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  • CANCER  (17)
  • 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 ; 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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  • 3
    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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  • 4
    Keywords: CANCER ; PROTEIN ; AGE ; WOMEN ; COUNTRIES ; DIET ; DIETARY ; FAT ; ALCOHOL ; CONSUMPTION ; EPIC ; nutrition ; LIFE-STYLE ; EUROPE ; nutrient intake ; DRINKING ; MASS INDEX ; WEIGHT ; RECALL ; EPIC PROJECT ; ERRORS ; 24-h dietary recall ; ENDB ; EPIC-soft ; ITALIAN WOMEN ; SMOKING-HABITS ; UNITED-STATES ADULTS
    Abstract: Background/objectives: Europe has the highest level of alcohol consumption in the world. As drinking patterns are important determinants of the beneficial and harmful effects of alcohol consumption, we investigated alcohol consumption in relation to nutrient intake, place of consumption, education and body weight in a sample of adults from 10 European countries. Methods: A 24-h dietary recall interview was conducted on 13 025 men and 23 009 women, aged 35-74 years, from 27 centres participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Means and standard errors of alcohol consumption, adjusted for age, were calculated, stratified by gender and centre. Results: In many centres, higher level drinkers (males consuming 424 g of ethanol/day, equivalent to 42 standard drinks and females consuming 412 g of ethanol/day equivalent to 41 standard drink) obtained more energy from fat and protein and less from sugar than did abstainers. The proportion of energy from starch tended to be higher for male and lower for female higher level drinkers than for abstainers. Female higher level drinkers had a lower body mass index than did abstainers, whereas male higher level drinkers generally weighed more. Male higher level drinkers were less educated than abstainers in Mediterranean countries, but were more educated elsewhere. Female higher level drinkers were usually more educated than were abstainers. Outside the home, consumption (both genders) tended to be at friends' homes, particularly among men in Northern and Central Europe, and in bars in Spain. Conclusions: This study reveals clear geographical differences in drinking habits across Europe, and shows that the characteristics of different alcohol consumption categories also vary.
    Type of Publication: Journal article published
    PubMed ID: 19888282
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  • 5
    Keywords: CANCER ; Germany ; COHORT ; DISEASE ; RISK ; METABOLISM ; CARCINOGENESIS ; PHOSPHORUS ; NEOPLASIA ; HEALTH ; AGE ; WOMEN ; COUNTRIES ; PROSTATE-CANCER ; DIETARY ; CALCIUM ; CONSUMPTION ; EPIC ; FRUIT ; nutrition ; VEGETABLES ; EUROPE ; FOOD ; nutrient intake ; EPIC CALIBRATION ; RECALL ; IRON ; 24-HOUR DIET RECALL ; POTASSIUM ; MAINTENANCE ; 24-h dietary recall ; RATIONALE ; EPIC-soft ; magnesium ; minerals ; nutrient intakes
    Abstract: Background/objectives: Adequate mineral intake is important for the maintenance of bone health, cellular function and general metabolism, and possibly in the aetiology of cancer and other chronic diseases. This study aimed at investigating variation in intakes of selected minerals across 10 European countries participating in the EPIC (European Prospective Investigation into Cancer and Nutrition) study. Methods: Nutrient intakes for 36 034 subjects, aged between 35 and 74 years, in 27 centres were obtained using standardized 24-h dietary recall software (EPIC-SOFT). Mean intakes of calcium, phosphorus, magnesium, iron and potassium were calculated by centre and weighted by season and day of the week and were also stratified by age group. The contribution of food groups to total nutrient intake was calculated. Results: There was clear geographical variability in intakes, with differences ranging from 35% for magnesium to 90% for iron in men and 36% for potassium to 75% for calcium in women, and a twofold difference in sources of haem iron (meat and fish). There was a geographical gradient in iron intake, with higher intakes in Southern than in Northern Europe and also around a twofold north-south gradient in the contribution of fruits and vegetables to potassium intake. Compared with reference intakes, the majority of age groups and centres had intakes above the recommended levels. Dairy foods and products contributed the most to calcium and phosphorus intake in almost all centres. Cereals and cereal products contributed the most to magnesium and iron intakes, except in Greece and Germany. Conclusions: Intakes of minerals vary substantially throughout Europe, with some geographical variability in their food sources.
