Search

The International Agency for Research on Cancer classified processed meats (PMs) as "carcinogenic" and red meat as "probably carcinogenic" for humans(1). The possible relationship between colorectal cancer (CRC) risk and processed meats (PMs), along with the specific compound contributing to this association have not been established yet. Nitrosyl-heme and heme iron have been proposed as potential-related compounds. The aim of this study was to assess the association of nitrosyl-heme and heme iron intake with CRC risk among participants from the European Prospective Investigation into Cancer and Nutrition (EPIC) Spain study. This prospective study included 38,262 subjects (61.5% females) from the EPIC-Spain study. Food consumption was assessed by a validated diet history questionnaire(2). Dietary intake of nitrosylheme and heme iron was estimated by matching PMs intake and composition data based on laboratory analyses conducted using a High Performance Liquid Chromatography method(3). In brief, the daily intake of nitrosyl-heme and heme iron was determined by multiplying the intake of each PM (in grams/day) by its corresponding content of nitrosyl-heme and heme iron, and then summing up the estimated intakes from all PMs. The proportional hazards models were used to examine the association between sex-specific tertiles of nitrosyl-heme and heme iron intake and CRC risk and 95% confidence intervals (CIs) were computed using Cox regression. Age served as the time scale, stratified by age and centre with adjustments for sex, energy intake, body mass index (BMI), waist circumference, education, smoking, physical activity in MET-h/week, lifetime alcohol consumption, dietary fibre, calcium intake, and family CRC history. Homogeneity of location subtype risk was also assessed. Interactions with smoking, BMI, physical activity, and alcohol were examined and sensitivity analyses were also conducted excluding the first three years of follow-up. During a mean follow-up of 16.7 years, 577 CRC were identified. We found no overall association between nitrosyl-heme (T3 vs T1; HR: 0.98 (95% CI: 0.79-1.21)) or heme iron intakes (T3 vs T1; HR: 0.88 (95% CI: 0.70-1.10)) with CRC risk, nor according to tumour subtypes. However, we found a non-statistically significant positive association between nitrosyl-heme intake and proximal colon, HR = 1.03; 95% CI, (0.65-1.61) and rectum cancer, HR = 1.04; 95% CI, (0.70-1.56). Our study found no evidence supporting a link between nitrosyl-heme or heme iron intake and CRC risk in Spanish subjects from the EPIC cohort. As these results are novel and preliminary, more heterogeneous studies are necessary to provide more convincing evidence on their role in colorectal carcinogenesis. [ABSTRACT FROM AUTHOR]

Objective: To conduct a comprehensive assessment of dietary intakes of nitrites and N-nitrosodimethylamine (NDMA).Subjects and Setting: A study was conducted within the Spanish cohort of the European Prospective Investigation in Cancer and Nutrition (EPIC) to assess the intake and food sources of these compounds in Spanish adults. The study included 41,446 health volunteers, aged 29-69 years, from Northern and Southern regions. Usual food intake was estimated by in-person interviews using a computerised dietary questionnaire.Results: The estimated geometric mean was 0.994 mg day(-1) for nitrites and 0.114 microg day(-1) for NDMA. For both compounds a positive trend in consumption with increasing energy intake was observed. Dietary NDMA was related to age and sex after energy adjustment, while nitrite consumption increased with higher intakes of vitamin C (P < 0.001). The food groups that contributed most to intakes were meat products, cereals, vegetables and fruits for nitrites, and processed meat, beer, cheese and broiled fish for NDMA. Current and past smokers, who had high levels of NDMA from tobacco exposure, were also identified as the highest consumers of dietary NDMA. Furthermore, smokers had low intakes of vitamin C (an inhibitor of endogenous nitrosation).Conclusions: Intake levels of NDMA and nitrites in a Mediterranean cohort are currently relatively lower than those previously reported, although processed meat, beer and cured cheese still are the most important contributors to NDMA intake. [ABSTRACT FROM AUTHOR]

Objective: To examine timing of eating across ten European countries., Design: Cross-sectional analysis of the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study using standardized 24 h diet recalls collected during 1995-2000. Eleven predefined food consumption occasions were assessed during the recall interview. We present time of consumption of meals and snacks as well as the later:earlier energy intake ratio, with earlier and later intakes defined as 06.00-14.00 and 15.00-24.00 hours, respectively. Type III tests were used to examine associations of sociodemographic, lifestyle and health variables with timing of energy intake., Setting: Ten Western European countries., Subjects: In total, 22 985 women and 13 035 men aged 35-74 years (n 36 020)., Results: A south-north gradient was observed for timing of eating, with later consumption of meals and snacks in Mediterranean countries compared with Central and Northern European countries. However, the energy load was reversed, with the later:earlier energy intake ratio ranging from 0·68 (France) to 1·39 (Norway) among women, and from 0·71 (Greece) to 1·35 (the Netherlands) among men. Among women, country, age, education, marital status, smoking, day of recall and season were all independently associated with timing of energy intake (all P&lt;0·05). Among men, the corresponding variables were country, age, education, smoking, physical activity, BMI and day of recall (all P&lt;0·05)., Conclusions: We found pronounced differences in timing of eating across Europe, with later meal timetables but greater energy load earlier during the day in Mediterranean countries compared with Central and Northern European countries.

