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  • MODEL  (4)
  • 1
    Keywords: CANCER ; Germany ; human ; MODEL ; MODELS ; FOLLOW-UP ; SUPPORT ; DEATH ; RISK ; RISKS ; TIME ; INDEX ; ASSOCIATION ; AGE ; WOMEN ; MEN ; OBESITY ; PROSPECTIVE COHORT ; smoking ; COUNTRIES ; RECRUITMENT ; PREDICTION ; ALCOHOL ; ALCOHOL-CONSUMPTION ; CONSUMPTION ; EPIC ; nutrition ; EUROPE ; RELATIVE RISK ; BODIES ; REGRESSION ; WEIGHT ; PHYSICAL-ACTIVITY ; HEIGHT ; LEVEL ; analysis ; methods ; BODY-MASS INDEX ; ALL-CAUSE MORTALITY ; alcohol consumption ; USA ; prospective ; BMI ; WAIST CIRCUMFERENCE ; TISSUE DISTRIBUTION ; MEDICINE ; NOV ; body mass ; RATIO ; European Prospective Investigation into Cancer ; PREDICTING MORTALITY ; ROC CURVE
    Abstract: BACKGROUND Previous studies have relied predominantly on the body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) to assess the association of adiposity with the risk of death, but few have examined whether the distribution of body fat contributes to the prediction of death. METHODS We examined the association of BMI, waist circumference, and waist-to-hip ratio with the risk of death among 359,387 participants from nine countries in the European Prospective Investigation into Cancer and Nutrition (EPIC). We used a Cox regression analysis, with age as the time variable, and stratified the models according to study center and age at recruitment, with further adjustment for educational level, smoking status, alcohol consumption, physical activity, and height. RESULTS During a mean follow-up of 9.7 years, 14,723 participants died. The lowest risks of death related to BMI were observed at a BMI of 25.3 for men and 24.3 for women. After adjustment for BMI, waist circumference and waist-to-hip ratio were strongly associated with the risk of death. Relative risks among men and women in the highest quintile of waist circumference were 2.05 (95% confidence interval [CI], 1.80 to 2.33) and 1.78 (95% CI, 1.56 to 2.04), respectively, and in the highest quintile of waist-to-hip ratio, the relative risks were 1.68 (95% CI, 1.53 to 1.84) and 1.51 (95% CI, 1.37 to 1.66), respectively. BMI remained significantly associated with the risk of death in models that included waist circumference or waist-to-hip ratio (P〈0.001). CONCLUSIONS These data suggest that both general adiposity and abdominal adiposity are associated with the risk of death and support the use of waist circumference or waist-tohip ratio in addition to BMI in assessing the risk of death
    Type of Publication: Journal article published
    PubMed ID: 19005195
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  • 2
    Keywords: CANCER ; Germany ; human ; MODEL ; INFORMATION ; screening ; TOOL ; COHORT ; cohort study ; HISTORY ; POPULATION ; RISK ; METABOLISM ; FAMILY ; RISK-FACTORS ; score ; lifestyle ; DESIGN ; AGE ; WOMEN ; MEN ; risk factors ; smoking ; POPULATIONS ; DIETARY ; HYPERTENSION ; meat ; nutrition ; TYPE-2 ; EPIC-GERMANY ; BETA-CELL FUNCTION ; insulin ; MELLITUS ; REGRESSION ; FAMILIES ; PHYSICAL-ACTIVITY ; RELATIVE VALIDITY ; development ; methods ; metabolic syndrome ; prospective ; correlation ; MEAT INTAKE ; RISK-FACTOR ; type 2 diabetes ; PREDICT ; type-2-diabetes ; FASTING GLUCOSE ; IMPAIRED GLUCOSE-TOLERANCE ; INSULIN SECRETORY DYSFUNCTION ; WHOLE-GRAIN INTAKE
    Abstract: OBJECTIVE - We aimed to develop a precise risk score for the screening of large populations for individuals at high risk of developing type 2 diabetes based on noninvasive measurements of major risk factors in German study populations. RESEARCH DESIGN AND METHODS - A prospective cohort study (European Prospective Investigation into Cancer and Nutrition [EPIC]-Potsdam study) of 9,729 men and 15,438 women aged 35-65 years was used to derive a risk score predicting incident type 2 diabetes. Multivariate Cox regression model coefficients were used to weigh each variable in the. calculation of the score. Data from the EPIC-Heidelberg, the Tubingen Family Study for Type 2 Diabetes (T F), and the Metabolic Syndrome Berlin Potsdam (MeSyBePo) study were used to validate this score. RESULTS - information on age, waist circumference, height, history of hypertension, physical activity, smoking, and consumption of red meat, whole-grain bread, coffee, and alcohol formed the German Diabetes Risk Score (mean 446 points [range 118-983]). The probability of developing diabetes within 5 years in the EPIC-Potsdam study increased from 0.3% for 300 to 23.2% for 750 score points. The area under the receiver-operator characteristic (ROC) curve was 0.84 in the EPIC-Potsdam and 0.82 in the EPIC-Heidelberg studies. Correlation coefficients between the German Diabetes Risk Score and insulin sensitivity in nondiabetic individuals were -0.56 in the TUF and -0.45 in the MeSyBePo studies. ROC values for undiagnosed diabetes were 0.83 in the TUF and 0.75 in the MeSyBePo studies. CONCLUSIONS - The German Diabetes Risk Score (available at www.dife.de) is an accurate tool to identify individuals at high risk for or with undiagnosed type 2 diabetes
