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  • 1
    Keywords: CANCER ; Germany ; LUNG ; FOLLOW-UP ; INFORMATION ; lung cancer ; LUNG-CANCER ; COHORT ; cohort study ; EPIDEMIOLOGY ; EXPOSURE ; MORTALITY ; occupation ; POPULATION ; RISK ; RISKS ; REDUCTION ; RISK-FACTORS ; ASSOCIATION ; HUMANS ; WOMEN ; MEN ; risk factors ; smoking ; COUNTRIES ; cancer risk ; POPULATIONS ; DIET ; VALIDITY ; EPIC ; nutrition ; SMOKERS ; RELATIVE RISK ; exercise ; physical activity ; REGRESSION ; ASSOCIATIONS ; PHYSICAL-ACTIVITY ; INTERVAL ; SUBTYPES ; prospective ; UNIT ; RISK-FACTOR ; CANCER-RISK ; sports ; occupations ; ACTIVITY QUESTIONNAIRE
    Abstract: Research conducted predominantly in male populations on physical activity and lung cancer has yielded inconsistent results. We examined this relationship among 416,277 men and women from the European Prospective Investigation into Cancer and Nutrition (EPIC). Detailed information on recent recreational, household and occupational physical activity, smoking habits and diet was assessed at baseline between 1992 and 2000. Relative risks (RR) were estimated using Cox regression. During 6.3 years of follow-up we identified 607 men and 476 women with incident lung cancer. We did not observe an inverse association between recent occupational, recreational or household physical activity and lung cancer risk in either males or females. However, we found some reduction in lung cancer risk associated with sports in males (adjusted RR = 0.71; 95% confidence interval 0.50-0.98; highest tertile vs. inactive group), cycling (RR = 0.73; 0.54-0.99) in females and non-occupational vigorous physical activity. For occupational physical activity, lung cancer risk was increased for unemployed men (adjusted RR = 1.57; 1.20-2.05) and men with standing occupations (RR = 1.35; 1.02-1.79) compared with sitting professions. There was no evidence of heterogeneity of physical activity associations across countries, or across any of the considered cofactors. For some histologic subtypes suggestive sex-specific reductions, limited by subgroup sizes, were observed, especially with vigorous physical activity. In total, our study shows no consistent protective associations of physical activity with lung cancer risk. It can be assumed that the elevated risks found for occupational physical activity are not produced mechanistically by physical activity itself but rather reflect exposure to occupation-related lung cancer risk factors. (c) 2006 Wiley-Liss, Inc
    Type of Publication: Journal article published
    PubMed ID: 16894558
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  • 2
    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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  • 3
    Keywords: CANCER ; carcinoma ; FOLLOW-UP ; INFORMATION ; COHORT ; RISK ; INFECTION ; ASSOCIATION ; PATTERNS ; HEALTH ; MEN ; COUNTRIES ; DIET ; NETHERLANDS ; STOMACH ; adenocarcinoma ; EPIC ; GASTRIC-CANCER ; HELICOBACTER-PYLORI ; nutrition ; physical activity ; ONCOLOGY ; POPULATION-BASED COHORT ; SCALE ; PHYSICAL-ACTIVITY ; METAANALYSIS ; SUBTYPES ; prospective ; CANCERS ; VARIABLES ; Helicobacter pylori ; stomach cancer ; BODY-MASS ; tumours ; gastric adenocarcinoma ; Type ; EURGAST ; REGISTER ; Oesophagus cancer
    Abstract: To analyse the association between types of physical activity (occupational, recreational and household, vigorous and overall) and risk of primary oesophageal (OAC) or gastric adenocarcinoma (GAC). From nine European countries, 420,449 participants were recruited between 1991 and 2000 and followed-up for a mean of 8.8 years to register incident GAC and OAC. Information on physical activity (PA), diet, lifestyle and health-related variables was obtained at baseline. Helicobacter pylori infection status was considered in a subset of 1,211 participants. Analyses were repeated by tumour site (cardia/non-cardia) and histological type (intestinal/diffuse). During the follow-up, 410 GAC and 80 OAC occurred. A lower risk of overall and non-cardia GAC was found for increasing levels of a PA index which combined occupational PA with weekly time spent in sports and cycling. The hazard ratio (HR) of GAC was 0.69, 95% CI: 0.50-0.94, for the comparison between active and inactive participants according to the PA index (HR = 0.44, 95% CI:0.26-0.74, for non-cardia GAC). No effect was found for cardia tumours or histological subtypes of GAC. PA of any kind was not associated with OAC. Overall and distal (non-cardia) gastric tumours were inversely associated with time spent on cycling and sports and a total PA index. No association was found for any type of PA and risk of cardia cancers of the stomach