Objective: To prospectively assess the associations between lean fish, fatty fish and total fish intakes and risk of stroke in the Spanish cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Spain)., Design: Fish intake was estimated from a validated dietary questionnaire. Cox proportional hazards regression models were used to assess the association between the intakes of lean fish, fatty fish and total fish and stroke risk. Models were run separately for men and women., Setting: Five Spanish regions (Asturias, San Sebastian, Navarra, Granada and Murcia)., Subjects: Individuals (n 41 020; 15 490 men and 25 530 women) aged 20-69 years, recruited from 1992 to 1996 and followed-up until December 2008 (December 2006 in the case of Asturias). Only participants with definite incident stroke were considered as cases., Results: During a mean follow-up of 13·8 years, 674 strokes were identified and subsequently validated by record linkage with hospital discharge databases, primary-care records and regional mortality registries, comprising 531 ischaemic, seventy-nine haemorrhagic, forty-two subarachnoid and twenty-two unspecific strokes. After multiple adjustments, no significant associations were observed between lean fish, fatty fish and total fish consumption and the risk of stroke in men or women. In men, results revealed a non-significant trend towards an inverse association between lean fish (hazard ratio=0·84; 95 % CI 0·55, 1·29, P trend=0·06) and total fish consumption (hazard ratio=0·77; 95 % CI 0·51, 1·16, P trend=0·06) and risk of total stroke., Conclusions: In the EPIC-Spain cohort, no association was found between lean fish, fatty fish and total fish consumption and risk of stroke.

Objective: Health-beneficial effects of adhering to a healthy Nordic diet index have been suggested. However, it has not been examined to what extent the included dietary components are exclusively related to the Nordic countries or if they are part of other European diets as well, suggesting a broader preventive potential. The present study describes the intake of seven a priori defined healthy food items (apples/pears, berries, cabbages, dark bread, shellfish, fish and root vegetables) across ten countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) and examines their consumption across Europe., Design: Cross-sectional study. A 24 h dietary recall was administered through a software program containing country-specific recipes. Sex-specific mean food intake was calculated for each centre/country, as well as percentage of overall food groups consumed as healthy Nordic food items. All analyses were weighted by day and season of data collection., Setting: Multi-centre, European study., Subjects: Persons (n 36 970) aged 35-74 years, constituting a random sample of 519 978 EPIC participants., Results: The highest intakes of the included diet components were: cabbages and berries in Central Europe; apples/pears in Southern Europe; dark bread in Norway, Denmark and Greece; fish in Southern and Northern countries; shellfish in Spain; and root vegetables in Northern and Central Europe. Large inter-centre variation, however, existed in some countries., Conclusions: Dark bread, root vegetables and fish are strongly related to a Nordic dietary tradition. Apples/pears, berries, cabbages, fish, shellfish and root vegetables are broadly consumed in Europe, and may thus be included in regional public health campaigns.

Objective: To compare the average out-of-home (OH) consumption of foods and beverages, as well as energy intake, among populations from 10 European countries and to describe the characteristics of substantial OH eaters, as defined for the purpose of the present study, in comparison to other individuals., Design: Cross-sectional study. Dietary data were collected through single 24-hour dietary recalls, in which the place of consumption was recorded. For the present study, substantial OH eaters were defined as those who consumed more than 25% of total daily energy intake at locations other than the household premises. Mean dietary intakes and the proportion of substantial OH eaters are presented by food group and country. Logistic regression analyses were used to estimate the odds of being a substantial OH eater in comparison to not being one, using mutually adjusted possible non-dietary determinants., Setting: Ten European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC)., Subjects: The subjects were 34 270 individuals, 12 537 men and 21 733 women, aged 35-74 years., Results: The fraction of energy intake during OH eating was generally higher in northern European countries than in the southern ones. Among the food and beverage groups, those selectively consumed outside the home were coffee/tea/waters and sweets and, to a lesser extent, cereals, meats, added lipids and vegetables. Substantial OH eating was positively associated with energy intake and inversely associated with age and physical activity. Substantial OH eating was less common among the less educated compared with the more educated, and more common during weekdays in central and north Europe and during the weekend in south Europe., Conclusions: Eating outside the home was associated with sedentary lifestyle and increased energy intake; it was more common among the young and concerned in particular coffee/tea/waters and sweets.