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  • 1
    Keywords: EXPOSURE ; BIOMARKERS ; BREAST ; HUMANS ; smoking ; VALIDITY ; ENDOMETRIAL ; HEMOGLOBIN ADDUCTS ; glycidamide
    Abstract: Acrylamide, classified in 1994 by IARC as 'probably carcinogenic' to humans, was discovered in 2002 in some heat-treated, carbohydrate-rich foods. The association between dietary acrylamide intake and epithelial ovarian cancer risk (EOC) has been previously studied in one case-control and three prospective cohort studies which obtained inconsistent results, and could not further examine histological subtypes other than serous EOC. The present study was carried out in the European Prospective Investigation into Cancer and Nutrition (EPIC) sub-cohort of women (n=325,006). Multivariate Cox proportional hazards models were used to assess the association between questionnaire-based acrylamide intake and EOC risk. Acrylamide was energy-adjusted using the residual method, and was evaluated both as a continuous variable (per 10microg/day) and in quintiles; when subgroups by histological EOC subtypes were analyzed, acrylamide intake was evaluated in quartiles. During a mean follow-up of 11 years, 1,191 incident EOC cases were diagnosed. At baseline, the median acrylamide intake in EPIC was 21.3 mug/day. No associations, and no evidence for a dose-response were observed between energy-adjusted acrylamide intake and EOC risk (HR10microg/day:1.02, 95%CI:0.96-1.09; HRQ5vsQ1:0.97, 95%CI:0.76-1.23). No differences were seen when invasive EOC subtypes (582 serous, 118 endometrioid, and 79 mucinous tumors) were analyzed separately. This study did not provide evidence that acrylamide intake, based on food intake questionnaires, was associated with risk for EOC in EPIC. Additional studies with more reliable estimates of exposure based on biomarkers may be needed.
    Type of Publication: Journal article published
    PubMed ID: 25300475
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  • 2
    Keywords: ENERGIES ; CANCER ; Germany ; human ; MODEL ; MODELS ; FOLLOW-UP ; COHORT ; EPIDEMIOLOGY ; RISK ; RISK-FACTORS ; ASSOCIATION ; BREAST ; breast cancer ; BREAST-CANCER ; TRIAL ; hormone ; HEALTH ; ENERGY ; AGE ; WOMEN ; HORMONE REPLACEMENT THERAPY ; OBESITY ; risk factors ; COUNTRIES ; cancer risk ; RISK FACTOR ; EPIC ; EPIC study ; European Prospective Investigation into Cancer and Nutrition ; nutrition ; POSTMENOPAUSAL WOMEN ; MASS INDEX ; PH ; WEIGHT ; body weight ; fat distribution ; HEIGHT ; ADIPOSITY ; breast neoplasm ; HORMONE-REPLACEMENT THERAPY ; METAANALYSIS
    Abstract: The evidence for anthropometric factors influencing breast cancer risk is accumulating, but uncertainties remain concerning the role of fat distribution and potential effect modifiers. We used data from 73,542 premenopausal and 103,344 postmenopausal women from 9 European countries, taking part in the EPIC study. RRs from Cox regression models were calculated, using measured height, weight, BMI and waist and hip circumferences; categorized by cohort wide quintiles; and expressed as continuous variables, adjusted for study center, age and other risk factors. During 4.7 years of follow-up, 1,879 incident invasive breast cancers were identified. In postmenopausal women, current HRT modified the body size-breast cancer association. Among nonusers, weight, BMI and hip circumference were positively associated with breast cancer risk (all P-trend less than or equal to 0.002); obese women (BMI 〉 30) had a 31% excess risk compared to women with BMI 〈 25. Among HRT users, body measures were inversely but nonsignificantly associated with breast cancer. Excess breast cancer risk with HRT was particularly evident among lean women. Pooled RRs per height increment of 5 cm were 1.05 (95% CI 