    Type of Publication: Journal article published
    PubMed ID: 20052611
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  • 4
    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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  • 5
    Keywords: COHORT ; PLASMA ; DIET ; STOMACH ; VALIDITY ; CONSUMPTION ; FOODS ; ESOPHAGEAL
    Abstract: In a previous European prospective investigation into cancer and nutrition (EPIC) analysis, we found an inverse association between total intake of vegetables, onion and garlic, and risk of intestinal gastric cancer (GC) and between citrus fruit and risk of cardia GC. The aim of this study is to reanalyze the effect of fruit and vegetables (F&V), based on a longer follow-up and twice the number of GC cases. Subjects are 477,312 men and women mostly aged 35 to 70 years participating in the EPIC cohort, including 683 gastric adenocarcinomas with 11 years of follow-up. Information on diet and lifestyle was collected at baseline. A calibration study in a subsample was used to correct for dietary measurement errors. When comparing the highest vs. lowest quintile of intake, we found an inverse association between total intake of V&F and GC risk [hazard ratio (HR) 0.77; 95% confidence interval (CI) 0.57-1.04; p for trend 0.02], between fresh fruit and risk of the diffuse type (HR 0.59; 95% CI 0.36-0.97; p for trend 0.03) and an inverse association between citrus fruit and risk of cardia cancer (HR 0.61; 95% CI 0.38-1.00, p for trend 0.01). Although calibration revealed somewhat stronger inverse associations, none of the risks reached statistical significance. There was no association between total or specific vegetables intake and GC risk. The inverse association between fresh fruit and citrus fruits and risk of GC seems to be restricted to smokers and the Northern European countries. Fresh fruit and citrus fruit consumption may protect against diffuse and cardia GC, respectively.
    Type of Publication: Journal article published
    PubMed ID: 22473701
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  • 6
    Keywords: COHORT ; POPULATION ; WOMEN ; CIGARETTE-SMOKING ; DIET ; UNITED-STATES ; nutrition ; TRENDS ; pooled analysis ; CANCER INCIDENCE
    Abstract: BACKGROUND: Results from several cohort and case-control studies suggest a protective association between current alcohol intake and risk of thyroid carcinoma, but the epidemiological evidence is not completely consistent and several questions remain unanswered. METHODS: The association between alcohol consumption at recruitment and over the lifetime and risk of differentiated thyroid carcinoma was examined in the European Prospective Investigation into Cancer and Nutrition. Among 477 263 eligible participants (70% women), 556 (90% women) were diagnosed with differentiated thyroid carcinoma over a mean follow-up of 11 years. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox proportional hazards models. RESULTS: Compared with participants consuming 0.1-4.9 g of alcohol per day at recruitment, participants consuming 15 or more grams (approximately 1-1.5 drinks) had a 23% lower risk of differentiated thyroid carcinoma (HR=0.77; 95% CI=0.60-0.98). These findings did not differ greatly when analyses were conducted for lifetime alcohol consumption, although the risk estimates were attenuated and not statistically significant anymore. Similar results were observed by type of alcoholic beverage, by differentiated thyroid carcinoma histology or according to age, sex, smoking status, body mass index and diabetes. CONCLUSIONS: Our study provides some support to the hypothesis that moderate alcohol consumption may be associated with a lower risk of papillary and follicular thyroid carcinomas.
