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  • 1
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  Mainz//2011; 56. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 6. Jahrestagung der Deutschen Gesellschaft für Epidemiologie (DGEpi); 20110926-20110929; Mainz; DOC11gmds310 /20110920/
    Publication Date: 2011-09-20
    Keywords: Vitamin D ; Myocardial infarction ; Prospective study ; ddc: 610
    Language: German
    Type: conferenceObject
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  • 2
    Keywords: CANCER ; MODEL ; MODELS ; FOLLOW-UP ; COHORT ; POPULATION ; INTERVENTION ; ASSOCIATION ; PATTERNS ; DESIGN ; ENERGY ; AGE ; WOMEN ; MEN ; OBESITY ; smoking ; COUNTRIES ; DIET ; FAT ; BLOOD-PRESSURE ; ALCOHOL ; PROJECT ; CONSUMPTION ; nutrition ; SMOKERS ; CALIBRATION ; MANAGEMENT ; physical activity ; ASSOCIATIONS ; PATTERN ; WEIGHT ; ENERGY-INTAKE ; LOW-CARBOHYDRATE ; PHYSICAL-ACTIVITY ; dietary patterns ; BODY-MASS INDEX ; prospective ; EUROPEAN COUNTRIES ; WAIST CIRCUMFERENCE ; WEIGHT CHANGE ; RANDOMIZED CLINICAL-TRIAL ; Lead ; Follow up ; weight gain ; OBESE ADULTS ; PLASMA LEPTIN ; PROTEIN DIET
    Abstract: Background: Meat intake may be related to weight gain because of its high energy and fat content. Some observational studies have shown that meat consumption is positively associated with weight gain, but intervention studies have shown mixed results. Objective: Our objective was to assess the association between consumption of total meat, red meat, poultry, and processed meat and weight gain after 5 y of follow-up, on average, in the large European population who participated in the European Prospective Investigation into Cancer and Nutrition-Physical Activity, Nutrition, Alcohol, Cessation of Smoking, Eating Out of Home and Obesity (EPIC-PANACEA) project. Design: A total of 103,455 men and 270,348 women aged 25-70 y were recruited between 1992 and 2000 in 10 European countries. Diet was assessed at baseline with the use of country-specific validated questionnaires. A dietary calibration study was conducted in a representative subsample of the cohort. Weight and height were measured at baseline and self-reported at follow-up in most centers. Associations between energy from meat (kcal/d) and annual weight change (g/y) were assessed with the use of linear mixed models, controlled for age, sex, total energy intake, physical activity, dietary patterns, and other potential confounders. Results: Total meat consumption was positively associated with weight gain in men and women, in normal-weight and overweight subjects, and in smokers and nonsmokers. With adjustment for estimated energy intake, an increase in meat intake of 250 g/d (eg, one steak at approximate to 450 kcal) would lead to a 2-kg higher weight gain after 5 y (95% CI: 1.5, 2.7 kg). Positive associations were observed for red meat, poultry, and processed meat. Conclusion: Our results suggest that a decrease in meat consumption may improve weight management. Am J Clin Nutr 2010; 92: 398-407
    Type of Publication: Journal article published
    PubMed ID: 20592131
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  • 3
    Keywords: CANCER ; cohort studies ; RISK-FACTORS ; PREVALENCE ; nutrition ; GENETIC EPIDEMIOLOGY ; PHYSICAL-ACTIVITY ; CORONARY-HEART-DISEASE ; SPAIN ; type 2 diabetes ; LOCI ; Diabetes Mellitus ; GENOME-WIDE ASSOCIATION ; Epidemiologic research design ; Gene-lifestyle interaction ; POPULATION-BASED INCIDENCE
    Abstract: Studying gene-lifestyle interaction may help to identify lifestyle factors that modify genetic susceptibility and uncover genetic loci exerting important subgroup effects. Adequately powered studies with prospective, unbiased, standardised assessment of key behavioural factors for gene-lifestyle studies are lacking. This case-cohort study aims to investigate how genetic and potentially modifiable lifestyle and behavioural factors, particularly diet and physical activity, interact in their influence on the risk of developing type 2 diabetes. Incident cases of type 2 diabetes occurring in European Prospective Investigation into Cancer and Nutrition (EPIC) cohorts between 1991 and 2007 from eight of the ten EPIC countries were ascertained and verified. Prentice-weighted Cox regression and random-effects meta-analyses were used to investigate differences in diabetes incidence by age and sex. A total of 12,403 verified incident cases of type 2 diabetes occurred during 3.99 million person-years of follow-up of 340,234 EPIC participants eligible for InterAct. We defined a centre-stratified subcohort of 16,154 individuals for comparative analyses. Individuals with incident diabetes who were randomly selected into the