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1. Dietary intake of plant- and animal-derived protein and incident cardiovascular diseases: the pan-European EPIC-CVD case–cohort study

Author

Zheng, Ju-Sheng, Steur, Marinka, Imamura, Fumiaki, Freisling, Heinz, Johnson, Laura, van der Schouw, Yvonne T, Tong, Tammy YN, Weiderpass, Elisabete, Bajracharya, Rashmita, Crous-Bou, Marta, Dahm, Christina C, Heath, Alicia K, Ibsen, Daniel B, Jannasch, Franziska, Katzke, Verena, Masala, Giovanna, Moreno-Iribas, Conchi, Sacerdote, Carlotta, Schulze, Matthias B, Sieri, Sabina, Wareham, Nicholas J, Danesh, John, Butterworth, Adam S, and Forouhi, Nita G

Published
2024
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3. Omega-3 Blood Levels and Stroke Risk: A Pooled and Harmonized Analysis of 183 291 Participants From 29 Prospective Studies

Author

O’Keefe, James H., Tintle, Nathan L., Harris, William S., O’Keefe, Evan L., Sala-Vila, Aleix, Attia, John, Garg, G. Manohar, Hure, Alexis, Bork, Christian Sørensen, Schmidt, Erik Berg, Venø, Stine Krogh, Chien, Kuo-Liong, Chen, Yun-Yu (Amelia), Egert, Sarah, Feldreich, Tobias Rudholm, Ärnlöv, Johan, Lind, Lars, Forouhi, Nita G., Geleijnse, Johanna M., Pertiwi, Kamalita, Imamura, Fumiaki, de Mello Laaksonen, Vanessa, Uusitupa, W. Matti, Tuomilehto, Jaakko, Laakso, Markku, Lankinen, Maria Anneli, Laurin, Danielle, Carmichael, Pierre-Hugues, Lindsay, Joan, Leander, Karin, Laguzzi, Federica, Swenson, Brenton R., Longstreth, William T., Manson, JoAnn E., Mora, Samia, Cook, Nancy R., Marklund, Matti, Melo van Lent, Debora, Murphy, Rachel, Gudnason, Vilmundur, Ninomiya, Toshihara, Hirakawa, Yoichiro, Qian, Frank, Sun, Qi, Hu, Frank, Ardisson Korat, Andres V., Risérus, Ulf, Lázaro, Iolanda, Samieri, Cecilia, Le Goff, Mélanie, Helmer, Catherine, Steur, Marinka, Voortman, Trudy, Ikram, M. Kamran, Tanaka, Toshiko, Das, Jayanta K., Ferrucci, Luigi, Bandinelli, Stefania, Tsai, Michael, Guan, Weihua, Garg, Parveen, Verschuren, W.M. Monique, Boer, Jolanda M.A., Biokstra, Anneke, Virtanen, Jyrki, Wagner, Michael, Westra, Jason, Albuisson, Luc, Yamagishi, Kazumasa, Siscovick, David S., Lemaitre, Rozenn N., and Mozaffarian, Dariush

Published
2024
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4. n–6 fatty acid biomarkers and incident atrial fibrillation: an individual participant-level pooled analysis of 11 international prospective studies

Author

Garg, Parveen K., Guan, Weihua, Nomura, Sarah, Weir, Natalie L., Tintle, Nathan, Virtanen, Jyrki K., Hirakawa, Yoichiro, Qian, Frank, Sun, Qi, Rimm, Eric, Lemaitre, Rozenn N., Jensen, Paul N., Heckbert, Susan R., Imamura, Fumiaki, Steur, Marinka, Leander, Karin, Laguzzi, Federica, Voortman, Trudy, Ninomiya, Toshiharu, Mozaffarian, Dariush, Harris, William S., Siscovick, David S., and Tsai, Michael Y.

Published
2023
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5. Omega-3 Fatty Acid Biomarkers and Incident Atrial Fibrillation

Author

Qian, Frank, Tintle, Nathan, Jensen, Paul N., Lemaitre, Rozenn N., Imamura, Fumiaki, Feldreich, Tobias Rudholm, Nomura, Sarah Oppeneer, Guan, Weihua, Laguzzi, Federica, Kim, Eunjung, Virtanen, Jyrki K., Steur, Marinka, Bork, Christian S., Hirakawa, Yoichiro, O'Donoghue, Michelle L., Sala-Vila, Aleix, Ardisson Korat, Andres V., Sun, Qi, Rimm, Eric B., Psaty, Bruce M., Heckbert, Susan R., Forouhi, Nita G., Wareham, Nicholas J., Marklund, Matti, Risérus, Ulf, Lind, Lars, Ärnlöv, Johan, Garg, Parveen, Tsai, Michael Y., Pankow, James, Misialek, Jeffrey R., Gigante, Bruna, Leander, Karin, Pester, Julie A., Albert, Christine M., Kavousi, Maryam, Ikram, Arfan, Voortman, Trudy, Schmidt, Erik B., Ninomiya, Toshiharu, Morrow, David A., Bayés-Genís, Antoni, O’Keefe, James H., Ong, Kwok Leung, Wu, Jason H.Y., Mozaffarian, Dariush, Harris, William S., and Siscovick, David S.

Published
2023
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6. Unraveling interindividual variation of trimethylamine N‐oxide and its precursors at the population level

Author

Andreu‐Sánchez, Sergio, primary, Ahmad, Shahzad, additional, Kurilshikov, Alexander, additional, Beekman, Marian, additional, Ghanbari, Mohsen, additional, van Faassen, Martijn, additional, van den Munckhof, Inge C. L., additional, Steur, Marinka, additional, Harms, Amy, additional, Hankemeier, Thomas, additional, Ikram, M. Arfan, additional, Kavousi, Maryam, additional, Voortman, Trudy, additional, Kraaij, Robert, additional, Netea, Mihai G., additional, Rutten, Joost H. W., additional, Riksen, Niels P., additional, Zhernakova, Alexandra, additional, Kuipers, Folkert, additional, Slagboom, P. Eline, additional, van Duijn, Cornelia M., additional, Fu, Jingyuan, additional, and Vojinovic, Dina, additional

Published
2024
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7. Association of plasma biomarkers of fruit and vegetable intake with incident type 2 diabetes : InterAct case-cohort study in eight European countries

Author

Zheng, Ju-Sheng, Sharp, Stephen J, Imamura, Fumiaki, Chowdhury, Rajiv, Gundersen, Thomas E, Steur, Marinka, Sluijs, Ivonne, van der Schouw, Yvonne T, Agudo, Antonio, Aune, Dagfinn, Barricarte, Aurelio, Boeing, Heiner, Chirlaque, María-Dolores, Dorronsoro, Miren, Freisling, Heinz, El-Fatouhi, Douae, Franks, Paul W, Fagherazzi, Guy, Grioni, Sara, Gunter, Marc J, Kyrø, Cecilie, Katzke, Verena, Kühn, Tilman, Khaw, Kay-Tee, Laouali, Nasser, Masala, Giovanna, Nilsson, Peter M, Overvad, Kim, Panico, Salvatore, Papier, Keren, Quirós, J Ramón, Rolandsson, Olov, Redondo-Sánchez, Daniel, Ricceri, Fulvio, Schulze, Matthias B, Spijkerman, Annemieke M W, Tjønneland, Anne, Tong, Tammy Y N, Tumino, Rosario, Weiderpass, Elisabete, Danesh, John, Butterworth, Adam S, Riboli, Elio, Forouhi, Nita G, and Wareham, Nicholas J

Published
2020

8. Dietary intake of plant- and animal-derived protein and incident cardiovascular diseases: the pan-European EPIC-CVD case–cohort study

Author

Cardiometabolic Health, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Cardiovasculaire Epi Team 1, Zheng, Ju Sheng, Steur, Marinka, Imamura, Fumiaki, Freisling, Heinz, Johnson, Laura, van der Schouw, Yvonne T., Tong, Tammy YN, Weiderpass, Elisabete, Bajracharya, Rashmita, Crous-Bou, Marta, Dahm, Christina C., Heath, Alicia K., Ibsen, Daniel B., Jannasch, Franziska, Katzke, Verena, Masala, Giovanna, Moreno-Iribas, Conchi, Sacerdote, Carlotta, Schulze, Matthias B., Sieri, Sabina, Wareham, Nicholas J., Danesh, John, Butterworth, Adam S., Forouhi, Nita G., Cardiometabolic Health, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Cardiovasculaire Epi Team 1, Zheng, Ju Sheng, Steur, Marinka, Imamura, Fumiaki, Freisling, Heinz, Johnson, Laura, van der Schouw, Yvonne T., Tong, Tammy YN, Weiderpass, Elisabete, Bajracharya, Rashmita, Crous-Bou, Marta, Dahm, Christina C., Heath, Alicia K., Ibsen, Daniel B., Jannasch, Franziska, Katzke, Verena, Masala, Giovanna, Moreno-Iribas, Conchi, Sacerdote, Carlotta, Schulze, Matthias B., Sieri, Sabina, Wareham, Nicholas J., Danesh, John, Butterworth, Adam S., and Forouhi, Nita G.

Published
2024

9. Omega-3 Blood Levels and Stroke Risk: A Pooled and Harmonized Analysis of 183 291 Participants From 29 Prospective Studies

Author

Cardiometabolic Health, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, O'Keefe, James H, Tintle, Nathan L, Harris, William S, O'Keefe, Evan L, Sala-Vila, Aleix, Attia, John, Garg, G Manohar, Hure, Alexis, Bork, Christian Sørensen, Schmidt, Erik Berg, Venø, Stine Krogh, Chien, Kuo-Liong, Chen, Yun-Yu Amelia, Egert, Sarah, Feldreich, Tobias Rudholm, Ärnlöv, Johan, Lind, Lars, Forouhi, Nita G, Geleijnse, Johanna M, Pertiwi, Kamalita, Imamura, Fumiaki, de Mello Laaksonen, Vanessa, Uusitupa, W Matti, Tuomilehto, Jaakko, Laakso, Markku, Lankinen, Maria Anneli, Laurin, Danielle, Carmichael, Pierre-Hugues, Lindsay, Joan, Leander, Karin, Laguzzi, Federica, Swenson, Brenton R, Longstreth, William T, Manson, JoAnn E, Mora, Samia, Cook, Nancy R, Marklund, Matti, Melo van Lent, Debora, Murphy, Rachel, Gudnason, Vilmundur, Ninomiya, Toshihara, Hirakawa, Yoichiro, Qian, Frank, Sun, Qi, Hu, Frank, Ardisson Korat, Andres V, Risérus, Ulf, Lázaro, Iolanda, Samieri, Cecilia, Le Goff, Mélanie, Helmer, Catherine, Steur, Marinka, Voortman, Trudy, Ikram, M Kamran, Tanaka, Toshiko, Das, Jayanta K, Ferrucci, Luigi, Bandinelli, Stefania, Tsai, Michael, Guan, Weihua, Garg, Parveen, Verschuren, W M Monique, Boer, Jolanda M A, Biokstra, Anneke, Virtanen, Jyrki, Wagner, Michael, Westra, Jason, Albuisson, Luc, Yamagishi, Kazumasa, Siscovick, David S, Lemaitre, Rozenn N, Mozaffarian, Dariush, Cardiometabolic Health, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, O'Keefe, James H, Tintle, Nathan L, Harris, William S, O'Keefe, Evan L, Sala-Vila, Aleix, Attia, John, Garg, G Manohar, Hure, Alexis, Bork, Christian Sørensen, Schmidt, Erik Berg, Venø, Stine Krogh, Chien, Kuo-Liong, Chen, Yun-Yu Amelia, Egert, Sarah, Feldreich, Tobias Rudholm, Ärnlöv, Johan, Lind, Lars, Forouhi, Nita G, Geleijnse, Johanna M, Pertiwi, Kamalita, Imamura, Fumiaki, de Mello Laaksonen, Vanessa, Uusitupa, W Matti, Tuomilehto, Jaakko, Laakso, Markku, Lankinen, Maria Anneli, Laurin, Danielle, Carmichael, Pierre-Hugues, Lindsay, Joan, Leander, Karin, Laguzzi, Federica, Swenson, Brenton R, Longstreth, William T, Manson, JoAnn E, Mora, Samia, Cook, Nancy R, Marklund, Matti, Melo van Lent, Debora, Murphy, Rachel, Gudnason, Vilmundur, Ninomiya, Toshihara, Hirakawa, Yoichiro, Qian, Frank, Sun, Qi, Hu, Frank, Ardisson Korat, Andres V, Risérus, Ulf, Lázaro, Iolanda, Samieri, Cecilia, Le Goff, Mélanie, Helmer, Catherine, Steur, Marinka, Voortman, Trudy, Ikram, M Kamran, Tanaka, Toshiko, Das, Jayanta K, Ferrucci, Luigi, Bandinelli, Stefania, Tsai, Michael, Guan, Weihua, Garg, Parveen, Verschuren, W M Monique, Boer, Jolanda M A, Biokstra, Anneke, Virtanen, Jyrki, Wagner, Michael, Westra, Jason, Albuisson, Luc, Yamagishi, Kazumasa, Siscovick, David S, Lemaitre, Rozenn N, and Mozaffarian, Dariush