    Type of Publication: Journal article published
    PubMed ID: 26313664
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  • 7
    Keywords: CANCER ; carcinoma ; FOLLOW-UP ; COHORT ; cohort study ; RISK ; SITE ; INFECTION ; ASSOCIATION ; antibodies ; WOMEN ; MEN ; COUNTRIES ; DIET ; STOMACH ; adenocarcinoma ; case-control studies ; CARDIA ; CONSUMPTION ; EPIC ; GASTRIC-CANCER ; HELICOBACTER-PYLORI ; nutrition ; CALIBRATION ; case-control study ; INCREASE ; case control studies ; HELICOBACTER-PYLORI INFECTION ; prospective ; Helicobacter pylori ; intake ; FOODS
    Abstract: It is considered that fruit and vegetable (F&V) protect against oesophagus and gastric cancer (GC). However, 2 recent meta-analyses suggest that the strength of association on GC seems to he weaker for vegetables than for fruit and weaker in cohort than in case-control studies. No evidence exists from cohort studies about adenocarcinoma of oesophagus (ACO). In 521,457 men and women participating in the EPIC cohort in 10 European countries, information of diet and lifestyle was collected at baseline. After an average of 6.5 years of follow-up, a total of 330 GC and 65 ACO, confirmed and classified by a panel of pathologists, was used for the analysis. We examined the relation between F&V intake and GC and ACO. A calibration study in a sub-sample was used to control diet measurement errors. In a sub-sample of cases and a random sample of controls, antibodies against Helicobacter pylori (Hp) were measured and interactions with F&V were examined in a nested case-control study. We observed no association with total vegetable intake or specific groups of vegetables and GC risk, except for the intestinal type, where a negative association is possible regarding total vegetable (calibrated HR 0.66; 95% CI 0.35-1.22 per 100 g increase) and onion and garlic intake (calibrated HR 0.70; 95% CI 0.38-1.29 per 10 g increase). No evidence of association between fresh fruit intake and GC risk was observed. We found a negative but non significant association between citrus fruit intake and the cardia site (calibrated HR 0.77; 95% CI 0.47-1.22 per 100 g increase) while no association was observed with the non-cardia site. Regarding ACO, we found a non significant negative association for vegetable intake and for citrus intake (calibrated HRs 0.72; 95% Cl 0.32-1.64 and 0.77; 95% CI 0.46-1.28 per 100 and 50 g increase, respectively). It seems that lip infection does not modify the effect of F&V intake. Our study supports a possible protective role of vegetable intake in the intestinal type of GC and the ACO. Citrus fruit consumption may have a role in the protection against cardia GC and ACO. (c) 2005 Wiley-Liss, Inc
    Type of Publication: Journal article published
    PubMed ID: 16380980
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  • 8
    Keywords: CANCER ; evaluation ; Germany ; LUNG ; MODEL ; MODELS ; FOLLOW-UP ; INFORMATION ; lung cancer ; LUNG-CANCER ; COHORT ; EPIDEMIOLOGY ; incidence ; POPULATION ; RISK ; ASSOCIATION ; FREQUENCY ; FREQUENCIES ; NO ; smoking ; cancer risk ; MEASUREMENT ERROR ; MULTIVARIATE ; DIET ; INDIVIDUALS ; CONSUMPTION ; EPIC ; European Prospective Investigation into Cancer and Nutrition ; FRUIT ; nutrition ; VEGETABLES ; CALIBRATION ; LIFE-STYLE ; BETA-CAROTENE ; FOOD FREQUENCY QUESTIONNAIRE ; ALPHA-TOCOPHEROL ; ONCOLOGY ; ASSOCIATIONS ; RE ; INCREASE ; NONSMOKING WOMEN ; VITAMIN-C ; pooled analysis ; USA ; CANCER INCIDENCE ; prospective ; CANCER-RISK ; comparison ; ERROR ; CHINESE WOMEN ; DIETARY CAROTENOIDS
    Abstract: The association of fruit and vegetable consumption and lung cancer incidence was evaluated using the most recent data from the European Prospective Investigation into Cancer and Nutrition (EPIC), applying a refined statistical approach (calibration) to account for measurement error potentially introduced by using food frequency questionnaire data. Between 1992 and 2000, detailed information on diet and life-style of 478,590 individuals participating in EPIC was collected. During a median follow-up of 6.4 years, 1,126 lung cancer cases were observed. Multivariate Cox proportional hazard models were applied for statistical evaluation. In the whole study population, fruit consumption was significantly inversely associated with lung cancer risk while no association was found for vegetable consumption. In current smokers, however, lung cancer risk significantly decreased with higher vegetable consumption; this association became more pronounced after calibration, the hazard ratio (HR) being 0.78 (95% CI 0.620.98) per 100 g increase in daily vegetable consumption. In comparison, the HR per 100 g fruit was 0.92 (0.85-0.99) in the entire cohort and 0.90 (0.81-0.99) in smokers. Exclusion of cases diagnosed during the first 2 years of follow-up strengthened these associations, the HR being 0.71 (0.55-0.94) for vegetables (smokers) and 0.86 (0.78-0.95) for fruit (entire cohort). Cancer incidence decreased with higher consumption of apples and pears (entire cohort) as well as root vegetables (smokers). In addition to an overall inverse association with fruit intake, the results of this evaluation add evidence for a significant inverse association of vegetable consumption and lung cancer incidence in smokers. (C) 2007 Wiley-Liss, Inc