1.00-1.16) in premenopausal and 1.10 (95% CI 1.05-1.16) in postmenopausal women. Among premenopausal women, hip circumference was the only other measure significantly related to breast cancer (P-trend = 0.03), after accounting for BMI. In postmenopausal women not taking exogenous hormones, general obesity is a significant predictor of breast cancer, while abdominal fat assessed as waist-hip ratio or waist circumference was not related to excess risk when adjusted for BMI. Among premenopausal women, weight and BMI showed nonsignificant inverse associations with breast cancer. (C) 2004 Wiley-Liss, Inc
    Type of Publication: Journal article published
    PubMed ID: 15252848
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  • 3
    Keywords: CANCER ; tumor ; Germany ; human ; MODEL ; MODELS ; COHORT ; MORTALITY ; RISK ; ASSOCIATION ; ovarian cancer ; OVARIAN-CANCER ; COUNTRIES ; cancer risk ; DIETARY ; CONSUMPTION ; nutrition ; QUESTIONNAIRE ; questionnaires ; VEGETABLES ; NUTRIENTS ; carotenoids ; DIETARY FACTORS ; DETERMINANTS ; SUBTYPE ; FRUITS ; PART ; PARTICIPANTS ; CANCER INCIDENCE ; ALLIUM VEGETABLES ; FOOD GROUPS
    Abstract: Objective: The association between consumption of fruit and vegetables and risk of ovarian cancer is still unclear from a prospective point of view. Methods: Female participants (n = 325,640) of the European Prospective Investigation into Cancer and Nutrition study, free of any cancer at baseline, were followed on average for 6.3 years to develop ovarian cancer. During 2,049,346 person-years, 581 verified cases of primary, invasive epithelial ovarian cancer were accrued. Consumption of fruits and vegetables as well as subgroups of vegetables, estimated from validated dietary questionnaires and calibrated thereafter, was related to ovarian cancer incidence in multivariable hazard regression models. Histologic subtype specific analyses were done. Results: Total intake of fruit and vegetables, separately or combined, as well as subgroups of vegetables (fruiting, root, leafy vegetables, cabbages) was unrelated to risk of ovarian cancer. A high intake of garlic/onion vegetables was associated with a borderline significant reduced risk of this cancer. The examination by histologic subtype indicated some differential effects of fruit and vegetable intake on ovarian cancer risk. Conclusion: Overall, a high intake of fruits and vegetables did not seem to protect from ovarian cancer. Garlic/onion vegetables may exert a beneficial effect. The study of the histologic subtype of the tumor warrants further investigation
    Type of Publication: Journal article published
    PubMed ID: 16284374
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  • 4
    Keywords: CANCER ; Germany ; human ; MODEL ; COHORT ; RISK ; ASSOCIATION ; MEN ; COUNTRIES ; DIETARY ; ALCOHOL ; CONSUMPTION ; EPIC ; nutrition ; VEGETABLES ; CALIBRATION ; RELATIVE RISK ; REGRESSION ; ASSOCIATIONS ; LEVEL ; INTERVAL ; FRUITS ; fruits and vegetables ; prospective ; prospective study ; RECOMMENDATIONS ; EUROPEAN COUNTRIES ; CANCERS ; VARIABLES ; root vegetables ; SUBGROUPS ; upper aero-digestive cancer
    Abstract: Epidemiologic studies suggest that a high intake of fruits and vegetables is associated with decreased risk of cancers of the upper aero-digestive tract. We studied data from 345,904 subjects of the prospective European Investigation into Cancer and Nutrition (EPIC) recruited in seven European countries, who had completed a dietary questionnaire in 1992-1998. During 2,182,560 person years of observation 352 histologically verified incident squamous cell cancer (SCC) cases (255 males; 97 females) of the oral cavity, pharynx, larynx, and esophagus were identified. Linear and restricted cubic spline Cox regressions were fitted on variables