Published
2024

10. Dietary intake of plant- and animal-derived protein and incident cardiovascular diseases:the pan-European EPIC-CVD case–cohort study

Author

Zheng, Ju Sheng, Steur, Marinka, Imamura, Fumiaki, Freisling, Heinz, Johnson, Laura, van der Schouw, Yvonne T., Tong, Tammy YN, Weiderpass, Elisabete, Bajracharya, Rashmita, Crous-Bou, Marta, Dahm, Christina C., Heath, Alicia K., Ibsen, Daniel B., Jannasch, Franziska, Katzke, Verena, Masala, Giovanna, Moreno-Iribas, Conchi, Sacerdote, Carlotta, Schulze, Matthias B., Sieri, Sabina, Wareham, Nicholas J., Danesh, John, Butterworth, Adam S., Forouhi, Nita G., Zheng, Ju Sheng, Steur, Marinka, Imamura, Fumiaki, Freisling, Heinz, Johnson, Laura, van der Schouw, Yvonne T., Tong, Tammy YN, Weiderpass, Elisabete, Bajracharya, Rashmita, Crous-Bou, Marta, Dahm, Christina C., Heath, Alicia K., Ibsen, Daniel B., Jannasch, Franziska, Katzke, Verena, Masala, Giovanna, Moreno-Iribas, Conchi, Sacerdote, Carlotta, Schulze, Matthias B., Sieri, Sabina, Wareham, Nicholas J., Danesh, John, Butterworth, Adam S., and Forouhi, Nita G.

Abstract

Background: Epidemiological evidence suggests that a potential association between dietary protein intake and cardiovascular disease (CVD) may depend on the protein source, that is, plant- or animal-derived, but past research was limited and inconclusive. Objectives: To evaluate the association of dietary plant- or animal-derived protein consumption with risk of CVD, and its components ischemic heart disease (IHD) and stroke. Methods: This analysis in the European Prospective Investigation into Cancer and Nutrition (EPIC)-CVD case–cohort study included 16,244 incident CVD cases (10,784 IHD and 6423 stroke cases) and 15,141 subcohort members from 7 European countries. We investigated the association of estimated dietary protein intake with CVD, IHD, and stroke (total, fatal, and nonfatal) using multivariable-adjusted Prentice-weighted Cox regression. We estimated isocaloric substitutions of replacing fats and carbohydrates with plant- or animal-derived protein and replacing food-specific animal protein with plant protein. Multiplicative interactions between dietary protein and prespecified variables were tested. Results: Neither plant- nor animal-derived protein intake was associated with incident CVD, IHD, or stroke in adjusted analyses without or with macronutrient-specified substitution analyses. Higher plant-derived protein intake was associated with 22% lower total stroke incidence among never smokers [HR 0.78, 95% confidence intervals (CI): 0.62, 0.99], but not among current smokers (HR 1.08, 95% CI: 0.83, 1.40, P-interaction = 0.004). Moreover, higher plant-derived protein (per 3% total energy) when replacing red meat protein (HR 0.52, 95% CI: 0.31, 0.88), processed meat protein (HR 0.39, 95% CI: 0.17, 0.90), and dairy protein (HR 0.54, 95% CI: 0.30, 0.98) was associated with lower incidence of fatal stroke.Conclusion: Plant- or animal-derived protein intake wa

Published
2024

11. Sarcopenia and Sarcopenic Obesity and Mortality Among Older People

Author

Benz, Elizabeth, Pinel, Alexandre, Guillet, Christelle, Capel, Frederic, Pereira, Bruno, De Antonio, Marie, Pouget, Melanie, Cruz-Jentoft, Alfonso J., Eglseer, Doris, Topinkova, Eva, Barazzoni, Rocco, Rivadeneira, Fernando, Ikram, M. Arfan, Steur, Marinka, Voortman, Trudy, Schoufour, Josje D., Weijs, Peter J.M., Boirie, Yves, Benz, Elizabeth, Pinel, Alexandre, Guillet, Christelle, Capel, Frederic, Pereira, Bruno, De Antonio, Marie, Pouget, Melanie, Cruz-Jentoft, Alfonso J., Eglseer, Doris, Topinkova, Eva, Barazzoni, Rocco, Rivadeneira, Fernando, Ikram, M. Arfan, Steur, Marinka, Voortman, Trudy, Schoufour, Josje D., Weijs, Peter J.M., and Boirie, Yves

Abstract

Importance: Sarcopenia and obesity are 2 global concerns associated with adverse health outcomes in older people. Evidence on the population-based prevalence of the combination of sarcopenia with obesity (sarcopenic obesity [SO]) and its association with mortality are still limited. Objective: To investigate the prevalence of sarcopenia and SO and their association with all-cause mortality. Design, Setting, and Participants: This large-scale, population-based cohort study assessed participants from the Rotterdam Study from March 1, 2009, to June 1, 2014. Associations of sarcopenia and SO with all-cause mortality were studied using Kaplan-Meier curves, Cox proportional hazards regression, and accelerated failure time models fitted for sex, age, and body mass index (BMI). Data analysis was performed from January 1 to April 1, 2023. Exposures: The prevalence of sarcopenia and SO, measured based on handgrip strength and body composition (BC) (dual-energy x-ray absorptiometry) as recommended by current consensus criteria, with probable sarcopenia defined as having low handgrip strength and confirmed sarcopenia and SO defined as altered BC (high fat percentage and/or low appendicular skeletal muscle index) in addition to low handgrip strength. Main Outcome and Measure: The primary outcome was all-cause mortality, collected using linked mortality data from general practitioners and the central municipal records, until October 2022. Results: In the total population of 5888 participants (mean [SD] age, 69.5 [9.1] years; mean [SD] BMI, 27.5 [4.3]; 3343 [56.8%] female), 653 (11.1%; 95% CI, 10.3%-11.9%) had probable sarcopenia and 127 (2.2%; 95% CI, 1.8%-2.6%) had confirmed sarcopenia. Sarcopenic obesity with 1 altered component of BC was present in 295 participants (5.0%; 95% CI, 4.4%-5.6%) and with 2 altered components in 44 participants (0.8%; 95% CI, 0.6%-1.0%). An increased risk of all-cause mortality was observed in participants with probable sarcopenia (hazard ratio [

Published
2024

13. Omega-6 fatty acid biomarkers and incident atrial fibrillation: an individual participant-level pooled analysis of 11 international prospective studies

Author

Garg, Parveen K., primary, Guan, Weihua, additional, Nomura, Sarah, additional, Weir, Natalie L., additional, Tintle, Nathan, additional, Virtanen, Jyrki K., additional, Hirakawa, Yoichiro, additional, Qian, Frank, additional, Sun, Qi, additional, Rimm, Eric, additional, Lemaitre, Rozenn N., additional, Jensen, Paul N., additional, Heckbert, Susan R., additional, Imamura, Fumiaki, additional, Steur, Marinka, additional, Leander, Karin, additional, Laguzzi, Federica, additional, Voortman, Trudy, additional, Ninomiya, Toshiharu, additional, Mozaffarian, Dariush, additional, Harris, William S., additional, Siscovick, David S., additional, and Tsai, Michael Y., additional

Published
2023
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16. Consumption of Meat, Fish, Dairy Products, and Eggs and Risk of Ischemic Heart Disease: A Prospective Study of 7198 Incident Cases Among 409 885 Participants in the Pan-European EPIC Cohort

Author

Key, Timothy J., Appleby, Paul N., Bradbury, Kathryn E., Sweeting, Michael, Wood, Angela, Johansson, Ingegerd, Kühn, Tilman, Steur, Marinka, Weiderpass, Elisabete, Wennberg, Maria, Lund Würtz, Anne Mette, Agudo, Antonio, Andersson, Jonas, Arriola, Larraitz, Boeing, Heiner, Boer, Jolanda M.A., Bonnet, Fabrice, Boutron-Ruault, Marie-Christine, Cross, Amanda J., Ericson, Ulrika, Fagherazzi, Guy, Ferrari, Pietro, Gunter, Marc, Huerta, José María, Katzke, Verena, Khaw, Kay-Tee, Krogh, Vittorio, La Vecchia, Carlo, Matullo, Giuseppe, Moreno-Iribas, Conchi, Naska, Androniki, Nilsson, Lena Maria, Olsen, Anja, Overvad, Kim, Palli, Domenico, Panico, Salvatore, Molina-Portillo, Elena, Quirós, J. Ramón, Skeie, Guri, Sluijs, Ivonne, Sonestedt, Emily, Stepien, Magdalena, Tjønneland, Anne, Trichopoulou, Antonia, Tumino, Rosario, Tzoulaki, Ioanna, van der Schouw, Yvonne T., Verschuren, W.M. Monique, di Angelantonio, Emanuele, Langenberg, Claudia, Forouhi, Nita, Wareham, Nick, Butterworth, Adam, Riboli, Elio, and Danesh, John

Published
2019
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17. Plant-based dietary patterns and the risk of dementia: a population-based study.

Author

Crom, Tosca O E de, Steur, Marinka, Ikram, M Kamran, Ikram, M Arfan, and Voortman, Trudy

Subjects
*DEMENTIA risk factors, *FOOD habits, *CONFIDENCE intervals, *FOOD consumption, *PLANT-based diet, *RISK assessment, *SEX distribution, *DESCRIPTIVE statistics, *QUESTIONNAIRES, *SECONDARY analysis, *PROPORTIONAL hazards models
Abstract

Background Plant-based dietary patterns are increasingly popular in western countries and are supported by many governments and health organisations for their potential beneficial role in the prevention of chronic diseases. Yet, the potential role of plant-based dietary patterns in the development of dementia remains unclear. Objective To evaluate the association between plant-based dietary patterns and the risk of dementia. Methods Dietary intake was measured at baseline in 9,543 dementia-free participants (mean age 64 years, birth years 1897–1960, 58% women) of the prospective population-based Rotterdam Study, using food frequency questionnaires. Based on these questionnaires, we calculated an overall plant-based dietary index (PDI), healthy PDI (hPDI) and unhealthy PDI (uPDI), with higher scores reflecting higher consumption of (any, healthy and unhealthy, respectively) plant-based foods and lower consumption of animal-based foods. We analysed the association of the PDIs with incident dementia using Cox proportional hazard models. Results During a mean follow-up of 14.5 years, 1,472 participants developed dementia. Overall, the PDIs were not associated with the risk of dementia (hazard ratio [95% confidence interval] per 10-point increase: 0.99 [0.91–1.08] for PDI, 0.93 [0.86–1.01] for hPDI, 1.02 [0.94–1.10] for uPDI). However, among men and APOE ε4 carriers, a higher hPDI was linearly associated with a lower risk of dementia (0.86 [0.75–0.99] and 0.83 [0.73–0.95], respectively), while this association was U-shaped among APOE ε4 non-carriers (P value for non-linearity = 0.01). Conclusions We found no strong evidence for an overall association between plant-based eating and the risk of dementia. Our findings in stratified analyses warranted further investigation. [ABSTRACT FROM AUTHOR]

Published
2023
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18. TMAO and its precursors in relation to host genetics, gut microbial composition, diet, and clinical outcomes: Meta-analysis of 5 prospective population-based cohorts

Author

Andreu-Sánchez, Sergio, primary, Ahmad, Shahzad, additional, Kurilshikov, Alexander, additional, Beekman, Marian, additional, Ghanbari, Mohsen, additional, van Faassen, Martijn, additional, van den Munckhof, Inge C.L., additional, Steur, Marinka, additional, Harms, Amy, additional, Hankemeier, Thomas, additional, Ikram, M. Arfan, additional, Kavousi, Maryam, additional, Voortman, Trudy, additional, Kraaij, Robert, additional, Netea, Mihai G., additional, Rutten, Joost H.W., additional, Riksen, Niels P., additional, Zhernakova, Alexandra, additional, Kuipers, Folkert, additional, Slagboom, P. Eline, additional, van Duijn, Cornelia M., additional, Fu, Jingyuan, additional, and Vojinovic, Dina, additional

