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BACKGROUND: Associations of body shape with breast cancer risk, independent of body size, are unclear because waist and hip circumferences are correlated strongly positively with body mass index (BMI).METHODS: We evaluated body shape with the allometric "a body shape index" (ABSI) and hip index (HI), which compare waist and hip circumferences, correspondingly, among individuals with the same weight and height. We examined associations of ABSI, HI, and BMI (per one standard deviation increment) with breast cancer overall, and according to menopausal status at baseline, age at diagnosis, and oestrogen and progesterone receptor status (ER+/-PR+/-) in multivariable Cox proportional hazards models using data from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort.RESULTS: During a mean follow-up of 14.0 years, 9011 incident breast cancers were diagnosed among 218,276 women. Although there was little evidence for association of ABSI with breast cancer overall (hazard ratio HR = 0.984; 95% confidence interval: 0.961-1.007), we found borderline inverse associations for post-menopausal women (HR = 0.971; 0.942-1.000; n = 5268 cases) and breast cancers diagnosed at age ≥ 55 years (HR = 0.976; 0.951-1.002; n = 7043) and clear inverse associations for ER + PR- subtypes (HR = 0.894; 0.822-0.971; n = 726) and ER-PR- subtypes (HR = 0.906; 0.835-0.983 n = 759). There were no material associations with HI. BMI was associated strongly positively with breast cancer overall (HR = 1.074; 1.049-1.098), for post-menopausal women (HR = 1.117; 1.085-1.150), for cancers diagnosed at age ≥ 55 years (HR = 1.104; 1.076-1.132), and for ER + PR + subtypes (HR = 1.122; 1.080-1.165; n = 3101), but not for PR- subtypes.CONCLUSIONS: In the EPIC cohort, abdominal obesity evaluated with ABSI was not associated with breast cancer risk overall but was associated inversely with the risk of post-menopausal PR- breast cancer. Our findings require validation in other cohorts and with a larger number of PR- breast cancer cases.

BACKGROUND: The Mediterranean diet has been associated with lower risk of breast cancer (BC) but evidence from prospective studies on the role of Mediterranean diet on BC survival remains sparse and conflicting. We aimed to investigate whether adherence to Mediterranean diet prior to diagnosis is associated with overall and BC-specific mortality. METHODS: A total of 13,270 incident breast cancer cases were identified from an initial sample of 318,686 women in 9 countries from the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Adherence to Mediterranean diet was estimated through the adapted relative Mediterranean diet (arMED), a 16-point score that includes 8 key components of the Mediterranean diet and excludes alcohol. The degree of adherence to arMED was classified as low (score 0-5), medium (score 6-8), and high (score 9-16). Multivariable Cox proportional hazards models were used to analyze the association between the arMED score and overall mortality, and Fine-Gray competing risks models were applied for BC-specific mortality. RESULTS: After a mean follow-up of 8.6 years from diagnosis, 2340 women died, including 1475 from breast cancer. Among all BC survivors, low compared to medium adherence to arMED score was associated with a 13% higher risk of all-cause mortality (HR 1.13, 95%CI 1.01-1.26). High compared to medium adherence to arMED showed a non-statistically significant association (HR 0.94; 95% CI 0.84-1.05). With no statistically significant departures from linearity, on a continuous scale, a 3-unit increase in the arMED score was associated with an 8% reduced risk of overall mortality (HR3-unit 0.92, 95% CI: 0.87-0.97). This result sustained when restricted to postmenopausal women and was stronger among metastatic BC cases (HR3-unit 0.81, 95% CI: 0.72-0.91). CONCLUSIONS: Consuming a Mediterranean diet before BC diagnosis may improve long-term prognosis, particularly after menopause and in cases of metastatic breast cancer. Well-designed dietary interventions are needed to confirm these findings and define specific dietary recommendations.