subcohort (n = 778) were included as cases in the analyses. All prevalent diabetes cases were excluded from the study. InterAct cases were followed-up for an average of 6.9 years; 49.7% were men. Mean baseline age and age at diagnosis were 55.6 and 62.5 years, mean BMI and waist circumference values were 29.4 kg/m(2) and 102.7 cm in men, and 30.1 kg/m(2) and 92.8 cm in women, respectively. Risk of type 2 diabetes increased linearly with age, with an overall HR of 1.56 (95% CI 1.48-1.64) for a 10 year age difference, adjusted for sex. A male excess in the risk of incident diabetes was consistently observed across all countries, with a pooled HR of 1.51 (95% CI 1.39-1.64), adjusted for age. InterAct is a large, well-powered, prospective study that will inform our understanding of the interplay between genes and lifestyle factors on the risk of type 2 diabetes development
    Type of Publication: Journal article published
    PubMed ID: 21717116
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  • 4
    Keywords: CANCER ; RISK ; BODY-WEIGHT ; WOMEN ; nutrition ; LIFE-STYLE ; MIDDLE-AGED WOMEN ; ENERGY-INTAKE ; dietary patterns ; metabolic syndrome ; GAIN ; EPIC-OXFORD ; INTERVENTION TRIAL
    Abstract: BACKGROUND: Fruit and vegetable consumption might prevent weight gain through their low energy density and high dietary fiber content. OBJECTIVE: We assessed the association between the baseline consumption of fruit and vegetables and weight change in participants from 10 European countries participating in the European Prospective Investigation into Cancer and Nutrition study. DESIGN: Diet was assessed at baseline in 373,803 participants by using country-specific validated questionnaires. Weight was measured at baseline and self-reported at follow-up in most centers. Associations between baseline fruit and vegetable intakes (per 100 g/d) and weight change (g/y) after a mean follow-up of 5 y were assessed by using linear mixed-models, with age, sex, total energy intake, and other potential confounders controlled for. RESULTS: After exclusion of subjects with chronic diseases at baseline and subjects who were likely to misreport energy intakes, baseline fruit and vegetable intakes were not associated with weight change overall. However, baseline fruit and vegetable intakes were inversely associated with weight change in men and women who quit smoking during follow-up. We observed weak positive associations between vegetable intake and weight change in women who were overweight, were former smokers, or had high prudent dietary pattern scores and weak inverse associations between fruit intake and weight change in women who were 〉50 y of age, were of normal weight, were never smokers, or had low prudent dietary pattern scores. CONCLUSIONS: In this large study, higher baseline fruit and vegetable intakes, while maintaining total energy intakes constant, did not substantially influence midterm weight change overall but could help to reduce risk of weight gain in persons who stop smoking. The interactions observed in women deserve additional attention.
    Type of Publication: Journal article published
    PubMed ID: 22170373
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  • 5
    Keywords: CANCER ; COHORT ; INTERVENTION ; DIETARY-INTAKE ; OLDER WOMEN ; POSTMENOPAUSAL WOMEN ; PHYSICAL-ACTIVITY ; RANDOMIZED CONTROLLED-TRIAL ; INSULIN SENSITIVITY ; DRINKING PATTERNS
    Abstract: Abstract. Beulens JWJ, van der Schouw YT, Bergmann MM, Rohrmann S, B Schulze M, Buijsse B, Grobbee DE, Arriola L, Cauchi S, Tormo M-J, Allen NE, van der A DL, Balkau B, Boeing H, Clavel-Chapelon F, de Lauzon-Guillan B, Franks P, Froguel P, Gonzales C, Halkjaer J, Huerta JM, Kaaks R, Key TJ, Khaw KT, Krogh V, Molina-Montes E, Nilsson P, Overvad K, Palli D, Panico S, Ramon Quiros J, Ronaldsson O, Romieu I, Romaguera D, Sacerdote C, Sanchez M-J, Spijkerman AMW, Teucher B, Tjonneland A, Tumino R, Sharp S, Forouhi NG, Langenberg C, Feskens EJM, Riboli E, Wareham NJ (University Medical Center Utrecht, The Netherlands; German Institute of Human Nutrition, Potsdam-Rehbrucke, Germany; German Cancer Research Centre, Heidelberg, Germany; Basque Government, San Sebastian, CIBERESP, Spain; Institut de Biologie de Lille, Lille, France; Murcia Regional Health Council, Murcia, Spain; CIBER Epidemiologia y Salud Publica (CIBERESP), Spain; University of Oxford, Oxford, UK; National Institute of Public Health and the Environment, Bilthoven, The Netherlands; Inserm, CESP Centre for Research in Epidemiology and Population Health, Villejuif Cedex, France; Lund University, Malmo, Sweden; Imperial College, London, UK; Department of Epidemiology, Barcelona, Spain; Danish Cancer