Published
2022
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21. List of Contributors

Author

Batchu, Sri Nagarjun, primary, Baumgartner, Jeannine, additional, Burth, Patrícia, additional, Busnello, Fernanda Michielin, additional, Castro-Faria, Mauro V., additional, Castro-Faria-Neto, Hugo C., additional, Chaudhary, Ketul, additional, Chilibeck, Philip D., additional, Chowdhury, Rajiv, additional, Contreras, Cristina, additional, Cornish, Stephen M., additional, Daak, Ahmed A., additional, Doreau, Michel, additional, Farooqui, Akhlaq A., additional, Farooqui, Tahira, additional, Ferlay, Anne, additional, Fievez, Veerle, additional, Finelli, Carmine, additional, Franco, Oscar H., additional, Gajos, Grzegorz, additional, Ghebremeskel, Kebreab, additional, Givens, Ian D., additional, Gonçalves-de-Albuquerque, Cassiano F., additional, Grimm, Marcus O.W., additional, Hamazaki, Kei, additional, Hamazaki, Tomohito, additional, Hartmann, Tobias, additional, Hobbs, Ditte A., additional, Kahn, Barkat Ali, additional, Kowey, Peter R., additional, Lawrence, Glen D., additional, López, Miguel, additional, Lovegrove, Julie A., additional, Mabalirajan, Ulaganathan, additional, McBreairty, Laura, additional, McNamara, Robert K., additional, Menaa, Abder, additional, Menaa, Bouzid, additional, Menaa, Farid, additional, Mett, Janine, additional, Meynadier, Annabelle, additional, Panda, Lipsa, additional, Pase, Matthew P., additional, Patel, Pinal S., additional, Pawa, Jasmine, additional, Pimentel, Gustavo D, additional, Poledne, Rudolf, additional, Pontin, Bruna, additional, Qi, Lu, additional, Robinson, Victoria M., additional, Rollefstad, S., additional, Sakai, Mai, additional, Santos, Zilda Elisabeth de Albuquerque, additional, Sasaki, Satoshi, additional, Semb, A.G., additional, Seubert, John M., additional, Sharafkhaneh, Hossein, additional, Silva, Adriana R., additional, Steur, Marinka, additional, St-Onge, Marie-Pierre, additional, Szarlej-Wcislo, Katarzyna, additional, Tarantino, Giovanni, additional, Travers, Alexane, additional, Wcislo, Gabriel, additional, Zello, Gordon A., additional, Zheng, Yan, additional, and Zlobine, Igor, additional

Published
2016
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22. Dietary Fatty Acids, Macronutrient Substitutions, Food Sources and Incidence of Coronary Heart Disease: Findings From the EPIC‐CVD Case‐Cohort Study Across Nine European Countries

Author

Steur, Marinka, primary, Johnson, Laura, additional, Sharp, Stephen J., additional, Imamura, Fumiaki, additional, Sluijs, Ivonne, additional, Key, Timothy J., additional, Wood, Angela, additional, Chowdhury, Rajiv, additional, Guevara, Marcela, additional, Jakobsen, Marianne U., additional, Johansson, Ingegerd, additional, Koulman, Albert, additional, Overvad, Kim, additional, Sánchez, Maria‐José, additional, van der Schouw, Yvonne T., additional, Trichopoulou, Antonia, additional, Weiderpass, Elisabete, additional, Wennberg, Maria, additional, Zheng, Ju‐Sheng, additional, Boeing, Heiner, additional, Boer, Jolanda M. A., additional, Boutron‐Ruault, Marie‐Christine, additional, Ericson, Ulrika, additional, Heath, Alicia K., additional, Huybrechts, Inge, additional, Imaz, Liher, additional, Kaaks, Rudolf, additional, Krogh, Vittorio, additional, Kühn, Tilman, additional, Kyrø, Cecilie, additional, Masala, Giovanna, additional, Melander, Olle, additional, Moreno‐Iribas, Conchi, additional, Panico, Salvatore, additional, Quirós, José R., additional, Rodríguez‐Barranco, Miguel, additional, Sacerdote, Carlotta, additional, Santiuste, Carmen, additional, Skeie, Guri, additional, Tjønneland, Anne, additional, Tumino, Rosario, additional, Verschuren, W. M. Monique, additional, Zamora‐Ros, Raul, additional, Dahm, Christina C., additional, Perez‐Cornago, Aurora, additional, Schulze, Matthias B., additional, Tong, Tammy Y. N., additional, Riboli, Elio, additional, Wareham, Nicholas J., additional, Danesh, John, additional, Butterworth, Adam S., additional, and Forouhi, Nita G., additional

Published
2021
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24. Dietary Fatty Acids, Macronutrient Substitutions, Food Sources and Incidence of Coronary Heart Disease : Findings From the EPIC-CVD Case-Cohort Study Across Nine European Countries

Author

Steur, Marinka, Johnson, Laura, Sharp, Stephen J, Imamura, Fumiaki, Sluijs, Ivonne, Key, Timothy J, Wood, Angela, Chowdhury, Rajiv, Guevara, Marcela, Jakobsen, Marianne U, Johansson, Ingegerd, Koulman, Albert, Overvad, Kim, Sánchez, Maria-José, van der Schouw, Yvonne T, Trichopoulou, Antonia, Weiderpass, Elisabete, Wennberg, Maria, Zheng, Ju-Sheng, Boeing, Heiner, Boer, Jolanda M A, Boutron-Ruault, Marie-Christine, Ericson, Ulrika, Heath, Alicia K, Huybrechts, Inge, Imaz, Liher, Kaaks, Rudolf, Krogh, Vittorio, Kühn, Tilman, Kyrø, Cecilie, Masala, Giovanna, Melander, Olle, Moreno-Iribas, Conchi, Panico, Salvatore, Quirós, José R, Rodríguez-Barranco, Miguel, Sacerdote, Carlotta, Santiuste, Carmen, Skeie, Guri, Tjønneland, Anne, Tumino, Rosario, Verschuren, W M Monique, Zamora-Ros, Raul, Dahm, Christina C, Perez-Cornago, Aurora, Schulze, Matthias B, Tong, Tammy Y N, Riboli, Elio, Wareham, Nicholas J, Danesh, John, Butterworth, Adam S, Forouhi, Nita G, Steur, Marinka, Johnson, Laura, Sharp, Stephen J, Imamura, Fumiaki, Sluijs, Ivonne, Key, Timothy J, Wood, Angela, Chowdhury, Rajiv, Guevara, Marcela, Jakobsen, Marianne U, Johansson, Ingegerd, Koulman, Albert, Overvad, Kim, Sánchez, Maria-José, van der Schouw, Yvonne T, Trichopoulou, Antonia, Weiderpass, Elisabete, Wennberg, Maria, Zheng, Ju-Sheng, Boeing, Heiner, Boer, Jolanda M A, Boutron-Ruault, Marie-Christine, Ericson, Ulrika, Heath, Alicia K, Huybrechts, Inge, Imaz, Liher, Kaaks, Rudolf, Krogh, Vittorio, Kühn, Tilman, Kyrø, Cecilie, Masala, Giovanna, Melander, Olle, Moreno-Iribas, Conchi, Panico, Salvatore, Quirós, José R, Rodríguez-Barranco, Miguel, Sacerdote, Carlotta, Santiuste, Carmen, Skeie, Guri, Tjønneland, Anne, Tumino, Rosario, Verschuren, W M Monique, Zamora-Ros, Raul, Dahm, Christina C, Perez-Cornago, Aurora, Schulze, Matthias B, Tong, Tammy Y N, Riboli, Elio, Wareham, Nicholas J, Danesh, John, Butterworth, Adam S, and Forouhi, Nita G

Abstract

Background: There is controversy about associations between total dietary fatty acids, their classes (saturated fatty acids [SFAs], monounsaturated fatty acids, and polyunsaturated fatty acids), and risk of coronary heart disease (CHD). Specifically, the relevance of food sources of SFAs to CHD associations is uncertain. Methods and Results: We conducted a case-cohort study involving 10 529 incident CHD cases and a random subcohort of 16 730 adults selected from a cohort of 385 747 participants in 9 countries of the EPIC (European Prospective Investigation into Cancer and Nutrition) study. We estimated multivariable adjusted country-specific hazard ratios (HRs) and 95% CIs per 5% of energy intake from dietary fatty acids, with and without isocaloric macronutrient substitutions, using Prentice-weighted Cox regression models and pooled results using random-effects meta-analysis. We found no evidence for associations of the consumption of total or fatty acid classes with CHD, regardless of macronutrient substitutions. In analyses considering food sources, CHD incidence was lower per 1% higher energy intake of SFAs from yogurt (HR, 0.93 [95% CI, 0.88-0.99]), cheese (HR, 0.98 [95% CI, 0.96-1.00]), and fish (HR, 0.87 [95% CI, 0.75-1.00]), but higher for SFAs from red meat (HR, 1.07 [95% CI, 1.02-1.12]) and butter (HR, 1.02 [95% CI, 1.00-1.04]). Conclusions: This observational study found no strong associations of total fatty acids, SFAs, monounsaturated fatty acids, and polyunsaturated fatty acids, with incident CHD. By contrast, we found associations of SFAs with CHD in opposite directions dependent on the food source. These findings should be further confirmed, but support public health recommendations to consider food sources alongside the macronutrients they contain, and suggest the importance of the overall food matrix.

Published
2021
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25. Plant foods, dietary fibre and risk of ischaemic heart disease in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort

Author

Perez-Cornago, Aurora, Crowe, Francesca L., Appleby, Paul N., Bradbury, Kathryn E., Wood, Angela M., Uhre Jakobsen, Marianne, Johnson, Laura, Sacerdote, Carlotta, Steur, Marinka, Weiderpass, Elisabete, Würtz, Anne Mette L., Kühn, Tilman, Katzke, Verena, Trichopoulou, Antonia, Karakatsani, Anna, La Vecchia, Carlo, Masala, Giovanna, Tumino, Rosario, Panico, Salvatore, Sluijs, Ivonne, Skeie, Guri, Imaz, Liher, Petrova, Dafina, Quirós, J. Ramón, Yohar, Sandra Milena Colorado, Jakszyn, Paula, Melander, Olle, Sonestedt, Emily, Andersson, Jonas, Wennberg, Maria, Aune, Dagfinn, Riboli, Elio, Schulze, Matthias B., di Angelantonio, Emanuele, Wareham, Nicholas J., Danesh, John, Forouhi, Nita G., Butterworth, Adam S., Key, Timothy J., Perez-Cornago, Aurora, Crowe, Francesca L., Appleby, Paul N., Bradbury, Kathryn E., Wood, Angela M., Uhre Jakobsen, Marianne, Johnson, Laura, Sacerdote, Carlotta, Steur, Marinka, Weiderpass, Elisabete, Würtz, Anne Mette L., Kühn, Tilman, Katzke, Verena, Trichopoulou, Antonia, Karakatsani, Anna, La Vecchia, Carlo, Masala, Giovanna, Tumino, Rosario, Panico, Salvatore, Sluijs, Ivonne, Skeie, Guri, Imaz, Liher, Petrova, Dafina, Quirós, J. Ramón, Yohar, Sandra Milena Colorado, Jakszyn, Paula, Melander, Olle, Sonestedt, Emily, Andersson, Jonas, Wennberg, Maria, Aune, Dagfinn, Riboli, Elio, Schulze, Matthias B., di Angelantonio, Emanuele, Wareham, Nicholas J., Danesh, John, Forouhi, Nita G., Butterworth, Adam S., and Key, Timothy J.