of intake of fruits and vegetables and adjusted for potential confounders. We observed a significant inverse association with combined total fruits and vegetables intake (estimated relative risk (RR) = 0.91; 95% confidence interval (95% CI) 0.83-1.00 per 80 g/d of consumption), and nearly significant inverse associations in separate analyses with total fruits and total vegetables intake (RR: 0.97 (95% CI: 0.92-1.02) and RR = 0.89 (95% CI: 0.78-1.02) per 40 g/d of consumption). Overall, vegetable subgroups were not related to risk with the exception of intake of root vegetables in men. Restricted cubic spline regression did not improve the linear model fits except for total fruits and vegetables and total fruits with a significant decrease in risk at low intake levels (〈 120 g/d) for fruits. Dietary recommendations should consider the potential benefit of increasing fruits and vegetables consumption for reducing the risk of cancers of the upper aero-digestive tract, particularly at low intake
    Type of Publication: Journal article published
    PubMed ID: 16841263
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  • 5
    Keywords: CANCER ; MODEL ; MODELS ; THERAPY ; FOLLOW-UP ; COHORT ; cohort studies ; EXPOSURE ; RISK ; RISKS ; INDEX ; ASSOCIATION ; NO ; hormone ; HEALTH ; WOMEN ; HORMONE REPLACEMENT THERAPY ; cancer risk ; FIBER ; MEASUREMENT ERROR ; DIET ; DIETARY ; FAT ; European Prospective Investigation into Cancer and Nutrition ; nutrition ; AUSTRALIA ; ENDOMETRIAL CANCER ; RELATIVE RISK ; dietary fiber ; insulin ; IGF-I ; ASSOCIATIONS ; ENDOMETRIAL ; THERAPIES ; ENERGY-INTAKE ; PHYSICAL-ACTIVITY ; LEVEL ; INTERVAL ; USA ; prospective ; INSULIN SENSITIVITY ; VARIABLES ; CANCER-RISK ; C-PEPTIDE ; FOODS ; Nutrition Assessment ; postmenopausal ; DIANA RANDOMIZED-TRIAL ; dietary carbohydrates ; endometrial neoplasms ; glycemic index ; IOWA WOMENS HEALTH
    Abstract: The associations of dietary total carbohydrates, overall glycemic index, total dietary glycemic load, total sugars, total starch, and total fiber with endometrial cancer risk were analyzed among 288,428 women in the European Prospective Investigation into Cancer and Nutrition cohort (1992-2004), including 710 incident cases diagnosed during a mean 6.4 years of follow-up. Cox proportional hazards models were used to estimate relative risks and 95% confidence intervals. There were no statistically significant associations with endometrial cancer risk for increasing quartile intakes of any of the exposure variables. However, in continuous models calibrated by using 24-hour recall values, the multivariable relative risks were 1.61 (95% confidence interval: 1.06, 2.45) per 100 g/day of total carbohydrates, 1.40 (95% confidence interval: 0.99, 1.99) per 50 units/day of total dietary glycemic load, and 1.36 (95% confidence interval: 1.05, 1.76) per 50 g/day of total sugars. These associations were stronger among women who had never used postmenopausal hormone therapy compared with ever users (total carbohydrates P-heterogeneity = 0.04). Data suggest no association of overall glycemic index, total starch, and total fiber with risk, and a possible modest positive association of total carbohydrates, total dietary glycemic load, and total sugars with risk, particularly among never users of hormone replacement therapy
    Type of Publication: Journal article published
    PubMed ID: 17670911
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  • 6
