectsIn 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.ResultsAn 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.ConclusionsGreater 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.

Published
2007

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