Abstract

Background: Epidemiological evidence indicates that diets rich in plant foods are associated with a lower risk of ischaemic heart disease (IHD), but there is sparse information on fruit and vegetable subtypes and sources of dietary fibre. This study examined the associations of major plant foods, their subtypes and dietary fibre with risk of IHD in the European Prospective Investigation into Cancer and Nutrition (EPIC). Methods: We conducted a prospective analysis of 490 311 men and women without a history of myocardial infarction or stroke at recruitment (12.6 years of follow-up, n cases = 8504), in 10 European countries. Dietary intake was assessed using validated questionnaires, calibrated with 24-h recalls. Multivariable Cox regressions were used to estimate hazard ratios (HR) of IHD. Results: There was a lower risk of IHD with a higher intake of fruit and vegetables combined [HR per 200 g/day higher intake 0.94, 95% confidence interval (CI): 0.90–0.99, P-trend = 0.009], and with total fruits (per 100 g/day 0.97, 0.95–1.00, P-trend = 0.021). There was no evidence for a reduced risk for fruit subtypes, except for bananas. Risk was lower with higher intakes of nuts and seeds (per 10 g/day 0.90, 0.82–0.98, P-trend = 0.020), total fibre (per 10 g/day 0.91, 0.85–0.98, P-trend = 0.015), fruit and vegetable fibre (per 4 g/day 0.95, 0.91–0.99, P-trend = 0.022) and fruit fibre (per 2 g/day 0.97, 0.95–1.00, P-trend = 0.045). No associations were observed between vegetables, vegetables subtypes, legumes, cereals and IHD risk. Conclusions: In this large prospective study, we found some small inverse associations between plant foods and IHD risk, with fruit and vegetables combined being the most strongly inversely associated with risk. Whether these small associations are causal remains unclear.

Published
2021
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26. Dietary fatty acids, macronutrient substitutions, food sources and incidence of coronary heart disease:Findings from the EPIC-CVD case-cohort study across nine european countries

Author

Steur, Marinka, Johnson, Laura, Sharp, Stephen J., Imamura, Fumiaki, Sluijs, Ivonne, Key, Timothy J., Wood, Angela, Chowdhury, Rajiv, Guevara, Marcela, Jakobsen, Marianne U., Johansson, Ingegerd, Koulman, Albert, Overvad, Kim, Sánchez, Maria José, van der Schouw, Yvonne T., Trichopoulou, Antonia, Weiderpass, Elisabete, Wennberg, Maria, Zheng, Ju Sheng, Boeing, Heiner, Boer, Jolanda M.A., Boutron-Ruault, Marie Christine, Ericson, Ulrika, Heath, Alicia K., Huybrechts, Inge, Imaz, Liher, Kaaks, Rudolf, Krogh, Vittorio, Kühn, Tilman, Kyrø, Cecilie, Masala, Giovanna, Melander, Olle, Moreno-Iribas, Conchi, Panico, Salvatore, Quirós, José R., Rodríguez-Barranco, Miguel, Sacerdote, Carlotta, Santiuste, Carmen, Skeie, Guri, Tjønneland, Anne, Tumino, Rosario, Monique Verschuren, W. M., Zamora-Ros, Raul, Dahm, Christina C., Perez-Cornago, Aurora, Schulze, Matthias B., Tong, Tammy Y.N., Riboli, Elio, Wareham, Nicholas J., Danesh, John, Butterworth, Adam S., Forouhi, Nita G., Steur, Marinka, Johnson, Laura, Sharp, Stephen J., Imamura, Fumiaki, Sluijs, Ivonne, Key, Timothy J., Wood, Angela, Chowdhury, Rajiv, Guevara, Marcela, Jakobsen, Marianne U., Johansson, Ingegerd, Koulman, Albert, Overvad, Kim, Sánchez, Maria José, van der Schouw, Yvonne T., Trichopoulou, Antonia, Weiderpass, Elisabete, Wennberg, Maria, Zheng, Ju Sheng, Boeing, Heiner, Boer, Jolanda M.A., Boutron-Ruault, Marie Christine, Ericson, Ulrika, Heath, Alicia K., Huybrechts, Inge, Imaz, Liher, Kaaks, Rudolf, Krogh, Vittorio, Kühn, Tilman, Kyrø, Cecilie, Masala, Giovanna, Melander, Olle, Moreno-Iribas, Conchi, Panico, Salvatore, Quirós, José R., Rodríguez-Barranco, Miguel, Sacerdote, Carlotta, Santiuste, Carmen, Skeie, Guri, Tjønneland, Anne, Tumino, Rosario, Monique Verschuren, W. M., Zamora-Ros, Raul, Dahm, Christina C., Perez-Cornago, Aurora, Schulze, Matthias B., Tong, Tammy Y.N., Riboli, Elio, Wareham, Nicholas J., Danesh, John, Butterworth, Adam S., and Forouhi, Nita G.

Abstract

BACKGROUND: There is controversy about associations between total dietary fatty acids, their classes (saturated fatty acids [SFAs], monounsaturated fatty acids, and polyunsaturated fatty acids), and risk of coronary heart disease (CHD). Specifically, the relevance of food sources of SFAs to CHD associations is uncertain. METHODS AND RESULTS: We conducted a case-cohort study involving 10 529 incident CHD cases and a random subcohort of 16 730 adults selected from a cohort of 385 747 participants in 9 countries of the EPIC (European Prospective Investigation into Cancer and Nutrition) study. We estimated multivariable adjusted country-specific hazard ratios (HRs) and 95% CIs per 5% of energy intake from dietary fatty acids, with and without isocaloric macronutrient substitutions, using Prentice-weighted Cox regression models and pooled results using random-effects meta-analysis. We found no evidence for associations of the consumption of total or fatty acid classes with CHD, regardless of macronutrient substitutions. In analyses considering food sources, CHD incidence was lower per 1% higher energy intake of SFAs from yogurt (HR, 0.93 [95% CI, 0.88– 0.99]), cheese (HR, 0.98 [95% CI, 0.96–1.00]), and fish (HR, 0.87 [95% CI, 0.75–1.00]), but higher for SFAs from red meat (HR, 1.07 [95% CI, 1.02–1.12]) and butter (HR, 1.02 [95% CI, 1.00–1.04]). CONCLUSIONS: This observational study found no strong associations of total fatty acids, SFAs, monounsaturated fatty acids, and polyunsaturated fatty acids, with incident CHD. By contrast, we found associations of SFAs with CHD in opposite direc-tions dependent on the food source. These findings should be further confirmed, but support public health recommendations to consider food sources alongside the macronutrients they contain, and suggest the importance of the overall food matrix.

Published
2021

27. Replacement of Red and Processed Meat With Other Food Sources of Protein and the Risk of Type 2 Diabetes in European Populations : The EPIC-InterAct Study

Author

Ibsen, Daniel B., Steur, Marinka, Imamura, Fumiaki, Overvad, Kim, Schulze, Matthias B., Bendinelli, Benedetta, Guevara, Marcela, Agudo, Antonio, Amiano, Pilar, Aune, Dagfinn, Barricarte, Aurelio, Ericson, Ulrika, Fagherazzi, Guy, Franks, Paul W., Freisling, Heinz, Quiros, Jose R., Grioni, Sara, Heath, Alicia K., Huybrechts, Inge, Katze, Verena, Laouali, Nasser, Mancini, Francesca, Masala, Giovanna, Olsen, Anja, Papier, Keren, Ramne, Stina, Rolandsson, Olov, Sacerdote, Carlotta, Sánchez, Maria-José, Santiuste, Carmen, Simeon, Vittorio, Spijkerman, Annemieke M. W., Srour, Bernard, Tjønneland, Anne, Tong, Tammy Y. N., Tumino, Rosario, van der Schouw, Yvonne T., Weiderpass, Elisabete, Wittenbecher, Clemens, Sharp, Stephen J., Riboli, Elio, Forouhi, Nita G., Wareham, Nick J., Ibsen, Daniel B., Steur, Marinka, Imamura, Fumiaki, Overvad, Kim, Schulze, Matthias B., Bendinelli, Benedetta, Guevara, Marcela, Agudo, Antonio, Amiano, Pilar, Aune, Dagfinn, Barricarte, Aurelio, Ericson, Ulrika, Fagherazzi, Guy, Franks, Paul W., Freisling, Heinz, Quiros, Jose R., Grioni, Sara, Heath, Alicia K., Huybrechts, Inge, Katze, Verena, Laouali, Nasser, Mancini, Francesca, Masala, Giovanna, Olsen, Anja, Papier, Keren, Ramne, Stina, Rolandsson, Olov, Sacerdote, Carlotta, Sánchez, Maria-José, Santiuste, Carmen, Simeon, Vittorio, Spijkerman, Annemieke M. W., Srour, Bernard, Tjønneland, Anne, Tong, Tammy Y. N., Tumino, Rosario, van der Schouw, Yvonne T., Weiderpass, Elisabete, Wittenbecher, Clemens, Sharp, Stephen J., Riboli, Elio, Forouhi, Nita G., and Wareham, Nick J.

Abstract

OBJECTIVE: There is sparse evidence for the association of suitable food substitutions for red and processed meat on the risk of type 2 diabetes. We modeled the association between replacing red and processed meat with other protein sources and the risk of type 2 diabetes and estimated its population impact. RESEARCH DESIGN AND METHODS: The European Prospective Investigation into Cancer (EPIC)-InterAct case cohort included 11,741 individuals with type 2 diabetes and a subcohort of 15,450 participants in eight countries. We modeled the replacement of self-reported red and processed meat with poultry, fish, eggs, legumes, cheese, cereals, yogurt, milk, and nuts. Country-specific hazard ratios (HRs) for incident type 2 diabetes were estimated by Prentice-weighted Cox regression and pooled using random-effects meta-analysis. RESULTS: There was a lower hazard for type 2 diabetes for the modeled replacement of red and processed meat (50 g/day) with cheese (HR 0.90, 95% CI 0.83-0.97) (30 g/day), yogurt (0.90, 0.86-0.95) (70 g/day), nuts (0.90, 0.84-0.96) (10 g/day), or cereals (0.92, 0.88-0.96) (30 g/day) but not for replacements with poultry, fish, eggs, legumes, or milk. If a causal association is assumed, replacing red and processed meat with cheese, yogurt, or nuts could prevent 8.8%, 8.3%, or 7.5%, respectively, of new cases of type 2 diabetes. CONCLUSIONS: Replacement of red and processed meat with cheese, yogurt, nuts, or cereals was associated with a lower rate of type 2 diabetes. Substituting red and processed meat by other protein sources may contribute to the prevention of incident type 2 diabetes in European populations.

Published
2020
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28. Association of plasma biomarkers of fruit and vegetable intake with incident type 2 diabetes : EPIC-InterAct case-cohort study in eight European countries

Author

Zheng, Ju-Sheng, Sharp, Stephen J., Imamura, Fumiaki, Chowdhury, Rajiv, Gundersen, Thomas E., Steur, Marinka, Sluijs, Ivonne, Schouw, Yvonne T. van der, Agudo, Antonio, Aune, Dagfinn, Barricarte, Aurelio, Boeing, Heiner, Chirlaque, Maria -Dolores, Dorronsoro, Miren, Freisling, Heinz, El-Fatouhi, Douae, Franks, Paul W., Fagherazzi, Guy, Grioni, Sara, Gunter, Marc J., Kyro, Cecilie, Katzke, Verena, Kuhn, Tilman, Khaw, Kay-Tee, Laouali, Nasser, Masala, Giovanna, Nilsson, Peter M., Overvad, Kim, Panico, Salvatore, Papier, Keren, Quiros, J. Ramon, Rolandsson, Olov, Redondo-Sanchez, Daniel, Ricceri, Fulvio, Schulze, Matthias B., Spijkerman, Annemieke M. W., Tjonneland, Anne, Tong, Tammy Y. N., Tumino, Rosario, Weiderpass, Elisabete, John, Danesh, Butterworth, Adam S., Riboli, Elio, Forouhi, Nita G., Wareham, Nicholas J., Zheng, Ju-Sheng, Sharp, Stephen J., Imamura, Fumiaki, Chowdhury, Rajiv, Gundersen, Thomas E., Steur, Marinka, Sluijs, Ivonne, Schouw, Yvonne T. van der, Agudo, Antonio, Aune, Dagfinn, Barricarte, Aurelio, Boeing, Heiner, Chirlaque, Maria -Dolores, Dorronsoro, Miren, Freisling, Heinz, El-Fatouhi, Douae, Franks, Paul W., Fagherazzi, Guy, Grioni, Sara, Gunter, Marc J., Kyro, Cecilie, Katzke, Verena, Kuhn, Tilman, Khaw, Kay-Tee, Laouali, Nasser, Masala, Giovanna, Nilsson, Peter M., Overvad, Kim, Panico, Salvatore, Papier, Keren, Quiros, J. Ramon, Rolandsson, Olov, Redondo-Sanchez, Daniel, Ricceri, Fulvio, Schulze, Matthias B., Spijkerman, Annemieke M. W., Tjonneland, Anne, Tong, Tammy Y. N., Tumino, Rosario, Weiderpass, Elisabete, John, Danesh, Butterworth, Adam S., Riboli, Elio, Forouhi, Nita G., and Wareham, Nicholas J.