    Type of Publication: Journal article published
    PubMed ID: 19888269
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  • 6
    Keywords: CANCER ; BLOOD ; validation ; BIOMARKERS ; hormone ; PLASMA ; COUNTRIES ; STABILITY ; CONSUMPTION ; EPIC ; nutrition ; VEGETABLES ; CALIBRATION ; carotenoids ; RE ; biomarker ; 24 h dietary recall ; 24-HOUR DIET RECALL ; EPIDEMIOLOGIC EVIDENCE ; food frequency questionnaires ; FRUITS ; fruits and vegetables ; SERUM CAROTENOIDS
    Type of Publication: Journal article published
    PubMed ID: 16160702
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  • 7
    Keywords: CANCER ; Germany ; MODEL ; MODELS ; FOLLOW-UP ; COHORT ; RISK ; ASSOCIATION ; FREQUENCY ; ACID ; WOMEN ; MEN ; fatty acids ; DIETARY ; EPIC ; nutrition ; QUESTIONNAIRE ; antioxidants ; FOOD ; DIETARY-INTAKE ; WEST-GERMANY ; asthma ; EAST-GERMANY ; EPIC-GERMANY ; FATTY-ACID ; ADULT ; ADULTS ; HAY-FEVER ; ASSOCIATIONS ; RE ; RELATIVE VALIDITY ; INTERVAL ; dietary intake ; dietary fat ; HDL CHOLESTEROL ; LUNG-FUNCTION ; ONSET ASTHMA ; RESPIRATORY SYMPTOMS ; YOUNG-ADULTS
    Abstract: Objective: Within a prospective study, we explored the associations between dietary intake of fatty acids, antioxidants and relevant food sources of these nutrients on the clinical manifestation of asthma in adulthood. Method: A total of 105 newly physician-diagnosed cases of asthma from the European Prospective Investigation into Cancer and Nutrition ( EPIC)-Heidelberg cohort were identified during follow-up and matched with 420 controls. Baseline dietary intake was obtained by means of validated food frequency questionnaires. The association of dietary intake variables and asthma risk was explored by unconditional logistic regression models. Results: A high intake of oleic acid (C18: 1 n-9) was positively associated with asthma (P-value for trend 0.035), while no significant associations were found for the other dietary fatty acids. Most prominently, a high margarine intake increased the risk of onset of asthma in adulthood ( adjusted odds ratio ( OR) 3rd tertile: 1.73 (95% confidence interval ( 95% CI): 1.05 - 2.87), P for trend = 0.050), the effect being stronger in men (2nd tertile: OR = 1.66, 3rd tertile: OR = 2.51) than in women ( 2nd tertile: OR = 0.91; 3rd tertile: OR = 1.47). The dietary intake of antioxidants and their main food sources had no effect on asthma risk. Conclusions: In summary, the present results provide evidence that even in adulthood a high margarine intake increases the risk of clinical onset of asthma. Whether oleic acid may serve as a proxy for margarine-derived trans-fatty acids ( C18: 1 t9) remains to be clarified
    Type of Publication: Journal article published
    PubMed ID: 15329676
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  • 8
    Keywords: CANCER ; EXPRESSION ; ALGORITHM ; ALGORITHMS ; COMMON ; NETWORK ; SYSTEM ; TOOL ; EXPOSURE ; COMPONENTS ; BIOMARKERS ; NO ; DESIGN ; COLORECTAL-CANCER ; COUNTRIES ; COMPONENT ; DATABASE ; DIETARY ; AD ; FUTURE ; PROJECT ; CONSUMPTION ; EPIC ; European Prospective Investigation into Cancer and Nutrition ; nutrition ; CALIBRATION ; MANAGEMENT ; GUIDELINES ; CHEMISTRY ; review ; WEIGHT ; 24-HOUR DIET RECALL ; analysis ; LOSSES ; prospective ; RECOMMENDATIONS ; STANDARDIZATION ; UNIT ; E ; SET ; WEIGHT CHANGE ; 24-h dietary recall ; ANALYSIS SYSTEMS ; DATA-BASE ; ENDB ; FOOD COMPOSITION DATABASES ; food composition tables ; nutrient databases ; NUTRITIONAL ANALYSIS
    Abstract: Objective: This paper describes the ad hoc methodological concepts and procedures developed to improve the comparability of Nutrient databases ( NDBs) across the 10 European countries participating in the European Prospective Investigation into Cancer and Nutrition ( EPIC). This was required because there is currently no European reference NDB available. Design: A large network involving national compilers, nutritionists and experts on food chemistry and computer science was set up for the 'EPIC Nutrient DataBase' ( ENDB) project. A total of 550-1500 foods derived from about 37 000 standardized EPIC 24-h dietary recalls (24-HDRS) were matched as closely as possible to foods available in the 10 national NDBs. The resulting national data sets ( NDS) were then successively documented, standardized and evaluated according to common guidelines and using a DataBase Management System specifically designed for this project. The nutrient values of foods unavailable or not readily available in NDSs were approximated by recipe calculation, weighted averaging or adjustment for weight changes and vitamin/mineral losses, using common algorithms. Results: The final ENDB contains about 550-1500 foods depending on the country and 26 common components. Each component value was documented and standardized for unit, mode of expression, definition and chemical method of analysis, as far as possible. Furthermore, the overall completeness of NDSs was improved (〉= 99%), particularly for beta-carotene and vitamin E. Conclusion: The ENDB constitutes a first real attempt to improve the comparability of NDBs across European countries. This methodological work will provide a useful tool for nutritional research as well as end-user recommendations to improve NDBs in the future