Background: We explored if fatigue influenced the long-term functional capacity of patients post COVID-19. Methods: People after COVID -19, grouped by treatment setting (home - H, hospital ward - HW or intensive care unit – ICU), were studied 12 months after discharge. Fatigue-Functional Chronic Illness Assessment Questionnaire Fatigue Subscale, FACIT-F and functional capacity-6min walk test, 6MWD and 1min sit-to-stand test, 1minSTS were assessed. Groups were compared with one-way ANOVA or Kruskal-Wallis H test. Spearman’s ρ and multiple regression analyses were performed between fatigue-functional tests. Results: 148 subjects (H, n=44; HW, n=60; ICU, n=44) participated. Fatigue was clinically relevant at 12 months although not significantly different among groups [H: 41(35-49); HW: 42(33-50); ICU; 42(32-48) points; p=.979). Functional capacity was significantly higher in those treated at home (6MWD: H,626 114m, HW: 527 146m, ICU: 528 129m, p

Background: Current epidemiologic evidence indicates that smoking is associated with a lower endometrial cancer risk. However, it is unknown if this association is causal or confounded. To further elucidate the role of smoking in endometrial cancer risk, we conducted complementary observational and Mendelian randomization (MR) analyses. Methods: The observational analyses included 286,415 participants enrolled in the European Prospective Investigation into Cancer and Nutrition and 179,271 participants in the UK Biobank, and multivariable Cox proportional hazards models were used. In twosampleMR analyses, genetic variants robustly associated with lifetime amount of smoking (n ¼ 126 variants) and ever having smoked regularly (n ¼ 112 variants) were selected and their association with endometrial cancer risk (12,906 cancer/108,979 controls from the Endometrial Cancer Association Consortium) was examined. Results: In the observational analysis, lifetime amount of smoking and ever having smoked regularly were associated with a lower endometrial cancer risk. In the MR analysis accounting for body mass index, a genetic predisposition to a higher lifetime amount of smoking was not associated with endometrial cancer risk (OR per 1-SD increment: 1.15; 95% confidence interval: 0.91–1.44). Genetic predisposition to ever having smoked regularly was not associated with risk of endometrial cancer. Conclusions: Smoking was inversely associated with endometrial cancer in the observational analyses, although unsupported by the MR. Additional studies are required to better understand the possible confounders and mechanisms underlying the observed associations between smoking and endometrial cancer. Impact: The results from this analysis indicate that smoking is unlikely to be causally linked with endometrial cancer risk., World Health Organization, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, NIHR Imperial Biomedical Research Centre (BRC), Danish Cancer Society, Ligue Contre le Cancer (France) Institut Gustave Roussy (France) MutuelleGenerale de l'Education Nationale (France), Institut National de la Sante et de la Recherche Medicale (Inserm), Deutsche Krebshilfe German Cancer Research Center (DKFZ) (Germany) German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE) (Germany) Federal Ministry of Education & Research (BMBF), Fondazione AIRC per la ricerca sul cancro Compagnia di San Paolo Consiglio Nazionale delle Ricerche (CNR), Netherlands Government Netherlands Government, World Cancer Research Fund International (WCRF), Netherlands Government, Health Research Fund (FIS) - Instituto de Salud Carlos III (ISCIII) (Spain), Junta de Andalucia, Principality of Asturias Regional Government of Basque Country (Spain) Regional Government of Murcia (Spain) Regional Government of Navarra (Spain) Catalan Institute of Oncology - ICO (Spain), Swedish Cancer Society Swedish Research Council County Council of Skane (Sweden) County Council of Vasterbotten (Sweden), Cancer Research UK 14136 C8221/A29017, UK Research & Innovation (UKRI), Medical Research Council UK (MRC) 1000143 MR/M012190/1 MR/N003284/1 MC-UU_12015/1 MC_UU_00006/ 1, Cancer Research UK C864/A14136 C18281/A29019