Abstract

Objective: To investigate the association of plasma vitamin C and carotenoids, as indicators of fruit and vegetable intake, with the risk of type 2 diabetes. Design: Prospective case-cohort study. Setting: Populations from eight European countries. Participants: 9754 participants with incident type 2 diabetes, and a subcohort of 13 662 individuals from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort of 340 234 participants: EPIC-InterAct case-cohort study. Main outcome measure: Incident type 2 diabetes. Results: In a multivariable adjusted model, higher plasma vitamin C was associated with a lower risk of developing type 2 diabetes (hazard ratio per standard deviation 0.82, 95% confidence interval 0.76 to 0.89). A similar inverse association was shown for total carotenoids (hazard ratio per standard deviation 0.75, 0.68 to 0.82). A composite biomarker score (split into five equal groups), comprising vitamin C and individual carotenoids, was inversely associated with type 2 diabetes with hazard ratios 0.77, 0.66, 0.59, and 0.50 for groups 2-5 compared with group 1 (the lowest group). Self-reported median fruit and vegetable intake was 274 g/day, 396 g/day, and 508 g/day for participants in categories defined by groups 1, 3, and 5 of the composite biomarker score, respectively. One standard deviation difference in the composite biomarker score, equivalent to a 66 (95% confidence interval 61 to 71) g/day difference in total fruit and vegetable intake, was associated with a hazard ratio of 0.75 (0.67 to 0.83). This would be equivalent to an absolute risk reduction of 0.95 per 1000 person years of follow up if achieved across an entire population with the characteristics of the eight European countries included in this analysis. Conclusions: These findings indicate an inverse association between plasma vitamin C, carotenoids, and their composite biomarker score, and incident type 2 diabetes in different European countries. These biomarkers

Published
2020
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29. Replacement of red and processed meat with other food sources of protein and the risk of type 2 diabetes in European populations:The epic-interact study

Author

Ibsen, Daniel B., Steur, Marinka, Imamura, Fumiaki, Overvad, Kim, Schulze, Matthias B., Bendinelli, Benedetta, Guevara, Marcela, Agudo, Antonio, Amiano, Pilar, Aune, Dagfinn, Barricarte, Aurelio, Ericson, Ulrika, Fagherazzi, Guy, Franks, Paul W., Freisling, Heinz, Quiros, Jose R., Grioni, Sara, Heath, Alicia K., Huybrechts, Inge, Katze, Verena, Laouali, Nasser, Mancini, Francesca, Masala, Giovanna, Olsen, Anja, Papier, Keren, Ramne, Stina, Rolandsson, Olov, Sacerdote, Carlotta, Sánchez, Maria José, Santiuste, Carmen, Simeon, Vittorio, Spijkerman, Annemieke M.W., Srour, Bernard, Tjønneland, Anne, Tong, Tammy Y.N., Tumino, Rosario, van der Schouw, Yvonne T., Weiderpass, Elisabete, Wittenbecher, Clemens, Sharp, Stephen J., Riboli, Elio, Forouhi, Nita G., Wareham, Nick J., Ibsen, Daniel B., Steur, Marinka, Imamura, Fumiaki, Overvad, Kim, Schulze, Matthias B., Bendinelli, Benedetta, Guevara, Marcela, Agudo, Antonio, Amiano, Pilar, Aune, Dagfinn, Barricarte, Aurelio, Ericson, Ulrika, Fagherazzi, Guy, Franks, Paul W., Freisling, Heinz, Quiros, Jose R., Grioni, Sara, Heath, Alicia K., Huybrechts, Inge, Katze, Verena, Laouali, Nasser, Mancini, Francesca, Masala, Giovanna, Olsen, Anja, Papier, Keren, Ramne, Stina, Rolandsson, Olov, Sacerdote, Carlotta, Sánchez, Maria José, Santiuste, Carmen, Simeon, Vittorio, Spijkerman, Annemieke M.W., Srour, Bernard, Tjønneland, Anne, Tong, Tammy Y.N., Tumino, Rosario, van der Schouw, Yvonne T., Weiderpass, Elisabete, Wittenbecher, Clemens, Sharp, Stephen J., Riboli, Elio, Forouhi, Nita G., and Wareham, Nick J.

Abstract

OBJECTIVE There is sparse evidence for the association of suitable food substitutions for red and processed meat on the risk of type 2 diabetes. We modeled the association between replacing red and processed meat with other protein sources and the risk of type 2 diabetes and estimated its population impact. RESEARCH DESIGN AND METHODS The European Prospective Investigation into Cancer (EPIC)-InterAct case cohort included 11,741 individuals with type 2 diabetes and a subcohort of 15,450 participants in eight countries. We modeled the replacement of self-reported red and processed meat with poultry, fish, eggs, legumes, cheese, cereals, yogurt, milk, and nuts. Country-specific hazard ratios (HRs) for incident type 2 diabetes were estimated by Prentice-weighted Cox regression and pooled using random-effects meta-analysis. RESULTS There was a lower hazard for type 2 diabetes for the modeled replacement of red and processed meat (50 g/day) with cheese (HR 0.90, 95% CI 0.83–0.97) (30 g/day), yogurt (0.90, 0.86–0.95) (70 g/day), nuts (0.90, 0.84–0.96) (10 g/day), or cereals (0.92, 0.88–0.96) (30 g/day) but not for replacements with poultry, fish, eggs, legumes, or milk. If a causal association is assumed, replacing red and processed meat with cheese, yogurt, or nuts could prevent 8.8%, 8.3%, or 7.5%, respectively, of new cases of type 2 diabetes. CONCLUSIONS Replacement of red and processed meat with cheese, yogurt, nuts, or cereals was associated with a lower rate of type 2 diabetes. Substituting red and processed meat by other protein sources may contribute to the prevention of incident type 2 diabetes in European populations.

Published
2020

30. Replacement of Red and Processed Meat With Other Food Sources of Protein and the Risk of Type 2 Diabetes in European Populations: The EPIC-InterAct Study

Author

UMC Utrecht, Cardiovasculaire Epi Team 1, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Ibsen, Daniel B., Steur, Marinka, Imamura, Fumiaki, Overvad, Kim, Schulze, Matthias B., Bendinelli, Benedetta, Guevara, Marcela, Agudo, Antonio, Amiano, Pilar, Aune, Dagfinn, Barricarte, Aurelio, Ericson, Ulrika, Fagherazzi, Guy, Franks, Paul W., Freisling, Heinz, Quiros, Jose R., Grioni, Sara, Heath, Alicia K., Huybrechts, Inge, Katze, Verena, Laouali, Nasser, Mancini, Francesca, Masala, Giovanna, Olsen, Anja, Papier, Keren, Ramne, Stina, Rolandsson, Olov, Sacerdote, Carlotta, Sanchez, Maria-Jose, Santiuste, Carmen, Simeon, Vittorio, Spijkerman, Annemieke M. W., Srour, Bernard, Tjonneland, Anne, Tong, Tammy Y. N., Tumino, Rosario, van der Schouw, Yvonne T., Weiderpass, Elisabete, Wittenbecher, Clemens, Sharp, Stephen J., Riboli, Elio, Forouhi, Nita G., Wareham, Nick J., UMC Utrecht, Cardiovasculaire Epi Team 1, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Ibsen, Daniel B., Steur, Marinka, Imamura, Fumiaki, Overvad, Kim, Schulze, Matthias B., Bendinelli, Benedetta, Guevara, Marcela, Agudo, Antonio, Amiano, Pilar, Aune, Dagfinn, Barricarte, Aurelio, Ericson, Ulrika, Fagherazzi, Guy, Franks, Paul W., Freisling, Heinz, Quiros, Jose R., Grioni, Sara, Heath, Alicia K., Huybrechts, Inge, Katze, Verena, Laouali, Nasser, Mancini, Francesca, Masala, Giovanna, Olsen, Anja, Papier, Keren, Ramne, Stina, Rolandsson, Olov, Sacerdote, Carlotta, Sanchez, Maria-Jose, Santiuste, Carmen, Simeon, Vittorio, Spijkerman, Annemieke M. W., Srour, Bernard, Tjonneland, Anne, Tong, Tammy Y. N., Tumino, Rosario, van der Schouw, Yvonne T., Weiderpass, Elisabete, Wittenbecher, Clemens, Sharp, Stephen J., Riboli, Elio, Forouhi, Nita G., and Wareham, Nick J.

Published
2020

31. Association of plasma biomarkers of fruit and vegetable intake with incident type 2 diabetes: EPIC-InterAct case-cohort study in eight European countries

Author

Cardiovasculaire Epi Team 1, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Zheng, Ju Sheng, Sharp, Stephen J., Imamura, Fumiaki, Chowdhury, Rajiv, Gundersen, Thomas E., Steur, Marinka, Sluijs, Ivonne, Van Der Schouw, Yvonne T., Agudo, Antonio, Aune, Dagfinn, Barricarte, Aurelio, Boeing, Heiner, Chirlaque, María Dolores, Dorronsoro, Miren, Freisling, Heinz, El-Fatouhi, Douae, Franks, Paul W., Fagherazzi, Guy, Grioni, Sara, Gunter, Marc J., Kyrø, Cecilie, Katzke, Verena, Kühn, Tilman, Khaw, Kay Tee, Laouali, Nasser, Masala, Giovanna, Nilsson, Peter M., Overvad, Kim, Panico, Salvatore, Papier, Keren, Quirós, J. Ramón, Rolandsson, Olov, Redondo-Sánchez, Daniel, Ricceri, Fulvio, Schulze, Matthias B., Spijkerman, Annemieke M.W., Tjønneland, Anne, Tong, Tammy Y.N., Tumino, Rosario, Weiderpass, Elisabete, Danesh, John, Butterworth, Adam S., Riboli, Elio, Forouhi, Nita G., Wareham, Nicholas J., Cardiovasculaire Epi Team 1, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Zheng, Ju Sheng, Sharp, Stephen J., Imamura, Fumiaki, Chowdhury, Rajiv, Gundersen, Thomas E., Steur, Marinka, Sluijs, Ivonne, Van Der Schouw, Yvonne T., Agudo, Antonio, Aune, Dagfinn, Barricarte, Aurelio, Boeing, Heiner, Chirlaque, María Dolores, Dorronsoro, Miren, Freisling, Heinz, El-Fatouhi, Douae, Franks, Paul W., Fagherazzi, Guy, Grioni, Sara, Gunter, Marc J., Kyrø, Cecilie, Katzke, Verena, Kühn, Tilman, Khaw, Kay Tee, Laouali, Nasser, Masala, Giovanna, Nilsson, Peter M., Overvad, Kim, Panico, Salvatore, Papier, Keren, Quirós, J. Ramón, Rolandsson, Olov, Redondo-Sánchez, Daniel, Ricceri, Fulvio, Schulze, Matthias B., Spijkerman, Annemieke M.W., Tjønneland, Anne, Tong, Tammy Y.N., Tumino, Rosario, Weiderpass, Elisabete, Danesh, John, Butterworth, Adam S., Riboli, Elio, Forouhi, Nita G., and Wareham, Nicholas J.