    Type of Publication: Journal article published
    PubMed ID: 17375121
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  • 9
    Keywords: CANCER ; POPULATION ; RISK ; risk factors ; DIET ; nutrition ; NUTRIENTS ; POSTMENOPAUSAL WOMEN ; elderly ; OLDER-ADULTS ; alcohol intake ; BONE-MINERAL DENSITY ; N-3 FATTY-ACIDS ; OSTEOPOROTIC FRACTURES ; hip fractures ; PREVENT FRACTURES ; PROTEIN-INTAKE ; RANCHO BERNARDO ; VITAMIN-D SUPPLEMENTATION
    Abstract: Background/Objectives: Evidence on the role of diet during adulthood and beyond on fracture occurrence is limited. We investigated diet and hip fracture incidence in a population of elderly Europeans, participants in the European Prospective Investigation into Cancer and nutrition study. Subjects/Methods: 29 122 volunteers (10 538 men, 18 584 women) aged 60 years and above (mean age: 64.3) from five countries were followed up for a median of 8 years and 275 incident hip fractures (222 women and 53 men) were recorded. Diet was assessed at baseline through validated dietary questionnaires. Data were analyzed through Cox proportional-hazards regression with adjustment for potential confounders. Results: No food group or nutrient was significantly associated with hip fracture occurrence. There were suggestive inverse associations, however, with vegetable consumption (hazard ratio (HR) per increasing sex-specific quintile: 0.93, 95% confidence interval (CI): 0.85-1.01), fish consumption (HR per increasing sex-specific quintile: 0.93, 95% CI: 0.85-1.02) and polyunsaturated lipid intake (HR per increasing sex-specific quintile: 0.92, 95% CI: 0.82-1.02), whereas saturated lipid intake was positively associated with hip fracture risk (HR per increasing sex-specific quintile: 1.13, 95% CI: 0.99-1.29). Consumption of dairy products did not appear to influence the risk (HR per increasing sex-specific quintile: 1.02, 95% CI: 0.93-1.12). Conclusions: In a prospective study of the elderly, diet, including consumption of dairy products, alcohol and vitamin D, did not appear to play a major role in hip fracture incidence. There is however, weak and statistically non-significant evidence that vegetable and fish consumption and intake of polyunsaturated lipids may have a beneficial, whereas saturated lipid intake a detrimental effect.
    Type of Publication: Journal article published
    PubMed ID: 20948558
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  • 10
    Keywords: CANCER ; PROTEIN ; AGE ; WOMEN ; PROSPECTIVE COHORT ; COLORECTAL-CANCER ; COUNTRIES ; SWEDEN ; DATABASE ; EPIC ; FRUIT ; nutrition ; VEGETABLES ; CALIBRATION ; EUROPE ; FOOD ; DIETARY-INTAKE ; RECALL ; CORONARY-HEART-DISEASE ; EPIC PROJECT ; METAANALYSIS ; SUBTYPES ; fish consumption ; ERRORS ; 24-h dietary recall ; ENDB ; WEIGHT-LOSS ; animal proteins ; EPIC-soft ; plant proteins ; total proteins
    Abstract: Objective: To describe dietary protein intakes and their food sources among 27 redefined centres in 10 countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). Methods: Between 1995 and 2000, 36 034 persons, aged between 35 and 74 years, were administered a standardized 24-h dietary recall (24-HDR) using a computerized interview software programme (EPIC-SOFT). Intakes (g/day) of total, animal and plant proteins were estimated using the standardized EPIC Nutrient Database (ENDB). Mean intakes were adjusted for age, and weighted by season and day of recall. Results: Mean total and animal protein intakes were highest in the Spanish centres among men, and in the Spanish and French centres among women; the lowest mean intakes were observed in the UK health-conscious group, in Greek men and women, and in women in Potsdam. Intake of plant protein was highest among the UK health-conscious group, followed by some of the Italian centres and Murcia, whereas Sweden and Potsdam had the lowest intake. Cereals contributed to the highest proportion of plant protein in all centres. The combined intake of legumes, vegetables and fruit contributed to a greater proportion of plant protein in the southern than in the northern centres. Total meat intake (with some heterogeneity across subtypes of meat) was, with few exceptions, the most important contributor to animal protein in all centres, followed by dairy and fish products. Conclusions: This study shows that intake of protein, especially of animal origin, differs across the 10 European countries, and also shows some differences in food sources of protein across Europe.
    Type of Publication: Journal article published
    PubMed ID: 19888272
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