    Keywords: CANCER ; BLOOD ; COHORT ; cohort studies ; cohort study ; POPULATION ; RISK ; MARKER ; BIOMARKERS ; colon ; ASSOCIATION ; NO ; HEALTH ; WOMEN ; colorectal cancer ; MEN ; PROSPECTIVE COHORT ; COLORECTAL-CANCER ; cancer risk ; FRANCE ; COLON-CANCER ; MULTIVARIATE ; UNITED-STATES ; case-control studies ; GLUCOSE ; nutrition ; BETA-CELL FUNCTION ; ONCOLOGY ; case-control study ; REGRESSION ; RE ; INCREASE ; LEVEL ; biomarker ; INSULIN-RESISTANCE ; metabolic syndrome ; USA ; prospective ; cancer research ; CANCER-RISK ; NOV ; HEMOGLOBIN ; TYPE-2 DIABETES-MELLITUS ; European Prospective Investigation into Cancer ; CHRONIC OXIDATIVE STRESS ; GLUCOSE TOXICITY ; RECTAL CANCERS ; SERUM C-PEPTIDE
    Abstract: Although large-scale prospective cohort studies have related hyperglycemia to increased risk of cancer overall, studies specifically on colorectal cancer have been generally small. We investigated the association between prediagnostic levels of glycosylated hemoglobin (HbA1c), a marker for average glucose level in blood, and colorectal cancer risk in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition cohort. One thousand and twenty-six incident colorectal cancer cases (561 men and 465 women) and 1,026 matched controls were eligible for the study. Multivariate conditional logistic regression was used to estimate odds ratios (ORS) adjusted for possible confounders. Increasing HbA1c percentages were statistically significantly associated with a mild increase in colorectal cancer risk in the whole population [OR, 1.10; 95% confidence interval (CI), 1.01,1.19 for a 10% increase in HbA1c]. In women, increasing HbA1c percentages were associated with a statistically significant increase in colorectal cancer risk (OR, 1.16; 95% CI, 1.01, 1.32 for a 10% increase in HbA1c) and with a borderline statistically significant increase in rectum cancer (OR, 1.22; 95% CI, 0.99,1.50 for a 10% increase in HbA1c). No significant association with cancer risk was observed in men. The results of the current study suggest a mild implication of hyperglycemia in colorectal cancer, which seems more important in women than in men, and more for cancer of the rectum than of the colon. (Cancer Epidemiol Biomarkers Prev 2008;17(11):3108-15)
    Type of Publication: Journal article published
    PubMed ID: 18990751
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  • 7
    Keywords: ENERGIES ; CANCER ; Germany ; MODEL ; MODELS ; PROSTATE ; FOLLOW-UP ; INFORMATION ; COHORT ; RISK ; RISKS ; ASSOCIATION ; NO ; HEALTH ; PLASMA ; ENERGY ; AGE ; MEN ; PROSPECTIVE COHORT ; smoking ; prostate cancer ; PROSTATE-CANCER ; ethanol ; MULTIVARIATE ; RECRUITMENT ; ALCOHOL ; ALCOHOL-CONSUMPTION ; CONSUMPTION ; nutrition ; RELATIVE RISK ; ONCOLOGY ; WEIGHT ; ENERGY-INTAKE ; PHYSICAL-ACTIVITY ; HEIGHT ; biomarker ; USA ; cancer research ; RISK-FACTOR ; MIDDLE-AGED MEN ; energy intake ; WINE ; BEVERAGES
    Abstract: Alcohol is a risk factor for several types of cancer. However, the results for prostate cancer have been inconsistent, with most studies showing no association. Within the European Prospective Investigation into Cancer and Nutrition, detailed information were collected from 142,607 male participants on the intake of alcoholic beverages at recruitment (for 100% of the cohort) and over lifetime (for 76% of the cohort) between 1992 and 2000. During a median follow-up of 8.7 years, 2,655 prostate cancer cases were observed. Multivariate Cox proportional hazard models were used to examine the association of alcohol consumption at recruitment and average lifetime alcohol consumption with prostate cancer adjusted for age, center, smoking, height, weight, physical activity, and nonalcohol energy intake. Overall, neither alcohol consumption at baseline nor average lifetime alcohol consumption was associated with the risk for prostate cancer in this cohort of men. Men who consumed 〉= 60 g alcohol per day had a relative risk of 0.88 [95% confidence interval (95% CI) 0.72-1.081 compared with men with an intake of 0.1-4.9 g/d; the respective relative risk for average lifetime intake was 1.09 (95% CI, 0.86-1.39). For advanced prostate cancer (n=537), the relative risks for 〉= 60 and 0.1-4.9 g alcohol per day at baseline were 0.98 (95% CI, 0.66-1.44) and 1.28 (95% CI, 0.79-2-07), respectively, for average lifetime intake. No statistically significant association was observed for alcohol intake from specific alcoholic beverages. Our results indicate no association between the consumption of alcohol and prostate cancer in this cohort of European men