Published
2020

32. Plant foods, dietary fibre and risk of ischaemic heart disease in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort

Author

Perez-Cornago, Aurora, primary, Crowe, Francesca L, additional, Appleby, Paul N, additional, Bradbury, Kathryn E, additional, Wood, Angela M, additional, Jakobsen, Marianne Uhre, additional, Johnson, Laura, additional, Sacerdote, Carlotta, additional, Steur, Marinka, additional, Weiderpass, Elisabete, additional, Würtz, Anne Mette L, additional, Kühn, Tilman, additional, Katzke, Verena, additional, Trichopoulou, Antonia, additional, Karakatsani, Anna, additional, La Vecchia, Carlo, additional, Masala, Giovanna, additional, Tumino, Rosario, additional, Panico, Salvatore, additional, Sluijs, Ivonne, additional, Skeie, Guri, additional, Imaz, Liher, additional, Petrova, Dafina, additional, Quirós, J Ramón, additional, Yohar, Sandra Milena Colorado, additional, Jakszyn, Paula, additional, Melander, Olle, additional, Sonestedt, Emily, additional, Andersson, Jonas, additional, Wennberg, Maria, additional, Aune, Dagfinn, additional, Riboli, Elio, additional, Schulze, Matthias B, additional, di Angelantonio, Emanuele, additional, Wareham, Nicholas J, additional, Danesh, John, additional, Forouhi, Nita G, additional, Butterworth, Adam S, additional, and Key, Timothy J, additional

Published
2020
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33. Replacement of red and processed meat with other food sources of protein and the risk of type 2 diabetes in European populations; the EPIC-InterAct study

Author

Ibsen, Daniel B., primary, Steur, Marinka, primary, Imamura, Fumiaki, primary, Overvad, Kim, primary, Schulze, Matthias B., primary, Bendinelli, Benedetta, primary, Guevara, Marcela, primary, Agudo, Antonio, primary, Amiano, Pilar, primary, Aune, Dagfinn, primary, Barricarte, Aurelio, primary, Ericson, Ulrika, primary, Fagherazzi, Guy, primary, Franks, Paul W., primary, Freisling, Heinz, primary, Quiros, Jose R., primary, Grioni, Sara, primary, Heath, Alicia K., primary, Huybrechts, Inge, primary, Katze, Verena, primary, Laouali, Nasser, primary, Mancini, Francesca, primary, Masala, Giovanna, primary, Olsen, Anja, primary, Papier, Keren, primary, Ramne, Stina, primary, Rolandsson, Olov, primary, Sacerdote, Carlotta, primary, Sánchez, Maria-José, primary, Santiuste, Carmen, primary, Simeon, Vittorio, primary, Spijkerman, Annemieke M.W., primary, Srour, Bernard, primary, Tjønneland, Anne, primary, Tong, Tammy Y.N., primary, Tumino, Rosario, primary, Schouw, Yvonne T. van der, primary, Weiderpass, Elisabete, primary, Wittenbecher, Clemens, primary, Sharp, Stephen J., primary, Riboli, Elio, primary, Forouhi, Nita G., primary, and Wareham, Nick J., primary

Published
2020
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34. Association of plasma biomarkers of fruit and vegetable intake with incident type 2 diabetes: EPIC-InterAct case-cohort study in eight European countries

Author

Zheng, Ju-Sheng, primary, Sharp, Stephen J, additional, Imamura, Fumiaki, additional, Chowdhury, Rajiv, additional, Gundersen, Thomas E, additional, Steur, Marinka, additional, Sluijs, Ivonne, additional, van der Schouw, Yvonne T, additional, Agudo, Antonio, additional, Aune, Dagfinn, additional, Barricarte, Aurelio, additional, Boeing, Heiner, additional, Chirlaque, María-Dolores, additional, Dorronsoro, Miren, additional, Freisling, Heinz, additional, El-Fatouhi, Douae, additional, Franks, Paul W, additional, Fagherazzi, Guy, additional, Grioni, Sara, additional, Gunter, Marc J, additional, Kyrø, Cecilie, additional, Katzke, Verena, additional, Kühn, Tilman, additional, Khaw, Kay-Tee, additional, Laouali, Nasser, additional, Masala, Giovanna, additional, Nilsson, Peter M, additional, Overvad, Kim, additional, Panico, Salvatore, additional, Papier, Keren, additional, Quirós, J Ramón, additional, Rolandsson, Olov, additional, Redondo-Sánchez, Daniel, additional, Ricceri, Fulvio, additional, Schulze, Matthias B, additional, Spijkerman, Annemieke M W, additional, Tjønneland, Anne, additional, Tong, Tammy Y N, additional, Tumino, Rosario, additional, Weiderpass, Elisabete, additional, Danesh, John, additional, Butterworth, Adam S, additional, Riboli, Elio, additional, Forouhi, Nita G, additional, and Wareham, Nicholas J, additional

Published
2020
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35. Consumption of Meat, Fish, Dairy Products, and Eggs and Risk of Ischemic Heart Disease:A Prospective Study of 7198 Incident Cases Among 409,885 Participants in the Pan-European EPIC Cohort

Author

Key, Timothy J, Appleby, Paul N, Bradbury, Kathryn E, Sweeting, Michael, Wood, Angela, Johansson, Ingegerd, Kühn, Tilman, Steur, Marinka, Weiderpass, Elisabete, Wennberg, Maria, Würtz, Anne Mette Lund, Agudo, Antonio, Andersson, Jonas, Arriola, Larraitz, Boeing, Heiner, Boer, Jolanda M A, Bonnet, Fabrice, Boutron-Ruault, Marie-Christine, Cross, Amanda J, Ericson, Ulrika, Fagherazzi, Guy, Ferrari, Pietro, Gunter, Marc, Huerta, José María, Katzke, Verena, Khaw, Kay-Tee, Krogh, Vittorio, La Vecchia, Carlo, Matullo, Giuseppe, Moreno-Iribas, Conchi, Naska, Androniki, Nilsson, Lena Maria, Olsen, Anja, Overvad, Kim, Palli, Domenico, Panico, Salvatore, Molina-Portillo, Elena, Quirós, J Ramón, Skeie, Guri, Sluijs, Ivonne, Sonestedt, Emily, Stepien, Magdalena, Tjønneland, Anne, Trichopoulou, Antonia, Tumino, Rosario, Tzoulaki, Ioanna, van der Schouw, Yvonne T, Verschuren, W M Monique, Di Angelantonio, Emanuele, Langenberg, Claudia, Forouhi, Nita, Wareham, Nick, Butterworth, Adam, Riboli, Elio, and Danesh, John

Subjects
Male, Adult, VASCULAR MORTALITY, Eggs/adverse effects, Time Factors, Myocardial Ischemia/blood, BLOOD-PRESSURE, Blood Pressure, Meat/adverse effects, Recommended Dietary Allowances, Diet Surveys, Risk Assessment, Europe/epidemiology, meat, Risk Factors, eggs, Humans, Prospective Studies, Aged, fish, CALIBRATION, INDIVIDUAL DATA, Cholesterol, HDL/blood, heart diseases, dairy products, CHOLESTEROL, food and beverages, UPDATED METAANALYSIS, ASSOCIATION, Middle Aged, Protective Factors, CANCER, Cross-Sectional Studies, RED MEAT, Seafood/adverse effects, LIFE-STYLE, Female, Diet, Healthy, Dairy Products/adverse effects, Nutritive Value, Risk Reduction Behavior, Biomarkers/blood
Abstract

Background: There is uncertainty about the relevance of animal foods to the pathogenesis of ischemic heart disease (IHD). We examined meat, fish, dairy products, and eggs and risk for IHD in the pan-European EPIC cohort (European Prospective Investigation Into Cancer and Nutrition). Methods: In this prospective study of 409 885 men and women in 9 European countries, diet was assessed with validated questionnaires and calibrated with 24-hour recalls. Lipids and blood pressure were measured in a subsample. During a mean of 12.6 years of follow-up, 7198 participants had a myocardial infarction or died of IHD. The relationships of animal foods with risk were examined with Cox regression with adjustment for other animal foods and relevant covariates. Results: The hazard ratio (HR) for IHD was 1.19 (95% CI, 1.06-1.33) for a 100-g/d increment in intake of red and processed meat, and this remained significant after exclusion of the first 4 years of follow-up (HR, 1.25 [95% CI, 1.09-1.42]). Risk was inversely associated with intakes of yogurt (HR, 0.93 [95% CI, 0.89-0.98] per 100-g/d increment), cheese (HR, 0.92 [95% CI, 0.86-0.98] per 30-g/d increment), and eggs (HR, 0.93 [95% CI, 0.88-0.99] per 20-g/d increment); the associations with yogurt and eggs were attenuated and nonsignificant after exclusion of the first 4 years of follow-up. Risk was not significantly associated with intakes of poultry, fish, or milk. In analyses modeling dietary substitutions, replacement of 100 kcal/d from red and processed meat with 100 kcal/d from fatty fish, yogurt, cheese, or eggs was associated with ≈20% lower risk of IHD. Consumption of red and processed meat was positively associated with serum non-high-density lipoprotein cholesterol concentration and systolic blood pressure, and consumption of cheese was inversely associated with serum non-high-density lipoprotein cholesterol. Conclusions: Risk for IHD was positively associated with consumption of red and processed meat and inversely associated with consumption of yogurt, cheese, and eggs, although the associations with yogurt and eggs may be influenced by reverse causation bias. It is not clear whether the associations with red and processed meat and cheese reflect causality, but they were consistent with the associations of these foods with plasma non-high-density lipoprotein cholesterol and for red and processed meat with systolic blood pressure, which could mediate such effects.

Published
2019

36. Consumption of Meat, Fish, Dairy Products, and Eggs and Risk of Ischemic Heart Disease

Author

Key, Timothy J, Appleby, Paul N, Bradbury, Kathryn E, Sweeting, Michael, Wood, Angela, Johansson, Ingegerd, Kühn, Tilman, Steur, Marinka, Weiderpass, Elisabete, Wennberg, Maria, Lund Würtz, Anne Mette, Agudo, Antonio, Andersson, Jonas, Arriola, Larraitz, Boeing, Heiner, Boer, Jolanda M A, Bonnet, Fabrice, Boutron-Ruault, Marie-Christine, Cross, Amanda J, Ericson, Ulrika, Fagherazzi, Guy, Ferrari, Pietro, Gunter, Marc, Huerta, José María, Katzke, Verena, Khaw, Kay-Tee, Krogh, Vittorio, La Vecchia, Carlo, Matullo, Giuseppe, Moreno-Iribas, Conchi, Naska, Androniki, Nilsson, Lena Maria, Olsen, Anja, Overvad, Kim, Palli, Domenico, Panico, Salvatore, Molina-Portillo, Elena, Quirós, J Ramón, Skeie, Guri, Sluijs, Ivonne, Sonestedt, Emily, Stepien, Magdalena, Tjønneland, Anne, Trichopoulou, Antonia, Tumino, Rosario, Tzoulaki, Ioanna, van der Schouw, Yvonne T, Verschuren, W M Monique, di Angelantonio, Emanuele, Langenberg, Claudia, Forouhi, Nita, Wareham, Nick, Butterworth, Adam, Riboli, Elio, Danesh, John, Wood, Angela [0000-0002-7937-304X], Steur, Marina [0000-0002-9028-0290], Di Angelantonio, Emanuele [0000-0001-8776-6719], Langenberg, Claudia [0000-0002-5017-7344], Forouhi, Nita [0000-0002-5041-248X], Wareham, Nicholas [0000-0003-1422-2993], Butterworth, Adam [0000-0002-6915-9015], Danesh, John [0000-0003-1158-6791], and Apollo - University of Cambridge Repository

Subjects
Adult, Male, Meat, Time Factors, Eggs, Myocardial Ischemia, Blood Pressure, Recommended Dietary Allowances, Diet Surveys, Risk Assessment, Risk Factors, Original Research Articles, Humans, Prospective Studies, Aged, fish, heart diseases, dairy products, Cholesterol, HDL, Middle Aged, Protective Factors, Europe, Cross-Sectional Studies, eggs, meat, Seafood, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, Female, Diet, Healthy, Nutritive Value, Risk Reduction Behavior, Biomarkers
Abstract

Supplemental Digital Content is available in the text., Background: There is uncertainty about the relevance of animal foods to the pathogenesis of ischemic heart disease (IHD). We examined meat, fish, dairy products, and eggs and risk for IHD in the pan-European EPIC cohort (European Prospective Investigation Into Cancer and Nutrition). Methods: In this prospective study of 409 885 men and women in 9 European countries, diet was assessed with validated questionnaires and calibrated with 24-hour recalls. Lipids and blood pressure were measured in a subsample. During a mean of 12.6 years of follow-up, 7198 participants had a myocardial infarction or died of IHD. The relationships of animal foods with risk were examined with Cox regression with adjustment for other animal foods and relevant covariates. Results: The hazard ratio (HR) for IHD was 1.19 (95% CI, 1.06–1.33) for a 100-g/d increment in intake of red and processed meat, and this remained significant after exclusion of the first 4 years of follow-up (HR, 1.25 [95% CI, 1.09–1.42]). Risk was inversely associated with intakes of yogurt (HR, 0.93 [95% CI, 0.89–0.98] per 100-g/d increment), cheese (HR, 0.92 [95% CI, 0.86–0.98] per 30-g/d increment), and eggs (HR, 0.93 [95% CI, 0.88–0.99] per 20-g/d increment); the associations with yogurt and eggs were attenuated and nonsignificant after exclusion of the first 4 years of follow-up. Risk was not significantly associated with intakes of poultry, fish, or milk. In analyses modeling dietary substitutions, replacement of 100 kcal/d from red and processed meat with 100 kcal/d from fatty fish, yogurt, cheese, or eggs was associated with ≈20% lower risk of IHD. Consumption of red and processed meat was positively associated with serum non–high-density lipoprotein cholesterol concentration and systolic blood pressure, and consumption of cheese was inversely associated with serum non–high-density lipoprotein cholesterol. Conclusions: Risk for IHD was positively associated with consumption of red and processed meat and inversely associated with consumption of yogurt, cheese, and eggs, although the associations with yogurt and eggs may be influenced by reverse causation bias. It is not clear whether the associations with red and processed meat and cheese reflect causality, but they were consistent with the associations of these foods with plasma non–high-density lipoprotein cholesterol and for red and processed meat with systolic blood pressure, which could mediate such effects.