    Type of Publication: Journal article published
    PubMed ID: 17327313
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  • 3
    Keywords: CANCER ; Germany ; human ; MODEL ; MODELS ; SUPPORT ; COHORT ; DEATH ; DISEASE ; MORTALITY ; POPULATION ; RISK ; RISKS ; PATIENT ; ASSOCIATION ; prevention ; MULTIVARIATE ; DIET ; CONSUMPTION ; nutrition ; QUESTIONNAIRE ; EUROPE ; RELATIVE RISK ; REGRESSION ; CARDIOVASCULAR-DISEASE ; ISCHEMIC-STROKE ; PHYSICAL-ACTIVITY ; CORONARY-HEART-DISEASE ; METAANALYSIS ; USA ; cardiovascular ; DEATHS ; COMPETING RISKS
    Abstract: We examined the associations of intake of vegetables, legumes and fruit with all-cause and cause-specific mortality in a population with prevalent diabetes in Europe. A cohort of 10,449 participants with self-reported diabetes within the European Prospective Investigation into Cancer and Nutrition study was followed for a mean of 9 y. Intakes of vegetables, legumes, and fruit were assessed at baseline between 1992 and 2000 using validated country-specific questionnaires. A total of 1346 deaths occurred. Multivariate relative risks (RR) for all-cause mortality were estimated in Cox regression models and FIR for cause-specific mortality were derived in a competing risk model. An increment in intake of total vegetables, legumes, and fruit of 80 g/d was associated with a RR of death from all causes of 0.94 [95% CI 0.90-0.98]. Analyzed separately, vegetables and legumes were associated with a significantly reduced risk, whereas nonsignificant inverse associations for fruit intake were observed. Cardiovascular disease (CVD) mortality and mortality due to non-CVD/non-cancer causes were significantly inversely associated with intake of total vegetables, legumes, and fruit (RR 0.88 [95% CI 0.81-0.95] and 0.90 [0.82-0.99], respectively) but not cancer mortality 0.08 [0.99-1.17]). Intake of vegetables, legumes, and fruit was associated with reduced risks of all-cause and CVD mortality in a diabetic population. The findings support the current state of evidence from general population studies that the protective potential of vegetable and fruit intake is larger for CVD than for cancer and suggest that diabetes patients may benefit from a diet high in vegetables and fruits
    Type of Publication: Journal article published
    PubMed ID: 18356334
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  • 4
    Keywords: CANCER ; Germany ; human ; MODEL ; MODELS ; LUNG-CANCER ; COHORT ; NEW-YORK ; POPULATION ; RISK ; RISKS ; ASSOCIATION ; BREAST-CANCER ; PATTERNS ; DESIGN ; WOMEN ; COLORECTAL-CANCER ; cancer risk ; POPULATIONS ; MULTIVARIATE ; DIETARY ; FAILURE ; EPIC ; nutrition ; QUESTIONNAIRE ; SMOKERS ; pancreatic cancer ; FOOD ; RELATIVE RISK ; DIETARY-INTAKE ; REGRESSION ; PANCREATIC-CANCER ; PATTERN ; CORONARY-HEART-DISEASE ; dietary patterns ; USA ; prospective ; CANCER-RISK ; MULTIETHNIC COHORT ; WINE ; European Prospective Investigation into Cancer ; LOS-ANGELES
    Abstract: Background: In the Multiethnic Cohort (MEC) study, we showed inverse associations between flavonols and pancreatic cancer risk. Objective: We aimed to define a food pattern associated with intakes of quercetin, kaempferol, and myricetin; to examine the association of that pattern with pancreatic cancer risk; and to investigate the associations in an independent study. Design: Reduced rank regression was applied to dietary data for 183 513 participants in the MEC. A food group pattern was extracted and simplified and applied to dietary data of 424 978 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Dietary intake in both studies was assessed by using specially developed questionnaires. Multivariate Cox proportional hazards models were used to estimate relative risks for pancreatic cancer in the MEC (610 cases) and the EPIC (517 cases) studies. Results: The food group pattern consisted mainly of tea, fruit, cabbage, and wine. In the MEC, inverse associations with pancreatic cancer in smokers were observed for the food group pattern [relative risk: 0.59 (95% CI: 0.31, 1.12) when extreme quintiles were compared; P for trend = 0.03]. In the EPIC study, the simplified pattern was not associated with pancreatic cancer risk (P for trend = 0.78). Conclusions: A food pattern associated with the intake of quercetin, kaempferol, and myricetin was associated with lower pancreatic cancer risk in smokers in a US-based population. However, failure to replicate the associations in an independent study weakens the conclusions and raises questions about the utility of food patterns for flavonols across populations. Am J Clin Nutr 2008; 88: 1653-62
    Type of Publication: Journal article published
    PubMed ID: 19064528
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