Society, Copenhagen, Denmark; University of Cambridge, Cambridge, UK; Fondazione IRCCS Istituto Nazionale Tumori Milan, Milan, Italy; Andalusian School of Public Health, Granada, Spain; School of Public Health, Aarhus, Denmark; Cancer Research and Prevention Institute (ISPO), Florence, Italy; Universita Federico II, Napoli, Italy; Consejeria de Salud y Servicios Sanitarios, Oviedo-Asturias, Spain; Umea University, Umea, Sweden; International Agency for Research of Cancer, Lyon, France; Center for Cancer Prevention (CPO-Piemonte), Torino, Italy; "Civile - M.P. Arezzo" Hospital, Ragusa, Italy; Addenbrooke's Hospital, Cambridge, UK; and Wageningen University, Wageningen, The Netherlands). Alcohol consumption and risk of type 2 diabetes in European men and women: influence of beverage type and body size. The EPIC-InterAct study. J Intern Med 2012; 272: 358-370. Objective: To investigate the association between alcohol consumption and type 2 diabetes, and determine whether this is modified by sex, body mass index (BMI) and beverage type. Design: Multicentre prospective case-cohort study. Setting: Eight countries from the European Prospective Investigation into Cancer and Nutrition cohort. Subjects: A representative baseline sample of 16 154 participants and 12 403 incident cases of type 2 diabetes. Interventions: Alcohol consumption assessed using validated dietary questionnaires. Main outcome measures: Occurrence of type 2 diabetes based on multiple sources (mainly self-reports), verified against medical information. Results: Amongst men, moderate alcohol consumption was nonsignificantly associated with a lower incidence of diabetes with a hazard ratio (HR) of 0.90 (95% CI: 0.78-1.05) for 6.1-12.0 versus 0.1-6.0 g day(-1) , adjusted for dietary and diabetes risk factors. However, the lowest risk was observed at higher intakes of 24.1-96.0 g day(-1) with an HR of 0.86 (95% CI: 0.75-0.98). Amongst women, moderate alcohol consumption was associated with a lower incidence of diabetes with a hazard ratio of 0.82 (95% CI: 0.72-0.92) for 6.1-12.0 g day(-1) (P interaction gender 〈0.01). The inverse association between alcohol consumption and diabetes was more pronounced amongst overweight (BMI 〉/= 25 kg m(-2) ) than normal-weight men and women (P interaction 〈 0.05). Adjusting for waist and hip circumference did not alter the results for men, but attenuated the association for women (HR=0.90, 95% CI: 0.79-1.03 for 6.1-12.0 g day(-1) ). Wine consumption for men and fortified wine consumption for women were most strongly associated with a reduced risk of diabetes. Conclusions: The results of this study show that moderate alcohol consumption is associated with a lower risk
    Type of Publication: Journal article published
    PubMed ID: 22353562
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  • 6
    Keywords: CANCER ; CONSUMPTION ; LIFE-STYLE ; BETA-CAROTENE ; FOOD FREQUENCY QUESTIONNAIRE ; dietary patterns ; RANDOMIZED CONTROLLED-TRIAL ; 10 EUROPEAN COUNTRIES ; MAGNESIUM INTAKE ; CHRONIC DISEASE RISK
    Abstract: Fruit and vegetable intake (FVI) may reduce the risk of type 2 diabetes (T2D), but the epidemiological evidence is inconclusive. The aim of this study is to examine the prospective association of FVI with T2D and conduct an updated meta-analysis. In the European Prospective Investigation into Cancer-InterAct (EPIC-InterAct) prospective case-cohort study nested within eight European countries, a representative sample of 16 154 participants and 12 403 incident cases of T2D were identified from 340 234 individuals with 3.99 million person-years of follow-up. For the meta-analysis we identified prospective studies on FVI and T2D risk by systematic searches of MEDLINE and EMBASE until April 2011. In EPIC-InterAct, estimated FVI by dietary questionnaires varied more than twofold between countries. In adjusted analyses the hazard ratio (95% confidence interval) comparing the highest with lowest quartile of reported intake was 0.90 (0.80-1.01) for FVI; 0.89 (0.76-1.04) for fruit and 0.94 (0.84-1.05) for vegetables. Among FV subtypes, only root vegetables were inversely associated with diabetes 0.87 (0.77-0.99). In meta-analysis using pooled data from five studies including EPIC-InterAct, comparing the highest with lowest category for FVI was associated with a lower relative risk of diabetes (0.93 (0.87-1.00)). Fruit or vegetables separately were not associated with diabetes. Among FV subtypes, only green leafy vegetable (GLV) intake (relative risk: 0.84 (0.74-0.94)) was inversely associated with diabetes. Subtypes of vegetables, such as root vegetables or GLVs may be beneficial for the prevention of diabetes, while total FVI may exert a weaker overall effect.