Published
2019

37. Consumption of Meat, Fish, Dairy Products, Eggs and Risk of Ischemic Heart Disease : A Prospective Study of 7198 Incident Cases Among 409,885 Participants in the Pan-European EPIC Cohort

Author

Key, Timothy J., Appleby, Paul N., Bradbury, Kathryn E., Sweeting, Michael, Wood, Angela, Johansson, Ingegerd, Kühn, Tilman, Steur, Marinka, Weiderpass, Elisabete, Wennberg, Maria, Würtz, Anne Mette Lund, Agudo, Antonio, Andersson, Jonas, Arriola, Larraitz, Boeing, Heiner, Boer, Jolanda M. A., Bonnet, Fabrice, Boutron-Ruault, Marie-Christine, Cross, Amanda J., Ericson, Ulrika, Fagherazzi, Guy, Ferrari, Pietro, Gunter, Marc, Huerta, José María, Katzke, Verena, Khaw, Kay-Tee, Krogh, Vittorio, La Vecchia, Carlo, Matullo, Giuseppe, Moreno-Iribas, Conchi, Naska, Androniki, Nilsson, Lena Maria, Olsen, Anja, Overvad, Kim, Palli, Domenico, Panico, Salvatore, Molina-Portillo, Elena, Quirós, J. Ramón, Skeie, Guri, Sluijs, Ivonne, Sonestedt, Emily, Stepien, Magdalena, Tjønneland, Anne, Trichopoulou, Antonia, Tumino, Rosario, Tzoulaki, Ioanna, van der Schouw, Yvonne T., Verschuren, W. M. Monique, Di Angelantonio, Emanuele, Langenberg, Claudia, Forouhi, Nita, Wareham, Nick, Butterworth, Adam, Riboli, Elio, and Danesh, John

Subjects
fish, meat, Medicin och hälsovetenskap, dairy products, eggs, food and beverages, Medical and Health Sciences
Abstract

BACKGROUND: There is uncertainty about the relevance of animal foods to the etiology of ischemic heart disease (IHD). We examined meat, fish, dairy products and eggs and risk for IHD in the pan-European EPIC cohort. METHODS: A prospective study of 409,885 men and women in nine European countries. Diet was assessed using validated questionnaires, calibrated using 24-hour recalls. Lipids and blood pressure were measured in a subsample. During 12.6 years mean follow up, 7198 participants had a myocardial infarction or died from IHD. The relationships of animal foods with risk were examined using Cox regression with adjustment for other animal foods and relevant covariates. RESULTS: The hazard ratio (HR) for IHD was 1.19 (95% CI 1.06-1.33) for a 100 g/d increment in intake of red and processed meat, and this remained significant after excluding the first 4 years of follow-up (HR 1.25 [1.09-1.42]). Risk was inversely associated with intakes of yogurt (HR 0.93 [0.89-0.98] per 100 g/d increment), cheese (HR 0.92 [0.86-0.98] per 30 g/d increment) and eggs (HR 0.93 [0.88-0.99] per 20 g/d increment); the associations with yogurt and eggs were attenuated and non-significant after excluding the first 4 years of follow-up. Risk was not significantly associated with intakes of poultry, fish or milk. In analyses modelling dietary substitutions, replacement of 100 kcal/d from red and processed meat with 100 kcal/d from fatty fish, yogurt, cheese or eggs was associated with approximately 20% lower risk of IHD. Consumption of red and processed meat was positively associated with serum non-HDL cholesterol concentration and systolic blood pressure, and consumption of cheese was inversely associated with serum non-HDL cholesterol. CONCLUSIONS: Risk for IHD was positively associated with consumption of red and processed meat, and inversely associated with consumption of yogurt, cheese and eggs, although the associations with yogurt and eggs may be influenced by reverse causation bias. It is not clear whether the associations with red and processed meat and cheese reflect causality, but they were consistent with the associations of these foods with plasma non-HDL cholesterol, and for red and processed meat with systolic blood pressure, which could mediate such effects.

Published
2019

38. Consumption of Meat, Fish, Dairy Products, and Eggs and Risk of Ischemic Heart Disease: A Prospective Study of 7198 Incident Cases Among 409 885 Participants in the Pan-European EPIC Cohort

Author

UMC Utrecht, Cardiovasculaire Epi Team 1, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Cardiovasculaire Epidemiologie, Public Health Epidemiologie, Key, Timothy J., Appleby, Paul N., Bradbury, Kathryn E., Sweeting, Michael, Wood, Angela, Johansson, Ingegerd, Kühn, Tilman, Steur, Marinka, Weiderpass, Elisabete, Wennberg, Maria, Lund Würtz, Anne Mette, Agudo, Antonio, Andersson, Jonas, Arriola, Larraitz, Boeing, Heiner, Boer, Jolanda M.A., Bonnet, Fabrice, Boutron-Ruault, Marie Christine, Cross, Amanda J., Ericson, Ulrika, Fagherazzi, Guy, Ferrari, Pietro, Gunter, Marc, Huerta, José María, Katzke, Verena, Khaw, Kay Tee, Krogh, Vittorio, La Vecchia, Carlo, Matullo, Giuseppe, Moreno-Iribas, Conchi, Naska, Androniki, Nilsson, Lena Maria, Olsen, Anja, Overvad, Kim, Palli, Domenico, Panico, Salvatore, Molina-Portillo, Elena, Quirós, J. Ramón, Skeie, Guri, Sluijs, Ivonne, Sonestedt, Emily, Stepien, Magdalena, Tjønneland, Anne, Trichopoulou, Antonia, Tumino, Rosario, Tzoulaki, Ioanna, van der Schouw, Yvonne T., Verschuren, W. M.Monique, di Angelantonio, Emanuele, Langenberg, Claudia, UMC Utrecht, Cardiovasculaire Epi Team 1, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Cardiovasculaire Epidemiologie, Public Health Epidemiologie, Key, Timothy J., Appleby, Paul N., Bradbury, Kathryn E., Sweeting, Michael, Wood, Angela, Johansson, Ingegerd, Kühn, Tilman, Steur, Marinka, Weiderpass, Elisabete, Wennberg, Maria, Lund Würtz, Anne Mette, Agudo, Antonio, Andersson, Jonas, Arriola, Larraitz, Boeing, Heiner, Boer, Jolanda M.A., Bonnet, Fabrice, Boutron-Ruault, Marie Christine, Cross, Amanda J., Ericson, Ulrika, Fagherazzi, Guy, Ferrari, Pietro, Gunter, Marc, Huerta, José María, Katzke, Verena, Khaw, Kay Tee, Krogh, Vittorio, La Vecchia, Carlo, Matullo, Giuseppe, Moreno-Iribas, Conchi, Naska, Androniki, Nilsson, Lena Maria, Olsen, Anja, Overvad, Kim, Palli, Domenico, Panico, Salvatore, Molina-Portillo, Elena, Quirós, J. Ramón, Skeie, Guri, Sluijs, Ivonne, Sonestedt, Emily, Stepien, Magdalena, Tjønneland, Anne, Trichopoulou, Antonia, Tumino, Rosario, Tzoulaki, Ioanna, van der Schouw, Yvonne T., Verschuren, W. M.Monique, di Angelantonio, Emanuele, and Langenberg, Claudia

Published
2019

40. Association of plasma biomarkers of fruit and vegetable intake with incident type 2 diabetes: EPIC-InterAct case-cohort study in eight European countries.

Author

Ju-Sheng Zheng, Sharp, Stephen J., Fumiaki Imamura, Chowdhury, Rajiv, Gundersen, Thomas E., Steur, Marinka, Sluijs, Ivonne, van der Schouw, Yvonne T., Agudo, Antonio, Aune, Dagfinn, Barricarte, Aurelio, Boeing, Heiner, Chirlaque, María-Dolores, Dorronsoro, Miren, Freisling, Heinz, El-Fatouhi, Douae, Franks, Paul W., Fagherazzi, Guy, Grioni, Sara, and Gunter, Marc J.

Subjects
BIOMARKERS, CAROTENOIDS, CONFIDENCE intervals, FRUIT, INGESTION, LONGITUDINAL method, TYPE 2 diabetes, VEGETABLES, VITAMIN C, DATA analysis software, DESCRIPTIVE statistics, DISEASE risk factors
Published
2020
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46. Plasma concentrations of 25-hydroxyvitamin D in meat eaters, fish eaters, vegetarians and vegans: results from the EPIC–Oxford study.

Author

Crowe, Francesca L, Steur, Marinka, Allen, Naomi E, Appleby, Paul N, Travis, Ruth C, and Key, Timothy J

Subjects
*VITAMIN D in human nutrition, *DIETARY supplements, *CROSS-sectional method, *VEGETARIANS, *FOOD of animal origin, *BLOOD testing, *BLOOD plasma
Abstract

ObjectiveVegetarians and vegans exclude certain food sources of vitamin D from their diet, but it is not clear to what extent this affects plasma concentrations of 25-hydroxyvitamin D (25(OH)D). The objective was to investigate differences in vitamin D intake and plasma concentrations of 25(OH)D among meat eaters, fish eaters, vegetarians and vegans.DesignA cross-sectional analysis.SettingUnited Kingdom.SubjectsPlasma 25(OH)D concentrations were measured in 2107 white men and women (1388 meat eaters, 210 fish eaters, 420 vegetarians and eighty-nine vegans) aged 20–76 years from the European Prospective Investigation into Cancer and Nutrition (EPIC)–Oxford cohort.ResultsPlasma 25(OH)D concentrations reflected the degree of animal product exclusion and, hence, dietary intake of vitamin D; meat eaters had the highest mean intake of vitamin D (3·1 (95 % CI 3·0, 3·2) μg/d) and mean plasma 25(OH)D concentrations (77·0 (95 % CI 75·4, 78·8) nmol/l) and vegans the lowest (0·7 (95 % CI 0·6, 0·8) μg/d and 55·8 (95 % CI 51·0, 61·0) nmol/l, respectively). The magnitude of difference in 25(OH)D concentrations between meat eaters and vegans was smaller (20 %) among those participants who had a blood sample collected during the summer months (July–September) compared with the winter months (38 %; January–March). The prevalence of low plasma concentrations of 25(OH)D (<25 nmol/l) during the winter and spring ranged from <1 % to 8 % across the diet groups.ConclusionsPlasma 25(OH)D concentrations were lower in vegetarians and vegans than in meat and fish eaters; diet is an important determinant of plasma 25(OH)D in this British population. [ABSTRACT FROM AUTHOR]

Published
2011
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47. Abstract 50: Associations of Dietary Saturated Fatty Acids With Incident Coronary Heart Disease Depend on the Food Sources: EPIC-CVD Prospective Case-cohort Study in Nine European Countries

Author

Steur, Marinka

Abstract

Introduction:The associations of dietary total fatty acids and the classes saturated, monounsaturated, and polyunsaturated fatty acids (SFAs, MUFAs, and PUFAs) with coronary heart disease (CHD) remain contentious. Moreover, the role of isocaloric macronutrient substitutions and specific food sources of SFAs, particularly in European context, is unclear.Hypothesis:We evaluated the hypothesis that associations of dietary fatty acids vary depending on specific macronutrient substitutions and food sources of SFAs.Methods:We conducted case-cohort analyses including 10,529 incident CHD cases and a random subcohort of 16,730 men and women selected from 385,747 eligible participants in nine countries of the European Prospective Investigation into Cancer and Nutrition Study. Habitual diet was assessed using country-specific dietary questionnaires, and macronutrient intakes were estimated using standardised nutrient databases. Country-specific HRs (95% CIs) per 5% energy intake from dietary total fatty acids, SFAs, MUFAs, and PUFAs were estimated using Prentice-weighted Cox regression models and pooled using random-effects meta-analyses, with and without considering isocaloric macronutrient substitutions. The associations of dietary SFAs from different food sources, including specific macronutrient substitutions, with CHD were also investigated.Results:There was no evidence of associations of dietary total fatty acids, SFAs, MUFAs, or PUFAs with incident CHD, regardless of the substitution macronutrient. Each 1% higher energy intake of SFAs from yoghurt, cheese, and fish were associated with a 7% (95% CI 1-12%), 2% (0-4%) and 13% (0-25%) lower CHD incidence, while SFAs from red meat and butter were associated with a 7% (2-12%) and 2% (0-4%) higher CHD incidence, respectively.Conclusions:There was no evidence of associations of dietary total fatty acids, SFAs, MUFAs, and PUFAs, with CHD incidence, regardless of the substitution nutrients, within the range of intakes in this European population. The opposite direction of associations of SFAs from different food sources such as red meat versus fermented dairy products suggests that public health recommendations should consider foods and overall diets, alongside the macronutrients they contain.