    Type of Publication: Journal article published
    PubMed ID: 18483352
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  • 8
    Keywords: ASSOCIATION ; ACID ; score ; PATTERNS ; WOMEN ; MEN ; PROSPECTIVE COHORT ; FISH ; REGION ; DIET ; FAT ; INDIVIDUALS ; ALCOHOL ; CONSUMPTION ; FRUIT ; nutrition ; VEGETABLES ; HETEROGENEITY ; REGRESSION ; PRODUCTS ; ENERGY-INTAKE ; ADIPOSITY ; metabolic syndrome ; BODY-MASS INDEX ; USA ; EUROPEAN COUNTRIES ; BMI ; FOODS ; WAIST CIRCUMFERENCE ; DAIRY-PRODUCTS ; EPIC-OXFORD PARTICIPANTS ; WEIGHT-LOSS ; Abdominal ; ABDOMINAL ADIPOSITY ; ELDERLY-PEOPLE ; HEALTH-STATUS ; TO-HIP RATIO
    Abstract: Given the lack of consistent evidence of the relationship between Mediterranean dietary patterns and body fat, we assessed the cross-sectional association between adherence to a modified Mediterranean diet, BMI, and waist circumference (WC). A total of 497,308 individuals (70.7% women) aged 25-70 y from 10 European countries participated in this study. Diet was assessed at baseline using detailed validated country-specific questionnaires, and anthropometrical measurements were collected using standardized procedures. The association between the degree of adherence to the modified-Mediterranean Diet Score (mMDS) (including high consumption of vegetables, legumes, fruits and nuts, cereals, fish and seafood, and unsaturated: saturated fatty acids ratio; moderate alcohol intake; and low consumption of meat and meat products and dairy products) and BMI (kg.m(-2)) or WC (cm was modeled through mixed-effects linear regression, controlling for potential confounders. Overall, the mMDS was not significantly associated with BMI. Higher adherence to the Mediterranean diet was significantly associated with lower WC, for a given BMI, in both men (-0.09; 95% CI -0.14 to -0.04) and women (-0.06; 95% CI -0.10 to -0.01). The association was stronger in men (-0.20; 95% CI -0.23 to -0.17) and women (-0.17; 95% CI -0.21 to -0.13) from Northern European countries. Despite the observed heterogeneity among regions, results of this study suggest that adherence to a modified Mediterranean diet, high in foods of vegetable origin and unsaturated fatty acids, is associated with lower abdominal adiposity measured by WC in European men and women. J. Nutr. 139: 1728-1737, 2009
    Type of Publication: Journal article published
    PubMed ID: 19571036
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  • 9
    Keywords: CANCER ; DISEASE ; POPULATION ; validation ; COMPLEX ; ASSOCIATION ; BREAST-CANCER ; ACID ; PLASMA ; MEN ; CENTERS ; EPIC ; nutrition ; FOOD-INTAKE ; nutrient intake ; SERUM PHOSPHOLIPIDS ; EPIC CALIBRATION ; 24-HOUR DIET RECALL ; prospective ; biological markers ; INVESTIGATE ; PROCESSED FOODS
    Abstract: Background: Plasma phospholipid fatty acids have been correlated with food intakes in populations with homogeneous dietary patterns. However, few data are available on populations with heterogeneous dietary patterns. Objective: The objective was to investigate whether plasma phospholipid fatty acids are suitable biomarkers of dietary intakes across populations involved in a large European multicenter study. Design: A cross-sectional study design nested to the European Prospective Investigation into Cancer and Nutrition (EPIC) was conducted to determine