Introducción: Tras su fase aguda, la COVID-19 afecta a los pacientes mediante síntomas residuales que pueden comprometer su actividad física (AF), conocido predictor de morbimortalidad. Los efectos a largo plazo aún se desconocen, por ende, conocer la AF de sujetos pos-CO-VID-19 1 año tras el alta cobra especial interés.Material y métodos: Estudio observacional transversal de una cohor-te de sujetos pos-COVID-19 12 meses tras el alta, tratados en domici-lio (H), planta hospitalaria (HW) y UCI (ICU). Se valoraron datos de-mográficos y clínicos (espirometría, síntomas persistentes) y AF (International Physical Activity Questionnaire – IPAQ). Para comparar características y síntomas, se empleó el ANOVA de un factor (post hoc, test de Tukey) para variables cuantitativas y el chi-cuadrado de Pearson para variables categóricas (fuerza de asociación, V de Cra-mer). Para estudiar los patrones de AF, se usó la prueba H de Kruskal-Wallis (post hoc, test de Dunn).Resultados: Se reclutaron 148 sujetos pos-COVID-19 (H, n = 44; HW, n = 60; ICU, n = 44) (tabla). Se evidenciaron diferencias significativas inter-grupos en edad, IMC, FEV1, FVC. El grupo H se caracterizó por menor edad e IMC (p < 0,01), y mayores valores FEV1 y FVC (p < 0,01) que los grupos HW-ICU. No se estimaron otras diferencias respecto a estos parámetros. Además, se destacaron diferencias inter-grupos en sexo, fatiga y otros síntomas, cuya fuerza de asociación resultó débil. De hecho, fatiga (p = 0,049, V = 0,2) y otros síntomas (p = 0,006, V = 0,3) resultaron más prevalentes en el grupo ICU. No hubo diferencias en disnea, dolor o ausencia de síntomas. Finalmente, se detectaron diferencias significativas inter-grupos en AF vigorosa, andar ≥ 10 min y sedentarismo. El grupo H empleó más tiempo en AF vigorosa que los grupos HW-ICU (p = 0,025), mientras el grupo ICU dedicó más tiempo en andar ≥ 10min (p = 0,029), pese a ser más sedentario (p = 0,089) (fig.).Conclusiones: Doce meses tras el alta, las personas pos-COVID-19 siguen con síntomas de fatiga u otros (calambres, parestesias), en par-ticular aquellas tratadas en UCI. El nivel de AF, independientemente de la severidad de la COVID-19 en fase aguda, es moderado. Los suje-tos tratados en domicilio resultan dedicar más tiempo a AF vigorosa, mientras que los ingresados en UCI emplean más tiempo en andar, pese a ser más sedentarios. Edad, función pulmonar y síntomas (fati-ga u otros) podrían influir en su AF, pero es necesario un análisis in-tegral y longitudinal para entender su impacto published

International audience; OBJECTIVES: To delineate the clustering of energy balance-related behaviors in adolescents and investigate whether these behaviors are associated with the household socioeconomic status and parental education level. METHODS: Two cross-sectional studies assessed information on sedentary behavior, physical activity, sugar-sweetened beverages and fruit and vegetable consumption, and sleep duration by self-reported questionnaires in adolescents (12.5-17.5 years old) from Maringa/Brazil (BRACAH Study; n = 682) and ten European cities (HELENA Study; n = 1252) from nine different countries. Gender-specific cluster analyses were performed separately for each study, applying a combination of hierarchical and non-hierarchical methods. RESULTS: Girls showed equivalent behaviors: Sedentary; Active; Unhealthy Eating; Healthy Eating; while boys differed (Brazilian: Sedentary; Active; Healthy Eating; European: Sedentary; Healthy; Unhealthy Eating). In Brazil, we found no association between socioeconomic status and parental education. In European girls, the high socioeconomic status and both parents' university degree were associated with Healthy Eating. In European boys, the high socioeconomic status was associated with Unhealthy Eating, and the mothers' university degree was associated with the Healthy cluster. CONCLUSIONS: Adolescents show Sedentary behavior, regardless of their sex, country of origin, or socioeconomic condition.

Background: A growing body of evidence suggests that alterations of dietary fatty acid (FA) profiles are associated with colorectal cancer risk. However, data from large-scale epidemiologic studies using circulating FA measurements to objectively assess individual FA and FA categories are scarce. Methods: We investigate the association between red blood cell (RBC) membrane FAs and risk of colorectal cancer in a case–control study nested within a large prospective cohort. After a median follow-up of 6.4 years, 1,069 incident colorectal cancer cases were identified and matched to 1,069 controls among participants of the European Prospective Investigation into Cancer and Nutrition (EPIC). The FA composition of RBC phospholipids (in mol%) was analyzed by gas chromatography, and their association with risk of colorectal cancer was estimated by multivariable adjusted conditional logistic regression models. Results: After correction for multiple testing, subjects with higher concentrations of RBC stearic acid were at higher risk for colorectal cancer (OR ¼ 1.23; 95% CI ¼ 1.07–1.42, per 1 mol%). Conversely, colorectal cancer incidence decreased with increasing proportions of RBC n-3 PUFA, particularly eicosapentaenoic acid (0.75; 0.62–0.92, per 1 mol%). The findings for the n-6 PUFA arachidonic acid were inconsistent. Conclusions: The positive association between prediagnostic RBC stearic acid and colorectal cancer reflects putative differences in FA intake and metabolism between cancer cases and matched controls, which deserve further investigation. The inverse relationship between EPA and colorectal cancer is in line with the repeatedly reported protective effect of fish consumption on colorectal cancer risk. Impact: These findings add to the evidence on colorectal cancer prevention.