    Type of Publication: Journal article published
    PubMed ID: 22854878
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  • 7
    Keywords: SURVIVAL ; POPULATION ; PATTERNS ; HEALTH ; nutrition ; PHYSICAL-ACTIVITY ; METAANALYSIS ; RECTAL CANCERS ; ADHERENCE ; EPIC cohort
    Abstract: The authors investigated the association of adherence to Mediterranean diet with colorectal cancer (CRC) risk in the European Prospective Investigation into Cancer and nutrition study. Adherence to Mediterranean diet was expressed through two 10-unit scales, the Modified Mediterranean diet score (MMDS) and the Centre-Specific MMDS (CSMMDS). Both scales share the same dietary components but differ in the cut-off values that were used for these components in the construction of the scales. Adjusted hazard ratios (HR) for the associations of these scales with CRC incidence were estimated. After 5,296,617 person-years of follow-up, 4,355 incident CRC cases were identified. A decreased risk of CRC, of 8 and 11 % was estimated when comparing the highest (scores 6-9) with the lowest (scores 0-3) adherence to CSMMDS and MMDS respectively. For MMDS the HR was 0.89 (95 % confidence interval (CI): 0.80, 0.99). A 2-unit increment in either Mediterranean scale was associated with a borderline statistically significant 3 to 4 % reduction in CRC risk (HR for MMDS: 0.96; 95 % CI: 0.92, 1.00). These associations were somewhat more evident, among women, were mainly manifested for colon cancer risk and their magnitude was not altered when alcohol was excluded from MMDS. These findings suggest that following a Mediterranean diet may have a modest beneficial effect on CRC risk.
    Type of Publication: Journal article published
    PubMed ID: 23579425
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  • 8
    Keywords: RISK ; REPRODUCIBILITY ; PROSTATE-CANCER ; FUTURE ; EPIC-GERMANY ; CARDIOVASCULAR-DISEASE ; GENOME-WIDE ASSOCIATION ; D-BINDING PROTEIN ; CIRCULATING VITAMIN-D ; CASE-COHORT
    Abstract: Circulating 25-hydroxyvitamin D (25(OH)D) has been associated with cardiovascular disease (CVD) risk in observational studies. Also, SNPs to explain variation in 25(OH)D have been identified by genome-wide association studies. Detection of direct associations between SNPs that significantly affect 25(OH)D and CVD risk would indicate a causal role of vitamin D, as reverse causation could be excluded and confounding could be better controlled. Thus, a combined analysis of candidate SNPs in relation to circulating 25(OH)D and CVD risk was carried out. A case-cohort study within the EPIC-Germany study was conducted comprising a randomly drawn subcohort of 2,132 subjects (57.9% women, mean age: 50.6 years) and incident cases of myocardial infarction (n=559) and stroke (n=471) that occurred during a mean follow-up duration of 7.6 years. 25(OH)D concentrations were measured by LC-MS/MS in baseline plasma samples. Additionally, eight candidate SNPs were assayed. Associations between 25(OH)D, SNPs and the risks of myocardial infarction and stroke were assessed by multivariable regression analyses. Mean 25(OH)D level was 47.2 nmol/L in the subcohort. Four SNPs were associated with 25(OH)D (p〈0.05). In subjects with 25(OH)D levels 〈25 nmol/L, the risks of CVD as composite endpoint (Hazard Ratio: 1.53, 95% confidence interval: 1.12-2.09), myocardial infarction, and stroke were significantly increased compared to subjects with levels 〉/=50 nmol/L, while no significant linear associations were observed. A SNP score was not related to the risks of total CVD (Hazard Ratio: 1.0, 95% confidence interval: 0.71-1.42), myocardial infarction, or stroke. The same was true concerning single SNPs. Given the lack of association between SNPs and the risks of stroke and myocardial infarction, the present findings do not point to a major causal role of vitamin D in the development of these diseases. However, a detection of modest associations between genetic markers and CVD risk in larger consortia cannot be ruled out.