plasma fatty acid profiles in 〉 3000 subjects from 16 centers, who had also completed 24-h dietary recalls and dietary questionnaires. Plasma fatty acids were assessed by capillary gas chromatography. Ecological and individual correlations were calculated between fatty acids and select food groups. Results: The most important determinant of plasma fatty acids was region, which suggests that the variations across regions are largely due to different food intakes. Strong ecological correlations were observed between fish intake and long-chain n-3 polyunsaturated fatty acids (r = 0.78, P 〈 0.01), olive oil and oleic acid (r = 0.73, P 〈 0.01), and margarine and elaidic acid (r = 0.76, P 〈 0.01). Individual correlations varied across the regions, particularly between olive oil and oleic acid and between alcohol and the saturation index, as an indicator of stearoyl CoA desaturase activity. Conclusions: These findings indicate that specific plasma phospholipid fatty acids are suitable biomarkers of some food intakes in the EPIC Study. Moreover, these findings suggest complex interactions between alcohol intake and fatty acid metabolism, which warrants further attention in epidemiologic studies relating dietary fatty acids to alcohol-related cancers and other chronic diseases. Am J Clin Nutr 2009; 89: 331-46
    Type of Publication: Journal article published
    PubMed ID: 19056549
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  • 10
    Keywords: CANCER ; COMBINATION ; Germany ; COHORT ; DISEASE ; EXPOSURE ; POPULATION ; RISK ; CONTRAST ; ASSOCIATION ; ACID ; PATTERNS ; COUNTRIES ; SWEDEN ; DATABASE ; REGION ; FRANCE ; REGIONS ; POPULATIONS ; NETHERLANDS ; FUTURE ; PROJECT ; EPIC ; nutrition ; CALIBRATION ; nutrient intake ; VITAMIN-E ; RETINOL ; ASSOCIATIONS ; PATTERN ; SCIENCE ; methods ; dietary patterns ; prospective ; vitamin D ; VITAMIN-D ; ERRORS ; RATIONALE ; Vitamin E ; Exposure assessment
    Abstract: Until recently, the study of nutrient patterns was hampered at an international level by a lack of standardization of both dietary methods and nutrient databases. We aimed to describe the diversity of nutrient patterns in the European Prospective Investigation into Cancer and Nutrition (EPIC) study at population level as a starting point for future nutrient pattern analyses and their associations with chronic diseases in multi-center studies. In this cross-sectional study, 36,034 persons aged 35-74 y were administered a single, standardized 24-h dietary recall. Intake of 25 nutrients (excluding intake from dietary supplements) was estimated using a standardized nutrient database. We used a graphic presentation of mean nutrient intakes by region and sex relative to the overall EPIC means to contrast patterns within and between 10 European countries. In Mediterranean regions, including Greece, Italy, and the southern centers of Spain, the nutrient pattern was dominated by relatively high intakes of vitamin E and monounsaturated fatty acids (MUFA), whereas intakes of retinol and vitamin D were relatively low. In contrast, in Nordic countries, including Norway, Sweden, and Denmark, reported intake of these same nutrients resulted in almost the opposite pattern. Population groups in Germany, The Netherlands, and the UK shared a fatty acid pattern of relatively high intakes of PUFA and SFA and relatively low intakes of MUFA, in combination with a relatively high intake of sugar. We confirmed large variability in nutrient intakes across the EPIC study populations and identified 3 main region-specific patterns with a geographical gradient within and between European countries. J. Nutr. 140: 1280-1286, 2010
    Type of Publication: Journal article published
    PubMed ID: 20484545
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