    Type of Publication: Journal article published
    PubMed ID: 17487840
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  • 9
    Keywords: CANCER ; GROWTH ; MODELS ; FOLLOW-UP ; COHORT ; RISK ; PROTEIN ; breast cancer ; BREAST-CANCER ; WOMEN ; COLORECTAL-CANCER ; DIET ; CALCIUM ; POSTMENOPAUSAL WOMEN ; GROWTH-FACTOR-I ; ELDERLY-MEN ; FACTOR (IGF)-I ; PREMENOPAUSAL WOMEN ; CIRCULATING LEVELS ; IGFBP-3 ; FACTOR SYSTEM ; VITAMIN-D ; insulin-like growth factor-I ; insulin-like growth factor binding protein-3 ; milk ; NUTRITIONAL FACTORS ; SOMATOMEDIN-C
    Abstract: Objective: The aim of this study was to examine the relationship of diet with serum insulin-like growth factor-I (IGF-I) and IGF-binding protein-3 in women. Design: Cross-sectional study. Setting and subjects: The population are 2109 women who were control subjects in a case-control study of breast cancer nested in the European Prospective Investigation into Cancer and Nutrition. Control subjects were randomly chosen among risk sets consisting of female cohort members alive and free of cancer (except non-melanoma skin cancer) at the time of diagnosis of the index case. Matching criteria were age at enrolment, follow-up time, time of the day of blood collection and study centre. Diet was measured through validated questionnaires. Serum hormone concentrations were measured by enzyme-linked immunosorbent assays. The relationship between serum IGF-I, IGFBP-3, and intake of nutrients and foods was explored by linear regression in models adjusted for energy intake, age, body mass index, smoking, physical activity, centre and laboratory batch. Results: Serum IGF-I levels were positively related to protein intake (P-trend 〈 0.001), but not related to energy, fat or carbohydrate intake. Positive relationships were observed with the intake of milk (P-trend = 0.007), calcium (P-trend 〈 0.001), magnesium (P-trend = 0.003), phosphorus (P-trend 〈 0.001), potassium (P-trend = 0.002), vitamin B6 (P-trend = 0.03), vitamin B2 (P-trend = 0.001) and inverse relationships with vegetables (P-trend = 0.02) and beta-carotene (P-trend = 0.02). IGFBP-3 was not related with most of the nutrients and foods in this study. Conclusions: In this population, circulating IGF-I is modestly related with the intake of protein and minerals, and with milk and cheese, while IGFBP-3 does not appear to be related with diet
    Type of Publication: Journal article published
    PubMed ID: 16900085
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  • 10
    Keywords: CANCER ; LUNG-CANCER ; COHORT ; DNA adducts ; EXPOSURE ; RISK ; DNA ; BIOMARKERS ; colon ; RATS ; CONTRAST ; BINDING ; ASSOCIATION ; COLORECTAL-CANCER ; BLADDER-CANCER ; cancer risk ; POLYCYCLIC AROMATIC-HYDROCARBONS ; COLON-CANCER ; MULTIVARIATE ; ADDUCTS ; CARCINOGENS ; DIET ; DIETARY ; ALCOHOL ; EPIC ; nutrition ; SMOKERS ; FOOD ; GUIDELINES ; VITAMIN-E ; DNA-ADDUCTS ; REGRESSION ; air pollution ; prospective studies ; N-NITROSAMINES ; LEVEL ; biomarker ; analysis ; prospective ; prospective study ; correlation ; BMI ; CANCER-RISK ; ENGLAND ; non-smokers ; AMINE ; gastrointestinal ; European Prospective Investigation into Cancer ; fibre intake ; haemoglobin adducts ; RESISTANT STARCH
    Abstract: In contrast to some extensively examined food mutagens, for example, aflatoxins, N-nitrosamines and heterocyclic amines, some other food contaminants, in particular polycyclic aromatic hydrocarbons (PAH) and other aromatic compounds, have received less attention. Therefore, exploring the relationships between dietary habits and the levels of biomarkers related to exposure to aromatic compounds is highly relevant. We have investigated in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort the association between dietary items (food groups and nutrients) and aromatic DNA adducts and 4-aminobiphenyl-Hb adducts. Both types of adducts are biomarkers of carcinogen exposure and possibly of cancer risk, and were measured, respectively, in leucocytes and erythrocytes of 1086 (DNA adducts) and 190 (Hb adducts) non-smokers. An inverse. statistically significant, association has been found between DNA adduct levels and dietary fibre intake (P=0.02), vitamin E (P =0.04) and alcohol (P=0.03) but not with other nutrients or food groups. Also, an inverse association between fibre and fruit intake, and BMI and 4-aminobiphenyl-Hb adducts (P=0.03, 0.04, and 0.03 respectively) was observed. After multivariate regression analysis these inverse correlations remained statistically significant, except for the correlation adducts v. fruit intake. The present study suggests that fibre intake in the usual range can modify the level of DNA or Hb aromatic adducts, but Such role seems to be quantitatively modest. Fibres could reduce the formation of DNA adducts in different manners, by diluting potential food mutagens and carcinogens in the gastrointestinal tract, by speeding their transit through the colon and by binding carcinogenic substances
    Type of Publication: Journal article published
    PubMed ID: 18275627
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