Published
2020
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48. Plant foods, dietary fibre and risk of ischaemic heart disease in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort

Author

Perez-Cornago, Aurora, Crowe, Francesca L, Appleby, Paul N, Bradbury, Kathryn E, Wood, Angela M, Jakobsen, Marianne Uhre, Johnson, Laura, Sacerdote, Carlotta, Steur, Marinka, Weiderpass, Elisabete, Würtz, Anne Mette L, Kühn, Tilman, Katzke, Verena, Trichopoulou, Antonia, Karakatsani, Anna, La Vecchia, Carlo, Masala, Giovanna, Tumino, Rosario, Panico, Salvatore, Sluijs, Ivonne, Skeie, Guri, Imaz, Liher, Petrova, Dafina, Quirós, J Ramón, Yohar, Sandra Milena Colorado, Jakszyn, Paula, Melander, Olle, Sonestedt, Emily, Andersson, Jonas, Wennberg, Maria, Aune, Dagfinn, Riboli, Elio, Schulze, Matthias B, Di Angelantonio, Emanuele, Wareham, Nicholas J, Danesh, John, Forouhi, Nita G, Butterworth, Adam S, and Key, Timothy J

Subjects
2. Zero hunger, vegetables, Dietary Fiber, Male, legumes, Myocardial Ischemia, food and beverages, nuts, seeds, 3. Good health, Diet, Europe, Risk Factors, Fruit, Neoplasms, Humans, Female, Prospective Studies, coronary heart disease, Life Style
Abstract

BACKGROUND: Epidemiological evidence indicates that diets rich in plant foods are associated with a lower risk of ischaemic heart disease (IHD), but there is sparse information on fruit and vegetable subtypes and sources of dietary fibre. This study examined the associations of major plant foods, their subtypes and dietary fibre with risk of IHD in the European Prospective Investigation into Cancer and Nutrition (EPIC). METHODS: We conducted a prospective analysis of 490 311 men and women without a history of myocardial infarction or stroke at recruitment (12.6 years of follow-up, n cases = 8504), in 10 European countries. Dietary intake was assessed using validated questionnaires, calibrated with 24-h recalls. Multivariable Cox regressions were used to estimate hazard ratios (HR) of IHD. RESULTS: There was a lower risk of IHD with a higher intake of fruit and vegetables combined [HR per 200 g/day higher intake 0.94, 95% confidence interval (CI): 0.90-0.99, P-trend = 0.009], and with total fruits (per 100 g/day 0.97, 0.95-1.00, P-trend = 0.021). There was no evidence for a reduced risk for fruit subtypes, except for bananas. Risk was lower with higher intakes of nuts and seeds (per 10 g/day 0.90, 0.82-0.98, P-trend = 0.020), total fibre (per 10 g/day 0.91, 0.85-0.98, P-trend = 0.015), fruit and vegetable fibre (per 4 g/day 0.95, 0.91-0.99, P-trend = 0.022) and fruit fibre (per 2 g/day 0.97, 0.95-1.00, P-trend = 0.045). No associations were observed between vegetables, vegetables subtypes, legumes, cereals and IHD risk. CONCLUSIONS: In this large prospective study, we found some small inverse associations between plant foods and IHD risk, with fruit and vegetables combined being the most strongly inversely associated with risk. Whether these small associations are causal remains unclear.

49. Dietary Fatty Acids, Macronutrient Substitutions, Food Sources and Incidence of Coronary Heart Disease: Findings From the EPIC-CVD Case-Cohort Study Across Nine European Countries

Author

Steur, Marinka, Johnson, Laura, Sharp, Stephen J, Imamura, Fumiaki, Sluijs, Ivonne, Key, Timothy J, Wood, Angela, Chowdhury, Rajiv, Guevara, Marcela, Jakobsen, Marianne U, Johansson, Ingegerd, Koulman, Albert, Overvad, Kim, Sánchez, Maria-José, Van Der Schouw, Yvonne T, Trichopoulou, Antonia, Weiderpass, Elisabete, Wennberg, Maria, Zheng, Ju-Sheng, Boeing, Heiner, Boer, Jolanda MA, Boutron-Ruault, Marie-Christine, Ericson, Ulrika, Heath, Alicia K, Huybrechts, Inge, Imaz, Liher, Kaaks, Rudolf, Krogh, Vittorio, Kühn, Tilman, Kyrø, Cecilie, Masala, Giovanna, Melander, Olle, Moreno-Iribas, Conchi, Panico, Salvatore, Quirós, José R, Rodríguez-Barranco, Miguel, Sacerdote, Carlotta, Santiuste, Carmen, Skeie, Guri, Tjønneland, Anne, Tumino, Rosario, Verschuren, WM Monique, Zamora-Ros, Raul, Dahm, Christina C, Perez-Cornago, Aurora, Schulze, Matthias B, Tong, Tammy YN, Riboli, Elio, Wareham, Nicholas J, Danesh, John, Butterworth, Adam S, and Forouhi, Nita G

Subjects
2. Zero hunger, saturated fat, Incidence, primary prevention, Fatty Acids, Coronary Disease, Nutrients, Dietary Fats, 3. Good health, Cohort Studies, Europe, nutritional epidemiology, Food, Humans, coronary heart disease, dietary guidelines
Abstract

Background There is controversy about associations between total dietary fatty acids, their classes (saturated fatty acids [SFAs], monounsaturated fatty acids, and polyunsaturated fatty acids), and risk of coronary heart disease (CHD). Specifically, the relevance of food sources of SFAs to CHD associations is uncertain. Methods and Results We conducted a case-cohort study involving 10 529 incident CHD cases and a random subcohort of 16 730 adults selected from a cohort of 385 747 participants in 9 countries of the EPIC (European Prospective Investigation into Cancer and Nutrition) study. We estimated multivariable adjusted country-specific hazard ratios (HRs) and 95% CIs per 5% of energy intake from dietary fatty acids, with and without isocaloric macronutrient substitutions, using Prentice-weighted Cox regression models and pooled results using random-effects meta-analysis. We found no evidence for associations of the consumption of total or fatty acid classes with CHD, regardless of macronutrient substitutions. In analyses considering food sources, CHD incidence was lower per 1% higher energy intake of SFAs from yogurt (HR, 0.93 [95% CI, 0.88-0.99]), cheese (HR, 0.98 [95% CI, 0.96-1.00]), and fish (HR, 0.87 [95% CI, 0.75-1.00]), but higher for SFAs from red meat (HR, 1.07 [95% CI, 1.02-1.12]) and butter (HR, 1.02 [95% CI, 1.00-1.04]). Conclusions This observational study found no strong associations of total fatty acids, SFAs, monounsaturated fatty acids, and polyunsaturated fatty acids, with incident CHD. By contrast, we found associations of SFAs with CHD in opposite directions dependent on the food source. These findings should be further confirmed, but support public health recommendations to consider food sources alongside the macronutrients they contain, and suggest the importance of the overall food matrix.

50. Plant foods, dietary fibre and risk of ischaemic heart disease in the EPIC cohort

Author

Perez-Cornago, Aurora, Crowe, Francesca L, Appleby, Paul N, Bradbury, Kathryn E, Wood, Angela M, Steur, Marinka, Di Angelantonio, Emanuele, Wareham, Nicholas J, Danesh, John, Forouhi, Nita G, Butterworth, Adam, Key, Timothy J, Wood, Angela [0000-0002-7937-304X], Di Angelantonio, Emanuele [0000-0001-8776-6719], Wareham, Nicholas [0000-0003-1422-2993], Forouhi, Nita [0000-0002-5041-248X], Butterworth, Adam [0000-0002-6915-9015], and Apollo - University of Cambridge Repository

Subjects
food and beverages
Abstract

Background: Epidemiological evidence indicates that diets rich in plant foods are associated with a lower risk of ischaemic heart disease (IHD), but there is sparse information on fruit and vegetable subtypes and sources of dietary fibre. This study examined the associations of major plant foods, their subtypes and dietary fibre with risk of IHD in EPIC. Methods: We conducted a prospective analysis of 490,311 men and women in ten European countries without a history of myocardial infarction or stroke at recruitment (12.6 years of follow-up, n cases=8504). Dietary intake was assessed using validated questionnaires, calibrated with 24-hour recalls. Multivariable Cox regressions were used to estimate hazard ratios (HR) of IHD. Results: There was a lower risk of IHD with a higher intake of fruit and vegetables combined (HR per 200 g/day higher intake 0.94, 95% CI:0.90-0.99, P-trend=0.009), and total fruits (per 100g/day 0.97, 0.95-1.00, P-trend=0.021). There was no evidence for a reduced risk for fruit subtypes, except for bananas. Risk was lower with higher intakes of nuts and seeds (per 10g/day 0.90, 0.82-0.98, P-trend=0.020), total fibre (per 10g/day 0.95, 0.85-0.98, P-trend=0.015), fruit and vegetable fibre (per 4g/day 0.95, 0.91-0.99, P-trend=0.022), and fruit fibre (per 2 g/day 0.97, 0.95-1.00, P-trend=0.045). No associations were observed between vegetables, vegetables subtypes, legumes, cereals and IHD risk. Conclusions: In this large prospective study, we found some small inverse associations between plant foods and IHD risk, with fruit and vegetables combined being the most strongly inversely associated with risk. Whether these small associations are causal remains unclear., Analyses supported by the UK Medical Research Council (MR/M012190/1), Cancer Research UK (C8221/A19170 and 570/A16491), and the Wellcome Trust (Our Planet Our Health, Livestock Environment and People 205212/Z/16/Z). APC is supported by a Cancer Research UK Population Research Fellowship (C60192/A28516) and by the World Cancer Research Fund (WCRF UK), as part of the Word Cancer Research Fund International grant programme (2019/1953). EPIC-CVD has been supported by the European Union Framework 7 (HEALTH-F2-2012-279233), the European Research Council (268834), the UK Medical Research Council (G0800270 and MR/L003120/1), the British Heart Foundation (SP/09/002 and RG/08/014 and RG13/13/30194), and the UK National Institute of Health Research. The InterAct project was funded by the EU FP6 programme (grant number LSHM_CT_2006_037197), and provided the biomarker data in the subcohort that was used in the current study. The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l’Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France); German Cancer Aid, German Cancer Research Center (DKFZ), Federal Ministry of Education and Research (BMBF) (Germany); the Hellenic Health Foundation (Greece); Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy and National Research Council (Italy); Dutch 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); Health Research Fund (FIS), PI13/00061 to Granada, PI13/01162 to EPIC-Murcia, Regional Governments of Andalucía, Asturias, Basque Country, Murcia (no. 6236) and Navarra, ISCIII RETIC (RD06/0020) (Spain); Swedish Cancer Society, Swedish Research Council and County Councils of Skåne and Västerbotten (Sweden); Cancer Research UK (14136 to EPIC-Norfolk; C570/A16491 and C8221/A19170 to EPIC-Oxford), UK Medical Research Council (1000143 to EPIC-Norfolk, MR/M012190/1 to EPIC-Oxford, MC_UU_12015/1 (NJW), MC_UU_12015/5 (NGF), and MC_UU_12015/520, and NIHR Biomedical Research Centre Cambridge: Nutrition, Diet, and Lifestyle Research Theme (IS-BRC-1215-20014) to the MRC Epidemiology Unit Cambridge (NJW, NGF). JD holds a British Heart Foundation Chair and an NIHR Senior Investigator Award. KEB holds a Girdlers’ New Zealand Health Research Council Fellowship.

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