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Hintergrund: Ein Ziel des Community Health Programme 2003 bis 2008 der Europäischen Union war die Entwicklung eines nachhaltigen Gesundheitsmonitoring Systems. In diesem Zusammenhang wurde das European Health Survey System entworfen. Dazu gehören der European Health Interview Survey (EHIS)[for full text, please go to the a.m. URL], Mainz//2011; 56. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 6. Jahrestagung der Deutschen Gesellschaft für Epidemiologie (DGEpi)

Objective: To analyse the current vitamin intake and the contribution of dietary supplements to this intake of 4030 participants of the German Nutrition Survey (GeNuS) 1998, which was part of the representative German National Health Interview and Examination Survey (GNHIES), conducted from October 1997 until March 1999. Design: In the GeNuS participants were interviewed comprehensively about their usual diet and supplementation patterns using a modified dietary history. Setting: Population-based nutritional survey. Subjects: A subsample of 4030 persons, aged 18-79 y, randomly selected from the GNHIES 1998. Results: The contribution of dietary supplements to the vitamin intake reached 5% for vitamin E among men and 6% for vitamin C among women. Among the group of regular users, the contribution to the vitamin E intake is 36% among men and 43% among women. A substantial part of the population does not reach the current recommendations for some vitamins, especially for folate and vitamin E through their diet alone. Among regular supplement users, about one-third for folate and about half for the other vitamins reach the recommended intake only when supplemental intake is considered. Among the regular users of folate supplements, this proportion is about half. Conclusion: If reference values are used as preference intake, a substantial population part improves their vitamin intake by taking supplements regularly. Nevertheless, there are persons who stay below the reference values including supplemental intake or already consume more than 100% of recommendation excluding supplemental intake.

Biomarkers of dietary exposure or nutritional status are sought actively to overcome limitations of traditional dietary methodology. We compared plasma and adipose tissue biomarkers for carotenoids and tocopherols. The data consisted of samples from 91 men and 122 women, ages 45-70 years, from the control group of the European Community Multicentre Study on Antioxidants, Myocardial Infarction, and Cancer of the Breast (EURAMIC) Study. Pearson correlations between plasma and adipose tissue measurements for β-carotene, lycopene, and α-tocopherol adjusted for smoking status displayed low, although significant, correlations of 0.39, 0.24, and 0.39, respectively. The correlation was further stratified by sex. After being corrected for measurement error using deattenuation factors obtained from a reproducibility study, the stratified correlation coefficients were as high as 0.80 for β-carotene in men, 0.62 for lycopene in women, and 0.52 for α- tocopherol in women. In addition, plasma and adipose tissue measurements from the myocardial infarction (MI) subset of the EURAMIC study population were used to evaluate the odds of MI, adjusting for confounders. We found that the concentration of lycopene in plasma was not positively associated significantly with MI (odds ratio, 1.78; P = 0.26). Adipose tissue lycopene, in contrast to reports elsewhere on the total population, showed an inverse association with MI (odds ratio, 0.62; P = 0.15). These results suggest that plasma and adipose carotenoids represent different markers for nutritional status and cannot be used interchangeably in epidemiological and dietary validation studies.

In the TRANSFAIR study, foods contributing to 95% of total fat intake were collected in 14 European countries. In addition to edible fats, dairy, meat, and bakery products some specific food items with relatively high amounts oftransfatty acids were found. French fried potatoes, both those from fast-food restaurants and those from the supermarkets (including potato chips), contained mostly between 12 and 35%transfatty acid, but some products fried in animal fat or vegetable oil contained lower proportions between 0.5 and 7% total fatty acids. Deep-fried croquettes were also rich intransfatty acids. Microwave popcorn samples contained 27-34%transfatty acids. Ready-made popcorn was low intransfatty acids but generally contained even more saturated fatty acids. Dry soup and sauce mixes and cubes and high-fat, frosted breakfast cereals were other examples of foods that often contained >10%transfatty acids. It is concluded that any deep-fried product such as French fried potatoes may contain high proportions of isomerictransfatty acids. Processed foods with a long shelf life such as dry soup powders and cubes, savory snacks, and popcorn often contained relatively high proportions oftransfatty acids, although the contributions of these products to total fat intake are probably small. The foods and snacks with a high proportion oftransfatty acids usually contained less saturated fatty acids and morecis-unsaturated fatty acids than respective foods prepared with low-transsaturated vegetable fats or animal fats. © 1998 Academic Press.