    Type of Publication: Journal article published
    PubMed ID: 23935930
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  • 9
    Keywords: FOOD-FREQUENCY QUESTIONNAIRE ; CORONARY-HEART-DISEASE ; N-3 FATTY-ACIDS
    Abstract: Recent meta-analyses have confirmed that fish consumption is related to decreased risks of ischaemic stroke and fatal CHD, while there seem to be no clear associations between fish consumption and the risks of haemorrhagic stroke and non-fatal CHD. As no studies in German populations have been reported to date, we assessed whether fish consumption as recorded by FFQ between 1994 and 1998 was related to incident myocardial infarction (MI) and stroke within the German arm of the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Cox proportional hazards regression analyses were conducted based on the data of 48 315 participants aged 35-65 years at baseline. The median fish intake was 16.4 g/d (25th-75th percentile 8.2-28.8 g/d). During a mean follow-up of 8.1 years, 605 incident MI and 525 incident strokes have been documented. After multiple adjustment, fish consumption was not related to incident MI (hazard ratio (HR) 0.84, 95% CI 0.66, 1.08, P-trend = 0.21) or stroke (HR 0.96, 95% CI 0.73, 1.26, Ptrend = 0.67). Separate analyses for fatal MI, ischaemic stroke and haemorrhagic stroke did not show significant associations, either. With regard to non-fatal MI, there was a non-significant trend for an inverse association (HR 0.78, 95% CI 0.59, 1.03, P-trend = 0.07). Overall, fish consumption was not related to the risks of MI and stroke in the EPIC-Germany study.
    Type of Publication: Journal article published
    PubMed ID: 23411152
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  • 10
    Keywords: RECEPTOR ; EXPRESSION ; RISK ; CALCIUM ; inflammation ; METAANALYSIS ; GENOME-WIDE ASSOCIATION ; INSULIN-SECRETION ; VITAMIN-D SUPPLEMENTATION ; GLUCOSE-TOLERANCE
    Abstract: It is unclear whether vitamin D lowers risk of type 2 diabetes (T2D). In an observational study, we assessed the prospective association between plasma 25-hydroxyvitamin D (25(OH)D) and incident T2D, and evaluated whether it holds up for genetically determined elevated 25(OH)D. We used a case-cohort study nested within the German arm of the European Prospective Investigation into Cancer. From a total cohort of 53,088 participants with a mean follow-up of 6.6 years, we identified a random subcohort of 2,121 participants (57 % women) and 1,572 incident cases of T2D. 25(OH)D was measured in baseline plasma samples retrieved from frozen storage. Mean plasma 25(OH)D in the subcohort was 47.1 (5th-95th percentile 19.6-80.7) nmol/L. After controlling for age, sex, center, season of blood draw, education, and lifestyle, the hazard of T2D decreased across increasing plasma concentrations of 25(OH)D (P linear trend 〈 0.0001). The association became non-linear after adjustment for BMI and waist circumference (P non-linearity 〈 0.0001), with the inverse association being restricted to participants with 25(OH)D concentrations below similar to 45 nmol/L (hazard ratio per 5 nmol/L higher 25(OH)D 0.91, 95 % CI 0.84-0.98). A score predicting genetically determined plasma 25(OH)D by weighting four independent single-nucleotide polymorphisms by their effect on 25(OH)D, explained 3.7 % of the variance in 25(OH)D. The hazard ratio (95 % CI) per 5 nmol/L higher genetically predicted 25(OH)D was 0.98 (0.89-1.08) in the entire study sample and 1.06 (0.93-1.21) in the sub-sample with 25(OH)D 〈 45 nmol/L. This latter finding casts doubt on a strong causal association of 25(OH)D with T2D, but further research in large-scale consortia is needed.
    Type of Publication: Journal article published
    PubMed ID: 24002339
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