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  • POPULATION  (4)
  • 1
    Keywords: CANCER ; COMBINATION ; Germany ; EPIDEMIOLOGY ; POPULATION ; PROTEIN ; PROTEINS ; PHOSPHORUS ; WOMEN ; COUNTRIES ; FATTY-ACIDS ; DIETARY ; CALCIUM ; ALCOHOL ; CONSUMPTION ; EPIC ; nutrition ; CALIBRATION ; FOOD ; nutrient intake ; BETA-CAROTENE ; NUTRIENTS ; RETINOL ; RECALL ; EPIC PROJECT ; IRON ; dietary patterns ; VITAMINS ; RECALLS ; POTASSIUM ; vitamin D ; 24-h dietary recall ; VEGETABLE-OIL ; magnesium ; nutrient intakes ; food component intakes ; food group combinations ; reduced rank regression
    Abstract: Objective: To identify combinations of food groups that explain as much variation in absolute intakes of 23 key nutrients and food components as possible within the country-specific populations of the European Prospective Investigation into Cancer and Nutrition (EPIC). Subjects/Methods: The analysis covered single 24-h dietary recalls (24-HDR) from 36 034 subjects (13 025 men and 23 009 women), aged 35-74 years, from all 10 countries participating in the EPIC study. In a set of 39 food groups, reduced rank regression (RRR) was used to identify those combinations (RRR factors) that explain the largest proportion of variation in intake of 23 key nutrients and food components, namely, proteins, saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids, cholesterol, sugars (sum of mono-and disaccharides), starch, fibre, alcohol, calcium, iron, potassium, phosphorus, magnesium, vitamin D, beta-carotene, retinol and vitamins E, B1, B2, B6, B12 and C (RRR responses). Analyses were performed at the country level and for all countries combined. Results: In the country-specific analyses, the first RRR factor explained a considerable proportion of the total nutrient intake variation in all 10 countries (27.4-37.1%). The subsequent RRR factors were much less important in explaining the variation (〈= 6%). Strong similarities were observed for the first country-specific RRR factor between the individual countries, largely characterized by consumption of bread, vegetable oils, red meat, milk, cheese, potatoes, margarine and processed meat. The highest explained variation was seen for protein, potassium, phosphorus and magnesium (50-70%), whereas sugars, beta-carotene, retinol and alcohol were only marginally explained (〈= 5%). The explained proportion of the other nutrients ranged between these extremes. Conclusions: A combination of food groups was identified that explained a considerable proportion of the nutrient intake variation in 24-HDRs in every country-specific EPIC population in a similar manner. This indicates that, despite the large variability in food and nutrient intakes reported in the EPIC, the variance of intake of important nutrients is explained, to a large extent, by similar food group combinations across countries.
    Type of Publication: Journal article published
    PubMed ID: 19888278
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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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