The fatty acid content of adipose tissue in postmenopausal breast cancer cases and controls from five European countries in the European Community Multicenter Study on Antioxidants, Myocardial Infarction, and Cancer (EURAMIC) breast cancer study (1991-1992) was used to explore the hypothesis that fatty acids of the omega-3 family inhibit breast cancer and that the degree of inhibition depends on background levels of omega-6 polyunsaturates. Considered in isolation, the level of omega-3 or omega-6 fat in adipose tissue displayed little consistent association with breast cancer across study centers. The ratio of long-chain omega-3 fatty acids to total omega-6 fat showed an inverse association with breast cancer in four of five centers. In Malaga, Spain, the odds ratio for the highest tertile relative to the lowest reached 0.32 (95% confidence interval 0.13-0.82). In this center, total omega-6 fatty acid was strongly associated with breast cancer. With all centers pooled, the odds ratio for long-chain omega-3 to total omega-6 reached 0.80 for the second tertile and 0.65 for the third tertile, a downward trend bordering on statistical significance (p for trend = 0.055). While not definitive, these results provide evidence for the hypothesis that the balance between omega-3 and omega-6 fat may play a role in breast cancer.

To evaluate the association of alcohol intake with the risk of breast cancer in post-menopausal women, we analyzed the data from an international case-control study conducted in five European countries (FRG, Switzerland, Northern Ireland, the Netherlands and Spain). Information on alcohol intake was available in 315 cases and 364 controls. Medians for the tertiles of alcohol intake among current drinkers were 1.7, 6.0, and 20.0 g/day. Adjusted relative risks (and 95% confidence intervals) of breast cancer for each tertile of intake in current drinkers, compared to never drinkers, were 1.00 (0.60-1.67), 1.01 (0.60-1.73), and 1.18 (0.69-2.03). The adjusted relative risk for ex-drinkers was 1.73 (1.07-2.79). Among both current drinkers and ex-drinkers, the relative risk was higher for those with body mass index above the median compared to those with body mass index below the median. These results do not support a dose-response effect of alcohol on breast cancer risk, although consumption levels were too low to exclude increased risk with high regular intake. Further research is necessary to evaluate the risk of developing breast cancer among ex-drinkers and the potential interaction between body mass index and alcohol drinking.

Antioxidants may protect against free radical mediated carcinogenesis. Epidemiological studies have not confirmed this hypothesis for breast cancer, possibly because of methodological limitations. Time-integrated exposure of α-tocopherol and β-carotene in adipose tissue, and selenium in toenails was investigated in a case-control study among postmenopausal women, ages 50-74 years, from five European countries. The study group comprised 347 incident breast cancer cases and 374 controls. Mean antioxidant levels, adjusted for age and center, did not significantly differ for α-tocopherol (cases were 4.5% higher than controls), β-carotene (3.0% lower), or selenium (1.8% lower). Odds ratios for highest versus lowest tertiles of exposure, adjusted for potential confounders, were 1.15 (95% confidence interval, 0.75-1.77), 0.74 (0.45-1.23), and 0.96 (0.63-1.47), respectively, without evidence for a decreasing trend. No statistically significant interactions were observed. Moreover, a provisional antioxidant score, indicating whether concentrations were above the median for zero, one, two, or all three antioxidants, yielded odds ratios of 1.00 (reference; all below median), 1.58, 1.58, and 1.21, respectively (χ2 for association = 4.00; P = 0.26). These results do not support the hypothesis that antioxidants are important determinants of this hormone-related malignancy among postmenopausal women. Chemicals/CAS: Antioxidants; beta Carotene, 7235-40-7; Free Radicals; Selenium, 7782-49-2; Vitamin E, 1406-18-4